Clinical lung cancer最新文献

{"title":"Brief Report: The Effectiveness of Osimertinib in Advanced Nonsmall Cell Lung Cancer Harboring Various EGFR Exon 19 Mutation Variants","authors":"Lih-Chyun Chang ,&nbsp;Hsiang-Wei Hu ,&nbsp;Min-Shu Hsieh ,&nbsp;Shang-Gin Wu ,&nbsp;Jin-Yuan Shih","doi":"10.1016/j.cllc.2025.03.008","DOIUrl":"10.1016/j.cllc.2025.03.008","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>No significant difference in progression-free survival and overall survival with osimertinib was observed between E746del (deletions starting at codon E746) and L747del (deletions starting at codon L747) mutations.</div></span></li><li><span>•</span><span><div><em>EGFR</em> exon 19 non-LRE deletions, which do not include the entire LRE fragment, may be linked to a poorer prognosis in patients receiving osimertinib treatment.</div></span></li><li><span>•</span><span><div>Rare <em>EGFR</em> exon 19 mutations demonstrated diverse responses to osimertinib.</div></span></li></ul></div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 5","pages":"Pages e353-e357.e2"},"PeriodicalIF":3.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990739","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":"Systematic Review for the Follow-up of Curatively Treated Patients With Lung Cancer","authors":"Yaron Shargall ,&nbsp;Emily T. Vella ,&nbsp;Maria Elisabeth Del Giudice ,&nbsp;Carole Dennie ,&nbsp;Peter M. Ellis ,&nbsp;Swati Kulkarni ,&nbsp;Robert MacRae ,&nbsp;Yee C. Ung","doi":"10.1016/j.cllc.2025.03.003","DOIUrl":"10.1016/j.cllc.2025.03.003","url":null,"abstract":"<div><h3>Introduction</h3><div>The follow-up of patients with lung cancer after curative-intent treatment should include strategies to improve their quality of life and survival. These could include the monitoring and management of symptoms of recurrence and late toxicities from cancer treatments, the use of patient-reported outcome (PRO) tools, and smoking cessation interventions. The objective of this systematic review was to examine these follow-up strategies.</div></div><div><h3>Materials and Methods</h3><div>This systematic review was developed by Ontario Health (Cancer Care Ontario)’s Program in Evidence-Based Care. MEDLINE, EMBASE, and the Cochrane Library were searched for systematic reviews and randomized controlled trials (RCTs) comparing different types of clinicians, PRO tools, smoking cessation interventions, and management strategies for signs, symptoms, risk factors, comorbidities, or late toxicities in adult patients with NSCLC or SCLC after curative-intent treatment.</div></div><div><h3>Results</h3><div>Thirty-five RCTs and nineteen systematic reviews were included. For nurse-led interventions, either significant effects were found in favor of the intervention, or no significant effects were found. The results for the use of PRO tools were mixed, possibly due to differences in comparators and settings. Evidence suggested that smoking cessation interventions might benefit these patients (RR, 0.84; 95% CI, 0.68-1.03). There was limited evidence in the target population for the management of signs, symptoms, risk factors, comorbidities, or late toxicities.</div></div><div><h3>Conclusions</h3><div>Smoking cessation interventions, exercise training, and the use of PRO tools may benefit these patients. The results of this systematic review were used to inform recommendations in a clinical practice guideline. Further RCTs in this patient population are needed.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 5","pages":"Pages e327-e341"},"PeriodicalIF":3.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991473","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":"Predictors of Up-To-Date Lung Cancer Screening Among Eligible People in the United States: A Nationally Representative Dataset","authors":"Safa Elkefi ,&nbsp;Erica Phillips ,&nbsp;Lauren K. Groner ,&nbsp;Alicia K. Matthews","doi":"10.1016/j.cllc.2025.03.005","DOIUrl":"10.1016/j.cllc.2025.03.005","url":null,"abstract":"<div><div>This study examines the factors associated with up-to-date lung cancer screening (UTD-LCS) among eligible adults. We analyzed survey data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) and selected participants eligible for LCS. Logistic regression models were used to examine the relationship between UTD-LCS and various