Clinical lung cancer最新文献

{"title":"Real-World Efficacy and Safety of Durvalumab Administration Following Chemoradiotherapy in Elderly Patients With Unresectable Locally Advanced Nonsmall Cell Lung Cancer: A Multicenter, Retrospective Study","authors":"Yosuke Kakiuchi ,&nbsp;Koichi Saruwatari ,&nbsp;Kenta Murotani ,&nbsp;Takaaki Tokito ,&nbsp;Toyohisa Iriki ,&nbsp;Jun Iwakawa ,&nbsp;Yoshihiko Sakata ,&nbsp;Naoki Shingu ,&nbsp;Sho Saeki ,&nbsp;Megumi Inaba ,&nbsp;Akira Takaki ,&nbsp;Shunsuke Misono ,&nbsp;Takayuki Suetsugu ,&nbsp;Koichi Azuma ,&nbsp;Keiko Mizuno ,&nbsp;Takuro Sakagami","doi":"10.1016/j.cllc.2024.07.001","DOIUrl":"10.1016/j.cllc.2024.07.001","url":null,"abstract":"<div><h3>Background</h3><div>The PACIFIC trial established durvalumab administration after chemoradiotherapy as the standard of care for unresectable locally advanced nonsmall cell lung cancer (LA-NSCLC). However, the efficacy and safety of durvalumab in elderly patients aged 75 years or above remains unclear. This study aimed to investigate the real-world efficacy and safety of durvalumab for LA-NSCLC, with a specific focus on elderly patients.</div></div><div><h3>Patients and Methods</h3><div>We reviewed 214 patients who received durvalumab out of 278 patients with unresectable LA-NSCLC who underwent chemoradiotherapy at 7 institutions between July 2018 and March 2022. Propensity score matching (PSM) analysis was performed to evaluate the efficacy of durvalumab in elderly patients.</div></div><div><h3>Results</h3><div>The 2-year progression-free survival (PFS) and 2-year overall survival (OS) rates were 42.2% (95% confidence interval [CI], 34.7%-49.5%) and 77.1% (95% CI, 70.1-82.7%), respectively. Grade ≥ 3 immune-related adverse events (irAEs) occurred in 8.2% of patients. PSM analysis revealed that OS was significantly shorter in elderly patients (≥ 75 years) than in younger patients (&lt; 75 years) (hazard ratio [HR]; 95% CI, 1.39-8.99; <em>P</em> = .008), whereas PFS did not differ significantly between the 2 groups (HR: 1.50, 95% CI, 0.84-2.68, <em>P</em> = .169). The frequency of irAEs did not differ between these groups.</div></div><div><h3>Conclusions</h3><div>The real-world efficacy and safety of durvalumab administration following chemoradiotherapy for LA-NSCLC coincided with the PACIFIC trial's findings. Disease control achieved with this protocol did not differ significantly between elderly and younger patients but had acceptable tolerability, demonstrating its benefit even in elderly LA-NSCLC patients aged 75 years or above.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 8","pages":"Pages 661-671.e7"},"PeriodicalIF":3.3,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141688468","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":"Current Trial Report: A Multicenter Phase I/Ib study of Capmatinib Plus Trametinib in Patients With Metastatic Nonsmall Cell Lung Center Harboring MET Exon 14 Skipping Mutations and Other MET-Alterations","authors":"Matthew S. Lara ,&nbsp;Jonathan W. Riess ,&nbsp;Jonathan W. Goldman ,&nbsp;Fei Jiang ,&nbsp;Trever G. Bivona ,&nbsp;Collin M. Blakely","doi":"10.1016/j.cllc.2024.07.002","DOIUrl":"10.1016/j.cllc.2024.07.002","url":null,"abstract":"<div><h3>Introduction</h3><div>MET tyrosine kinase inhibitor (TKI) therapy is associated with improved outcomes in patients with nonsmall cell lung cancer (NSCLC) harboring a MET alteration, including MET exon 14 (METex14) skipping mutation, MET amplification, or MET fusion. However, primary or acquired resistance to TKI therapy ultimately develops. In preclinical models, hyperactivation of MAPK signaling was shown to promote resistance to MET TKI; resistance was overcome by co-treatment with a MET inhibitor and a MEK inhibitor. This phase I/Ib study offers a potential combination strategy simultaneously targeting MET (with capmatinib) and MEK signaling (with trametinib) to overcome resistance to MET inhibitor monotherapy in METex14 NSCLC.