Pub Date : 2024-09-01DOI: 10.1016/j.cllc.2024.08.015
Kyle F. Concannon, Bonnie S. Glisson, Robert C. Doebele, Chao Huang, Marcelo Marotti, D. Ross Camidge, John V. Heymach
Small cell lung cancer (SCLC) is known to express high levels of the proangiogenic factor vascular endothelial growth factor (VEGF). We assessed the safety and tolerability of cediranib, an oral inhibitor of VEGF receptor tyrosine kinases, in combination with etoposide and cisplatin as first-line therapy for extensive-stage (ES) SCLC or metastatic lung neuroendocrine cancer (NEC). Patients received up to six 21-day cycles of etoposide (100 mg/m, days 1-3) and cisplatin (80 mg/m, day 1) with once-daily cediranib until disease progression or unacceptable toxicity. Cediranib dosing started at 30 mg with de-escalation cohorts planned based on cycle 1 dose-limiting toxicities (DLTs). An expansion cohort of 12 patients was enrolled at the recommended phase II dose. Twenty-two patients (18 with ES SCLC, 4 with NEC) received treatment. Only 4 patients were enrolled at the 30 mg cediranib dose before other studies established 20 mg/day as the recommended dose with chemotherapy. Among the 18 patients enrolled at the 20-mg dose, common adverse events included nausea/vomiting, neutropenia, and diarrhea; 8 patients (44%) had grade 1 or 2 hypertension, and 2 (11%) had grade 3 hemoptysis. For all 18 patients, the objective response rate and median progression-free survival duration were 67% and 7.9 months. Plasma levels of VEGF were significantly higher, and those of soluble VEGFR2 were significantly lower, on day 22 than at baseline but were not correlated with tumor shrinkage. Cediranib (20 mg) plus etoposide and cisplatin is well tolerated and has promising clinical activity.
众所周知，小细胞肺癌（SCLC）表达高水平的促血管生成因子血管内皮生长因子（VEGF）。我们评估了血管内皮生长因子受体酪氨酸激酶口服抑制剂西地尼布联合依托泊苷和顺铂作为广泛期（ES）SCLC或转移性肺神经内分泌癌（NEC）一线疗法的安全性和耐受性。患者最多接受6个21天周期的依托泊苷（100毫克/米，第1-3天）和顺铂（80毫克/米，第1天）治疗，同时每天服用一次西地尼布，直到疾病进展或出现不可接受的毒性。西地尼布的剂量从 30 毫克开始，并根据第一周期的剂量限制性毒性（DLT）计划降级队列。12名患者组成的扩大队列以推荐的II期剂量入组。22 名患者（18 名 ES SCLC 患者，4 名 NEC 患者）接受了治疗。在其他研究确定20毫克/天为化疗推荐剂量之前，只有4名患者以30毫克西地尼布剂量入组。在18名接受20毫克剂量治疗的患者中，常见的不良反应包括恶心/呕吐、中性粒细胞减少和腹泻；8名患者（44%）出现1级或2级高血压，2名患者（11%）出现3级咯血。所有18名患者的客观反应率和中位无进展生存期分别为67%和7.9个月。与基线时相比，第22天的血浆VEGF水平明显升高，可溶性VEGFR2水平明显降低，但与肿瘤缩小无关。塞地拉尼（20 毫克）加依托泊苷和顺铂的耐受性良好，临床活性也很好。
{"title":"A Phase I Open-Label Study of Cediranib Plus Etoposide and Cisplatin as First-Line Therapy for Patients With Extensive-Stage Small-Cell Lung Cancer or Metastatic Neuroendocrine Non–Small-Cell Lung Cancer","authors":"Kyle F. Concannon, Bonnie S. Glisson, Robert C. Doebele, Chao Huang, Marcelo Marotti, D. Ross Camidge, John V. Heymach","doi":"10.1016/j.cllc.2024.08.015","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.08.015","url":null,"abstract":"Small cell lung cancer (SCLC) is known to express high levels of the proangiogenic factor vascular endothelial growth factor (VEGF). We assessed the safety and tolerability of cediranib, an oral inhibitor of VEGF receptor tyrosine kinases, in combination with etoposide and cisplatin as first-line therapy for extensive-stage (ES) SCLC or metastatic lung neuroendocrine cancer (NEC). Patients received up to six 21-day cycles of etoposide (100 mg/m, days 1-3) and cisplatin (80 mg/m, day 1) with once-daily cediranib until