Clinical lung cancer最新文献

{"title":"Comparative Efficacy and Safety of Lorlatinib Versus Alectinib and Lorlatinib Versus Brigatinib for ALK-Positive Advanced/Metastatic NSCLC: Matching-Adjusted Indirect Comparisons","authors":"Christine Garcia ,&nbsp;Devin Abrahami ,&nbsp;Anna Polli ,&nbsp;Haitao Chu ,&nbsp;Conor Chandler ,&nbsp;Min Tan ,&nbsp;John Mark Kelton ,&nbsp;Despina Thomaidou ,&nbsp;Todd Bauer","doi":"10.1016/j.cllc.2024.08.003","DOIUrl":"10.1016/j.cllc.2024.08.003","url":null,"abstract":"<div><h3>Introduction</h3><div>The comparative efficacy and safety of lorlatinib, a third-generation anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitor (TKI), versus second-generation ALK TKIs as a first-line treatment for ALK+ advanced/metastatic nonsmall cell lung cancer (NSCLC) remains uncertain as there are no head-to-head clinical trials.</div></div><div><h3>Methods</h3><div>Matching-adjusted indirect comparisons (MAICs) were conducted using phase III trial data demonstrating superior efficacy over crizotinib, a first-generation ALK TKI. MAICs were conducted to compare lorlatinib (CROWN) versus alectinib (ALEX and ALESIA) and brigatinib (ALTA-1L) with matching based on prespecified effect modifiers. Efficacy outcomes included progression-free survival (PFS), objective response (OR), and time to progression in the central nervous system (TTP-CNS). Safety outcomes included Grade ≥3 adverse events (AEs) and AEs leading to treatment discontinuation, dose reduction, or dose interruption.</div></div><div><h3>Results</h3><div>Lorlatinib was estimated to improve PFS compared to alectinib (ALEX) (HR: 0.54 [95% CI: 0.33, 0.88]) and brigatinib (ALTA-1L) (HR: 0.51 [95% CI: 0.31, 0.82]). Lorlatinib was estimated to improve TTP-CNS compared with brigatinib (HR: 0.19 [95% CI: 0.05, 0.71]). The estimated Grade ≥3 AE rate was higher with lorlatinib than with alectinib (RR: 1.48 [95% CI: 1.13, 1.94]); however, no differences were observed in other safety endpoints (ie, AEs leading to discontinuation, dose reduction, or interruption) or compared to brigatinib.</div></div><div><h3>Conclusion</h3><div>Lorlatinib was estimated to have superior efficacy over first- and second-generation ALK-TKIs, but a higher rate of Grade ≥3 AEs compared to alectinib. These data support the use of lorlatinib as a first-line treatment for ALK+ advanced/metastatic NSCLC.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 7","pages":"Pages 634-642"},"PeriodicalIF":3.3,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132065","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":"Efficacy of Prophylactic Cranial Irradiation in Early to Mid-stage Small Cell Lung Cancer Patients in the Era of Magnetic Resonance Imaging","authors":"Jianjiang Liu ,&nbsp;Yang Yang ,&nbsp;Dongping Wu ,&nbsp;Hongru Li","doi":"10.1016/j.cllc.2024.08.005","DOIUrl":"10.1016/j.cllc.2024.08.005","url":null,"abstract":"<div><h3>Background</h3><div>Recent advancements in magnetic resonance imaging (MRI) for staging have highlighted the critical question of the need for prophylactic cranial irradiation (PCI) in managing early to mid-stage small cell lung cancer (SCLC). This study assesses the impact of PCI on overall survival (OS) and intracranial control among patients with stage I-IIB SCLC.</div></div><div><h3>Methods</h3><div>Data from 148 stage I-IIB SCLC patients treated with thoracic radiation therapy (TRT) at two centers were examined. Patients were categorized based on PCI administration: 63 received PCI, while 85 did not. All underwent pretreatment MRI, achieving at least a partial response to therapy. A 1:1 propensity score matching analysis corrected for potential biases.