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Ospina AV, Bolufer Nadal S, Campo-Cañaveral de la Cruz JL, González Larriba JL, Macía Vidueira I, Massutí Sureda B, Nadal E, Trancho FH, Álvarez Kindelán A, Del Barco Morillo E, Bernabé Caro R, Bosch Barrera J, Calvo de Juan V, Casal Rubio J, de Castro J, Cilleruelo Ramos Á, Cobo Dols M, Dómine Gómez M, Figueroa Almánzar S, Garcia Campelo R, Insa Mollá A, Jarabo Sarceda JR, Jiménez Maestre U, López Castro R, Majem M, Martinez-Marti A, Martínez Téllez E, Sánchez Lorente D, Provencio M. Multidisciplinary approach for locally advanced non-small cell lung cancer (NSCLC): 2023 expert consensus of the Spanish Lung Cancer Group GECP. Clin Transl Oncol 2024:10.1007/s12094-024-03382-y. [PMID: 38530556 DOI: 10.1007/s12094-024-03382-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/03/2024] [Indexed: 03/28/2024]
Abstract
INTRODUCTION Recent advances in the treatment of locally advanced NSCLC have led to changes in the standard of care for this disease. For the selection of the best approach strategy for each patient, it is necessary the homogenization of diagnostic and therapeutic interventions, as well as the promotion of the evaluation of patients by a multidisciplinary oncology team. OBJECTIVE Development of an expert consensus document with suggestions for the approach and treatment of locally advanced NSCLC leaded by Spanish Lung Cancer Group GECP. METHODS Between March and July 2023, a panel of 28 experts was formed. Using a mixed technique (Delphi/nominal group) under the guidance of a coordinating group, consensus was reached in 4 phases: 1. Literature review and definition of discussion topics 2. First round of voting 3. Communicating the results and second round of voting 4. Definition of conclusions in nominal group meeting. Responses were consolidated using medians and interquartile ranges. The threshold for agreement was defined as 85% of the votes. RESULTS New and controversial situations regarding the diagnosis and management of locally advanced NSCLC were analyzed and reconciled based on evidence and clinical experience. Discussion issues included: molecular diagnosis and biomarkers, radiologic and surgical diagnosis, mediastinal staging, role of the multidisciplinary thoracic committee, neoadjuvant treatment indications, evaluation of response to neoadjuvant treatment, postoperative evaluation, and follow-up. CONCLUSIONS Consensus clinical suggestions were generated on the most relevant scenarios such as diagnosis, staging and treatment of locally advanced lung cancer, which will serve to support decision-making in daily practice.
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Affiliation(s)
- Aylen Vanessa Ospina
- Head of the Oncology Department at the Hospital Universitario Puerta de Hierro. Full Professor of Medicine, Universidad Autónoma de Madrid, C/Manuel de Falla, 1 Majadahonda, 28222, Madrid, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Mariano Provencio
- Head of the Oncology Department at the Hospital Universitario Puerta de Hierro. Full Professor of Medicine, Universidad Autónoma de Madrid, C/Manuel de Falla, 1 Majadahonda, 28222, Madrid, Spain.
- Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain.
