Clinical lung cancer最新文献

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Osimertinib-Related QTc Prolongation: Real-World Incidence and Impact of Drug Dosing on Recurrence Risk 奥希替尼相关 QTc 延长:现实世界中的发病率以及药物剂量对复发风险的影响
IF 3.3 3区 医学
Clinical lung cancer Pub Date : 2024-07-02 DOI: 10.1016/j.cllc.2024.06.012
Olivia H. Chen , Wesley K.Y. Wong , Kevin K.S. Mok , Landon L. Chan , Candy Tang , Molly S.C. Li
{"title":"Osimertinib-Related QTc Prolongation: Real-World Incidence and Impact of Drug Dosing on Recurrence Risk","authors":"Olivia H. Chen ,&nbsp;Wesley K.Y. Wong ,&nbsp;Kevin K.S. Mok ,&nbsp;Landon L. Chan ,&nbsp;Candy Tang ,&nbsp;Molly S.C. Li","doi":"10.1016/j.cllc.2024.06.012","DOIUrl":"10.1016/j.cllc.2024.06.012","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>In a real-world retrospective study of 970 patients treated with osimertinib, incidence of grade 3 QTc prolongation was 0.9% which was similar to clinical trials. No events of ventricular arrhythmia or arrhythmia-related deaths were observed.</div></span></li><li><span>•</span><span><div>Baseline QTc prolongation (QTc ≥450ms) may be a potential risk factor for osimertinib-related grade 3 QTc prolongation.</div></span></li><li><span>•</span><span><div>In patients with grade 3 osimertinib-related QTc prolongation, rechallenging osimertinib at 80mg daily dose confers high recurrence risk while dose reduction mitigates recurrence risk.</div></span></li></ul></div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 8","pages":"Pages 738-743.e2"},"PeriodicalIF":3.3,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141771724","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}
引用次数: 0
Impact of Durvalumab on the Duration and Complexity of Corticosteroid Therapy for Pneumonitis After Chemoradiotherapy Durvalumab对化疗后肺炎皮质类固醇治疗的持续时间和复杂性的影响
IF 3.3 3区 医学
Clinical lung cancer Pub Date : 2024-07-02 DOI: 10.1016/j.cllc.2024.06.009
Saori Murata , Hidehito Horinouchi , Momoko Morishita , Sawako Kaku , Yuki Shinno , Yusuke Okuma , Tatsuya Yoshida , Yasushi Goto , Noboru Yamamoto , Tairo Kashihara , Kae Okuma , Masahiko Kusumoto , Yuichiro Ohe
{"title":"Impact of Durvalumab on the Duration and Complexity of Corticosteroid Therapy for Pneumonitis After Chemoradiotherapy","authors":"Saori Murata ,&nbsp;Hidehito Horinouchi ,&nbsp;Momoko Morishita ,&nbsp;Sawako Kaku ,&nbsp;Yuki Shinno ,&nbsp;Yusuke Okuma ,&nbsp;Tatsuya Yoshida ,&nbsp;Yasushi Goto ,&nbsp;Noboru Yamamoto ,&nbsp;Tairo Kashihara ,&nbsp;Kae Okuma ,&nbsp;Masahiko Kusumoto ,&nbsp;Yuichiro Ohe","doi":"10.1016/j.cllc.2024.06.009","DOIUrl":"10.1016/j.cllc.2024.06.009","url":null,"abstract":"<div><h3>Introduction</h3><div>It is unclear how the duration and tapering pattern of corticosteroid therapy for pneumonitis changed after the introduction of durvalumab consolidation therapy.</div></div><div><h3>Methods</h3><div>We retrospectively evaluated the medical records of patients diagnosed with nonsmall cell lung cancer who received chemoradiotherapy between January 2014 and December 2020.</div></div><div><h3>Results</h3><div>Data for 135 patients treated before durvalumab approval and 100 patients treated with durvalumab after its approval were analyzed. In both groups, more than 70% were male, with a median age of 66 y. Approximately 85% were smokers, and the most common tumor histology was adenocarcinoma. Most patients were treated with doses of 60 and 66 Gy (n = 127 [94%] vs. n = 95 [95%]). Among the patients treated with durvalumab, 57%, 38%, and 5% had grade 1, grade 2, and grade 3 pneumonitis; none had grade 4 or 5 pneumonitis. Patients treated with durvalumab exhibited a longer duration of corticosteroid therapy for pneumonitis (17 wk; range: 2-88 wk) than patients not treated with durvalumab (7 wk; range: 0.4-21 wk; <em>P</em> &lt; 0.001). Pneumonitis relapse was more frequent in patients treated with durvalumab (n = 8; 23%) than in patients not treated with durvalumab (n = 2; 7%). Among the 8 patients treated with durvalumab, 2 had recurrent pneumonitis, 1 could not terminate corticosteroids.