</div></div><div><h3>Results</h3><div>Propensity scores were generated to 116 patients, considering patient demographics, disease progression, and treatment methods. Death was included as a competing risk. The 3-year brain metastases (BM) occurrence rate was significantly higher in patients who did not receive PCI (30.0%) compared to those who did (14.8%), however, the difference was not statistically significant (No PCI vs. PCI, hazard ratio [HR]: 2.08, 95% CI [0.93-4.55], <em>P</em> = .07). No significant effect of PCI on OS was observed [PCI vs. No PCI, HR: 0.80, 95% CI (0.45-1.43), <em>P</em> = .45]. A subgroup analysis of stage IIB patients showed a significant increase in BM risk and mortality for those not receiving PCI (No PCI vs. PCI, BM risk HR: 5.85, 95% CI: 1.83-18.87, <em>P</em> = .003; mortality HR: 2.78, 95% CI: 1.14-6.67, <em>P</em> = .02), with less pronounced effects in stages I-IIA.</div></div><div><h3>Conclusion</h3><div>With modern MRI-based screening, PCI may markedly benefit stage IIB SCLC patients by reducing BM and improving OS after initial sensitive treatment. This benefit does not appear to extend to stage I-IIA patients.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 8","pages":"Pages 690-698.e2"},"PeriodicalIF":3.3,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132066","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":"DARES: A Phase II Trial of Durvalumab and Ablative Radiation in Extensive-Stage Small Cell Lung Cancer","authors":"Christine M. Bestvina ,&nbsp;Jared H.L. Hara ,&nbsp;Theodore Karrison ,&nbsp;Benjamen Bowar ,&nbsp;Janet Chin ,&nbsp;Marina C. Garassino ,&nbsp;Sean P. Pitroda ,&nbsp;Rajat Thawani ,&nbsp;Everett E. Vokes ,&nbsp;Gregory Gan ,&nbsp;Jun Zhang ,&nbsp;Andrew M. Baschnagel ,&nbsp;Toby C. Campbell ,&nbsp;Steven Chmura ,&nbsp;Aditya Juloori","doi":"10.1016/j.cllc.2024.08.004","DOIUrl":"10.1016/j.cllc.2024.08.004","url":null,"abstract":"<div><h3>Background</h3><div>Immunotherapy in combination with chemotherapy is first-line treatment for patients with extensive-stage small-cell lung cancer (ES-SCLC). Growing evidence</div><div>suggests that radiation, specifically stereotactic body radiation therapy (SBRT), may enhance the immunogenic response as well as cytoreduce tumor burden. The primary objective of the study is to determine the progression free survival for patients with newly diagnosed ES-SCLC treated with combination multisite SBRT and chemo-immunotherapy (carboplatin, etoposide, and durvalumab).</div></div><div><h3>Methods</h3><div>This is a multicenter, single arm, phase 2 study. Patients with treatment-naïve, ES-SCLC will be eligible for this study. Patients will receive durvalumab 1500mg IV q3w, carboplatin AUC 5 to 6 mg/mL q3w, and etoposide 80 to 100 mg/m2 on days 1 to 3 q3w for four cycles, followed by durvalumab 1500mg IV q4w until disease progression or unacceptable toxicity. Ablative radiation will be delivered 1 to 4 extracranial sites in 3 or 5 fractions, determined by location, during cycle 2. The primary endpoint is progression-free survival, measured from day 1 of chemoimmunotherapy. Secondary endpoints include grade ≥3 toxicity by CTCAE v5.0 within three months of RT, overall survival, response rate, time to second line systemic therapy, and time to new distant progression.</div></div><div><h3>Conclusions</h3><div>Now that immunotherapy is an established part of ES-SCLC management, it is important to further optimize its use and effect. This study will investigate the progression-free survival of combined SBRT and chemo-immunotherapy in patients with ES-SCLC. In addition, the data from this study may further inform the immunogenic role of SBRT with chemo-immunotherapy, as well as identify clinical, biological, or radiomic prognostic features.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 8","pages":"Pages e448-e452"},"PeriodicalIF":3.3,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145330","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":"Outcomes Analysis of Patients Receiving Local Ablative Therapy for Oligoprogressive Metastatic NSCLC Under First-Line Immunotherapy","authors":"C. Huet ,&nbsp;C. Basse ,&nbsp;M. Knetki-Wroblewska ,&nbsp;P. Chilczuk ,&nbsp;PE. Bonte ,&nbsp;S. Cyrille ,&nbsp;E. Gobbini ,&nbsp;P. Du Rusquec ,&nbsp;M. Olszyna-Serementa ,&nbsp;C. Daniel ,&nbsp;F. Lucibello ,&nbsp;L. Lahmi ,&nbsp;M. Krzakowski ,&nbsp;N. Girard","doi":"10.1016/j.cllc.2024.07.009","DOIUrl":"10.1016/j.cllc.2024.07.009","url":null,"abstract":"<div><h3>Context</h3><div>Nonsmall Cell Lung Cancer (NSCLC) treatment relies on first-line immunotherapy as single agent or combined with chemotherapy. Oligoprogression may be observed in this setting.