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Candal-Pedreira C, Ruano-Ravina A, Calvo de Juan V, Cobo M, Trigo JM, Rodríguez-Abreu D, Estival A, Carcereny E, Cucurull M, López Castro R, Medina A, García Campelo R, Cordeiro González P, Sánchez-Gastaldo A, Bosch-Barrera J, Massutí B, Dómine M, Camps C, Ortega AL, Sánchez-Hernández A, Guirado Risueño M, Del Barco Morillo E, Garrido Fernández A, Provencio M. Comparison of Clinical and Genetic Characteristics Between Younger and Older Lung Cancer Patients. Arch Bronconeumol 2024; 60:88-94. [PMID: 38160163 DOI: 10.1016/j.arbres.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION The aim of this study was to analyze the clinical and genetic characteristics of young lung cancer cases, and to compare them with those of older cases. METHODS We used the Thoracic Tumors Registry (TTR) as a data source representative of lung cancer cases diagnosed in Spain, and included all cases registered until 9/01/2023 which had information on age at diagnosis or the data needed to calculate it. We performed a descriptive statistical analysis and fitted logistic regressions to analyze how different characteristics influenced being a younger lung cancer patient. RESULTS A total of 26,336 subjects were included. Lung cancer cases <50 years old had a higher probability of being women (OR: 1.38; 95% CI: 1.21-1.57), being in stage III or IV (OR: 1.32; 95% CI: 1.08-1.62), not having comorbidities (OR: 5.21; 95% CI: 4.59-5.91), presenting with symptoms at diagnosis (OR: 1.53; 95% CI: 1.29-1.81), and having ALK translocation (OR: 7.61; 95% CI: 1.25-46.32) and HER2 mutation (OR: 5.71; 95% CI: 1.34-24.33), compared with subjects ≥50 years. Among subjects <35 years old (n=61), our study observed a higher proportion of women (59.0% vs. 26.6%; p<0.001), never smokers (45.8% vs. 10.3%; p<0.001), no comorbidities (21.3% vs. 74.0%; p<0.001); ALK translocation (33.3% vs. 4.4%; p<0.001) and ROS1 mutation (14.3% vs. 2.3%; p=0.01), compared with subjects ≥35 years. CONCLUSIONS Lung cancer displays differences by age at diagnosis which may have important implications for its clinical management.
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Affiliation(s)
- Cristina Candal-Pedreira
- Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Galicia, Spain
| | - Alberto Ruano-Ravina
- Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Galicia, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain.
| | | | - Manuel Cobo
- UGC Medical Oncology Intercenters, Regional and Virgen de la Victoria University Teaching Hospitals, Malaga, IBIMA, Malaga, Spain
| | - José Manuel Trigo
- UGC Medical Oncology Intercenters, Regional and Virgen de la Victoria University Teaching Hospitals, Malaga, IBIMA, Malaga, Spain
| | | | - Anna Estival
- Gran Canaria Island Hospital, Las Palmas de Gran Canaria, Spain
| | - Enric Carcereny
- Medical Oncology Department, Catalonian Oncology Institute, Badalona-Germans Trias i Pujol Hospital, B-ARGO Group, Spain
| | - Marc Cucurull
- Medical Oncology Department, Catalonian Oncology Institute, Badalona-Germans Trias i Pujol Hospital, B-ARGO Group, Spain
| | - Rafael López Castro
- Medical Oncology Section, Valladolid University Clinical Teaching Hospital, Spain
| | - Andrea Medina
- Medical Oncology Section, Valladolid University Clinical Teaching Hospital, Spain
| | | | | | | | - Joaquim Bosch-Barrera
- Catalonian Oncology Institute, Dr. Josep Trueta University Teaching Hospital, Girona, Spain
| | - Bartomeu Massutí
- Dr. Balmis University Teaching Hospital, Alicante Health Research and Biomedical Institute (ISABIAL), Alicante, Spain
| | - Manuel Dómine
- Jiménez Díaz Foundation University Hospital, IIS-FJD, Madrid, Spain
| | - Carlos Camps
- Department of Medical Oncology, Catalan Institute of Oncology, Doctor Josep Trueta University Hospital and Precision Oncology Group (OncoGIR-Pro), Girona Biomedical Research Institute (IDIBGI), Girona, Spain
| | | | | | | | - Edel Del Barco Morillo
- Medical Oncology Department, Salamanca University Healthcare Complex-IBSAL, Salamanca, Spain
