Lung Cancer Management最新文献

{"title":"Efficacy and safety of tyrosine kinase inhibitors in advanced non-small-cell lung cancer harboring epidermal growth factor receptor mutation: a network meta-analysis.","authors":"Abdullah Alanazi,&nbsp;Ismaeel Yunusa,&nbsp;Khaled Elenizi,&nbsp;Abdulaziz I Alzarea","doi":"10.2217/lmt-2020-0011","DOIUrl":"https://doi.org/10.2217/lmt-2020-0011","url":null,"abstract":"<p><strong>Aim: </strong>To compare the efficacy and safety of tyrosine kinase inhibitors (TKIs) as first-line treatment in patients with locally advanced or metastatic non-small-cell lung cancer (NSCLC) with positive <i>EGFR</i> mutation.</p><p><strong>Materials & methods: </strong>Following a systematic literature review until December 2019, we conducted a random-effects pairwise and network meta-analyses (NMA). We ranked treatments for efficacy and safety based on the surface under the cumulative ranking curve (SUCRA).</p><p><strong>Results: </strong>Tyrosine kinase inhibitors of the epidermal growth factor receptor (EGFR-TKI) improved survival outcomes with fewer grade 3 or higher adverse events compared to chemotherapy. Overall survival results suggest that osimertinib has the highest probability of being the most efficacious (SUCRA, 79.9%), followed by dacomitinib (SUCRA, 75.8%). Adverse events results suggest that osimertinib (SUCRA, 84.3%) and gefitinib (SUCRA, 78.9%) has the highest probability of being the safest.</p><p><strong>Conclusion: </strong>In this NMA, we found that osimertinib is the most efficacious and safest EGFR-TKI. These results may guide clinicians in choosing the most appropriate treatment option among EGFR-TKIs for their patient's individual clinical characteristics.</p>","PeriodicalId":43551,"journal":{"name":"Lung Cancer Management","volume":"10 1","pages":"LMT43"},"PeriodicalIF":2.8,"publicationDate":"2020-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/lmt-2020-0011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38709407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Humanistic burden of living with anaplastic lymphoma kinase-positive non-small-cell lung cancer: findings from the ALKConnect patient insight network and research platform.","authors":"Huamao M Lin,&nbsp;Xiaoyun Pan,&nbsp;Alyssa Biller,&nbsp;Kyla J Covey,&nbsp;Hui Huang,&nbsp;Rebecca Sugarman,&nbsp;Fatima Scipione,&nbsp;Howard West","doi":"10.2217/lmt-2020-0018","DOIUrl":"https://doi.org/10.2217/lmt-2020-0018","url":null,"abstract":"<p><strong>Aim: </strong>Evaluate real-world patient preferences, experiences and outcomes (health-related quality of life [HRQoL]) from patients with anaplastic lymphoma kinase-positive (ALK+) non-small-cell lung cancer (NSCLC) utilizing the ALKConnect Patient Insight Network.</p><p><strong>Patients & methods: </strong>Demographics, disease history/status/treatment, patient preferences and HRQoL (MD Anderson Symptom Inventory lung cancer module, reported as symptom severity and interference) were evaluated for US adults with ALK+ NSCLC.</p><p><strong>Results: </strong>Among 104 patients (median age: 53.0 years, 67.3% female, 40.0% employed), HRQoL and 3-month delay in disease progression were important treatment attributes. Burdensome symptoms included fatigue and disturbed sleep. Symptoms interfered most with work and day-to-day activity. Higher HRQoL was associated with ALK tyrosine kinase inhibitor (TKI) treatment and employment.</p><p><strong>Conclusion: </strong>ALKConnect demonstrated that disease progression, HRQoL, fatigue/sleep, ALK TKIs and employment matter in ALK+ NSCLC.</p>","PeriodicalId":43551,"journal":{"name":"Lung Cancer Management","volume":"10 1","pages":"LMT42"},"PeriodicalIF":2.8,"publicationDate":"2020-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/lmt-2020-0018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38709406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and management of small pulmonary atypical carcinoid tumor associated with Cushing syndrome.","authors":"Dathe Z Benissan-Messan, Robert E Merritt, Konstantin Shilo, Desmond M D'Souza, Peter J Kneuertz","doi":"10.2217/lmt-2020-0010","DOIUrl":"10.2217/lmt-2020-0010","url":null,"abstract":"<p><p>Ectopic adrenocorticotropic hormone (ACTH) syndrome is rare and identification of its source is often challenging. We report the case of an ectopic Cushing syndrome in a young adult male secondary to an occult ACTH producing atypical carcinoid tumor. Extensive biochemical and imaging workup was unrevealing. The diagnosis was aided by Ga-DOTA PET scan demonstrating a suspicious left upper lobe lung nodule. The patient underwent video-assisted thoracoscopic exploration with wedge resection and mediastinal lymphadenectomy of a T2aN2M0 atypical carcinoid, resulting in the normalization of ACTH levels and complete resolution of symptoms. The role of a Ga-DOTA PET scan in diagnosing pulmonary carcinoid tumors and their management are discussed.