factors, including demographics, mental and physical health, and access to healthcare. Among the respondents (Weighted <em>N</em> = 13,037,747), 8.18% were eligible for LCS. However, only 24.53% of those eligible had undergone screening in the past year. Individuals who self-identified as Asian (OR = 0.77, <em>P</em> = .008), American Indian (OR = 0.78, <em>P</em> = .002), and Hispanic (OR = 0.79, <em>P</em> = .006) were significantly less likely to participate in LCS screening. In contrast, married individuals (OR = 1.07, <em>P</em> = .019) and older adults aged 70 to 80 years (OR = 1.78, <em>P</em> &lt; .001) were more likely to have undergone screening. Additionally, a poor physical health status was associated with UTD-LCS, as having more days of poor health increased the odds of screening (for 14 days or more: OR = 1.28, <em>P</em> &lt; .001). Finally, having insurance (private plan: OR = 3.7, <em>P</em> &lt; .001) and not experiencing medical cost issues (OR = 1.13, <em>P</em> = .025) were also associated with greater odds of being up-to-date on lung cancer screening. Our results underscore the need for targeted public health interventions that increase awareness and accessibility of LCS. The study also emphasizes the critical role of primary care providers in promoting screening.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 4","pages":"Pages 271-278"},"PeriodicalIF":3.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977825","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":"Genetic Ancestry and Lung Cancer in Latin American Patients: A Crucial Step for Understanding a Diverse Population","authors":"Juan Pablo Castañeda-González ,&nbsp;Rafael Parra-Medina ,&nbsp;Jonathan W. Riess ,&nbsp;David R. Gandara ,&nbsp;Luis G. Carvajal-Carmona","doi":"10.1016/j.cllc.2025.03.004","DOIUrl":"10.1016/j.cllc.2025.03.004","url":null,"abstract":"<div><div>Lung cancer is the second leading cause of cancer-related deaths in Latin America. While incidence and mortality rates are higher in other populations, the ``Hispanic paradox'' observed in US Hispanics reflects a lower mortality rate for mortality from non-small cell lung cancer (NSCLC) despite socioeconomic disparities, which may be related to epigenetic and cultural factors. Genetic studies have identified single nucleotide polymorphisms associated with ancestry as key contributors to lung cancer risk and outcomes, emphasizing the importance of genomic insights for early detection and personalized treatments. This narrative review explores the impact of genetic ancestry on lung cancer in Hispanic/Latino populations. We searched MEDLINE and Google Scholar for “((SNP) OR (germline) OR (variant)) AND (lung cancer) AND ((Hispanic) OR (Latin)),” focusing on Latin American studies. We included articles published up to December 2024. Specific variation in genes such as <em>XRCC1, CYP1A1, CYP1A2, SEMA3B, PADPRP</em>, and <em>mEPHX</em> have been associated with increased lung cancer risk. Lung cancer incidence and prognosis vary significantly among Hispanics due to their diverse genetic ancestry. Understanding ancestry-specific genetic variations may help personalize treatment and improve outcomes for this population.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 5","pages":"Pages e342-e352"},"PeriodicalIF":3.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961540","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":"Longitudinal Analysis of Recurrence and Risk Factors of Early-Stage Resected Adenocarcinoma With Common EGFR Mutations: A Multicenter Retrospective Cohort Study in South Korea","authors":"June Hong Ahn ,&nbsp;Sun Ha Choi ,&nbsp;Sun Hyo Park ,&nbsp;Insu Kim ,&nbsp;Jin Han Park ,&nbsp;Ji Yeon Kim ,&nbsp;Tae Hoon Kim ,&nbsp;Taehoon Lee ,&nbsp;Hyun Kyu Cho ,&nbsp;Jong Hwan Jeong ,&nbsp;Jung Wook Yang ,&nbsp;Ji Eun Park ,&nbsp;Tae Hun Kim ,&nbsp;Hyun-Kyung Lee ,&nbsp;Ho Young Lee ,&nbsp;Ho Jin Jung ,&nbsp;Jinmi Kim ,&nbsp;Jungmin Son ,&nbsp;Jung Seop Eom","doi":"10.1016/j.cllc.2025.02.016","DOIUrl":"10.1016/j.cllc.2025.02.016","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite curative surgery for lung cancer, 30% to 55% of patients experience recurrence or death, which highlights the importance of adjuvant treatment. Adjuvant osimertinib therapy effectively prolongs disease-free and overall survival in patients with lung cancer harboring common epidermal growth factor receptor (<em>EGFR</em>) mutations. To identify potential candidates for adjuvant osimertinib, it is crucial to understand the rates and identify risk factors of recurrence.