Thoracic Cancer最新文献

{"title":"Immune Checkpoint Inhibitor-Based Therapy as the First-Line Treatment for Advanced Non-Small Cell Lung Cancer: Efficacy, Challenges, and Future Perspectives.","authors":"Xingxiang Pu, Yu Zhou, Jingyi Wang, Lin Wu","doi":"10.1111/1759-7714.70113","DOIUrl":"10.1111/1759-7714.70113","url":null,"abstract":"<p><p>The selection of initial systemic treatment for advanced non-small cell lung cancer (NSCLC) depends on histological subtypes, oncogenic driver identification through genomic profiling, and programmed death-ligand 1 (PD-L1) expression quantification. The choice of first-line treatment is crucial as patients with advanced NSCLC may not have the opportunity to receive second- or later-line therapies due to the rapid progression of the disease. Current guidelines recommend pretreatment PD-L1 expression quantification evaluation prior to initiating systemic therapy in advanced NSCLC. Except for histology, PD-L1 expression, and absence of actionable driver mutations, single-agent immune checkpoint inhibitors (ICIs) are foundational first-line interventions. ICIs combined with chemotherapy or other ICIs have shown improved survival outcomes compared to ICI monotherapy. However, choosing the best option can be challenging due to limited head-to-head comparisons. Treatment decisions are often influenced by drug availability, reimbursement coverage, and patient's economic conditions. Despite the development of new ICI therapies, overall survival data seem to have plateaued, highlighting the need for sustained investigations and extensive clinical validation studies to develop novel therapies, optimize ICI combinations, and monitor adverse effects. Collaboration among data scientists, clinicians, biologists, and policymakers is essential to establish biomarkers that enhance patient selection and overall survival in NSCLC.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 12","pages":"e70113"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476884","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":"Enhancing the Precision and Efficiency of Pulmonary Tumor Detection With Robotic-Assisted ¹⁸F-FDG PET/CT-Guided Lung Biopsy: A Case Report.","authors":"Jian Liu, Chuan Xu, Haiyan Li, Bing Niu, Kai Xu, Xia Lu","doi":"10.1111/1759-7714.70105","DOIUrl":"10.1111/1759-7714.70105","url":null,"abstract":"<p><p>Sarcomatoid carcinoma, a rare and aggressive form of non-small cell lung cancer, presents diagnostic challenges due to its heterogeneity and atypical features. This case report evaluates robotic-assisted ¹⁸F-FDG PET/CT-guided percutaneous lung biopsy for improving diagnostic accuracy and efficiency in such complex lung lesions. We present the case of an 86-year-old male with a right upper lung lesion, chronic cough, intermittent hemoptysis, chills, and fever. Initial fiberoptic bronchoscopy and CT-guided lung biopsy (16 min, three needle adjustments) were inconclusive. Subsequently, a robotic-assisted PET/CT-guided percutaneous lung biopsy was performed, targeting metabolically active regions. This procedure was completed in 6 min without any needle adjustments. This efficiency stemmed from the system's clear, precise navigation, eliminating extensive manual lesion localization and collision risk with critical structures. Unlike some navigated procedures, it avoids time-consuming marker placement and registration. Its high accuracy guidance facilitated single needle insertion, preventing repeated adjustments, confirmatory CTs, and step-by-step needle advancement. Imaging confirmed a hypermetabolic lesion and mediastinal lymphadenopathy suggestive of malignancy, and histopathology revealed sarcomatoid carcinoma with pleomorphic atypical cell infiltration, high mitotic activity, and necrosis. Genetic testing identified a MET mutation, leading to targeted therapy with Bozitinib. Follow-up imaging at 1 month showed a significant reduction in the lesion size, indicating a positive treatment response. This case underscores the potential advantages of robotic-assisted ¹⁸F-FDG PET/CT-guided lung biopsy in enhancing diagnostic sensitivity and procedural efficiency by precisely targeting metabolically active areas, minimizing needle adjustments, and potentially reducing false-negative results. Broader application in interventional radiology and oncology warrants further investigation.