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Thor M, Fitzgerald K, Apte A, Oh JH, Iyer A, Odiase O, Nadeem S, Yorke ED, Chaft J, Wu AJ, Offin M, Simone Ii CB, Preeshagul I, Gelblum DY, Gomez D, Deasy JO, Rimner A. Exploring published and novel pre-treatment CT and PET radiomics to stratify risk of progression among early-stage non-small cell lung cancer patients treated with stereotactic radiation. Radiother Oncol 2024; 190:109983. [PMID: 37926331 DOI: 10.1016/j.radonc.2023.109983] [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: 04/12/2023] [Revised: 10/23/2023] [Accepted: 10/30/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE Disease progression after definitive stereotactic body radiation therapy (SBRT) for early-stage non-small cell lung cancer (NSCLC) occurs in 20-40% of patients. Here, we explored published and novel pre-treatment CT and PET radiomics features to identify patients at risk of progression. MATERIALS/METHODS Published CT and PET features were identified and explored along with 15 other CT and PET features in 408 consecutively treated early-stage NSCLC patients having CT and PET < 3 months pre-SBRT (training/set-aside validation subsets: n = 286/122). Features were associated with progression-free survival (PFS) using bootstrapped Cox regression (Bonferroni-corrected univariate predictor: p ≤ 0.002) and only non-strongly correlated predictors were retained (|Rs|<0.70) in forward-stepwise multivariate analysis. RESULTS Tumor diameter and SUVmax were the two most frequently reported features associated with progression/survival (in 6/20 and 10/20 identified studies). These two features and 12 of the 15 additional features (CT: 6; PET: 6) were candidate PFS predictors. A re-fitted model including diameter and SUVmax presented with the best performance (c-index: 0.78; log-rank p-value < 0.0001). A model built with the two best additional features (CTspiculation1 and SUVentropy) had a c-index of 0.75 (log-rank p-value < 0.0001). CONCLUSIONS A re-fitted pre-treatment model using the two most frequently published features - tumor diameter and SUVmax - successfully stratified early-stage NSCLC patients by PFS after receiving SBRT.
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Affiliation(s)
- Maria Thor
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, USA.
| | - Kelly Fitzgerald
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, USA
| | - Aditya Apte
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, USA
| | - Jung Hun Oh
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, USA
| | - Aditi Iyer
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, USA
| | - Otasowie Odiase
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, USA
| | - Saad Nadeem
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, USA
| | - Ellen D Yorke
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, USA
| | - Jamie Chaft
- Department of Medicine, Memorial Sloan Kettering Cancer Center, USA
| | - Abraham J Wu
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, USA
| | - Michael Offin
- Department of Medicine, Memorial Sloan Kettering Cancer Center, USA
| | - Charles B Simone Ii
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, USA
| | | | - Daphna Y Gelblum
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, USA
| | - Daniel Gomez
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, USA
| | - Joseph O Deasy
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, USA
| | - Andreas Rimner
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, USA
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Tsuang FY, Jeon JP, Huang AP, Chai CL. Overall Survival of Non-Small Cell Lung Cancer With Spinal Metastasis: A Systematic Review and Meta-Analysis. Neurospine 2023; 20:567-576. [PMID: 37401075 PMCID: PMC10323357 DOI: 10.14245/ns.2245026.513] [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: 12/01/2022] [Revised: 02/22/2023] [Accepted: 03/23/2023] [Indexed: 07/05/2023] Open
Abstract
OBJECTIVE The long-term survival data of lung cancer patients with spinal metastases are crucial for informed treatment decision-making. However, most studies in this field involve small sample sizes. Moreover, survival benchmarking and an analysis of changes in survival over time are required, but data are unavailable. To meet this need, we performed a metaanalysis of survival data from small studies to obtain a survival function based on largescale data. METHODS We performed a single-arm systematic review of survival function following a published protocol. Data of patients who received surgical, nonsurgical, and mixed modes of treatment were meta-analyzed separately. Survival data were extracted from published figures with a digitizer program and then processed in R. Median survival time was used as an effect size for moderator analysis to explain the heterogeneity. RESULTS Sixty-two studies with 5,242 participants were included for pooling. The survival functions showed a median survival of 6.72 months for surgery (95% confidence interval [CI], 61.9-7.01; 2,367 participants; 36 studies), 5.99 months for nonsurgery (95% CI, 5.33-6.47; 891 participants; 12 studies), and 5.96 months for mixed (95% CI, 5.67-6.43; 1,984 participants; 18 studies). Patients enrolled since 2010 showed the highest survival rates. CONCLUSION This study provides the first large-scale data for lung cancer with spinal metastasis that allows survival benchmarking. Data from patients enrolled since 2010 had the best survival and thus may more accurately reflect current survival. Researchers should focus on this subset in future benchmarking and remain optimistic in the management of these patients.
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Affiliation(s)
- Fon-Yih Tsuang
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
- Spine Tumor Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Jin Pyeong Jeon
- Department of Neurosurgery, Hallym University College of Medicine, Chuncheon, Korea
| | - An-Ping Huang
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
- Spine Tumor Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Chung Liang Chai
- Department of Neurosurgery, Yee Zen General Hospital, Taoyuan, Taiwan
- School of Health Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
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Becco Neto E, Chaves de Almeida Bastos D, Telles JPM, Figueiredo EG, Teixeira MJ, de Assis de Souza Filho F, Prabhu S. Predictors of Survival After Stereotactic Radiosurgery for Untreated Single Non-Small Cell Lung Cancer Brain Metastases: 5- and 10-year Results. World Neurosurg 2023; 172:e447-e452. [PMID: 36682534 DOI: 10.1016/j.wneu.2023.01.049] [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: 01/08/2023] [Accepted: 01/15/2023] [Indexed: 01/21/2023]
Abstract
BACKGROUND Stereotactic radiosurgery (SRS) presents as a good treatment option for smaller, deep-seated brain metastases (BMs). This study aims to determine predictors of SRS failure for patients with non-small cell lung cancer BMs. METHODS This was a retrospective study of single non-small cell lung cancer BMs treated using SRS. We included patients >18 years with a single, previously untreated lesion. Primary outcome was treatment failure, defined as BMs dimension increase above the initial values. Demographic, clinical, and radiological data were collected to study potential predictors of treatment failure. RESULTS Worse rates of progression-free survival (PFS) were associated with heterogeneous contrast enhancement (18.1 ± 4.1 vs. 41.9 ± 4 months; P < 0.001). Better rates of PFS were associated with volumes <1.06 cm3 (log-rank; P = 0.001). Graded prognostic assessment was significantly associated with survival at 120 months (log-rank; P < 0.001). Karnofsky Performance Scale was evaluated in 3 strata: 90-100, 80, and ≤70. Mean survival rates for these strata were 31.8 ± 3.9, 10.6 ± 2.2, and 9.8 ± 2.3 months, respectively (log-rank; P < 0.001). There were no differences regarding presence of extracranial metastases, age, or lesion location. A multivariable logistic regression found that volume <1.06 cm3 was associated with higher survival rates at 10 years (odds ratio: 3.2, 95% confidence interval: 1.3-8.0). CONCLUSIONS Contrast-homogeneous metastases and lesions <1.06 cm3 are associated with better rates of PFS. Karnofsky Performance Scale and graded prognostic assessment were associated with more favorable survival rates after 10 years. Volume <1.06 cm3 was the only significant predictor of survival in the multivariable analysis.