</div></div><div><h3>Methods</h3><div>This multicenter, retrospective cohort study was conducted in the Republic of Korea and enrolled patients who, between 2010 and 2017, underwent resection of stages I-III adenocarcinomas, with common <em>EGFR</em> mutations. The primary outcomes comprised the rate and risk factors of postoperative recurrence.</div></div><div><h3>Results</h3><div>Among the 759 participants, the overall recurrence rate and median recurrence-free survival were 39.1% and 59.8 (interquartile range [IQR], 26.3-84.2) months, respectively, during a median follow-up of 73.0 (IQR, 55.4-95.0) months. The recurrence rates for stages IA, IB, IIA, IIB, IIIA, and IIIB were 14.7%, 45.5%, 53.8%, 72.5%, 80.3%, and 93.3%, respectively. Multivariate analysis revealed that age ≥ 65 years, body mass index &lt; 18.5 kg/m², the <em>Del19</em> subtype of <em>EGFR</em> mutation, tumor size ≥ 2.3 cm, N1 involvement, N2 involvement, predominantly micropapillary or solid pattern, and the presence of visceral pleural invasion were independently associated with recurrence.</div></div><div><h3>Conclusion</h3><div>This multicenter cohort study demonstrated that stages I-III <em>EGFR</em>-mutated adenocarcinoma has a postoperative recurrence rate of 39.1%, and identified 7 independent risk factors for recurrence.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 4","pages":"Pages 314-323.e6"},"PeriodicalIF":3.3,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742505","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":"First-Line Pembrolizumab Efficacy in Octogenarians With NSCLCs Expressing ≥ 50% PD-L1 (ESCKEYP GFPC 05-2018)","authors":"Romain Corre ,&nbsp;Chantal Decroisette ,&nbsp;Jean-Bernard Auliac ,&nbsp;Lionel Falchero ,&nbsp;Hubert Curcio ,&nbsp;Karim Amrane ,&nbsp;Maurice Perol ,&nbsp;Stéphane Hominal ,&nbsp;Sabine Vieillot ,&nbsp;Eric Huchot ,&nbsp;Anne Laure Desage ,&nbsp;Marie Bernardi ,&nbsp;Remi Veillon ,&nbsp;Hélène Doubre ,&nbsp;Suzanna Bota ,&nbsp;Gwenaelle Legarff ,&nbsp;Grégoire Justeau ,&nbsp;Oliver Bylicki ,&nbsp;Magali Roa ,&nbsp;Renaud Descourt ,&nbsp;Laurent Greillier","doi":"10.1016/j.cllc.2025.03.001","DOIUrl":"10.1016/j.cllc.2025.03.001","url":null,"abstract":"<div><h3>Background</h3><div>Pembrolizumab alone is a first-line therapeutic option for patients with metastatic non-small cell lung cancer (NSCLC) with ≥ 50% PD-L1 expression, but few data are available for elderly patients, specifically octogenarians.</div></div><div><h3>Methods</h3><div>This retrospective, multicenter study included all consecutive patients with metastatic NSCLC PD-L1 ≥ 50% treated with first-line pembrolizumab monotherapy between May 2017 and November 2019. Information was collected from medical files with local evaluation of therapeutic response and progression-free survival (PFS).</div></div><div><h3>Results</h3><div>Among the 844 patients included, 73 (8.4%) were ≥ 80 (median: 82) years old, 74% men, 23.3% with ECOG-PS ≥ 2, 26% had ≥ 5% weight loss, PD-L1 50%-75%/≥ 75%: 45.2%/46.6%, respectively, with significantly more nonsmokers and (17.4% vs. 5.6%, <em>P</em> = .0002) and fewer adenocarcinomas (57.5% vs. 70.8%, <em>P</em> = .0217) than those &lt; 80 years. After median follow-up of 45.7 (95% CI: 43.0-49.1) months, respective median overall survival (OS) for octogenarians versus younger patients lasted 12.0 (95% CI: 7.7-16.2) versus 23.9 (95% CI: 19.5-27.4) months (<em>P</em> = .0002), and median PFS for 5.0 (95% CI: 2.8-9.2) versus 8.3 (95% CI: 7.2-9.8) months (<em>P</em> = .039). Their respective objective response rates did not differ significantly: 42% (95% CI: 24-60) vs. 49% (95% CI: 43-54).</div></div><div><h3>Conclusions</h3><div>Based on the results of this large multicenter population, first-line pembrolizumab efficacy against NSCLCs expressing ≥ 50% PD-L1 in octogenarians seems inferior to that obtained in younger patients. The higher percentage of nonsmokers and fewer adenocarcinomas could partially explain that finding.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 4","pages":"Pages 331-337"},"PeriodicalIF":3.