Clinical lung cancer最新文献

{"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 ,&nbsp;He Zhang ,&nbsp;Jianwen Sun ,&nbsp;Lihua Wang ,&nbsp;Maomei Ruan ,&nbsp;Hui Yan ,&nbsp;Aimi Zhang ,&nbsp;Cheng Chang ,&nbsp;Hao Yang ,&nbsp;Gang Huang ,&nbsp;Liu Liu ,&nbsp;Wenhui Xie","doi":"10.1016/j.cllc.2024.11.001","DOIUrl":"10.1016/j.cllc.2024.11.001","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Materials and Methods</h3><div>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.</div></div><div><h3>Results</h3><div>High SUVs, TLG, and MTV were associated with postoperative progression of NSCLC (the area under the ROC curve: 0.695 to 0.750, <em>P</em> &lt; .001). The increase of SUVs, TLG or MTV was associated with short postoperative PFS (<em>P</em> &lt; .001) while an increase in TLG (<em>P</em> = .016) or MTV (<em>P</em> = .018) was associated with short postoperative OS. TLG &gt; 16.81 was an independent indicator of both the short PFS (HR = 5.534, <em>P</em> = .002) and the short OS (HR = 5.075, <em>P</em> = .031). Further, adjuvant chemotherapy was associated with longer PFS in NSCLCs with TLG &gt; 16.81 (treated vs. untreated: 63 vs. 52 months; HR = 2.242, <em>P</em> = .022) rather than those with TLG ≤ 16.81.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 1","pages":"Pages 18-28.e6"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","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":"Multicentre Validation of the RESECT-90 Prediction Model for 90-Day Mortality After Lung Resection","authors":"Marcus Taylor ,&nbsp;Glen P. Martin ,&nbsp;Udo Abah ,&nbsp;Michael Shackcloth ,&nbsp;Felice Granato ,&nbsp;Richard Booton ,&nbsp;Aman Coonar ,&nbsp;Stuart W. Grant ,&nbsp;RESECT-90 collaborators","doi":"10.1016/j.cllc.2024.10.005","DOIUrl":"10.1016/j.cllc.2024.10.005","url":null,"abstract":"<div><h3>Background</h3><div>The RESECT-90 model was developed to predict 90-day mortality for patients undergoing lung resection but hasn't been externally validated. The aim of this study was to validate the RESECT-90 clinical prediction model using multicentre patient data from across the United Kingdom (UK).</div></div><div><h3>Materials and Methods</h3><div>Data from 12 UK thoracic surgery centers for patients undergoing lung resection between 2016 and 2020 with available 90-day mortality status were used to externally validate the RESECT-90 model. Measures of discrimination (area under the receiving operator characteristic curve [AUC]) and calibration (calibration slope, calibration intercept and flexible calibration plot) were assessed as measures of model performance. Model recalibration was also performed by updating the original model intercept and coefficients.</div></div><div><h3>Results</h3><div>A total of 12,241 patients were included. Overall 90-day mortality was 2.9% (<em>n</em> = 360). Acceptable model discrimination was demonstrated (AUC 0.74 [0.73, 0.75]). Calibration varied between centers with some evidence of overall model miscalibration (calibration slope 0.80 [0.66, 0.95] and calibration intercept 0.40 [0.29, 0.52]) despite acceptable appearances of the flexible calibration plot. The model was subsequently recalibrated, after which all measures of calibration indicated excellent performance.</div></div><div><h3>Conclusions</h3><div>After external validation and recalibration using a large contemporary cohort of patients undergoing surgery in multiple geographical locations across the UK, the RESECT-90 model demonstrated satisfactory statistical performance for the prediction of 90-day mortality after lung resection. Whilst the recalibrated model will require ongoing validation, the results of this study suggest that routine use of the RESECT-90 model in UK thoracic surgery practice should be considered.