1
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Spils M, Klikovits T, Krenbek D, Hochmair MJ, Jankovic I, Schulte L, Krajc T, Benej M, Getman V, Navarrete JR, Akan A, Mueller MR, Aigner C, Watzka SB. Prognostic factors of recurrence and disease-free survival in radically resected pulmonary carcinoids: a real-world analysis. J Thorac Dis 2024; 16:1911-1922. [PMID: 38617753 PMCID: PMC11009585 DOI: 10.21037/jtd-23-1681] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/02/2024] [Indexed: 04/16/2024]
Abstract
Background Pulmonary carcinoids (PCs) are rare neuroendocrine lung tumors which may recur, thus worsening their otherwise favorable overall prognosis. Aiming to identify patients at risk for recurrence, we examined parameters affecting disease-free survival (DFS). Methods A retrospective single-center analysis of 82 consecutive patients undergoing curative intent resection for primary PC tumors between 2010 and 2019 was carried out. Kaplan-Meier method was utilized for survival analysis. Independent prognostic factors were determined using multivariable Cox and logistic regression. Results During the observation period 82 patients, 48 females (58.5%) and 34 males (41.5%) were operated, representing 84 cases of PCs, 56 typical (TCs) (66.7%) and 28 atypical (ACs) (33.3%) carcinoids. Five-year overall survival was 87.5% and 84.7%, 5-year DFS 97.5% and 74.9% (P=0.012) for TCs and ACs, respectively. Recurrences occurred in one patient (1.8%) with TCs and five patients (17.9%) with ACs (P=0.014). Using multivariable Cox regression, tumor size (cm) remained as an independent prognostic factor for reduced DFS (P=0.018). In logistic regression, nodal involvement (P=0.043) and tumor size (cm) (P=0.023) were independently associated with higher risk of recurrence. Age, sex, smoking, location, and Ki-67 index were not independently associated with recurrence or DFS. Conclusions Recurrence in PCs after complete resection is relatively rare. However, DFS is reduced in ACs compared to TCs. Tumor size (cm) and nodal involvement appear as the most important prognostic factors associated with recurrence in PCs, independent of histologic type.
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Affiliation(s)
- Marc Spils
- Department of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, Vienna, Austria
| | - Thomas Klikovits
- Department of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, Vienna, Austria
| | - Dagmar Krenbek
- Institute for Pathology, Clinic Floridsdorf, Vienna, Austria
| | - Maximilian Johannes Hochmair
- Department of Respiratory and Critical Care Medicine, Karl-Landsteiner-Institute for Lung Research and Pulmonary Oncology, Clinic Floridsdorf, Vienna, Austria
| | - Igor Jankovic
- Department of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, Vienna, Austria
| | - Lisa Schulte
- Department of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, Vienna, Austria
| | - Tibor Krajc
- Department of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, Vienna, Austria
| | - Michal Benej
- Department of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, Vienna, Austria
| | - Vladyslav Getman
- Department of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, Vienna, Austria
| | - José Ruiz Navarrete
- Department of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, Vienna, Austria
| | - Ahmet Akan
- Department of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, Vienna, Austria
| | - Michael R. Mueller
- Department of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, Vienna, Austria
| | - Clemens Aigner
- Department of Thoracic Surgery, Vienna General Hospital, Vienna, Austria
| | - Stefan B. Watzka
- Department of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, Vienna, Austria
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Robinson I, Hochmair MJ, Schmidinger M, Absenger G, Pichler M, Nguyen VA, Richtig E, Rainer BM, Ay L, Jansen C, Pacífico C, Knabl A, Sladek B, Gasche N, Valipour A. Assessing the Performance of a Novel Stool-Based Microbiome Test That Predicts Response to First Line Immune Checkpoint Inhibitors in Multiple Cancer Types. Cancers (Basel) 2023; 15:3268. [PMID: 37444378 DOI: 10.3390/cancers15133268] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 07/15/2023] Open
Abstract