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Affiliation(s)
- Eliseu Becco Neto
- Division of Neurosurgery, Department of Neurology, University of São Paulo, São Paulo, São Paulo, Brazil
| | | | - João Paulo Mota Telles
- Division of Neurosurgery, Department of Neurology, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Eberval Gadelha Figueiredo
- Division of Neurosurgery, Department of Neurology, University of São Paulo, São Paulo, São Paulo, Brazil.
| | - Manoel Jacobsen Teixeira
- Division of Neurosurgery, Department of Neurology, University of São Paulo, São Paulo, São Paulo, Brazil
| | | | - Sujit Prabhu
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Pluvy J, Zaccariotto A, Habert P, Bermudez J, Mogenet A, Gaubert JY, Tomasini P, Padovani L, Greillier L. Stereotactic body radiation therapy (SBRT) as salvage treatment for early stage lung cancer with interstitial lung disease (ILD): An observational and exploratory case series of non-asian patients. Respir Med Res 2022; 83:100984. [PMID: 36634555 DOI: 10.1016/j.resmer.2022.100984] [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: 05/06/2022] [Revised: 07/26/2022] [Accepted: 11/27/2022] [Indexed: 12/13/2022]
Abstract
Interstitial lung disease (ILD) can coexist with early-stage lung cancer (LC) and may compromise surgery and worsen patients' outcomes. Stereotactic body radiation therapy (SBRT) is the gold standard treatment for medically inoperable early-stage lung cancer, but radiation therapy is contra-indicated for patients with ILD because of the higher risk of severe radiation-induced pneumonitis. SBRT may spare healthy lung tissue, but data are scarce in this rare population. Our exploratory case series aimed to retrospectively identify patients treated with SBRT in this setting: 19 patients were diagnosed with early-stage LC-ILD over the past 6 years and 9 received SBRT. Most of them were smokers with a median age of 71, 4 had no pathological documentation. After SBRT, 5 patients had grade I-II respiratory adverse events (AEs), but none had treatment-related grade III-IV respiratory AEs. Two patients died within 6 months of SBRT, and for both, death was related to metastatic relapse. In this case series, the radiological evolution of ILD before radiotherapy and the evolution of the radiotherapy scar on CT-Scan were also explored with different evolutionary models. This exploratory study shows available data that could be studied in a larger retrospective cohort to identify risk factors for SBRT in the LC-ILD population. The use of dosimetric data as a risk factor for SBRT should be done with cautiousness due to heterogeneous and complex dose delivery and different fractionation schedule.
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Affiliation(s)
- J Pluvy
- Department of Multidisciplinary Oncology and Therapeutic Innovations Assistance Publique Hôpitaux de Marseille AP-HM, Hôpital Nord, Marseille, France.
| | - A Zaccariotto
- Department of Radiation Oncology, Assistance Publique Hôpitaux de Marseille AP-HM, Marseille, France
| | - P Habert
- Radiology Department, Hôpital Nord, AP-HM, Aix Marseille Univ, LIIE, CERIMED, Marseille, France
| | - J Bermudez
- Department of Respiratory Medicine and Lung Transplantation, Assistance Publique - Hôpitaux de Marseille APHM, Hôpital Nord, Marseille, Aix -Marseille University, France
| | - A Mogenet
- Department of Multidisciplinary Oncology and Therapeutic Innovations Assistance Publique Hôpitaux de Marseille AP-HM, Hôpital Nord, Aix Marseille University, Marseille, France
| | - J Y Gaubert
- Radiology Department, Hôpital Nord, Assistance Publique Hôpitaux de Marseille AP-HM, Marseille, France
| | - P Tomasini
- Department of Multidisciplinary Oncology and Therapeutic Innovations, Assistance Publique Hôpitaux de Marseille AP-HM, Aix Marseille University, Marseille, France; Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm UMR1068, CNRS UMR7258, Marseille, France
| | - L Padovani
- Department of Radiation Oncology, Assistance Publique Hôpitaux de Marseille AP-HM, Marseille, France
| | - L Greillier
- Multidisciplinary Oncology and Therapeutic Innovations Department, Aix Marseille University, APHM, INSERM, CNRS, CRCM, Hôpital Nord, Marseille, France
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Sugawara S, Kondo M, Yokoyama T, Kumagai T, Nishio M, Goto K, Nakagawa K, Seto T, Yamamoto N, Kudou K, Asato T, Zhang P, Ohe Y. Brigatinib in Japanese patients with tyrosine kinase inhibitor-naive ALK-positive non-small cell lung cancer: first results from the phase 2 J-ALTA study. Int J Clin Oncol 2022; 27:1828-1838. [PMID: 36036294 PMCID: PMC9700635 DOI: 10.1007/s10147-022-02232-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/03/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND We evaluated the safety and efficacy of the anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitor (TKI) brigatinib in Japanese patients with TKI-naive ALK-positive non-small cell lung cancer (NSCLC) from the phase 2, open-label, single-arm, multicenter J-ALTA study. METHODS In the TKI-naive cohort of J-ALTA, the primary end point was independent review committee (IRC)-assessed 12-month progression-free survival (PFS). Secondary end points included objective response rate (ORR), intracranial response, overall survival (OS), and safety. RESULTS The data were cut approximately 12 months after last patient enrollment. Thirty-two patients with ALK TKI-naive ALK-positive NSCLC were enrolled (median age [range], 60.5 [29-85] years; median duration of follow-up, 14.2 [3.2-19.3] months; median treatment duration, 13.8 [0.4-19.3] months). IRC-assessed 12-month PFS was 93.0% (90% confidence interval (CI) 79.2-97.8%); ORR, 96.9% (95% CI 83.8-99.9%), 12-month OS, 96.9% (95% CI 79.8-99.6%), and median OS was not reached. Of five patients with measurable baseline CNS metastases, two had partial intracranial response. The most common treatment-emergent adverse events were increased blood creatine phosphokinase (81%), hypertension (59%), and diarrhea (47%). Grade ≥ 3 adverse events occurred in 91% of patients; pneumonitis was reported in 3 (9%) patients. CONCLUSIONS In the J-ALTA TKI-naive cohort, brigatinib demonstrated clinically meaningful efficacy consistent with the international phase 3 study. The safety profile in Japanese patients was consistent with previous studies. Brigatinib is an important first-line option for Japanese patients with ALK-positive NSCLC. CLINICAL REGISTRATION NCT03410108.
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Affiliation(s)
- Shunichi Sugawara
- grid.415501.4Department of Pulmonary Medicine, Sendai Kousei Hospital, Miyagi, Japan
| | - Masashi Kondo
- grid.256115.40000 0004 1761 798XDepartment of Respiratory Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - Toshihide Yokoyama
- grid.415565.60000 0001 0688 6269Department of Respiratory Medicine, Kurashiki Central Hospital, Kurashiki, Japan
| | - Toru Kumagai
- grid.489169.b0000 0004 8511 4444Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Makoto Nishio
- grid.410807.a0000 0001 0037 4131Department of Thoracic Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Koichi Goto
- grid.497282.2Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Kazuhiko Nakagawa
- grid.258622.90000 0004 1936 9967Department of Medical Oncology, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan
| | - Takashi Seto
- grid.470350.50000 0004 1774 2334Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Nobuyuki Yamamoto
- grid.412857.d0000 0004 1763 1087Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Kentarou Kudou
- grid.419841.10000 0001 0673 6017Biostatistics, Japan Development Center, Takeda Pharmaceutical Company Limited, Osaka, Japan
| | - Takayuki Asato
- grid.419841.10000 0001 0673 6017Oncology Clinical Research Department, Oncology Therapeutic Area Unit for Japan and Asia, Takeda Pharmaceutical Company Limited, Osaka, Japan
| | - Pingkuan Zhang
- grid.419849.90000 0004 0447 7762Takeda Development Center Americas, Inc., Lexington, MA USA
| | - Yuichiro Ohe
- grid.272242.30000 0001 2168 5385Department of Thoracic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji Chuo-ku, Tokyo, 104-0045 Japan
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Kim MS, Kim SH, Yang SH, Kim MS. Afatinib mediates autophagic degradation of ORAI1, STIM1, and SERCA2, which inhibits proliferation of non-small cell lung cancer cells. Tuberc Respir Dis (Seoul) 2021; 85:147-154. [PMID: 34847639 PMCID: PMC8987670 DOI: 10.4046/trd.2021.0095] [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: 07/06/2021] [Accepted: 10/24/2021] [Indexed: 11/24/2022] Open
Abstract
Background The expression of calcium signaling pathway molecules is altered in various carcinomas, which are related to the proliferation and altered characteristics of cancer cells. However, changes in calcium signaling in anti-cancer drug-resistant cells (bearing a T790M mutation in epidermal growth factor receptor [EGFR]) remain unclear. Methods Afatinib-mediated changes in the level of store-operated Ca2+ entry (SOCE)-related proteins and intracellular Ca2+ level in non–small cell lung cancer cells with T790M mutation in the EGFR gene were analyzed using western blot and ratiometric assays, respectively. Afatinib-mediated autophagic flux was evaluated by measuring the cleavage of LC3B-II. Flow cytometry and cell proliferation assays were conducted to assess cell apoptosis and proliferation. Results The levels of SOCE-mediating proteins (ORAI calcium release-activated calcium modulator 1 [ORAI1], stromal interaction molecule 1 [STIM1], and sarco/endoplasmic reticulum Ca2+ ATPase [SERCA2]) decreased after afatinib treatment in non–small cell lung cancer cells, whereas the levels of SOCE-related proteins did not change in gefitinibresistant non–small cell lung cancer cells (PC-9/GR; bearing a T790M mutation in EGFR). Notably, the expression level of SOCE-related proteins in PC-9/GR cells was reduced also responding to afatinib in the absence of extracellular Ca2+. Moreover, extracellular Ca2+ influx through the SOCE was significantly reduced in PC-9 cells pre-treated with afatinib than in the control group. Additionally, afatinib was found to decrease the level of SOCE-related proteins through autophagic degradation, and the proliferation of PC-9GR cells was significantly inhibited by a lack of extracellular Ca2+. Conclusion Extracellular Ca2+ plays important role in afatinib-mediated autophagic degradation of SOCE-related proteins in cells with T790M mutation in the EGFR gene and extracellular Ca2+ is essential for determining anti-cancer drug efficacy.
