Clinical lung cancer最新文献

{"title":"Association Between Lung Immune Prognostic Index and Durvalumab Consolidation Outcomes in Patients With Locally Advanced Non‐Small‐Cell Lung Cancer","authors":"Mariona Riudavets ,&nbsp;Edouard Auclin ,&nbsp;Miguel Mosteiro ,&nbsp;Naomi Dempsey ,&nbsp;Margarita Majem ,&nbsp;Arsela Prelaj ,&nbsp;Rafael López-Castro ,&nbsp;Joaquim Bosch-Barrera ,&nbsp;Sara Pilotto ,&nbsp;Elena Escalera ,&nbsp;Marco Tagliamento ,&nbsp;Joaquin Mosquera ,&nbsp;Gérard Zalcman ,&nbsp;Frank Aboubakar Nana ,&nbsp;Santiago Ponce ,&nbsp;Víctor Albarrán-Artahona ,&nbsp;Alessandro Dal Maso ,&nbsp;Martina Spotti ,&nbsp;Xabier Mielgo ,&nbsp;Elodie Mussat ,&nbsp;David Planchard","doi":"10.1016/j.cllc.2023.11.007","DOIUrl":"10.1016/j.cllc.2023.11.007","url":null,"abstract":"<div><h3>Introduction</h3><p>The LIPI, based on pretreatment derived neutrophils/[leukocytes-neutrophils] ratio (dNLR) and LDH, is associated with immune checkpoint inhibitors (ICI) outcomes in advanced non–small-cell lung cancer (NSCLC). We aimed to assess baseline LIPI correlation with durvalumab consolidation outcomes in the locally advanced setting.</p></div><div><h3>Material and Methods</h3><p>Multicentre retrospective study (330 patients) with stage III unresectable NSCLC treated with durvalumab after chemo-radiotherapy between April 2015 and December 2020; 65 patients treated with chemo-radiotherapy only. Baseline LIPI characterized 3 groups: good (dNLR≤3+LDH≤ULN), intermediate (dNLR&gt;3/LDH&gt;ULN) and poor (dNLR&gt;3+LDH&gt;ULN). Primary endpoint was overall survival (OS).</p></div><div><h3>Results</h3><p>In the durvalumab cohort, median age was 67 years, 95% smokers, 98% with a performance status of 0-1; 60% had nonsquamous histology and 16% a PD-L1 expression &lt;1%. Radiotherapy was delivered concurrently in 81%. LIPI was evaluable in 216 patients: 66% good, 31% intermediate, 3% poor.</p><p>LIPI significantly correlated with median OS (median follow-up: 19 months): 18.1 months vs. 47.0 months vs. not reached in poor, intermediate and good LIPI groups, respectively (<em>P</em> = .03). A trend between objective response rate and LIPI groups was observed: 0% vs. 41% vs. 45%, respectively (<em>P</em> = .05). The pooled intermediate/poor LIPI group was associated with shorter OS (HR 1.97; <em>P</em> = .03) and higher risk of progressive disease (OR 2.68; <em>P</em> = .047). Survivals and response were not influenced in the control cohort.</p></div><div><h3>Conclusion</h3><p>Baseline LIPI correlated with outcomes in patients with locally advanced NSCLC treated with durvalumab consolidation, but not in those who only received chemo-radiotherapy, providing further evidence of its prognostic and potential predictive role of ICI benefit in NSCLC.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138538914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ETV6-NTRK2 Fusion in a Patient With Metastatic Pulmonary Atypical Carcinoid Successfully Treated With Entrectinib: A Case Report and Review of the Literature","authors":"Wusheng Zhang ,&nbsp;Sen Tian ,&nbsp;Xiang Li ,&nbsp;Yilin Chen ,&nbsp;Xinyu Wang ,&nbsp;Yunshuo Zhang ,&nbsp;Lihui Lv ,&nbsp;Yonghua Li ,&nbsp;Hui Shi ,&nbsp;Chong Bai","doi":"10.1016/j.cllc.2024.03.005","DOIUrl":"10.1016/j.cllc.2024.03.005","url":null,"abstract":"<div><p>Pulmonary atypical carcinoid (AC) is an extremely rare neuroendocrine tumor. The neurotrophic tropomyosin receptor kinase (NTRK) fusions are reported in only 0.5% of nonsmall cell lung cancer, and are more rare in AC with only one previously reported case. Currently, there is little established evidence on the optimal therapeutic strategies and prognosis for advanced cases. We present a female patient with metastatic AC after complete resection. Due to low expression of somatostatin receptor in this case, somatostatin analogs and peptide receptor radionuclide therapy were not available. After pursuing other alternative treatments, including chemotherapy (ie, carboplatin, etoposide, capecitabine, temozolomide, and paclitaxel), everolimus, and atezolizumab, she returned with