</p>","PeriodicalId":43551,"journal":{"name":"Lung Cancer Management","volume":"9 4","pages":"LMT41"},"PeriodicalIF":0.9,"publicationDate":"2020-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/86/lmt-09-41.PMC7729590.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38709411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biopsy frequency and complications among lung cancer patients in the United States.","authors":"Yichen Zhang, Lizheng Shi, Michael J Simoff, Oliver J Wagner, James Lavin","doi":"10.2217/lmt-2020-0022","DOIUrl":"10.2217/lmt-2020-0022","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to describe the frequency and distribution of biopsy procedures for patients diagnosed and treated for primary lung cancer.</p><p><strong>Study design: </strong>Retrospective cohort study within an administrative database.</p><p><strong>Materials & methods: </strong>This observational study used data from the IBM MarketScan^® Databases between 2013 and 2015.</p><p><strong>Results: </strong>The total number of lung biopsies performed among eligible subjects was 32,814; an average of 1.7 biopsies per patient. Bronchoscopy and percutaneous approaches accounted for 95% of all procedures. Complication rates by procedure are remarkably similar irrespective of biopsy frequency.</p><p><strong>Conclusion: </strong>Nearly half (46%) of patients in this population experienced multiple biopsies prior to diagnosis. Further, biopsy choice or sequence in patients receiving multiple procedures was unpredictable.</p>","PeriodicalId":43551,"journal":{"name":"Lung Cancer Management","volume":"9 4","pages":"LMT40"},"PeriodicalIF":2.8,"publicationDate":"2020-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/77/e8/lmt-09-40.PMC7729592.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38709410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of palliative care in the management of patients with lung cancer.","authors":"Irena Tan,&nbsp;Kavitha Ramchandran","doi":"10.2217/lmt-2020-0016","DOIUrl":"https://doi.org/10.2217/lmt-2020-0016","url":null,"abstract":"<p><p>Palliative care (PC) is the care of patients and their families with serious illness and is rapidly becoming an important part of the care of cancer patients. Patients with advanced lung cancer are a highly symptomatic population of patients and clearly experience benefits in quality of life and potentially benefits in overall survival when PC is incorporated early on after diagnosis. However, referrals to PC are still reliant on clinical judgment of patient prognosis and symptom burden. Moving forward, improving the integration of PC and lung cancer care will require more efficient real-time screening of patient symptoms, which may be accomplished through the use of patient-reported outcomes.</p>","PeriodicalId":43551,"journal":{"name":"Lung Cancer Management","volume":"9 4","pages":"LMT39"},"PeriodicalIF":2.8,"publicationDate":"2020-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/lmt-2020-0016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38709409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choosing the best first-line therapy: NSCLC with no actionable oncogenic driver.","authors":"So Yeon Kim,&nbsp;Balazs Halmos","doi":"10.2217/lmt-2020-0003","DOIUrl":"https://doi.org/10.2217/lmt-2020-0003","url":null,"abstract":"<p><p>Combination platinum-based therapy has been the standard of care for the treatment of advanced non-small-cell lung cancer (NSCLC). Immunotherapy has emerged and demonstrated to show benefit in the treatment of patients with advanced NSCLC. In this review, we discuss the pivotal trials that led to the US FDA approval of specific immunotherapy regimens in particular patient populations. We discuss the optimal use of immunotherapy as monotherapy based on the KEYNOTE-024, KEYNOTE-042 and IMpower110 trials, chemo-immunotherapy based on KEYNOTE-189, KEYNOTE-407, IMpower150 and IMpower130 trials, and as doublet immunotherapy based on CheckMate-227. We also discuss the role and limitations of PD-L1 expression and tumor mutational burden as predictive biomarkers in response to single-agent immunotherapy and combination chemoimmunotherapy. Furthermore, we discuss emerging resistance markers such as <i>STK11</i> and <i>KEAP1</i> mutations in immunotherapy response and briefly discuss the role of immunotherapy in elderly patients and in patients with actionable mutations.