Seminars in oncology最新文献

{"title":"Influence of Cancer on COVID-19 Incidence, Outcomes, and Vaccine Effectiveness: A Prospective Cohort Study of U.S. Veterans","authors":"Harshraj Leuva ,&nbsp;Mengxi Zhou ,&nbsp;Norbert Brau ,&nbsp;Sheldon T. Brown ,&nbsp;Prabhjot Mundi ,&nbsp;Ta-Chueh Melody Rosenberg ,&nbsp;Carol Luhrs ,&nbsp;Susan E. Bates ,&nbsp;Yeun-Hee Anna Park ,&nbsp;Tito Fojo","doi":"10.1053/j.seminoncol.2022.07.005","DOIUrl":"10.1053/j.seminoncol.2022.07.005","url":null,"abstract":"<div><h3>Purpose</h3><p>Coronavirus disease 2019 (COVID-19) has been a constant health threat since its emergence. Amongst risk factors proposed, a diagnosis of cancer has been worrisome. We report the impact of cancer and other risk factors in US Veterans receiving care at Veterans Administration (VA) Hospitals, their adjusted odds ratio (aOR) for infection and death, and report on the impact of vaccines on the incidence and severity of COVID-19 infections in Veterans without/with cancer.</p></div><div><h3>Methods</h3><p>We conducted a cohort study of US Veterans without/with cancer by mining VA COVID-19 Shared Data Resource (CSDR) data using the VA Informatics and Computing Infrastructure (VINCI). Our observation period includes index dates from 14DEC2020 to 25JAN2022, encompassing both the delta and omicron waves in the US.</p></div><div><h3>Results</h3><p>We identified 915,928 Veterans, 24% of whom were African Americans who had undergone COVID testing–688,541 were and 227,387 were not <em>vaccinated</em>. 157,072 had a cancer diagnosis in the preceding two years. Age emerged as the major risk factor, with gender, BMI, and (Elixhauser) comorbidity contributing less. Among veterans with solid tumors other than lung cancer, risks of infection and death within 60 days were comparable to Veterans without cancer. However, those with hematologic malignancies fared worse. Vaccination was highly effective across all cancer cohorts; the respective rates of infection and death after infection were 8% and 5% among the <em>vaccinated</em> compared to 47% and 10% in the <em>unvaccinated</em>. Amongst <em>vaccinated</em>, increased risk of infection was noted in both, Veterans with hematologic malignancy treated with chemotherapy (HR, 2.993, <em>P</em> &lt; 0.0001) or targeted therapies (HR, 1.781, <em>P</em> &lt; 0.0001), and in solid tumors treated with either chemotherapy (HR 2.328, 95%CI 2.075–2.611, <em>P</em> &lt; 0.0001) or targeted therapies (HR 1.328, <em>P</em> &lt; 0.0001) when compared to those not on treatment.</p></div><div><h3>Conclusions</h3><p>Risk for COVID-19 infection and death from infection vary based on cancer type and therapies administered. Importantly and encouragingly, the duration of protection from infection following vaccination in Veterans with a diagnosis of cancer was remarkably like those without a cancer diagnosis. Veterans with hematologic malignancies are especially vulnerable, with lower vaccine effectiveness (VE).</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 5","pages":"Pages 363-370"},"PeriodicalIF":4.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9353607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10359541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel targeted therapies for advanced non-small lung cancer","authors":"Omar Abughanimeh ,&nbsp;Anahat Kaur ,&nbsp;Badi El Osta ,&nbsp;Apar Kishor Ganti","doi":"10.1053/j.seminoncol.2022.03.003","DOIUrl":"10.1053/j.seminoncol.2022.03.003","url":null,"abstract":"<div><p>Non-small cell lung cancer (NSCLC) is the most common type of lung cancer accounting for almost 80%–85% of all lung cancer cases. Unfortunately, more than half of the patients will be diagnosed with advanced disease at the time of presentation, which makes their disease incurable. Historically, the 5 year overall survival for advanced NSCLC was 5%. However, there has been a significant increase in our understanding of the genetic basis of NSCLC, which has led to development of both immunotherapy and targeted therapy agents. This has improved the 5 year overall survival to become within the range of 15%–50% depending on certain mutations and biomarkers. Over the last decade the United States Food and Drug Administration (FDA) has approved almost 20 new targeted therapies and clinical trials are still undergoing to evaluate more novel agents. In this review, we will present recent updates on novel targeted therapies.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 3","pages":"Pages 326-336"},"PeriodicalIF":4.