JTO Clinical and Research Reports最新文献

{"title":"Successful Rechallenge of Trastuzumab Deruxtecan After Drug-Induced Interstitial Lung Disease in a NSCLC With HER2 Mutation: A Case Report","authors":"Sangho Nam MD ,&nbsp;Sun Min Lim MD, PhD ,&nbsp;Byoung Chul Cho MD, PhD ,&nbsp;Jii Bum Lee MD","doi":"10.1016/j.jtocrr.2023.100628","DOIUrl":"10.1016/j.jtocrr.2023.100628","url":null,"abstract":"<div><p>Trastuzumab deruxtecan, an antibody-drug conjugate targetingHER2-expressing tumor cells, was found to have promising results in treatment-refractory, metastatic NSCLC harboring <em>HER2</em> mutations. Nevertheless, drug-induced interstitial lung disease (ILD)/pneumonitis is a concern that limits treatment response in this subset of patients. For grade 2 or more ILD/pneumonitis, permanent discontinuation is warranted with vigorous treatment with high-dose steroid. We report a case of successful rechallenge of trastuzumab deruxtecan after recovery of grade 3 ILD/pneumonitis in treatment-refractory NSCLC harboring <em>ERBB2</em> Y772-A775dup.</p></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666364323001716/pdfft?md5=aa062d963526168862c30d4691ed7ca4&pid=1-s2.0-S2666364323001716-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139193515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RELAY, Erlotinib Plus Ramucirumab in Untreated, EGFR-Mutated, Metastatic NSCLC: Outcomes by EGFR Exon 19 Deletion Variants","authors":"Kazumi Nishino MD, PhD ,&nbsp;Jin-Yuan Shih MD, PhD ,&nbsp;Kazuhiko Nakagawa MD, PhD ,&nbsp;Martin Reck MD, PhD ,&nbsp;Edward B. Garon MD ,&nbsp;Michelle Carlsen MS ,&nbsp;Tomoko Matsui ,&nbsp;Carla Visseren-Grul MD ,&nbsp;Ernest Nadal MD, PhD","doi":"10.1016/j.jtocrr.2023.100624","DOIUrl":"10.1016/j.jtocrr.2023.100624","url":null,"abstract":"<div><h3>Introduction</h3><p><em>EGFR</em> gene mutations are drivers of NSCLC. The RELAY double-blind, placebo (PBO)-controlled phase 3 study revealed superior progression-free survival (PFS) for ramucirumab plus erlotinib (RAM + ERL) versus PBO (PBO + ERL) in patients with untreated advanced NSCLC and an <em>EGFR-</em>activating mutation. This exploratory analysis evaluated potential associations between <em>EGFR</em> exon 19 deletion (ex19del) variants and clinical outcomes.</p></div><div><h3>Methods</h3><p>Patients (N = 449) were randomized (1:1) to RAM plus ERL or PBO plus ERL. Plasma samples were collected at baseline, on treatment, and at 30-day post-study treatment discontinuation follow-up. Baseline and treatment-emergent gene alterations were investigated by Guardant360 next-generation sequencing. Patients with a valid baseline plasma sample and ex19del were included (RAM + ERL, n = 62; PBO + ERL, n = 72).</p></div><div><h3>Results</h3><p>The most common ex19del variant was E746_A750del (67.2%); <em>EGFR</em> E746 deletions (E746del) occurred more frequently than L747 deletions (74.6% versus 25.4%, respectively). <em>TP53</em> mutations were the most frequently co-occurring baseline gene alterations. With treatment arms combined, median PFS was 18.0 months versus 12.5 months for patients with uncommon (non-E746_A750del, n = 44) versus common (E746_A750del, n = 90) ex19del variants (hazard ratio [HR] = 1.657 [95% confidence interval or CI:1.044–2.630]). Median PFS was longer with RAM plus ERL versus PBO plus ERL for patients with the common (15.2 versus 9.9 mo; HR = 0.564 [95% CI: 0.344–0.926]) and E746del (15.4 versus 9.9 mo; HR = 0.587 [95% CI: 0.363–0.951]) variants. Treatment-emergent post-progression <em>EGFR</em> T790M rates were higher in the common versus uncommon and E746del versus L747 deletion subgroups.</p></div><div><h3>Conclusions</h3><p>RAM plus ERL provides benefit and improves treatment outcomes for patients with metastatic NSCLC with <em>EGFR</em> ex19del variants.