Lung Cancer最新文献

{"title":"Difference in efficacy of osimertinib between patients with EGFR-positive NSCLC with postoperative recurrence and those with de novo unresectable disease: A prospective, observational study","authors":"Masato Karayama ,&nbsp;Takafumi Suda ,&nbsp;Kiyotaka Yoh ,&nbsp;Kazuhiro Usui ,&nbsp;Yukio Hosomi ,&nbsp;Kazuma Kishi ,&nbsp;Go Naka ,&nbsp;Kageaki Watanabe ,&nbsp;Shu Tamano ,&nbsp;Kohei Uemura ,&nbsp;Hideo Kunitoh","doi":"10.1016/j.lungcan.2024.108037","DOIUrl":"10.1016/j.lungcan.2024.108037","url":null,"abstract":"<div><h3>Background</h3><div>Although clinical trials of systemic chemotherapy for advanced non-small-cell lung cancer (NSCLC) have included both postoperative recurrence and <em>de novo</em> unresectable cases, postoperative recurrence is reported to have a better efficacy and prognosis. However, there are no efficacy data of first-line osimertinib for postoperative recurrence.</div></div><div><h3>Methods</h3><div>We conducted a post hoc analysis of a multicenter, prospective, observational study that evaluated the efficacy of first-line osimertinib in patients with <em>epidermal growth factor receptor (EGFR)</em>-positive NSCLC. The patients were divided into two groups: those with postoperative recurrence (recurrence group, n = 167) and those with <em>de novo</em> unresectable disease (<em>de novo</em> group, n = 385).</div></div><div><h3>Results</h3><div>The recurrence group had a significantly better Eastern Cooperative Oncology Group performance status (ECOG-PS, <em>p</em> &lt; 0.001) and fewer bone metastases (<em>p</em> &lt; 0.001), brain metastases (<em>p</em> &lt; 0.001), cancer pleurisy (<em>p</em> = 0.006), pleural dissemination (<em>p</em> = 0.003), liver metastases (<em>p</em> = 0.017), and adrenal metastases (<em>p</em> = 0.009) at the start of osimertinib than the <em>de novo</em> group. The recurrence group had a significantly better progression-free survival (PFS) and overall survival (OS) than the <em>de novo</em> group (hazard ratio [HR] = 0.62, 95 % confidence interval [CI], 0.49–0.81, <em>p</em> &lt; 0.001; and HR = 0.58, 95 % CI, 0.43–0.79, <em>p</em> &lt; 0.001, respectively). In a 1:1 propensity score-matching analysis, the matched recurrence group had significantly better PFS and OS than the matched de novo group (HR = 0.72, 95 % CI, 0.52–0.99, <em>p</em> = 0.034; and HR = 0.65, 95 % CI, 0.44–0.95, <em>p</em> &lt; 0.001, respectively).</div></div><div><h3>Conclusion</h3><div>Patients with <em>EGFR</em>-positive NSCLC and postoperative recurrence have a better ECOG-PS and fewer distant metastases at the start of first-line osimertinib, and better PFS and OS than those with <em>de novo</em> unresectable disease. Postoperative recurrence should be considered as a stratification factor in future clinical trials for advanced <em>EGFR</em>-positive NSCLC.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"Article 108037"},"PeriodicalIF":4.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721163","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":"Validation of the Lung Immune Prognostic Index in patients with untreated advanced non-small cell lung cancer: Post hoc analysis of the IMpower 130, 131 and 150 trials","authors":"Edouard Auclin ,&nbsp;Matthieu Roulleaux Dugage ,&nbsp;Teresa Gorria ,&nbsp;Charles Vauchier ,&nbsp;Constance Thibault ,&nbsp;Juan Carlos Laguna ,&nbsp;Lorena Lupinacci ,&nbsp;Carme Crous ,&nbsp;Marie Naigeon ,&nbsp;Stéphane Oudard ,&nbsp;Benjamin Besse ,&nbsp;Laura Mezquita","doi":"10.1016/j.lungcan.2024.108039","DOIUrl":"10.1016/j.lungcan.2024.108039","url":null,"abstract":"<div><h3>Introduction</h3><div>LIPI has been strongly correlated with immunotherapy (IT) outcomes in advanced NSCLC. Limited data is available for upfront chemotherapy (CT) + IT combinations. We aimed to study its prognostic value in 1st-line CT +/- IT +/- antiangiogenics.