</p>","PeriodicalId":43551,"journal":{"name":"Lung Cancer Management","volume":"9 3","pages":"LMT36"},"PeriodicalIF":2.8,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/lmt-2020-0003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38245942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed tomography texture analysis of response to second-line nivolumab in metastatic non-small cell lung cancer.","authors":"Rahul Ladwa,&nbsp;Kate E Roberts,&nbsp;Connor O'Leary,&nbsp;Nicole Maggacis,&nbsp;Kenneth J O'Byrne,&nbsp;Kenneth Miles","doi":"10.2217/lmt-2020-0002","DOIUrl":"https://doi.org/10.2217/lmt-2020-0002","url":null,"abstract":"<p><strong>Objectives: </strong>Assess computed tomography texture analysis of patients likely to benefit from nivolumab.</p><p><strong>Materials & methods: </strong>Texture analysis was used to quantify heterogeneity within the largest tumor before immunotherapy. Histogram analysis was classified as hyperdense (positive skewness) or hypodense (negative skewness) and subclassified on median standard deviation value or entropy measurement.</p><p><strong>Results: </strong>47 patients were included. At a median follow-up of 18 months, statistical significant differences in progression-free survival were observed when stratified by positive skewness with low entropy, hazard ratio: 0.43 (0.19-0.95); p = 0.036, and positive skewness with low standard deviation, hazard ratio: 0.42 (0.18-0.96); p = 0.04.</p><p><strong>Conclusion: </strong>Patients who derive a clinical benefit to Nivolumab show a computed tomography texture of a hyperdense yet homogenous tumor.</p>","PeriodicalId":43551,"journal":{"name":"Lung Cancer Management","volume":"9 3","pages":"LMT38"},"PeriodicalIF":2.8,"publicationDate":"2020-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/lmt-2020-0002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38246384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic significance of the neutrophil/lymphocyte ratio in patients undergoing treatment with nivolumab for recurrent non-small-cell lung cancer.","authors":"Bernardo L Rapoport,&nbsp;Annette J Theron,&nbsp;Daniel A Vorobiof,&nbsp;Lizanne Langenhoven,&nbsp;Jacqueline M Hall,&nbsp;Ronwyn I Van Eeden,&nbsp;Teresa Smit,&nbsp;Sze-Wai Chan,&nbsp;Michael C Botha,&nbsp;Johann I Raats,&nbsp;Margriet De Necker,&nbsp;Ronald Anderson","doi":"10.2217/lmt-2020-0014","DOIUrl":"https://doi.org/10.2217/lmt-2020-0014","url":null,"abstract":"<p><strong>Aim: </strong>We investigated the prognostic potential of pretherapy measurement of the neutrophil/lymphocyte ratio (NLR) in patients (n = 56) with non-small-cell lung cancer deemed suitable for treatment with nivolumab.</p><p><strong>Materials & methods: </strong>This was a multicenter, noninterventional, retrospective data analysis, involving five oncology centers.</p><p><strong>Results: </strong>Patients with prenivolumab NLR values of <5 and ≥5 had respective median overall survival (OS) values of 14.5 and 7.02 months (p = 0.0026). Patients with ≤2 and >2 metastatic sites had median OS values of 11.4 and 6.1 months, respectively (p = 0.0174). A Cox multiple regression model revealed baseline NLR ≥5 as the only variable significantly associated with decreased OS (p < 0.0447).</p><p><strong>Conclusion: </strong>Pretreatment elevated NLR values are associated with poor outcomes in patients with recurrent metastatic non-small-cell lung cancer treated with nivolumab.