</div></div><div><h3>Methods</h3><div>In the dose escalation phase, a minimum of 6 and maximum of 18 patients will be enrolled using a conventional 3+3 design with the primary endpoint of identifying a recommended phase 2 dose (RP2D) of capmatinib in combination with trametinib. Once the RP2D is identified, patients will continue to enroll in a dose expansion phase to a total of 15 patients. The primary endpoint of the dose expansion phase is to further characterize the safety profile of the combination.</div></div><div><h3>Conclusion</h3><div>This phase I/Ib clinical trial will assess the safety and efficacy of combination capmatinib and trametinib in NSCLC patients whose tumors harbor METex14 skipping mutations, MET amplification, or MET fusion and had developed progressive disease on single agent MET inhibitor therapy.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 8","pages":"Pages 732-737"},"PeriodicalIF":3.3,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141696642","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":"Osimertinib-Related QTc Prolongation: Real-World Incidence and Impact of Drug Dosing on Recurrence Risk","authors":"Olivia H. Chen ,&nbsp;Wesley K.Y. Wong ,&nbsp;Kevin K.S. Mok ,&nbsp;Landon L. Chan ,&nbsp;Candy Tang ,&nbsp;Molly S.C. Li","doi":"10.1016/j.cllc.2024.06.012","DOIUrl":"10.1016/j.cllc.2024.06.012","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>In a real-world retrospective study of 970 patients treated with osimertinib, incidence of grade 3 QTc prolongation was 0.9% which was similar to clinical trials. No events of ventricular arrhythmia or arrhythmia-related deaths were observed.</div></span></li><li><span>•</span><span><div>Baseline QTc prolongation (QTc ≥450ms) may be a potential risk factor for osimertinib-related grade 3 QTc prolongation.</div></span></li><li><span>•</span><span><div>In patients with grade 3 osimertinib-related QTc prolongation, rechallenging osimertinib at 80mg daily dose confers high recurrence risk while dose reduction mitigates recurrence risk.</div></span></li></ul></div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 8","pages":"Pages 738-743.e2"},"PeriodicalIF":3.3,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141771724","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":"Impact of Durvalumab on the Duration and Complexity of Corticosteroid Therapy for Pneumonitis After Chemoradiotherapy","authors":"Saori Murata ,&nbsp;Hidehito Horinouchi ,&nbsp;Momoko Morishita ,&nbsp;Sawako Kaku ,&nbsp;Yuki Shinno ,&nbsp;Yusuke Okuma ,&nbsp;Tatsuya Yoshida ,&nbsp;Yasushi Goto ,&nbsp;Noboru Yamamoto ,&nbsp;Tairo Kashihara ,&nbsp;Kae Okuma ,&nbsp;Masahiko Kusumoto ,&nbsp;Yuichiro Ohe","doi":"10.1016/j.cllc.2024.06.009","DOIUrl":"10.1016/j.cllc.2024.06.009","url":null,"abstract":"<div><h3>Introduction</h3><div>It is unclear how the duration and tapering pattern of corticosteroid therapy for pneumonitis changed after the introduction of durvalumab consolidation therapy.</div></div><div><h3>Methods</h3><div>We retrospectively evaluated the medical records of patients diagnosed with nonsmall cell lung cancer who received chemoradiotherapy between January 2014 and December 2020.