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 11","pages":"e70105"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286601","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":"Comparison of the Immune Checkpoint InhibitorFree Survival Between Patients Who Completed and Those Who Discontinued ICI for Non-Small Cell Lung Cancer.","authors":"Takahiro Nagai, Hiroaki Akamatsu, Eri Takase, Eriko Murakami, Takeya Sugimoto, Ryota Shibaki, Atsushi Hayata, Toshio Shimizu, Masanori Nakanishi, Yasuhiro Koh, Nobuyuki Yamamoto","doi":"10.1111/1759-7714.70090","DOIUrl":"10.1111/1759-7714.70090","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICI)-containing therapy for advanced or recurrent non-small cell lung cancer (NSCLC) are not completed by some responders for reasons other than progressive disease (PD). The proportion of patients who discontinue ICI and the length of their treatment-free status are unclear.</p><p><strong>Methods: </strong>In this single-center retrospective study, we examined the medical records of 233 patients who initiated ICI-based therapy at our hospital between 2016 and 2020. We identified patients who completed treatment and discontinued it for reasons other than PD. The primary outcome was treatment-free survival, which we termed ICI-free survival.</p><p><strong>Results: </strong>Sixty-five patients were eligible for analysis. In the discontinuation group, the median duration of ICI was 3.9 months. Median progression-free survival, ICI-free survival, and overall survival in the entire population were 25.0, 11.5, and 78.3 months, respectively. The ICI-free survival rates at 1, 2, and 3 years were 48%, 38%, and 36%. The Kaplan-Meier curve of ICI-free survival almost reached a plateau 2 years after ICI termination. The median ICI-free survival for the completion group and discontinuation group was not reached and 9.4 months, respectively (adjusted HR 0.28, p = 0.01). Estimated ICI-free survival rates in the completion and discontinuation groups were 80% vs. 38% at 1 year, 66% vs. 30% at 2 years, and 66% vs. 28% at 3 years.</p><p><strong>Conclusion: </strong>Patients who discontinued ICI therapy had poorer ICI-free survival than those who completed it. However, there was a notable population of patients with long-term ICI-free survival.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 11","pages":"e70090"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209624","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":"Expert Consensus on Subxiphoid and Subcostal Arch Thoracoscopic Resection for the Treatment of Thymoma.","authors":"Xunliang Yin, Hongtao Duan, Zhengwei Zhao, Xiuyi Zhi, Gening Jiang, Shugeng Gao, Chun Chen, Haiquan Chen, Xiaofei Li, Jian Hu, Lanjun Zhang, Hecheng Li, Zhentao Yu, Hui Tian, Zhenfa Zhang, Q I Xue, Yunchao Huang, Junqiang Fan, Qing Geng, Dong Chao, Taiqian Gong, Wenjie Jiao, Zhigang Li, Hongjing Jiang, Yufeng Ba, Jigang Dai, Bo Deng, Shuchen Chen, Shouyin Di, Jianyong Ding, Liang Duan, Jiang Fan, Yingtong Feng, Yunjiu Gou, Zhitao Gu, Yong Han, Jinxi He, Xiaomin He, Jianbin Hou, Feng Jiang, Bin Li, Qingxin Li, Shuben Li, Xiangnan Li, Chunguang Li, Zhongcheng Li, Jianhong Lian, Junguo Liang, Naixin Liang, Jiangbo Lin, Dazhi Liu, Huifeng Liu, Junfeng Liu, Wei Liu, Yangchun Liu, Shumin Wang, Shijie Zhang, Shaohua Ma, Nan Wu, Wenhao Liu, Jun Yi, Chenxi Zhong, Songtao Xu, Shengmao Ma, Hui Sun, Hai Xu, Li Wei, Qiang Pu, Ruixiang Zhang, Wenxiang Wang, Desong Yang, Jiufa Wu, Nan Sun, Ping Xu, Haitao Ma, Lei