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Article ; Online: Factors associated with prolonged progression-free survival of patients treated with first-line afatinib for advanced epidermal growth factor receptor-mutated non-small cell lung cancer.

Chiu, Li-Chung / Hsu, Ping-Chih / Wang, Chin-Chou / Ko, How-Wen / Kuo, Scott Chih-Hsi / Ju, Jia-Shiuan / Tung, Pi-Hung / Huang, Allen Chung-Cheng / Yang, Cheng-Ta

Thoracic cancer

2024 Volume 15, Issue 7, Page(s) 529–537

Abstract: Background: This study aimed to investigate the factors associated with prolonged progression-free survival (PFS) (>36 months) of advanced non-small cell lung cancer (NSCLC) patients harboring epidermal growth factor receptor (EGFR) mutations treated ... ...

Abstract	Background: This study aimed to investigate the factors associated with prolonged progression-free survival (PFS) (>36 months) of advanced non-small cell lung cancer (NSCLC) patients harboring epidermal growth factor receptor (EGFR) mutations treated with first-line afatinib. Methods: We performed a retrospective analysis of data of patients with advanced EGFR-mutated NSCLC receiving first-line afatinib at two tertiary care referral centers, Linkou and Kaohsiung Chang Gung Memorial Hospital, in Taiwan between June 2014 and April 2022. Results: The data of 546 treatment-naïve EGFR-mutated advanced NSCLC patients were analyzed. Median PFS and overall survival were 14.5 months and 27.2 months, respectively. The PFS of 462 patients (84.6%) was less than 36 months and of 84 patients (15.4%) was more than 36 months. The PFS > 36 months group had a significantly higher percentage of patients with uncommon mutations (p = 0.002). The PFS ≤36 months group had significantly higher incidences of bone, liver, and adrenal metastases (all p < 0.05) and a higher rate of multiple distant metastases. Multivariate logistic regression analysis showed that liver metastasis was negatively and independently associated with prolonged PFS (adjusted odds ratio = 0.246 [95% CI: 0.067-0.908], p = 0.035). The median overall survival of the PFS >36 months group was 46.0 months and that of the PFS ≤36 months group was 22.9 months (log-rank test, p < 0.001). Conclusions: We found that EGFR-mutated NSCLC patients receiving first-line afatinib were prone to shorter PFS if they had distant organ metastasis, especially liver metastasis.
MeSH term(s)	Humans ; Carcinoma, Non-Small-Cell Lung/drug therapy ; Carcinoma, Non-Small-Cell Lung/genetics ; Carcinoma, Non-Small-Cell Lung/pathology ; Afatinib/therapeutic use ; Lung Neoplasms/drug therapy ; Lung Neoplasms/genetics ; Progression-Free Survival ; Retrospective Studies ; ErbB Receptors/genetics ; Mutation ; Liver Neoplasms ; Protein Kinase Inhibitors/therapeutic use
Chemical Substances	Afatinib (41UD74L59M) ; ErbB Receptors (EC 2.7.10.1) ; Protein Kinase Inhibitors
Language	English
Publishing date	2024-01-26
Publishing country	Singapore
Document type	Journal Article
ZDB-ID	2625856-0
ISSN	1759-7714 ; 1759-7706
ISSN (online)	1759-7714
ISSN	1759-7706
DOI	10.1111/1759-7714.15212
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Article: Differential prognostic value of tumor and plasma T790M mutations in EGFR TKI-treated advanced NSCLC.

Tung, Pi-Hung / Chiu, Tzu-Hsuan / Huang, Allen Chung-Cheng / Ju, Jia-Shiuan / Huang, Chi-Hsien / Wang, Chin-Chou / Ko, How-Wen / Chung, Fu-Tsai / Hsu, Ping-Chih / Fang, Yueh-Fu / Guo, Yi-Ke / Kuo, Chih-Hsi Scott / Yang, Cheng-Ta

Therapeutic advances in medical oncology

2024 Volume 16, Page(s) 17588359231222604

Abstract: Background: Substitution of methionine for threonine at codon 790 (T790M) of epidermal growth factor receptor (EGFR) represents the major mechanism of resistance to EGFR tyrosine kinase inhibitors (TKIs) in : Methods: Patients (n = 460) progressing ... ...