</div></div><div><h3>Results</h3><div>Data for 135 patients treated before durvalumab approval and 100 patients treated with durvalumab after its approval were analyzed. In both groups, more than 70% were male, with a median age of 66 y. Approximately 85% were smokers, and the most common tumor histology was adenocarcinoma. Most patients were treated with doses of 60 and 66 Gy (n = 127 [94%] vs. n = 95 [95%]). Among the patients treated with durvalumab, 57%, 38%, and 5% had grade 1, grade 2, and grade 3 pneumonitis; none had grade 4 or 5 pneumonitis. Patients treated with durvalumab exhibited a longer duration of corticosteroid therapy for pneumonitis (17 wk; range: 2-88 wk) than patients not treated with durvalumab (7 wk; range: 0.4-21 wk; <em>P</em> &lt; 0.001). Pneumonitis relapse was more frequent in patients treated with durvalumab (n = 8; 23%) than in patients not treated with durvalumab (n = 2; 7%). Among the 8 patients treated with durvalumab, 2 had recurrent pneumonitis, 1 could not terminate corticosteroids.</div></div><div><h3>Conclusions</h3><div>Our data show that durvalumab prolongs the duration of corticosteroid therapy and increases the complexity of corticosteroid tapering patterns. This study can help manage pneumonitis caused by immune checkpoint inhibitors and other drugs used after chemoradiotherapy in routine practice and clinical trials.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 7","pages":"Pages e369-e378.e3"},"PeriodicalIF":3.3,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141704697","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":"Impact of PROphet Test in Changing Physicians' Therapeutic Decision-Making for Checkpoint Immunotherapy in Non–Small-Cell Lung Cancer","authors":"David R. Gandara ,&nbsp;Janakiraman Subramanian ,&nbsp;Edgardo S. Santos ,&nbsp;Yehuda Brody ,&nbsp;Itamar Sela ,&nbsp;Yehonatan Elon ,&nbsp;Michal Harel ,&nbsp;Anat Reiner-Benaim ,&nbsp;Coren Lahav ,&nbsp;Kimberly McGregor","doi":"10.1016/j.cllc.2024.06.011","DOIUrl":"10.1016/j.cllc.2024.06.011","url":null,"abstract":"<div><h3>Purpose</h3><p>Immune Checkpoint Inhibitor (ICI) regimens are approved for first-line treatment of metastatic nononcogene-driven NSCLC. Guidelines do not differentiate which patients with PD-L1 ≥ 50% should receive ICI monotherapy. The clinically validated PROphet NSCLC plasma proteomic-based test is designed to inform this therapeutic decision.</p></div><div><h3>Methods</h3><p>One hundred oncologists were presented with 3 “virtual” metastatic NSCLC cases with PD-L1 scores and asked to recommend an approved first-line regimen. They then watched an online educational webinar on the PROphetNSCLC test. Postwebinar, the same cases were represented with the addition of a PROphet result, and oncologists again recommended a first-line regimen. Responses were compared to assess the impact on first-line treatment selection.</p></div><div><h3>Results</h3><p>Treatment recommendation changed in 39.6% of PROphet-tested cases, with 93% of physicians changing at least 1 case. In the PD-L1 ≥ 50% group, 89% of physicians changed their recommendation, followed by 77%, in PD-L1 &lt; 1%, and 36% in PD-L1 1% to 49%. ​In the PD-L1 ≥ 50%, PROphet POSITIVE group, the recommendation for ICI monotherapy increased from 60% to 89%. ​For the PD-L1 ≥ 50%, PROphet NEGATIVE group, the recommendation for monotherapy dropped from 60% to 9%. In the PD-L1 &lt; 1%, PROphet NEGATIVE group, 35% of patients were spared toxicity from ICI compared to 11% in PROphet untested cases.</p></div><div><h3>Conclusion</h3><p>Adding PROphet to PD-L1 expression impacted therapeutic decision making in first-line NSCLC. PROphet identifies those predicted to have an overall survival benefit from ICI monotherapy versus combination versus chemotherapy, improving the probability of efficacy and reducing toxicity for some patients.