Clinical lung cancer最新文献

{"title":"Gefitinib Resensitization After a TKI-Free Interval in Osimertinib Resistant Non–Small-Cell Lung Cancer: A Glimpse of Hope in Time of Crisis?","authors":"","doi":"10.1016/j.cllc.2024.06.003","DOIUrl":"10.1016/j.cllc.2024.06.003","url":null,"abstract":"<div><p></p><ul><li><span>•</span><span><p>After osimertinib<span> resistance some patients are still sensitive to EGFR blockage.</span></p></span></li><li><span>•</span><span><p>Gefitinib rechallenge seems effective after a TKI-free interval.</p></span></li><li><span>•</span><span><p><span>Liquid biopsy can track clonal evolution of </span><em>EGFR</em> mutated NSCLCs.</p></span></li><li><span>•</span><span><p>Detection of EGFR mutations on ctDNA can identify patients for this strategy.</p></span></li></ul></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141401317","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 Emerging Role of Immune Checkpoint Blockade for the Treatment of Lung Cancer Brain Metastases","authors":"","doi":"10.1016/j.cllc.2024.06.004","DOIUrl":"10.1016/j.cllc.2024.06.004","url":null,"abstract":"<div><p><span>Lung cancer has the highest incidence of brain metastases (BM) among solid organ cancers. Traditionally </span>whole brain radiation therapy<span><span><span> has been utilized for non–small-cell lung cancer (NSCLC) BM treatment, although stereotactic radiosurgery<span> has emerged as the superior treatment modality for most patients. Highly penetrant central nervous system<span><span> (CNS) tyrosine kinase inhibitors have also shown significant CNS activity in patients harboring select oncogenic drivers. There is emerging evidence that patients without oncogene-driven tumors derive benefit from the use of </span>immune checkpoint inhibitors<span><span> (ICIs). The CNS activity of ICIs have not been well studied given exclusion of patients with active BM from landmark trials, due to concerns of inadequate CNS penetration and activity. However, studies have challenged the idea of an immune-privileged CNS, given the presence of functional lymphatic drainage within the CNS and destruction of the </span>blood brain barrier by BM. An emerging understanding of the interactions between tumor and CNS </span></span></span></span>immune cells<span><span> in the BM tumor microenvironment also support a role for </span>immunotherapy in BM treatment. In addition, posthoc analyses of major trials have shown improved intracranial response and survival benefit of regimens with ICIs over chemotherapy (CT) alone for patients with BM. Two prospective phase 2 trials evaluating </span></span>pembrolizumab<span><span> monotherapy and </span>atezolizumab plus CT in patients with untreated NSCLC BM also demonstrated significant intracranial responses. This review describes the interplay between CNS immune cells and tumor cells, discusses current evidence for ICI CNS activity from retrospective and prospective studies, and speculates on future directions of investigation.</span></span></p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141406353","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":"Surgery and Stereotactic Radiotherapy for Stage I Small-Cell Lung Carcinoma: A 25-Year Experience","authors":"","doi":"10.1016/j.cllc.2024.06.001","DOIUrl":"10.1016/j.cllc.2024.06.001","url":null,"abstract":"<div><h3>Objectives</h3><p>Small-cell lung carcinoma (SCLC) is usually a wide-spread, highly-lethal malignancy but occasionally presents as localized, limited stage cancer amenable to local treatment. We reviewed our experience using surgery or stereotactic body radiotherapy (SBRT) to assess safety, survival rates and treatment toxicity in clinical stage I SCLC patients.</p></div><div><h3>Materials and Methods</h3><p>Electronic medical records of patients with clinical stage I lymph node-negative SCLC who underwent surgical resection or SBRT between 1996 and 2021 were retrospectively reviewed. A multivariable Cox Proportional Hazards model was constructed.