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Affiliation(s)
- Mi Seong Kim
- Department of Oral Physiology, Institute of Biomaterial-Implant, School of Dentistry, Wonkwang University, Iksan, Republic of Korea.,Wonkwang Dental Research Institute, School of Dentistry, Wonkwang University, Iksan, Republic of Korea
| | - So Hui Kim
- Department of Carbon Convergence Engineering, College of Engineering, Wonkwang University, Iksan, Republic of Korea
| | - Sei-Hoon Yang
- Department of Internal Medicine, School of Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Min Seuk Kim
- Department of Oral Physiology, Institute of Biomaterial-Implant, School of Dentistry, Wonkwang University, Iksan, Republic of Korea
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Yilmaz TF, Yurtsever İ, Turk HM, Gultekin MA, Besiroglu M, Cesme DH, Shbair ATM, Alkan A. Relationship with programmed cell death ligand 1 (PD-L1) and DTI features in brain metastases of non-small cell lung cancer; Preliminary study. Curr Med Imaging 2021; 17:1369-1373. [PMID: 33602100 DOI: 10.2174/1573405617666210218095953] [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: 10/07/2020] [Revised: 01/05/2021] [Accepted: 01/11/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The purpose of the study was to determine DTI properties of brain metastases in subjects with non-small cell lung carcinoma (NSCLC), to evaluate whether there was a correlation between DTI findings and programmed cell death ligand-1 (PD-L1). METHODS The study population (n:22) was assigned to PD-L1 negative (Group 1: PD-L1 expression<%50) (n=11) or positive (Group 2: PD-L1 expression ≥%50) (n=11). We compared ADC and FA values measured from the enhanced solid metastases and peritumoral edema area with PD-L1 protein status. RESULTS The mean ADC values were lower in group 2 compared to group 1. The peritumoral ADC values were higher in group 2 compared to group 1. Mean peritumoral edema FA values are lower in group 2 compared to group 1. The peritumoral edema nADC values were higher in group 2 compared to group 1. As PD-L1 expression frequency increased, ADC values in the peritumoral edema area increased and FA values decreased. CONCLUSIONS We thought that the existence of PD-L1 protein doesn't affect ADC and FA values of brain metastasis (BM) originating from NSCLC. DTI characteristics of the peritumoral edema area could be a guide in determining PD-L1 protein status of brain metastases of NSCLC. The relationship between PD-L1 expression status and DTI features in BM from NSCLC could help us to have an idea in response to immunotherapy.
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Affiliation(s)
- Temel Fatih Yilmaz
- Departments of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul. Turkey
| | - İsmail Yurtsever
- Departments of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul. Turkey
| | - Hacı Mehmet Turk
- Departments of Medical Oncology, Faculty of Medicine, Bezmialem Vakif University, Istanbul. Turkey
| | - Mehmet Ali Gultekin
- Departments of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul. Turkey
| | - Mehmet Besiroglu
- Departments of Medical Oncology, Faculty of Medicine, Bezmialem Vakif University, Istanbul. Turkey
| | - Dilek Hacer Cesme
- Departments of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul. Turkey
| | - Abdallah T M Shbair
- Departments of Medical Oncology, Faculty of Medicine, Bezmialem Vakif University, Istanbul. Turkey
| | - Alpay Alkan
- Departments of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul. Turkey
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Reck M, Syrigos K, Miliauskas S, Zöchbauer-Müller S, Fischer JR, Buchner H, Kitzing T, Kaiser R, Radonjic D, Kerr K. Non-interventional LUME-BioNIS study of nintedanib plus docetaxel after chemotherapy in adenocarcinoma non-small cell lung cancer: A subgroup analysis in patients with prior immunotherapy. Lung Cancer 2020; 148:159-165. [PMID: 32927350 DOI: 10.1016/j.lungcan.2020.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 06/04/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To evaluate the effectiveness and safety of nintedanib plus docetaxel in patients with advanced adenocarcinoma non-small cell lung cancer (NSCLC) previously treated with both chemo- and immunotherapy. MATERIALS AND METHODS LUME-BioNIS is a European, prospective, multicenter, non-interventional study of patients with advanced adenocarcinoma NSCLC, who initiated nintedanib plus docetaxel after first-line chemotherapy in routine practice according to the approved nintedanib EU label. The primary objective is to explore whether molecular biomarkers can predict overall survival (OS). Information on clinical or radiologic progression and death, and adverse drug reactions (ADRs)/fatal adverse events (AEs) was collected during follow-up. Here, we report a subgroup analysis evaluating outcomes in immunotherapy-pretreated patients. RESULTS Of 260 enrolled patients, 67 (25.8%) had prior immunotherapy and were included in this subgroup analysis. Prior immunotherapy was administered in first-line in 20 patients (29.9%; combined with chemotherapy in 4 patients [6.0%]) and later-lines in 47 patients (70.1%), and most commonly comprised nivolumab (39 patients; 58.2%), atezolizumab (14 patients; 20.9%) and pembrolizumab (11 patients; 16.4%). Nintedanib plus docetaxel was given in second-line in 10 patients (14.9%) and in later-lines in 57 patients (85.1%). Median OS was 8.8 months (95% confidence interval [CI]: 7.0-11.5) and median progression-free survival (PFS) was 4.6 months (95% CI: 3.5-5.7). Among 55 patients with available data, rates of objective response and disease control were 18.2% and 78.2%, respectively. In 65 patients evaluable for safety, the most common on-treatment ADRs/AEs were malignant neoplasm progression (19 patients; 29.2%), diarrhea (21 patients; 32.3%) and nausea (10 patients; 15.4%). CONCLUSIONS Used according to the approved nintedanib label in routine practice, nintedanib plus docetaxel demonstrated clinical effectiveness, with no unexpected safety findings, in patients with prior chemotherapy and first- or later-line immunotherapy. These data add to the real-world evidence that can inform clinical decisions in the changing therapeutic landscape.