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 1","pages":"Pages e73-e80"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567657","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":"Augmenting Prognostication: Utilizing Activity Trackers to Enhance Survival Prediction in Metastatic Non-Small Cell Lung Cancer","authors":"Yeonjung Jo ,&nbsp;Sonam Puri ,&nbsp;Benjamin Haaland ,&nbsp;Adriana M. Coletta ,&nbsp;Jonathan J. Chipman ,&nbsp;Kelsey Embrey ,&nbsp;Kathleen C. Kerrigan ,&nbsp;Shiven B. Patel ,&nbsp;Kelly Moynahan ,&nbsp;Matthew Gumbleton ,&nbsp;Wallace L. Akerley","doi":"10.1016/j.cllc.2024.10.001","DOIUrl":"10.1016/j.cllc.2024.10.001","url":null,"abstract":"<div><h3>Introduction/Background</h3><div>Prognostication by performance status (PS) assessment is a fundamental element of treatment decisions and clinical trial design in oncology, but it is limited by subjectivity and potential miscommunication between patient, physician, and family. Activity tracker offers the potential to collect a broad range of patient-generated data to supplement the assessment of PS.</div></div><div><h3>Patients and Methods</h3><div>Patients with metastatic NSCLC (mNSCLC) participated in a single institute, prospective, observational feasibility study conducted at Huntsman Cancer Institute. Patients were given a Fitbit® activity tracker, which collects their steps taken, distance moved, heart rate, and activity intensity. At baseline, PS was assessed by physicians and patients, and demographics and clinical data were collected. We defined novel indices of health: Heart rate Activity zone Mismatch (HAM) and excessive Sedentary Heart Rate (eSHR). We used multivariable Cox proportional hazards models adjusted for age, sex, and treatment line to estimate and test the prognostic ability of clinical and fitness metrics on overall survival (OS). Each prognostic model was evaluated using Harrell's concordance index (C-index).</div></div><div><h3>Results</h3><div>Fifty-five patients with mNSCLC were enrolled. The median OS was 10.4 months (95% CI: 7.2, 15.2). PS-physician (HR = 2.0; <em>P</em> &lt; .001) and Fitbit metrics were associated with OS, including daily total steps (1,000-steps) (HR = 0.8; <em>P</em> = .004), HAM (HR = 2; <em>P</em> = .02), eSHR (HR = 0.3; <em>P</em> = .001). The prognostic model that includes PS-physician was associated with the best concordance (C-index = 0.75), followed by daily total distance (C-index = 0.74) and steps (C-index = 0.73)</div></div><div><h3>Conclusions</h3><div>Tracker-based measures were prognostic of survival in mNSCLC and may be useful as a supplement or alternative to PS in practice and clinical trials.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 1","pages":"Pages 29-38"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686026","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: Phase II Clinical Trial of Atezolizumab in Advanced Nonsmall Cell Lung Cancer Patients Previously Treated With PD-1-Directed Therapy","authors":"Dylan Fortman ,&nbsp;Hong Wang ,&nbsp;Robert VanderWeele ,&nbsp;Terry Evans ,&nbsp;James G. Herman ,&nbsp;John Rhee ,&nbsp;Vincent Reyes ,&nbsp;Brian McLaughlin ,&nbsp;Antoinette Wozniak ,&nbsp;Ashwin Somasundaram ,&nbsp;Tarek Mekhail ,&nbsp;Mark A. Socinski ,&nbsp;Katja Schulze ,&nbsp;Liza C. Villaruz","doi":"10.1016/j.cllc.2024.10.014","DOIUrl":"10.1016/j.cllc.2024.10.014","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>There are limited prospective data evaluating the sequencing of anti-PD-L1 therapy after prior anti-PD-1 therapy in advanced NSCLC.</div></span></li><li><span>•</span><span><div>In patients with prior progression of immune checkpoint inhibition (ICI), primary resistance is defined as progressive or stable disease lasting less than 6 months after at least 2 cycles of ICI therapy, and secondary resistance is defined as an initial benefit of at least 6 months of ICI followed by progressive disease.