disease progression or unacceptable toxicity. Cediranib dosing started at 30 mg with de-escalation cohorts planned based on cycle 1 dose-limiting toxicities (DLTs). An expansion cohort of 12 patients was enrolled at the recommended phase II dose. Twenty-two patients (18 with ES SCLC, 4 with NEC) received treatment. Only 4 patients were enrolled at the 30 mg cediranib dose before other studies established 20 mg/day as the recommended dose with chemotherapy. Among the 18 patients enrolled at the 20-mg dose, common adverse events included nausea/vomiting, neutropenia, and diarrhea; 8 patients (44%) had grade 1 or 2 hypertension, and 2 (11%) had grade 3 hemoptysis. For all 18 patients, the objective response rate and median progression-free survival duration were 67% and 7.9 months. Plasma levels of VEGF were significantly higher, and those of soluble VEGFR2 were significantly lower, on day 22 than at baseline but were not correlated with tumor shrinkage. Cediranib (20 mg) plus etoposide and cisplatin is well tolerated and has promising clinical activity.","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-31DOI: 10.1016/j.cllc.2024.08.013
Qin Chen, Xinyue Wang, Richeng Jiang
{"title":"Response to Editor: Commentary on “Influence of Tumor Cavitation on Assessing the Clinical Benefit of Anti-PD1 or PD-L1 Inhibitors in Advanced Lung Squamous Cell Carcinoma”","authors":"Qin Chen, Xinyue Wang, Richeng Jiang","doi":"10.1016/j.cllc.2024.08.013","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.08.013","url":null,"abstract":"","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-31DOI: 10.1016/j.cllc.2024.08.014
Kalyani Narra, Bassam Ghabach, Vivek Athipatla, James-Michael Blackwell, Kari J. Teigen, Jolonda C. Bullock, Anna Diaz, David E. Gerber, Mitchell S. von Itzstein
Advances in the testing and treatment of patients with nonsmall cell lung cancer (NSCLC) harboring oncogenic drivers have improved outcomes. Little is known about testing and treatment patterns in the diverse patient populations. We conducted a retrospective study in a diverse cohort of patients treated in the John Peter Smith safety net healthcare system. We determined patterns of blood- and tissue-based testing and treatment of patients with and alterations. Cox proportional-hazards regression models were used to assess the impact of and testing. A total of 220 patients were included, 97 (44%) were non-Hispanic White, 72 (33%) were Black, 28 (13%) were Hispanic, and 23(10%) were Asian. and testing increased over time from 55% and 52%, respectively, in 2017 to 87% and 82%, respectively, in 2021. Frequency of alterations were highest in Asian patients (45%) and comparable among other groups (6-13%). Frequency of alterations were highest in Hispanic (13%), and Asian (11%) patients, and were 2% for both Black and non-Hispanic White patients. In a multivariate model, lack of testing was associated with worse survival (aHR 1.6; = .003) and testing positive for (aHR 0.43; = .01) or (aHR 0.28; = .04) was associated with improved survival. Race and ethnicity were not associated with survival differences. As molecular testing for oncogenic mutations in NSCLC increases, druggable alterations such as and can be identified in all race-ethnicity groups and are associated with improved outcomes.