The intestinal microbiome is by now an undebatable key player in the clinical outcome of ICI therapies. However, no microbiome profiling method to aid therapy decision is yet validated. We conducted a multi-centric study in patients with stage III/IV melanoma, NSCLC, or RCC receiving ICI treatment. The stool microbiome profile of 63 patients was analyzed with BiomeOne®, a microbiome-based algorithm that anticipates whether a patient will achieve clinical benefit with ICIs prior to therapy initiation. Classification of patient samples as Rs and NRs was achieved with a sensitivity of 81% and a specificity of 50% in this validation cohort. An ICI-favorable response was characterized by an intestinal microbiome rich in bacteria such as Oscillospira sp., Clostridia UCG-014, Lachnospiraceae UCG-010 sp., Prevotella copri, and a decrease in Sutterella sp., Lactobacillales, and Streptococcus sp. Patients who developed immune-related adverse events (irAEs) had an overall increased microbial diversity and richness, and a stool microbiome depleted in Agathobacter. When compared with the programmed death-ligand 1 (PD-L1) expression test in the subcohort of NSCLC patients (n = 38), BiomeOne® exhibited a numerically higher sensitivity (78.6%) in identifying responders when compared with the PD-L1 test (67.9%). This study provides an evaluation of BiomeOne®, the first microbiome-based test for prediction of ICI response, to achieve market authorization. Validation with further indications and expansion to other microbiome-based interventions will be essential to bring microbiome-based diagnostics into standard clinical practice.
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Affiliation(s)
- Irina Robinson
- Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna Healthcare Group, 1210 Vienna, Austria
| | - Maximilian Johannes Hochmair
- Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna Healthcare Group, 1210 Vienna, Austria
| | - Manuela Schmidinger
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria
| | - Gudrun Absenger
- Department of Internal Medicine, Division of Oncology, Medical University of Graz, 8036 Graz, Austria
| | - Martin Pichler
- Department of Internal Medicine, Division of Oncology, Medical University of Graz, 8036 Graz, Austria
| | - Van Anh Nguyen
- Department of Dermatology, Medical University Innsbruck, 6020 Innsbruck, Austria
| | - Erika Richtig
- Department of Dermatology, Medical University of Graz, 8036 Graz, Austria
| | | | - Leyla Ay
- Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna Healthcare Group, 1210 Vienna, Austria
| | | | | | | | | | | | - Arschang Valipour
- Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna Healthcare Group, 1210 Vienna, Austria
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3
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Benej M, Klikovits T, Krajc T, Bohanes T, Schulte L, Hochmair MJ, Watzka S, Mosleh B, Hoetzenecker K, Aigner C, Hoda MA, Mueller MR. Lymph Node Log-Odds Ratio Accurately Defines Prognosis in Resectable Non-Small Cell Lung Cancer. Cancers (Basel) 2023; 15:cancers15072082. [PMID: 37046743 PMCID: PMC10093675 DOI: 10.3390/cancers15072082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/08/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Objectives: The ratio of positive and resected lymph nodes (LN ratio) has been shown to be prognostic in non-small cell lung cancer (NSCLC). Contrary to the LN ratio, calculating the LN log-odds ratio (LN-LOR) additionally considers the total number of resected lymph nodes. We aim to evaluate LN-LOR between positive and resected lymph nodes as a prognostic factor in operable NSCLC. Methods: Patients with NSCLC who underwent curative intent lobectomy treated at two high-volume centers were retrospectively studied. LN-LOR was dichotomized according to impact on OS and further combined with N descriptors and correlated with clinical variables and survival. Results: 944 patients were included. Cut-off analysis revealed that an LN-LOR of −0.34 significantly discriminated patients according to OS (p < 0.001, chi-squared test 41.26). When combined with N1 and N2 descriptors, LN-LOR low risk (median OS not reached and 83 months) and LN-LOR high-risk patients (median OS 50 and 59 months) had similar survival irrespective of the anatomical location of the positive lymph nodes. Multivariable Cox regression analysis revealed that age (HR 1.02, 95% CI 1.001–1.032), sex (male, HR 1.65, 95% CI 1.25–2.19), histological subtype (HR 2.11, 95% CI 1.35–3.29), pathological stage (HR 1.23, 95% CI 1.01–1.45) and LN-LOR risk groups (low risk, HR 0.48, 95% CI 0.32–0.72) were independent prognostic factors for OS. Conclusions: This retrospective two-center analysis shows that LN-LOR is significantly associated with OS in resectable NSCLC and might better reflect the biological behavior of the disease, regardless of anatomical lymph node locations. This finding may additionally support the value of extensive LN dissection.