</div></div><div><h3>Conclusions</h3><div>Our data show that durvalumab prolongs the duration of corticosteroid therapy and increases the complexity of corticosteroid tapering patterns. This study can help manage pneumonitis caused by immune checkpoint inhibitors and other drugs used after chemoradiotherapy in routine practice and clinical trials.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 7","pages":"Pages e369-e378.e3"},"PeriodicalIF":3.3,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141704697","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}
引用次数: 0
Impact of PROphet Test in Changing Physicians' Therapeutic Decision-Making for Checkpoint Immunotherapy in Non–Small-Cell Lung Cancer PROphet测试在改变医生对非小细胞肺癌检查点免疫疗法治疗决策方面的影响
IF 3.3 3区 医学
Clinical lung cancer Pub Date : 2024-07-02 DOI: 10.1016/j.cllc.2024.06.011
David R. Gandara , Janakiraman Subramanian , Edgardo S. Santos , Yehuda Brody , Itamar Sela , Yehonatan Elon , Michal Harel , Anat Reiner-Benaim , Coren Lahav , Kimberly McGregor
{"title":"Impact of PROphet Test in Changing Physicians' Therapeutic Decision-Making for Checkpoint Immunotherapy in Non–Small-Cell Lung Cancer","authors":"David R. Gandara ,&nbsp;Janakiraman Subramanian ,&nbsp;Edgardo S. Santos ,&nbsp;Yehuda Brody ,&nbsp;Itamar Sela ,&nbsp;Yehonatan Elon ,&nbsp;Michal Harel ,&nbsp;Anat Reiner-Benaim ,&nbsp;Coren Lahav ,&nbsp;Kimberly McGregor","doi":"10.1016/j.cllc.2024.06.011","DOIUrl":"10.1016/j.cllc.2024.06.011","url":null,"abstract":"<div><h3>Purpose</h3><p>Immune Checkpoint Inhibitor (ICI) regimens are approved for first-line treatment of metastatic nononcogene-driven NSCLC. Guidelines do not differentiate which patients with PD-L1 ≥ 50% should receive ICI monotherapy. The clinically validated PROphet NSCLC plasma proteomic-based test is designed to inform this therapeutic decision.</p></div><div><h3>Methods</h3><p>One hundred oncologists were presented with 3 “virtual” metastatic NSCLC cases with PD-L1 scores and asked to recommend an approved first-line regimen. They then watched an online educational webinar on the PROphetNSCLC test. Postwebinar, the same cases were represented with the addition of a PROphet result, and oncologists again recommended a first-line regimen. Responses were compared to assess the impact on first-line treatment selection.</p></div><div><h3>Results</h3><p>Treatment recommendation changed in 39.6% of PROphet-tested cases, with 93% of physicians changing at least 1 case. In the PD-L1 ≥ 50% group, 89% of physicians changed their recommendation, followed by 77%, in PD-L1 &lt; 1%, and 36% in PD-L1 1% to 49%. ​In the PD-L1 ≥ 50%, PROphet POSITIVE group, the recommendation for ICI monotherapy increased from 60% to 89%. ​For the PD-L1 ≥ 50%, PROphet NEGATIVE group, the recommendation for monotherapy dropped from 60% to 9%. In the PD-L1 &lt; 1%, PROphet NEGATIVE group, 35% of patients were spared toxicity from ICI compared to 11% in PROphet untested cases.</p></div><div><h3>Conclusion</h3><p>Adding PROphet to PD-L1 expression impacted therapeutic decision making in first-line NSCLC. PROphet identifies those predicted to have an overall survival benefit from ICI monotherapy versus combination versus chemotherapy, improving the probability of efficacy and reducing toxicity for some patients.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 6","pages":"Pages e252-e261.e4"},"PeriodicalIF":3.3,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1525730424001384/pdfft?md5=68fe4e60e1c9153f5469964a5f1d6d04&pid=1-s2.0-S1525730424001384-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141690612","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}
