Clinical lung cancer最新文献

{"title":"Genomic and Immune Landscape Comparison of MET Exon 14 Skipping and MET-Amplified Non-small Cell Lung Cancer","authors":"","doi":"10.1016/j.cllc.2024.05.001","DOIUrl":"10.1016/j.cllc.2024.05.001","url":null,"abstract":"<div><h3>Background</h3><p>Mutation or amplification of the mesenchymal-epithelial transition (MET) tyrosine kinase receptor causes dysregulation of receptor function and stimulates tumor growth in non-small cell lung cancer (NSCLC) with the most common mutation being MET exon 14 (METex14). We sought to compare the genomic and immune landscape of MET-altered NSCLC with MET wild-type NSCLC.</p></div><div><h3>Methods</h3><p>18,047 NSCLC tumors were sequenced with Tempus xT assay. Tumors were categorized based on MET exon 14 (METex14) mutations; low MET amplification defined as a copy number gain (CNG) 6-9, high MET amplification defined as CNG ≥ 10, and MET other type mutations. Immuno-oncology (IO) biomarkers and the frequency of other somatic gene alterations were compared across MET-altered and MET wild-type groups.</p></div><div><h3>Results</h3><p>276 (1.53%) METex14, 138 (0.76%) high METamp, 63 (0.35%) low METamp, 27 (0.15%) MET other, and 17,543 (97%) MET wild-type were identified. Patients with any MET mutation including METex14 were older, while patients with METex14 were more frequently female and nonsmokers. MET gene expression was highest in METamp tumors. PD-L1 positivity rates were higher in MET-altered groups than MET wild-type. METex14 exhibited the lowest tumor mutational burden (TMB) and lowest neoantigen tumor burden (NTB). METamp exhibited the lowest proportion of CD4 T cells and the highest proportion of NK cells. There were significant differences in co-alterations between METamp and METex14.</p></div><div><h3>Conclusions</h3><p>METex14 tumors exhibited differences in IO biomarkers and the somatic landscape compared to non-METex14 NSCLC tumors. Variations in immune profiles can affect immunotherapy selection in MET-altered NSCLC and require further exploration.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141049388","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: The Immune Profiles of the Molecular Subtypes of EGFR-Mutant Lung Adenocarcinomas in a Large Real-World Cohort","authors":"","doi":"10.1016/j.cllc.2024.04.016","DOIUrl":"10.1016/j.cllc.2024.04.016","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>EGFR-mutant tumors with exon 19 deletions, L858R mutations, or exon 20 insertions were less likely to be PD-L1 high (TPS ≥ 50%) or TMB high (≥10 mut/MB) as compared to wild-type (WT) tumors. Among EGFR-mutant tumors, those with uncommon alterations in L861Q and G719X had greater rates of TMB high and TP53 co-mutations.</div></span></li><li><span>•</span><span><div>Utilizing bulk<span> RNA sequencing<span> data to characterize the immune tumor microenvironment<span> (TME), exon 19 deletion and L858R mutation tumors were found to have lower median percent fractions of CD8+ T cells versus WT. However, a wide range of values for CD8+ T cells was observed and a subset of exon 19 deletion and L858R tumors had higher values comparable to WT.</span></span></span></div></span></li><li><span>•</span><span><div><span>Exon 19 deletion, L858R, and exon 20 insertion tumors were enriched with immunosuppressive<span> M2 macrophages and </span></span>neutrophils as compared to WT. In contrast, L861Q and G719X tumors had levels of M2 macrophages similar to WT.</div></span></li><li><span>•</span><span><div>A small subset of EGFR-mutant tumors, particularly those with uncommon alterations, bear characteristics that may render them more immunogenic. Continued research is needed to evaluate biomarkers, including the specific subtype of EGFR<span>, as predictors of immunotherapy response to better identify the small subgroup of patients with EGFR-mutant disease that benefit from checkpoint inhibitors.