</div></div><div><h3>Material and Method</h3><div>We performed a European multicentric retrospective study on patients treated with first-line immunotherapy, who presented with oligoprogressive disease, treated with a local ablative treatment.</div></div><div><h3>Results</h3><div>A total of 61 patients were retrospectively included between 2018 and 2022. Twenty-four patients (39%) received immunotherapy as single agent, and 37 (61%) chemo-immunotherapy. First oligoprogression occurred more frequently in pre-existing metastatic sites (47% of patients). Median PFS1 (defined as time to first oligoprogression) was 11.5 months [IC95%: 10.0-12.3]. We observed that 37 patients (61%) progressed after first oligoprogression, and 20 (54%) from them presented second oligoprogression. Median OS for the whole cohort was 72.0 months [IC95%: 19.3-124.8], with positive correlation between OS and PFS1 (R=0.65, <em>P</em> &lt; .0001). After loco-ablative treatment with radiotherapy, disease control rate was 89% with ablative radiotherapy: 88% with conventional radiotherapy, and 89% with stereotactic radiotherapy.</div></div><div><h3>Conclusion</h3><div>Patients with oligoprogression under/after immunotherapy have better prognosis with a high risk of subsequent oligoprogression.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 8","pages":"Pages e402-e410.e3"},"PeriodicalIF":3.3,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105079","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":"Comments on “Influence of Tumor Cavitation on Assessing the Clinical Benefit of Anti-PD1 or PD-L1 Inhibitors in Advanced Lung Squamous Cell Carcinoma”","authors":"Jie Huang","doi":"10.1016/j.cllc.2024.08.001","DOIUrl":"10.1016/j.cllc.2024.08.001","url":null,"abstract":"","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 8","pages":"Pages e446-e447"},"PeriodicalIF":3.3,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142092479","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":"Liquid Biopsy and 18F-FDG PET/CT Derived Parameters as Predictive Factors of Osimertinib Treatment in Advanced EGFR-Mutated NSCLC","authors":"Alessandro Leonetti ,&nbsp;Veronica Cervati ,&nbsp;Roberta Minari ,&nbsp;Maura Scarlattei ,&nbsp;Michela Verzè ,&nbsp;Marianna Peroni ,&nbsp;Monica Pluchino ,&nbsp;Francesco Bonatti ,&nbsp;Fabiana Perrone ,&nbsp;Giulia Mazzaschi ,&nbsp;Agnese Cosenza ,&nbsp;Letizia Gnetti ,&nbsp;Paola Bordi ,&nbsp;Livia Ruffini ,&nbsp;Marcello Tiseo","doi":"10.1016/j.cllc.2024.07.016","DOIUrl":"10.1016/j.cllc.2024.07.016","url":null,"abstract":"<div><h3>Objectives</h3><div>Despite the outstanding results achieved by osimertinib for the treatment of advanced <em>EGFR</em>-mutated NSCLC, the development of resistance is almost inevitable. While molecular mechanism responsible for osimertinib resistance are being mostly revealed, the definition of predictive biomarkers is crucial in order to identify patients at higher risk of progression and optimize treatment strategy.</div></div><div><h3>Materials and Methods</h3><div>This is a prospective single-center study aimed to assess the potential role of liquid biopsy and 18F-FDG PET/CT derived metabolic parameters as noninvasive predictive biomarkers of osimertinib outcomes in advanced <em>EGFR</em>-mutated NSCLC patients. Patients underwent blood samples for ctDNA analysis at baseline, after 15 days and 1 month (t1) of osimertinib. 18F-FDG PET/CT was performed at baseline and after 1 month of osimertinib.