Xue, Shunkai Zhou, Haidong Wang, Enwu Xu, Guangxia Wei, Kun Wang, Guofang Zhao, Zhongmin Peng, Guoqiang Yin, Xueliang Yang, Teng Mao, Deping Zhao, Hua Tang, Jiandong Mei, Yun Wang, Weiguo Jin, Dongsheng Yue, Hao Zhang, Liwei Zhang, Dianbo Li, Yongfu Ma, Saibo Pan, Luming Wang, Ming Wu, Zixiang Wu, Yanhe Su, Yu Qi, Jianjun Qin, Hongcan Shi, Guangqiang Zhao, Fengwei Tan, Tianhu Wang, Han Yang, Haoxian Yang, Yingguo Zhang, Kai Cui, Wuping Wang, Wenhai Li, Ting Chang, Kai Guo, Yawei Dou, Shudong Li, Dong Han, Kunxiang Gao, Chao Ding, Yong Zhang, Guangjian Zhang, Junke Fu, Wen Liu, Qingchun Liu, Xi Zhang, Weidong Lv, Jia Liu, Guangyan Lei, Yunfeng Zhang, Tao Xu, Yong Zhang, Xiaoquan Ding, Hongtao Tang, Xiaoping Liang, Xiaokang Zhang, Peng Ge, Junqi Wang, Jiantao Jiang, Jianzhong Li, Ruibin Xu, Yize Guo, Mingliang Xing, Jiakuan Chen, Honggang Liu, Ende Yang, Shaoyi Cheng, Liping Tong, Haihua Guo, Tao Wang, Guang Yang, Jianyong Sun, Yongshi Liu, Nianlin Xie, Lei Wang, Feng Tian, Daixing Zhong, Yunfeng Ni, Jian Wang, Jinbo Zhao, Jie Lei, Lijun Huang, Zhongping Gu, Tao Zhang, Xiaoping Wang, Tao Jiang, Qiang Lu, Xiaolong Yan, Yongan Zhou","doi":"10.1111/1759-7714.70094","DOIUrl":"10.1111/1759-7714.70094","url":null,"abstract":"<p><p>Surgery is the primary treatment for thymoma. Although subxiphoid and subcostal arch thoracoscopic thymoma surgery is widely used, there is currently a lack of consensus regarding its use, nor have standards been established. Based on the surgical experience of many domestic thoracic surgery centers, the Department of Thoracic Surgery of Tangdu Hospital of Air Force Medical University has formulated this expert consensus regarding key clinical issues related to thoracoscopic thymoma surgery, including preoperative evaluation, surgical indications, preoperative preparation, surgical details, perioperative management, postoperative treatment, and follow-up. Our aim is to provide consistent and clear guidance for fellow thoracic surgeons to ensure patient safety while optimizing the treatment effect.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 12","pages":"e70094"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498105","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":"Repeated Anatomical Pulmonary Resection for Second Primary Nonsmall-Cell Lung Cancer: Safety and Short-Term Outcomes.","authors":"Céline Forster, Louis-Emmanuel Chriqui, Etienne Abdelnour-Berchtold, Matthieu Zellweger, Jean Yannis Perentes, Thorsten Krueger, Michel Gonzalez","doi":"10.1111/1759-7714.70116","DOIUrl":"10.1111/1759-7714.70116","url":null,"abstract":"<p><strong>Background: </strong>Repeated anatomical pulmonary resections in second primary nonsmall-cell lung cancer (NSCLC) pose significant challenges due to prior surgery. This study evaluates the feasibility and short-term outcomes of repeated anatomical pulmonary resections for second primary NSCLC.</p><p><strong>Method: </strong>We retrospectively reviewed all consecutive cases of repeated anatomical pulmonary resections for second primary NSCLC performed in our institution from January 2014 to December 2023.</p><p><strong>Results: </strong>A total of 55 patients (median age 68 years; interquartile range [IQR]: 61.5-72) underwent repeated anatomical pulmonary resections for second primary NSCLC. Adenocarcinoma predominated in both primary (78.2%) and secondary (76.4%) cases. Video-assisted thoracoscopy (VATS) approach was used in 94.5% and 96.4% for first and repeated resection, respectively (p = 0.647). The extent of pulmonary resection differed between first and repeated resection, with a predominance of lobectomy during first resection (56.4%) and segmentectomy during repeated resection (85.5%, p < 0.001). We did not observe any significant difference in postoperative overall morbidity after first and repeated resection (23.6% vs. 40%, p = 0.065). However, there was an increased incidence of atrial fibrillation (16.4% vs. 0%) and prolonged air leak (> 5 days) after repeated resection (25.5% vs. 5.5%, p = 0.008). The median length of hospital stay was similar after first and repeated resection (5 vs. 5 days, p = 0.089). The three-year overall survival (OS) was 73% after first resection and 87% after repeated resection. Overall disease recurrence rate was not statistically different between first and repeated resection (1.8% vs. 3.6%, p = 0.558).