</p></div><div><h3>Results</h3><p>Of 96 patients meeting inclusion criteria, 77 underwent resection and 19 underwent SBRT. Surgical patients were younger (mean 68.4 ± 9.2 years surgery versus 74.3 ± 6.6 years SBRT, <em>P</em> = .005) and had better pulmonary function (81.5 ± 19.6 FEV1% of predicted surgery versus 44.0 ± 20.9% SBRT, <em>P</em> &lt; .001). SBRT patients had significantly more comorbidities. For both cohorts, 59 tumors were pure SCLC and 37 were mixed SCLC/NSCLC histology. Median survivals were 21 months versus 31 months for SBRT and surgery patients respectively (<em>P</em> = .07). There were no treatment-related mortalities. Mean length of hospital stay for surgical patients was 5.4 ± 5.7 days. Survival was longer in lymph node-negative surgery patients (median 48 months node-negative versus 19 months node-positive, <em>P</em> = .04). For node-negative-surgery patients, the estimated 2- and 5-year survival rates are 60% and 48%.</p></div><div><h3>Conclusions</h3><p>Our single-institutional experience over 25 years demonstrates that local treatment with surgery or SBRT for clinical stage I SCLC is safe and effective, with survivals lower than similar stage non–small-cell carcinoma patients. However, our results compare favorably with prior small-cell surgical series and far better than reported results of chemoradiotherapy for similar stage patients, thereby validating current recommendations for employing surgery or SBRT for stage I SCLC.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1525730424001104/pdfft?md5=2719331e3ee9daf272c5902b07058ecd&pid=1-s2.0-S1525730424001104-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141405878","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 design for a phase II, randomized, multicenter study of ctDNA-guided treatment with furmonertinib combined therapy or furmonertinib alone for untreated advanced EGFR mutant non-small cell lung cancer patients: The FOCUS-C study","authors":"Yaxiong Zhang, Zihong Chen, Gang Chen, Yan Huang, Yunpeng Yang, W. Fang, Li Zhang","doi":"10.1016/j.cllc.2024.06.002","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.06.002","url":null,"abstract":"","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141399561","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":"Patients' Preferences for Adjuvant Osimertinib in Non–Small-Cell Lung Cancer After Complete Surgical Resection: What Makes It Worth It to Patients?","authors":"","doi":"10.1016/j.cllc.2024.05.003","DOIUrl":"10.1016/j.cllc.2024.05.003","url":null,"abstract":"<div><h3>Background</h3><p><span>The ADAURA trial confirmed adjuvant Osimertinib's efficacy in EGFR-mutated Non–small-cell lung cancer (NSCLC), yet the limited mature </span>overall survival<span><span> (OS) data at approval poses a challenge. This study explores patient preferences in the </span>absence of complete OS information, hypothesizing that disease-free survival (DFS) benefit alone may influence adjuvant Osimertinib pursuit.</span></p></div><div><h3>Methods</h3><p>At Roswell Park Comprehensive Cancer Center (Jan-Dec 2021), patients assessed for adjuvant therapy received a survey probing OS and DFS preferences. Scenarios were (a) minimum OS justifying Osimertinib, (b) minimum DFS improvement justifying 3-years of adjuvant Osimertinib, (c) minimum 5-year DFS percent change, and (d) minimum OS justifying copay changes. Results were analyzed.</p></div><div><h3>Results</h3><p>Of 524 NSCLC patients, 51 participated. Scenario 1 saw 56% requiring a 12-month OS benefit for Osimertinib justification. In scenario 2, 72% deemed a 12-month DFS benefit sufficient. Scenario 3 revealed 31% opting out despite a 10% OS increase. Scenario 4 showed varied willingness to pay, with 33% unwilling to any shoulder copayment even with a 10-year OS benefit.</p></div><div><h3>Conclusion</h3><p>This study explores patient preferences without complete OS data, revealing diverse thresholds. Factors include employment, education, and willingness to pay. Findings underscore shared decision-making importance. Limitations include sample size, potential biases, and regional focus; larger cohorts are needed for validation.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327247","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":"Clinicopathological Features and Survival Outcomes of Resected Lung Adenosquamous Carcinoma: Results From a Nationwide Japanese Registry Data","authors":"","doi":"10.1016/j.cllc.2024.05.010","DOIUrl":"10.1016/j.cllc.2024.05.010","url":null,"abstract":"<div><h3>Objectives</h3><p>The objective of this study was to clarify the clinicopathological features and prognostic factors of resected lung adenosquamous carcinoma (ASC) using a nationwide multi-institutional database.