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Affiliation(s)
- Martin Reck
- Lung Clinic Grosshansdorf, Airway Research Center North (ARCN), German Center of Lung Research (DZL), Wöhrendamm 80, 22927, Grosshansdorf, Germany.
| | - Kostas Syrigos
- National and Kapodistrian University of Athens, Sotiria General Hospital, Mesogion 152, Athens 115 27, Greece.
| | - Skaidrius Miliauskas
- Lithuanian University of Health Sciences, Department of Pulmonology, Medical Academy, Kaunas, A. Mickevičiaus g. 9, Kaunas 44307, Lithuania.
| | - Sabine Zöchbauer-Müller
- Medical University of Vienna, Department of Medicine I, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Jürgen R Fischer
- Department of Oncology, Lungenklinik Löwenstein, D-74245 Löwenstein, Germany.
| | | | - Thomas Kitzing
- Translational Medicine and Clinical Pharmacology, Boehringer Ingelheim Pharma GmbH & Co. KG, Binger Straße 173 D-55216 Ingelheim am Rhein, Germany.
| | - Rolf Kaiser
- Boehringer Ingelheim Pharma GmbH & Co. KG, Binger Straße 173 D-55216 Ingelheim am Rhein, Institute of Pharmacology, Johannes Gutenberg-University Mainz, Saarstraße 21, 55122 Mainz, Germany.
| | - Dejan Radonjic
- Boehringer Ingelheim International GmbH, Binger Straße 173 D-55216 Ingelheim am Rhein, Germany.
| | - Keith Kerr
- Department of Pathology, Aberdeen Royal Infirmary, Foresterhill Rd, Aberdeen AB25 2ZN, United Kingdom.
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Debieuvre D, Moreau L, Coudert M, Locher C, Asselain B, Coëtmeur D, Dayen C, Goupil F, Martin F, Brun P, De Faverges G, Hauss PA, Gally S, Ben Hadj Yahia B, Grivaux M. [Second- or third-line treatment with erlotinib in EGFR wild-type non-small cell lung cancer: Real-life data]. Rev Mal Respir 2019; 36:649-663. [PMID: 31204231 DOI: 10.1016/j.rmr.2019.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 03/16/2019] [Indexed: 01/29/2023]
Abstract
INTRODUCTION The benefit of tyrosine kinase inhibitors for patients with an EGFR wild-type non-small cell lung cancer (NSCLC) remains controversial. METHODS The survival of patients with an EGFR wild-type NSCLC who received second- or third-line erlotinib treatment was assessed using real-life data that had been collected in a prospective, national, multicenter, non-interventional cohort study. RESULTS Data from 274 patients were analysed, 185 (68%) treated with erlotinib and 89 (32%) treated with supportive care only. The median overall survival was 4.2months (95% CI [3.5; 5.4]) with erlotinib, and 1.3months (95% CI [1.0; 1.8]) with supportive care. Survival rate at 3, 6, and 12months was 62%, 37%, and 17%, respectively, with erlotinib, versus 20%, 8%, et 3%, with exclusive supportive care. Significant predictive factors for longer overall survival were the presence of adenocarcinoma, and use of 1st line chemotherapy including either taxanes, pemetrexed or vinorelbine (P<0.05). CONCLUSION Erlotinib remains a valuable therapeutic option to treat inoperable locally advanced or metastatic NSCLC after failure of at least one prior chemotherapy regimen in fragile patients who are not eligible for chemotherapy.
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Affiliation(s)
- D Debieuvre
- Service de pneumologie, GHRMSA-hôpital Émile-Muller, 20, rue du Dr-Laënnec, BP 1370, 68070 Mulhouse cedex, France.
| | - L Moreau
- Service de pneumologie, hôpitaux civils de Colmar, 68000 Colmar, France
| | - M Coudert
- Roche France SAS, direction médicale, 92100 Boulogne-Billancourt, France
| | - C Locher
- Service de pneumologie, centre hospitalier de Meaux, 77100 Meaux, France
| | - B Asselain
- IR4M-UMR8081 CNRS, université Paris Saclay, 91400 Paris, France
| | - D Coëtmeur
- Service de pneumologie et oncologie thoracique, centre hospitalier de Saint-Brieuc, 22000 Saint-Brieuc, France
| | - C Dayen
- Service de pneumologie, centre hospitalier de Saint-Quentin, 02100 Saint-Quentin, France
| | - F Goupil
- Service de maladies respiratoires, centre hospitalier du Mans, 72000 Le Mans, France
| | - F Martin
- Hôpital de Chantilly-Les-Jockeys, centre du sommeil, 60500 Chantilly, France
| | - P Brun
- Service de pneumologie-infectiologie, centre hospitalier de Valence, 26000 Valence, France
| | - G De Faverges
- Service de pneumologie, centre hospitalier de l'agglomération de Nevers, 58000 Nevers, France
| | - P-A Hauss
- Service de pneumologie, centre hospitalier intercommunal Elbeuf-Louviers, 76500 Elbeuf, France
| | - S Gally
- Roche France SAS, direction médicale, 92100 Boulogne-Billancourt, France
| | - B Ben Hadj Yahia
- Roche France SAS, direction médicale, 92100 Boulogne-Billancourt, France
| | - M Grivaux
- Service de pneumologie, centre hospitalier de Meaux, 77100 Meaux, France
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10
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Tao X, Yuan C, Zheng D, Ye T, Pan Y, Zhang Y, Xiang J, Hu H, Chen H, Sun Y. Outcomes comparison between neoadjuvant chemotherapy and adjuvant chemotherapy in stage IIIA non-small cell lung cancer patients. J Thorac Dis 2019; 11:1443-1455. [PMID: 31179087 DOI: 10.21037/jtd.2019.03.42] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background A neoadjuvant chemotherapy (NCT) is a feasible second-option other than an adjuvant chemotherapy (ACT); however, no definite conclusions have been drawn about whether or not a NCT is associated with better clinical outcomes for IIIA non-small cell lung cancer (NSCLC) patients. Methods We reviewed 68 clinical IIIA NSCLC patients who received preoperative chemotherapy (NCT group), and 535 pathological IIIA NSCLC patients who received ACT after surgery (ACT group). After a 1:1 propensity score matching (PSM), we compared the relapse-free survival (RFS) and overall survival (OS) rates as the long-term clinical outcomes, and hospital stay, surgery duration, postoperative complications as the short-term clinical outcomes. To evaluate the predictive value of the NCT response, we also assessed the response evaluation criteria in solid tumors (RECIST) response to NCT. Results There was no significant difference in RFS or OS between the NCT group and ACT group (RFS: P=0.1138; OS: P=0.4234). On multivariate analysis, large cell lung carcinoma (P=0.0264), bilobectomy (P=0.0039) and clinical N2 stage (P=0.0309) were independent predictive factors of a worse OS. Short-term clinical outcomes including the hospital stay and postoperative complications had no statistically distinct difference between the ACT and NCT groups. Meanwhile, the OS of the partial response (PR) patients group was better than the stable disease/progressive disease (SD/PD) (P=0.0205) and ACT (P=0.0442) group, but none of the clinical features we tested was found to be a predictive factor for a PR response. Conclusions There was a non-significant difference between the long-term and short-term clinical outcomes of both NCT and ACT. The OS of PR patients was better than SD/PD and ACT, indicating that NCT response acts as a predictor for a higher long-term survival rate.
