Lung Cancer最新文献

{"title":"Lorlatinib-associated weight gain and dyslipidaemia: A retrospective analysis and implications for future care.","authors":"A John, D J McMahon, D Chauhan, S Mullings, N Samuel, F Kalofonou, C Milner-Watts, N Tokaca, N Yousaf, M Davidson, J Bhosle, A Minchom, O'Brien Mer, S Popat","doi":"10.1016/j.lungcan.2024.108034","DOIUrl":"https://doi.org/10.1016/j.lungcan.2024.108034","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of our study was to benchmark the incidence and severity of lorlatinib-related weight gain and dyslipidaemia in a real-world context, to guide future therapeutic strategies to mitigate these toxicities.</p><p><strong>Methods: </strong>We conducted a retrospective, observational analysis of patients with ALK and ROS1-positive NSCLC at a single institution in the UK who were commenced on lorlatinib from 11/2016 to 11/2022. Non-small cell lung cancer (NSCLC) patients prescribed lorlatinib were identified through institutional electronic pharmacy records. Descriptive analyses were conducted. Patients without recorded baseline weight were excluded from the analysis. Changes in weight, body mass index (BMI), triglycerides, and total/low-density lipoprotein (LDL)/high-density lipoprotein (HDL) cholesterol were calculated from serial measurements and graded in accordance with CTCAE v5.0.</p><p><strong>Results: </strong>43 patients were evaluated. 81 % of patients developed weight gain on lorlatinib (median: 4.5 kg, 6.5 % increase from baseline); Grade < 1 in 37 % (n = 16/43), Grade 1 in 23 % (n = 10/43), Grade 2 in 12 % (n = 5/43), and Grade ≥ 3 in 9 % (n = 4/43). BMI increase was observed in 79 % of patients. 35 % of patients with healthy baseline BMI moved into overweight/obese categories. Of patients with recorded baseline lipid levels, 91 % developed increase in total cholesterol, and 68 % an increase in triglycerides, respectively. 7 % (n = 1/15) patients with normal baseline total cholesterol developed Grade ≥ 3 elevated cholesterol; no patients with normal baseline triglycerides developed Grade ≥ 3 elevated hypertriglyceridaemia (n = 12). Median time to onset of total cholesterol elevation was 21 days. Lipid-lowering therapy was required in most patients (86 %). One patient developed a non-ST elevation myocardial infarction (NSTEMI) which may have been attributable to lorlatinib.</p><p><strong>Conclusion: </strong>Weight gain and dyslipidaemia are commonly observed with lorlatinib, highlighting the need for effective pharmacologic and non-pharmacologic strategies to manage these toxicities. Rates were similar to those reported in the CROWN trial. Given the 60 % 5-year progression-free survival (PFS) demonstrated in CROWN, mitigation of treatment-related toxicities is paramount to minimise impact on patient quality of life (QOL) and cancer-independent morbidity in this subgroup of NSCLC patients with favourable outcomes.</p>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"108034"},"PeriodicalIF":4.5,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiological follow-up in patients with resected pulmonary carcinoids: Should we reduce radiation exposure?","authors":"F.W.J. Heijboer ,&nbsp;T.A. Mulders ,&nbsp;M. van Straten ,&nbsp;L. Moonen ,&nbsp;E.M. Speel ,&nbsp;J.H. von der Thüsen ,&nbsp;J.L. Derks ,&nbsp;A.C. Dingemans","doi":"10.1016/j.lungcan.2024.108030","DOIUrl":"10.1016/j.lungcan.2024.108030","url":null,"abstract":"<div><h3>Introduction</h3><div>After primary resection of pulmonary carcinoids, the recurrence rate is low (approximately 10 %). However, long-term radiological follow-up is generally recommended due to the risk of late recurrence. This must be weighed against risk of radiation-induced cancer, particularly in young patients.</div></div><div><h3>Methods</h3><div>The frequency and modality of radiological follow-up according to the ENETS, ESMO, and CommNETs-NANETS guidelines were assessed. Cumulative radiation exposure per guideline and subsequent increased lifetime cancer risk were estimated using sex- and age-dependent risk factors. Data from the Netherlands Cancer Registry (2003–2012) of adults with resected pulmonary carcinoids were used as a reference.