Abstract	Background: Substitution of methionine for threonine at codon 790 (T790M) of epidermal growth factor receptor (EGFR) represents the major mechanism of resistance to EGFR tyrosine kinase inhibitors (TKIs) in Methods: Patients (n = 460) progressing from first-line EGFR-TKI treatment were assessed. Tissue and/or liquid biopsies were used to determine T790M status; post-progression overall survival (OS) was analyzed. Results: Overall, 143 (31.1%) patients were T790M positive, 95 (20.7%) were T790M negative, and 222 (48.2%) had unknown T790M status. T790M status [T790M positive Conclusion: T790M positivity predicts better post-progression OS than T790M negativity; tumor T790M positivity has a stronger prognostic impact than plasma T790M positivity. Osimertinib and chemotherapy provide similar OS benefits in patients with T790M-positive tumors.
Language	English
Publishing date	2024-01-19
Publishing country	England
Document type	Journal Article
ZDB-ID	2503443-1
ISSN	1758-8359 ; 1758-8340
ISSN (online)	1758-8359
ISSN	1758-8340
DOI	10.1177/17588359231222604
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Article ; Online: Concomitant infection with COVID-19 and Mycoplasma pneumoniae

Allen Chung-Cheng Huang / Chung-Guei Huang / Cheng-Ta Yang / Han-Chung Hu

Biomedical Journal, Vol 43, Iss 5, Pp 458-

2020 Volume 461

Abstract: In late 2019, cases of atypical pneumonia caused by a novel coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were first reported in Wuhan, China. The disease was officially called coronavirus disease 2019 (COVID-19) and has ...

Abstract	In late 2019, cases of atypical pneumonia caused by a novel coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were first reported in Wuhan, China. The disease was officially called coronavirus disease 2019 (COVID-19) and has been declared a pandemic disease by the World Health Organization (WHO). The clinical symptoms may include fever, cough, fatigue, headache, and diarrhea. The radiographic features comprise various presentations, including ground-glass opacities, tiny nodules, and consolidation. However, some atypical pathogens related to community-acquired pneumonia (CAP) may share similar presentations. They may be difficult to distinguish according to the clinical presentation and radiographic findings. Recently, there have been several reports reminding physicians to heed the possibility of co-infection with other pathogens in patients diagnosed with COVID-19. We report a COVID-19 patient co-infected with Mycoplasma pneumoniae who recovered well after combination therapy. We propose that all COVID-19 patients should undergo a meticulous screening routine to ensure that they receive adequate treatments.
Keywords	Medicine (General) ; R5-920 ; Biology (General) ; QH301-705.5
Subject code	610
Language	English
Publishing date	2020-10-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
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Article ; Online: Effects of dexamethasone use on viral clearance among patients with COVID-19: a multicenter cohort study.

Lin, Shu-Min / Lee, Chung-Shu / Huang, Allen Chung-Cheng / Chiu, Tzu-Hsuan / Chang, Ko-Wei / Huang, Tse-Hung / Yang, Tsung-Hsien / Shiao, Yi-Hsien / Chung, Fu-Tsai / Chen, Chyi-Liang / Chiu, Cheng-Hsun

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

2023 Volume 128, Page(s) 257–264

Abstract: Objectives: This study explored the outcomes and predictors of early viral clearance among patients with COVID-19.: Methods: This study recruited consecutive patients from March 1, 2020 to July 31, 2021. Early viral clearance was defined as having a ... ...

