1
|
Hua X, Feng W, Ye M, Lai M, Yu X, Sun M, Li J, Ai R, He Y, Cai L, Shi C, Liu X. Development and validation of a nomogram to predict leptomeningeal metastases in lung adenocarcinoma: Cervical lymph node metastasis is an important association factor. Cancer Med 2024; 13:e7206. [PMID: 38686619 PMCID: PMC11058696 DOI: 10.1002/cam4.7206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND The goal of this study was to create a nomogram using routine parameters to predict leptomeningeal metastases (LMs) in advanced lung adenocarcinoma (LAC) patients to prevent needless exams or lumbar punctures and to assist in accurately diagnosing LMs. METHODS Two hundred and seventy-three patients with LMs and brain metastases were retrospectively reviewed and divided into derivation (n = 191) and validation (n = 82) cohorts using a 3:7 random allocation. All LAC patients with LMs had positive cerebrospinal fluid cytology results and brain metastases confirmed by magnetic resonance imaging. Binary logistic regression with backward stepwise selection was used to identify significant characteristics. A predictive nomogram based on the logistic model was assessed through receiver operating characteristic curves. The validation cohort and Hosmer-Lemeshow test were used for internal validation of the nomogram. RESULTS Five clinicopathological parameters, namely, gene mutations, surgery at the primary lung cancer site, clinical symptoms of the head, N stage, and therapeutic strategy, were used as predictors of LMs. The area under the curve was 0.946 (95% CI 0.912-0.979) for the training cohort and 0.861 (95% CI 0.761-0.961) for the internal validation cohort. There was no significant difference in performance between the two cohorts (p = 0.116). In the internal validation, calibration plots revealed that the nomogram predictions were well suited to the actual outcomes. CONCLUSIONS We created a user-friendly nomogram to predict LMs in advanced lung cancer patients, which could help guide treatment decisions and reduce unnecessary lumbar punctures.
Collapse
Affiliation(s)
- Xiaoyu Hua
- Department of Medical Imaging CentreThe First Affiliated Hospital, Jinan UniversityGuangzhouChina
| | - Weifeng Feng
- The First Affiliated Hospital, Jinan UniversityGuangzhouChina
| | - Minting Ye
- Department of Medical OncologyGuangdong Sanjiu Brain HospitalGuangzhouChina
| | - Mingyao Lai
- Department of Medical OncologyGuangdong Sanjiu Brain HospitalGuangzhouChina
| | - Xiaojun Yu
- Department of Medical Imaging CentreThe First Affiliated Hospital, Jinan UniversityGuangzhouChina
| | - Mengnan Sun
- Department of Medical Imaging CentreThe First Affiliated Hospital, Jinan UniversityGuangzhouChina
| | - Juan Li
- Department of Medical OncologyGuangdong Sanjiu Brain HospitalGuangzhouChina
| | - Ruyu Ai
- Department of Medical OncologyGuangdong Sanjiu Brain HospitalGuangzhouChina
| | - Yanlin He
- Department of Medical Imaging CentreInner Mongolia People's HospitalHohhotChina
| | - Linbo Cai
- Department of Medical OncologyGuangdong Sanjiu Brain HospitalGuangzhouChina
| | - Changzheng Shi
- Department of Medical Imaging CentreThe First Affiliated Hospital, Jinan UniversityGuangzhouChina
| | - Xiangning Liu
- Clinical Research Platform for Interdiscipline of StomatologyThe First Affiliated Hospital of Jinan UniversityGuangzhouChina
- Department of StomatologyCollege of Stomatology, Jinan UniversityGuangzhouChina
| |
Collapse
|
2
|
Metro G, Gariazzo E, Costabile S, Baglivo S, Roila F, Colamartini F, Palumbo B, Chiarini P, Gori S, Conti A, Marcomigni L, Bellezza G, Lunardi G. Repotrectinib's Clinical Benefit and Its Brain Penetration in a Patient with Meningeal Carcinomatosis from G2032R-Mutated ROS-1 Positive Non-Small Cell Lung Cancer. Oncol Ther 2024; 12:163-171. [PMID: 37973688 PMCID: PMC10881448 DOI: 10.1007/s40487-023-00251-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023] Open
Abstract
In this work, we report on a clinically significant response of meningeal carcinomatosis to repotrectinib in a woman with a heavily pretreated ROS1-rearranged non-small cell lung cancer (NSCLC) that harbored the concomitant solvent front G2032R mutation. Meningeal carcinomatosis has a higher incidence in oncogene addicted NSCLC due to increased life expectancy, yet no report has ever documented the activity of repotrectinib in this context. In line with its activity, we documented the presence of the drug at potentially active concentrations in the cerebrospinal fluid. Nevertheless, the short-lived response reported by our patient highlights the importance for novel ROS1-tyrosine kinase inhibitors (TKIs) to be specifically developed to be able to penetrate the blood-brain barrier.