</p></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666364323001674/pdfft?md5=9730c0b0a5718311961dbe0dd364d96e&pid=1-s2.0-S2666364323001674-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139017940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Timing, Trajectory, and Incidence of Immune-Related Adverse Events in NSCLC Treated With Atezolizumab","authors":"Katherine E.R. Smith MD ,&nbsp;Stephanie L. Pritzl MD ,&nbsp;Wei Yu PhD ,&nbsp;Ilze Bara MD ,&nbsp;Gita Thanarajasingam MD ,&nbsp;Monika D. Kaul MD, MBA ,&nbsp;Kirstin A. Williams PhD, CNP ,&nbsp;Amylou C. Dueck MD ,&nbsp;Aaron S. Mansfield MD","doi":"10.1016/j.jtocrr.2023.100611","DOIUrl":"https://doi.org/10.1016/j.jtocrr.2023.100611","url":null,"abstract":"<div><h3>Introduction</h3><p>Immune-related adverse events (irAEs) due to immune checkpoint inhibitors can have complicated clinical courses. We comprehensively evaluated the timing, trajectory, and incidence of both single and multiple irAEs for NSCLC treated with atezolizumab.</p></div><div><h3>Methods</h3><p>Data were pooled from 2457 patients who participated in the IMpower130, IMpower132, and IMpower150 clinical trials investigating the use of atezolizumab in metastatic NSCLC as part of a chemoimmunotherapy regimen. Longitudinal irAE data with landmark analysis, time-to-onset, changes in grading severity, and occurrence of multiple events were summarized.</p></div><div><h3>Results</h3><p>In general, 1557 patients were treated with atezolizumab and 900 patients were in the control groups. Median follow-up was 32.3 and 23.5 months, respectively. In the atezolizumab group, 753 patients (48.4%) experienced at least one irAE. In the control group, 289 patients (32.1%) experienced at least one nonimmune adverse event that was attributed to an irAE. In the atezolizumab group, the most common irAEs were rash, hepatitis, and hypothyroidism. Furthermore, 13% of the patients experienced two irAEs and 4% experienced three irAEs. Within 5 months of treatment, the cumulative incidence for any irAE was 39.2%. Median time-to-onset varied from 1 to 10 months based on the specific irAE. Grade 1 to 2 irAEs increased in severity for 33% of the patients.</p></div><div><h3>Conclusions</h3><p>We identified dynamic clinical patterns for irAEs in patients treated with atezolizumab, including variations in time-to-onset, incidence of multiple irAEs, and frequency of irAEs increasing in severity. These results can guide clinical management and future reporting of adverse events to enable comprehensive longitudinal analyses.</p></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666364323001546/pdfft?md5=5254110e9bac5aa64247581a4288b471&pid=1-s2.0-S2666364323001546-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138558479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addition of Trastuzumab Deruxtecan to Selpercatinib in a Patient With RET Fusion-Driven NSCLC and an Acquired HER2 Amplification: Case Report","authors":"Chetan V. Vakkalagadda MD ,&nbsp;Jyoti D. Patel MD","doi":"10.1016/j.jtocrr.2023.100603","DOIUrl":"https://doi.org/10.1016/j.jtocrr.2023.100603","url":null,"abstract":"<div><p>Despite the high activity of selective RET inhibitors in RET-driven NSCLC, resistance eventually develops and there is unmet need to better define therapeutic options for patients. This is a case of a patient initially thought to have no targetable alterations, then found to have a RET fusion, and subsequently HER2 amplification on three distinct biopsies. She was treated initially with chemotherapy and immune therapy, then switched to selpercatinib, and eventually had fam-trastuzumab deruxtecan added to selpercatinib. She also developed neuroendocrine differentiation at time of progression in the context of a p53 mutation, which is a known factor that can lead to small cell transformation. This patient’s case highlights the need for comprehensive molecular testing at both diagnosis and progression, as unexpected resistance mechanisms may be identified particularly for patients with uncommon driver mutations.