</p></div><div><h3>Methods</h3><p>We retrospectively reviewed the records of 15,542 patients who underwent complete R0 resection for ASC (n = 326), adenocarcinoma (AC, n = 11,820), or squamous cell carcinoma (SC, n = 3396) from a Japanese lung cancer registry in 2010. To reduce the selection bias, an inverse probability of treatment weighting (IPTW) method using a propensity score was implemented.</p></div><div><h3>Results</h3><p>The ASC group showed worse recurrence-free and overall survival (RFS and OS) than both the AC and SC groups (5-year OS: 57.5% in ASC, 83.9% in AC [&lt; 0.001], and 62.3% in SC [<em>P</em> = .086]). In multivariate analyses, prognostic factors that affected OS for ASC included male, p-stage II-III, and postoperative complications within 30 days (grade ≥ 3 in the Clavien–Dindo classification). The sensitizing <em>EGFR</em> mutation was detected in 28 (21.5%) of 130 screened patients with ASC, but it did not affect either RFS, OS, or postrecurrence survival. Although more patients in the ASC group received adjuvant chemotherapy compared to the AC and SC groups, both multivariate and IPTW-adjusted analyses did not show positive impact of adjuvant chemotherapy on RFS and OS in ASC.</p></div><div><h3>Conclusions</h3><p>In this nationwide registry study, lung ASC was more aggressive than both AC and SC. No apparent survival impact of conventional adjuvant chemotherapy prompted us to investigate novel adjuvant strategies to optimize survival outcomes.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1525730424001074/pdfft?md5=6c89cecd835bca966a9b78547b6e0efa&pid=1-s2.0-S1525730424001074-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141436348","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":"Tepotinib in a Patient With Advanced Non-Small Cell Lung Cancer Harboring MET Exon 14 Skipping Undergoing Concomitant Hemodialysis for Renal Failure: A Case Report","authors":"","doi":"10.1016/j.cllc.2024.05.008","DOIUrl":"10.1016/j.cllc.2024.05.008","url":null,"abstract":"<div><p></p><ul><li><span>•</span><span><p>Tepotinib, a potent, highly selective, once-daily, oral MET tyrosine kinase inhibitor, is approved in multiple countries for the treatment of advanced/metastatic <em>MET</em>ex14 skipping NSCLC and can be used in patients with mild-moderate renal impairment without dose adjustment. However, data in severe renal impairment are lacking.</p></span></li><li><span>•</span><span><p>We report the feasibility of using the standard dose of tepotinib (500 mg; 450 mg active moiety) in a patient with advanced <em>MET</em>ex14 skipping NSCLC with end-stage renal disease undergoing hemodialysis, who attained disease control, with only mild adverse events that did not necessitate dose adjustment.</p></span></li><li><span>•</span><span><p>Use of the standard dose was supported by tepotinib plasma concentration measurements, which fell within the expected range for a typical patient with NSCLC predicted using a population pharmacokinetic model and indicated no clinically relevant drug loss during dialysis.</p></span></li></ul></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1525730424001098/pdfft?md5=14101f14756f4deae6004a00cbe71a77&pid=1-s2.0-S1525730424001098-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141509304","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":"Routes to Diagnosis in Danish Lung Cancer Patients: Emergency Presentation, Age and Smoking History-A Population-Based Cohort Study.","authors":"Niels Lyhne Christensen, Anja Gouliaev, Sean McPhail, Georgios Lyratzopoulos, Torben Riis Rasmussen, Henry Jensen","doi":"10.1016/j.cllc.2024.05.009","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.05.009","url":null,"abstract":"<p><strong>Background: </strong>The fast-track cancer pathway aims to expedite diagnosis of lung cancer and treatment and is the preferred route to diagnosis. Diagnosis following an unplanned admission (unplanned route) has been associated with poor outcomes.</p><p><strong>Objective: </strong>This study explores factors associated with lung cancer diagnosis following unplanned admissions, focusing on the elderly population.</p><p><strong>Methods: </strong>A retrospective cohort study using population-based data from Danish registries. Factors such as age, comorbidity, performance status, smoking history, socioeconomic parameters and treatment modality were analyzed in relation to route to diagnosis and prognosis.