</div></div><div><h3>Methods</h3><div>Data from patients with wild-type <em>EGFR/ALK</em> aNSCLC included in IMpower150, IMpower131, and IMpower130 (international phase 3 multicenter studies) treated with 1st-line CT +/- atezolizumab and/or bevacizumab were retrospectively analysed. LIPI was calculated based on the neutrophil/(leucocytes-neutrophils) (dNLR) ratio and serum LDH: good (dNLR &lt; 3 and LDH &lt; ULN), intermediate (dNLR ≥ 3 or LDH ≥ ULN) and poor (dNLR ≥ 3 and LDH ≥ ULN).</div></div><div><h3>Results</h3><div>Out of 2540 patients, 48.6 % were LIPI good, 40.8 % intermediate and 10.6 % poor. LIPI was significantly associated with treatment outcomes (PFS, OS) in the overall cohort (p &lt; 0.001) and in each treatment cohort (all p &lt; 0.001). After adjustment for age, smoking status, number of metastatic sites, brain or liver involvement and performance status, LIPI remained an independent prognostic factor for PFS and OS. In the LIPI good group (n = 1235), longer PFS was observed in patients treated with CT + IT + AA (median [m] PFS 11.3 vs. &lt; 7.6 months with other regimens, p &lt; 0.001), with a trend for OS (mOS 26.1 vs 20.7 months, p = 0.08). No regimen demonstrated significant PFS benefit in the LIPI poor group compared to chemotherapy. LIPI-good + PD-L1 ≥ 50 % (n = 105) showed long responses (mPFS of 11.1 months, mOS not reached).</div></div><div><h3>Conclusions</h3><div>LIPI was prognostic for PFS and OS in prospective trials in aNSCLC, regardless of the treatment regimen. LIPI poor patients derived no benefit from combination treatment. LIPI combined to PD-L1 may improve the upfront treatment selection.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"199 ","pages":"Article 108039"},"PeriodicalIF":4.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142747218","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":"The efficacy of continuing osimertinib with platinum pemetrexed chemotherapy upon progression in patients with metastatic non-small cell lung cancer harboring sensitizing EGFR mutations","authors":"Tejas Patil ,&nbsp;Dexiang Gao ,&nbsp;Alexander Watson ,&nbsp;Mandy Sakamoto ,&nbsp;Yunan Nie ,&nbsp;Amanda Gibson ,&nbsp;Michelle L Dean ,&nbsp;Benjamin A. Yoder ,&nbsp;Eliza Miller ,&nbsp;Margaret Stalker ,&nbsp;Dara L. Aisner ,&nbsp;Paul A. Bunn ,&nbsp;Erin L. Schenk ,&nbsp;Melina E. Marmarelis ,&nbsp;Chiara Bennati ,&nbsp;Vishal Navani ,&nbsp;Yongchang Zhang ,&nbsp;D. Ross Camidge","doi":"10.1016/j.lungcan.2024.108040","DOIUrl":"10.1016/j.lungcan.2024.108040","url":null,"abstract":"<div><h3>Introduction</h3><div>For patients with EGFR mutant NSCLC who progress on osimertinib, the clinical benefit of continuing osimertinib with next line platinum pemetrexed chemotherapy remains unknown.</div></div><div><h3>Methods</h3><div>In this international, multi-center, retrospective cohort study, a total of 159 patients with EGFR mutant NSCLC who progressed on osimertinib and received platinum-pemetrexed therapy on progression from 2013 to 2023 were included. The data cutoff was December 31, 2023. Data analysis was conducted from January 2024 to June 2024. The primary endpoints were progression free survival (PFS) and overall survival (OS), analyzed using Kaplan-Meier methods. Multivariable Cox regression adjusting for patient-specific and cancer-specific factors was performed.</div></div><div><h3>Results</h3><div>421 patients with EGFR mutant NSCLC with progression on osimertinib were identified, of which159 patients who met pre-specified inclusion criteria were divided into two groups: Cohort 1 (osimertinib + platinum-pemetrexed) included 50 patients (median [IQR] age, 59 [30 – 83] years; 36 [72.0 %] female; 11 [22.4 %] Asian) and Cohort 2 (platinum-pemetrexed alone) included 109 patients (median [IQR] age, 54 [25 – 80] years; 62 [56.9 %] female; 74 [64.9 %] Asian). Most patients were never smokers (Cohort 1, 37 [74.0 %]; Cohort 2, 66 [60.6 %]). One third of patients had baseline brain metastases (Cohort 1, 19 [38.0 %]; Cohort 2, 36 [38.3 %]). Both cohorts had a median of two prior lines of anti-cancer therapy. The addition of bevacizumab or immune checkpoint inhibitors (ICI) to next-line