Clinical lung cancer最新文献

{"title":"Tepotinib Plus an EGFR Tyrosine Kinase Inhibitor in Patients With EGFR-Mutant MET-Altered NSCLC: A Case Series","authors":"Xiuning Le ,&nbsp;Anna Eisert ,&nbsp;Te-Chun Hsia ,&nbsp;Nirmal Vivek Raut ,&nbsp;Azura Ahmad ,&nbsp;Oscar Siu Hong Chan ,&nbsp;Charlotte De Bondt ,&nbsp;David Farrugia ,&nbsp;Patrizia Froesch ,&nbsp;Maria González-Cao ,&nbsp;Lizza Hendriks ,&nbsp;Maximillian J. Hochmair ,&nbsp;Julien Mazieres ,&nbsp;Hazel O'Sullivan ,&nbsp;Sanjay Popat ,&nbsp;Jens Samol ,&nbsp;Anthonie J. van der Wekken ,&nbsp;Tsung-Ying Yang ,&nbsp;Lye Mun Tho ,&nbsp;Ulrike Himpe ,&nbsp;Gee-Chen Chang","doi":"10.1016/j.cllc.2025.02.013","DOIUrl":"10.1016/j.cllc.2025.02.013","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>No targeted treatments are currently approved for patients with <em>EGFR</em>-mutant non–small-cell lung cancer (NSCLC) and <em>MET</em>-mediated resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs).</div></span></li><li><span>•</span><span><div>This case series describes real-world outcomes with tepotinib, a selective MET-TKI, in combination with EGFR-TKIs in patients with <em>EGFR</em>-mutant, <em>MET</em>-altered NSCLC and resistance to EGFR-TKIs.</div></span></li><li><span>•</span><span><div>Among the 25 patients included, tepotinib was given in combination with a range of EGFR-TKIs (osimertinib, n = 18; gefitinib, n = 5; dacomitinib, n = 1; afatinib, n = 1) as second (n = 8), third (n = 9), or fourth-or-later (n = 8) line therapy.</div></span></li><li><span>•</span><span><div>Tepotinib plus EGFR-TKIs demonstrated clinical benefit per physician's assessment in 23/25 patients, with a partial response in 15/25 patients.</div></span></li><li><span>•</span><span><div>Tepotinib plus EGFR-TKIs showed favorable tolerability that was consistent with previous observations, with edema reported as the most common tepotinib-related adverse event (14/25 patients).</div></span></li><li><span>•</span><span><div>This case series, including patients with several prior treatment lines, suggest tepotinib plus an EGFR-TKI as a potential chemotherapy-sparing, oral targeted treatment option for patients with <em>EGFR</em>‑mutated, <em>MET</em>-altered NSCLC after progression on EGFR‑TKIs.</div></span></li></ul></div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 4","pages":"Pages 338-346.e1"},"PeriodicalIF":3.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718268","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":"Predicting Severe Radiation Pneumonitis in Patients With Locally-Advanced Non–Small-Cell Lung Cancer After Thoracic Radiotherapy: Development and Validation of a Nomogram Based on the Clinical, Hematological, and Dose-Volume Histogram Parameters","authors":"Ying Zhang ,&nbsp;Shi-Hong Zhou ,&nbsp;Yu-Jie Yan ,&nbsp;Lei-Lei Wu ,&nbsp;Xiao-Shuai Yuan ,&nbsp;Min Hu ,&nbsp;Jing-Jing Kang ,&nbsp;Chen-Xue Jiang ,&nbsp;Yao-Yao Zhu ,&nbsp;Shuang-Yan Yang ,&nbsp;Rui-Feng Zhao ,&nbsp;Jian Hu ,&nbsp;Min-Ren Hu ,&nbsp;Hui Liu ,&nbsp;Liang Liu ,&nbsp;Lan Zhao ,&nbsp;Ya-Ping Xu","doi":"10.1016/j.cllc.2025.02.009","DOIUrl":"10.1016/j.cllc.2025.02.009","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to investigate the risk factors for severe radiation pneumonitis (RP) after thoracic radiotherapy (RT) in patients with locally advanced non-small cell lung cancer (NSCLC), develop a prediction model to identify high-risk groups, and investigate the impact of severe RP on overall survival (OS).</div></div><div><h3>Methods</h3><div>We retrospectively collected clinical, dosimetric, and hematological factors of patients with stage III NSCLC receiving thoracic RT without immunotherapy. The primary and secondary end points were severe RP and OS, respectively. Fine-Gray competing risk regression analyses were used to identify the risk factors for severe RP. The patients were randomly divided into training and validation cohorts at a ratio of 6:4. The model was evaluated using receiver operating characteristic (ROC) and calibration curves, and decision curve analysis (DCA). The OS of patients in the RP vs. non-RP and mild RP vs. severe RP groups was analyzed using the Kaplan-Meier method.