</div></div><div><h3>Results</h3><div>Of 706 reference patients, 32 (4.5 %) were 18–30 years (y). After median follow-up of 127 months, none of the patients aged 18-30y at diagnosis developed recurrence. For these patients, the additional radiation exposure at the age of 40y due to follow-up ranges from 140-308 mSv following ENETS and 35–42 mSv following ESMO guidelines. The additional risk of death due to carcinogenic effects ranged from 0.7 % (male 30y) to 3.1 % (female 18y) following ENETS and 0.2 % (male) to 0.4 % (female) following ESMO guidelines.</div></div><div><h3>Conclusions</h3><div>Individualised, less extensive follow-up for young patients with resected carcinoids and a low risk of recurrence are worth exploring to decrease radiation exposure and the corresponding risk of cancer induction. The use of predictive biomarkers to personalise follow-up is warranted.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"Article 108030"},"PeriodicalIF":4.5,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief Report: Should a prior cancer history be reevaluated as an exclusion for clinical trial participation?","authors":"Oluwaseun Ayoade, Maureen E Canavan, Giorgio Caturegli, Daniel J Boffa","doi":"10.1016/j.lungcan.2024.108032","DOIUrl":"https://doi.org/10.1016/j.lungcan.2024.108032","url":null,"abstract":"<p><strong>Background: </strong>Clinical trials are designed to minimize factors capable of influencing patient outcomes beyond the specific diseases and treatments being studied; however, exclusion of prior cancer (PC) patients could potentially affect the generalizability of study results. We attempted to create a real-world proxy of recent immunotherapy trials in stage III and IV Non-Small Cell Lung Cancer (NSCLC) to understand the relevance of a PC history using the National Cancer Database.</p><p><strong>Methods: </strong>Patients diagnosed between 2017 and 2020 were stratified by the presence of a prior cancer history and propensity matched to compare receipt of immunotherapy with those who did not. We analyzed overall survival using Kaplan Meier analysis and Cox proportional hazards models.</p><p><strong>Results: </strong>The addition of immunotherapy to a regimen of chemotherapy and radiation was associated with superior survival whether stage III NSCLC patients had a PC history (HR): 0.65 (95% CI 0.59, 0.71) or had no PC history (HR:0.69 95% CI: 0.66, 0.72). The addition of immunotherapy was also associated with superior survival for stage IV patients with a PC history (HR) 0.78 95% CI 0.72, 0.85) or without PC history (HR:0.75 95% CI: 0.73, 0.78).</p><p><strong>Discussion: </strong>Examination of real-world outcomes of two practice-changing trial regimens found the innovative treatment approach to be superior, regardless of patient PC history. Risk for a second malignancy is a reality of improving cancer treatment, thus, to individualize treatment for patients based on their personal and tumor attributes, cancer survivors will need to be included in trials.</p>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"108032"},"PeriodicalIF":4.5,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral propranolol for the treatment of amivantamab-induced scalp ulcers with granulation tissues","authors":"Po-Wei Huang,&nbsp;Chong-Jen Yu,&nbsp;James Chih-Hsin Yang,&nbsp;Chia-Yu Chu","doi":"10.1016/j.lungcan.2024.108028","DOIUrl":"10.1016/j.lungcan.2024.108028","url":null,"abstract":"","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"Article 108028"},"PeriodicalIF":4.5,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating efficacy and safety of a novel registration-free CT-guided needle biopsy navigation system (RC 120): A multicenter, prospective clinical trial","authors":"Lei Wang ,&nbsp;Biao Song ,&nbsp;Zheng Zhang ,&nbsp;Bing Bo ,&nbsp;Anwen Xiong ,&nbsp;Lingyun Ye ,&nbsp;Dacheng Xie ,&nbsp;Juanjuan Li ,&nbsp;Sha Zhao ,&nbsp;Chenlei Cai ,&nbsp;Shanghu Wang ,&nbsp;Yuan Li ,&nbsp;Qilong Song ,&nbsp;Zhaohua Wang ,&nbsp;Mengjie Wang ,&nbsp;Yanan Cao ,&nbsp;Hui Yin ,&nbsp;Kunpeng Ji ,&nbsp;Chunfu Fang ,&nbsp;Shu-ting Shen ,&nbsp;Caicun Zhou","doi":"10.1016/j.lungcan.2024.108025","DOIUrl":"10.1016/j.lungcan.2024.108025","url":null,"abstract":"<div><h3>Background</h3><div>Current percutaneous transthoracic needle biopsies (PTNB) navigation systems present challenges due to additional steps and limitations on the operating environment.