Clinical lung cancer最新文献

{"title":"Outcomes Following Treatment for Progression in Patients Treated With Durvalumab Consolidation in LA-NSCLC.","authors":"Margaret Stalker, Melina Marmarelis, Corey Langer, Roger B Cohen, Aditi Singh, Charu Aggarwal, Lova Sun","doi":"10.1016/j.cllc.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.11.002","url":null,"abstract":"<p><strong>Introduction: </strong>PACIFIC established consolidative durvalumab for LA-NSCLC, but only about half of patients completed a year of therapy. Data on treatment patterns and outcomes after durvalumab are limited.</p><p><strong>Methods: </strong>Our analysis included patients from a US nationwide database with LA-NSCLC who received consolidative durvalumab between 2017 and 2023 and had subsequent systemic therapy, classified as PD-L1 monotherapy, PD-L1+chemotherapy, chemotherapy alone, PD-L1+CTLA4, or targeted therapy (TT). Time to next treatment (TTNT) was analyzed from durvalumab start and finish to next line of therapy initiation. Overall survival (OS) from start of postdurvalumab therapy was analyzed using Kaplan Meier methodology.</p><p><strong>Results: </strong>Our cohort included 751 patients, median age 68 (IQR, 61-74), 53% female, 80% White, 91% ECOG 0-1, 90% smoking history, and 53% nonsquamous histology. The most common postdurvalumab treatment was chemotherapy alone in 349 (46%), followed by PD-L1+chemotherapy in 147 (20%), PD-L1 monotherapy in 114 (15%), and TT in 104 (14%). Median duration of durvalumab treatment was 5.5 months (IQR 2.3-10.6); only 9% of patients received a full year of durvalumab, and 64% started next treatment within a year of initiation. Patients treated with chemotherapy-containing regimens had shorter TTNT from durvalumab start/end, as well as shorter median OS [10.8 (5.6-18.8) months for chemotherapy and 12.9 (6.0-24.2) months for chemoimmunotherapy, versus 23.8 (8.7-34.5) months for PD-L1 monotherapy and 30.1 (9.5-NR) months for TT (P < .001)].</p><p><strong>Conclusion: </strong>Patients treated with systemic therapy after consolidative durvalumab, particularly those requiring chemotherapy-based treatment, have poor outcomes and are in need of improved treatment strategies.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766918","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 Potential of Basal F-18-FDG PET/CT in Evaluating Prognosis and Benefit From Adjuvant Chemotherapy After Tumor Resection of Stage IB(T2, ≤ 3 cm With VPI, N0, M0)NSCLC.","authors":"Bei Lei, He Zhang, Jianwen Sun, Lihua Wang, Maomei Ruan, Hui Yan, Aimi Zhang, Cheng Chang, Hao Yang, Gang Huang, Liu Liu, Wenhui Xie","doi":"10.1016/j.cllc.2024.11.001","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.11.001","url":null,"abstract":"<p><strong>Objectives: </strong>To investigated whether the basal F-18-FDG PET/CT could evaluate the prognosis or the benefit from adjuvant chemotherapy after surgery of patients with early-stage NSCLC with visceral pleural invasion.</p><p><strong>Materials and methods: </strong>A total of 116 patients with stage IB (T2, ≤ 3 cm with VPI, N0, M0) NSCLC underwent tumor resection and F-18-FDG PET/CT 1-3 weeks before surgery and were followed up for 1-79 months after surgery. SUVpeak, SUVmax, SUVmean, MTV, and TLG of tumors were obtained. The primary and secondary endpoints were progression-free survival (PFS) and overall survival (OS), respectively. ROC curve analysis, Cox regression test, and the Kaplan-Meier method were used for statistical analysis.</p><p><strong>Results: </strong>High SUVs, TLG, and MTV were associated with postoperative progression of NSCLC (the area under the ROC curve: 0.695 to 0.750, P < .001). The increase of SUVs, TLG or MTV was associated with short postoperative PFS (P < .001) while an increase in TLG (P = .016) or MTV (P = .018) was associated with short postoperative OS. TLG > 16.81 was an independent indicator of both the short PFS (HR = 5.534, P = .002) and the short OS (HR = 5.075, P = .031). Further, adjuvant chemotherapy was associated with longer PFS in NSCLCs with TLG > 16.81 (treated vs. untreated: 63 vs. 52 months; HR = 2.242, P = .022) rather than those with TLG ≤ 16.81.</p><p><strong>Conclusion: </strong>SUV-based parameters on F-18-FDG PET/CT have the potential to evaluate the prognosis and benefit from adjuvant chemotherapy after tumor resection in stage IB (T2, ≤ 3 cm with VPI, N0, M0) NSCLC and therefore may be helpful for lung cancer treatment.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754806","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":"Radiologists Versus AI-Based Software: Predicting Lymph Node Metastasis and Prognosis in Lung Adenocarcinoma From CT Under Various Image Display Conditions.","authors":"Junya Sato, Masahiro Yanagawa, Daiki Nishigaki, Akinori Hata, Yukinori Sakao, Noriaki Sakakura, Yasushi Yatabe, Yasushi Shintani, Shoji Kido, Noriyuki Tomiyama","doi":"10.1016/j.cllc.2024.10.015","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.10.015","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the variability of quantitative values from lung adenocarcinoma CT images independently assessed by 2 radiologists and AI-based software under different display conditions, and to identify predictors of pathological lymph node metastasis (LNM), disease-free survival (DFS), and overall survival (OS).