</div></div><div><h3>Results</h3><div>A total of 305 patients were enrolled in the analysis, and 32 (10.5%) developed severe RP. Interstitial lung disease (ILD) (<em>P</em> = .013), percentage of ipsilateral lung volume receiving ≥ 20 Gy (ipsilateral V₂₀) (<em>P</em> = .029), pre-RT derived neutrophil lymphocyte ratio (dNLR) (<em>P</em> = .026), and post-RT systemic inflammation response index (SIRI) (<em>P</em> = .010) were independent predictors of severe RP, and were used to establish the nomogram based on a training cohort. The ROC area under the curve (AUC) of the nomogram was 0.804. Calibration curves and DCA showed favorable consistency and positive net benefits in both training and validation cohorts. Cases who developed severe RP had a shorter OS than those who developed mild RP (<em>P</em> = .027).</div></div><div><h3>Conclusion</h3><div>ILD, ipsilateral V₂₀, pre-RT dNLR, and post-RT SIRI could predict severe RP in patients with locally advanced NSCLC receiving thoracic RT. By combining these indicators, a nomogram was constructed and validated, demonstrating its potential value in clinical practice.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 5","pages":"Pages 393-406"},"PeriodicalIF":3.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630021","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":"Small Cell Lung Cancer With de novo BRAF V600E Mutation and Durable Response to Targeted Therapy: A Case Report","authors":"Radhika Kulkarni ,&nbsp;Elias Zeine ,&nbsp;Bindu Potugari ,&nbsp;Shirish Gadgeel ,&nbsp;Joseph Montecalvo ,&nbsp;Fawzi Abu Rous","doi":"10.1016/j.cllc.2025.02.012","DOIUrl":"10.1016/j.cllc.2025.02.012","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>Small Cell Lung Cancer (SCLC) is rare in those without a history of smoking, underscoring the importance of a thorough smoking history assessment.</div></span></li><li><span>•</span><span><div>While rare, targetable genetic alterations can occur in SCLC, necessitating comprehensive molecular profiling in select cases.</div></span></li><li><span>•</span><span><div>Next generation sequencing should be considered for SCLC patients without a smoking history to identify potentially actionable mutations.</div></span></li><li><span>•</span><span><div>When targetable genetic alterations are detected, a trial of therapy with targeted inhibitors is reasonable, albeit with the understanding that outcomes are typically not promising.</div></span></li></ul></div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 4","pages":"Pages e306-e310"},"PeriodicalIF":3.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708814","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":"Lung Cancer in Patients Under 50: What is the Role of Social Determinants of Health?","authors":"Fatima G. Wilder ,&nbsp;Miles McAllister ,&nbsp;Anupama Singh ,&nbsp;Yue Xie ,&nbsp;Emanuele Mazzola ,&nbsp;Michael T. Jaklitsch","doi":"10.1016/j.cllc.2025.02.011","DOIUrl":"10.1016/j.cllc.2025.02.011","url":null,"abstract":"<div><h3>Background</h3><div>Black patients present with non–small-cell lung cancer (NSCLC) at younger ages, and Black race is a poor prognostic factor. We aimed to identify specific socioeconomic factors that may contribute to these disparities.</div></div><div><h3>Methods</h3><div>The National Cancer Database (NCDB) was queried for NSCLC cases (2000-2020). Patients were grouped into 3 categories: 18 to 44(A), 45 to 49(B) and 50 to 90 years(C). Demographics, tumor characteristics, survival, insurance status, distance from the treating hospital, median household income, and proportion of residents without a high school diploma (HSD) were compared.