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775422000240/pdfft?md5=d001b3b5176390baacf43ec31dd4c016&pid=1-s2.0-S0093775422000240-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42737179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-small cell lung cancer in the era of immunotherapy","authors":"Quillan Huang ,&nbsp;Jan Kemnade ,&nbsp;Loraine Cornwell ,&nbsp;Farrah Kheradmand ,&nbsp;Anita L. Sabichi ,&nbsp;Devika Das","doi":"10.1053/j.seminoncol.2022.06.009","DOIUrl":"10.1053/j.seminoncol.2022.06.009","url":null,"abstract":"<div><p>Immunotherapy for non-small cell lung cancer (NSCLC) has revolutionized treatment for those with advanced disease, and recent data have emerged providing evidence for its benefits in earlier stages of the disease. Several pivotal clinical trials provide compelling data that adaptive immune cells may be highly effective and possibly even curative for NSCLC. Immune checkpoint inhibitors (ICIs) can unleash highly reactive memory immune responses to tumor antigens with durable effects against advanced or recurrent disease. Despite these encouraging results, many critical questions remain in the field including, for example, how to identify the subsets of NSCLC patients who most benefit from ICI treatment, and how ICI efficacy might be enhanced by utilizing combinations or sequencing of agents. A deeper understanding of biological mechanisms involved in lung cancer offers a unique opportunity to further explore the interaction between the adaptive immune landscape and NSCLC. Given the high incidence of lung cancer in Veterans and many Veterans being treated with immunotherapy for this disease, it is timely to have their adequate representation in future clinical trials. New clinical trials focused on Veterans can assist in exploring ways to mitigate resistant mechanisms as well as to investigate predictive and prognostic biomarkers for response to ICIs and other treatments. This paper will review current data and indications for immunotherapy in NSCLC, introduce new areas of research within immunotherapy, and discuss its applicability to the Veteran population.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 3","pages":"Pages 337-343"},"PeriodicalIF":4.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775422000495/pdfft?md5=81b075500210afaff9fbe90409644ce4&pid=1-s2.0-S0093775422000495-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40553965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbidity and life expectancy in shared decision making for lung cancer screening","authors":"Brett Bade ,&nbsp;Mary Gwin ,&nbsp;Matthew Triplette ,&nbsp;Renda Soylemez Wiener ,&nbsp;Kristina Crothers","doi":"10.1053/j.seminoncol.2022.07.003","DOIUrl":"10.1053/j.seminoncol.2022.07.003","url":null,"abstract":"<div><p>Shared decision making (SDM) is an important part of lung cancer screening (LCS) that includes discussing the risks and benefits of screening, potential outcomes, patient eligibility and willingness to participate, tobacco cessation, and tailoring a strategy to an individual patient. More than other cancer screening tests, eligibility for LCS is nuanced, incorporating the patient's age as well as tobacco use history and overall health status. Since comorbidities and multimorbidity (ie, 2 or more comorbidities) impact the risks and benefits of LCS, these topics are a fundamental part of decision-making. However, there is currently little evidence available to guide clinicians in addressing comorbidities and an individual's “appropriateness” for LCS during SDM visits. Therefore, this literature review investigates the impact of comorbidities and multimorbidity among patients undergoing LCS. Based on available evidence and guideline recommendations, we identify comorbidities that should be considered during SDM conversations and review best practices for navigating SDM conversations in the context of LCS. Three conditions are highlighted since they concomitantly portend higher risk of developing lung cancer, potentially increase risk of screening-related evaluation and treatment complications and can be associated with limited life expectancy: chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, and human immunodeficiency virus infection.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 3","pages":"Pages 220-231"},"PeriodicalIF":4.