platinum-pemetrexed chemotherapy was more common in Cohort 2 (bevacizumab use, 30.3 % vs 8.0 %, p = 0.002; ICI use, 33.0 % vs 2.0 %, p = 0.001). With a median duration of follow up of 30 months, there was a significant PFS benefit to continuing osimertinib with next line platinum pemetrexed chemotherapy (9.0 vs 4.5 months; HR 0.49, 95 % CI 0.32 – 0.74, p = 0.0032), also seen in subset analyses of patients who received first line osimertinib (n = 55, 11.0 vs 6.2 months; HR 0.41, 95 % CI 0.25 – 0.73, p = 0.002). Among patients with EGFR mutant NSCLC without brain metastases after progression on osimertinib, we found that continuing osimertinib with next line platinum pemetrexed significantly reduced the median time to CNS progression (n = 38; 7.0 vs 4.1 months; HR 0.47, 95 % CI 0.48 – 0.98, p = 0.01). After adjusted analysis, there was no significant OS difference between Cohorts 1 and 2 (19 months vs 13 months; HR 0.92, 95 % CI 0.60 – 1.39, p = 0.68).</div></div><div><h3>Conclusions and relevance</h3><div>For patients with EGFR mutant NSCLC who progress on osimertinib, there is a significant PFS, but not OS, benefit to continuing osimertinib with next line platinum pemetrexed chemotherapy. The continuation of osimertinib with next line platinum pemetrexed chemotherapy appears to reduce the risk of CNS progression.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"199 ","pages":"Article 108040"},"PeriodicalIF":4.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746977","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":"Impact of HA-PCI on self-reported cognitive functioning and brain metastases in small-cell lung cancer: Pooled findings of NCT01780675 and PREMER trials","authors":"Haiyan Zeng ,&nbsp;Sanne B. Schagen ,&nbsp;Lizza E.L. Hendriks ,&nbsp;Gonzalo Sánchez-Benavides ,&nbsp;Jaap P.M. Jaspers ,&nbsp;Rosa María Manero ,&nbsp;Yolande Lievens ,&nbsp;Mauricio Murcia-Mejía ,&nbsp;Marianne Kuenen ,&nbsp;Mikel Rico-Oses ,&nbsp;Elaine A.C. Albers ,&nbsp;Pilar Samper ,&nbsp;Ruud Houben ,&nbsp;Michiel B. de Ruiter ,&nbsp;Edith M.T. Dieleman ,&nbsp;José Luis López-Guerra ,&nbsp;Katrien De Jaeger ,&nbsp;Felipe Couñago ,&nbsp;Maarten Lambrecht ,&nbsp;Patricia Calvo-Crespo ,&nbsp;Núria Rodríguez de Dios","doi":"10.1016/j.lungcan.2024.108036","DOIUrl":"10.1016/j.lungcan.2024.108036","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive decline is an arising concern in patients who need cranial irradiation. We used the pooled longitudinal individual patient data of two phase III trials: NCT01780675 and PREMER to investigate whether hippocampal avoidance (HA)-PCI is associated with improved self-reported cognitive functioning (SRCF) compared with PCI without increasing brain metastases (BM) development within the HA area.</div></div><div><h3>Methods</h3><div>Patients with stage I-IV small cell lung cancer (SCLC) were randomized to PCI or HA-PCI. SRCF was assessed and contrast enhanced brain magnetic resonance imaging (MRI) was performed at baseline and up to 24 months follow-up. SRCF and BM incidence after (HA)-PCI were compared between arms. Self reported cognitive impairment was defined as SCRF &lt; 75.</div></div><div><h3>Results</h3><div>In total, 318 patients were randomized. Longitudinal generalized estimating equation (GEE) analysis showed that HA-PCI neither had a significant impact on SRCF (β = 1.41, <em>p</em> = 0.52) nor on cognitive impairment (OR 0.81, 95 %CI 0.53–1.25, <em>p</em> = 0.34). The median follow up was 41.7 (95 %CI 35.7–47.6) months, during which 61 patients developed BM (PCI arm: 30, HA-PCI arm: 31<em>, p</em> = 0.9). BM site was solitary in 15 patients (PCI arm: 7, HA-PCI arm: 8<em>, p</em> = 0.8). Nine of the 61 patients had BM within the HA area (PCI arm: 4, HA-PCI arm: 5<em>, p</em> = 1.0). The BM incidence was not significantly different between arms (subdistribution hazard ratio [sHR] 1.03, 95 %CI 0.62–1.70, <em>p</em> = 0.91).</div></div><div><h3>Conclusion</h3><div>HA-PCI did not preserve longitudinal SRCF but did also not increase the risk of BM. Additional strategies should be investigated to further improve the therapeutic ratio of PCI.