引用次数: 0
Bevacizumab for Brain Radiation Necrosis in Patients With Nonsquamous Nonsmall Cell Lung Cancer 贝伐单抗治疗非鳞癌非小细胞肺癌患者的脑放射坏死
IF 3.3 3区 医学
Clinical lung cancer Pub Date : 2024-07-02 DOI: 10.1016/j.cllc.2024.06.010
Daisuke Shibahara , Kentaro Tanaka , Osamu Togao , Yoshimasa Shiraishi , Yasuto Yoneshima , Eiji Iwama , Tadamasa Yoshitake , Kousei Ishigami , Isamu Okamoto
{"title":"Bevacizumab for Brain Radiation Necrosis in Patients With Nonsquamous Nonsmall Cell Lung Cancer","authors":"Daisuke Shibahara ,&nbsp;Kentaro Tanaka ,&nbsp;Osamu Togao ,&nbsp;Yoshimasa Shiraishi ,&nbsp;Yasuto Yoneshima ,&nbsp;Eiji Iwama ,&nbsp;Tadamasa Yoshitake ,&nbsp;Kousei Ishigami ,&nbsp;Isamu Okamoto","doi":"10.1016/j.cllc.2024.06.010","DOIUrl":"10.1016/j.cllc.2024.06.010","url":null,"abstract":"<div><p></p><ul><li><span>•</span><span><p>The incidence of brain radiation necrosis is increasing in NSCLC patients undergoing radiotherapy for brain metastases.</p></span></li><li><span>•</span><span><p>[<sup>11</sup>C] methionine–PET and MRS are valuable tools for diagnosing brain radiation necrosis.</p></span></li><li><span>•</span><span><p>Bevacizumab is an effective treatment for brain radiation necrosis in patients with nonsquamous NSCLC.</p></span></li></ul></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 6","pages":"Pages 581-586.e3"},"PeriodicalIF":3.3,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1525730424001359/pdfft?md5=6792b8d4e751aaccaf770a85083f2252&pid=1-s2.0-S1525730424001359-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141771624","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}
引用次数: 0
A Novel EGFR Germline Mutation in Lung Adenocarcinoma: Case Report and Literature Review 肺腺癌中的新型表皮生长因子受体基因突变:病例报告和文献综述
IF 3.3 3区 医学
Clinical lung cancer Pub Date : 2024-07-01 DOI: 10.1016/j.cllc.2024.04.009
Parth Sharma , Himil Mahadevia , Sreekanth Donepudi , Lara Kujtan , Beth Gustafson , Ben Ponvilawan , Ammar Al-Obaidi , Janakiraman Subramanian , Dhruv Bansal
{"title":"A Novel EGFR Germline Mutation in Lung Adenocarcinoma: Case Report and Literature Review","authors":"Parth Sharma ,&nbsp;Himil Mahadevia ,&nbsp;Sreekanth Donepudi ,&nbsp;Lara Kujtan ,&nbsp;Beth Gustafson ,&nbsp;Ben Ponvilawan ,&nbsp;Ammar Al-Obaidi ,&nbsp;Janakiraman Subramanian ,&nbsp;Dhruv Bansal","doi":"10.1016/j.cllc.2024.04.009","DOIUrl":"10.1016/j.cllc.2024.04.009","url":null,"abstract":"<div><p></p><ul><li><span>•</span><span><p>While most molecular testing focuses on somatic alterations in patients with non-small cell lung cancer, evidence is growing regarding the presence of germline lung cancer mutations. The most common lung cancer germline mutation is EGFR T790M.</p></span></li><li><span>•</span><span><p>Herein, we describe an EGFR germline mutation not previously reported outside of Asia, T725M.</p></span></li><li><span>•</span><span><p>Identification of germline lung cancer mutations could help to identify new therapeutic targets. Furthermore, further characterization of these mutations can aid in the development of screening and surveillance guidelines for patients with hereditary lung cancer, which currently do not exist.</p></span></li></ul></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 5","pages":"Pages 479-482"},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1525730424000524/pdfft?md5=9135c62f62eeb19fdc77fa14f8ab402b&pid=1-s2.0-S1525730424000524-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140790092","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}
