Lung Cancer最新文献

{"title":"Brief Report: Should a prior cancer history be reevaluated as an exclusion for clinical trial participation?","authors":"Oluwaseun Ayoade ,&nbsp;Maureen E. Canavan ,&nbsp;Giorgio Caturegli ,&nbsp;Daniel J. Boffa","doi":"10.1016/j.lungcan.2024.108032","DOIUrl":"10.1016/j.lungcan.2024.108032","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Discussion</h3><div>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.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"Article 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":"Association between higher glucose levels and reduced survival in patients with non-small cell lung cancer treated with immune checkpoint inhibitors","authors":"Soravis Osataphan ,&nbsp;Muhammad Awidi ,&nbsp;Yu Jen Jan ,&nbsp;Krishna Gunturu ,&nbsp;Shriram Sundararaman ,&nbsp;Hollis Viray ,&nbsp;Edward Frankenberger ,&nbsp;Melissa Mariano ,&nbsp;Lauren O’Loughlin ,&nbsp;Andrew Piper-Vallillo ,&nbsp;Katherine Stafford ,&nbsp;Aleksandra Kolnick ,&nbsp;Hind Ghazalah ,&nbsp;Kartik Sehgal ,&nbsp;Mary-Elizabeth Patti ,&nbsp;Daniel Costa ,&nbsp;Prudence Lam ,&nbsp;Deepa Rangachari","doi":"10.1016/j.lungcan.2024.108023","DOIUrl":"10.1016/j.lungcan.2024.108023","url":null,"abstract":"<div><h3>Background</h3><div>Obesity and hypercholesterolemia have been associated with better responses to ICIs in NSCLC, while type 2 diabetes (T2D) has been associated with a worse response. However, the association between glucose levels and outcomes remains unknown. This study investigated the impact of mean baseline glucose levels, T2D, dyslipidemia, and obesity on overall survival (OS) in NSCLC patients undergoing ICI therapy.</div></div><div><h3>Methods</h3><div>A multicenter retrospective cohort study was conducted using data from three medical centers, with locally advanced or metastatic NSCLC patients receiving ICI, regardless of treatment line or concurrent therapy. Random venous glucose levels within 4 weeks prior to ICI initiation, BMI, history of dyslipidemia, and T2D, along with OS, were assessed. Patients with BMI &lt; 18.5 were excluded.</div></div><div><h3>Results</h3><div>Among 438 patients, those with the highest quartile of baseline glucose levels had significantly shorter OS compared to those in the lowest quartile (HR, 1.53; 95 % CI, 1.08 – 2.15; p-value = 0.016). This association remind consistent after adjusting for steroid use, diabetes, performance status and glucose-lowering medication use. These effects were consistently observed in subsets of patients treated with ICI monotherapy and with PD-L1 TPS ≥ 1 %.</div></div><div><h3>Conclusion</h3><div>Higher mean baseline glucose levels correlated with shorter survival in patients with NSCLC treated with ICIs. The divergent effects of individual metabolic syndrome components on ICI response in patients with NSCLC underscore the complexity of metabolic influences on treatment outcomes.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"Article 108023"},"PeriodicalIF":4.5,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687477","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":"Real-world status of multimodal treatment of Stage IIIA-N2 non-small cell lung cancer in Japan: Results from the SOLUTION study, a non-interventional, multicenter cohort study.","authors":"Hidehito Horinouchi, Haruyasu Murakami, Hideyuki Harada, Tomotaka Sobue, Tomohiro Kato, Shinji Atagi, Toshiyuki Kozuki, Takaaki Tokito, Satoshi Oizumi, Masahiro Seike, Kadoaki Ohashi, Tadashi Mio, Takashi Sone, Chikako Iwao, Takeshi Iwane, Ryo Koto, Masahiro Tsuboi","doi":"10.1016/j.lungcan.2024.108027","DOIUrl":"https://doi.org/10.1016/j.lungcan.2024.108027","url":null,"abstract":"<p><strong>Objectives: </strong>There is limited consensus on resectability criteria for Stage IIIA-N2 non-small cell lung cancer (NSCLC). We examined the patient characteristics, N2 status, treatment decisions, and clinical outcomes according to the treatment modality for Stage IIIA-N2 NSCLC in Japan.