Collapse
Affiliation(s)
- Giulio Metro
- Medical Oncology, Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia, Via Dottori, 1, 06156, Perugia, Italy
| | - Eleonora Gariazzo
- Medical Oncology, Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia, Via Dottori, 1, 06156, Perugia, Italy.
| | - Silvia Costabile
- Medical Oncology, Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia, Via Dottori, 1, 06156, Perugia, Italy
| | - Sara Baglivo
- Medical Oncology, Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia, Via Dottori, 1, 06156, Perugia, Italy
| | - Fausto Roila
- Medical Oncology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Francesca Colamartini
- Medical Oncology, Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia, Via Dottori, 1, 06156, Perugia, Italy
| | - Barbara Palumbo
- Department of Medicine and Surgery, Section of Nuclear Medicine and Health Physics, University of Perugia, Perugia, Italy
| | - Pietro Chiarini
- Neuroradiology, Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia, Perugia, Italy
| | - Stefania Gori
- Medical Oncology, IRCCS-Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Antonio Conti
- Clinical Analysis Laboratory and Transfusional Medicine, Clinical Pharmacology, IRCCS-Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Luca Marcomigni
- Medical Oncology, Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia, Via Dottori, 1, 06156, Perugia, Italy
| | - Guido Bellezza
- Section of Anatomic Pathology and Histology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Gianluigi Lunardi
- Clinical Analysis Laboratory and Transfusional Medicine, Clinical Pharmacology, IRCCS-Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| |
Collapse
|
3
|
Cha HK, Ryu WK, Lee HY, Kim HJ, Ryu JS, Lim JH. Spine Metastasis Is Associated with the Development of Brain Metastasis in Non-Small-Cell Lung Cancer Patients. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:152. [PMID: 38256412 PMCID: PMC10820916 DOI: 10.3390/medicina60010152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/03/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024]
Abstract
Background and Objectives: The mechanisms involved in the development of brain metastasis (BM) remain elusive. Here, we investigated whether BM is associated with spine involvement in patients with non-small-cell lung cancer (NSCLC). Materials and Methods: A consecutive 902 patients with metastatic NSCLC were included from the Inha Lung Cancer Cohort. Patients with BM at diagnosis or subsequent BM development were evaluated for both spine involvement in NSCLC and anatomic proximity of BM to the cerebrospinal fluid (CSF) space. Results: At diagnosis, BM was found in 238 patients (26.4%) and bone metastasis was found in 393 patients (43.6%). In patients with bone metastasis, spine involvement was present in 280 patients. BM subsequently developed in 82 (28.9%) of 284 patients without BM at diagnosis. The presence of spine metastasis was associated with BM at diagnosis and subsequent BM development (adjusted odd ratios and 95% confidence intervals = 2.42 and 1.74-3.37, p < 0.001; 1.94 and 1.19-3.18, p = 0.008, respectively). Most patients with spine metastasis, either with BM at diagnosis or subsequent BM, showed BM lesions located adjacent (within 5mm) to the CSF space (93.8% of BM at the diagnosis, 100% of subsequent BM). Conclusions: These findings suggest that the presence of spine involvement is a risk factor for BM development in NSCLC patients with bone metastasis.
Collapse
Affiliation(s)
- Hyung-Keun Cha
- Department of Pulmonology, Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon 22332, Republic of Korea; (H.-K.C.); (W.-K.R.); (H.-J.K.)
| | - Woo-Kyung Ryu
- Department of Pulmonology, Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon 22332, Republic of Korea; (H.-K.C.); (W.-K.R.); (H.-J.K.)
| | - Ha-Young Lee
- Department of Radiology, Inha University Hospital, Inha University College of Medicine, Incheon 22332, Republic of Korea;
| | - Hyun-Jung Kim
- Department of Pulmonology, Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon 22332, Republic of Korea; (H.-K.C.); (W.-K.R.); (H.-J.K.)
| | - Jeong-Seon Ryu
- Department of Pulmonology, Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon 22332, Republic of Korea; (H.-K.C.); (W.-K.R.); (H.-J.K.)
| | - Jun-Hyeok Lim
- Department of Pulmonology, Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon 22332, Republic of Korea; (H.-K.C.); (W.-K.R.); (H.-J.K.)