Abstract	Objectives: This study explored the outcomes and predictors of early viral clearance among patients with COVID-19. Methods: This study recruited consecutive patients from March 1, 2020 to July 31, 2021. Early viral clearance was defined as having a duration from symptom onset to successive detection of SARS-CoV-2 polymerase chain reaction cycle threshold (Ct) value of ≥30 within 10 days. Results: Among the 239 enrolled patients, 54.4% (130 patients) had early viral clearance. A multivariate logistic regression analysis identified that dexamethasone use and day 1 Ct values were independent factors associated with late viral clearance. Patients with mild-moderate severity and who received dexamethasone therapy had a longer time to viral clearance than those who did not receive dexamethasone (17.2 ± 1.8 days vs 12.3 ± 1.1 days, P = 0.018). Patients with severe-critical severity had a similar duration from symptom onset to Ct value ≥30, regardless of dexamethasone therapy (18.3 ± 0.9 days vs 16.7 ± 4.7 days, P = 0.626). Conclusion: The study revealed that dexamethasone therapy and Ct values are independent predictors of late viral clearance. Patients with severe disease course due to older age, increased number of comorbidities, and worse clinical outcomes experienced delayed viral clearance.
MeSH term(s)	Humans ; COVID-19 ; SARS-CoV-2 ; COVID-19 Drug Treatment ; Dexamethasone ; Cohort Studies
Chemical Substances	Dexamethasone (7S5I7G3JQL)
Language	English
Publishing date	2023-01-13
Publishing country	Canada
Document type	Multicenter Study ; Journal Article
ZDB-ID	1331197-9
ISSN	1878-3511 ; 1201-9712
ISSN (online)	1878-3511
ISSN	1201-9712
DOI	10.1016/j.ijid.2023.01.011
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Article ; Online: Concomitant infection with COVID-19 and Mycoplasma pneumoniae.

Huang, Allen Chung-Cheng / Huang, Chung-Guei / Yang, Cheng-Ta / Hu, Han-Chung

Biomedical journal

2020 Volume 43, Issue 5, Page(s) 458–461

Abstract	In late 2019, cases of atypical pneumonia caused by a novel coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were first reported in Wuhan, China. The disease was officially called coronavirus disease 2019 (COVID-19) and has been declared a pandemic disease by the World Health Organization (WHO). The clinical symptoms may include fever, cough, fatigue, headache, and diarrhea. The radiographic features comprise various presentations, including ground-glass opacities, tiny nodules, and consolidation. However, some atypical pathogens related to community-acquired pneumonia (CAP) may share similar presentations. They may be difficult to distinguish according to the clinical presentation and radiographic findings. Recently, there have been several reports reminding physicians to heed the possibility of co-infection with other pathogens in patients diagnosed with COVID-19. We report a COVID-19 patient co-infected with Mycoplasma pneumoniae who recovered well after combination therapy. We propose that all COVID-19 patients should undergo a meticulous screening routine to ensure that they receive adequate treatments.
MeSH term(s)	COVID-19/diagnosis ; COVID-19/virology ; Cough/diagnosis ; Cough/virology ; Diagnosis, Differential ; Diarrhea/complications ; Diarrhea/diagnosis ; Diarrhea/virology ; Fever/complications ; Fever/diagnosis ; Fever/virology ; Humans ; Male ; Middle Aged ; Mycoplasma pneumoniae/virology ; SARS-CoV-2/pathogenicity
Keywords	covid19
Language	English
Publishing date	2020-07-14
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2698541-X
ISSN	2320-2890 ; 2319-4170
ISSN (online)	2320-2890
ISSN	2319-4170
DOI	10.1016/j.bj.2020.07.002
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Article ; Online: Comparison of Clinical Characteristics and Outcomes of Hospitalized Patients Infected with the D614G Strain or Alpha Variant of COVID-19 in Taiwan: A Multi-Center Cohort Study.

Huang, Allen Chung-Cheng / Lin, Shu-Min / Chiu, Tzu-Hsuan / Chang, Ko-Wei / Huang, Tse-Hung / Yang, Tsung-Hsien / Shiao, Yi-Hsien / Lee, Chung-Shu / Chung, Fu-Tsai / Chiu, Cheng-Hsun

International journal of medical sciences

2022 Volume 19, Issue 13, Page(s) 1912–1919

Abstract: Objective: ...