</div></div><div><h3>Results</h3><div>There were 1,703,062 patients, 77,107 of whom were under 50-years-old. Compared to White patients, more Black patients in A and B presented at stage IV (A: 39.7% vs. 35%; B: 40.9% vs. 35%), had higher 90-day mortality (A: 2.7% vs. 2.2%; B: 4% vs. 2.7%) and were uninsured (A: 14.2% vs. 9.6%; B: 14.8% vs. 10.2%). Additionally, more Black patients in A (38.2% vs. 18.2%) and B (42% vs. 18%) were from regions with fewer high school graduates and where the median income was in the lowest quartile (A: 45.2% vs. 18.3%; B: 48.8% vs. 19.4%). Black patients lived closer to treating hospitals and were more often seen at academic centers. Despite this, Black patients under 50 years presented more frequently with stage IV disease and were commonly from disadvantaged settings compared to White patients.</div></div><div><h3>Conclusions</h3><div>Interventions on social determinants such as education and income might address some of the disparities surrounding NSCLC in young Black patients.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 3","pages":"Pages 228-235"},"PeriodicalIF":3.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669380","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: Real-World Clinical Utility of Next-Generation Sequencing of Circulating Tumor DNA for Patients With Advanced Lung Squamous Cell Carcinoma (SQUIN)","authors":"Miguel García-Pardo ,&nbsp;Marta García de Herreros ,&nbsp;Juan Carlos Laguna ,&nbsp;Teresa Gorría ,&nbsp;Yolanda Lage ,&nbsp;Ana Gómez ,&nbsp;Mª Eugenia Olmedo ,&nbsp;Pilar Garrido ,&nbsp;Víctor Manuel Albarran-Artahona ,&nbsp;Ainara Arcocha ,&nbsp;Cristina Teixido ,&nbsp;Noemí Reguart ,&nbsp;Alejandro Navarro ,&nbsp;Edouard Auclin ,&nbsp;Mike S Nahorski ,&nbsp;Karen Howarth ,&nbsp;David Planchard ,&nbsp;Benjamin Besse ,&nbsp;Natasha B. Leighl ,&nbsp;Laura Mezquita","doi":"10.1016/j.cllc.2025.02.007","DOIUrl":"10.1016/j.cllc.2025.02.007","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>Plasma-based next generation sequencing (NGS) can identify clinically informative results in a meaningful proportion of patients with lung squamous cell carcinoma.</div></span></li><li><span>•</span><span><div>ESMO ESCAT tier I genomic alterations (ready for routine use; alteration-drug match associated with improved outcome in clinical trials) were found in 4% of patients.</div></span></li><li><span>•</span><span><div>Routine comprehensive molecular profiling, including plasma ctDNA NGS testing, may be considered in patients with lung squamous cell carcinoma.</div></span></li></ul></div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 4","pages":"Pages e300-e305.e2"},"PeriodicalIF":3.3,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596382","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":"Racial Diversity and Co-Mutational Analysis of Biologically Relevant Alterations in EGFR Mutant Lung Cancers","authors":"Radhika Gutta ,&nbsp;Emily Teslow ,&nbsp;Ellen Jaeger ,&nbsp;Melissa C. Stoppler ,&nbsp;Calvin Chao ,&nbsp;Fawzi Abu Rous ,&nbsp;Bindu Potguari ,&nbsp;Shirish Gadgeel","doi":"10.1016/j.cllc.2025.02.008","DOIUrl":"10.1016/j.cllc.2025.02.008","url":null,"abstract":"<div><h3>Background</h3><div><em>EGFR</em> alterations have significant therapeutic implications in lung cancer (LCa), yet their prevalence and co-mutational patterns in African American populations remain understudied. This study analyzes <em>EGFR</em>-mutant LCa across races using the Tempus database.</div></div><div><h3>Methods</h3><div>De-identified records sequenced via Tempus xT assay, (595 to 648 gene DNA panel) were included if they had ≥ 1 pathogenic EGFR mutation (short variants (SVs), copy number amplifications (CNAs), or fusions). Race was determined based on recorded clinical records. Co-mutations were restricted to genes with ≥ 5% frequency in at least 1 race. Statistical analyses were performed using chi-squared tests with Bonferroni or false discovery rate adjustments for multiple testing.