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 6","pages":"Pages e252-e261.e4"},"PeriodicalIF":3.3,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1525730424001384/pdfft?md5=68fe4e60e1c9153f5469964a5f1d6d04&pid=1-s2.0-S1525730424001384-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141690612","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":"Bevacizumab for Brain Radiation Necrosis in Patients With Nonsquamous Nonsmall Cell Lung Cancer","authors":"Daisuke Shibahara ,&nbsp;Kentaro Tanaka ,&nbsp;Osamu Togao ,&nbsp;Yoshimasa Shiraishi ,&nbsp;Yasuto Yoneshima ,&nbsp;Eiji Iwama ,&nbsp;Tadamasa Yoshitake ,&nbsp;Kousei Ishigami ,&nbsp;Isamu Okamoto","doi":"10.1016/j.cllc.2024.06.010","DOIUrl":"10.1016/j.cllc.2024.06.010","url":null,"abstract":"<div><p></p><ul><li><span>•</span><span><p>The incidence of brain radiation necrosis is increasing in NSCLC patients undergoing radiotherapy for brain metastases.</p></span></li><li><span>•</span><span><p>[¹¹C] methionine–PET and MRS are valuable tools for diagnosing brain radiation necrosis.</p></span></li><li><span>•</span><span><p>Bevacizumab is an effective treatment for brain radiation necrosis in patients with nonsquamous NSCLC.</p></span></li></ul></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 6","pages":"Pages 581-586.e3"},"PeriodicalIF":3.3,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1525730424001359/pdfft?md5=6792b8d4e751aaccaf770a85083f2252&pid=1-s2.0-S1525730424001359-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141771624","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":"A Novel EGFR Germline Mutation in Lung Adenocarcinoma: Case Report and Literature Review","authors":"Parth Sharma ,&nbsp;Himil Mahadevia ,&nbsp;Sreekanth Donepudi ,&nbsp;Lara Kujtan ,&nbsp;Beth Gustafson ,&nbsp;Ben Ponvilawan ,&nbsp;Ammar Al-Obaidi ,&nbsp;Janakiraman Subramanian ,&nbsp;Dhruv Bansal","doi":"10.1016/j.cllc.2024.04.009","DOIUrl":"10.1016/j.cllc.2024.04.009","url":null,"abstract":"<div><p></p><ul><li><span>•</span><span><p>While most molecular testing focuses on somatic alterations in patients with non-small cell lung cancer, evidence is growing regarding the presence of germline lung cancer mutations. The most common lung cancer germline mutation is EGFR T790M.</p></span></li><li><span>•</span><span><p>Herein, we describe an EGFR germline mutation not previously reported outside of Asia, T725M.</p></span></li><li><span>•</span><span><p>Identification of germline lung cancer mutations could help to identify new therapeutic targets. Furthermore, further characterization of these mutations can aid in the development of screening and surveillance guidelines for patients with hereditary lung cancer, which currently do not exist.</p></span></li></ul></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 5","pages":"Pages 479-482"},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1525730424000524/pdfft?md5=9135c62f62eeb19fdc77fa14f8ab402b&pid=1-s2.0-S1525730424000524-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140790092","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: Impact of Anti-Cancer Treatments on Outcomes of COVID-19 in Patients With Thoracic Cancers: A CCC19 Registry Analysis","authors":"Amit A. Kulkarni ,&nbsp;Cassandra Hennessy ,&nbsp;Grace Wilson ,&nbsp;Vidhyalakshmi Ramesh ,&nbsp;Clara Hwang ,&nbsp;Joy Awosika ,&nbsp;Ziad Bakouny ,&nbsp;Hina Khan ,&nbsp;Diana Vilar-Compte ,&nbsp;Rana McKay ,&nbsp;Chinmay Jani ,&nbsp;Lisa Weissmann ,&nbsp;Elizabeth Griffiths ,&nbsp;Gerald Batist ,&nbsp;Nathaniel Bouganim ,&nbsp;Blanche Mavromatis ,&nbsp;Babar Bashir ,&nbsp;Ryan H. Nguyen ,&nbsp;Jonathan W. Riess ,&nbsp;Matthew Puc ,&nbsp;Narjust Florez","doi":"10.1016/j.cllc.2024.04.003","DOIUrl":"10.1016/j.cllc.2024.04.003","url":null,"abstract":"<div><p></p><ul><li><span>•</span><span><p>Patients with thoracic cancers and COVID-19 have high mortality and morbidity.