</p>","PeriodicalId":43551,"journal":{"name":"Lung Cancer Management","volume":"9 3","pages":"LMT37"},"PeriodicalIF":2.8,"publicationDate":"2020-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/lmt-2020-0014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38245943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung cancer screening guidelines are clear but are they being followed?","authors":"Coral Olazagasti,&nbsp;Carolina Bernabe,&nbsp;Nagashree Seetharamu","doi":"10.2217/lmt-2020-0015","DOIUrl":"https://doi.org/10.2217/lmt-2020-0015","url":null,"abstract":"Lung cancer is the second most common cause of cancer worldwide and the leading cause of cancer death in the USA [1]. The American Cancer Society (NY, USA) estimated a total of 228,150 new cases of lung cancer with 142,670 deaths from lung cancer in the USA for 2019 [1]. Smoking is the main cause of lung cancer and contributes to 80% of lung cancer deaths in women and 90% in men [2]. Lung cancer is typically diagnosed at advanced stages and carries a high mortality rate, with a 5-year survival rate of only 18% [3]. Randomized controlled trials targeted toward lung cancer screening started in the 1970s when the US National Cancer Institute (NCI; MD, USA) sponsored several clinical trials to evaluate the benefit of adding sputum cytology to annual chest radiography (CXR) [4,5]. However, none of the trials showed a reduction in lung cancer mortality (Supplementary Table 1). Decades later, the NCI initiated the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO), a large randomized controlled trial that aimed to reduce disease-specific cancer mortality by evaluating the use of CXR for screening [6]. The study found that 2% of participants that had a positive radiographic findings were diagnosed with lung cancer within 12 months of the screen, 44% of whom were diagnosed with stage I disease [6]. Pertinent findings that paved the road for future guidelines included the discovery that high incidences of lung cancer were noted in active smokers or those that had quit within 15 years of randomization [6]. In the 2000s, prospective studies were created throughout the world to evaluate the role of low-dose computed tomography (LDCT) for screening. The Lung Screening Study compared LDCT and CXR as screening modalities and revealed that LDCT was twice as effective as CXR in detecting lung cancer [7]. It also showed that 48% of lung cancers detected by LDCT screening were diagnosed at stage I [7]. Inspired by the Lung Screening Study, a large scale study called the National Lung Screening Trial (NLST), which enrolled 53,456 participants, was created. Participants were randomized to LDCT or CXR at a 1:1 ratio. The study demonstrated a 20% relative reduction in mortality in patients screened with LDCT compared with CXR [8]. Results from this trial were updated in 2013 and confirmed the benefit of LDCT for lung cancer screening in specific patient populations [9]. Similar results were showcased from The Dutch–Belgian Randomized Lung Cancer Screening Trial (NELSON) which began in Europe in 2003 [10]. More than 15,000 participants were enrolled and assigned to either computer tomography (CT) screening or to the control group with no screening [10]. The study reported a 41% positive predictive value with screening and 50% of the cancers diagnosed in the screening arm were found at early stages of the disease [10]. During a 10-year follow-up, there was a 26% mortality rate reduction in men and 39% in women [10]. Updated results published in the New E","PeriodicalId":43551,"journal":{"name":"Lung Cancer Management","volume":"9 4","pages":"LMT35"},"PeriodicalIF":2.8,"publicationDate":"2020-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1b/3b/lmt-09-35.PMC7724650.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38709408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding sex disparities in lung cancer incidence: are women more at risk?","authors":"Meera V Ragavan,&nbsp;Manali I Patel","doi":"10.2217/lmt-2020-0013","DOIUrl":"https://doi.org/10.2217/lmt-2020-0013","url":null,"abstract":"Meera V Ragavan*,1 & Manali I Patel2,3,4 1Department of Medicine, Stanford University School of Medicine, Stanford, 94305 CA 94305, USA 2Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA 3Division of Oncology, VA Palo Alto Healthcare System, Palo Alto, CA 94304, USA 4Center for Health Policy/Primary Care Outcomes Research, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA *Author for correspondence: mragavan@stanford.edu","PeriodicalId":43551,"journal":{"name":"Lung Cancer Management","volume":"9 3","pages":"LMT34"},"PeriodicalIF":2.8,"publicationDate":"2020-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/lmt-2020-0013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38245941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}