</div></div><div><h3>Research Question</h3><div>We developed a novel, registration-free navigation system for swift and precise CT-guided PTNB, eliminating the need for body surface markers and intraoperative registration. This study assesses its efficacy and safety.</div></div><div><h3>Methods</h3><div>A prospective study was conducted on participants aged 18–80 years prepared for PTNB at two clinical centers, from December 2021 to August 2022. The primary endpoint was the success rate of biopsies within 2 needle adjustments, and the secondary endpoint was the success rate within a single adjustment. Safety endpoints were defined by adverse events occurrence.</div></div><div><h3>Results</h3><div>The study included 98 patients (median age, 64 years, IQR 54–69 years, 71 men). The primary endpoint achieved a biopsy success rate of 98.98 %, and the secondary endpoint demonstrated 97.96 %. The overall success rate was 98.98 %, significantly exceeding the target value of 85 % (P &lt; 0.0001). The median number of CT scans was 3, significantly fewer than predicted for the manual puncture scheme [3 (IQR 3–3) to 8 (IQR 6–8), P &lt; 0.0001]. The average procedure duration was 18.0 min (IQR: 14.0–29.0 min). The most common adverse events were hemorrhage (14 instances) and pneumothorax (8 instances). Other adverse events included elevated blood pressure, hemoptysis, and other common events.</div></div><div><h3>Interpretation</h3><div>Our registration-free navigation system proved to be an effective and safe system for assisting percutaneous lung biopsies in clinical practice.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"Article 108025"},"PeriodicalIF":4.5,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Entrectinib versus crizotinib in Asian patients with ROS1-positive non-small cell lung cancer: A matching-adjusted indirect comparison","authors":"Yongfeng Yu ,&nbsp;Yun Fan ,&nbsp;Xiaorong Dong ,&nbsp;Juan Li ,&nbsp;Yan Yu ,&nbsp;Jun Zhao ,&nbsp;Sha Tao ,&nbsp;Yujun Chen ,&nbsp;Mo Chen ,&nbsp;Yueming Liu ,&nbsp;Jiahui Xu ,&nbsp;Qiaonan Zhu ,&nbsp;Xichun Hu ,&nbsp;Shun Lu","doi":"10.1016/j.lungcan.2024.108018","DOIUrl":"10.1016/j.lungcan.2024.108018","url":null,"abstract":"<div><h3>Objectives</h3><div>Entrectinib and crizotinib are the only <em>ROS</em> proto-oncogene 1 receptor (ROS1) tyrosine kinase inhibitors available for most Asian patients. Their efficacy has neither been compared directly in clinical trials in patients with <em>ROS1</em>-positive non-small cell lung cancer (NSCLC), nor indirectly in Asian populations. Thus, we aimed to provide comparative evidence of the efficacy and safety of entrectinib and crizotinib for Asian patients with advanced or metastatic <em>ROS1</em>-positive NSCLC.</div></div><div><h3>Materials and Methods</h3><div>Efficacy, including overall survival (OS) and progression-free survival (PFS), and safety were evaluated using an unanchored matching-adjusted indirect comparison (MAIC). Individual patient data (IPD) from entrectinib trials (ALKA-372–001/EudraCT 2012–000148-88, STARTRK-1/NCT02097810, and STARTRK-2/NCT02568267; dosage, ≥600 mg once daily; enrollment cutoff, 02 July 2020; data cutoff, 02 August 2021) and aggregate data with simulated pseudo-IPD from a crizotinib trial (OxOnc/NCT01945021; dosage, 250 mg twice daily) were analyzed. Key eligibility criteria from the crizotinib trial were applied to IPD from the entrectinib trials. Baseline characteristics were match-adjusted between arms using propensity score weighting.</div></div><div><h3>Results</h3><div>Fifty-two and 127 patients from the entrectinib and crizotinib trials, respectively, were available for evaluation. Median OS was not reached (NR; weighted; 95 % confidence interval [CI] 28.3–NR) in the entrectinib arm and 44.2 months (95 % CI 32.0–NR) in the crizotinib arm (hazard ratio [HR], 0.662; 95 % CI 0.32–1.37). The respective median PFS was 39.4 months (weighted; 95 % CI 10.4–46.8) and 15.9 months (95 % CI 12.9–24.0) (HR, 0.688; 95 % CI 0.37–1.27). Most AEs were Grade 1–2; both drugs were generally well tolerated. Neutropenia was the most common Grade 3 or 4 treatment-related adverse event for both entrectinib and crizotinib.</div></div><div><h3>Conclusions</h3><div>The outcomes in this MAIC study including Asian patients with <em>ROS1</em>-positive NSCLC showed a trend for greater clinical benefit with entrectinib versus crizotinib. These findings may contribute to better-informed treatment decisions.