</p></span></li><li><span>•</span><span><p>Systematic data evaluating the impact of recent anti-cancer therapies on COVID-19 outcomes in patients with thoracic cancers are limited.</p></span></li><li><span>•</span><span><p>We analyzed clinical data from patients with thoracic cancers and COVID-19 (N=927) to systematically evaluate the impact of recent anti-cancer therapies on the clinical outcomes of COVID-19 from the COVID-19 and Cancer Consortium (CCC19).</p></span></li><li><span>•</span><span><p>As opposed to immunotherapy or targeted therapy, recent (&lt;3 months prior to COVID-19 diagnosis) cytotoxic chemotherapy exposure was significantly associated with COVID-19 severity.</p></span></li><li><span>•</span><span><p>None of the other systemic therapies or treatment modalities were significantly associated with 30-day all-cause mortality.</p></span></li><li><span>•</span><span><p>Baseline steroid use of 10 mg or more of prednisone equivalent was not associated COVID-19 severity and 30-day all-cause mortality.</p></span></li></ul></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 5","pages":"Pages e229-e237.e7"},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140810555","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":"AI-driven Characterization of Solid Pulmonary Nodules on CT Imaging for Enhanced Malignancy Prediction in Small-sized Lung Adenocarcinoma","authors":"Yujin Kudo ,&nbsp;Taiyo Nakamura ,&nbsp;Jun Matsubayashi ,&nbsp;Akimichi Ichinose ,&nbsp;Yushi Goto ,&nbsp;Ryosuke Amemiya ,&nbsp;Jinho Park ,&nbsp;Yoshihisa Shimada ,&nbsp;Masatoshi Kakihana ,&nbsp;Toshitaka Nagao ,&nbsp;Tatsuo Ohira ,&nbsp;Jun Masumoto ,&nbsp;Norihiko Ikeda","doi":"10.1016/j.cllc.2024.04.015","DOIUrl":"10.1016/j.cllc.2024.04.015","url":null,"abstract":"<div><h3>Objectives</h3><p>Distinguishing solid nodules from nodules with ground-glass lesions in lung cancer is a critical diagnostic challenge, especially for tumors ≤2 cm. Human assessment of these nodules is associated with high inter-observer variability, which is why an objective and reliable diagnostic tool is necessary. This study focuses on artificial intelligence (AI) to automatically analyze such tumors and to develop prospective AI systems that can independently differentiate highly malignant nodules.</p></div><div><h3>Materials and methods</h3><p>Our retrospective study analyzed 246 patients who were diagnosed with negative clinical lymph node metastases (cN0) using positron emission tomography-computed tomography (PET/CT) imaging and underwent surgical resection for lung adenocarcinoma. AI detected tumor sizes ≤2 cm in these patients. By utilizing AI to classify these nodules as solid (AI_solid) or non-solid (non-AI_solid) based on confidence scores, we aim to correlate AI determinations with pathological findings, thereby advancing the precision of preoperative assessments.</p></div><div><h3>Results</h3><p>Solid nodules identified by AI with a confidence score ≥0.87 showed significantly higher solid component volumes and proportions in patients with AI_solid than in those with non-AI_solid, with no differences in overall diameter or total volume of the tumors. Among patients with AI_solid, 16% demonstrated lymph node metastasis, and a significant 94% harbored invasive adenocarcinoma. Additionally, 44% were upstaging postoperatively. These AI_solid nodules represented high-grade malignancies.