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Affiliation(s)
- Michal Benej
- Department of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, 1210 Vienna, Austria
| | - Thomas Klikovits
- Department of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, 1210 Vienna, Austria
| | - Tibor Krajc
- Department of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, 1210 Vienna, Austria
| | - Tomas Bohanes
- Department of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, 1210 Vienna, Austria
| | - Lisa Schulte
- Department of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, 1210 Vienna, Austria
| | - Maximilian Johannes Hochmair
- Department of Respiratory and Critical Care Medicine, Karl-Landsteiner-Institute for Lung Research and Pulmonary Oncology, Clinic Floridsdorf, 1210 Vienna, Austria
| | - Stefan Watzka
- Department of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, 1210 Vienna, Austria
| | - Berta Mosleh
- Department of Thoracic Surgery, Medical University of Vienna, 1090 Vienna, Austria
| | - Konrad Hoetzenecker
- Department of Thoracic Surgery, Medical University of Vienna, 1090 Vienna, Austria
| | - Clemens Aigner
- Department of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, 1210 Vienna, Austria
| | - Mir Alireza Hoda
- Department of Thoracic Surgery, Medical University of Vienna, 1090 Vienna, Austria
| | - Michael Rolf Mueller
- Department of Thoracic Surgery and Karl-Landsteiner-Institute, Clinic Floridsdorf, 1210 Vienna, Austria
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4
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Hochmair MJ, Kolb R, Wurm R, Zach H, Bittner N. Nintedanib plus Docetaxel after Immune Checkpoint Inhibitor Failure in Patients with Advanced Non-Small-Cell Lung Cancer: A Case Series. Case Rep Oncol 2022; 15:138-148. [PMID: 35350799 PMCID: PMC8921945 DOI: 10.1159/000520939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/05/2021] [Accepted: 11/15/2021] [Indexed: 11/19/2022] Open
Abstract
Advances in the treatment of non-small-cell lung cancers (NSCLCs) lacking an actionable driver mutation have included the approval of immunotherapies, such as monotherapy or in combination with chemotherapy. However, limited evidence exists to guide clinical decision-making after progression with immunotherapy. The vascular endothelial growth factor (VEGF) signaling pathway promotes tumor angiogenesis and the development of an immunosuppressive tumor microenvironment (TME). Anti-VEGF treatment is postulated to favor an immunosupportive TME through an “angio-immunogenic switch.” Nintedanib, an anti-VEGF receptor treatment, is approved in the EU and other countries, in combination with docetaxel for the treatment of locally advanced, metastatic, or locally recurrent adenocarcinoma NSCLC after failure of first-line chemotherapy. We present a case series from 5 patients treated with nintedanib plus docetaxel, after chemotherapy and immunotherapy, during routine clinical practice in Austria and Hungary. Four patients were treated with nintedanib plus docetaxel as a second- or third-line treatment after chemotherapy and immunotherapy, and a fifth patient received immunotherapy before and after nintedanib plus docetaxel. Although these patients would typically have a poor prognosis, each achieved a partial response with nintedanib plus docetaxel, with response duration from 8 months to over 30 months. Adverse events were manageable. The fifth patient case shows that nintedanib does not preclude later-line immunotherapy or chemotherapy, supporting the angio-immunogenic switch hypothesis. Overall, the case studies indicate that nintedanib plus docetaxel is an effective and well tolerated treatment, after sequential or combined chemo-immunotherapy for advanced NSCLC, and is compatible with a rechallenge with immunotherapy.