Abstract	Objective:
MeSH term(s)	Humans ; Aged ; COVID-19 ; RNA, Viral/genetics ; Taiwan/epidemiology ; SARS-CoV-2/genetics ; Cohort Studies
Chemical Substances	RNA, Viral
Language	English
Publishing date	2022-10-24
Publishing country	Australia
Document type	Multicenter Study ; Journal Article
ZDB-ID	2151424-0
ISSN	1449-1907 ; 1449-1907
ISSN (online)	1449-1907
ISSN	1449-1907
DOI	10.7150/ijms.76725
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Article ; Online: Afatinib in Untreated Stage IIIB/IV Lung Adenocarcinoma with Major Uncommon Epidermal Growth Factor Receptor (EGFR) Mutations (G719X/L861Q/S768I): A Multicenter Observational Study in Taiwan.

Hsu, Ping-Chih / Lee, Suey-Haur / Chiu, Li-Chung / Lee, Chung-Shu / Wu, Chiao-En / Kuo, Scott Chih-Hsi / Ju, Jia-Shiuan / Huang, Allen Chung-Cheng / Li, Shih-Hong / Ko, Ho-Wen / Yang, Cheng-Ta / Wang, Chin-Chou

Targeted oncology

2023 Volume 18, Issue 2, Page(s) 195–207

Abstract: Background: Real-world clinical experience with afatinib as a treatment for advanced lung adenocarcinoma harboring uncommon epidermal growth factor receptor (EGFR) mutations (G719X, L861Q and S768I) has rarely been reported.: Objective: We aimed to ... ...

Abstract	Background: Real-world clinical experience with afatinib as a treatment for advanced lung adenocarcinoma harboring uncommon epidermal growth factor receptor (EGFR) mutations (G719X, L861Q and S768I) has rarely been reported. Objective: We aimed to perform a retrospective multicenter study to analyze afatinib therapy in untreated advanced lung adenocarcinoma harboring uncommon EGFR mutations. Patients and methods: Between May 2014 and June 2021, the data of 90 stage IIIB/IV lung adenocarcinoma patients with uncommon EGFR mutations (G719X/L861Q/S768I) treated with first-line afatinib from the cancer center database of Linkou, Tucheng, and Kaohsiung Chang Gung Memorial Hospitals were retrospectively retrieved and analyzed. Results: Afatinib had an objective response rate (ORR) of 63.3% and a disease control rate (DCR) of 86.7%. The median progression-free survival (PFS) with first-line afatinib therapy was 17.3 months (95% confidence interval (CI), 12.07-22.53), and the median overall survival (OS) was 28.5 months (95% CI, 20.22-36.77) in all study patients. In the multivariate analysis, poor performance (Eastern Cooperative Oncology Group performance status (ECOG PS) ≥ 2) and brain and liver metastases were independent predictors of unfavorable PFS. The G719X mutation (alone+compound) was an independent predictor of favorable PFS (hazard ratio (HR) = 0.578; 95% CI, 0.355-0.941; P = 0.027). Most afatinib-related adverse events (AEs) were limited to grades 1 and 2 and were manageable. Conclusions: First-line afatinib therapy is effective and safe for advanced lung adenocarcinoma harboring uncommon EGFR mutations. The G719X mutation was an independent factor associated with a favorable outcome. Poor performance (ECOG PS ≥ 2), brain metastasis, and liver metastasis were predictive factors of shorter PFS with first-line afatinib therapy.
MeSH term(s)	Humans ; Afatinib/pharmacology ; Afatinib/therapeutic use ; Lung Neoplasms/drug therapy ; Lung Neoplasms/genetics ; Lung Neoplasms/pathology ; Retrospective Studies ; Taiwan ; Protein Kinase Inhibitors/therapeutic use ; Adenocarcinoma of Lung/drug therapy ; Adenocarcinoma of Lung/genetics ; ErbB Receptors/genetics ; ErbB Receptors/therapeutic use ; Mutation
Chemical Substances	Afatinib (41UD74L59M) ; Protein Kinase Inhibitors ; ErbB Receptors (EC 2.7.10.1) ; EGFR protein, human (EC 2.7.10.1)
Language	English
Publishing date	2023-02-20
Publishing country	France
Document type	Multicenter Study ; Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2222136-0
ISSN	1776-260X ; 1776-2596
ISSN (online)	1776-260X
ISSN	1776-2596
DOI	10.1007/s11523-023-00946-w
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Article: Sequential treatment in advanced epidermal growth factor receptor-mutated lung adenocarcinoma patients receiving first-line bevacizumab combined with 1st/2nd-generation EGFR-tyrosine kinase inhibitors.