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Affiliation(s)
- Xiaoting Tao
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Chongze Yuan
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Difan Zheng
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Ting Ye
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Yunjian Pan
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Yawei Zhang
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Jiaqing Xiang
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Hong Hu
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Haiquan Chen
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Yihua Sun
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
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11
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Reck M, Brahmer J, Bennett B, Taylor F, Penrod JR, DeRosa M, Dastani H, Spigel DR, Gralla RJ. Evaluation of health-related quality of life and symptoms in patients with advanced non-squamous non-small cell lung cancer treated with nivolumab or docetaxel in CheckMate 057. Eur J Cancer 2018; 102:23-30. [PMID: 30103096 DOI: 10.1016/j.ejca.2018.05.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [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: 01/30/2018] [Revised: 05/07/2018] [Accepted: 05/13/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Nivolumab, a programmed death-1 inhibitor, prolonged overall survival and had a favourable safety profile versus docetaxel in previously treated patients with advanced non-squamous non-small cell lung cancer (NSCLC) in the phase III CheckMate 057 trial. AIM To evaluate health-related quality of life (HRQoL) using patient-reported outcomes. METHODS Disease-related symptoms and general health status were assessed using two validated patient-reported instruments, the Lung Cancer Symptom Scale (LCSS) and the European Quality of Life Five Dimensions (EQ-5D), respectively. The proportion of patients with disease-related symptom improvement at 12 weeks on the LCSS average symptom burden index (ASBI) was a secondary end-point. LCSS 3-item global index (3-IGI), EQ-5D utility index and EQ-5D visual analogue scale (VAS) scores were also determined. Mixed-effects model repeated measures (MMRM) and time to first deterioration analyses assessed longitudinal changes. RESULTS Mean baseline LCSS ASBI scores were similar in both arms. By week 12, rates of disease-related improvement (95% confidence interval) were similar between nivolumab (17.8% [13.6-22.7]) and docetaxel (19.7% [15.2-24.7]); however, numerical differences in LCSS ASBI mean change from baseline favoured nivolumab. Subsequently, LCSS ASBI scores improved with nivolumab and worsened with docetaxel, with statistically significant between-arm differences at weeks 12, 24, 30 and 42. HRQoL improvements with nivolumab versus docetaxel were also supported by the LCSS 3-IGI, EQ-5D VAS and MMRM analysis. Time to first HRQoL deterioration was longer with nivolumab than with docetaxel. CONCLUSION Nivolumab improved disease-related symptoms and overall health status versus docetaxel for second-line treatment of advanced non-squamous NSCLC. CLINICAL TRIAL REGISTRATION NCT01673867.
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Affiliation(s)
- Martin Reck
- Thoracic Oncology, Lung Clinic Grosshansdorf, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Wöhrendamm 80, 22927, Grosshansdorf, Germany.
| | - Julie Brahmer
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 1650 Orleans St, CRB 440, Baltimore, MD, 21231, USA
| | - Bryan Bennett
- Adelphi Values, Adelphi Mill, Grimshaw Ln, Bollington, Cheshire, SK10 5JB, UK
| | - Fiona Taylor
- Adelphi Values, 290 Congress Street 7th Floor, Boston, MA, 02210, USA
| | - John R Penrod
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrenceville, NJ, 08648, USA
| | - Michael DeRosa
- Adelphi Values, 290 Congress Street 7th Floor, Boston, MA, 02210, USA
| | - Homa Dastani
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrenceville, NJ, 08648, USA
| | - David R Spigel
- Sarah Cannon Research Institute/Tennessee Oncology, PLLC, 250 25th Ave North, Suite 100, Nashville, TN, 37203, USA
| | - Richard J Gralla
- Albert Einstein College of Medicine, 1400 Pelham Parkway South Building 1, Room 3N20, Bronx, NY, 10461, USA
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12
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Demuth C, Madsen AT, Weber B, Wu L, Meldgaard P, Sorensen BS. The T790M resistance mutation in EGFR is only found in cfDNA from erlotinib-treated NSCLC patients that harbored an activating EGFR mutation before treatment. BMC Cancer 2018; 18:191. [PMID: 29448920 PMCID: PMC5815238 DOI: 10.1186/s12885-018-4108-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 09/01/2016] [Accepted: 02/08/2018] [Indexed: 01/29/2023] Open
Abstract
Background Lung cancer patients with an activating mutation in the EGFR (epidermal growth factor receptor) can develop resistance to erlotinib treatment, which is often mediated by the T790M resistance mutation in EGFR. The difficulties in obtaining biopsies at progression make it challenging to investigate the appearance of the T790M mutation at progression in large patient cohorts. We have used cell free DNA (cfDNA) from patients treated with erlotinib to investigate if the development of a T790M mutation coincides with the presence of an activating EGFR mutation in the pre-treatment blood sample. Methods A cohort of 227 NSCLC (non-small cell lung cancer) adenocarcinoma patients was treated with erlotinib irrespective of EGFR-mutational status. Blood samples were drawn immediately before erlotinib treatment was initiated and again at progression. The cobas® EGFR Mutation Test v2 designed for cfDNA was used to identify 42 EGFR mutations. Results Of the 227 NSCLC patients, blood samples were available from 144 patients both before erlotinib treatment and at progression (within 1 month before or after clinical progression). One hundred and twenty-eight of the 144 were wild-type EGFR before treatment, and we demonstrate that the T790M mutation was not present at progression in any of these. In contrast, in the 16 patients with an activating EGFR mutation in the pre-treatment blood sample six patients (38%) were identified with a T790M mutation in the progression blood sample. Conclusion The T790M resistance mutation is only found in the cfDNA of erlotinib-treated NSCLC patients if they have an activating EGFR mutation before treatment. Electronic supplementary material The online version of this article (10.1186/s12885-018-4108-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Christina Demuth
- Department of Clinical Biochemistry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
| | - Anne Tranberg Madsen
- Department of Clinical Biochemistry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Britta Weber
- Department of Oncology, Aarhus University Hospital, Norrebrogade 44 bld. 5, 8000, Aarhus C, Denmark
| | - Lin Wu
- Roche Molecular Solutions, Pleasanton, CA, 94588, USA
| | - Peter Meldgaard
- Department of Oncology, Aarhus University Hospital, Norrebrogade 44 bld. 5, 8000, Aarhus C, Denmark
| | - Boe Sandahl Sorensen
- Department of Clinical Biochemistry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
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13
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Abstract
INTRODUCTION Characteristics of never-smokers with lung cancer are still not fully clarified. The aim of this study was to compare never-smokers and ever-smokers with non-small cell lung cancer (NSCLC) regarding patient and tumor characteristics. METHODS All consecutive newly NSCLC patients with known smoking status diagnosed between 2011 and 2015 were included in this retrospective cohort study. Clinical, histological, and molecular characteristics were compared between ever-smokers and never-smokers. RESULTS Of the 558 included patients, 125 (22.4%) were never-smokers. These patients were more likely to be female (74% vs. 7%, p < .001), older (67 vs. 66 years-old, p = .019), and have adenocarcinoma (93% vs. 65%, p < .001). Never-smokers took longer to seek medical care after the symptoms onset (3 vs. 2 months, p < .001), regardless of the symptoms, histological type, or gender (OR: 1.2 [1.4-2.0]). The metastatic pattern was different in never-smokers: pleural metastases were more frequent (OR: 2.1 [1.1-4.0]), regardless of the histological type and gender. Never-smokers had a higher prevalence of ALK translocations (26% vs. 4%, p < .001) and EGFR mutations (36% vs. 8%, p < .001). The type of EGFR mutation was also significantly different between groups. CONCLUSIONS Never-smokers with NSCLC present distinct demographic and clinical characteristics. The characteristics of tumor also differ between never-smokers and ever-smokers, which may suggest different carcinogenic pathways.