</div><div>Trials registration:</div><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (NCT01780675)</div><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (NCT02397733).</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"199 ","pages":"Article 108036"},"PeriodicalIF":4.5,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142747219","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":"Addressing knowledge and attitude barriers to lung cancer screening: Development and evaluation of web-based decision aid","authors":"Wonyoung Jung ,&nbsp;In Young Cho ,&nbsp;Keun Hye Jeon ,&nbsp;Yohwan Yeo ,&nbsp;Jongho Cho ,&nbsp;Kyu-Won Jung ,&nbsp;Kui Son Choi ,&nbsp;Dong Wook Shin ,&nbsp;Jungkwon Lee","doi":"10.1016/j.lungcan.2024.108031","DOIUrl":"10.1016/j.lungcan.2024.108031","url":null,"abstract":"<div><h3>Objective</h3><div>Low-dose computed tomography screening reduces lung cancer and overall mortality, but the participation rate remains low. The objective of this study was to develop a decision aid (DA) that addresses the overabundance of healthcare options and barriers to participation in lung cancer screening (LCS) among the general population aged 40–79 years in Korea.</div></div><div><h3>Materials and Methods</h3><div>The DA was developed by following the International Patient Decision Aid Standards process. To evaluate the DA, participants aged 40–79 years were purposively sampled from four districts of the Seoul metropolitan area, with 25 individuals from each decade of the age range. Participants used the DA for LCS, and pre–post comparison was conducted. The primary outcome was a change in intention to undergo LCS after completing the DA. The secondary outcomes were changes in knowledge and attitude about LCS, decisional conflict, and the perceived usefulness of the DA.</div></div><div><h3>Results</h3><div>The DA prototype contained lung cancer risk assessment and decision-making components that addressed knowledge, risks, benefits, costs, and personal values. In a pilot study of 100 participants (mean age 59.0 [SD 11.1] years, 80 % male, 25 % of whom had undergone LCS), knowledge about LCS increased (mean [SD] score [out of 100] before vs. after: 68.3 [13.4] vs. 73.6 [18.0], p &lt; 0.001). A positive change in attitude was observed (p = 0.004), but the intention to screen remained consistent (70 % before vs. 72 % after; p = 0.650). Eighty-eight participants reported the lowest level of conflict in decision-making, and most reported that the DA was useful (mean [SD] score 78.8 [9.0] out of 100). 72 % reported that the DA facilitated self-decision-making, but 27 % felt the DA recommended LCS.</div></div><div><h3>Conclusions</h3><div>This study highlights the potential of a well-designed DA to enhance knowledge and attitudes about LCS, but those improvements did not translate to a significant change in screening intentions.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"Article 108031"},"PeriodicalIF":4.5,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699628","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":"Lorlatinib-associated weight gain and dyslipidaemia: A retrospective analysis and implications for future care","authors":"A. John ,&nbsp;D.J. McMahon ,&nbsp;D. Chauhan ,&nbsp;S. Mullings ,&nbsp;N. Samuel ,&nbsp;F. Kalofonou ,&nbsp;C. Milner-Watts ,&nbsp;N. Tokaca ,&nbsp;N. Yousaf ,&nbsp;M. Davidson ,&nbsp;J. Bhosle ,&nbsp;A. Minchom ,&nbsp;O’Brien MER ,&nbsp;S. Popat","doi":"10.1016/j.lungcan.2024.108034","DOIUrl":"10.1016/j.lungcan.2024.108034","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, observational analysis of patients with <em>ALK</em> and <em>ROS1</em>-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.</div></div><div><h3>Results</h3><div>43 patients were evaluated. 