</p><p><strong>Materials and methods: </strong>Patients with Stage IIIA-N2 NSCLC in Japan were consecutively registered in the SOLUTION study between 2013 and 2014. Patients were divided according to treatment (chemoradiotherapy [CRT], surgery + perioperative therapy [neoadjuvant and/or adjuvant therapy], surgery alone). Demographic characteristics, N2 status (number and morphological features), pathological information, and treatments were analyzed descriptively. Overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) were estimated using the Kaplan-Meier method.</p><p><strong>Results: </strong>Of 227 patients registered, 133 underwent CRT, 56 underwent surgery + perioperative therapy, and 38 underwent surgery alone. The physicians reported the following reasons for unresectability for 116 of 133 CRT patients: large number of metastatic lymph nodes (70.7 %), extranodal infiltration (25.0 %), poor surgical tolerance (19.0 %), or other reasons (18.1 %). CRT was more frequently performed in patients whose lymph nodes had an infiltrative appearance (64.3 %) and was the predominant treatment in patients with multiple involved stations (discrete: 60.0 %; infiltrative: 80.4 %). Distant metastasis with/without local progression was found in 50.4 %, 50.0 %, and 36.8 % of patients in the CRT, surgery + perioperative therapy, and surgery alone groups, respectively. The respective 3-year OS and DFS/PFS rates (median values) were as follows: surgery + perioperative therapy-61.9 % (not reached) and 37.1 % (22.4 months; DFS); CRT group-42.2 % (31.9 months) and 26.8 % (12.0 months; PFS); surgery alone group-37.7 % (26.5 months) and 28.7 % (12.6 months; DFS).</p><p><strong>Conclusion: </strong>This study has illuminated the real-world decision rules for choosing between surgical and non-surgical approaches in patients with Stage IIIA-N2 NSCLC. Our landmark data could support treatment decision making for using immune checkpoint inhibitors and targeted therapy for driver oncogenes in the perioperative therapy era.</p>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"199 ","pages":"108027"},"PeriodicalIF":4.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872516","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":"Comprehensive serum biomarker analysis reveals IL-8 changes as the only predictor of the effectiveness of immune checkpoint inhibitors for patients with advanced non-small cell lung cancer","authors":"Hiroaki Akamatsu ,&nbsp;Yasuhiro Koh ,&nbsp;Makoto Nishio ,&nbsp;Yasushi Goto ,&nbsp;Hidetoshi Hayashi ,&nbsp;Satoru Miura ,&nbsp;Koji Tamada ,&nbsp;Hiroshi Kagamu ,&nbsp;Akihiko Gemma ,&nbsp;Ichiro Yoshino ,&nbsp;Toshihiro Misumi ,&nbsp;Atsuto Mouri ,&nbsp;Ryota Saito ,&nbsp;Naoto Takase ,&nbsp;Noriko Yanagitani ,&nbsp;Hiroshi Nokihara ,&nbsp;Masahiro Seike ,&nbsp;Kei Takamura ,&nbsp;Masahide Mori ,&nbsp;Shunichiro Iwasawa ,&nbsp;Tetsuya Mitsudomi","doi":"10.1016/j.lungcan.2024.108017","DOIUrl":"10.1016/j.lungcan.2024.108017","url":null,"abstract":"<div><h3>Objectives</h3><div>Programmed cell death ligand 1 (PD-L1) expression is widely used to predict the effectiveness of PD-(L)1 inhibitors despite its imperfection. Previous studies suggested the utilization of various serum biomarkers; nonetheless, findings are inconclusive because of limited sample sizes or the focus on a single biomarker in many of these studies. This study analyzed multiplex serum biomarkers to explore their predictive ability in a large cohort of patients with advanced non-small-cell lung cancer (NSCLC) treated with a PD-L1 inhibitor in a real-world setting.