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Affiliation(s)
- Margarida Dias
- Pulmonology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Rita Linhas
- Pulmonology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Sérgio Campainha
- Pulmonology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Sara Conde
- Pulmonology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Ana Barroso
- Pulmonology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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14
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Saxena A, Schneider BJ, Christos PJ, Audibert LF, Cagney JM, Scheff RJ. Treatment of recurrent and platinum-refractory stage IV non-small cell lung cancer with nanoparticle albumin-bound paclitaxel (nab-paclitaxel) as a single agent. Med Oncol 2016; 33:13. [PMID: 26749586 DOI: 10.1007/s12032-015-0728-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 12/14/2015] [Accepted: 12/31/2015] [Indexed: 01/23/2023]
Abstract
The role of single-agent nab-paclitaxel in relapsed or platinum-refractory advanced non-small cell lung cancer (NSCLC) has not been well reported in Western populations. We reviewed our own institution's experience using nab-paclitaxel in these settings. We analyzed the records of stage IV NSCLC patients with relapsed or platinum-refractory disease treated with single-agent nab-paclitaxel at Weill Cornell Medical College between October 2008 and December 2013. The primary endpoint of the study was treatment failure-free survival (TFFS), defined as the time from the start of nab-paclitaxel therapy to discontinuation of the drug for any reason. The best overall response was recorded for each patient, and overall response and disease control rates were calculated. Thirty-one stage IV NSCLC patients received a median of 4 cycles (range 1-40) of nab-paclitaxel. Dose reduction or drug discontinuation due to toxicity occurred in 10 patients, mainly because of grade 2/3 fatigue or peripheral neuropathy. The overall response rate was 16.1 %, and the disease control rate was 64.5 %. Median TFFS was 3.5 months (95 % CI 1.3-5.3 months). No statistically significant difference in TFFS based on line of therapy or prior taxane exposure was identified. There was a statistically significant decrease in TFFS for patients with non-adenocarcinoma histology, although there were only five patients in this group. There was a trend toward reduction in the risk of treatment failure with increasing age. One patient remained on nab-paclitaxel therapy for over 3 years. Single-agent nab-paclitaxel was well tolerated and demonstrated efficacy in advanced NSCLC patients with relapsed or platinum-refractory disease. Further prospective clinical trials with nab-paclitaxel in these settings are warranted.
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Affiliation(s)
- Ashish Saxena
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, 1305 York Avenue, 7th Floor, New York, NY, 10021, USA.
| | - Bryan J Schneider
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, 1305 York Avenue, 7th Floor, New York, NY, 10021, USA.,Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan Health System, Cancer Center Floor B1, Reception C, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Paul J Christos
- Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, Weill Cornell Medicine, 402 East 67th Street, New York, NY, 10065, USA
| | - Lauren F Audibert
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, 1305 York Avenue, 7th Floor, New York, NY, 10021, USA.,Pulmonary and Sleep Medicine, The Mount Sinai Hospital, 5 East 98th St, 8th Floor, New York, NY, 10029, USA
| | - Jennifer M Cagney
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, 1305 York Avenue, 7th Floor, New York, NY, 10021, USA.,Breast Cancer Medicine Service, Breast and Imaging Center, Memorial Sloan Kettering Cancer Center, 300 East 66th St, New York, NY, 10065, USA
| | - Ronald J Scheff
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, 1305 York Avenue, 7th Floor, New York, NY, 10021, USA
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15
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Fraser SP, Hemsley F, Djamgoz MBA. Caffeic acid phenethyl ester: Inhibition of metastatic cell behaviours via voltage-gated sodium channel in human breast cancer in vitro. Int J Biochem Cell Biol 2015; 71:111-118. [PMID: 26724521 DOI: 10.1016/j.biocel.2015.12.012] [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: 08/18/2015] [Revised: 12/09/2015] [Accepted: 12/21/2015] [Indexed: 11/28/2022]
Abstract
Caffeic acid phenethyl ester, derived from natural propolis, has been reported to have anti-cancer properties. Voltage-gated sodium channels are upregulated in many cancers where they promote metastatic cell behaviours, including invasiveness. We found that micromolar concentrations of caffeic acid phenethyl ester blocked voltage-gated sodium channel activity in several invasive cell lines from different cancers, including breast (MDA-MB-231 and MDA-MB-468), colon (SW620) and non-small cell lung cancer (H460). In the MDA-MB-231 cell line, which was adopted as a 'model', long-term (48 h) treatment with 18 μM caffeic acid phenethyl ester reduced the peak current density by 91% and shifted steady-state inactivation to more hyperpolarized potentials and slowed recovery from inactivation. The effects of long-term treatment were also dose-dependent, 1 μM caffeic acid phenethyl ester reducing current density by only 65%. The effects of caffeic acid phenethyl ester on metastatic cell behaviours were tested on the MDA-MB-231 cell line at a working concentration (1 μM) that did not affect proliferative activity. Lateral motility and Matrigel invasion were reduced by up to 14% and 51%, respectively. Co-treatment of caffeic acid phenethyl ester with tetrodotoxin suggested that the voltage-gated sodium channel inhibition played a significant intermediary role in these effects. We conclude, first, that caffeic acid phenethyl ester does possess anti-metastatic properties. Second, the voltage-gated sodium channels, commonly expressed in strongly metastatic cancers, are a novel target for caffeic acid phenethyl ester. Third, more generally, ion channel inhibition can be a significant mode of action of nutraceutical compounds.
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Affiliation(s)
- Scott P Fraser
- Imperial College London, Department of Life Sciences, Neuroscience Solutions to Cancer Research Group, South Kensington Campus, London SW7 2AZ, UK.
| | - Faye Hemsley
- Imperial College London, Department of Life Sciences, Neuroscience Solutions to Cancer Research Group, South Kensington Campus, London SW7 2AZ, UK
| | - Mustafa B A Djamgoz
- Imperial College London, Department of Life Sciences, Neuroscience Solutions to Cancer Research Group, South Kensington Campus, London SW7 2AZ, UK; Biotechnology Research Centre (BRC), Cyprus International University, Haspolat, Lefkosa, North Cyprus, Mersin 10, Turkey
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16
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Naderi S, Ghorra C, Haddad F, Kourie HR, Rassy M, El Karak F, Ghosn M, Abadjian G, Kattan J. EGFR mutation status in Middle Eastern patients with non-squamous non-small cell lung carcinoma: A single institution experience. Cancer Epidemiol 2015; 39:1099-102. [PMID: 26362141 DOI: 10.1016/j.canep.2015.08.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [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: 05/04/2015] [Revised: 08/01/2015] [Accepted: 08/27/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND Epidermal growth factor receptor (EGFR) represents an important molecular target in the treatment of lung adenocarcinomas; many anti-EGFR therapies are approved as first line and second-line treatment in patients having metastatic lung adenocarcinomas. The occurrence of this mutation varies in terms of race; it is around 10% in Caucasians and can reach 30% in Asians. Its prevalence in our Middle Eastern region is not well known. METHODS Patients diagnosed with non-squamous non-small cell lung carcinomas between March 2013 and March 2015 were included. This study was conducted at Hôtel-Dieu de France University Hospital, a tertiary medical center in Lebanon. EFGR mutations were analyzed using real time PCR technique on the Rotor-Gene Q using Scorpions and ARMS technologies. The following data was collected: the patients' characteristics (age, gender, smoking status, stage), the samples' characteristics (histology subtype, TTF-1 and Napsin A immunostainings, the site and the adequacy and the type of the sample), and the mutational EGFR status (presence and type of mutation). These variables were analyzed using SPSS 20. RESULTS 201 patients were included. The mean age was 65.2 years [31-87]; 40.2% were females. 78.1% of the included patients were smokers or ex-smokers. 12.9% of patients had a localized disease, 17.4% a locally advanced disease and 69.7% a metastatic disease. Adenocarcinoma was the main histologic subtype found in 90.5% of patients, followed by large cell carcinoma (3.5%), adenosquamous carcinoma (3.0%) and non-small cell carcinoma not otherwise specified (3.0%). 11.9% of patients had an EGFR mutation: 48% of them presented a deletion on exon 19, 40.0% a L858R mutation on exon 21, 4.0% a G719X mutation in exon 18, 4.0% an insertion in exon 20, and 4% a T790M mutation in exon 20. The presence of an EGFR mutation was significantly associated with the female gender (two-third) (p<0.05) and the non-smoking status (two-third) (p<0.05). CONCLUSIONS The prevalence of EGFR mutation (11.9%) detected in our Lebanese population is similar to that observed in the Caucasian population. This mutation is also significantly more frequent in females and non-smokers.