</p></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666364323001467/pdfft?md5=21ad2d1be4933b122d024bf5464ee71c&pid=1-s2.0-S2666364323001467-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138480610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Impact of Pre-Existing Autoantibodies in Patients With SCLC Treated With Immune Checkpoint Inhibitor: A Multicenter Prospective Observational Study","authors":"Yuki Sato MD ,&nbsp;Satoru Fujiwara MD ,&nbsp;Akito Hata MD ,&nbsp;Yoko Kida MD ,&nbsp;Takahiro Masuda MD ,&nbsp;Hisanori Amimoto MD ,&nbsp;Hirotaka Matsumoto MD ,&nbsp;Kotoko Miyoshi MD ,&nbsp;Kojiro Otsuka MD, PhD ,&nbsp;Keisuke Tomii MD, PhD","doi":"10.1016/j.jtocrr.2023.100608","DOIUrl":"https://doi.org/10.1016/j.jtocrr.2023.100608","url":null,"abstract":"<div><h3>Introduction</h3><p>Although pretreatment autoantibodies have been associated with immune-related adverse events (irAEs) and immune checkpoint inhibitor treatment efficacy in some types of cancer, their importance has not been evaluated in patients with SCLC.</p></div><div><h3>Methods</h3><p>A multicenter prospective observational study was conducted on a total of 52 patients with extensive-disease SCLC who received immune checkpoint inhibitors in combination with chemotherapy as the first-line treatment at either of the six participating centers in Japan. Pretreatment serum samples were collected and analyzed for autoantibodies (rheumatoid factor, antinuclear antibodies, and antithyroid). Moreover, 12 antineuronal antibodies (AMPH, CV2, PNMA2, Ri, Yo, Hu, Recoverin, SOX1, Titin, Zic4, GAD65, and Tr) were analyzed using immunoblot assays. The primary end point was the incidence of irAEs with or without autoantibodies. The secondary end points were progression-free survival (PFS) and overall survival (OS) on the basis of the presence or absence of autoantibodies.</p></div><div><h3>Results</h3><p>PFS and OS were 4.4 and 25.3 months, respectively. Autoantibodies (rheumatoid factor, antinuclear antibodies, and antithyroid antibodies) were detected in 29 patients (56%). In total, irAEs were observed in 18 patients (35%); irAE incidence was 48% in the autoantibody-positive group and 17% in the autoantibody-negative group (<em>p</em> = 0.039). There was no difference in PFS or OS between patients with and without autoantibodies (4.4 mo versus 4.6 mo, <em>p</em> = 0.36; 15.3 mo versus 18.2 mo, <em>p</em> = 0.36). Antineuronal antibodies were detected in 16 patients (31%). However, the development of neurologic irAEs was not observed in both groups.</p></div><div><h3>Conclusions</h3><p>Vigilance is required against the development of irAEs in pretreatment antibody-positive patients.</p></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666364323001510/pdfft?md5=eee6b503312bda68f42335a8bfe68ff8&pid=1-s2.0-S2666364323001510-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138558549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Immunotherapy Use and Effectiveness in Advanced NSCLC With Programmed Death-Ligand 1 Greater Than or Equal to 50% and Greater Than or Equal to 90%","authors":"Ashley Jackson BSc ,&nbsp;Nina Chang MD ,&nbsp;Deborah Akurang BSc ,&nbsp;Paul Wheatley-Price MD ,&nbsp;Sara Moore MD","doi":"10.1016/j.jtocrr.2023.100601","DOIUrl":"10.1016/j.jtocrr.2023.100601","url":null,"abstract":"<div><h3>Background</h3><p>Immunotherapy has vastly changed the treatment landscape for patients with advanced NSCLC. With high programmed death-ligand 1 (PD-L1) expression (tumor proportion score ≥50%), options include programmed cell death protein 1 or PD-L1 inhibitor with or without chemotherapy. A cut-point of greater than or equal to 50% defines PD-L1–high, but a more precise PD-L1 tumor proportion score may be an important predictor of outcomes.