</div></div><div><h3>Materials and Methods</h3><div>This was a sub-study of J-TAIL, a prospective observational study of atezolizumab monotherapy in pre-treated patients with advanced NSCLC. From April to October 2019, 262 patients were enrolled from 73 sites in Japan. Serum samples were collected at baseline and at the second dose of atezolizumab. Quantification of the 51 serum cytokines, chemokines, growth factors, and vascular endothelial growth factors was performed using the Luminex platform. Baseline values and fold changes of the time of the second dose to the baseline were examined in association with the effectiveness of atezolizumab.</div></div><div><h3>Results</h3><div>Among the 51 proteins assessed, a higher baseline interleukin (IL)-12 level, a higher soluble CD40 ligand fold change, a lower IL-8 fold change were associated with higher objective response rate (ORR). Of these, only the lower IL-8 fold change was associated with better progression-free survival (PFS) (adjusted hazard ratio, 1.98; 95 % confidence interval, 1.45–2.70; <em>P</em> &lt; 0.01). Multivariate analysis demonstrated that the lower IL-8 fold change was an independent factor for both the ORR and PFS. The IL-8 fold change was independent of the neutrophil/lymphocyte ratio, and durable PFS was observed in patients with both low.</div></div><div><h3>Conclusion</h3><div>Comprehensive serum biomarker analysis revealed that a lower fold change in serum IL-8 was associated with better outcomes in pre-treated patients with advanced NSCLC receiving atezolizumab.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"Article 108017"},"PeriodicalIF":4.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687478","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":"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":"Continuing immune checkpoint inhibitors after progression: Real-world patterns of care and outcomes in second-line treatment for extensive-stage small-cell lung cancer.","authors":"Baishen Zhang, Hejing Bao, Zhanquan Li, Jing Chen, Hui Yu, Meichen Li, Muyan Cai, Likun Chen","doi":"10.1016/j.lungcan.2024.108021","DOIUrl":"https://doi.org/10.1016/j.lungcan.2024.108021","url":null,"abstract":"<p><strong>Introduction: </strong>Small cell lung cancer (SCLC) is a highly malignant tumor with an extremely poor prognosis. In the currentera of immunotherapy, the role of immune checkpoint inhibitors (ICIs) in the second-line treatment of patients with extensive-stage SCLC (ES-SCLC) who have progressed to initial chemoimmunotherapy remains unclear.</p><p><strong>Methods: </strong>A multicenter retrospective study were conducted, involving patients with ES-SCLC who received second-line (2L) therapy after progression to first-line chemoimmunotherapy. Patients were divided into 2L-ICIs group and 2L-non-ICIs group according to whether ICIs were added to the 2L treatment. The efficacy and adverse events of the two groups were analyzed and compared.</p><p><strong>Results: </strong>A total of 103 patients were included in this study, with 53 in the 2L-ICIs group and 50 in the 2L-non-ICIs group. The 2L-ICIs group demonstrated a longer median progression-free survival (PFS) compared to the 2L-non-ICIs group (4.4 months vs 3.9 months, HR = 0.45, p = 0.001). Similarly, median overall survival was also prolonged in the 2L-ICIs group (10.0 months vs 6.9 months, HR = 0.56, p = 0.015). Cox regression analysis revealed that the addition of ICIs to 2L treatment was an independent prognostic factor for both PFS and OS in ES-SCLC patients. Subgroup analysis indicated that patients with a first-line PFS of ≥6 months could potentially benefit more from 2L ICIs. Furthermore, the occurrence of adverse events in the two groups exhibited a similar pattern.</p><p><strong>Conclusion: </strong>For ES-SCLC patients who have progressed to first-line chemoimmunotherapy, adding ICIs to second-line treatment may be considered as an option with limited benefit but manageable adverse effects.</p>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"199 ","pages":"108021"},"PeriodicalIF":4.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872509","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}