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Affiliation(s)
- Maximilian Johannes Hochmair
- Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna, Austria
| | - Rainer Kolb
- Department of Pulmonology, Klinikum Wels-Grieskirchen, Wels, Austria
| | - Robert Wurm
- Department of Pulmonology, Medical University Graz, Graz, Austria
| | - Herwig Zach
- Boehringer Ingelheim RCV GmbH & Co KG, Vienna, Austria
| | - Nora Bittner
- Department of Pulmonology, University of Debrecen, Debrecen, Hungary
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Ansari J, Eltigani Mohmmed Y, Ghazal-Aswad S, Ansari H, Akhter SMJ, Hassoun Hadid O, Rizwan S, Almazrouei R, Dawoud E, Azribi F, Elhasin H, Kumar P, Al Sumaida AR, Al-Qawasmeh K, Glaholm J, Hochmair MJ, Hussain S, Balaraj K. Rare case of chemotherapy-refractory metastatic vaginal squamous cell carcinoma with complete response to concurrent pembrolizumab and radiotherapy- case report and literature review. Gynecol Oncol Rep 2021; 38:100878. [PMID: 34926759 PMCID: PMC8651786 DOI: 10.1016/j.gore.2021.100878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 09/11/2021] [Accepted: 10/04/2021] [Indexed: 12/12/2022] Open
Abstract
Metastatic vaginal cancer, rare cancer with limited treatment options. Pembrolizumab and radiotherapy led to complete response in a patient with metastatic vaginal cancer. Wall-eyed bilateral internuclear ophthalmoplegia, a new immune related adverse event.
Primary vaginal cancer is a rare malignancy with a lack of international guidelines and supporting clinical trial evidence to guide decision making. Historical results have shown poor outcomes with chemotherapy for stage IVB vaginal squamous cell carcinoma (SCC). The evolving role of checkpoint inhibitors in rare gynaecological cancers prompted us to investigate the role of pembrolizumab in this setting. The efficacy of pembrolizumab in vaginal SCC has never been investigated in any clinical trial. There is established data to support the use of concurrent chemoradiotherapy in gynaecological cancers, however, the data for concurrent use of immunotherapy and radiotherapy is still lacking but is the subject of several clinical trials. We herein present the first reported case of chemotherapy refractory vaginal SCC with complete response to pembrolizumab and concurrent pelvic radiotherapy. We also present wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) as a rare but new immune related adverse event.
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Affiliation(s)
- Jawaher Ansari
- Department of Medical Oncology, Tawam Hospital, Al Ain, United Arab Emirates
| | | | - Saad Ghazal-Aswad
- Department of Gynaecology, Tawam Hospital, Al Ain, United Arab Emirates
| | - Hidayath Ansari
- Department of Radiology and Nuclear Medicine, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Syed M J Akhter
- Department of Pathology, Tawam Hospital, Al Ain, United Arab Emirates
| | - Omar Hassoun Hadid
- Department of Ophthalmology, Tawam Hospital, Al Ain, United Arab Emirates
| | - Syed Rizwan
- Department of Radiology and Nuclear Medicine, Tawam Hospital, Al Ain, United Arab Emirates
| | - Raya Almazrouei
- Department of Endocrinology, Tawam Hospital, Al Ain, United Arab Emirates
| | - Emad Dawoud
- Department of Medical Oncology, Tawam Hospital, Al Ain, United Arab Emirates
| | - Fathi Azribi
- Department of Medical Oncology, Tawam Hospital, Al Ain, United Arab Emirates
| | - Heba Elhasin
- Department of Neurology, Tawam Hospital, Al Ain, United Arab Emirates
| | - Pawan Kumar
- Department of Medical Oncology, Tawam Hospital, Al Ain, United Arab Emirates
| | | | - Khaled Al-Qawasmeh
- Department of Medical Oncology, Tawam Hospital, Al Ain, United Arab Emirates
| | - John Glaholm
- Institute of Cancer Research, London SM2 5NG, United Kingdom
| | - M J Hochmair
- Department of Respiratory & Critical Care Medicine, Karl Landsteiner Institute of Lung Research & Pulmonary Oncology, Krankenhaus Nord, 3500 Vienna, Austria
| | - Syed Hussain