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775422000574/pdfft?md5=32fe283765c04ac5522625aeecd3b378&pid=1-s2.0-S0093775422000574-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40595120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Cancer Screening and Precision Oncology","authors":"Susan E. Bates MD (Series Editor)","doi":"10.1053/j.seminoncol.2022.09.006","DOIUrl":"10.1053/j.seminoncol.2022.09.006","url":null,"abstract":"","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 3","pages":"Pages 189-190"},"PeriodicalIF":4.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775422000744/pdfft?md5=6870da0b76a3c74d269eab625e3b0c55&pid=1-s2.0-S0093775422000744-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48757624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Military exposures and lung cancer in United States Veterans","authors":"William Grier ,&nbsp;Hatoon Abbas ,&nbsp;Rediet Regassa Gebeyehu ,&nbsp;Ankur Kumar Singh ,&nbsp;Jimmy Ruiz ,&nbsp;Stella Hines ,&nbsp;Fahid Alghanim ,&nbsp;Janaki Deepak","doi":"10.1053/j.seminoncol.2022.06.010","DOIUrl":"10.1053/j.seminoncol.2022.06.010","url":null,"abstract":"<div><p>Lung cancer screening begins at age 50, with yearly low dose computed tomography (LDCT) scans until age 80, for patients determined to be high risk due to tobacco smoking. Veterans serving from World War II to the Gulf War are now at the age where LDCT is recommended. This recommendation from the United States Preventative Service Task Force includes patients who have a 20-pack year tobacco history and currently smoke or quit within the last 15 years. This recommendation does not consider additional risk factors such as exposures to lung carcinogens. We discuss unique operational and occupational exposures encountered while serving in the armed forces, which may potentially increase the risk of lung cancers in the Veteran population. The additional risk of lung cancer due to military exposure history is unclear and more work is needed to identify and quantify risk at an individual level. Increasing awareness at the provider level regarding the carcinogenic exposures encountered may allow a larger population of Veterans, not meeting traditional LDCT criteria, to benefit from lung cancer screening.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 3","pages":"Pages 241-246"},"PeriodicalIF":4.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775422000501/pdfft?md5=0cfd7b3b1a14eb31f84cbe6a8489bc49&pid=1-s2.0-S0093775422000501-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40627346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in initiating a lung cancer screening program: Experiences from two VA medical centers","authors":"Stephen Bujarski ,&nbsp;Robert Flowers ,&nbsp;Mansour Alkhunaizi ,&nbsp;Dave Cuvi ,&nbsp;Sneha Sathya ,&nbsp;Jennifer Melcher ,&nbsp;Farrah Kheradmand ,&nbsp;Gregory Holt","doi":"10.1053/j.seminoncol.2022.06.006","DOIUrl":"10.1053/j.seminoncol.2022.06.006","url":null,"abstract":"<div><p>Establishing a lung cancer screening (LCS) program is an important endeavor that delivers life-saving healthcare to an at-risk population. However, developing a comprehensive LCS program requires critical elements including obtaining institutional level buy-in, hiring necessary personnel, developing appropriate infrastructure and actively engaging primary care providers, subspecialty services, and radiology. The process required to connect such services to deliver an organized LCS program that reaches all eligible candidates must be individualized to each institution's needs and infrastructure. Here we provide detailed experiences from two successful LCS programs, one using a primary care provider-based service and the other using a consult-based service. In each case, we provide the pros and cons of each system. We propose that the decision to setup an ideal LCS program could include a hybrid design that combines aspects of each system.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 3","pages":"Pages 232-240"},"PeriodicalIF":4.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S009377542200046X/pdfft?md5=56ec504d193c057cbf95c5db99dcd01e&pid=1-s2.0-S009377542200046X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9747389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loss of function STK11 alterations and poor outcomes in non–small-cell lung cancer: Literature and case series of US Veterans","authors":"Hafsa Farooq ,&nbsp;Harold Bien ,&nbsp;Victor Chang ,&nbsp;Daniel Becker ,&nbsp;Yeun-Hee Park ,&nbsp;Susan E. Bates","doi":"10.1053/j.seminoncol.2022.06.008","DOIUrl":"10.1053/j.seminoncol.2022.06.008","url":null,"abstract":"<div><p>Emerging evidence suggests that STK11 alterations, frequently found in non–small-cell lung cancers, may be prognostic and/or