</p><p><strong>Conclusion: </strong>Our series demonstrated that second primary NSCLC can be safely managed by VATS segmentectomy, yielding favorable short-term survival and low recurrence rates.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 12","pages":"e70116"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498106","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":"Late-Onset Crizotinib-Associated Renal Cysts With Subsequent Regression Following Dose Reduction: A Case Report.","authors":"Joon-Young Yoon, Won Gi Jeong, Yoo-Duk Choi, Seung Ji Kang, Hwa Kyung Park, Hyung-Joo Oh, Cheol-Kyu Park, In-Jae Oh, Young-Chul Kim","doi":"10.1111/1759-7714.70111","DOIUrl":"10.1111/1759-7714.70111","url":null,"abstract":"<p><p>Crizotinib, an anaplastic lymphoma kinase (ALK)/ROS1/c-MET inhibitor, improves outcomes in ALK-positive non-small cell lung cancer (NSCLC) but can cause crizotinib-associated renal cysts (CARCs), a rare yet clinically relevant adverse effect. We report a case of a 68-year-old Korean male who developed complex renal cysts after 4 years of crizotinib therapy. Radiologic findings initially raised suspicion for either an abscess or a neoplastic lesion, leading to surgical resection. However, recurrent renal cysts developed during continued crizotinib therapy, and CARCs were subsequently suspected. A dose reduction was implemented, which led to cyst regression without compromising tumor control. This case highlights the need to recognize and manage late-onset toxicities during long-term treatment, emphasizing the clinical value of multidisciplinary evaluation and tailored dose adjustments.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 12","pages":"e70111"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340442","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":"Subcutaneous Fat Area Can Be as a Predictors of Drainage Volume After Lobectomy for Lung Cancer.","authors":"Jie Xu, Shuai Yuan, Xiaopeng An, Jie Dong","doi":"10.1111/1759-7714.70114","DOIUrl":"10.1111/1759-7714.70114","url":null,"abstract":"<p><strong>Objective: </strong>Currently, no uniform standard exists for the maximum drainage volume permitting chest tube removal following lobectomy in lung cancer patients, and limited research has explored factors influencing postoperative drainage. This study aimed to investigate the relationship between subcutaneous fat area (SFA) and postoperative drainage volume.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 509 lung cancer patients who underwent video-assisted thoracoscopic lobectomy. Clinical characteristics, postoperative outcomes (length of stay, hospitalization expenses), blood parameters, chest tube duration, 3-day postoperative drainage volume, and SFA were recorded. Predictive factors for drainage volume were identified using univariate and multivariate logistic regression analyses. SFA was measured at the level of the 12th thoracic vertebra cross-section using preoperative CT imaging.</p><p><strong>Results: </strong>The analysis revealed significant positive correlations between chest tube duration and both length of stay (p < 0.001) and hospitalization expenses (p < 0.001). Chest tube duration (< 3 vs. ≥ 3 days) was primarily determined by 3-day postoperative drainage volume (574 ± 252 vs. 885 ± 362 mL; p < 0.001). Univariate analysis demonstrated that 3-day postoperative drainage volume correlated with age (p < 0.001), gender (p = 0.002), pathological type (p < 0.001), diabetes (p = 0.026), hypertension (p = 0.011), and SFA (p < 0.001). Multivariate logistic regression confirmed that age ≥ 65 years (p = 0.016), small cell lung cancer (SCLC; p = 0.022), and SFA ≥ 100 cm² (p = 0.005) were independently associated with postoperative drainage volume ≥ 650 mL.