</div></span></li><li><span>•</span><span><div>In the current study, atezolizumab was associated with a response rate of 11.8% amongst patients with prior progression on nivolumab and pembrolizumab, 0% amongst patients with prior stable disease on nivolumab or pembrolizumab and 12.5% amongst patients with prior partial or complete response to nivolumab or pembrolizumab.</div></span></li><li><span>•</span><span><div>Based on the data in the current study, a response rate of 10% may be considered the baseline activity of ongoing checkpoint inhibition in the immunotherapy experienced NSCLC population.</div></span></li></ul></div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 1","pages":"Pages 78-81"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Primary Care Providers in Lung Cancer Screening: A Cross-Sectional Survey","authors":"Lye-Yeng Wong ,&nbsp;Ntemena Kapula ,&nbsp;Augustine Kang ,&nbsp;Anuradha J. Phadke ,&nbsp;Andrew D. Schechtman ,&nbsp;Irmina A. Elliott ,&nbsp;Brandon A. Guenthart ,&nbsp;Douglas Z. Liou ,&nbsp;Leah M. Backhus ,&nbsp;Mark F. Berry ,&nbsp;Joseph B. Shrager ,&nbsp;Natalie S. Lui","doi":"10.1016/j.cllc.2024.10.002","DOIUrl":"10.1016/j.cllc.2024.10.002","url":null,"abstract":"<div><h3>Background</h3><div>Multidisciplinary lung cancer screening (LCS) programs that perform shared decision-making visits (SDMV) and follow up annual low dose computed tomography (LDCT) have been emerging. We hypothesize that primary care providers (PCPs) prefer to refer patients to LCS programs instead of facilitating the screening process themselves.</div></div><div><h3>Methods</h3><div>This is a mixed-methods, cross-sectional study in which an online survey was administered to PCPs between April 2023 and June 2023.</div></div><div><h3>Results</h3><div>58 PCPs in the same hospital network participated in the study with a median age of 43 (34-51), predominance of women (77.6%), and clinicians of white and Asian race (44.8% and 48.3%). Respondents estimated that 26.1% (SD 32.4%) of their eligible patients participate in LCS screening. PCPs thought that an LCS program was equally convenient to performing screening themselves for identifying eligible patients and ordering LDCT. However, 63.8% of participants preferred an LCS program for performing SDMVs, 62.1% for ensuring annual follow-up on negative LDCTs, 70.7% for deciding next steps on positive LDCTs, and 60.4% for performing smoking cessation counseling. PCPs agreed that an LCS program saves time (69%), allows patients to receive specialty care (65.6%), addresses patient concerns (70.7%), ensures annual follow-up (77.6%), and manages abnormal findings (79.3%). However, they also expressed concerns about an additional visit for the patient (48.2%) and patient cost (46.5%).</div></div><div><h3>Conclusion</h3><div>Most PCPs believe that formal LCS programs have many benefits including providing specialized care and follow up, although there were concerns about patient time and cost.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 1","pages":"Pages 39-44"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544153","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":"Comparison of Sublobar Resection and Proton Therapy for Early-Stage Non–small Cell Lung Cancer","authors":"Tadashi Sakane ,&nbsp;Koichiro Nakajima ,&nbsp;Hiromitsu Iwata ,&nbsp;Keisuke Hioki ,&nbsp;Emi Hagui ,&nbsp;Shuou Sudo ,&nbsp;Yusuke Tsuzuki ,&nbsp;Kento Nomura ,&nbsp;Yukiko Hattori ,&nbsp;Hiroyuki Ogino ,&nbsp;Hiroshi Haneda","doi":"10.1016/j.cllc.2024.12.012","DOIUrl":"10.1016/j.cllc.2024.12.012","url":null,"abstract":"<div><h3>Background</h3><div>For early-stage lung cancer, sublobar resection (SLR) is an alternative to lobectomy, which is the standard treatment. Recently, proton therapy (PT) is being increasingly used, even in patients with operable lung cancer, as an attractive alternative to conventional radiation therapy. Thus, we performed propensity score matching (PSM) to compare the outcomes of SLR and PT in patients with early-stage non–small cell lung cancer (NSCLC).