引用次数: 0
Brief Report: Impact of Anti-Cancer Treatments on Outcomes of COVID-19 in Patients With Thoracic Cancers: A CCC19 Registry Analysis 简要报告:抗癌治疗对胸腺癌患者 COVID-19 治疗结果的影响:CCC19 登记分析
IF 3.3 3区 医学
Clinical lung cancer Pub Date : 2024-07-01 DOI: 10.1016/j.cllc.2024.04.003
Amit A. Kulkarni , Cassandra Hennessy , Grace Wilson , Vidhyalakshmi Ramesh , Clara Hwang , Joy Awosika , Ziad Bakouny , Hina Khan , Diana Vilar-Compte , Rana McKay , Chinmay Jani , Lisa Weissmann , Elizabeth Griffiths , Gerald Batist , Nathaniel Bouganim , Blanche Mavromatis , Babar Bashir , Ryan H. Nguyen , Jonathan W. Riess , Matthew Puc , Narjust Florez
{"title":"Brief Report: Impact of Anti-Cancer Treatments on Outcomes of COVID-19 in Patients With Thoracic Cancers: A CCC19 Registry Analysis","authors":"Amit A. Kulkarni ,&nbsp;Cassandra Hennessy ,&nbsp;Grace Wilson ,&nbsp;Vidhyalakshmi Ramesh ,&nbsp;Clara Hwang ,&nbsp;Joy Awosika ,&nbsp;Ziad Bakouny ,&nbsp;Hina Khan ,&nbsp;Diana Vilar-Compte ,&nbsp;Rana McKay ,&nbsp;Chinmay Jani ,&nbsp;Lisa Weissmann ,&nbsp;Elizabeth Griffiths ,&nbsp;Gerald Batist ,&nbsp;Nathaniel Bouganim ,&nbsp;Blanche Mavromatis ,&nbsp;Babar Bashir ,&nbsp;Ryan H. Nguyen ,&nbsp;Jonathan W. Riess ,&nbsp;Matthew Puc ,&nbsp;Narjust Florez","doi":"10.1016/j.cllc.2024.04.003","DOIUrl":"10.1016/j.cllc.2024.04.003","url":null,"abstract":"<div><p></p><ul><li><span>•</span><span><p>Patients with thoracic cancers and COVID-19 have high mortality and morbidity.</p></span></li><li><span>•</span><span><p>Systematic data evaluating the impact of recent anti-cancer therapies on COVID-19 outcomes in patients with thoracic cancers are limited.</p></span></li><li><span>•</span><span><p>We analyzed clinical data from patients with thoracic cancers and COVID-19 (N=927) to systematically evaluate the impact of recent anti-cancer therapies on the clinical outcomes of COVID-19 from the COVID-19 and Cancer Consortium (CCC19).</p></span></li><li><span>•</span><span><p>As opposed to immunotherapy or targeted therapy, recent (&lt;3 months prior to COVID-19 diagnosis) cytotoxic chemotherapy exposure was significantly associated with COVID-19 severity.</p></span></li><li><span>•</span><span><p>None of the other systemic therapies or treatment modalities were significantly associated with 30-day all-cause mortality.</p></span></li><li><span>•</span><span><p>Baseline steroid use of 10 mg or more of prednisone equivalent was not associated COVID-19 severity and 30-day all-cause mortality.</p></span></li></ul></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 5","pages":"Pages e229-e237.e7"},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140810555","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}
引用次数: 0
AI-driven Characterization of Solid Pulmonary Nodules on CT Imaging for Enhanced Malignancy Prediction in Small-sized Lung Adenocarcinoma 人工智能驱动的 CT 成像肺实性结节特征描述,用于增强对小尺寸肺腺癌的恶性程度预测
IF 3.3 3区 医学
Clinical lung cancer Pub Date : 2024-07-01 DOI: 10.1016/j.cllc.2024.04.015
Yujin Kudo , Taiyo Nakamura , Jun Matsubayashi , Akimichi Ichinose , Yushi Goto , Ryosuke Amemiya , Jinho Park , Yoshihisa Shimada , Masatoshi Kakihana , Toshitaka Nagao , Tatsuo Ohira , Jun Masumoto , Norihiko Ikeda