- Department of oncology and metabolism, Room 228, 2nd Floor, Broomcross Building, Weston Park Hospital, Whitham Road, Sheffield S10 2SJ, United Kingdom
| | - Khalid Balaraj
- Department of Radiation Oncology, Tawam Hospital, Al Ain, United Arab Emirates
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6
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Hochmair MJ, Illini O, Prosch H, Krenbek D, Valipour A. Complete Remission to Afatinib in a Patient Harboring a Novel Epidermal Growth Factor Mutation in De Novo Small-Cell Lung Cancer: A Case Report: Clinical Lung Cancer. Clin Lung Cancer 2021; 23:e289-e292. [PMID: 34865962 DOI: 10.1016/j.cllc.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/29/2021] [Accepted: 11/04/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Maximilian Johannes Hochmair
- Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna, Austria.
| | - Oliver Illini
- Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna, Austria
| | - Helmut Prosch
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Dagmar Krenbek
- Department of Pathology and Bacteriology, Klinik Floridsdorf, Vienna, Austria
| | - Arschang Valipour
- Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna, Austria
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7
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Illini O, Hochmair MJ, Fabikan H, Weinlinger C, Tufman A, Swalduz A, Lamberg K, Hashemi SMS, Huemer F, Vikström A, Wermke M, Absenger G, Addeo A, Banerji S, Calles A, Clarke S, Di Maio M, Durand A, Duruisseaux M, Itchins M, Kääränien OS, Krenn F, Laack E, de Langen AJ, Mohorcic K, Pall G, Passaro A, Prager G, Rittmeyer A, Rothenstein J, Schumacher M, Wöll E, Valipour A. Selpercatinib in RET fusion-positive non-small-cell lung cancer (SIREN): a retrospective analysis of patients treated through an access program. Ther Adv Med Oncol 2021; 13:17588359211019675. [PMID: 34178121 PMCID: PMC8202258 DOI: 10.1177/17588359211019675] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [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: 04/09/2021] [Accepted: 04/30/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Rearranged during transfection (RET) gene fusions are rare genetic drivers in non-small cell lung cancer (NSCLC). Selective RET-inhibitors such as selpercatinib have shown therapeutic activity in early clinical trials; however, their efficacy in the real-world setting is unknown. METHODS A retrospective efficacy and safety analysis was performed on data from RET fusion-positive NSCLC patients who participated in a selpercatinib access program (named patient protocol) between August 2019 and January 2021. RESULTS Data from 50 patients with RET fusion-positive advanced NSCLC treated with selpercatinib at 27 centers in 12 countries was analyzed. Most patients were Non-Asian (90%), female (60%), never-smokers (74%), with a median age of 65 years (range, 38-89). 32% of the patients had known brain metastasis at the time of selpercatinib treatment. Overall, 13 patients were treatment-naïve, while 37 were pretreated with a median of three lines of therapy (range, 1-8). The objective response rate (ORR) was 68% [95% confidence interval (CI), 53-81] in the overall population. The disease control rate was 92%. The median progression-free survival was 15.6 months (95% CI, 8.8-22.4) after a median follow-up of 9 months. In patients with measurable brain metastases (n = 8) intracranial ORR reached 100%. In total, 88% of patients experienced treatment-related adverse events (TRAEs), a large majority of them being grade 1 or 2. The most common grade ⩾ 3 TRAEs were increased liver enzyme levels (in 10% of patients), prolonged QTc time (4%), abdominal pain (4%), hypertension (4%), and fatigue/asthenia (4%). None of patients discontinued selpercatinib treatment for safety reasons. No new safety concerns were observed, nor where there any treatment-related death. CONCLUSIONS In this real-world setting, the selective RET-inhibitor selpercatinib demonstrated durable systemic and intracranial antitumor activity in RET fusion-positive NSCLC and was well tolerated.