</div></div><div><h3>Results</h3><div>Among 17,482 LCa samples, <em>EGFR</em> alterations occurred in 8.9% of CA, 7.6% of BAA, 39% of API, 15% of other races, and 12% of unknown races. Exon 19 deletions (<em>P</em> = .017) and L858R mutations (<em>P</em> &lt; .001) varied by race, with higher L858R frequency in CA compared to BAA (<em>P</em> = .034) and in API compared to CA (<em>P</em> = .006). <em>EGFR</em> copy number variants (CNVs) were highest in BAA (<em>P</em> &lt; .001). <em>TP53</em> alterations occurred at a higher frequency in patients with a history of smoking, those with high tumor mutational burden (TMB), and high PD-L1. <em>KMT2C</em> co-mutations were significantly more common in BAA (13%) compared to CA (3%) and API (4%) (<em>q</em> = 0.003). Similarly, <em>GLI1</em> co-mutations were most frequent in BAA (5.8%) compared to 1.5% in CA and 0% in API patients (<em>q</em> = 0.025).</div></div><div><h3>Conclusions</h3><div><em>EGFR</em> mutation subtypes and co-mutations differ by race. <em>KMT2C</em> may influence TMB and immunotherapy response, while <em>GLI1</em> is linked to TKI resistance. <em>TP53</em> alterations were more commen in smokers, and patients with high PDL-1 and TMB, highlighting additional factors that drive tumors with these alterations.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 4","pages":"Pages 307-313.e7"},"PeriodicalIF":3.3,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596386","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 PESGA Trial: A Prospective, Open-Label, Single-Arm, Phase II Study to Evaluate First Line Therapy for Extensive-Stage Small Cell Lung Cancer (ES-SCLC) Patients, Treated by Induction Carboplatin/Etoposide/Pembrolizumab Followed by Maintenance of Pembrolizumab/ Sacituzumab Govitecan","authors":"Laila C. Roisman,&nbsp;Shir Mann,&nbsp;Afifi Basel,&nbsp;Ranin Marei,&nbsp;Belal Krayim,&nbsp;Gleb Kornev,&nbsp;Noam Asna,&nbsp;Nir Peled","doi":"10.1016/j.cllc.2025.02.002","DOIUrl":"10.1016/j.cllc.2025.02.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite recent advances in immunotherapy combinations for extensive-stage small cell lung cancer (ES-SCLC), rapid disease progression following chemotherapy discontinuation remains a significant challenge. While the addition of pembrolizumab to platinum-etoposide has demonstrated a modest improvement in progression-free survival (PFS), there is an urgent need for more effective maintenance strategies. Sacituzumab govitecan (SG), an antibody-drug conjugate targeting Trop-2, has shown promising activity in pretreated ES-SCLC. This phase II study evaluates the efficacy and safety of adding SG to pembrolizumab maintenance therapy following chemoimmunotherapy induction in treatment-naïve ES-SCLC patients.</div></div><div><h3>Methods</h3><div>In the PESGA trial, a prospective, open-label, single-arm phase II trial, patients with previously untreated ES-SCLC will receive induction therapy consisting of pembrolizumab (200 mg Q3 W) plus carboplatin (AUC 5) and etoposide (100 mg/m² Days 1-3) for 4 cycles. This will be followed by maintenance therapy combining pembrolizumab (200 mg Q3 W) with SG (10 mg/kg on Days 1 and 8 of 21-day cycles) for up to 31 cycles. The primary endpoint is PFS from the start of induction treatment. Secondary endpoints include overall survival, duration of response, and safety. Exploratory analyses will investigate molecular resistance mechanisms through sequential liquid and tissue biopsies and evaluate correlations between tumor Trop-2 expression and clinical outcomes. The study plans to enroll 21 patients over 18 months, with an estimated total study duration of 54 months. Results will be analyzed after 50% of patients have achieved PFS.</div></div><div><h3>Conclusions</h3><div>The PESGA study design builds upon the KEYNOTE-604 regimen by incorporating SG into the maintenance phase, potentially addressing the challenge of early progression in ES-SCLC. The study may provide valuable insights into novel maintenance strategies and molecular mechanisms of treatment resistance in ES-SCLC.