| |
Collapse
|
4
|
Liu X, Mei F, Fang M, Jia Y, Zhou Y, Li C, Tian P, Lu C, Li G. Cerebrospinal fluid ctDNA testing shows an advantage over plasma ctDNA testing in advanced non-small cell lung cancer patients with brain metastases. Front Oncol 2024; 13:1322635. [PMID: 38269023 PMCID: PMC10806520 DOI: 10.3389/fonc.2023.1322635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/13/2023] [Indexed: 01/26/2024] Open
Abstract
Background Brain metastases (BM), including brain parenchyma metastases (BPM) and leptomeningeal metastases (LM), are devastating metastatic complications in advanced cancer patients. Next-generation sequencing (NGS) is emerging as a new promising tool for profiling cancer mutation, which could facilitate the diagnosis of cancer. This retrospective study aimed to investigate the molecular genetic characteristics of non-small cell lung cancer (NSCLC) patients with BPM and LM using NGS. Methods Cerebrospinal fluid (CSF) samples and paired plasma samples were collected from 37 patients of NSCLC-BM. We profiled genetic mutation characteristics using NGS from NSCLC-BM by comparing CSF circulating tumour DNA (ctDNA) with plasma ctDNA and primary tumour tissues. Results Among the 37 patients with NSCLC-BM, 28 patients had LM with or without BPM, while 9 patients only had BPM. Driver and drug-resistant mutations in primary tumours with LM included: EGFR L858R (10, 35.7%), EGFR 19del (6, 21.4%), EGFR L858R+MET (1, 3.6%), EGFR L858R+S768I (1, 3.6%), ALK (2, 7.1%), ROS1 (1, 3.6%), negative (5, 17.9%), and unknown (2, 7.1%). In patients with NSCLC-LM, the detection rate and abundance of ctDNA in the CSF were significantly higher than those in paired plasma. The main driver mutations of NSCLC-LM remained highly consistent with those of the primary tumours, along with other unique mutations. Circulating tumour DNA was negative in the CSF samples of BPM patients. Patients with BMP had a higher ratio of EGFR 19del than L858R mutation (55.6% vs 11.1.%), whereas NSCLC patients with LM had a higher ratio of EGFR L858R than 19del mutation (50.0% vs 25.0%). Most patients with positive plasma ctDNA results were male (p = 0.058) and in an unstable state (p = 0.003). Conclusion Our study indicated that the CSF ctDNA detected by NGS may reflect the molecular characteristics and heterogeneity of NSCLC-LM. Timely screening of patients with NSCLC for CSF ctDNA, especially for patients with positive plasma ctDNA, may facilitate the early detection of LM. Furthermore, patients with the EGFR 19del may have a higher risk of developing BPM.
Collapse
Affiliation(s)
- Xiaocui Liu
- Department of Neurology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Neurology, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, China
| | - Fengjun Mei
- Department of Neurology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Mei Fang
- Department of Reproductive Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yaqiong Jia
- Department of Neurology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yazhu Zhou
- Department of Neurology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Chenxi Li
- Department of Neurology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Panpan Tian
- Department of Neurology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Chufan Lu
- Department of Neurology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Guangrui Li
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Infectious Diseases, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| |
Collapse
|
5
|
Yang Z, Chen H, Jin T, Sun L, Li L, Zhang S, Wu B, Jin K, Zou Y, Sun C, Xia L. The Impact of Time Interval on Prognosis in Patients with Non-Small Cell Lung Cancer Brain Metastases After Metastases Surgery. World Neurosurg 2023; 180:e171-e182. [PMID: 37704036 DOI: 10.1016/j.wneu.2023.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Non-small cell lung cancer (NSCLC) is a prominent malignancy often linked to the development of brain metastases (BM), which commonly appear at diverse time intervals (TI) following the lung cancer diagnosis. This study endeavors to determine the prognostic significance of the time interval in patients with NSCLC who undergo BM surgery. Through this investigation, we aim to improve our understanding of the factors impacting the prognosis of BM cases originating from NSCLC. METHODS We analyzed data from 74 patients (2011-2021) who underwent BM surgery at our institution. The relationship between various clinical, radiological, and histopathological factors, as well as TI and overall survival (OS), was examined. RESULTS The median TI from initial NSCLC diagnosis to BM surgery was 19 months (range: 9-36 months). Notably, a shorter TI of less than 23 months was found to be independently associated with postoperative survival (adjusted odds ratio [aOR] 2.87, 95% confidence interval [CI] 1.03-8.02, P = 0.045). Additionally, a shorter TI was independently correlated with the absence of adjuvant chemotherapy for NSCLC (aOR 0.25, 95% CI 0.07-0.83, P = 0.023) and lack of targeted therapy (aOR 0.02, 95% CI 0.00-0.16, P < 0.001). Late-onset BM (TI ≥ 36 months) was observed in 15 cases (20.3%), in this subgroup, patients aged 60 years or older at the time of lung cancer diagnosis exhibited a significant independent correlation with late-onset BM (aOR 7.24, 95% CI 1.59-32.95, P = 0.011). NSCLC patients who underwent adjuvant chemotherapy displayed a notable correlation with late-onset BM (aOR 6.46, 95% CI 1.52-27.43, P = 0.011), while those who received targeted therapy also exhibited an independent association (aOR 2.27, 95% CI 1.70-3.03, P < 0.001). CONCLUSIONS Multiple factors contribute to the variability in the onset interval of BM subsequent to NSCLC diagnosis. The occurrence of BM within TI < 23 months following the initial diagnosis of NSCLC was demonstrated as an independent factor associated with an unfavorable prognosis following BM surgery. Furthermore, patients with NSCLC who did not receive adjuvant chemotherapy and lacked targeted therapy were shown to have an elevated likelihood of developing BM after a long progression-free survival.