81 % of patients developed weight gain on lorlatinib (median: 4.5 kg, 6.5 % increase from baseline); Grade &lt; 1 in 37 % (<em>n</em> = 16/43), Grade 1 in 23 % (<em>n</em> = 10/43), Grade 2 in 12 % (<em>n</em> = 5/43), and Grade ≥ 3 in 9 % (<em>n</em> = 4/43). BMI increase was observed in 79 % of patients. 35 % of patients with healthy baseline BMI moved into overweight/obese categories.</div><div>Of patients with recorded baseline lipid levels, 91 % developed increase in total cholesterol, and 68 % an increase in triglycerides, respectively. 7 % (<em>n</em> = 1/15) patients with normal baseline total cholesterol developed Grade ≥ 3 elevated cholesterol; no patients with normal baseline triglycerides developed Grade ≥ 3 elevated hypertriglyceridaemia (<em>n</em> = 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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"Article 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":"The molecular subtypes of small cell lung cancer defined by key transcription factors and their clinical significance","authors":"Zhuchen Yu ,&nbsp;Juntao Zou ,&nbsp;Fei Xu","doi":"10.1016/j.lungcan.2024.108033","DOIUrl":"10.1016/j.lungcan.2024.108033","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer, a prevalent and deadly malignancy, is classified into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). SCLC is further subdivided into four molecular subtypes—SCLC-A, SCLC-N, SCLC-P, and SCLC-I—based on key transcription factor expression.</div></div><div><h3>Methods</h3><div>Immunohistochemistry (IHC) was used to assess ASCL1, NEUROD1, and POU2F3 expression in tumor tissues. The H-Score quantified these results. Clinical characteristics, overall survival (OS), progression-free survival (PFS), and treatment responses were analyzed by subtype, and sensitivity to different treatments was assessed. Risk factors were identified through univariate and multivariate analyses.</div></div><div><h3>Results</h3><div>IHC and H-Score analysis showed that POU2F3 expression was mutually exclusive with ASCL1 or NEUROD1. Subtype distribution was as follows: SCLC-A (40 %), SCLC-N (33 %), SCLC-P (7 %), and SCLC-I (20 %). There were no significant differences in baseline characteristics, OS (p = 0.829), or PFS (p = 0.924) among subtypes. However, the SCLC-I subtype showed a trend toward improved outcomes with platinum-based doublet chemotherapy plus immune checkpoint inhibitors. Multivariate COX regression identified M stage (HR: 1.72, 95 % CI: 1.13–2.63, p = 0.012) and bone metastasis at diagnosis (HR: 1.58, 95 % CI: 1.02–2.43, p = 0.040) as independent risk factors.</div></div><div><h3>Conclusion</h3><div>This study confirmed the SCLC subtyping based on key transcription factors. While no significant differences in OS and PFS among subtypes were found, the SCLC-I subtype showed potential benefit from platinum-based chemotherapy combined with immune checkpoint inhibitors. M stage and bone metastasis at diagnosis were identified as independent risk factors for SCLC.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"Article 108033"},"PeriodicalIF":4.5,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687382","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":"Diagnostic performance of Shape-Sensing Robotic-Assisted bronchoscopy with mobile Cone-Beam CT for cystic and cavitary pulmonary lesions","authors":"Sebastian Fernandez-Bussy ,&nbsp;Rodrigo Funes-Ferrada ,&nbsp;Alejandra Yu Lee-Mateus ,&nbsp;Bryan F. Vaca-Cartagena ,&nbsp;Alanna Barrios-Ruiz ,&nbsp;Sofia Valdes-Camacho ,&nbsp;Mohamed I. Ibrahim ,&nbsp;Neal M. Patel ,&nbsp;Britney N. Hazelett ,&nbsp;Kelly S. Robertson ,&nbsp;Ryan M. Chadha ,&nbsp;David Abia-Trujillo","doi":"10.1016/j.lungcan.2024.108029","DOIUrl":"10.1016/j.lungcan.2024.108029","url":null,"abstract":"<div><h3>Introduction</h3><div>Cystic and cavitary pulmonary lesions (PLs) frequently require histologic confirmation for an accurate diagnosis. Shape-sensing robotic-assisted bronchoscopy (ssRAB) with mobile cone beam computed tomography (mCBCT) offers a minimally invasive alternative to traditional biopsy techniques like CT-guided transthoracic biopsy. This study aimed to evaluate the diagnostic performance and safety of ssRAB in cystic and cavitary PLs.