</div></div><div><h3>Patients and Methods</h3><div>A total of 202 patients with histologically confirmed clinical stage 0 or I peripheral NSCLC who underwent SLR or PT at our institution between July 2013 and December 2021 were included in the study. PSM was performed to adjust for confounding effects.</div></div><div><h3>Results</h3><div>PSM generated a cohort of 104 patients who were treated with SLR (<em>n</em> = 52) or PT (<em>n</em> = 52). We observed no significant differences in overall survival (OS) (<em>P</em> = .77), cause-specific survival (<em>P</em> = .43), recurrence-free survival (RFS) (<em>P</em> = .35), local tumor control (<em>P</em> = .51), regional lymph node tumor control (<em>P</em> = .99), and distant tumor control (<em>P</em> = .37). The 5-year OS and 5-year RFS were 85.2% and 73.7%, respectively, in the SLR group and 83.4% and 70.2%, respectively, in the PT group.</div></div><div><h3>Conclusion</h3><div>This study demonstrated no significant differences in the prognosis or tumor control efficacy between SLR and PT in patients with histologically confirmed clinical stage 0 or I peripheral NSCLC. Further studies are warranted to clarify the comparative effectiveness of SLR and PT across various patient risk strata.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 3","pages":"Pages e181-e189.e1"},"PeriodicalIF":3.3,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001324","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":"Phase I Clinical Trial of Autologous Hematopoietic Stem Cell Transplantation-Supported Dose-Intensified Chemotherapy With Adebrelimab as First-Line Treatment for Extensive-Stage Small Cell Lung Cancer","authors":"Ming Liu ,&nbsp;Wenhui Guan ,&nbsp;Xiaohong Xie ,&nbsp;Zekun Li ,&nbsp;Guihuan Qiu ,&nbsp;Xinqing Lin ,&nbsp;Zhanhong Xie ,&nbsp;Jiexia Zhang ,&nbsp;Yinyin Qin ,&nbsp;Zhenqian Huang ,&nbsp;Xin Xu ,&nbsp;Chengzhi Zhou","doi":"10.1016/j.cllc.2024.12.013","DOIUrl":"10.1016/j.cllc.2024.12.013","url":null,"abstract":"<div><h3>Background</h3><div>Small cell lung cancer (SCLC) is initially highly sensitive to chemotherapy, which often leads to significant tumor reduction. However, the majority of patients eventually develop resistance, and the disease is further complicated by its “cold” tumor microenvironment, characterized by low tumor immunogenicity and limited CD8+ <em>T</em> cell infiltration. These factors contribute to the poor response to immunotherapy in many cases of extensive-stage SCLC (ES-SCLC). High-dose chemotherapy has shown potential in enhancing tumor cytoreduction, but its use is often limited by severe hematologic toxicity. Combining chemotherapy with immune checkpoint inhibitors (ICIs) can create a synergistic effect by promoting immunogenic cell death and enhancing immune activation. Autologous hematopoietic stem cell transplantation (auto-HSCT) provides a means to support hematopoietic recovery, mitigate chemotherapy-induced myelosuppression, and contribute to immune reconstitution. In this context, the integration of auto-HSCT with dose-intensified chemotherapy and ICIs aims to both protect the bone marrow and enhance antitumor immune responses, potentially overcoming resistance to immunotherapy in ES-SCLC.