</p></div><div><h3>Methods</h3><p>We reviewed all patients with PD-L1–high NSCLC who received pembrolizumab from June 2019 to June 2021. Demographic, diagnosis, treatment, and outcomes data were collected retrospectively. The primary end point was a descriptive analysis of pembrolizumab prescribing patterns. Secondary end points included overall survival (OS) by treatment choice and absolute PD-L1 expression.</p></div><div><h3>Results</h3><p>Overall, 132 patients received pembrolizumab; 124 (94%) as monotherapy, and 8 (6%) with chemotherapy. Baseline characteristics include the following: (1) median age 70 years (50–89); (2) 55% men; (3) 79% Eastern Cooperative Oncology Group performance status 0 to 1; and (4) 96% current or former smokers. There were 39% who have PD-L1 greater than or equal to 90% versus 61% with PD-L1 of 50% to 89%. The median OS in the overall population was 14.4 months. The median OS in the pembrolizumab monotherapy cohort and combination cohort were 13.6 months and 16.6 months, respectively (<em>p</em> = 0.67). Within the monotherapy cohort, the median OS was longer for PD-L1 greater than or equal to 90% (19.8 mo) versus PD-L1 50% to 89% (11.9 mo, <em>p</em> = 0.039). The 24-month OS was 27.8% among patients with PD-L1 50% to 89% and 47.4% among patients with PD-L1 greater than or equal to 90%.</p></div><div><h3>Conclusions</h3><p>Most patients with advanced PD-L1–high NSCLC received pembrolizumab monotherapy, among whom OS was strongly correlated with PD-L1 expression, with PD-L1 greater than or equal to 90% of patients experiencing substantially longer survival. PD-L1 expression level could be an important determinant in immunotherapy prescribing patterns and a predictor of success in advanced NSCLC.</p></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666364323001443/pdfft?md5=d40bffccdc00c552f1a235eb7ad5d5e1&pid=1-s2.0-S2666364323001443-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135763502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief Report: circRUNX1 as Potential Biomarker for Cancer Recurrence in EGFR Mutation-Positive Surgically Resected NSCLC","authors":"Carlos Pedraz-Valdunciel PhD ,&nbsp;Masaoki Ito MD ,&nbsp;Stavros Giannoukakos PhD student ,&nbsp;Ana Giménez-Capitán MSc ,&nbsp;Miguel Ángel Molina-Vila PhD ,&nbsp;Rafael Rosell MD, PhD","doi":"10.1016/j.jtocrr.2023.100604","DOIUrl":"https://doi.org/10.1016/j.jtocrr.2023.100604","url":null,"abstract":"<div><h3>Introduction</h3><p>As recently evidenced by the ADAURA trial, most patients with stages IB to IIIA of resected EGFR-mutant lung adenocarcinoma benefit from osimertinib as adjuvant therapy. Nevertheless, predictive markers of response and recurrence are still an unmet need for more than 10% of these patients. Some circular RNAs (circRNAs) have been reported to play a role in tumor growth and proliferation. In this project, we studied circRNA expression levels in formalin-fixed, paraffin-embedded lung tumor samples to explore their biomarker potential and develop a machine learning (ML)-based signature that could predict the benefit of adjuvant EGFR tyrosine kinase inhibitors in patients with EGFR-mutant NSCLC.</p></div><div><h3>Methods</h3><p>Patients with surgically resected EGFR mutant-positive, stages I to IIIB NSCLC were recruited from February 2007 to December 2015. Formalin-fixed, paraffin-embedded tumor samples were retrospectively collected from those patients with a follow-up period of more than or equal to 36 months (N = 76). Clinicopathologic features were annotated. Total RNA was purified and quantified prior nCounter processing with our circRNA custom panel. Data analysis and ML were performed taking into consideration circRNA expression levels and recurrence-free survival (RFS). RFS was defined from the day of surgery to the day when recurrence was detected radiologically or the death owing to any cause.