</p><p><strong>Methods: </strong>Preoperative CT images of 307 patients were displayed under 4 conditions: lung-1, lung-2, mediastinum-1, and mediastinum-2. Two radiologists (R1, R2) measured total diameter (tD) and the longest solid diameter (sD) under each condition. The AI-based software automatically detected lung nodules, providing tD, sD, total volume (tV), and solid volume (sV).</p><p><strong>Results: </strong>All measurements by R1 and R2 with AI-based software were identical. Four out of the 8 measurements showed significant variation between R1 and R2. For LNM, multivariate logistic regression identified significant indicators including sD at mediastinum-2 of R1, sD at mediastinum-1 and mediastinum-2 of R2, tV, and the proportion of sV to tV (sV/tV) of AI-based software. For DFS, multivariate Cox regression identified sD at lung-1 of R1, the proportions of sD to tD at lung-2 of R1, sD at lung-2 and mediastinum-1 of R2, tV, and sV/tV of AI-based software as significant. For OS, multivariate Cox regression identified sD at lung-1 and mediastinum-2 of R1, tD at lung-2 of R2, sD at mediastinum-1 of R2, sV, and sV/tV of AI-based software as significant.</p><p><strong>Conclusion: </strong>Radiologists' CT measurements were significant predictors of LNM and prognosis, but variability existed among radiologists and display conditions. AI-based software can provide accurate and reproducible indicators for predicting LNM and prognosis.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726572","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":"Biomarker Landscape of Antibody Drug Conjugates (ADCs) and Bispecific Antibodies in Clinical Trials for Lung Cancer.","authors":"Madhan Srinivasan Kumar, Sameer Deshmukh, Charmi Bhanushali, Yanis Boumber, Johnathan Riess, Abdul Rafeh Naqash, Vivek Subbiah, Aakash Desai","doi":"10.1016/j.cllc.2024.10.008","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.10.008","url":null,"abstract":"","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726570","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: Phase II Clinical Trial of Atezolizumab in Advanced Nonsmall Cell Lung Cancer Patients Previously Treated With PD-1-Directed Therapy.","authors":"Dylan Fortman, Hong Wang, Robert VanderWeele, Terry Evans, James G Herman, John Rhee, Vincent Reyes, Brian McLaughlin, Antoinette Wozniak, Ashwin Somasundaram, Tarek Mekhail, Mark A Socinski, Katja Schulze, Liza C Villaruz","doi":"10.1016/j.cllc.2024.10.014","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.10.014","url":null,"abstract":"","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692723","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":"Clinical Characteristics and Management of Checkpoint Inhibitor Pneumonitis in Non-Small-Cell Lung Cancer Patients After Neoadjuvant Immunotherapy.","authors":"Long Jiang, Shanshan Jiang, Wang Miao, Yaofeng Shen, Larisa Bolotina, Hongda Zhu, Ningyuan Zou, Yu Tian, Hanbo Pan, Jia Huang, Andrey Ryabov, Qingquan Luo","doi":"10.1016/j.cllc.2024.10.012","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.10.012","url":null,"abstract":"<p><strong>Objective: </strong>Neoadjuvant immunotherapy with checkpoint inhibitors has shown promising results for non-small-cell lung cancer (NSCLC) patients. However, it has been associated with immune-related adverse events (irAEs), including checkpoint inhibitor pneumonitis (CIP), which can be life-threatening.</p><p><strong>Methods: </strong>This retrospective study analysed the medical records of 197 NSCLC patients who underwent neoadjuvant checkpoint inhibitor therapy to investigate the incidence, clinical characteristics, and management of CIP.</p><p><strong>Results: </strong>Of the 197 patients, 24 (12.2%) developed CIP. The majority of patients presented with respiratory symptoms, and ground-glass opacities were the most common radiographic finding. Patients with CIP had a longer duration of immunotherapy and a higher baseline C-reactive protein level than those without CIP. Most cases were mild to moderate in severity (Grade 1: 11, Grade 2: 6, Grade 3: 5) and managed with corticosteroids, while 2 patients of Grade 4 developed severe respiratory failure requiring mechanical ventilation. No patient died due to respiratory failure.</p><p><strong>Conclusions: </strong>CIP was identified as a potential complication of neoadjuvant treatment with checkpoint inhibitors in patients with resectable NSCLC. Therefore, close monitoring for CIP and prompt recognition and management of symptoms are essential for the safe use of checkpoint inhibitors in NSCLC patients. While the study also found that such neoadjuvant treatment can induce a major pathological response in a significant proportion of these patients, further research is required to fully understand and manage the risk factors of CIP in this patient population.