{"title":"AI-driven Characterization of Solid Pulmonary Nodules on CT Imaging for Enhanced Malignancy Prediction in Small-sized Lung Adenocarcinoma","authors":"Yujin Kudo ,&nbsp;Taiyo Nakamura ,&nbsp;Jun Matsubayashi ,&nbsp;Akimichi Ichinose ,&nbsp;Yushi Goto ,&nbsp;Ryosuke Amemiya ,&nbsp;Jinho Park ,&nbsp;Yoshihisa Shimada ,&nbsp;Masatoshi Kakihana ,&nbsp;Toshitaka Nagao ,&nbsp;Tatsuo Ohira ,&nbsp;Jun Masumoto ,&nbsp;Norihiko Ikeda","doi":"10.1016/j.cllc.2024.04.015","DOIUrl":"10.1016/j.cllc.2024.04.015","url":null,"abstract":"<div><h3>Objectives</h3><p>Distinguishing solid nodules from nodules with ground-glass lesions in lung cancer is a critical diagnostic challenge, especially for tumors ≤2 cm. Human assessment of these nodules is associated with high inter-observer variability, which is why an objective and reliable diagnostic tool is necessary. This study focuses on artificial intelligence (AI) to automatically analyze such tumors and to develop prospective AI systems that can independently differentiate highly malignant nodules.</p></div><div><h3>Materials and methods</h3><p>Our retrospective study analyzed 246 patients who were diagnosed with negative clinical lymph node metastases (cN0) using positron emission tomography-computed tomography (PET/CT) imaging and underwent surgical resection for lung adenocarcinoma. AI detected tumor sizes ≤2 cm in these patients. By utilizing AI to classify these nodules as solid (AI_solid) or non-solid (non-AI_solid) based on confidence scores, we aim to correlate AI determinations with pathological findings, thereby advancing the precision of preoperative assessments.</p></div><div><h3>Results</h3><p>Solid nodules identified by AI with a confidence score ≥0.87 showed significantly higher solid component volumes and proportions in patients with AI_solid than in those with non-AI_solid, with no differences in overall diameter or total volume of the tumors. Among patients with AI_solid, 16% demonstrated lymph node metastasis, and a significant 94% harbored invasive adenocarcinoma. Additionally, 44% were upstaging postoperatively. These AI_solid nodules represented high-grade malignancies.</p></div><div><h3>Conclusion</h3><p>In small-sized lung cancer diagnosed as cN0, AI automatically identifies tumors as solid nodules ≤2 cm and evaluates their malignancy preoperatively. The AI classification can inform lymph node assessment necessity in sublobar resections, reflecting metastatic potential.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 5","pages":"Pages 431-439"},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140928510","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}
引用次数: 0
Completion of Pembrolizumab in Advanced Non-Small Cell Lung Cancer—Real World Outcomes After Two Years of Therapy (COPILOT) 完成 Pembrolizumab 治疗晚期非小细胞肺癌--两年治疗后的真实结果 (COPILOT)
IF 3.3 3区 医学
Clinical lung cancer Pub Date : 2024-07-01 DOI: 10.1016/j.cllc.2024.04.008
Andrew Fantoni , Lydia Warburton , Benjamin Solomon , Marliese Alexander , Meghana Maddula , Lauren Julia Brown , Ines Pires da Silva , Adnan Nagrial , Farah Abu Al-Hial , Malinda Itchins , Nick Pavlakis , Samantha Bowyer
{"title":"Completion of Pembrolizumab in Advanced Non-Small Cell Lung Cancer—Real World Outcomes After Two Years of Therapy (COPILOT)","authors":"Andrew Fantoni ,&nbsp;Lydia Warburton ,&nbsp;Benjamin Solomon ,&nbsp;Marliese Alexander ,&nbsp;Meghana Maddula ,&nbsp;Lauren Julia Brown ,&nbsp;Ines Pires da Silva ,&nbsp;Adnan Nagrial ,&nbsp;Farah Abu Al-Hial ,&nbsp;Malinda Itchins ,&nbsp;Nick Pavlakis ,&nbsp;Samantha Bowyer","doi":"10.1016/j.cllc.2024.04.008","DOIUrl":"10.1016/j.cllc.2024.04.008","url":null,"abstract":"<div><h3>Background</h3><p>Seminal trials with first-line pembrolizumab for metastatic non-small cell lung cancer (NSCLC) mandated a maximum two-years treatment. We describe real-world outcomes of a multi-site Australian cohort of patients who completed two-years of pembrolizumab.