</p><p><strong>Results: </strong>Among 17,835 patients, 16% were elderly (≥ 80 years). The unplanned route constituted 28% of diagnostic routes, with higher proportion among the elderly (33%). Poor performance status and advanced disease stage were associated with the unplanned route. Married patients were less likely to undergo an unplanned route to diagnosis. Smoking did not significantly influence diagnostic route. The adjusted odds ratio for curative treatment and dying 12 months after diagnosis, following unplanned route to diagnosis were 0.68 (95% CI, 0.61-0.76) and 1.48 (95% CI, 1.36-1.61), respectively.</p><p><strong>Conclusion: </strong>Frailty (poor performance status and high burden of comorbidity) in addition to unfavorable socioeconomic factors, which all were more prevalent among elderly patients, were associated with undergoing an unplanned route to diagnosis. However, age itself was not. Diagnosis following unplanned admission correlated with reduced likelihood of curative treatment and poorer prognosis. Expanding screening initiatives to include frail elderly individuals living alone, along with alertness by primary care clinicians, is warranted to improve outcomes for these patients.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141418131","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":"Primary Stereotactic Body Radiotherapy for Spinal Bone Metastases From Lung Adenocarcinoma.","authors":"Kuan-Nien Chou, David J Park, Yusuke S Hori, Amit R Persad, Cynthia Chuang, Sara C Emrish, Louisa Ustrzynski, Armine Tayag, Kiran Kumar, Melissa Usoz, Maria Mendoza, Elham Rahimy, Erqi Pollom, Scott G Soltys, Shiue-Wei Lai, Steven D Chang","doi":"10.1016/j.cllc.2024.05.007","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.05.007","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the results of primary stereotactic body radiotherapy (SBRT) for spinal bone metastases (SBM) originating from lung adenocarcinoma (ADC). We considered the revised Tokuhashi score (rTS), Spinal Instability Neoplastic Score (SINS), and genetic characteristics.</p><p><strong>Methods: </strong>We examined adult patients with lung ADC who underwent primary SBRT (using the CyberKnife System) for SBM between March 2012 and January 2023.</p><p><strong>Results: </strong>We analyzed data from 99 patients, covering 152 SBM across 194 vertebrae. The overall local control (LC) rate was 77.6% for SBM from lung ADC, with a LC rate of 90.7% at 1 year. The median period for local progression (LP) occurrence was recorded at 10.0 (3-52) months. Additionally, Asian patients demonstrated higher LC rates than White patients. Utilizing the rTS and SINS as predictive tools, we revealed that a poor survival prognosis and an unstable spinal structure were associated with increased rates of LP. Furthermore, the presence of osteolytic bone destructions and pain complaints were significantly correlated with the occurrence of LP. In the cohort of this study, 108 SBM underwent analysis to determine the expression levels of programmed cell death ligand 1 (PD-L1). Additionally, within this group, 60 showed mutations in the epidermal growth factor receptor (EGFR) alongside PD-L1 expression. Nevertheless, these genetic differences did not result in statistically significant differences in the LC rate.</p><p><strong>Conclusion: </strong>The one-year LC rate for primary SBRT targeting SBM from lung ADC stood at 90.7%, particularly with the use of the CyberKnife System. Patients achieving LC exhibited significantly longer survival times compared to those with LP.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426506","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: Carboplatin, Weekly Paclitaxel and Pembrolizumab in Elderly Patients for Advanced Non-Small Cell Lung Cancer With PD-L1 < 50%: Real-World Data.","authors":"Guillaume Rousseau, Edouard Dantoing, Bénédicte Léturgie, Julie Tillon-Strozyk, Nicolas Delberghe, Antoine Grégoire, Suzanna Bota, Romain Corre, Luc Thiberville, Florian Guisier","doi":"10.1016/j.cllc.2024.05.005","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.05.005","url":null,"abstract":"","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141189315","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}