</p></div><div><h3>Conclusion</h3><p>In small-sized lung cancer diagnosed as cN0, AI automatically identifies tumors as solid nodules ≤2 cm and evaluates their malignancy preoperatively. The AI classification can inform lymph node assessment necessity in sublobar resections, reflecting metastatic potential.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 5","pages":"Pages 431-439"},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140928510","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 of Pembrolizumab in Advanced Non-Small Cell Lung Cancer—Real World Outcomes After Two Years of Therapy (COPILOT)","authors":"Andrew Fantoni ,&nbsp;Lydia Warburton ,&nbsp;Benjamin Solomon ,&nbsp;Marliese Alexander ,&nbsp;Meghana Maddula ,&nbsp;Lauren Julia Brown ,&nbsp;Ines Pires da Silva ,&nbsp;Adnan Nagrial ,&nbsp;Farah Abu Al-Hial ,&nbsp;Malinda Itchins ,&nbsp;Nick Pavlakis ,&nbsp;Samantha Bowyer","doi":"10.1016/j.cllc.2024.04.008","DOIUrl":"10.1016/j.cllc.2024.04.008","url":null,"abstract":"<div><h3>Background</h3><p>Seminal trials with first-line pembrolizumab for metastatic non-small cell lung cancer (NSCLC) mandated a maximum two-years treatment. We describe real-world outcomes of a multi-site Australian cohort of patients who completed two-years of pembrolizumab.</p></div><div><h3>Methods</h3><p>Retrospective data were collected from the national AUstralian Registry and biObank of thoRacic cAncers (AURORA). Primary endpoints were progression rate post pembrolizumab discontinuation; and progression free survival (PFS). Local treatment of oligoprogressive disease during pembrolizumab was allowed.</p></div><div><h3>Results</h3><p>A total of 71 patients from six centers, median age 66.0 years, 49% male and 90% ECOG ≤ 1 were identified. Patients were Caucasian (82%) or Asian (16%); past (66%) or current (24%) smokers with mean 37 pack-years. Histology comprised 73% adenocarcinoma and 16% squamous. 18 patients (25%) had brain metastases at diagnosis. Median PD-L1 tumor proportion score (TPS) was 68%; 12 patients (17%) TPS &lt; 1% and 43 (61%) TPS ≥ 50%. No patients had <em>EGFR/ALK/ROS1</em> alterations; 29/49 tested (60%) had <em>KRAS</em> mutations.</p><p>Median follow up was 38.7 months. Objective response rate 78.6%. Median PFS 46.1 months (95% CI 39.5-NR), not reached (46.1-NR) in PD-L1 TPS ≥ 1% versus 28.1 months (16.3-NR) in TPS &lt; 1% (<em>P</em> = .013). 17 patients (24%) received additional local therapy for oligoprogression. Post pembrolizumab discontinuation, 20 patients (28%) had disease progression. Higher rates of progression occurred with TPS &lt; 1% (OR 3.46, <em>P</em> = .06), without complete response (OR 5.06, <em>P</em> = .04), and with treated oligoprogression (OR 3.11, <em>P</em> = .05). 36-month landmark survival was 98.2%.</p></div><div><h3>Conclusion</h3><p>Patients completing two-years of pembrolizumab for NSCLC in an Australian cohort had high rates of <em>KRAS</em> mutation and PD-L1 expression; a proportion had brain metastases and treated oligoprogression. Progression post pembrolizumab was higher in PD-L1 TPS &lt; 1% and in those without complete response.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 5","pages":"Pages 449-459"},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1525730424000512/pdfft?md5=524d5c384a3ad5567016e7b9d7b96cf3&pid=1-s2.0-S1525730424000512-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140785750","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}