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 4","pages":"Pages 267-270"},"PeriodicalIF":3.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596408","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 Impact of Radiation Dose to Immune Cells in Stage IV Non-Small Cell Lung Cancer in the Era of Immunotherapy","authors":"Junyi He ,&nbsp;Yingxin Liu ,&nbsp;Xiaoqing Wang ,&nbsp;Ruiting Song ,&nbsp;Jingze Zhang ,&nbsp;Butuo Li ,&nbsp;Haohua Wang ,&nbsp;Jinming Yu ,&nbsp;Linlin Wang","doi":"10.1016/j.cllc.2025.02.006","DOIUrl":"10.1016/j.cllc.2025.02.006","url":null,"abstract":"<div><h3>Purpose</h3><div>Thoracic radiotherapy (RT) is now widely used in the treatment of advanced non-small cell lung cancer (NSCLC) as palliative, consolidative or radical therapy. However, RT adversely impacts the immune system, which can be evaluated by calculating the estimated dose of radiation to immune cells (EDRIC). We evaluated the prognostic impact of the EDRIC in patients with advanced NSCLC who received immunotherapy and thoracic RT.</div></div><div><h3>Methods</h3><div>We retrospectively enrolled 152 stage IV NSCLC patients who had received first-line immunotherapy and thoracic RT. EDRIC was a model developed by Jin et al., calculated using the number of radiotherapy fractions, mean lung dose, mean heart dose, and mean body dose. Spearman's rank correlation was used to assess the correlations between variables. The relationships of EDRIC (≥5.7 Gy vs. &lt;5.7 Gy) with survival were assessed using Kaplan-Meier and Cox proportional hazard models.</div></div><div><h3>Results</h3><div>The median PFS and OS were shorter in the EDRIC ≥ 5.7 Gy group (PFS: 10.2 months vs. 18.6 months, <em>P</em> &lt; .0001; OS: 19.8 months vs. 30.2 months, <em>P</em> = .024). In the multivariate model, higher EDRIC was associated with worse PFS (HR = 2.791, P &lt; .0001) and OS (HR = 1.823, P = .028). Additionally, bone metastasis was associated with worse OS (HR = 1.751, P = .022).</div></div><div><h3>Conclusion</h3><div>EDRIC was an independent predictor for PFS and OS in advanced NSCLC patients receiving immunotherapy and RT. These observations necessitate further exploration into techniques to optimize radiation exposure to the immune system in cancer treatment.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 3","pages":"Pages 221-227.e1"},"PeriodicalIF":3.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584963","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":"Nonbacterial Thrombotic Endocarditis (NBTE) Treated With Crizotinib in Lung Adenocarcinoma Harboring ROS-1 Rearrangement: Two Case Report and Review of Literature","authors":"Jesús Chamorro-Pérez ,&nbsp;Yolanda Lage ,&nbsp;Víctor Albarrán-Fernández ,&nbsp;Diana Isabel Rosero-Rodríguez ,&nbsp;Pilar Agudo ,&nbsp;Pablo Martínez-Vives ,&nbsp;María Eugenia Olmedo ,&nbsp;Ana Gómez-Rueda ,&nbsp;Miguel García-Pardo ,&nbsp;Pilar Garrido-López","doi":"10.1016/j.cllc.2025.02.005","DOIUrl":"10.1016/j.cllc.2025.02.005","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>Understanding nonbacterial endocarditis: the clinical suspicion of nonbacterial endocarditis (NBTE) should be raised in the presence of arterial embolic events in patients with highly thrombogenic tumors such as lung adenocarcinoma, the main cause of NBTE.</div></span></li><li><span>•</span><span><div>Association with ROS-1 rearrangements: patients with non-small cell lung cancer (NSCLC) carrying driver mutations have an elevated risk of thromboembolic events compared to those without them. These events can even serve as a sentinel sign of a possible relapse with a low disease burden.</div></span></li><li><span>•</span><span><div>Diagnostic approach: in case of clinical suspicion of NBTE, transthoracic echocardiography has a significant rate of false negatives, so a transesophageal echocardiogram is usually necessary.