</span></div></span></li></ul></div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141062683","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":"Plunging Into the PACIFIC: Outcomes of Patients With Unresectable KRAS-Mutated Non-Small Cell Lung Cancer Following Definitive Chemoradiation and Durvalumab Consolidation","authors":"Adam Barsouk ,&nbsp;Cole Friedes ,&nbsp;Michelle Iocolano ,&nbsp;Abigail Doucette ,&nbsp;Roger B. Cohen ,&nbsp;Kyle W. Robinson ,&nbsp;Christopher A. D'Avella ,&nbsp;Melina E. Marmarelis ,&nbsp;John A. Kosteva ,&nbsp;Aditi P. Singh ,&nbsp;Christine A. Ciunci ,&nbsp;William P. Levin ,&nbsp;Keith A. Cengel ,&nbsp;Jeffrey D. Bradley ,&nbsp;Steven J. Feigenberg ,&nbsp;Lova Sun ,&nbsp;Charu Aggarwal ,&nbsp;Corey J. Langer ,&nbsp;Nikhil Yegya-Raman","doi":"10.1016/j.cllc.2023.12.009","DOIUrl":"10.1016/j.cllc.2023.12.009","url":null,"abstract":"<div><h3>Background</h3><p><span><span>Immune checkpoint inhibitor (ICI) consolidation following concurrent </span>chemoradiotherapy<span><span> (CRT) substantially improved progression free survival (PFS) and overall survival (OS) in the PACIFIC trial becoming the standard of care in locally-advanced, unresectable </span>NSCLC. </span></span><em>KRAS</em> mutation may influence response to ICI.</p></div><div><h3>Methods</h3><p><span>In this single-institution, retrospective analysis, we compared treatment outcomes for patients with unresectable </span><em>KRAS</em> mutated (<em>KRAS</em>-mt) and wild-type (<em>KRAS</em>-wt) NSCLC treated with CRT between October 2017 and December 2021. Kaplan–Meier analysis was conducted comparing median progression free survival and median overall survival from completion of radiotherapy in all <em>KRAS</em>-mt patients and <em>KRAS-G12C-</em>mutated patients. Outcomes were also compared with and without ICI consolidation.</p></div><div><h3>Results</h3><p>Of 156 patients, 42 (26.9%) were <em>KRAS</em>-mt and 114 (73.1%) were <em>KRAS</em>-wt. Baseline characteristics differed only in histology; <em>KRAS</em>-mt NSCLC more likely to be adenocarcinoma. <em>KRAS</em>-mt patients had worse PFS (median 6.3 vs. 10.7 months, <em>P</em> = .041) but similar OS (median 23.1 vs. 27.3 months, <em>P</em> = .237). <em>KRAS</em><span>-mt patients were more likely to not receive ICI due to rapid disease progression post-CRT (23.8% vs. 4.4%, </span><em>P</em> = .007). Among patients who received ICI (n = 114), <em>KRAS</em>-mt was not associated with inferior PFS (8.1 vs. 11.9 months, <em>P</em> = .355) or OS (30.5 vs. 31.7 months, <em>P</em> = .692). <em>KRAS-G12C</em> patients (n = 22) had similar PFS and OS to other <em>KRAS</em>-mt.</p></div><div><h3>Conclusion</h3><p>In one of the largest post-CRT <em>KRAS</em>-mt cohort published, <em>KRAS</em>-mt was associated with inferior PFS, largely due to rapid progression prior to ICI consolidation, but did not affect OS. Among those who received ICI consolidation, outcomes were comparable regardless of <em>KRAS</em>-mt status.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139027050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Cancer Survival Trends in the Veterans Health Administration","authors":"Drew Moghanaki ,&nbsp;James Taylor ,&nbsp;Alex K. Bryant ,&nbsp;Lucas K. Vitzthum ,&nbsp;Nikhil Sebastian ,&nbsp;David Gutman ,&nbsp;Abigail Burns ,&nbsp;Zhonglu Huang ,&nbsp;Jennifer A. Lewis ,&nbsp;Lucy B. Spalluto ,&nbsp;Christina D. Williams ,&nbsp;Donald R. Sullivan ,&nbsp;Christopher G. Slatore ,&nbsp;Madhusmita Behera ,&nbsp;William A. Stokes","doi":"10.1016/j.cllc.2024.02.009","DOIUrl":"10.1016/j.cllc.2024.02.009","url":null,"abstract":"<div><h3>Introduction</h3><p>Lung cancer survival is improving in the United States. We investigated whether there was a similar trend within the Veterans Health Administration (VHA), the largest integrated healthcare system in the United States.</p></div><div><h3>Materials and Methods</h3><p>Data from the Veterans Affairs Central Cancer Registry were analyzed for temporal survival trends using Kaplan-Meier estimates and linear regression.</p></div><div><h3>Results</h3><p>A total number of 54,922 Veterans were identified with lung cancer diagnosed from 2010 to 2017. Histologies were classified as non–small-cell lung cancer (NSCLC) (64.2%), small cell lung cancer (SCLC) (12.9%), and ‘other’ (22.9%). The proportion with stage I increased from 18.1% to 30.4%, while stage IV decreased from 38.9% to 34.6% (both <em>P</em> &lt; .001). The 3-year overall survival (OS) improved for stage I (58.6% to 68.4%, <em>P</em> &lt; .001), stage II (35.5% to 48.4%, <em>P</em> &lt; .001), stage III (18.7% to 29.4%, <em>P</em> &lt; .001), and stage IV (3.4% to 7.8%, <em>P</em> &lt; .001). For NSCLC, the median OS increased from 12 to 21 months (<em>P</em> &lt; .001), and the 3-year OS increased from 24.1% to 38.3% (<em>P</em> &lt; .001). For SCLC, the median OS remained unchanged (8 to 9 months, <em>P</em> = .10), while the 3-year OS increased from 9.1% to 12.3% (<em>P</em> = .014). Compared to White Veterans, Black Veterans with NSCLC had similar OS (<em>P</em> = .81), and those with SCLC had higher OS (<em>P</em> = .003).