</p></div><div><h3>Methods</h3><p>Retrospective data were collected from the national AUstralian Registry and biObank of thoRacic cAncers (AURORA). Primary endpoints were progression rate post pembrolizumab discontinuation; and progression free survival (PFS). Local treatment of oligoprogressive disease during pembrolizumab was allowed.</p></div><div><h3>Results</h3><p>A total of 71 patients from six centers, median age 66.0 years, 49% male and 90% ECOG ≤ 1 were identified. Patients were Caucasian (82%) or Asian (16%); past (66%) or current (24%) smokers with mean 37 pack-years. Histology comprised 73% adenocarcinoma and 16% squamous. 18 patients (25%) had brain metastases at diagnosis. Median PD-L1 tumor proportion score (TPS) was 68%; 12 patients (17%) TPS &lt; 1% and 43 (61%) TPS ≥ 50%. No patients had <em>EGFR/ALK/ROS1</em> alterations; 29/49 tested (60%) had <em>KRAS</em> mutations.</p><p>Median follow up was 38.7 months. Objective response rate 78.6%. Median PFS 46.1 months (95% CI 39.5-NR), not reached (46.1-NR) in PD-L1 TPS ≥ 1% versus 28.1 months (16.3-NR) in TPS &lt; 1% (<em>P</em> = .013). 17 patients (24%) received additional local therapy for oligoprogression. Post pembrolizumab discontinuation, 20 patients (28%) had disease progression. Higher rates of progression occurred with TPS &lt; 1% (OR 3.46, <em>P</em> = .06), without complete response (OR 5.06, <em>P</em> = .04), and with treated oligoprogression (OR 3.11, <em>P</em> = .05). 36-month landmark survival was 98.2%.</p></div><div><h3>Conclusion</h3><p>Patients completing two-years of pembrolizumab for NSCLC in an Australian cohort had high rates of <em>KRAS</em> mutation and PD-L1 expression; a proportion had brain metastases and treated oligoprogression. Progression post pembrolizumab was higher in PD-L1 TPS &lt; 1% and in those without complete response.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 5","pages":"Pages 449-459"},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1525730424000512/pdfft?md5=524d5c384a3ad5567016e7b9d7b96cf3&pid=1-s2.0-S1525730424000512-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140785750","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}
引用次数: 0
A patient with a Germline (p.R776H) EGFR Mutation With Multiple Lung Cancers Harboring Different Somatic EGFR Mutations 一名表皮生长因子受体基因突变(p.R776H)患者患有多种肺癌,并携带不同的体细胞表皮生长因子受体基因突变。
IF 3.3 3区 医学
Clinical lung cancer Pub Date : 2024-07-01 DOI: 10.1016/j.cllc.2024.04.007
Iacopo Petrini , Rossella Bruno , Iosè Di Stefano , Vittorio Aprile , Stylianos Korasidis , Eleonora Pardini , Antonio Chella , Greta Alì
{"title":"A patient with a Germline (p.R776H) EGFR Mutation With Multiple Lung Cancers Harboring Different Somatic EGFR Mutations","authors":"Iacopo Petrini ,&nbsp;Rossella Bruno ,&nbsp;Iosè Di Stefano ,&nbsp;Vittorio Aprile ,&nbsp;Stylianos Korasidis ,&nbsp;Eleonora Pardini ,&nbsp;Antonio Chella ,&nbsp;Greta Alì","doi":"10.1016/j.cllc.2024.04.007","DOIUrl":"10.1016/j.cllc.2024.04.007","url":null,"abstract":"<div><p></p><ul><li><span>•</span><span><p>There are not standard guidelines for the selection and treatment of patients with synchronous multiple nodules with ground glass/lepidic features.</p></span></li><li><span>•</span><span><p>The presence of different <em>EGFR</em> mutations in the various resected nodules with ground glass/lepidic features suggests the existence of multifocal primary tumors.