Collapse
Affiliation(s)
- Zhi Yang
- Department of Neurosurgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China; Postgraduate Training Base Alliance of Wenzhou Medical University, WenZhou, Zhejiang Province, China
| | - Haibin Chen
- Department of Neurosurgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China; Postgraduate Training Base Alliance of Wenzhou Medical University, WenZhou, Zhejiang Province, China
| | - Tao Jin
- Department of Neurosurgery, The Second Affiliated Hospital of Mudanjiang Medical University, Mudanjiang, Helongjiang Province, China
| | - Liang Sun
- Department of Neurosurgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China; Postgraduate Training Base Alliance of Wenzhou Medical University, WenZhou, Zhejiang Province, China
| | - Liwen Li
- Department of Neurosurgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China
| | - Shuyuan Zhang
- Department of Neurosurgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China
| | - Bin Wu
- Department of Neurosurgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China
| | - Kai Jin
- Department of Neurosurgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China
| | - Yangfan Zou
- Department of Neurosurgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China
| | - Caixing Sun
- Department of Neurosurgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China; Postgraduate Training Base Alliance of Wenzhou Medical University, WenZhou, Zhejiang Province, China
| | - Liang Xia
- Department of Neurosurgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China; Postgraduate Training Base Alliance of Wenzhou Medical University, WenZhou, Zhejiang Province, China.
| |
Collapse
|
6
|
Nguyen A, Nguyen A, Dada OT, Desai PD, Ricci JC, Godbole NB, Pierre K, Lucke-Wold B. Leptomeningeal Metastasis: A Review of the Pathophysiology, Diagnostic Methodology, and Therapeutic Landscape. Curr Oncol 2023; 30:5906-5931. [PMID: 37366925 DOI: 10.3390/curroncol30060442] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 06/14/2023] [Accepted: 06/16/2023] [Indexed: 06/28/2023] Open
Abstract
The present review aimed to establish an understanding of the pathophysiology of leptomeningeal disease as it relates to late-stage development among different cancer types. For our purposes, the focused metastatic malignancies include breast cancer, lung cancer, melanoma, primary central nervous system tumors, and hematologic cancers (lymphoma, leukemia, and multiple myeloma). Of note, our discussion was limited to cancer-specific leptomeningeal metastases secondary to the aforementioned primary cancers. LMD mechanisms secondary to non-cancerous pathologies, such as infection or inflammation of the leptomeningeal layer, were excluded from our scope of review. Furthermore, we intended to characterize general leptomeningeal disease, including the specific anatomical infiltration process/area, CSF dissemination, manifesting clinical symptoms in patients afflicted with the disease, detection mechanisms, imaging modalities, and treatment therapies (both preclinical and clinical). Of these parameters, leptomeningeal disease across different primary cancers shares several features. Pathophysiology regarding the development of CNS involvement within the mentioned cancer subtypes is similar in nature and progression of disease. Consequently, detection of leptomeningeal disease, regardless of cancer type, employs several of the same techniques. Cerebrospinal fluid analysis in combination with varied imaging (CT, MRI, and PET-CT) has been noted in the current literature as the gold standard in the diagnosis of leptomeningeal metastasis. Treatment options for the disease are both varied and currently in development, given the rarity of these cases. Our review details the differences in leptomeningeal disease as they pertain through the lens of several different cancer subtypes in an effort to highlight the current state of targeted therapy, the potential shortcomings in treatment, and the direction of preclinical and clinical treatments in the future. As there is a lack of comprehensive reviews that seek to characterize leptomeningeal metastasis from various solid and hematologic cancers altogether, the authors intended to highlight not only the overlapping mechanisms but also the distinct patterning of disease detection and progression as a means to uniquely treat each metastasis type. The scarcity of LMD cases poses a barrier to more robust evaluations of this pathology. However, as treatments for primary cancers have improved over time, so has the incidence of LMD. The increase in diagnosed cases only represents a small fraction of LMD-afflicted patients. More often than not, LMD is determined upon autopsy. The motivation behind this review stems from the increased capacity to study LMD in spite of scarcity or poor patient prognosis. In vitro analysis of leptomeningeal cancer cells has allowed researchers to approach this disease at the level of cancer subtypes and markers. We ultimately hope to facilitate the clinical translation of LMD research through our discourse.