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Affiliation(s)
- Samah Naderi
- Pathology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Claude Ghorra
- Pathology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Fady Haddad
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Hampig Raphael Kourie
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Marc Rassy
- Pathology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.
| | - Fadi El Karak
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Marwan Ghosn
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Gérard Abadjian
- Pathology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Joseph Kattan
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
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17
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Levy BP, Chioda MD, Herndon D, Longshore JW, Mohamed M, Ou SHI, Reynolds C, Singh J, Wistuba II, Bunn PA, Hirsch FR. Molecular Testing for Treatment of Metastatic Non-Small Cell Lung Cancer: How to Implement Evidence-Based Recommendations. Oncologist 2015; 20:1175-81. [PMID: 26330460 DOI: 10.1634/theoncologist.2015-0114] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [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: 03/19/2015] [Accepted: 07/02/2015] [Indexed: 12/28/2022] Open
Abstract
The recent discovery of relevant biomarkers has reshaped our approach to therapy selection for patients with non-small cell lung cancer. The unprecedented outcomes demonstrated with tyrosine kinase inhibitors in molecularly defined cohorts of patients has underscored the importance of genetic profiling in this disease. Despite published guidelines on biomarker testing, successful tumor genotyping faces significant hurdles at both academic and community-based practices. Oncologists are now faced with interpreting large-scale genomic data from multiple tumor types, possibly making it difficult to stay current with practice standards in lung cancer. In addition, physicians' lack of time, resources, and face-to-face opportunities can interfere with the multidisciplinary approach that is essential to delivery of care. Finally, several challenges exist in optimizing the amount and quality of tissue for molecular testing. Recognizing the importance of biomarker testing, a series of advisory boards were recently convened to address these hurdles and clarify best practices. We reviewed these challenges and established recommendations to help optimize tissue acquisition, processing, and testing within the framework of a multidisciplinary approach.
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Affiliation(s)
- Benjamin P Levy
- Mount Sinai Health Systems, New York, New York, USA; Pfizer Oncology, New York, New York, USA; Cone Health Cancer Center, Greensboro, North Carolina, USA; Carolinas Pathology Group, Carolinas HealthCare System, Charlotte, North Carolina, USA; Chao Family Comprehensive Cancer Center, University of California at Irvine School of Medicine, Orange, California, USA; US Oncology Research, Ocala, Florida, USA; Carolinas HealthCare System, Charlotte, North Carolina, USA; The University of Texas MD Anderson Cancer Center, Houston, Texas, USA; University of Colorado Cancer Center, Aurora, Colorado, USA
| | - Marc D Chioda
- Mount Sinai Health Systems, New York, New York, USA; Pfizer Oncology, New York, New York, USA; Cone Health Cancer Center, Greensboro, North Carolina, USA; Carolinas Pathology Group, Carolinas HealthCare System, Charlotte, North Carolina, USA; Chao Family Comprehensive Cancer Center, University of California at Irvine School of Medicine, Orange, California, USA; US Oncology Research, Ocala, Florida, USA; Carolinas HealthCare System, Charlotte, North Carolina, USA; The University of Texas MD Anderson Cancer Center, Houston, Texas, USA; University of Colorado Cancer Center, Aurora, Colorado, USA
| | - Dana Herndon
- Mount Sinai Health Systems, New York, New York, USA; Pfizer Oncology, New York, New York, USA; Cone Health Cancer Center, Greensboro, North Carolina, USA; Carolinas Pathology Group, Carolinas HealthCare System, Charlotte, North Carolina, USA; Chao Family Comprehensive Cancer Center, University of California at Irvine School of Medicine, Orange, California, USA; US Oncology Research, Ocala, Florida, USA; Carolinas HealthCare System, Charlotte, North Carolina, USA; The University of Texas MD Anderson Cancer Center, Houston, Texas, USA; University of Colorado Cancer Center, Aurora, Colorado, USA
| | - John W Longshore
- Mount Sinai Health Systems, New York, New York, USA; Pfizer Oncology, New York, New York, USA; Cone Health Cancer Center, Greensboro, North Carolina, USA; Carolinas Pathology Group, Carolinas HealthCare System, Charlotte, North Carolina, USA; Chao Family Comprehensive Cancer Center, University of California at Irvine School of Medicine, Orange, California, USA; US Oncology Research, Ocala, Florida, USA; Carolinas HealthCare System, Charlotte, North Carolina, USA; The University of Texas MD Anderson Cancer Center, Houston, Texas, USA; University of Colorado Cancer Center, Aurora, Colorado, USA
| | - Mohamed Mohamed
- Mount Sinai Health Systems, New York, New York, USA; Pfizer Oncology, New York, New York, USA; Cone Health Cancer Center, Greensboro, North Carolina, USA; Carolinas Pathology Group, Carolinas HealthCare System, Charlotte, North Carolina, USA; Chao Family Comprehensive Cancer Center, University of California at Irvine School of Medicine, Orange, California, USA; US Oncology Research, Ocala, Florida, USA; Carolinas HealthCare System, Charlotte, North Carolina, USA; The University of Texas MD Anderson Cancer Center, Houston, Texas, USA; University of Colorado Cancer Center, Aurora, Colorado, USA
| | - Sai-Hong Ignatius Ou
- Mount Sinai Health Systems, New York, New York, USA; Pfizer Oncology, New York, New York, USA; Cone Health Cancer Center, Greensboro, North Carolina, USA; Carolinas Pathology Group, Carolinas HealthCare System, Charlotte, North Carolina, USA; Chao Family Comprehensive Cancer Center, University of California at Irvine School of Medicine, Orange, California, USA; US Oncology Research, Ocala, Florida, USA; Carolinas HealthCare System, Charlotte, North Carolina, USA; The University of Texas MD Anderson Cancer Center, Houston, Texas, USA; University of Colorado Cancer Center, Aurora, Colorado, USA
| | - Craig Reynolds
- Mount Sinai Health Systems, New York, New York, USA; Pfizer Oncology, New York, New York, USA; Cone Health Cancer Center, Greensboro, North Carolina, USA; Carolinas Pathology Group, Carolinas HealthCare System, Charlotte, North Carolina, USA; Chao Family Comprehensive Cancer Center, University of California at Irvine School of Medicine, Orange, California, USA; US Oncology Research, Ocala, Florida, USA; Carolinas HealthCare System, Charlotte, North Carolina, USA; The University of Texas MD Anderson Cancer Center, Houston, Texas, USA; University of Colorado Cancer Center, Aurora, Colorado, USA
| | - Jaspal Singh
- Mount Sinai Health Systems, New York, New York, USA; Pfizer Oncology, New York, New York, USA; Cone Health Cancer Center, Greensboro, North Carolina, USA; Carolinas Pathology Group, Carolinas HealthCare System, Charlotte, North Carolina, USA; Chao Family Comprehensive Cancer Center, University of California at Irvine School of Medicine, Orange, California, USA; US Oncology Research, Ocala, Florida, USA; Carolinas HealthCare System, Charlotte, North Carolina, USA; The University of Texas MD Anderson Cancer Center, Houston, Texas, USA; University of Colorado Cancer Center, Aurora, Colorado, USA
| | - Ignacio I Wistuba
- Mount Sinai Health Systems, New York, New York, USA; Pfizer Oncology, New York, New York, USA; Cone Health Cancer Center, Greensboro, North Carolina, USA; Carolinas Pathology Group, Carolinas HealthCare System, Charlotte, North Carolina, USA; Chao Family Comprehensive Cancer Center, University of California at Irvine School of Medicine, Orange, California, USA; US Oncology Research, Ocala, Florida, USA; Carolinas HealthCare System, Charlotte, North Carolina, USA; The University of Texas MD Anderson Cancer Center, Houston, Texas, USA; University of Colorado Cancer Center, Aurora, Colorado, USA
| | - Paul A Bunn