</p><p><strong>Conclusions: </strong>SFA significantly correlated with 3-day postoperative drainage volume and may serve as a predictor for drainage volume following lobectomy in lung cancer patients. This association highlights its utility in guiding chest tube removal timing and potentially reducing the risk of pleural effusion recurrence.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 12","pages":"e70114"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340443","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":"The Thoracic Absorption Dose and Secondary Tumor Risk Caused by Different Imaging Methods in Image-Guided Particle Radiotherapy.","authors":"Qinghao Cui, Xianrui Yan, Chengqiang Li, Jian Zhu, Jun Ma, Tingting Liu","doi":"10.1111/1759-7714.70102","DOIUrl":"10.1111/1759-7714.70102","url":null,"abstract":"<p><strong>Background: </strong>Image-guided radiation therapy uses imaging methods such as CBCT to effectively improve treatment precision. Kilovoltage-imaging technology provides high soft tissue contrast at low doses, whereas megavoltage-imaging technology better displays deep and bony structures at high doses. Proton therapy is more sensitive to tissue density and positional accuracy, so it requires more stringent image guidance and higher precision than traditional X-ray therapy.</p><p><strong>Objective: </strong>This study evaluates radiation doses from CBCT systems (TrueBeam, Halcyon, ProBeam, TOMO) in both adult and pediatric phantoms, measuring dose variations and predicting secondary tumor risks using a radiobiological model.</p><p><strong>Methods: </strong>Absorbed doses in organs of adult and pediatric phantoms were measured with OSLDs across imaging systems. The risk of secondary tumors was estimated using the BEIR VII model.</p><p><strong>Results: </strong>Halcyon 2.0 and TOMO's MV-level imaging systems showed significantly higher doses than KV-level systems. Pediatric patients received 2-3 times higher doses than adults. In KV-level imaging, Halcyon 2.0 resulted in the highest lung tissue dose in both age groups (17.464 mGy for pediatric, 9.109 mGy for adult), whereas ProBeam had the lowest (6.844 and 4.073 mGy, respectively). The lifetime attributable risk for lung cancer correlated with the dose, with higher risks in children.</p><p><strong>Conclusions: </strong>Higher radiation doses lead to greater secondary tumor risk, with the risk being more pronounced in pediatric patients. Continuous thoracic CBCT can deliver up to 1 Gy in thoracic organs, posing a significant risk of secondary tumors, especially in younger patients. Careful consideration of this risk is essential in treatment planning.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 12","pages":"e70102"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310497","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":"Association Between Baseline Neutrophil Count and Febrile Neutropenia Following Docetaxel and Ramucirumab With Prophylactic Pegfilgrastim.","authors":"Tomonori Makiguchi, Haruka Odagiri, Hisashi Tanaka, Kageaki Taima, Sadatomo Tasaka","doi":"10.1111/1759-7714.70099","DOIUrl":"10.1111/1759-7714.70099","url":null,"abstract":"<p><strong>Background: </strong>Patients with non-small cell lung cancer (NSCLC) receiving docetaxel (DTX) and ramucirumab (RAM) regimen frequently experience febrile neutropenia (FN). We aimed to clarify the incidence rate and predictive factors of FN under prophylactic pegfilgrastim.