significant progression, including innumerable subcutaneous nodules, left pleura metastasis, multiple bone metastases, and brain metastases. New biopsy analysis revealed an ETV6-NTRK2 fusion. She was immediately administered the first-generation tropomyosin receptor kinase inhibitor entrectinib at a dose of 600 mg q.d. A subsequent month of treatment resulted in a complete response in all of the metastatic lung lesions. To date, she has maintained sustained benefit for at least 1 year from initiation of entrectinib. Here, we present the first case of a female patient with metastatic AC harboring the ETV6-NTRK2 fusion, and successfully treated with entrectinib, providing evidence for the application of entrectinib in patients with NTRK-positive AC, and underscoring the critical role of molecular profiling for such cases.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140199673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Brief Report of Durvalumab With or Without Tremelimumab in Combination With Chemotherapy as First-Line Therapy for Metastatic Non-Small-Cell Lung Cancer: Outcomes by Tumor PD-L1 Expression in the Phase 3 POSEIDON Study","authors":"Edward B. Garon ,&nbsp;Byoung Chul Cho ,&nbsp;Alexander Luft ,&nbsp;Jorge Alatorre-Alexander ,&nbsp;Sarayut Lucien Geater ,&nbsp;Dmytro Trukhin ,&nbsp;Sang-We Kim ,&nbsp;Grygorii Ursol ,&nbsp;Maen Hussein ,&nbsp;Farah Louise Lim ,&nbsp;Cheng-Ta Yang ,&nbsp;Luiz Henrique Araujo ,&nbsp;Haruhiro Saito ,&nbsp;Niels Reinmuth ,&nbsp;Milena Kohlmann ,&nbsp;Caitlin Lowery ,&nbsp;Helen Mann ,&nbsp;Solange Peters ,&nbsp;Tony S. Mok ,&nbsp;Melissa L. Johnson","doi":"10.1016/j.cllc.2024.03.003","DOIUrl":"10.1016/j.cllc.2024.03.003","url":null,"abstract":"<div><p></p><ul><li><span>•</span><span><p>In the phase 3 POSEIDON study, patients with <em>EGFR/ALK</em> wild-type metastatic NSCLC (mNSCLC) were randomized (1:1:1) to first-line tremelimumab plus durvalumab and platinum-based chemotherapy (T + D + CT), durvalumab plus chemotherapy (D + CT), or chemotherapy alone (CT), with stratification by programmed cell death ligand-1 (PD-L1) tumor cell (TC) expression level (≥ 50% vs. &lt; 50%), disease stage, and histology.</p></span></li><li><span>•</span><span><p>In alpha-controlled analyses in the ITT population, T + D + CT significantly improved overall survival (OS) and progression-free survival (PFS) versus CT, leading to approval for this regimen. PFS was also significantly improved with D + CT versus CT; a trend for improved OS did not reach statistical significance.</p></span></li><li><span>•</span><span><p>Patients with PD-L1-low or -negative tumors may show primary resistance to anti-PD-(L)1 therapy, with real-world data suggesting that treatment benefits observed in trials do not always translate into optimal outcomes in clinical practice.</p></span></li><li><span>•</span><span><p>Here we report outcomes from POSEIDON from post-hoc exploratory analyses in subgroups with PD-L1 TC ≥ 1% versus &lt; 1%.</p></span></li><li><span>•</span><span><p>Among 1012/1013 randomized patients with known PD-L1 status, 644 (63.6%) versus 368 (36.4%) had PD-L1 TC ≥ 1% versus &lt; 1%.</p></span></li><li><span>•</span><span><p>Both T + D + CT and D + CT appeared to show OS/PFS benefit versus CT in patients with PD-L1 TC ≥ 1%.</p></span></li><li><span>•</span><span><p>Consistent with the role of cytotoxic T-lymphocyte-associated antigen 4 and PD-L1 in the immune response, the addition of tremelimumab to first-line durvalumab and chemotherapy also conferred clinical benefit to patients with PD-L1 TC &lt; 1% mNSCLC.</p></span></li><li><span>•</span><span><p>This exploratory subgroup analysis of POSEIDON supports T + D + CT as a first-line treatment option for patients with mNSCLC irrespective of PD-L1 expression, including the harder-to-treat subgroup with PD-L1 TC &lt; 1%.