</div></div><div><h3>Methods</h3><div>A phase I, single-center, single-arm trial was designed to evaluate the safety and efficacy of auto-HSCT-supported dose-intensified chemotherapy combined with adebrelimab in treatment-naive ES-SCLC patients. Participants will receive induction chemotherapy followed by stem cell mobilization, apheresis, and cryopreservation. After successful mobilization, consolidation chemotherapy with stem cell reinfusion and granulocyte colony-stimulating factor (G-CSF) support will be performed. Maintenance therapy with adebrelimab continues until disease progression or unacceptable toxicity. Safety and efficacy data, including adverse events, objective response rate (ORR), progression-free survival (PFS), and overall survival (OS), will be analyzed.</div></div><div><h3>Results</h3><div>The study aims to enhance treatment outcomes by overcoming resistance to immuno-chemotherapy and promoting immune reconstitution. The trial is ongoing at the First Affiliated Hospital of Guangzhou Medical University.</div></div><div><h3>Trial Registration</h3><div>ClinicalTrials.gov Identifier: NCT06597513.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 3","pages":"Pages e236-e241"},"PeriodicalIF":3.3,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028144","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":"Prognostic Analysis of Pathological Stage I Lung Adenocarcinoma Harboring Major EGFR Mutations","authors":"Shinkichi Takamori ,&nbsp;Makoto Endo ,&nbsp;Akira Hamada ,&nbsp;Shuta Ohara ,&nbsp;Shota Fukuda ,&nbsp;Yasuaki Tomioka ,&nbsp;Satoshi Takamori ,&nbsp;Atsushi Osoegawa ,&nbsp;Kotaro Nomura ,&nbsp;Kosuke Fujino ,&nbsp;Mao Yoshikawa ,&nbsp;Ken Suzawa ,&nbsp;Kazuhiko Shien ,&nbsp;Kenichi Suda ,&nbsp;Fumihiko Kinoshita ,&nbsp;Kazuki Hayasaka ,&nbsp;Hirotsugu Notsuda ,&nbsp;Taichi Nagano ,&nbsp;Kyoto Matsudo ,&nbsp;Asato Hashinokuchi ,&nbsp;Mototsugu Shimokawa","doi":"10.1016/j.cllc.2024.12.011","DOIUrl":"10.1016/j.cllc.2024.12.011","url":null,"abstract":"<div><h3>Background</h3><div>While <em>Epidermal growth factor receptor</em> (<em>EGFR</em>) mutation-positive lung adenocarcinoma (LUAD) has favorable outcomes with targeted therapy, early-stage prognosis remains influenced by pathological factors and central nervous system (CNS) recurrence. The study aimed to clarify prognostic factors in pathological stage (pStage) I <em>EGFR</em> mutation-positive LUAD.</div></div><div><h3>Methods</h3><div>Between 2015 and 2018, 2,191 pStage I LUAD cases with known <em>EGFR</em> status (excluding <em>EGFR</em> testing after recurrence) who received anatomical resection were included from multiple institutions in Japan. Univariate and multivariate analyses of disease-free survival (DFS) and overall survival (OS) were performed.</div></div><div><h3>Results</h3><div>1,073 (49.0%) cases harbored <em>EGFR</em> mutations, including 419 (19.1%) with <em>19del</em> and 529 (24.1%) with <em>L858R</em>. In cases with major <em>EGFR</em> mutation (<em>n</em> = 948), multivariate analysis showed that the absence of noninvasive area (NIA) (hazard ratio [HR]: 1.778, 95% confidence interval [CI]: 1.174-2.692, <em>P</em> = .0065), pStage (IA2 vs. IA1, HR: 2.079, 95% CI: 1.129-3.827, <em>P</em> = .0345; IA3 vs. IA1, HR: 4.009, 95% CI: 2.088-7.696, <em>P</em> = .0001; IB vs. IA1, HR: 5.280, 95% CI: 2.871-9.709, <em>P</em> &lt; .0001), and presence of lymphatic invasion (HR: 1.855, 95% CI: 1.103-3.119, <em>P</em> = .0197) were independent predictors of shorter DFS, and only advanced pStage was an independent predictor of CNS recurrence (relative risk for pStage IA3 or more: 9.729, <em>P</em> &lt; .0001).</div></div><div><h3>Conclusion</h3><div>In <em>EGFR</em> mutation-positive pStage I LUAD, those without NIA, with higher pStage and lymphatic invasion were independent predictive factors for DFS, and pStage ≥ IA3 was an independent predictor of CNS recurrence.