</p><p><strong>Methods: </strong>Fifty-four patients with NSCLC received DTX + RAM from 2018 to 2023 in our hospital. Age, gender, performance status (PS), treatment line, prior thoracic irradiation, body mass index (BMI), neutrophil count at baseline (BNC) and the lowest neutrophil count (LNC), serum albumin, and incidence of FN were recorded. The correlation between BNC and LNC was analyzed. We evaluated the association between BNC and FN using logistic regression analysis. The baseline characteristics of two groups stratified by the cutoff BNC using the ROC curve were compared.</p><p><strong>Results: </strong>All the patients received prophylactic pegfilgrastim. Three (5.5%) patients experienced FN. There was a significant correlation between BNC and LNC (r_s = 0.43, p = 0.0003). BNC and cardiovascular disease were significantly associated with FN (odds ratio 0.998, p = 0.0151 and odds ratio 28.64, p = 0.034). The receiver operating characteristic curve showed the cutoff value of BNC was 3000/μL (AUC 0.88). There was no significant difference in other baseline characteristics between the patients with BNC of 3000/μL or more and those with BNC less than 3000/μL.</p><p><strong>Conclusion: </strong>Our data showed the incidence rate of FN receiving DTX + RAM with prophylactic pegfilgrastim was 5.5%. Despite prophylactic pegfilgrastim, BNC was correlated with LNC and might be predictive of FN. We should be careful of BNC even if it meets the criteria for starting DTX + RAM treatment.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 11","pages":"e70099"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226865","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":"Effect of Cancer Cachexia on the Efficacy and Treatment Delivery of Chemotherapy in Older Patients With Advanced Small Cell Lung Cancer.","authors":"Michitoshi Yabe, Tateaki Naito, Suguru Matsuda, Meiko Morita, Motoki Sekikawa, Keita Miura, Hiroaki Kodama, Toshiya Fujisaki, Nobuaki Mamesaya, Haruki Kobayashi, Ryo Ko, Kazushige Wakuda, Akira Ono, Hirotsugu Kenmotsu, Haruyasu Murakami, Toshiaki Takahashi","doi":"10.1111/1759-7714.70104","DOIUrl":"10.1111/1759-7714.70104","url":null,"abstract":"<p><strong>Background: </strong>Cachexia is a syndrome in patients with cancer that reduces life quality and prognosis, characterized by severe weight loss, muscle atrophy, and anorexia. How cachexia adversely affects older patients with small cell lung cancer (SCLC) remains uncertain. This study aimed to determine the effect of cachexia on prognosis, treatment delivery, and efficacy in older patients with advanced SCLC receiving first-line platinum-based chemotherapy.</p><p><strong>Method: </strong>We retrospectively analyzed older patients (≥ 70 years) with advanced SCLC treated with carboplatin and etoposide between January 2015 and June 2020 at the Shizuoka Cancer Center. Cachexia was diagnosed based on the % weight loss and body mass index. After excluding patients with no documented weight change and those who relapsed after radiotherapy, we examined the effect of cachexia on treatment delivery, progression-free survival (PFS), and overall survival (OS).</p><p><strong>Results: </strong>Cachexia was identified in 57% (28 of 49) of patients. The cachexia group experienced more frequent treatment interruptions and dose reductions than the non-cachexia group (46% vs. 10% for dose reductions, p < 0.05; 61% vs. 90% for completion of four chemotherapy courses, p < 0.05). Median PFS and OS were significantly shorter in the cachexia group compared to those in the non-cachexia group (PFS: 3.3 vs. 5.4 months; OS: 6.3 vs. 15.1 months).</p><p><strong>Conclusion: </strong>Older patients with advanced SCLC and cachexia undergoing carboplatin and etoposide therapy exhibited shorter PFS and OS than those without cachexia. Treatment delivery was less effective in the cachexia group than in the non-cachexia group, suggesting that their vulnerabilities affected treatment efficacy.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 12","pages":"e70104"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333898","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}