</div></div><div><h3>Material and Methods</h3><div>A retrospective study was conducted at Mayo Clinic Florida, of patients who underwent ssRAB with mCBCT for cavitary and cystic PLs from October 2020 to February 2024. Baseline clinical, demographic, lesion characteristics, and procedure-related data were collected. Diagnostic yield, accuracy, sensitivity for malignancy and complication rates were calculated while logistic models identified associations between variables and diagnostic yield.</div></div><div><h3>Results</h3><div>52 patients were included, 54 nodules were sampled. ssRAB provided a diagnostic yield of 83 % and a diagnostic accuracy of 83 %, with a sensitivity for malignancy of 97 % and specificity of 58 %. Pneumothorax occurred in 4 % of cases, with one requiring chest tube insertion. Nashville bleeding scale ≥ 2 occurred in 4 % of procedures. There was no significant association between lesion size, distance to chest wall, type of lesion and diagnostic yield.</div></div><div><h3>Conclusion</h3><div>ssRAB with mCBCT demonstrated high diagnostic yield and sensitivity for malignancy in cavitary and cystic PLs, with a low complication rate. Its ability to perform mediastinal staging in the same anesthetic event, along with its safety profile, suggests ssRAB as a valuable tool in the assessment of air-filled pulmonary lesions.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"Article 108029"},"PeriodicalIF":4.5,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693277","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":"Use of commercial WAMs for monitoring individual with lung cancer. A systematic review","authors":"Shayan Bahadori ,&nbsp;Mozhdeh Hosseini","doi":"10.1016/j.lungcan.2024.108026","DOIUrl":"10.1016/j.lungcan.2024.108026","url":null,"abstract":"<div><div>This systematic review explored the feasibility and impact of interventions using commercial activity monitors to track physical activity and health-related outcomes during lung cancer treatment. Inclusion criteria focused on studies involving commercially available activity trackers that provided monitoring feedback to lung cancer patients. The devices selected were popular models, including Fitbit, Garmin, Apple, Samsung, and Polar. Studies assessing the reliability or validity of these trackers, as well as qualitative studies, protocols, non-English publications, and those featuring non-commercial devices, were excluded. Additionally, studies incorporating physical activity with other interventions (e.g., robotic surgery) were excluded if exercise outcomes could not be analysed independently. Searches were conducted across various electronic databases, including the Cochrane Database of Systematic Reviews, CINAHL Complete®, Science Citation Index, Google Scholar, Scopus, IEEE Xplore, and PubMed, covering the period from January 2000 to November 2023. The quality of the studies was assessed using the Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I) and the Risk of Bias in Randomised Trials (RoB 2.0) tools. Twelve studies met the inclusion criteria, utilising commercial wearable technology for monitoring lung cancer patients over an average of 6.3 ± 4.7 weeks. A key limitation of this review was the wide variation in how interventions were implemented across studies. Yet, the interventions significantly improved daily activity levels and intensity, quality of life, psychological impact, and physical function compared to usual care. These monitors show promise in predicting, monitoring, and detecting physical activity, motivating patients, and aiding in recovery. However, limitations exist, and further evidence is needed to confirm their efficacy as primary monitoring tools in lung cancer treatment.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"Article 108026"},"PeriodicalIF":4.5,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693278","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}