</p></span></li></ul></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S152573042400038X/pdfft?md5=74f2cabd13240bb3ada54b4f21c1d1d1&pid=1-s2.0-S152573042400038X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140147751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief Report: Evaluating the Impact of Perioperative Immune Checkpoint Inhibitor in the Treatment of Patients with Resectable Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis","authors":"Ben Ponvilawan ,&nbsp;Himil Mahadevia ,&nbsp;Hana Qasim ,&nbsp;Parth Sharma ,&nbsp;Dhruv Bansal ,&nbsp;Janakiraman Subramanian","doi":"10.1016/j.cllc.2024.02.003","DOIUrl":"10.1016/j.cllc.2024.02.003","url":null,"abstract":"<div><p></p><ul><li><span>•</span><span><p>Resectable NSCLC has a high recurrence rate of 30-55%. Neoadjuvant, adjuvant, or perioperative combination of ICIs and CTX improved survival outcomes and response rates compared to CTX alone. Our meta-analysis of 11 RCTs suggests that neoadjuvant or perioperative treatment resulted in more favorable OS, EFS, and pathological response rates, supporting the use of these treatment regimens in this patient population. Meanwhile, adjuvant ICI significantly improved DFS with a trend towards improvement in OS.</p></span></li><li><span>•</span><span><p>Positive PD-L1 status, non-squamous histology, and stage III achieved a more profound EFS advantage. A longer, perioperative regimen might be required to improve survival outcomes in subgroups that obtained less advantage from ICI, such as squamous histology. Other clinical factors, such as age, sex, race, and geographical location, did not modify the benefit obtained from ICI, exhibiting the generalizability of ICI in different demographics.</p></span></li><li><span>•</span><span><p>Head-to-head studies to compare neoadjuvant versus perioperative ICI and the duration of adjuvant ICI should be further investigated to determine the optimal sequence and duration of ICI in patients with resectable NSCLC.</p></span></li></ul></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139918227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief Report: Nonmalignant Surgical Resection Among Individuals with Screening-Detected Versus Incidental Lung Nodules","authors":"Brian M. Till ,&nbsp;Tyler Grenda ,&nbsp;Taylor Tidwell ,&nbsp;Baylor Wickes ,&nbsp;Christine Shusted ,&nbsp;Brooke Ruane ,&nbsp;Olugbenga Okusanya ,&nbsp;Nathaniel R. Evans III ,&nbsp;Julie A. Barta","doi":"10.1016/j.cllc.2023.12.006","DOIUrl":"10.1016/j.cllc.2023.12.006","url":null,"abstract":"<div><p></p><ul><li><span>•</span><span><p>With the increasing emphasis on early detection of lung cancer through lung cancer screening programs and incidental lung nodule programs, identifying and measuring clinically relevant patient-centered outcomes is critical.</p></span></li><li><span>•</span><span><p>This study aimed to characterize factors associated with nonmalignant surgical resection among patients with suspicious pulmonary nodules, focusing on comparisons among individuals with screen-detected versus incidental lung nodules. Individuals with screen-detected or incidental lung nodules may experience differing nodule management strategies and surgical outcomes.</p></span></li><li><span>•</span><span><p>In addition, receipt of more intensive lung nodule management may be associated with lower odds of nonmalignant resection. These findings underscore the need for further investigation of best practices in lung nodule management by multidisciplinary teams.</p></span></li></ul></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138745166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Mobocertinib and Amivantamab in Patients With Advanced Non–Small Cell Lung Cancer With EGFR Exon 20 Insertions Previously Treated With Platinum-Based Chemotherapy: An Indirect Treatment Comparison","authors":"Sai-Hong Ignatius Ou ,&nbsp;Thibaud Prawitz ,&nbsp;Huamao M. Lin ,&nbsp;Jin-liern Hong ,&nbsp;Min Tan ,&nbsp;Irina Proskorovsky ,&nbsp;Luis Hernandez ,&nbsp;Shu Jin ,&nbsp;Pingkuan Zhang ,&nbsp;Jianchang Lin ,&nbsp;Jyoti Patel ,&nbsp;Danny Nguyen ,&nbsp;Joel W. Neal","doi":"10.1016/j.cllc.2023.11.011","DOIUrl":"10.1016/j.cllc.2023.11.011","url":null,"abstract":"<div><h3>Introduction</h3><p>Exon 20 insertions (ex20ins) mutations of the <em>EGFR</em><span><span><span> gene account for 1% to 2% of all non–small-cell lung cancers (NSCLCs). Targeted therapies have been developed to treat this </span>cancer type but have not been studied in head-to-head trials. Our objective was to use a matching-adjusted indirect comparison (MAIC) to assess the efficacy of mobocertinib and amivantamab </span>in patients with NSCLC </span><em>EGFR</em> ex20ins mutations who were previously treated with platinum-based chemotherapy.