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"Article 108018"},"PeriodicalIF":4.5,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter regarding “The significance of inflammatory markers in prognosticating the effectiveness and safety of immunotherapy in conjunction with chemotherapy during the primary intervention of advanced non-small cell lung carcinoma”","authors":"Nanami Kosaka,&nbsp;Yuki Kataoka","doi":"10.1016/j.lungcan.2024.108020","DOIUrl":"10.1016/j.lungcan.2024.108020","url":null,"abstract":"","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"Article 108020"},"PeriodicalIF":4.5,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective treatment strategies and key factors influencing therapeutic efficacy in advanced SMARCA4-deficient non-small cell lung cancer","authors":"Hui Liu ,&nbsp;Qiyuan Hong ,&nbsp;Shuohan Zheng ,&nbsp;Meifang Zhang ,&nbsp;Ling Cai","doi":"10.1016/j.lungcan.2024.108022","DOIUrl":"10.1016/j.lungcan.2024.108022","url":null,"abstract":"<div><h3>Introduction</h3><div>SMARCA4/BRG1-deficient non-small cell lung cancer (SD-NSCLC) with high invasiveness and poor prognosis is associated with primary resistance to standard treatment, especially in late-stage patients. This study aimed to explore effective treatments and identify critical factors impacting therapeutic efficacy to enhance outcomes for SD-NSCLC patients.</div></div><div><h3>Methods</h3><div>103 SD-NSCLC patients in stage III/IV diagnosed by immunohistochemistry from May 2019 to March 2024 were included in this study. We assessed the patients’ clinical and genetic features, analyzed the clinical outcomes of local treatment and immunotherapy according to the TNM stage, and further evaluated the factors impacting therapeutic efficacy.</div></div><div><h3>Results</h3><div>In stage III patients, no significant differences in the median progression-free survival (mPFS) and median overall survival (mOS) were observed between patients receiving local treatment at the primary site and those who did not (p &gt; 0.05), while adding ICIs (immune checkpoint inhibitors) to local treatment significantly improved mPFS compared with non-ICIs (15.0 vs. 7.7 months, p = 0.033), though not mOS (p &gt; 0.05). For stage IV patients, ICIs significantly improved mPFS (8.9 vs. 4.2 months, p = 0.006) and mOS (19.7 vs. 13.1 months, p = 0.007) compared to non-ICIs treatments. However, among ICIs-treated patients, the addition of local treatment to the primary lesion did not significantly affect mPFS and mOS (p &gt; 0.05). Patients with <em>STK11/KEAP1</em> mutations had significantly shorter mPFS (3.6 vs. 16.2 months, p = 0.001) and mOS (17.7 vs. 31.3 months, p = 0.002), while no significant difference was observed in mPFS and mOS in patients with different tumor mutation burden (TMB) and PD-L1 expression levels.</div></div><div><h3>Conclusion</h3><div>The addition of ICIs to local treatment shows promising results for locally advanced patients with SD-NSCLC, and first-line ICIs are associated with improved survival in metastatic SD-NSCLC. <em>STK11</em>/<em>KEAP1</em> mutations may be linked to reduced efficacy of immunotherapy.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"Article 108022"},"PeriodicalIF":4.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NOTCH and PTP4A3 alterations emerge as novel predictive biomarkers and potential therapeutic targets in pleural mesothelioma","authors":"Mariacarmela Santarpia ,&nbsp;Marta Aliprandi ,&nbsp;Calogera Claudia Spagnolo ,&nbsp;Amir Avan ,&nbsp;Rafael Rosell ,&nbsp;Paolo Andrea Zucali ,&nbsp;Elisa Giovannetti","doi":"10.1016/j.lungcan.2024.108024","DOIUrl":"10.1016/j.lungcan.2024.108024","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies showed opposite effects of NOTCH1 and NOTCH2 on mesothelioma cell survival under hypoxia. Mechanisms underlying these effects are not still clear and this pathway plays a key role in angiogenesis and cancer stem cells (CSCs) self-renewal processes.</div></div><div><h3>Purpose</h3><div>In this study we evaluated whether NOTCH1, NOTCH2 copy number alterations (CNAs) might predict prognosis of patients with pleural mesothelioma (PM) and if the modulation of this pathway might target CSCs, potentiating pemetrexed activity, also in hypoxic conditions.