</div></div><div><h3>Results</h3><div>Seventy-two advanced <em>EGFR</em>-mutated NSCLC patients treated with osimertinib in first (<em>n</em> = 63) and in second-line (<em>n</em> = 9) were prospectively enrolled. Baseline positive shedding status was significantly associated with a shorter progression-free survival (PFS) (9.5 vs. 29.2 months, <em>P</em> = .031). Early metabolic response (MR) led to improved PFS (16.8 vs. 5.5 months, <em>P</em> = .038) and OS (35.2 vs. 15.3 months, <em>P</em> = .047). Early MR was significantly correlated with subsequent radiologic response (<em>P</em> = .010). All 18F-FDG PET/CT baseline parameters were significantly related to baseline <em>EGFR</em> activating mutation allele frequency. Both clearance and no detection of <em>EGFR</em> at t1 were significantly associated with MR (<em>P</em> = .001 and <em>P</em> = .004, respectively).</div></div><div><h3>Conclusion</h3><div>Molecular and 18F-FDG PET/CT derived metabolic parameters might represent a useful tool to predict osimertinib outcome in advanced <em>EGFR</em>-mutated NSCLC patients.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 8","pages":"Pages e436-e445.e9"},"PeriodicalIF":3.3,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142092493","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":"Long-Term Clinical, Radiological, and Mortality Outcomes Following Pneumonitis in Nonsmall Cell Lung Cancer Patients Receiving Immune Checkpoint Inhibitors: A Retrospective Analysis","authors":"Felipe Soto-Lanza ,&nbsp;Lydia Glick ,&nbsp;Colin Chan ,&nbsp;Linda Zhong ,&nbsp;Nathaniel Wilson ,&nbsp;Saadia Faiz ,&nbsp;Saumil Gandhi ,&nbsp;Aung Naing ,&nbsp;John V. Heymach ,&nbsp;Vickie R. Shannon ,&nbsp;Maria Franco-Vega ,&nbsp;Zhongxing Liao ,&nbsp;Steven H. Lin ,&nbsp;Nicolas L. Palaskas ,&nbsp;Jia Wu ,&nbsp;Girish S. Shroff ,&nbsp;Mehmet Altan ,&nbsp;Ajay Sheshadri","doi":"10.1016/j.cllc.2024.07.017","DOIUrl":"10.1016/j.cllc.2024.07.017","url":null,"abstract":"<div><h3>Aims</h3><div>Despite known short-term mortality risk of immune checkpoint inhibitor (ICI) pneumonitis, its impact on 1-year mortality, long-term pulmonary function, symptom persistence, and radiological resolution remains unclear.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 71 nonsmall cell lung cancer (NSCLC) patients treated with anti-PD(L)1 monoclonal antibodies between 2018-2021, who developed pneumonitis. Clinical and demographic covariates were collected from electronic medical record. Cox regression assessed associations with mortality, while logistic regression evaluated associations with persistent symptoms, hypoxemia, and radiological resolution.</div></div><div><h3>Results</h3><div>Steroid-refractory pneumonitis (hazard ratio [HR] = 15.1, 95% confidence interval [95% CI]:3.9-57.8, <em>P</em> &lt; .0001) was associated with higher 1-year mortality compared to steroid-responsive cases. However, steroid-resistant (odds ratio [OR] = 1.4, 95% CI: 0.4-5.1, <em>P</em> = .58) and steroid-dependent (OR = 0.4, 95% CI: 0.1-1.2, <em>P</em> = .08) pneumonitis were not. Nonadenocarcinoma histology (OR = 6.7, 95% CI: 1.6-46.6, <em>P</em> = .01), grade 3+ pneumonitis (OR = 4.6, 95% CI: 1.3-22.7, <em>P</em> = .03), and partial radiological resolution (OR = 6.3, 95% CI: 1.8-23.8, <em>P</em> = .004) were linked to increased pulmonary symptoms after pneumonitis resolution. Grade 3+ pneumonitis (OR = 8.1, 95% CI: 2.3-31.5, <em>P</em> = .001) and partial radiological resolution (OR = 5.45, 95% CI: 1.29-37.7, <em>P</em> = .03) associated with residual hypoxemia. Nonadenocarcinoma histology (OR = 3.6, 95% CI: 1.01-17.6, <em>P</em> = .06) and pretreatment ILAs (OR = 4.8, 95% CI: 1.14-33.09, <em>P</em> = .05) were associated with partial radiological resolution.</div></div><div><h3>Conclusions</h3><div>Steroid refractory pneumonitis increases 1-year mortality in NSCLC patients. Pretreatment ILAs may signal predisposition to fibrosis-related outcomes, seen as partial resolution, which in turn is associated with postresolution symptoms and residual hypoxemia. These findings offer insights for identifying patients at risk of adverse outcomes post-pneumonitis resolution.