</p></div><div><h3>Materials and Methods</h3><p>An unanchored MAIC was conducted to estimate the treatment effects of mobocertinib and amivantamab using individual-level data from the mobocertinib phase I/II single-arm trial (NCT02716116) and published data from the amivantamab single-arm CHRYSALIS trial (NCT02609776). Confirmed overall response rate (cORR), progression-free survival (PFS), overall survival (OS), and duration of response (DoR) were assessed.</p></div><div><h3>Results</h3><p>Both trials were comparable in terms of study population, study design, and outcome definitions and included 114 patients who received mobocertinib and 114 patients who received amivantamab. After MAIC weighting, all reported baseline characteristics were balanced between mobocertinib and amivantamab. The weighted odds ratio (OR) [95% confidence interval (CI)] comparing mobocertinib to amivantamab was 0.56 (0.30-1.04) for independent review committee (IRC)-assessed cORR and 0.98 (0.53-1.82) for investigator (INV)-assessed cORR. The weighted hazard ratio (HR) comparing mobocertinib to amivantamab was 0.74 (0.51-1.07) for IRC-assessed PFS, 0.92 (0.57-1.48) for OS, and 0.59 (0.30-1.18) for INV-assessed DoR.</p></div><div><h3>Conclusion</h3><p>MAIC analysis showed that mobocertinib and amivantamab had similar efficacy in patients with NSCLC harboring <em>EGFR</em> ex20ins mutations whose disease progressed during or after platinum-based chemotherapy. These findings may benefit patients by supporting future treatment options.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138538974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transitioning to Neoadjuvant Therapy for Resectable Non-Small Cell Lung Cancer: Trends and Surgical Outcomes in a Regionalized Pulmonary Oncology Network","authors":"Yohann Pilon ,&nbsp;Merav Rokah ,&nbsp;Joseph Seitlinger ,&nbsp;Boris Sepesi ,&nbsp;Roni F. Rayes ,&nbsp;Jonathan Cools-Lartigue ,&nbsp;Sara Najmeh ,&nbsp;Christian Sirois ,&nbsp;David Mulder ,&nbsp;Lorenzo Ferri ,&nbsp;Bassam Abdulkarim ,&nbsp;Nicole Ezer ,&nbsp;Richard Fraser ,&nbsp;Sophie Camilleri-Broët ,&nbsp;Pierre-Olivier Fiset ,&nbsp;Annick Wong ,&nbsp;Shelly Sud ,&nbsp;Adrian Langleben ,&nbsp;Jason Agulnik ,&nbsp;Carmela Pepe ,&nbsp;Jonathan D. Spicer","doi":"10.1016/j.cllc.2023.12.005","DOIUrl":"10.1016/j.cllc.2023.12.005","url":null,"abstract":"<div><h3>Background</h3><p>Several regulatory agencies have approved the use of the neoadjuvant chemo-immunotherapy for resectable stage II and III of non-small cell lung cancer (NSCLC) and numerous trials investigating novel agents are underway. However, significant concerns exist around the feasibility and safety of offering curative surgery to patients treated within such pathways. The goal in this study was to evaluate the impact of a transition towards a large-scale neoadjuvant therapy program for NSCLC.</p></div><div><h3>Methods</h3><p>Medical charts of patients with clinical stage II and III NSCLC who underwent resection from January 2015 to December 2020 were reviewed. The primary outcome was perioperative complication rate between neoadjuvant-treated versus upfront surgery patients. Multivariable logistic regression estimated occurrence of postoperative complications and overall survival was assessed as an exploratory secondary outcome by Kaplan–Meier and Cox-regression analyses.