| | | | - Mariano Provencio
- Oncology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
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Hitt R, Mesía R, Lozano A, Iglesias Docampo L, Grau JJ, Taberna M, Rubió-Casadevall J, Martínez-Trufero J, Morillo EDB, García Girón C, Vázquez Estévez S, Cirauqui B, Cruz-Hernández JJ. Randomized phase 3 noninferiority trial of radiotherapy and cisplatin vs radiotherapy and cetuximab after docetaxel-cisplatin-fluorouracil induction chemotherapy in patients with locally advanced unresectable head and neck cancer. Oral Oncol 2022; 134:106087. [PMID: 36126605 DOI: 10.1016/j.oraloncology.2022.106087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 07/27/2022] [Accepted: 08/12/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Concurrent chemoradiotherapy is the standard treatment for patients with unresectable, locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN); induction chemotherapy (ICT) may provide survival benefits in some patients. This study aimed to demonstrate the noninferiority of concomitant cetuximab plus radiotherapy (cet+RT) vs cisplatin plus radiotherapy (cis+RT) in patients with unresectable LA-SCCHN who were responsive to ICT. MATERIALS AND METHODS This randomized, open-label, phase 3 trial studied patients with unresectable LA-SCCHN who received 3 cycles of ICT (docetaxel, cisplatin, and 5-fluorouracil; TPF) followed by cis+RT (standard arm) or cet+RT (experimental arm). The primary endpoint was noninferiority of the experimental arm vs the standard arm in terms of overall survival (OS), based on a hazard ratio (HR) of < 1.3. Secondary endpoints included progression-free survival, overall response, safety, and quality of life (QOL). RESULTS Between July 15, 2008, and July 5, 2013, 519 patients were recruited and started ICT; 407 patients received post-ICT treatment (cis+RT, n = 205; cet+RT, n = 202). At a median follow-up of 43.9 (cis+RT) and 41.1 (cet+RT) months, median OS was 63.6 and 42.9 months with cis+RT and cet+RT, respectively (HR [90% CI] = 1.106 [0.888-1.378], P =.4492). There were no differences in progression-free survival, overall response rates, or adverse event rates between groups. There was greater late neurotoxicity with cis+RT than cet+RT (P =.0058). Several QOL dimensions improved with cet+RT vs cis+RT (physical functioning, P =.0287; appetite loss, P =.0248; social contact, P =.0153). CONCLUSION Noninferiority of cet+RT over cis+RT was not demonstrated.
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Affiliation(s)
- Ricardo Hitt
- Medical Oncology Service, University Hospital Severo Ochoa, Leganés, Madrid, Spain.
| | - Ricard Mesía
- Medical Oncology Department, Institut Català d́Oncologia (ICO), Hospitalet, Barcelona, Spain
| | - Alicia Lozano
- Radiotherapy Oncology Department, Institut Català d́Oncologia (ICO), Hospitalet, Barcelona, Spain
| | | | - Juan J Grau
- Medical Oncology Department, Hospital Clinic, Barcelona, Spain
| | - Miren Taberna
- Medical Oncology Department, Institut Català d́Oncologia (ICO), ONCOBELL, IDIBELL, Hospitalet, Barcelona, Spain
| | - Jordi Rubió-Casadevall
- Medical Oncology Department, University Hospital Josep Trueta, Institut Català d'Oncologia (ICO), Girona, Spain
| | | | - Edel Del Barco Morillo
- Medical Oncology Service, University Hospital of Salamanca- IBSAL (Biomedical Research Institute of Salamanca), Salamanca, Spain
| | | | | | - Beatriz Cirauqui
- Medical Oncology Department, Institut Català d'Oncologia (ICO), Badalona Applied Research Group in Oncology (B-ARGO), Badalona, Spain
| | - Juan Jesús Cruz-Hernández
- Medical Oncology Service, University Hospital of Salamanca- IBSAL (Biomedical Research Institute of Salamanca), Salamanca, Spain