predictive of response to therapy, particularly immunotherapy. STK11 affects multiple important cellular pathways, and mutations lead to tumor growth by creating an immunosuppressive and altered metabolic environment through changes in AMPK, STING, and vascular endothelial growth factor pathways. We illustrate the questions surrounding STK11 genomic alteration in NSCLC with a case series comprising six United States Veterans from a single institution. We discuss the history of STK11, review studies on its clinical impact, and describe putative mechanisms of how loss of STK11 might engender resistance to immunotherapy or other therapies. While the exact impact of STK11 alteration in non–small-cell lung cancer remain to be fully elucidated, future research and ongoing clinical trials will help us better understand its role in cancer development and devise more effective treatment strategies.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 3","pages":"Pages 319-325"},"PeriodicalIF":4.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775422000483/pdfft?md5=d0bdad1db8edbd63244a1de4545aa12c&pid=1-s2.0-S0093775422000483-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40519069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers and the microbiome in the detection and treatment of early-stage non-small cell lung cancer","authors":"Mark Klein ,&nbsp;Alexa A. Pragman ,&nbsp;Christine Wendt","doi":"10.1053/j.seminoncol.2022.06.011","DOIUrl":"10.1053/j.seminoncol.2022.06.011","url":null,"abstract":"<div><p>Lung cancer is one of the most common and deadly cancers in the world. However, over the last several years, research into lung cancer screening and novel therapeutic approaches have provided promise that earlier detection combined with new treatment strategies may result in significantly improved outcomes. Biomarkers will most certainly play a major role in identifying those who may benefit from, and how to apply, these new treatment strategies. Here we discuss potential biomarkers, including the microbiome, in both detection and treatment strategies for early stage lung cancer.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 3","pages":"Pages 285-297"},"PeriodicalIF":4.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775422000513/pdfft?md5=138993754f3c3e2485b6a1ee7cb96982&pid=1-s2.0-S0093775422000513-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9948407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular biomarkers and liquid biopsies in lung cancer","authors":"Kamya Sankar ,&nbsp;Mina Zeinali ,&nbsp;Sunitha Nagrath ,&nbsp;Nithya Ramnath","doi":"10.1053/j.seminoncol.2022.06.007","DOIUrl":"10.1053/j.seminoncol.2022.06.007","url":null,"abstract":"<div><p>Liquid biopsy refers to the identification of tumor-derived materials in body fluids including in blood circulation. In the age of immunotherapy and targeted therapies used for the treatment of advanced malignancies, molecular analysis of the tumor is considered a crucial step to guide management. In lung cancer, the concept of liquid biopsies is particularly relevant given the invasiveness of tumor biopsies in certain locations, and the potential risks of biopsy in a patient population with significant co-morbidities. Liquid biopsies have many advantages including non-invasiveness, lower cost, potential for genomic testing, ability to monitor tumor evolution through treatment, and the ability to overcome spatial and temporal intertumoral heterogeneity. The potential clinical applications of liquid biopsy are vast and include screening, detection of minimal residual disease and/or early relapse after curative intent treatment, monitoring response to immunotherapy, and identifying mutations that might be targetable or can confer resistance. Herein, we review the potential role of circulating tumor DNA and circulating tumor cells as forms of liquid biopsies and blood biomarkers in non-small cell lung cancer. We discuss the methodologies/platforms available for each, clinical applications, and limitations/challenges in incorporation into clinical practice. We additionally review emerging forms of liquid biopsies including tumor educated platelets, circular RNA, and exosomes.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 3","pages":"Pages 275-284"},"PeriodicalIF":4.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775422000471/pdfft?md5=578251d67cb50f8af9ec14a06a205fb2&pid=1-s2.0-S0093775422000471-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40515813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}