</p></div><div><h3>Results</h3><p>Of the 428 patients included, 106 (24.8%) received neoadjuvant therapy and 322 (75.2%) upfront surgery. Frequency of minor and major postoperative complications was similar between groups (<em>P</em> = .22). Occurrence in postoperative complication was similar in both cohort (aOR = 1.31, 95% CI 0.73-2.34). Neoadjuvant therapy administration increased from 10% to 45% with a rise in targeted and immuno-therapies over time, accompanied by a reduced rate of preoperative radiation therapy use. 1-, 2-, and 5-year overall survival was higher in neoadjuvant therapy compared to upfront surgery patients (Log-Rank <em>P</em> = .017).</p></div><div><h3>Conclusions</h3><p>No significant differences in perioperative outcomes and survival were observed in resectable NSCLC patients treated by neoadjuvant therapy versus upfront surgery. Transition to neoadjuvant therapy among resectable NSCLC patients is safe and feasible from a surgical perspective.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138744792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To Crush or Not to Crush: Administering Dabrafenib and Trametinib Through a Nasogastric Tube in a Critically Ill Patient With Nonsmall Cell Lung Cancer – A Case Report and Review of Literature of Targeted Therapies Given Through Enteral Feeding Tubes","authors":"Charley Jang ,&nbsp;Sally CM Lau ,&nbsp;Vamsidhar Velcheti","doi":"10.1016/j.cllc.2023.12.013","DOIUrl":"10.1016/j.cllc.2023.12.013","url":null,"abstract":"<div><p>Up to 71% of lung cancer patients admitted to the ICU are newly diagnosed. The decision to initiate cancer directed treatments in lung cancer patients admitted to the ICU remains complex. For those with identified oncogene driver mutations, targeted therapies with rapid and high response rates are attractive treatment options. However, mechanically ventilated patients face additional barriers in which enteral tube administration of oral therapies may require tablets or capsules to be crushed or opened and diluted. Data on the pharmacodynamics and pharmacokinetics of this alternative route of administration are often very limited. Here we describe the first case report of an intubated patient with newly diagnosed NSCLC who was successfully treated with opened dabrafenib capsules and crushed trametinib tablets administered through a nasogastric tube. We also provide a review of the existing literature on feeding tube administration of commonly used tyrosine kinase inhibitors in lung cancer. Tyrosine kinase inhibitors administered through feeding tubes can lead to a clinically meaningful recovery in critically ill patients.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S152573042300270X/pdfft?md5=9aa7cb43b430888e6bde73445343b5fb&pid=1-s2.0-S152573042300270X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139053266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"STAR-121: A Phase III Randomized Study of Domvanalimab and Zimberelimab in Combination With Chemotherapy Versus Pembrolizumab With Chemotherapy in Untreated Metastatic Non–Small Cell Lung Cancer With No Actionable Gene Alterations","authors":"Delvys Rodriguez-Abreu ,&nbsp;Joaquim Bosch-Barrera ,&nbsp;Jhanelle E. Gray ,&nbsp;Myung-Ju Ahn ,&nbsp;Melissa Johnson ,&nbsp;Xinwei Yu ,&nbsp;Saad Mohammad ,&nbsp;Xueying Chen ,&nbsp;Trever Todd ,&nbsp;Jongseok Kim ,&nbsp;Martin Reck","doi":"10.1016/j.cllc.2023.12.010","DOIUrl":"10.1016/j.cllc.2023.12.010","url":null,"abstract":"<div><h3>Introduction</h3><p>Dual inhibition with a T-cell immunoreceptor with immunoglobulin and ITIM domains plus programmed death (ligand)-1 (PD[L]-1) inhibitors, with or without chemotherapy, is an emerging therapeutic strategy in metastatic non–small cell lung cancer (mNSCLC). The STAR-121 (NCT05502237) phase III, global, randomized, open-label study will investigate first-line domvanalimab (anti-TIGIT) and zimberelimab (anti–PD-1) plus chemotherapy versus pembrolizumab plus chemotherapy in mNSCLC with no actionable gene alterations.