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Affiliation(s)
- Oliver Illini
- Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Brünner Strasse 68, Vienna, 1210, Austria
| | - Maximilian Johannes Hochmair
- Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna, Austria
| | - Hannah Fabikan
- Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna, Austria
| | - Christoph Weinlinger
- Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna, Austria
| | - Amanda Tufman
- Medizinische Klinik und Poliklinik V, Klinikum der Universitaet Muenchen, LMU München, Mitglied des Deutschen Zentrums für Lungenforschung, CPC-M, Munich, Bayern, Germany
| | | | - Kristina Lamberg
- Department of Pulmonary and Allergic diseases, Uppsala University hospital, Uppsala, Sweden
| | - Sayed M. S. Hashemi
- Amsterdam UMC, VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Florian Huemer
- Department of Respiratory Care, Ludwig Boltzmann Institute Lung Health, Klinik Penzing, Vienna, Austria
| | - Anders Vikström
- Pulmonary clinic, University hospital Linköping, Linköping, Sweden
| | - Martin Wermke
- Medical Faculty C.-G.-Carus, NCT/UCC Early Clinical Trial Unit Dresden, Technical University Dresden, Germany
| | - Gudrun Absenger
- Department of Oncology, Medical University of Graz, Graz, Austria
| | - Alfredo Addeo
- Oncology Department, University Hospital of Geneva, Geneva, Switzerland
| | - Shantanu Banerji
- Research Institute in Oncology and Hematology, CancerCare Manitoba, University of Manitoba, Winnipeg, MB, Canada
| | - Antonio Calles
- Medical Oncology Department, Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | - Stephen Clarke
- Medical Oncology Unit, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Massimo Di Maio
- Department of Oncology, University of Turin, Italy
- Medical Oncology, Ordine Mauriziano Hospital, Torino, Italy
| | - Alice Durand
- Respiratory Department, Louis Pradel Hospital, Hospices Civils de Lyon Cancer Institute, Lyon, France Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Michaël Duruisseaux
- Respiratory Department, Louis Pradel Hospital, Hospices Civils de Lyon Cancer Institute, Lyon, France
- Oncopharmacology Laboratory, Cancer Research Center of Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Malinda Itchins
- Medical Oncology Unit, Royal North Shore Hospital, St Leonards, NSW, Australia
| | | | - Florian Krenn
- LKH Hochsteiermark – Standort Leoben, Abteilung für Lungenkrankheiten, Austria
| | - Eckart Laack
- Studiengesellschaft Hämato-Onkologie Hamburg, Hamburg, Germany
| | | | - Katja Mohorcic
- Medical Oncology Unit, University Clinic Golnik, Golnik, Slovenia
| | - Georg Pall
- Department of Internal Medicine V, Hematology/Oncology, University Hospital Innsbruck, Innsbruck, Austria
| | - Antonio Passaro
- Division of Thoracic Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - Gerald Prager
- Department of Medicine I, Comprehensive Cancer Center Vienna, Vienna, Austria
| | - Achim Rittmeyer
- LKI Lungenfachklinik Immenhausen, Department of Thoracic Oncology, Immenhausen, Germany
| | - Jeffrey Rothenstein
- R.S. McLaughlin Durham Regional Cancer Center at Lakeridge Health, Adjunct Assistant Professor Queen’s University, Ontario, Canada
| | - Michael Schumacher
- Department of Pneumology, Ordensklinikum Elisabethinen Linz, Linz, Austria
| | - Ewald Wöll
- Department Internal Medicine, St. Vinzenz Krankenhaus Betriebs GmbH, Sanatoriumstr. 43, 6511 Zams, Austria
| | - Arschang Valipour
- Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna
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Hochmair MJ. Resistance to chemoimmunotherapy in non-small-cell lung cancer. Cancer Drug Resist 2020; 3:445-453. [PMID: 35582443 PMCID: PMC8992480 DOI: 10.20517/cdr.2020.09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/14/2020] [Accepted: 06/12/2020] [Indexed: 12/14/2022]
Abstract
Recent clinical trials evaluating the combination of chemotherapy with immune checkpoint inhibition for the primary treatment of lung cancer showed increased progression-free and overall survival compared with chemotherapy alone. However, the combination of these two modalities is less than additive and the mechanisms of resistance to this therapeutic intervention are discussed here. So far, the conventional biomarkers for immunotherapy, namely programmed death-ligand 1 expression or tumor mutational burden are poor predictors of the efficacy of immunochemotherapy, and the optimal sequence of chemotherapy and immunotherapy has yet to be defined.