</p></div><div><h3>Results</h3><p>Of the 76 patients with EGFR mutation-positive NSCLC included in the study, 34 relapsed within 3 years after resection. The median age of the relapsing cohort was 71.5 (range: 49–89) years. Most patients were nonsmokers (n = 21; 61.8%) and of female sex (n = 21; 61.8%). Most cases (n = 17; 50%) presented an exon 21 mutation, whereas 15 and four patients had an exon 19 and exon 18 mutation, respectively. Differential expression analysis revealed that circRUNX1, along with circFUT8 and circAASDH, was up-regulated in relapsing patients (<em>p</em> &lt; 0.05 and &gt;2 fold-change). A ML-based circRNA signature predictive of recurrence in patients with EGFR mutation-positive NSCLC, comprising circRUNX1, was developed. Our final model including selected 6-circRNA signature with random forest algorithm was able to classify relapsing patients with an accuracy of 83% and an area under the receiver operating characteristic curve of 0.91.</p><p>RFS was significantly shorter not only for the subgroup of patients with high versus low circRUNX1 expression but also for the group classified as recurrent by the ML circRNA signature when compared with those classified as nonrecurrent.</p></div><div><h3>Conclusions</h3><p>Our findings suggest that circRUNX1 and the presented ML-developed signature could be novel tools to predict the benefit of adjuvant EGFR tyrosine kinase inhibitors with regard to RFS in patients with EGFR-mutant NSCLC. The training and validation phases of our ML signature will be conducted ","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666364323001479/pdfft?md5=0c62d819a6a6d63f5beae8d75d3e638f&pid=1-s2.0-S2666364323001479-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138557405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Survival and Failure Outcomes of Single-Fraction Stereotactic Body Radiation Therapy in Early Stage NSCLC","authors":"Austin J. Iovoli MD ,&nbsp;Sharan Prasad BSc ,&nbsp;Sung Jun Ma MD ,&nbsp;Fatemeh Fekrmandi MD, MSc ,&nbsp;Nadia K. Malik MD ,&nbsp;Simon Fung-Kee-Fung MD ,&nbsp;Mark K. Farrugia MD, PhD ,&nbsp;Anurag K. Singh MD","doi":"10.1016/j.jtocrr.2023.100598","DOIUrl":"10.1016/j.jtocrr.2023.100598","url":null,"abstract":"<div><h3>Introduction</h3><p>This study aims to report our 13-year institutional experience with single-fraction stereotactic body radiation therapy (SF-SBRT) for early stage NSCLC.</p></div><div><h3>Methods</h3><p>A single-institutional retrospective review of patients with biopsy-proven peripheral cT1-2N0M0 NSCLC undergoing definitive SF-SBRT between September 2008 and May 2022 was performed. All patients were treated to 27 Gy with heterogeneity corrections or 30 Gy without. Primary outcomes were overall survival and progression-free survival. Secondary outcomes included local failure, nodal failure, distant failure, and second primary lung cancer.</p></div><div><h3>Results</h3><p>Among 263 eligible patients, the median age was 76 years (interquartile range [IQR]: 70–81 y) and median follow-up time was 27.2 months (IQR: 14.25–44.9 mo). Median tumor size was 1.9 cm (IQR: 1.4–2.6 cm), and 224 (85%) tumors were T1. There were 92 patients (35%) alive at the time of analysis with a median follow-up of 34.0 months (IQR: 16.6–50.0 mo). Two- and five-year overall survival was 65% and 26%, respectively. A total of 74 patients (28%) developed disease progression. Rates of five-year local failure, nodal failure, distant failure, and second primary lung cancer were 12.7%, 14.7%, 23.5%, and 12.0%, respectively.</p></div><div><h3>Conclusions</h3><p>Consistent with multiple prospective randomized trials, in a large real-world retrospective cohort, SF-SBRT for peripheral early stage NSCLC was an effective treatment approach.