METHODS: Cross-sectional analysis of the Malaysian Elders Longitudinal Research (MELoR) study involving community-dwelling individuals aged >55 years was conducted. Information on sociodemographic factors, medical history, and lifestyle were obtained by computer-assisted interviews in participants' homes. Cognitive performance was assessed with the Montreal Cognitive Assessment (MoCA) tool during subsequent hospital-based health checks. Hierarchical multiple linear regression analyses were conducted with continuous MoCA scores as the dependent variable.
RESULTS: Data were available for 1,140 participants, mean (standard deviation [SD]) = 68.48 (7.23) years, comprising 377 (33.1%) ethnic Malays, 414 (36.3%) Chinese, and 349 (30.6%) Indians. Mean (SD) MoCA scores were 20.44 (4.92), 23.97 (4.03), and 22.04 (4.83) for Malays, Chinese, and Indians, respectively (p = 0.01). Age >75 years, <12 years of education, and low functional ability were common risk factors for low cognitive performance across all three ethnic groups. Cognitive performance was positively associated with social engagement among the ethnic Chinese (β [95% CI] = 0.06 [0.01, 0.11]) and Indians (β [95% CI] = 0.16 [0.09, 0.23]) and with lower depression scores (β [(95% CI] = -0.08 [-0.15, -0.01]) among the ethnic Indians.
CONCLUSION: Common factors associated with cognitive performance include age, education, and functional ability, and ethnic-specific factors were social engagement and depression. Interethnic comparisons of risk factors may form the basis for identification of ethnic-specific modifiable risk factors for cognitive decline and provision of culturally acceptable prevention measures.
METHODS: The phase 3 LASER301 study evaluated lazertinib efficacy and safety in treatment-naive patients with EGFR-mutated (exon 19 deletion or L858R) locally advanced or metastatic NSCLC. Patients were randomized one-to-one and received either lazertinib or gefitinib. The primary end point was investigator-assessed progression-free survival using Response Evaluation Criteria in Solid Tumors version 1.1. Secondary end points included overall survival, objective response rate, duration of response, and safety.
RESULTS: Between February 13, 2020, and July 29, 2022, among 258 patients of Asian descent, the median progression-free survival was significantly longer with lazertinib than gefitinib (20.6 versus 9.7 mo; hazard ratio: 0.46; 95% confidence interval [CI]: 0.34-0.63, p < 0.001), and the benefit was consistent across predefined subgroups (exon 19 deletion, L858R, baseline central nervous system metastases). Objective response rate and disease control rates were similar between treatment groups. The median duration of response was 19.4 months (95% CI: 16.6-24.9) versus 9.6 months (95% CI: 6.9-12.4) in the lazertinib versus gefitinib group. Adverse event rates in Asian patients were comparable with the overall LASER301 population. Adverse events leading to discontinuation in the lazertinib and gefitinib groups were 13% and 12%, respectively.
CONCLUSIONS: In LASER301, efficacy and safety results in Asian patients were consistent with the overall population. Lazertinib exhibited better efficacy than gefitinib in Asian patients with a tolerable safety profile.