</p></div><div><h3>Conclusion</h3><p>Lung cancer survival is improving within the VHA. Compared to White Veterans, Black Veterans had similar or higher survival rates. The observed racial equity in outcomes within a geographically and socioeconomically diverse population warrants further investigation to better understand and replicate this achievement in other healthcare systems.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1525730424000354/pdfft?md5=d4d33f3c814fe8444dc2af0f1761ce89&pid=1-s2.0-S1525730424000354-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140018513","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":"Prognostic Impact of TP53 Mutations in Metastatic Nonsquamous Non–small-cell Lung Cancer","authors":"Laurent Mathiot ,&nbsp;Benoit Nigen ,&nbsp;Thomas Goronflot ,&nbsp;Sandrine Hiret ,&nbsp;Ludovic Doucet ,&nbsp;Elvire Pons-Tostivint ,&nbsp;Jaafar Bennouna ,&nbsp;Marc G. Denis ,&nbsp;Guillaume Herbreteau ,&nbsp;Judith Raimbourg","doi":"10.1016/j.cllc.2023.12.004","DOIUrl":"10.1016/j.cllc.2023.12.004","url":null,"abstract":"<div><h3>Background</h3><p>The prognostic impact of TP53 mutations in advanced or metastatic nonsquamous non–small-cell lung cancer (nsNSCLC) patients treated with chemotherapy and/or immune checkpoint inhibitors (ICI) remains unclear.</p></div><div><h3>Materials and Methods</h3><p>We retrospectively collected data from patients with nsNSCLC treated in the first line from January 2018 to May 2021. The patient was separated into 2 groups according to their TP53 mutation status (wt vs. mut). Survival was estimated through the Kaplan-Meier method and compared by log-rank test.</p></div><div><h3>Results</h3><p>Of 220 patients included, 126 were in the mutTP53 group, and 94 were in the wtTP53wt group. Median OS (mOS) was not significantly different between the mutTP53 and wtTP53 groups [17.5 months (95% confidence interval (CI), 11.3-21.5) vs. 9.5 months (95% CI, 7.4-14.2), (<em>P</em> = .051)]. In subgroup analyses, the mutTP53 group treated with ICI had a significantly improved mOS compared to the wtTP53 group [(24.7 months (95% CI, 20.8–not reach) vs. 12.0 months (95% CI, 4.7–not reach), (<em>P</em> = .017)] and mPFS [(9.6 months (95% CI, 5.8–not reach) vs. 3.2 months (95% CI, 1.3-13.8) (<em>P</em> = .048)]. There was no difference in terms of mOS and mPFS between the mutTP53 and the wtTP53 group treated by chemotherapy alone or combined with ICI.</p></div><div><h3>Conclusion</h3><p>TP53 mutation had no survival impact in the overall population, but is associated with better outcomes with ICI alone. These results suggest that patients with TP53 mutations could be treated with ICI alone, and wild-type patients could benefit from the addition of chemotherapy.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1525730423002607/pdfft?md5=4ba682b8c6d938a0b0bb315805822961&pid=1-s2.0-S1525730423002607-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138681599","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: Impact of Reflex Testing on Tissue-Based Molecular Genotyping in Patients With Advanced Non-Squamous Non-Small Cell Lung Cancer","authors":"Melina E. Marmarelis ,&nbsp;Dylan G. Scholes ,&nbsp;Cindy M. McGrath ,&nbsp;Salvatore F. Priore ,&nbsp;Jacquelyn J. Roth ,&nbsp;Michael Feldman ,&nbsp;Jennifer J.D. Morrissette ,&nbsp;Leslie Litzky ,&nbsp;Charu Deshpande ,&nbsp;Jeffrey C. Thompson ,&nbsp;Abigail Doucette ,&nbsp;Peter E. Gabriel ,&nbsp;Lova Sun ,&nbsp;Aditi P. Singh ,&nbsp;Roger B. Cohen ,&nbsp;Corey J. Langer ,&nbsp;Erica L. Carpenter ,&nbsp;Charu Aggarwal","doi":"10.1016/j.cllc.2024.03.002","DOIUrl":"10.1016/j.cllc.2024.03.002","url":null,"abstract":"<div><p></p><ul><li><span>•</span><span><p>Timely molecular testing is integral to determining the best treatment for patients with non-small cell lung cancer. In small studies, reflex molecular testing on pathology samples has been shown to improve timeliness and rates of molecular testing. In our study, we show that implementation of reflex molecular genotyping on tissue-based tests at a large academic center improved the proportion of patients with successful DNA molecular testing. In addition, liquid cytology specimens proved to be a rich DNA source that may spare tissue for other testing or clinical trial eligibility.