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692733","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":"Comment on ``Prognostic Impact of TP53 Mutations in Metastatic Nonsquamous Non-small-cell Lung Cancer''.","authors":"Laurent Mathiot, Judith Raimbourg","doi":"10.1016/j.cllc.2024.10.011","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.10.011","url":null,"abstract":"","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681071","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 Poor Prognostic ALK Phenotype: A Review of Molecular Markers of Poor Prognosis in ALK Rearranged Nonsmall Cell Lung Cancer.","authors":"Sze Wah Samuel Chan, Joy Zeng, Jack Young, Samir H Barghout, Faisal Al-Agha, Stavroula Raptis, M Catherine Brown, Geoffrey Liu, Rosalyn Juergens, Kevin Jao","doi":"10.1016/j.cllc.2024.10.009","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.10.009","url":null,"abstract":"<p><strong>Background: </strong>Patients with nonsmall cell lung cancer with anaplastic lymphoma kinase (ALK) rearrangements derive a significant and durable clinical benefit from tyrosine kinase inhibitors (TKIs). However, early progression/death on treatment occurs in a subset of patients, which we term the poor prognostic ALK phenotype. This review aims to summarize the known molecular mechanisms that underlie this phenotype with a focus on variant 3 and TP53 mutations.</p><p><strong>Methods: </strong>A scoping review was performed using scientific databases such as Ovid Medline, Ovid Embase, and Cochrane Central Register of Controlled Trials. Studies included molecular markers of poor prognosis, with a focus on TP53 mutations, variant 3 re-arrangements, and poor clinical response to TKIs.</p><p><strong>Results: </strong>Of 4371 studies screened, 108 were included. Numerous studies implicated a negative prognostic role of variant 3, likely mediated through the acquisition of on-target resistance mutations and TP53 mutations which are associated with greater chromosomal instability and mutational burden. Co-occurring variant 3 and TP53 mutations were associated with even worse survival. Other mediators of early resistance development include aberrations in cell cycle regulators and mutations in cell signaling pathways. Comprehensive genomic analysis from first-line TKI clinical trial data was unable to identify a singular genomic signature that underlies the poor prognostic phenotype but implicated a combination of pathways.</p><p><strong>Conclusions: </strong>This scoping review highlights that the poor prognostic ALK phenotype is likely composed of a heterogeneous variety of genomic factors. There remains an unmet need for a genomic assay to integrate these various molecular markers to predict this ALK phenotype.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692721","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: Methylation-Based ctDNA Serial Monitoring Correlates With Immunotherapy Response in NSCLC.","authors":"Angela Hsiao, Brian Woodward, Patrick Ye, Matthew G Varga, Ghaith Altaie, Kevin Lu, Naomi Searle, Robb Viens, Sydne Langpap, Zeqian Li, Gary Palmer, Hatim Husain","doi":"10.1016/j.cllc.2024.10.013","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.10.013","url":null,"abstract":"<p><strong>Purpose: </strong>Circulating tumor DNA (ctDNA) can reflect the genetic and epigenetic composition of malignancies and can serve as a noninvasive biomarker for cancer diagnostics and monitoring. This study aimed to evaluate the utility of a methylation-based ctDNA assay as a predictive tool in non-small cell lung cancer (NSCLC) anti-PD1 based immunotherapy monitoring.</p><p><strong>Methods: </strong>We evaluated a cohort of 20 patients with NSCLC treated with anti-PD1 based immunotherapy that had both baseline and follow-up blood draws as well as outcome data available. Tumor Methylation Scores (TMS) were measured with an amplicon-based, multiplexed cfDNA assay that utilizes quantitative counting templates (QCTs) in conjunction with next-generation sequencing to count the number of methylated molecules at more than 500 genomic locations that are hypermethylated in cancer tissue. The association between TMS and real-world progression-free survival (rwPFS) on therapy was conducted using Cox proportional hazards model and plotted using the Kaplan-Meier method.</p><p><strong>Results: </strong>The change in TMS measured 4-10 weeks post-treatment initiation strongly correlated with immunotherapy response, as measured by rwPFS (P < 0.0001), compared to a weaker correlation of imaging RECIST v1.1 measurements with rwPFS (P = 0.55). Furthermore, TMS tracked with tumor burden on therapy in real-world cases.</p><p><strong>Conclusions: </strong>In this real-world dataset of NSCLC patients treated with anti-PD1 immunotherapy regimens, the TMS score measured within a 4-10 week window after treatment initiation can be predictive of response to therapy. Beyond this window, the TMS score can be associated with rwPFS and tumor dynamics. Early evidence suggests that changes in the methylation profile may be informative for monitoring occurrence of new somatic mutations. The cases presented demonstrate the application of using TMS for serial therapeutic response monitoring.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766916","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":"Comment on \"Prognostic Impact of TP53 Mutations in Metastatic Nonsquamous Non-Small-Cell Lung Cancer\".","authors":"Rameez Qasim, Zahra Riaz","doi":"10.1016/j.cllc.2024.10.010","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.10.010","url":null,"abstract":"","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686049","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}