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9
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Hochmair MJ, Setinek U, Krenbek D, Fazekas A, Illini O, Weinlinger C, Draxler H, Marcher M, Valipour A, Müllauer L, Beer L. Rapid Clinical and Radiologic Responses With Larotrectinib Treatment in a Patient With TRK-Fusion-Positive Metastatic Lung Cancer. Clin Lung Cancer 2019; 21:e49-e53. [PMID: 31879191 DOI: 10.1016/j.cllc.2019.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 10/30/2019] [Accepted: 11/10/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Maximilian Johannes Hochmair
- Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Krankenhaus Nord, Vienna, Austria.
| | - Ulrike Setinek
- Department of Pathology, Wilhelminenspital, Vienna, Austria
| | - Dagmar Krenbek
- Department of Pathology, Wilhelminenspital, Vienna, Austria; Department of Pathology, Klinik Floridsdorf, Krankenhaus Nord, Vienna, Austria
| | - Andreas Fazekas
- Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Krankenhaus Nord, Vienna, Austria
| | - Oliver Illini
- Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Krankenhaus Nord, Vienna, Austria
| | - Christoph Weinlinger
- Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Krankenhaus Nord, Vienna, Austria
| | - Hermann Draxler
- Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Krankenhaus Nord, Vienna, Austria
| | - Markus Marcher
- Department of Thoracic Surgery, Klinik Floridsdorf, Krankenhaus Nord, Vienna, Austria
| | - Arschang Valipour
- Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Krankenhaus Nord, Vienna, Austria
| | - Leonhard Müllauer
- Institute of Pathology, Medical University of Vienna, Vienna, Austria
| | - Lucian Beer
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria; Department of Radiology and Cancer Research UK, Cambridge, England, UK
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10
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Abstract
Introduction: Brigatinib is a second-line inhibitor for the treatment of rearranged anaplastic lymphoma kinase (ALK) in lung cancer patients which has significant activity against brain metastases. This tyrosine kinase inhibitor (TKI) overcomes a wide range of ALK mutations which confer therapeutic resistance and is increasingly applied in first-line therapy due to improved benefit for patients compared to crizotinib, the current standard of care. Areas covered: The authors review the development and characteristics of brigatinib and discuss the optimal clinical use and sequence of the application of ALK inhibitors in patients progressing under therapy. Expert opinion: ALK-rearranged NSCLC can be treated with a broad range of approved and novel inhibitors at various stages of therapy, including the second-line therapeutic brigatinib. Besides this TKI, the second-line ALK inhibitors alectinib and ceritinib, as well as the third-line lorlatinib are approved for the treatment of ALK-positive NSCLC patients. The main challenge is to find sequences and combinations of ALK inhibitors which provide the best benefit for the patients.
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Affiliation(s)
- G Hamilton
- Department of Surgery, Medical University of Vienna , Vienna , Austria
| | - M J Hochmair
- Respiratory Oncology Unit, Otto Wagner Hospital , Vienna , Austria
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