Hsu, Ping-Chih / Huang, Chun-Yao / Lin, Yu-Ching / Lee, Suey-Haur / Chiu, Li-Chung / Wu, Chiao-En / Kuo, Scott Chih-Hsi / Ju, Jia-Shiuan / Huang, Allen Chung-Cheng / Ko, Ho-Wen / Wang, Chin-Chou / Yang, Cheng-Ta

Frontiers in oncology

2023 Volume 13, Page(s) 1249106

Abstract: Introduction: The clinical outcomes of sequential treatment of advanced epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) patients with first-line bevacizumab combined with 1st/2nd-generation EGFR-TKIs are unclear. Thus, ...

Abstract	Introduction: The clinical outcomes of sequential treatment of advanced epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) patients with first-line bevacizumab combined with 1st/2nd-generation EGFR-TKIs are unclear. Thus, we aimed to analyze the outcomes of these patients. Methods: Between January 2015 and December 2020, data for 102 advanced EGFR-mutated lung adenocarcinoma patients receiving first-line bevacizumab combined with erlotinib or afatinib followed by treatments at multiple institutions were retrospectively analyzed. All patients with progressive disease (PD) after first-line therapy underwent secondary T790M mutation detection. Results: The secondary T790M mutation positive rate of all study patients was 57.9%. First-line erlotinib use and progression-free survival (PFS) after first-line therapy > 12 months were positively associated with the T790M mutation (P <0.05). The response rates (RRs) to second-line treatments were 51.7% and 22.7% for the osimertinib and nonosimertinib groups, respectively (P = 0.001). The median PFS associated with second-line osimertinib and nonosimertinib therapy was 13.7 and 7.1 months, respectively (hazard ratio (HR) = 0.38; 95% confidence interval (CI), 0.23-0.63; P< 0.001). Patients with a secondary T790M mutation receiving second-line osimertinib treatment had a median overall survival (OS) of 54.3 months, and the median OS was 31.9 months for non-T790M-mutated patients receiving second-line nonosimertinib treatments (HR = 0.36; CI: 0.21-0.62, P < 0.001). Conclusion: The majority of acquired resistance to first-line bevacizumab combined with 1st/2nd-generation EGFR-TKIs is associated with the T790M mutation. Sequential osimertinib treatment in patients with positive secondary T790M mutation is associated with better outcomes among these patients.
Language	English
Publishing date	2023-10-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2023.1249106
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Article ; Online: Clinical and laboratory predictors for disease progression in patients with COVID-19

Shu-Min Lin / Allen Chung-Cheng Huang / Tzu-Hsuan Chiu / Ko-Wei Chang / Tse-Hung Huang / Tsung-Hsien Yang / Yi-Hsien Shiao / Chung-Shu Lee / Fu-Tsai Chung / Chyi-Liang Chen / Cheng-Hsun Chiu

Biomedical Journal, Vol 46, Iss 1, Pp 100-

A multi-center cohort study

2023 Volume 109

Abstract: Background: Reliable clinical and laboratory predictors of coronavirus disease 2019 (COVID-19) disease progression could help to identify the subset of patients who are susceptible to severe symptoms. This study sought to identify the predictors for ... ...