</p></span></li><li><span>•</span><span><p>The results suggest the possibility that a germline mutation in an oncogene could facilitate the development of a tumor with additional mutations in the same oncogene.</p></span></li></ul></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 5","pages":"Pages e238-e242"},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1525730424000500/pdfft?md5=3fc1e0067224b967458ed5d35f33c257&pid=1-s2.0-S1525730424000500-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140790725","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}
引用次数: 0
Pre-Operative Measures of Systemic Inflammation Predict Survival After Surgery for Primary Lung Cancer 术前全身炎症指标可预测原发性肺癌手术后的存活率
IF 3.3 3区 医学
Clinical lung cancer Pub Date : 2024-07-01 DOI: 10.1016/j.cllc.2024.04.018
Marcus Taylor , Matt Evison , Sarah Michael , Emmanuel Obale , Nils C. Fritsch , Udo Abah , Matthew Smith , Glen P. Martin , Michael Shackcloth , Felice Granato , Stuart W. Grant , Northwest Thoracic Surgery Collaborative (NWTSC)
{"title":"Pre-Operative Measures of Systemic Inflammation Predict Survival After Surgery for Primary Lung Cancer","authors":"Marcus Taylor ,&nbsp;Matt Evison ,&nbsp;Sarah Michael ,&nbsp;Emmanuel Obale ,&nbsp;Nils C. Fritsch ,&nbsp;Udo Abah ,&nbsp;Matthew Smith ,&nbsp;Glen P. Martin ,&nbsp;Michael Shackcloth ,&nbsp;Felice Granato ,&nbsp;Stuart W. Grant ,&nbsp;Northwest Thoracic Surgery Collaborative (NWTSC)","doi":"10.1016/j.cllc.2024.04.018","DOIUrl":"10.1016/j.cllc.2024.04.018","url":null,"abstract":"<div><h3>Background</h3><p>Measures of systemic inflammation (MSIs) have been developed and shown to help predict prognosis in patients with lung cancer. However, studies investigating the impact of MSIs on outcomes solely in cohorts of patients undergoing curative-intent resection of NSCLC are lacking. In the era of individualized therapies, targeting inflammatory pathways could represent a novel addition to the armamentarium of lung cancer treatment.</p></div><div><h3>Methods</h3><p>A multicentre retrospective review of patients who underwent primary lung cancer resection between 2012 and 2018 was undertaken. MSIs assessed were neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic immune inflammation index (SII), advanced lung cancer inflammation index (ALI), prognostic nutritional index (PNI) and haemoglobin albumin lymphocyte platelet (HALP) score. Cox regression analysis was performed to assess the impact of MSIs on overall survival.</p></div><div><h3>Results</h3><p>A total of 5029 patients were included in the study. Overall 90-day mortality was 3.7% (n = 185). All MSIs were significantly associated with overall survival on univariable analysis. After multivariable Cox regression analyses, lower ALI (expressed as a continuous variable) (HR 1.000, 95% CI 1.000-1.000, <em>P</em> = .049) and ALI &lt;366.43 (expressed as a dichotomous variable) (HR 1.362, 95% CI 1.137-1.631, <em>P</em> &lt; .001) remained independently associated with reduced overall survival.</p></div><div><h3>Conclusions</h3><p>MSIs have emerged in this study as potentially important factors associated with survival following lung resection for NSCLC with curative intent. In particular, ALI has emerged as independently associated with long-term outcomes. The role of MSIs in the clinical management of patients with primary lung cancer requires further investigation.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"25 5","pages":"Pages 460-467.e7"},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141062688","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}
引用次数: 0
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