- Mount Sinai Health Systems, New York, New York, USA; Pfizer Oncology, New York, New York, USA; Cone Health Cancer Center, Greensboro, North Carolina, USA; Carolinas Pathology Group, Carolinas HealthCare System, Charlotte, North Carolina, USA; Chao Family Comprehensive Cancer Center, University of California at Irvine School of Medicine, Orange, California, USA; US Oncology Research, Ocala, Florida, USA; Carolinas HealthCare System, Charlotte, North Carolina, USA; The University of Texas MD Anderson Cancer Center, Houston, Texas, USA; University of Colorado Cancer Center, Aurora, Colorado, USA
| | - Fred R Hirsch
- Mount Sinai Health Systems, New York, New York, USA; Pfizer Oncology, New York, New York, USA; Cone Health Cancer Center, Greensboro, North Carolina, USA; Carolinas Pathology Group, Carolinas HealthCare System, Charlotte, North Carolina, USA; Chao Family Comprehensive Cancer Center, University of California at Irvine School of Medicine, Orange, California, USA; US Oncology Research, Ocala, Florida, USA; Carolinas HealthCare System, Charlotte, North Carolina, USA; The University of Texas MD Anderson Cancer Center, Houston, Texas, USA; University of Colorado Cancer Center, Aurora, Colorado, USA
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18
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Scagliotti GV, Gridelli C, de Marinis F, Thomas M, Dediu M, Pujol JL, Manegold C, San Antonio B, Peterson PM, John W, Chouaki N, Visseren-Grul C, Paz-Ares LG. Efficacy and safety of maintenance pemetrexed in patients with advanced nonsquamous non-small cell lung cancer following pemetrexed plus cisplatin induction treatment: A cross-trial comparison of two phase III trials. Lung Cancer 2014; 85:408-14. [PMID: 25088661 DOI: 10.1016/j.lungcan.2014.07.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [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: 04/15/2014] [Revised: 07/01/2014] [Accepted: 07/07/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Two phase III trials of advanced NSCLC patients were compared to examine relative efficacy and safety of differing treatment regimens. The JMDB trial investigated first-line pemetrexed-cisplatin (pemetrexed 500mg/m(2) plus cisplatin 75mg/m(2) every 21 days; maximum: 6 cycles). The PARAMOUNT phase III trial compared maintenance pemetrexed versus placebo after patients with nonsquamous NSCLC completed 4 cycles of first-line pemetrexed-cisplatin without disease progression. METHODS Overall survival (OS) and progression-free survival (PFS), analyzed by Kaplan-Meier and Cox methods, and toxicity rates were compared between the PARAMOUNT arms and a selected homogeneous population from JMDB: 346 patients with disease and prior treatment characteristics matching the PARAMOUNT population. RESULTS Outcomes for the PARAMOUNT placebo arm were similar to the JMDB homogeneous group (median PFS: 5.6 versus 6.2 months, p=0.117, HR=1.16; median OS: 14.0 versus 14.2 months, p=0.979, HR=1.00). The PARAMOUNT maintenance pemetrexed group had statistically superior efficacy compared with the JMDB homogeneous group (median PFS: 7.5 versus 6.2 months, p<0.00001, HR=0.66; median OS: 16.9 versus 14.2 months, p=0.003, HR=0.75). Patients who received pemetrexed maintenance (median 4 cycles, range 1-44) following 4 cycles of pemetrexed-cisplatin exhibited a higher incidence of drug-related serious adverse events compared with JMDB patients (median 6 cycles of pemetrexed-cisplatin) (10.6% versus 2.9%); grade 3/4 fatigue and renal toxicity were also higher in the pemetrexed arm of PARAMOUNT. CONCLUSIONS The across-trial comparison of a relevant JMDB study population with the two arms of the PARAMOUNT study supported the efficacy of the pemetrexed continuation maintenance strategy and suggested the results are not influenced by limiting the pemetrexed-cisplatin induction treatment to four cycles. Although longer exposure to pemetrexed-cisplatin or maintenance pemetrexed increased some toxicities, the overall incidence remained low, underscoring the relative safety of these treatment regimens.
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Affiliation(s)
- G V Scagliotti
- University of Torino at S. Luigi Hospital, Orbassano, Torino, Italy
| | - C Gridelli
- S. Giuseppe Moscati Hospital, Avellino, Italy
| | - F de Marinis
- European Institute of Oncology, Thoracic Oncology Division, Milan, Italy
| | - M Thomas
- Internistische Onkologie der Thoraxtumoren, Thoraxklinik im Universitätsklinikum Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Germany
| | - M Dediu
- Institute of Oncology Bucharest, Bucharest, Romania
| | - J-L Pujol
- Montpellier Academic Hospital, Montpellier, France
| | - C Manegold
- Heidelberg University Medical Center, Mannheim, Germany
| | | | | | - W John
- Eli Lilly and Company, Indianapolis, IN, USA
| | - N Chouaki
- Eli Lilly and Company, Suresnes, Hauts de Seine, France
| | | | - L G Paz-Ares
- Instituto de Biomedicina de Sevilla (University Hospital Virgen del Rocío, CSIC and Seville University), Seville, Spain.
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19
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Ha S, Choi H, Cheon GJ, Kang KW, Chung JK, Kim EE, Lee DS. Autoclustering of Non-small Cell Lung Carcinoma Subtypes on (18)F-FDG PET Using Texture Analysis: A Preliminary Result. Nucl Med Mol Imaging 2014; 48:278-86. [PMID: 26396632 DOI: 10.1007/s13139-014-0283-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [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: 02/14/2014] [Revised: 05/20/2014] [Accepted: 05/22/2014] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Texture analysis on (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) scan is a relatively new imaging analysis tool to evaluate metabolic heterogeneity. We analyzed the difference in textural characteristics between non-small cell lung carcinoma (NSCLC) subtypes, namely adenocarcinoma (ADC) and squamous cell carcinoma (SqCC). METHODS Diagnostic (18)F-FDG PET/computed tomography (CT) scans of 30y patients (median age, 67; range, 42-88) with NSCLC (17 ADC and 13 SqCC) were retrospectively analyzed. Regions of interest were manually determined on selected transverse image containing the highest SUV value in tumors. Texture parameters were extracted by histogram-based algorithms, absolute gradient-based algorithms, run-length matrix-based algorithms, co-occurrence matrix-based algorithms, and autoregressive model-based algorithms. Twenty-four out of hundreds of texture features were selected by three algorithms: Fisher coefficient, minimization of both classification error probability and average correlation, and mutual information. Automated clustering of tumors was based on the most discriminating feature calculated by linear discriminant analysis (LDA). Each tumor subtype was determined by histopathologic examination after biopsy and surgery. RESULTS Fifteen texture features had significant different values between ADC and SqCC. LDA with 24 automate-selected texture features accurately clustered between ADC and SqCC with 0.90 linear separability. There was no high correlation between SUVmax and texture parameters (|r| ≤ 0.62). CONCLUSION Each subtype of NSCLC tumor has different metabolic heterogeneity. The results of this study support the potential of textural parameters on FDG PET as an imaging biomarker.
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Affiliation(s)
- Seunggyun Ha
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea ; Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine or College of Pharmacy, Seoul National University, Seoul, Korea
| | - Hongyoon Choi
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea ; Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine or College of Pharmacy, Seoul National University, Seoul, Korea
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea ; Cancer Research Institute, Seoul National University, Seoul, Korea ; Department of Nuclear Medicine, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu Seoul, 110-744 Korea
| | - Keon Wook Kang
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea ; Cancer Research Institute, Seoul National University, Seoul, Korea
| | - June-Key Chung
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea ; Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Euishin Edmund Kim
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine or College of Pharmacy, Seoul National University, Seoul, Korea ; Department of Radiological Science, University of California at Irvine, Irvine, CA USA
| | - Dong Soo Lee
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea ; Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine or College of Pharmacy, Seoul National University, Seoul, Korea
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