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 7","pages":"Pages 624-633.e2"},"PeriodicalIF":3.3,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055154","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":"Single-drug Chemotherapy Plus Immunotherapy as First-line Treatment for Stage Ⅳ Non-small Cell Lung Cancer Elderly Patients: A Phase II Clinical Trial UNICORN Study","authors":"Jia Ma ,&nbsp;Min Peng ,&nbsp;Jianping Bi ,&nbsp;Qian Chen ,&nbsp;Guoliang Pi ,&nbsp;Ying Li ,&nbsp;Yi Peng ,&nbsp;Fanyu Zeng ,&nbsp;Chuangying Xiao ,&nbsp;Guang Han","doi":"10.1016/j.cllc.2024.07.005","DOIUrl":"10.1016/j.cllc.2024.07.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Lung cancer remains the most common malignancy and the leading cancer-related death among the elderly in China, which deserves more research attention. Immunotherapy combined with platinum-based doublet chemotherapy has been approved as the standard treatment for advanced non-small cell lung cancer (NSCLC) patients who are devoid of specific gene mutations or fusions. Given that patients with NSCLC over the age of 65 typically exhibit declining organ function and physical condition, they often showed reduced tolerance for this rigorous treatment regimen. However, the KEYNOTE-042 study illuminated a promising pathway: in patients testing positive for programmed death-ligand 1 (PD-L1), immunotherapy alone has demonstrated a superior overall survival (OS) compared to platinum-based doublet chemotherapy. This suggests that moderating the intensity of chemotherapy and prioritizing immunotherapy may be a gentler alternative in elderly demographic.</div></div><div><h3>Patients and Methods</h3><div>This multicenter phase II clinical trial named UNICORN aimed to enroll 49 patients aged 65 and older, utilizing paclitaxel or nab-paclitaxel for those with squamous NSCLC, and pemetrexed for those diagnosed with lung adenocarcinoma. The treatment protocol entails 4 cycles of serplulimab plus chemotherapy followed by an extended regimen of serplulimab maintenance, spanning a total of 35 cycles. Primary endpoints of this study are progression-free survival (PFS), disease control rate (DCR) and the secondary endpoints are OS, objective control rate (ORR) and safety metrics.</div></div><div><h3>Conclusion</h3><div>This is the first study to evaluate the efficacy and safety of serplulimab combined with either paclitaxel or pemetrexed in elderly treatment-naïve patients with stage IV NSCLC whose PD-L1 are positive.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 8","pages":"Pages e389-e392"},"PeriodicalIF":3.3,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141847131","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":"Association Between PD-L1 Score and the Outcomes of Consolidation Durvalumab in a Large Nationwide Series of Patients With Stage III NSCLC Treated With Chemoradiotherapy","authors":"Ronald Damhuis ,&nbsp;Idris Bahce ,&nbsp;Suresh Senan","doi":"10.1016/j.cllc.2024.07.013","DOIUrl":"10.1016/j.cllc.2024.07.013","url":null,"abstract":"<div><h3>Background</h3><div>The Pacific trial reported improved outcomes when durvalumab was administered following concurrent chemoradiotherapy (CRT) for stage III NSCLC. Post-hoc subgroup analysis did not show favorable results for PD-L1 negative cases. We compared nationwide survival data with the trial outcomes, and evaluated the influence of PD-L1.</div></div><div><h3>Patients and methods</h3><div>Data from the Netherlands Cancer Registry were queried regarding patients with clinical stage III who underwent CRT, either by concurrent or sequential administration. Predictors for the use of consolidation treatment with durvalumab were evaluated by tabulations and logistic regression analysis. Overall survival (OS) was calculated from start of radiation or start of durvalumab and was stratified by PD-L1 score.</div></div><div><h3>Results</h3><div>Between 2017 and 2021, application of consolidation durvalumab increased from 2% to 21%, 40%, 57%, 62%, respectively. In the period 2020-2021, durvalumab use was more frequent among patients with younger age, concurrent CRT, better performance score and proton radiation, but was irrespective of PD-L1 score.