</p></span></li></ul></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140147379","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":"Perioperative Immunotherapy for Non-Small Cell Lung Cancer: Practical Application of Emerging Data and New Challenges","authors":"Angelica D'Aiello ,&nbsp;Brendon Stiles ,&nbsp;Nitin Ohri ,&nbsp;Benjamin Levy ,&nbsp;Perry Cohen ,&nbsp;Balazs Halmos","doi":"10.1016/j.cllc.2024.02.004","DOIUrl":"10.1016/j.cllc.2024.02.004","url":null,"abstract":"<div><p>Immune checkpoint inhibition, with or without chemotherapy, is an established standard of care for metastatic non-small cell lung cancer (NSCLC). For locally advanced NSCLC treated with chemoradiotherapy, consolidation immunotherapy has dramatically improved outcomes. Recently, immunotherapy has also been established as a valuable component of treatment for resectable NSCLC with pembrolizumab, atezolizumab, and nivolumab all approved for use in this setting. As more results read out from ongoing perioperative clinical trials, navigating treatment options will likely become increasingly complex for the practicing oncologist. In this paper, we distill key outcomes from major perioperative trials and highlight current knowledge gaps. In addition, we provide practical considerations for incorporating perioperative immunotherapy into the clinical management of operable NSCLC.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139827485","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 Clinical Outcomes of Thoracoscopic Versus Open Lobectomy for Non–Small-Cell Lung Cancer After Neoadjuvant Therapy: A Multi-Center Retrospective Cohort Study","authors":"Jinlin Cao ,&nbsp;Chong Zhang ,&nbsp;Xun Zhang ,&nbsp;Lunxu Liu ,&nbsp;Xiaofei Li ,&nbsp;Jianxing He ,&nbsp;Lin Xu ,&nbsp;Xiangning Fu ,&nbsp;Yang Liu ,&nbsp;Deruo Liu ,&nbsp;Jian Hu ,&nbsp;Luming Wang","doi":"10.1016/j.cllc.2023.12.008","DOIUrl":"10.1016/j.cllc.2023.12.008","url":null,"abstract":"<div><h3>Background</h3><p>The safety and efficacy of video-assisted thoracic surgical (VATS) versus open lobectomy for non–small-cell lung cancer (NSCLC) following neoadjuvant therapy remained controversial. The aim of this study was to compare the outcomes of VATS with those of open lobectomy for NSCLC after neoadjuvant therapy.</p></div><div><h3>Methods</h3><p>Patients who had undergone VATS or open lobectomy for NSCLC following neoadjuvant therapy in nine hospitals in China from July 2014 to July 2020 were retrospectively reviewed. The clinical characteristics and overall survival (OS) of patients were analyzed using Cox regression models and propensity score matching.</p></div><div><h3>Results</h3><p>We identified 685 patients, 436 (63.6%) who had undergone VATS lobectomy and 249 (36.4%) who had undergone open lobectomy. Patients who had undergone VATS lobectomy tended to have had fewer nodes removed than those who had undergone open lobectomy. However, compared with open group, the VATS group had a better perioperative outcome, such as smaller blood loss volumes and shorter postoperative stays. The groups had a similar operation durations and postoperative complications, and there was a nonsignificant difference between their 30-day mortality rates. After propensity score matching, there was no significant different between the OS of the groups, and only postoperative adjuvant therapy was associated with worse OS.</p></div><div><h3>Conclusion</h3><p>This multi-center analysis of patients with NSCLC who had undergone surgery subsequent to neoadjuvant therapy reveals that VATS lobectomy tended to have a better perioperative outcome, and have a similar OS compared to open lobectomy. These findings suggest that VATS lobectomy is appropriate for NSCLC following neoadjuvant therapy.