Collapse
Affiliation(s)
- Andrew Nguyen
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Alexander Nguyen
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | | | - Persis D Desai
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Jacob C Ricci
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Nikhil B Godbole
- School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Kevin Pierre
- Department of Radiology, University of Florida, Gainesville, FL 32610, USA
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, Gainesville, FL 32610, USA
| |
Collapse
|
7
|
Wang JW, Yuan Q, Li L, Cao KH, Liu Q, Wang HL, Hu K, Wu X, Wan JH. Role of Systemic Immunoinflammation Landscape in the Overall Survival of Patients with Leptomeningeal Metastases from Lung Cancer. Onco Targets Ther 2023; 16:179-187. [PMID: 36993872 PMCID: PMC10041983 DOI: 10.2147/ott.s402389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/10/2023] [Indexed: 03/31/2023] Open
Abstract
Purpose Several biomarkers, such as baseline neutrophil-to-lymphocyte ratio (NLR), have been more investigated in patients with brain metastases (BM), while their role in patients with leptomeningeal metastases (LM) has not been clarified. Considering the difference between the clinical behaviour of BM and LM, there is the need for addressing the role of these biomarkers in LM. Methods The present study retrospectively analyzed 95 consecutive patients with LM from lung cancer who were diagnosed at the National Cancer Center, Cancer Hospital of Chinese Academy of Medical Sciences between January 2016 and December 2019. Baseline NLR, platelet-to-lymphocyte ratio (PLR), systemic immunoinflammation index (SII), and lymphocyte-to-monocyte ratio at diagnosis of LM were calculated based on complete blood count and correlated, along with other characteristics, with overall survival (OS) using univariate and multivariate analyses. The best cutoff values for systemic immunoinflammation biomarkers were derived using the surv_cutpoint function in R software, which optimized the significance of the split between Kaplan-Meier survival curves. Results Median OS of patients with LM was 12 months (95% CI 9-17 months). On univariate analysis, NLR, PLR, SII, LMR, sex, smoking history, ECOG performance status (PS) scores, histological subtypes and targeted therapy were all significantly associated with OS. Only NLR (P=0.034, 95% CI 1.060-4.578) and ECOG PS scores (P=0.019, 95% CI 0.137-0.839) maintained a significant association with OS on multivariate analysis. Furthermore, patients with baseline NLR >3.57 had significantly worse OS than patients with NLR ≤3.57 (median OS 7 vs 17 months), as did patients with ECOG PS scores >2 vs ≤2 (median OS 4 vs 15 months). Conclusion Both baseline NLR and PS scores at the time of LM diagnosis are helpful and available prognostic biomarkers for patients with LM from lung cancer.
Collapse
Affiliation(s)
- Jia-Wei Wang
- Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Qing Yuan
- Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Li Li
- Medical Records Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Kai-Hua Cao
- Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Qi Liu
- Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Hong-Liang Wang
- Department of Neurosurgery, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Ke Hu
- Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
- Correspondence: Ke Hu, Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Nanli Panjiayuan, Chaoyang District, Beijing, 100021, People’s Republic of China, Tel/Fax +86-10-87787350, Email
| | - Xi Wu
- General Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
- Xi Wu, General Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Nanli Panjiayuan, Chaoyang District, Beijing, 100021, People’s Republic of China, Tel/Fax +86-10-87788200, Email
| | - Jing-Hai Wan
- Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| |
Collapse
|