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Sugumar V, Sr RRS, Ye XY, Zhan L, Sun A, Bezjak A, Cho J, Raman S, Hope AJ, Giuliani ME, Leighl N, Sacher AG, Shepherd F, Bradbury P, Liu G, Lok BH. Survival Outcomes of Extensive Stage Small Cell Lung Cancer Patients Treated with Consolidative Thoracic Radiotherapy at a Tertiary Cancer Center. Int J Radiat Oncol Biol Phys 2023; 117:e60. [PMID: 37785810 DOI: 10.1016/j.ijrobp.2023.06.779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Most small cell lung cancer cases present as Stage IV (M1) or extensive stage (ES-SCLC), which are defined as tumor extending outside the hemithorax without a tolerable radiation portal. The CREST trial demonstrated improved local control with a modest overall survival (OS) benefit at the 2-year secondary endpoint of 14% survival with consolidative thoracic radiotherapy (CTRT) compared to 3% without CTRT. Low toxicity rates were also observed. This study reports our institutional ES-SCLC experience for patients treated with CTRT. MATERIALS/METHODS A retrospective review was conducted on ES-SCLC patients treated with CTRT at our institution between 2014 and 2019. CTRT was defined as ≥30 Gy of thoracic radiotherapy. OS and tolerability of treatment were assessed in this population. Chemotherapy details were also captured. OS rate was determined using the Kaplan-Meier method and the time from start of CTRT to last date of follow-up or death. CTRT tolerability was determined using incidence and grade of esophagitis and radiation pneumonitis as per CTCAE v5. RESULTS We identified 100 ES-SCLC patients treated with any thoracic RT at our institute, of which 45 received thoracic RT for palliative intent or with <30 Gy. The remaining 55 patients received ≥30 Gy CTRT and were included for analysis. The median age was 65.1 years (range 46.6-86.9) and 36 (65%) were male. The median follow-up for this sample was 0.8 (range 0.03-4.2) years. Median chemotherapy cycles were 6 (range 1-6), most receiving ≥4 cycles (87%) and completing chemotherapy prior to CTRT initiation (91%) with a minority concurrently receiving chemotherapy and CTRT (9%). Platinum chemotherapy was the most common (96%) with 2 patients receiving etoposide alone (4%). The most common CTRT regimens were 30 Gy in 10 fractions (80%) followed by 40 Gy in 15 fractions (9%) and 45 Gy in 30 twice-daily fractions (7%). Most patients (67%) were treated with IMRT/VMAT technique, while the remaining (33%) patients were treated with 3DCRT. The median survival time was 1.3 years with 1- and 2-year OS of 57.2% (CI 44.0 - 74.3%) and 26.1% (CI 12.9 - 52.7%), respectively. CTRT was well tolerated with no grade 4+ toxicities. The most common toxicity was esophagitis with 21 patients (39%), of which 15 were G1 (28%) and 6 were G2 (11%). Radiation pneumonitis was present in 5 patients (9.2%) with 1 G1 (2%), 3 G2 (6%), and 1 G3 (2%) cases. CONCLUSION Consolidative TRT for ES-SCLC in this institutional series was at least as good as the reported CREST outcome with modest acute toxicities in this cohort. Disease burden at diagnosis, chemotherapy response, patterns of failure, and subsequent therapies will be further investigated.
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Hoxha T, Pienkowski M, Khan K, Moore A, Balaratnam K, Chowdhury M, Walia P, Sabouhanian A, Herman J, Strom E, Hueniken K, Corke L, Leighl N, Shepherd F, Bradbury P, Sacher A, Cheng S, Brown M, Mai V, Garcia M, Zhan L, Xu W, Liu G. EP02.04-009 Real World Survival Outcome Analysis of Adjuvant Therapies in Non-EGFR, Non-ALK Early Stage Resected NSCLC. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Sacher A, Lau S, Allen M, Corke L, Makarem M, Chen E, Jang RJ, Elimova E, Grant R, Shepherd F, Bradbury P, Eng L, Rogalla P, Liu G, Tsao MS, Leighl N, Garonce-Hediger R, Wang B, Ohashi P, Knox J. 1202TiP Evolution of the tumor immune microenvironment in hepatocellular carcinoma (HCC) and non-squamous non-small cell lung cancer (NSCLC) with liver metastases treated with atezolizumab and bevacizumab (INTEGRATE). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Lau S, Makarem M, Cabanero M, Tsao MS, Bradbury P, Shepherd F, Liu G, Leighl N, Sacher A. 1058P Non-smokers with squamous lung cancers have a high incidence of HHV infections, DDR gene alterations and good prognosis. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Corke L, García Pardo de Santayana M, Meteleva K, Shepherd F, Bradbury P, Eng L, Kuang S, Cabanero M, Rogalla P, Liu G, Tsao MS, Pugh T, Wang B, Ohashi P, Leighl N, Sacher A. 1191TiP Nivolumab-ipilimumab with cfDNA-guided treatment intensification as a chemotherapy-sparing strategy in metastatic non-small cell lung cancer (ATLAS). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Lee J, Mai V, Garcia M, Cheng S, Khan K, Balaratnam K, Thakral A, Brown M, Zhan L, Corke L, Leighl N, Shepherd F, Bradbury P, Sacher A, Liu G. EP08.02-082 Treatment Patterns and Outcomes of First-line Osimertinib-treated Advanced EGFR Mutated NSCLC Patients: A Real-world Study. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hoang T, Elliot M, Poletes C, Makarem M, Corke L, Weiss J, Tsao MS, Bradbury P, Shepherd F, Liu G, Leighl N, Sacher A, Lau S. EP08.01-067 Rechallenging with PD-1 Inhibitors: Incidence and Management of Immune-Related Adverse Events in Metastatic NSCLC. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Schmid S, Zhan L, Garcia M, Cheng S, Khan K, Chowdhury M, Sabouhanian A, Herman J, Walia P, Strom E, Brown M, Patel D, Xu W, Shepherd F, Sacher A, Leighl N, Bradbury P, Shultz D, Liu G. 1144P Clinical outcomes of NSCLC patients (pts) who had brain-only metastasis at time of stage IV diagnosis, by presence versus absence of EGFR/ALK mutations. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Herman J, Schmid S, Zhan L, Garcia M, Brown M, Khan K, Chowdhury M, Sabouhanian A, Walia P, Strom E, Sacher A, Bradbury P, Shepherd F, Leighl N, Cheng S, Patel D, Shultz D, Liu G. FP12.07 Clinico-demographic Factors, EGFR status and their association with Stage at Diagnosis in Lung Adenocarcinoma Patients. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gauthier M, Law J, Le L, Li J, Zahir S, Sung M, Pettengell C, Darwish L, Aviv S, Chu R, Sacher A, Liu G, Bradbury P, Shepherd F, Leighl N. OA08.04 Validation of Scalable, Automated Data Extraction in an Advanced Lung Cancer Patient Population. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Schmid S, Chotai S, Cheng S, Zhan L, Balaratnam K, Khan K, Patel D, Brown M, Xu W, Moriarty P, Kaidanovich-Beilin O, Shepherd F, Sacher A, Leighl N, Bradbury P, Liu G. MA08.02 Outcomes of Early Stage ALK-positive NSCLC patients in a Real-World Cohort. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Chotai S, Schmid S, Cheng S, Zhan L, Balaratnam K, Khan K, Patel D, Brown M, Xu W, Moriarty P, Kaidanovich-Beilin O, Shepherd F, Sacher A, Leighl N, Bradbury P, Liu G. P45.09 Real-World Sequencing of ALK-TKIs in Advanced Stage ALK-positive NSCLC patients in Canada. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Garcia M, Schmid S, Hueniken K, Zhan L, Balaratnam K, Khan K, Fares A, Chan S, Smith E, Aggarwal R, Brown M, Patel D, Sacher A, Bradbury P, Shepherd F, Leighl N, Liu G. P48.05 Is Relapse-Free Survival at 2-Years an Appropriate Surrogate for Overall Survival at 5-Years in EGFR-mutated Resected NSCLC? J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lau S, Rabindranath M, Weiss J, Li J, Nirmalakumar S, Ruff H, Boerner S, Tong L, Tsao M, Pal P, Cabanero M, Hsu Y, Fung A, Sacher A, Shepherd F, Liu G, Bradbury P, Yasufuku K, Czarnecka-Kujawa K, Ko H, Leighl N, Schwock J. FP12.01 PD-L1 Assessment in Cytology is Comparable to Histology in Predicting Treatment Response to Checkpoint Inhibitors in NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lau S, Perdrizet K, Giffoni M.M. Mata D, Fung A, Liu G, Bradbury P, Shepherd F, Sacher A, Sheffield B, Hwang D, Tsao M, Cheng S, Cheema P, Leighl N. P45.05 Sequencing of PD-1 Inhibitors and TKIs in Metastatic NSCLC with MET Exon 14 Skipping Mutation May Influence Survival. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lau S, Elliott M, Rabinovitch A, Makarem M, Kuang S, Schmid S, Sharma K, Lee J, Mackay K, Wong S, Wang B, Ohashi P, Tsao M, Shepherd F, Bradbury P, Liu G, Leighl N, McGaha T, Sacher A. 1298P PD-1 inhibitors combined with chemotherapy may preferentially improve survival in metastatic NSCLC with myeloid-mediated primary resistance to immunotherapy. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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O'Kane G, Leon A, Shabir M, Law J, Bradbury P, Liu G, Sacher A, Shepherd F, Torti D, Stockley T, Tsao M, Pugh T, Leighl N. P35.03 Methylation Signatures Associated with T790M Status in Progressive NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Lau S, Soleimani S, Wong S, Wang B, Pedersen S, Patel D, Bradbury P, Liu G, Leighl N, Tsao M, Siu L, Bratman S, Ohashi P, Pugh T, Shepherd F, Sacher A. P14.24 Evolution of TCR Clonality during Chemoradiation and Durvalumab as Predictors of Survival in Stage 3 NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chowdhury M, Hueniken K, Schmid S, Brown C, Khan K, Walia P, Sabouhanian A, Strom E, Herman J, Xu W, Leighl N, Bradbury P, Sacher A, Shepherd F, Liu G, Shultz D. P76.84 EGFR Status, Risk Factors for Brain Metastases and Overall Survival in Advanced Non-Small Cell Lung Cancer (NSCLC) Patients. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Schmid S, Schouwenburg S, Stewart E, Fares A, Bradbury P, Shepherd F, Leighl N, Sacher A, Patel D, Li X, Xu W, Liu G. 1217P Breathomics eNose technology as a non-invasive, inexpensive, point-of-care predictive test to detect early stage lung cancer in never or former light smokers. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Martins-Filho S, Fares A, Raghavan V, Stewart E, Ravi D, Perdrizet K, Weiss J, Hueniken K, Patel D, Pham N, Sacher A, Bradbury P, Leighl N, Shepherd F, Tsao M, Liu G. P2.03-11 Impact of Ethnicity on Outcome in Never Smokers with EGFR and ALK Wildtype (EGFR/ALK-Wildtype) Lung Adenocarcinomas. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Stewart E, Martins-Filho S, Cabanero M, Wang A, Huang J, Bao H, Wu X, Patel D, Chen Z, Law J, Bradbury P, Shepherd F, Leighl N, Tsao M, Pugh T, Bratman S, Liu G, Sacher A. P2.14-62 Early, Subclinical SCLC Transformation in Patients with EGFR Mutant Lung Cancer Receiving Osimertinib, Detected Through Cell-Free DNA. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Juergens R, Ellis P, Tu D, Hao D, Laurie S, Mates M, Goss G, Goffin J, Bradbury P, Tehfe M, Kollmansberger C, Brown-Walker P, Smoragiewicz M, Tsao M, Seymour L. MA11.04 Platinum Doublet + Durvalumab +/- Tremelimumab in Patients with Advanced NSCLC: A CCTG Phase IB Study - IND.226. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Eng L, Su J, Hueniken K, Brown M, Hope A, Bezjak A, Sacher A, Bradbury P, Shepherd F, Leighl N, Pierre A, Selby P, Goldstein D, Xu W, Giuliani M, Evans W, Liu G, Chaiton M. P1.10-05 Tobacco Retail Availability and Tobacco Cessation Among Lung Cancer Survivors. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lau S, Le L, Chan S, Smith E, Ryan M, Brown M, Hueniken K, Eng L, Patel D, Chen R, Sung M, Zer A, Bradbury P, Ohashi P, Shepherd F, Tsao M, Leighl N, Liu G, Sacher A. P1.01-70 Dominant Circulating Myeloid Populations Are Associated with Poor Response in NSCLC Treated with 1st Line PD-1 Monotherapy. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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