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138681910","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":"So Now We Know—Reflections on the Extent of Resection for Stage I Lung Cancer","authors":"Frank Detterbeck ,&nbsp;Sora Ely ,&nbsp;Brooks Udelsman ,&nbsp;Justin Blasberg ,&nbsp;Daniel Boffa ,&nbsp;Andrew Dhanasopon ,&nbsp;Vincnet Mase ,&nbsp;Gavitt Woodard","doi":"10.1016/j.cllc.2023.12.007","DOIUrl":"10.1016/j.cllc.2023.12.007","url":null,"abstract":"<div><p>Lobectomy has been the standard treatment for stage I lung cancer in healthy patients, largely based on a randomized trial published in 1995. Nevertheless, research has continued regarding the role of sublobar resection. Three additional randomized trials addressing resection extent in healthy patients have recently been published. These 4 trials involve differences in design, eligibility, interventions, and intraoperative processes. Patients were ineligible if intraoperative assessment demonstrated stage &gt; IA or inadequate resection margins. All trials consistently show no differences in perioperative morbidity, mortality, and postoperative changes in lung function between sublobar resection and lobectomy—consistent with other nonrandomized evidence. Long-term outcomes are generally encouraging of lesser resection, but some inconsistencies are apparent. The 2 larger recent trials demonstrated no overall survival difference while the others suggested better survival after lobectomy versus sublobar resection. Recurrence-free survival was found to be the same after lobectomy versus sublobar resection in 3 trials, despite higher locoregional recurrences after sublobar resection. The low 5-year recurrence-free survival (64%, regardless of resection extent) in 1 recent trial highlights the need for further optimization. Thus, there is high-level evidence that sublobar resection is a reasonable alternative to lobectomy in healthy patients. However, variability in long-term results suggests that aspects of patients, tumors and interventions need to be better understood. Therefore, we propose to apply sublobar resection cautiously; especially because there are no short-term benefits. Sublobar resection requires careful attention to intraoperative details (nodes, margins), and may be best suited for less aggressive (eg, ground glass, slow growing) tumors.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139062873","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 II Trial of Adjuvant Atezolizumab Therapy in Elderly Patients with Completely Resected Stage II/III Non-Small Cell Lung Cancer: RELIANCE Trial","authors":"Taichi Matsubara ,&nbsp;Masafumi Yamaguchi ,&nbsp;Mototsugu Shimokawa ,&nbsp;Isamu Okamoto","doi":"10.1016/j.cllc.2024.01.009","DOIUrl":"10.1016/j.cllc.2024.01.009","url":null,"abstract":"<div><h3>Introduction</h3><p>Atezolizumab following platinum chemotherapy and complete pulmonary resection has become the new standard of adjuvant care for patients with stage II-III non-small cell lung cancer (NSCLC) expressing programmed death-ligand 1 (PD-L1). However, the efficacy and safety of postoperative adjuvant therapy and subsequent atezolizumab in patients aged 75 and older have not been established.</p></div><div><h3>Methods</h3><p>Patients with completely resected stage II–III NSCLC aged 75 and older will be prospectively registered in this single-arm phase II study. The enrolled patients will receive cisplatin plus vinorelbine (CDDP + VNR) followed by atezolizumab for up to 12 months. PD-L1 expression in at least 1% of cells will be confirmed by immunohistochemical staining. We plan to enroll 33 patients over 1 year at 25 institutions in Japan. The primary endpoint is the completion rate of adjuvant treatment (CDDP + VNR initiation to atezolizumab completion).</p></div><div><h3>Conclusion</h3><p>The present study represents the first prospective trial of the tolerability of postoperative adjuvant therapy with immune checkpoint inhibitors in elderly individuals. The results of this trial might help promote postoperative adjuvant immunotherapy in the future for the elderly.</p></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139635417","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}