Abstract	Background: Reliable clinical and laboratory predictors of coronavirus disease 2019 (COVID-19) disease progression could help to identify the subset of patients who are susceptible to severe symptoms. This study sought to identify the predictors for disease progression in patients with COVID-19. Methods: This study recruited consecutive patients from four hospitals between March 1, 2020, and July 31, 2021. Demographic characteristics, laboratory results, and clinical outcomes were collected. Results: Among the 239 enrolled patients, 39.3% (94/239) experienced in-hospital disease progression. Multivariate logistic regression revealed that coronary arterial disease (CAD) (OR, 4.15; 95% C.I., 1.47–11.66), cerebrovascular attack (CVA) (OR, 12.98; 95% C.I., 1.30–129.51), platelet count < median value (OR, 3.23; 95% C.I., 1.65–6.32), and C-reactive protein (CRP) levels > median value of (OR, 2.25; 95% C.I., 1.02–4.99) were independent factors associated with COVID-19 progression. Patients who underwent disease progression at days 1, 4, and 7 presented lower lymphocyte counts and higher CRP levels, compared to patients without disease progression. Conclusions: The study revealed that in hospitalized COVID-19 patients, comorbidity with CAD and CVA, low platelet count, and elevated CRP levels were independently associated with disease progression. Compared with patients without disease progression, those with disease progression presented persistently low lymphocyte counts and elevated CRP levels.
Keywords	Progression ; COVID-19 ; Outcomes ; Medicine (General) ; R5-920 ; Biology (General) ; QH301-705.5
Subject code	610
Language	English
Publishing date	2023-02-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
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Article ; Online: Clinical and laboratory predictors for disease progression in patients with COVID-19: A multi-center cohort study.

Lin, Shu-Min / Huang, Allen Chung-Cheng / Chiu, Tzu-Hsuan / Chang, Ko-Wei / Huang, Tse-Hung / Yang, Tsung-Hsien / Shiao, Yi-Hsien / Lee, Chung-Shu / Chung, Fu-Tsai / Chen, Chyi-Liang / Chiu, Cheng-Hsun

Biomedical journal

2022 Volume 46, Issue 1, Page(s) 100–109

Abstract	Background: Reliable clinical and laboratory predictors of coronavirus disease 2019 (COVID-19) disease progression could help to identify the subset of patients who are susceptible to severe symptoms. This study sought to identify the predictors for disease progression in patients with COVID-19. Methods: This study recruited consecutive patients from four hospitals between March 1, 2020, and July 31, 2021. Demographic characteristics, laboratory results, and clinical outcomes were collected. Results: Among the 239 enrolled patients, 39.3% (94/239) experienced in-hospital disease progression. Multivariate logistic regression revealed that coronary arterial disease (CAD) (OR, 4.15; 95% C.I., 1.47-11.66), cerebrovascular attack (CVA) (OR, 12.98; 95% C.I., 1.30-129.51), platelet count < median value (OR, 3.23; 95% C.I., 1.65-6.32), and C-reactive protein (CRP) levels > median value of (OR, 2.25; 95% C.I., 1.02-4.99) were independent factors associated with COVID-19 progression. Patients who underwent disease progression at days 1, 4, and 7 presented lower lymphocyte counts and higher CRP levels, compared to patients without disease progression. Conclusions: The study revealed that in hospitalized COVID-19 patients, comorbidity with CAD and CVA, low platelet count, and elevated CRP levels were independently associated with disease progression. Compared with patients without disease progression, those with disease progression presented persistently low lymphocyte counts and elevated CRP levels.
MeSH term(s)	Humans ; COVID-19/diagnosis ; SARS-CoV-2 ; Disease Progression ; C-Reactive Protein/analysis ; Cohort Studies ; Retrospective Studies
Chemical Substances	C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2022-11-19
Publishing country	United States
Document type	Multicenter Study ; Journal Article
ZDB-ID	2698541-X
ISSN	2320-2890 ; 2320-2890
ISSN (online)	2320-2890
ISSN	2320-2890
DOI	10.1016/j.bj.2022.11.002
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