</p></div><div><h3>Participants and Methods</h3><p>Approximately 720 participants (≥18 years old) with untreated mNSCLC and no <em>EGFR</em> and <em>ALK</em> mutations will be randomized into 3 groups (A, B, or C) in a 4:4:1 ratio and stratified by baseline PD-L1 expression (tumor cells &lt;50% vs. ≥50%), histology (squamous vs. nonsquamous), and geographic region (East Asia vs. non-East Asia). Group A will receive domvanalimab 1200 mg plus zimberelimab 360 mg plus platinum-doublet chemotherapy (PT), group B will receive pembrolizumab 200 mg plus PT, and group C will receive zimberelimab 360 mg plus PT, every 3 weeks. Treatment will be administered until disease progression or intolerable toxicity. Dual primary endpoints are progression-free survival (by blinded independent central review [BICR]) and overall survival for group A versus B. Key secondary endpoints comprise overall response rate (by BICR), safety, and quality of life. Exploratory endpoints include efficacy and safety between groups A and C, pharmacokinetics, patient-reported outcomes, and biomarkers.</p></div><div><h3>Conclusion</h3><p>Enrollment in the STAR-121 study commenced on October 12, 2022, and is currently ongoing with completion planned by September 2024. The study completion is expected by December 2027.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139372793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief Report on Global Clinician Practices in the First-Line Management of Metastatic Non-Small Cell Lung Cancer","authors":"","doi":"10.1016/j.cllc.2024.04.013","DOIUrl":"10.1016/j.cllc.2024.04.013","url":null,"abstract":"<div><h3>Introduction</h3><div>In the dynamic landscape of metastatic NSCLC<span><span> (mNSCLC) management, marked by several frontline options and the integration of next generation sequencing (NGS) for informed decision-making, barriers persist despite advancements. This includes challenges in </span>clinical trial recruitment. To gain global insights into clinicians’ practices, we conducted a survey on their testing and management approaches for patients with mNSCLC.</span></div></div><div><h3>Methods</h3><div>The survey, conducted from July 12 to August 20, 2023, utilized multiple-choice questions and qualitative research questions, employing the Likert Scale for comprehensive insights.</div></div><div><h3>Results</h3><div><span>A total of 127 individuals responded, with 72% affiliated with academic health systems<span>, and 55% practicing in the USA. Regarding testing practices, 93% consistently ordered NGS for non-squamous histology, while 54% did so for squamous cell histology. Concurrent tissue and </span></span>liquid biopsies<span> were routinely ordered by 28%, while 39% reported ordering both testing platforms concurrently for select cases only. Respondents cited logistical barriers, such as insufficient tissue and lack of infrastructure, as the most common hindrance to molecular testing (76%), followed by reimbursement challenges (56%) and concerns about delayed turnaround time (50%). While most respondents were confident in interpreting NGS results, 22% lacked confidence. Concerning treatment decisions, 72% preferred awaiting molecular testing results before initiating systemic therapy. Less than 50% routinely referred patients for clinical trials in the frontline setting for mNSCLC. For patients with disease expressing high PD-L1 levels, most oncologists preferred pembrolizumab<span> monotherapy<span>. For disease with low PD-L1 expression, a platinum doublet chemotherapy regimen<span> combined with pembrolizumab<span><span> was favored. In disease cases with negative PD-L1 expression, a platinum doublet chemotherapy regimen with pembrolizumab was preferred. Key factors influencing oncologists' preferred </span>immune checkpoint inhibitor (ICI) included experience with one ICI over another, preferred status per national guidelines, availability of trial data with a significant follow-up period, and consideration of drug cost.</span></span></span></span></span></div></div><div><h3>Conclusion</h3><div>Although this study demonstrates an improved awareness and adoption of ordering NGS for the management of mNSCLC, it underscores the persistence of various barriers that must be addressed to improve upon the quality of care for patients diagnosed with mNSCLC.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141062652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}