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691128","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":"The Role of GLP-1 Agonists in Mitigating Lorlatinib-Induced Metabolic Syndrome: Two Case Studies","authors":"Erica Pietroluongo ,&nbsp;Silvana Pannain ,&nbsp;Marina Chiara Garassino ,&nbsp;Christine M. Bestvina","doi":"10.1016/j.cllc.2025.03.002","DOIUrl":"10.1016/j.cllc.2025.03.002","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>Lorlatinib-induced metabolic syndrome, including hypercholesterolemia, hypertriglyceridemia, weight gain, and hyperglycemia, poses a significant challenge during therapy.</div></span></li><li><span>•</span><span><div>Metabolic disturbances may not warrant lorlatinib dose reduction in mild to moderate cases, as they are often manageable with adjunctive therapies such as lipid-lowering agents.</div></span></li><li><span>•</span><span><div>Our cases demonstrate the potential of GLP-1 receptor agonists (e.g., semaglutide) to effectively address metabolic side effects, including weight loss and normalization of lipid and glycemic profiles.</div></span></li><li><span>•</span><span><div>A phase II clinical trial is warranted to rigorously evaluate the pharmacokinetics and safety of GLP-1 agonists in combination with lorlatinib, given their potential to enhance patient quality of life and long-term treatment adherence.</div></span></li><li><span>•</span><span><div>Oncologists should screen patients for metabolic syndrome prior to lorlatinib initiation and throughout treatment to enable early intervention and tailored treatment strategies.</div></span></li></ul></div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 5","pages":"Pages 429-433"},"PeriodicalIF":3.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742506","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":"Unmet Needs in Maintenance Therapy for Extensive Stage Small Cell Lung Cancer","authors":"Luis Paz-Ares ,&nbsp;Brinda Gupta ,&nbsp;Javier Baena ,&nbsp;Stephen V. Liu","doi":"10.1016/j.cllc.2025.02.015","DOIUrl":"10.1016/j.cllc.2025.02.015","url":null,"abstract":"<div><div>Small cell lung cancer (SCLC) is a highly aggressive malignancy and an exceptionally lethal disease; most patients present with extensive stage (ES) disease at diagnosis. Very little had changed in the treatment of ES-SCLC for decades until immune checkpoint inhibitor (ICI) therapy combined with chemotherapy followed by ICI maintenance monotherapy was added to standard treatment paradigms in 2019. Despite this important advance, high rates of relapse are still observed in patients with ES-SCLC and long-term survival rates remain low, with approximately 40% of patients proceeding to receive second-line treatment. There is an urgent need for novel treatment strategies to improve patient outcomes. In this review, we describe the rationale for maintenance therapy approaches in ES-SCLC and summarize the existing data on chemotherapy, ICIs, and other agents in the first-line maintenance setting. Predictive biomarkers, SCLC subtypes, and new therapeutics in development are discussed including lurbinectedin, antibody-drug conjugates, and T-cell engager molecules.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 3","pages":"Pages 168-178"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742432","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":"Young Onset Lung Cancer in India: Insights Into Clinical, Demographic, and Genomic Profiles","authors":"Prabhat Singh Malik ,&nbsp;Neha Pathak ,&nbsp;Aparna Sharma ,&nbsp;Meghna Birla ,&nbsp;Abhay Rastogi ,&nbsp;Abha Sharma ,&nbsp;Sachin Khurana ,&nbsp;Deepam Pushpam ,&nbsp;Ishaan Gupta ,&nbsp;Amber Rathore ,&nbsp;Deepali Jain ,&nbsp;Sunil Kumar ,&nbsp;Sushmita Pathy ,&nbsp;Rajiv Kaushal ,&nbsp;Vanita Noronha ,&nbsp;Kumar Prabhash ,&nbsp;Aarati Karaba ,&nbsp;Vijayshree Gauribidanur Raghavendrachar ,&nbsp;Nagesh Muniyappa","doi":"10.1016/j.cllc.2025.02.014","DOIUrl":"10.1016/j.cllc.2025.02.014","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer (LC) is traditionally perceived as a disease primarily affecting the elderly. However, individuals under the age of 40 represent a rare subset, accounting for up to 6% of all LC cases. There is limited information about demographic, clinical, pathological, and molecular features and treatment outcomes of young-onset LC.