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Ruano-Ravina A, Provencio M, Calvo de Juan V, Carcereny E, Estival A, Rodríguez-Abreu D, Benítez G, López-Castro R, Belver M, Guirado-Risueño M, Guirao-Rubio C, Blasco A, Massutí B, Ortega AL, Cobo M, Mosquera-Martínez J, Aguado de la Rosa C, Bosch-Barrera J, Sánchez-Gastaldo A, Del Barco Morillo E, Juan Ó, Dómine M, Trigo JM, Pereiro Corbacho D, Oramas J. Are there differences by sex in lung cancer characteristics at diagnosis? -a nationwide study. Transl Lung Cancer Res 2021; 10:3902-3911. [PMID: 34858780 PMCID: PMC8577975 DOI: 10.21037/tlcr-21-559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/16/2021] [Indexed: 12/30/2022]
Abstract
Background Lung cancer causes approximately 25% of all cancer deaths. Despite its relevance, few studies have analyzed differences by sex at the time of diagnosis in terms of symptoms, stage, age or smoking status. We aim to assess if there are differences between men and women on these characteristics at diagnosis. Methods We analyzed the Thoracic Tumour Registry (TTR), sponsored by the Spanish Lung Cancer Group using a case-series design. This is a nationwide registry of lung cancer cases which started recruitment in 2016. For each case included, clinicians fulfilled an electronic record registering demographic data, symptoms, exposure to lung cancer risk factors, and treatment received in detail. We compared men and women using descriptive statistics. Results A total of 13,590 participants took part in this study, 25.6% women. Women were 4 years younger than men (64 vs. 69), and men had smoked more frequently. Adenocarcinoma was the most frequent histological type in both sexes. Stage IV at diagnosis was 50.8% in women compared to 43.6% in men. Weight loss/anorexia/asthenia was the most frequent symptom in both sexes and there were no differences in the number of symptoms at diagnosis. There were no relevant differences in the frequency or number of symptoms by sex when non-small cell lung cancer (NSCLC) and small-cell lung cancer (SCLC) were analyzed separately. Smoking status did not appear to cause different lung cancer presentation in men compared to women. Conclusions There seems to be no differences in lung cancer characteristics by sex at the time at diagnosis on stage, specific symptoms or number of symptoms.
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Affiliation(s)
- Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología and Salud Pública/CIBERESP), Madrid, Spain.,Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain
| | - Mariano Provencio
- Department of Oncology, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain
| | - Virginia Calvo de Juan
- Department of Oncology, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain
| | - Enric Carcereny
- Medical Oncology Department, Catalan Institute of Oncology, Badalona- Germans Trias i Pujol Hospital B-ARGO group, Barcelona, Spain
| | - Anna Estival
- Medical Oncology Department, Catalan Institute of Oncology, Badalona- Germans Trias i Pujol Hospital B-ARGO group, Barcelona, Spain
| | | | - Gretel Benítez
- Hospital Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Rafael López-Castro
- Servicio de Oncología, Sección de oncología médica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Marta Belver
- Servicio de Oncología, Sección de oncología médica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | | | - Ana Blasco
- Hospital General de Valencia, Valencia, Spain
| | | | - Ana Laura Ortega
- Servicio de Oncología Médica. Complejo Hospitalario de Jaén, Jaén, Spain
| | - Manuel Cobo
- Unidad de Gestión Clínica Intercentros de Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, IBIMA, Málaga, Spain
| | | | | | - Joaquim Bosch-Barrera
- Girona Biomedical Research Institute (IDIBGI), Girona, Spain.,Department of Medical Sciences, Medical School, University of Girona, Girona, Spain.,Medical Oncology, Catalan Institute of Oncology, Hospital Universitari Dr. Josep Trueta, Girona, Catalonia, Spain
| | | | | | - Óscar Juan
- Servicio Oncología Médica, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | | | - José Manuel Trigo
- Servicio de Oncología Médica y Unidad de Fases I, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | | | - Juana Oramas
- Hospital Universitario de Canarias, Santa Cruz Tenerife, Spain
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