</div><div>For patients receiving durvalumab (n = 1639), the 4-year OS was 53% overall (95%CI 50-57), and it was 56% (95%CI 52-60) after concurrent CRT. Four-year OS was considerably better for the PD-L1 subgroup ≧50% at 67% (95%CI 59-73), and it was similar for PD-L1 subgroups 0 and 1-49, at 51% (95%CI 42-58) and 46% (95%CI 39-54), respectively.</div></div><div><h3>Conclusion</h3><div>In real-world clinical practice, survival outcomes were equivalent to results from trial series. Overall survival in patients with negative PD-L1 was similar to the survival in patients with PD-L1 1-49, questioning the restrictions imposed by the European Medicines Agency.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 8","pages":"Pages 683-689"},"PeriodicalIF":3.3,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141843514","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":"Real-World Outcomes of Subsequent Chemotherapy after Progression Following Chemoradiation and Consolidative Durvalumab Therapy in Locally Advanced Non-small Cell Lung Cancer: An Exploratory Analysis from the CRIMSON Study (HOPE-005)","authors":"Hayato Kawachi ,&nbsp;Motohiro Tamiya ,&nbsp;Yuko Oya ,&nbsp;Go Saito ,&nbsp;Yoshihiko Taniguchi ,&nbsp;Hirotaka Matsumoto ,&nbsp;Yuki Sato ,&nbsp;Taiichiro Otsuki ,&nbsp;Hidekazu Suzuki ,&nbsp;Yasushi Fukuda ,&nbsp;Satoshi Tanaka ,&nbsp;Yoko Tsukita ,&nbsp;Junji Uchida ,&nbsp;Yoshihiko Sakata ,&nbsp;Yuki Nakatani ,&nbsp;Ryota Shibaki ,&nbsp;Daisuke Arai ,&nbsp;Asuka Okada ,&nbsp;Satoshi Hara ,&nbsp;Koichi Takayama ,&nbsp;Kazumi Nishino","doi":"10.1016/j.cllc.2024.07.014","DOIUrl":"10.1016/j.cllc.2024.07.014","url":null,"abstract":"<div><h3>Background</h3><div>The optimal subsequent treatment strategy for locally advanced non-small cell lung cancer (LA-NSCLC) after chemoradiotherapy (CRT) and consolidative durvalumab therapy remains unknown. We aimed to determine the optimal subsequent treatment strategy for this clinical population.</div></div><div><h3>Materials and Methods</h3><div>We retrospectively enrolled 523 consecutive patients with LA-NSCLC treated with CRT and analyzed the treatment outcomes of subsequent therapy after progression following CRT and consolidative durvalumab therapy. Patients who received tyrosine kinase inhibitors as subsequent therapy were excluded.</div></div><div><h3>Results</h3><div>Out of 122 patients who received subsequent chemotherapy, 55% underwent platinum-based, 25% non-platinum-based, and 20% immune checkpoint inhibitor (ICI)-containing therapies. In the platinum-based group, patients with a durvalumab-progression-free survival (Dur-PFS) ≥ 1 year had a significantly longer median subsequent therapy-PFS (SubTx-PFS) than those with Dur-PFS &lt; 1 year (13.2 months vs. 4.7 months; hazard ratio, 0.45; 95% confidence interval, 0.21–0.97; <em>P</em> = .04). Furthermore, among patients receiving non-platinum-based chemotherapy, the median SubTx-PFS was longer in the combined with angiogenesis inhibitor group than in the without group, although the difference was not statistically significant. No significant difference of SubTx-PFS was observed between the reason for durvalumab discontinuation and the outcomes of ICI-containing therapy.</div></div><div><h3>Conclusion</h3><div>In clinical practice, platinum-based chemotherapy rechallenge is frequently employed following progression subsequent to CRT and consolidative durvalumab therapy for LA-NSCLC. Optimal treatment strategies may consider Dur-PFS and angiogenesis inhibitor feasibility. Further research is warranted to identify clinical biomarkers that can help identify patients who would benefit from ICI rechallenge.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 7","pages":"Pages 643-652.e4"},"PeriodicalIF":3.3,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141848899","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}