</div></div><div><h3>Methods</h3><div>Recurrent CNAs were determined by high-resolution whole-genome sequencing from paraffin-embedded samples of a “discovery cohort” (26 patients treated with pemetrexed-based chemotherapy). Prognostic CNAs were validated by PCR gene copy-number and expression analyses in the “discovery” and in two independent “validation” cohorts of pemetrexed-treated and untreated patients (N = 45 and N = 40). Functional analyses of emerging genes were performed through siRNA in different subpopulation of PM cells, growing under hypoxia.</div></div><div><h3>Results</h3><div>A copy number gain of NOTCH2 was observed in 50% of patients with progressive disease and its overexpression correlated with a worse prognosis in both pemetrexed-treated and untreated-patients’ cohorts. Conversely, losses of PTP4A3 correlated with clinical benefit, while patients with overexpression of both NOTCH2 and PTP4A3 had the worse prognosis. Moreover, NOTCH2 silencing through siRNA in vitro reduced migration, enhancing apoptosis of PM cells, while the PTP4A3 inhibitor BR-1 overcame pemetrexed resistance in PM cells characterized by high NOTCH2/PTP4A3 expression.</div></div><div><h3>Conclusions</h3><div>NOTCH2 and PTP4A3 alterations are associated with clinical outcomes in pemetrexed-treated PM patients. The inhibition of NOTCH pathway may be exploited to eradicate CSCs and improve patients’ survival.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"Article 108024"},"PeriodicalIF":4.5,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical impact of preoperative sarcopenia and immunonutritional impairment on postoperative outcomes in non-small cell lung cancer surgery","authors":"Atsuki Uchibori,&nbsp;Satoru Okada,&nbsp;Masanori Shimomura,&nbsp;Tatsuo Furuya,&nbsp;Chiaki Nakazono,&nbsp;Tomoki Nishimura,&nbsp;Masayoshi Inoue","doi":"10.1016/j.lungcan.2024.108004","DOIUrl":"10.1016/j.lungcan.2024.108004","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to clarify the relationship between preoperative sarcopenia and prognostic nutritional index (PNI) statuses and clinicopathological factors in patients with non-small cell lung cancer (NSCLC) who underwent surgical resection, and to evaluate short- and long-term outcomes by stratifying groups according to sarcopenia and PNI status as prognostic predictors.</div></div><div><h3>Materials and methods</h3><div>This study included 300 patients with p-Stage I-IIIA NSCLC who underwent complete resection with lobectomy. Sarcopenia was assessed using the skeletal muscle index (SMI) and the immunonutritional index was evaluated using the PNI. The first quartile was used as the cutoff for the sarcopenia/non-sarcopenia and low/high-PNI groups.</div></div><div><h3>Results</h3><div>The median patient age was 70 years, and 184 patients (61.3 %) were male individuals. The median PNI was 50.2, and the median SMI was 48.1 and 37.5 for male and female patients, respectively. The median follow-up period was 64 months (60 patients died). Survival analysis showed that overall survival was significantly worse in the sarcopenia and low-PNI groups than in the control group (<em>p</em> = 0.002 and <em>p</em> &lt; 0.001, respectively). When stratified by sarcopenia and PNI status, the sarcopenia with low-PNI group had a particularly poor prognosis (5-year survival rate, 52.8 % [<em>p</em> &lt; 0.001]). Multivariable Cox regression analysis revealed that sarcopenia with low PNI was an independent prognostic factor that indicated a poor outcome. The response to drug treatment for postoperative recurrence was significantly worse in the sarcopenia with low-PNI group than in<!--> <!-->the other group.</div></div><div><h3>Conclusion</h3><div>The combination of preoperative sarcopenia and immunonutritional impairment had a negative clinical impact independent of tumor factors, and patients with these two indications had a particularly poor prognosis. These factors may be associated with poor responses to drug treatment for postoperative recurrence. The evaluation of skeletal muscle mass using preoperative imaging and nutritional assessment using serum markers may be useful for perioperative management and prognosis prediction.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"Article 108004"},"PeriodicalIF":4.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}