</p></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666364323001418/pdfft?md5=c9f4a859c9b356b9ce87f6c064b2105d&pid=1-s2.0-S2666364323001418-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135372114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Resection of Benign Nodules in Lung Cancer Screening: Incidence and Features","authors":"John M. Archer MD ,&nbsp;Dexter P. Mendoza MD ,&nbsp;Yin P. Hung MD, PhD ,&nbsp;Michael Lanuti MD ,&nbsp;Subba R. Digumarthy MD","doi":"10.1016/j.jtocrr.2023.100605","DOIUrl":"https://doi.org/10.1016/j.jtocrr.2023.100605","url":null,"abstract":"<div><h3>Introduction</h3><p>Interventions and surgical procedures are common for nonmalignant lung lesions detected on lung cancer screening (LCS). Inadvertent surgical resection of benign nodules with a clinical suspicion of lung cancer can occur, can be associated with complications, and adds to the cost of screening. The objective of this study is to assess the characteristics of surgically resected benign nodules detected on LCS computed tomography which were presumed to be lung cancers.</p></div><div><h3>Methods</h3><p>This retrospective study included 4798 patients who underwent LCS between June 2014 and January 2021. The benign lung nodules, surgically resected with a presumed cancer diagnosis, were identified from the LCS registry. Patient demographics, imaging characteristics, and pathologic diagnoses of benign nodules were analyzed.</p></div><div><h3>Results</h3><p>Of the 4798 patients who underwent LCS, 148 (3.1%) underwent surgical resection of a lung nodule, and of those who had a resection, 19 of 148 (12.8%) had a benign diagnosis (median age = 64 y, range: 56–77 y; F = 12 of 19, 63.2%; M = seven of 19, 36.8%). The median nodule size was 10 mm (range: 6–31 mm). Most nodules were solid (15 of 19, 78.9%), located in the upper lobes (11 of 19; 57.9%), and were peripheral (17 of 19, 89.5%). Most nodules (13 of 17; 76.5%) had interval growth, and four of 17 (23.5%) had increased fluorodeoxyglucose uptake. Of the 19 patients, 17 (89.5%) underwent sublobar resection (16 wedge resection and one segmentectomy), whereas two central nodules (10.5%) had lobectomies. Pathologies identified included focal areas of fibrosis or scarring (n = 8), necrotizing granulomatous inflammation (n = 3), other nonspecific inflammatory focus (n = 3), benign tumors (n = 3), reactive lymphoid hyperplasia (n = 1), and organizing pneumonia (n = 1).</p></div><div><h3>Conclusions</h3><p>Surgical resections of benign nodules that were presumed malignant are infrequent and may be unavoidable given overlapping imaging features of benign and malignant nodules. Knowledge of benign pathologies that can mimic malignancy may help reduce the incidence of unnecessary surgeries.</p></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666364323001480/pdfft?md5=18de592a4f45a6774309a4d987496455&pid=1-s2.0-S2666364323001480-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138475440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mobocertinib and Bevacizumab for Amivantamab-Refractory Lung Cancer With EGFR Exon 20 Insertion Mutation: A Case Report","authors":"Jaemin Kim BS ,&nbsp;Youngjoo Lee MD, PhD","doi":"10.1016/j.jtocrr.2023.100600","DOIUrl":"10.1016/j.jtocrr.2023.100600","url":null,"abstract":"<div><p>Amivantamab is the first drug approved in <em>EGFR</em> exon 20 insertion-mutated NSCLC. Nevertheless, primary or secondary resistance to amivantamab is a frequent problem in clinical practice. We report a case of a patient with <em>EGFR</em> exon 20-mutated NSCLC who had primary resistance to amivantamab but was successfully treated by combining therapy of another <em>EGFR</em> exon 20 insertion-specific targeted drug mobocertinib and bevacizumab.</p></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666364323001431/pdfft?md5=36050fb5b8616fe1ed39b080155b1894&pid=1-s2.0-S2666364323001431-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135509538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}