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 3","pages":"Pages e172-e180.e5"},"PeriodicalIF":3.3,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001368","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":"Surgical and Pathological Results Following Neoadjuvant Nivolumab and Platinum-Based Chemotherapy for Locally Advanced Resectable NSCLC: A Multicentre Real-World Series From England","authors":"Alessandro Brunelli ,&nbsp;Ross Hoffman ,&nbsp;Robin Wotton ,&nbsp;Shobhit Baijal ,&nbsp;Pooja Bhatnagar ,&nbsp;Katy Clarke ,&nbsp;Carles Escriu ,&nbsp;Omar Fakih ,&nbsp;Kevin Franks ,&nbsp;Joshil Lodhia ,&nbsp;Marco Nardini ,&nbsp;Babu Naidu ,&nbsp;Michael Shackcloth","doi":"10.1016/j.cllc.2024.12.010","DOIUrl":"10.1016/j.cllc.2024.12.010","url":null,"abstract":"<div><h3>Background</h3><div>To evaluate the real-world surgical and pathological outcomes following neoadjuvant nivolumab in combination with chemotherapy in a multicentre national cohort of patients.</div></div><div><h3>Methods</h3><div>Retrospective analysis on consecutive patients treated in three tertiary referral hospitals in UK with neoadjuvant chemotherapy and immunotherapy (nivolumab) for stage II-IIIB nonsmall cell lung cancer (March 2023-May 2024). Surgical and pathological outcomes were assessed.</div></div><div><h3>Results</h3><div>130 patients started neoadjuvant treatment. 121 patients (93.1%) were able to proceed to surgery. 62% of patients had surgery more than 6 weeks after completion of the last neoadjuvant cycle. 91 operations (75.2%) were started using a minimally invasive approach with a conversion rate of 18.7%. The most frequent resection was lobectomy in 85% of patients. 30- and 90-days postoperative mortality rates were 3.3% and 5.8%.</div><div>The pCR occurred in 38 patients (31.4% of the surgical patients), MPR in 57 patients (47.1% of the surgical patients). The incidence of pCR (<em>P</em> = .90) and MPR (<em>P</em> = .66) were similar in patients with clinical stage II and III. pCR rate was higher in patients with PD-L1 ≥50% compared to those with PD-L1 &lt;50% (41.9% vs. 25.6%, <em>P</em> = .066). A higher pCR (44.7% vs. 23%, <em>P</em> = .012) and MPR (66% vs. 35.1%, <em>P</em> = .001) in squamous vs. non-squamous histology tumors.</div></div><div><h3>Conclusions</h3><div>The use of neoadjuvant chemo-ICI in the real clinical practice is safe and effective. The pathological response rates parallel those reported in trials and appear consistent across stages. Our findings provide real world data from a public healthcare system which will be valuable to inform multidisciplinary treatment selection for locally advanced resectable NSCLC.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 3","pages":"Pages 253-261"},"PeriodicalIF":3.3,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001376","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":"Radiation Induced Unilateral Vocal Fold Paralysis Following Lung Stereotactic Ablative Radiation Therapy: A Case Report and Review of the Literature","authors":"Adam Raffi Guemidjian,&nbsp;Cari L. Wright,&nbsp;Megan E. Daly","doi":"10.1016/j.cllc.2024.12.006","DOIUrl":"10.1016/j.cllc.2024.12.006","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>Peripheral neuropathies following thoracic SABR have only rarely been described in the literature.</div></span></li><li><span>•</span><span><div>Treatment of left upper lobe tumors in close proximity to the course of the vagal or recurrent laryngeal nerves poses risk of unilateral vocal cord paralysis.</div></span></li><li><span>•</span><span><div>The vagal and recurrent laryngeal nerves should be prospectively contoured and constrained when treating tumors in close proximity with high dose SABR.</div></span></li></ul></div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 3","pages":"Pages e150-e153"},"PeriodicalIF":3.3,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001370","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}