</div></div><div><h3>Methods</h3><div>In this study, we have analyzed the clinical, pathological, molecular, treatment, and survival outcome data of non–small-cell lung cancer patients <span><math><mi>δ</mi></math></span> 40 years of age treated at a tertiary care center in India. Additionally, we compared the in-house genomic data of young-onset LC and late-onset LC tested on a common targeted next-generation sequencing (NGS) panel.</div></div><div><h3>Results</h3><div>A total of 133 patients were included, with a median age of 36 years (21-40 years). Females constituted 40.6% of total, and 79% were never smokers. Adenocarcinoma was the most common histology (85.7%), and oncogene fusions were common (<em>ALK</em> fusion in 34% and <em>ROS1</em> in 7%). After a median follow-up of 39.2 months (95% CI 20.3-49.86), median overall survival was 26 months (95% CI 15.56-32.43) and median progression-free survival (of patients with stage 4 disease) was 6.53 months (95% CI 5.03-8.4). In-house NGS data reveals a striking enrichment of fusions (<em>ALK</em> and <em>RET</em>) in young-onset LC.</div></div><div><h3>Conclusion</h3><div>Young-onset LC is a unique entity with a higher prevalence of targetable genomic alterations, especially oncogene fusions. All efforts should be made to identify the targetable alterations in this enriched population and implement targeted therapy.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 5","pages":"Pages 420-428.e4"},"PeriodicalIF":3.3,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691170","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":"Completion Rates for Patients Undergoing Concurrent Chemoradiotherapy for Stage III Nonsmall Cell Lung Cancer and its Importance in the Era of Consolidation Immunotherapy: A Cohort Study","authors":"Neil D Wallace ,&nbsp;Jing Xie ,&nbsp;Marliese Alexander ,&nbsp;David Ball ,&nbsp;Fiona Hegi-Johnson ,&nbsp;Nikki Plumridge ,&nbsp;Shankar Siva ,&nbsp;Mark Shaw ,&nbsp;Susan Harden ,&nbsp;Tom John ,&nbsp;Ben Solomon ,&nbsp;Louis Irving ,&nbsp;Mary Duffy ,&nbsp;Ann Officer ,&nbsp;Michael MacManus","doi":"10.1016/j.cllc.2025.02.010","DOIUrl":"10.1016/j.cllc.2025.02.010","url":null,"abstract":"<div><h3>Background</h3><div>Definitive concurrent chemoradiotherapy (CRT) is the primary curative-intent treatment option for unresectable locally advanced nonsmall-cell lung cancer (NSCLC). Completion of CRT is generally required for eligibility for consolidation durvalumab, which significantly improves survival. We sought to establish CRT completion rates at a comprehensive cancer center.</div></div><div><h3>Patients and Methods</h3><div>265 patients were treated with concurrent CRT over the decade 2012-2022, during which durvalumab became available. 63% were male, median age was 67, and 91% had performance status 0-1. All patients were recruited into the AURORA prospective cohort study which captured baseline demographics and comorbidities, and prospectively updated treatment and outcome data at subsequent hospital visits. Data were analyzed retrospectively to evaluate CRT completion rates, reasons for noncompletion, and survival outcomes. Survival was also analyzed based on durvalumab availability and administration.</div></div><div><h3>Results</h3><div>CRT was completed as planned by 246/265 (93%) patients. Reasons for noncompletion included treatment related toxicity (<em>n</em> = 6/19), unrelated illnesses (<em>n</em> = 7/19), local disease progression (<em>n</em> = 2/19), and distant progression (<em>n</em> = 4/19). Median overall survival (OS) was 2.2 years (95% CI, 1.7-2.8) for the entire cohort and 1.0 years (95% CI, 0.2-1.5) for those who ceased CRT early. No specific baseline characteristics predicted noncompletion of CRT. Consolidation durvalumab was associated with improved OS (HR 0.39; 95% CI, 0.21-0.72, <em>P</em> = .002).</div></div><div><h3>Conclusion</h3><div>With appropriate supportive care, most patients initially considered suitable for CRT could complete it and access consolidation durvalumab. Consolidation durvalumab was associated with improved survival in this “real-world” stage III NSCLC cohort.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 4","pages":"Pages e311-e320.e6"},"PeriodicalIF":3.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669378","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}