</div></span></li><li><span>•</span><span><div>Therapeutic approach and integration of targeted therapies: There are various scenarios in which cardiac surgery is indicated for endocarditis (such as neurological ischemic events or heart failure caused by valve failure). Regarding NBTE, the evidence in this regard is less solid, and the most relevant treatment is that of the underlying tumor. The use of targeted therapies against driver mutations in NSCLC offers a high rate of response, deep and rapid, which can also help achieve rapid control of complications derived from it that avoid performing invasive procedures with severe complications. This approach must always be discussed in a multidisciplinary board.</div></span></li></ul></div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 4","pages":"Pages e293-e299"},"PeriodicalIF":3.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584956","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":"Genomic Profiling of Driver Gene Alterations in Patients With Non–Small Cell Lung Cancer, Patterns of Treatment and Impact on Survival Outcomes: A Single Center Experience of More Than 1200 Patients","authors":"Minit Shah ,&nbsp;Vanita Noronha ,&nbsp;Vijay Patil ,&nbsp;Ajay Kumar Singh ,&nbsp;Nandini Menon ,&nbsp;Supriya Goud ,&nbsp;Srushti Shah ,&nbsp;Sucheta More ,&nbsp;Akhil Kapoor ,&nbsp;Bal Krishna Mishra ,&nbsp;Pratik Chandrani ,&nbsp;Anuradha Chougule ,&nbsp;Vinod Gupta ,&nbsp;Priyanka Pange ,&nbsp;Omshree Shetty ,&nbsp;Trupti Pai ,&nbsp;Rajiv Kaushal ,&nbsp;Subhash Yadav ,&nbsp;Moitrri Basu ,&nbsp;Deep Vora ,&nbsp;Kumar Prabhash","doi":"10.1016/j.cllc.2025.02.001","DOIUrl":"10.1016/j.cllc.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>The utility of Next-Generation-Sequencing (NGS) in patients of non–small-cell-lung-cancer (NSCLC) has led to an exponential increase in the identification of driver-gene alterations, however, Indian NGS data was lacking.</div></div><div><h3>Materials and Methods</h3><div>This retrospective study conducted between May’2019 and Dec’2023 included histologically confirmed NSCLC cases with NGS testing done on tissue and/or liquid biopsy samples prior to treatment initiation. We reported the frequency of driver-gene alterations, clinicopathological profile, treatment patterns, and outcomes [Overall-Survival (OS)].</div></div><div><h3>Results</h3><div>Data of 1230 patients was analyzed. Median age was 59 years (IQR,51-66), 65.3% (<em>n</em> = 803) were males, 34.6% (<em>n</em> = 426) had a history of smoking, and 78.1% (<em>n</em> = 961) had an adenocarcinoma histology. NCCN-recommended driver-gene alterations were seen in 64.8% (<em>n</em> = 797) cases. EGFR, ALK, ROS1, ERBB2, MET, RET, NTRK, BRAF and KRAS gene alterations were seen in 33.7% (<em>n</em> = 414), 7.6% (<em>n</em> = 94), 2.4% (<em>n</em> = 29), 6.1% (<em>n</em> = 75), 1.9% (<em>n</em> = 23), 2.2% (<em>n</em> = 22), 0.7% (<em>n</em> = 8), 3.3% (<em>n</em> = 40), and 9.6% (<em>n</em> = 118) cases respectively. 62.1% (<em>n</em> = 495/797) driver-positive patients could receive targeted therapy, and 21.7% (<em>n</em> = 94/433) driver-negative patients could receive immunotherapy. With the receipt of targeted therapy, median-OS of driver-positive patients was 26.7 months (95%CI, 23.3-32.7) versus 9.3 months (95%CI, 7.3-12.2, <em>P</em> &lt; .001) without. Similarly, in driver-negative patients, median OS with the receipt of immunotherapy was 16.4months (95%CI, 14.7-24.4) versus 11.5 months (95%CI, 9.0-13.4, <em>P</em> = .006) without.</div></div><div><h3>Conclusion</h3><div>All eligible NSCLC patients must undergo molecular testing by appropriately chosen and cost-effective methods at diagnosis. Wherever possible, this should be done by NGS. Efforts should focus on improving access to targeted agents in India, and developing cost-effective alternatives.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 4","pages":"Pages e270-e283"},"PeriodicalIF":3.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572387","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}