{"title":"Identification and Treatment of Lung Cancer Oncogenic Drivers in a Diverse Safety Net Setting","authors":"Kalyani Narra, Bassam Ghabach, Vivek Athipatla, James-Michael Blackwell, Kari J. Teigen, Jolonda C. Bullock, Anna Diaz, David E. Gerber, Mitchell S. von Itzstein","doi":"10.1016/j.cllc.2024.08.014","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.08.014","url":null,"abstract":"Advances in the testing and treatment of patients with nonsmall cell lung cancer (NSCLC) harboring oncogenic drivers have improved outcomes. Little is known about testing and treatment patterns in the diverse patient populations. We conducted a retrospective study in a diverse cohort of patients treated in the John Peter Smith safety net healthcare system. We determined patterns of blood- and tissue-based testing and treatment of patients with and alterations. Cox proportional-hazards regression models were used to assess the impact of and testing. A total of 220 patients were included, 97 (44%) were non-Hispanic White, 72 (33%) were Black, 28 (13%) were Hispanic, and 23(10%) were Asian. and testing increased over time from 55% and 52%, respectively, in 2017 to 87% and 82%, respectively, in 2021. Frequency of alterations were highest in Asian patients (45%) and comparable among other groups (6-13%). Frequency of alterations were highest in Hispanic (13%), and Asian (11%) patients, and were 2% for both Black and non-Hispanic White patients. In a multivariate model, lack of testing was associated with worse survival (aHR 1.6; = .003) and testing positive for (aHR 0.43; = .01) or (aHR 0.28; = .04) was associated with improved survival. Race and ethnicity were not associated with survival differences. As molecular testing for oncogenic mutations in NSCLC increases, druggable alterations such as and can be identified in all race-ethnicity groups and are associated with improved outcomes.","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-31DOI: 10.1016/j.cllc.2024.08.011
Christopher M. Kapp, Chelsi Green, Jeffrey Thiboutot, Jeremy Kim, Mary M. Pasquinelli, Benjamin Aronson, A. Christine Argento
Lung cancer remains the leading cause of cancer death in the United States. There is an association between certain social determinants of health (SDOH) and adverse cancer outcomes. These include Black race and low-income, which are associated with poorer adherence to lung cancer screening and presentation at a later stage of disease. We conducted a retrospective review of all patients with a diagnosis of lung cancer at a single urban, academic center from 2015 to 2021. Demographic data including race and clinical data including time taken to progress through various checkpoints (ie, concerning CT scan to diagnosis, diagnosis to treatment) were collected. Income data was approximated based on population medians at patient's home address zip code. A total of 550 patients were included in the final analysis. The study population was 57.4% Black and 61.2% of patients presenting with a household income of $40,000 US Dollars or lower based on approximated median household income. The time from CT scan to first treatment for the entire cohort was 121.3 days with no statistically significant variance by race. However, among patients presenting at stage IV, 72.7% were black and 76.0% resided in a zip code with a median income < $40,000. This study demonstrated no significant delays in progressing through checkpoints of lung cancer diagnosis and treatment on the basis of race or income approximation. Black patients and patients in low-income households were diagnosed with lung cancer at a more advanced stage. Efforts to close the gap in lung cancer disparities should be focused on targeting screening and early identification toward social groups that may be at highest risk of late presentation. Institutional focus on patient navigation through these stages should be paramount. There were no delays in progression to lung cancer diagnostic and therapeutic milestones based on race or income approximation.
{"title":"Understanding the Social Risk Factors That Avert Equitable Lung Cancer Care","authors":"Christopher M. Kapp, Chelsi Green, Jeffrey Thiboutot, Jeremy Kim, Mary M. Pasquinelli, Benjamin Aronson, A. Christine Argento","doi":"10.1016/j.cllc.2024.08.011","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.08.011","url":null,"abstract":"Lung cancer remains the leading cause of cancer death in the United States. There is an association between certain social determinants of health (SDOH) and adverse cancer outcomes. These include Black race and low-income, which are associated with poorer adherence to lung cancer screening and presentation at a later stage of disease. We conducted a retrospective review of all patients with a diagnosis of lung cancer at a single urban, academic center from 2015 to 2021. Demographic data including race and clinical data including time taken to progress through various checkpoints (ie, concerning CT scan to diagnosis, diagnosis to treatment) were collected. Income data was approximated based on population medians at patient's home address zip code. A total of 550 patients were included in the final analysis. The study population was 57.4% Black and 61.2% of patients presenting with a household income of $40,000 US Dollars or lower based on approximated median household income. The time from CT scan to first treatment for the entire cohort was 121.3 days with no statistically significant variance by race. However, among patients presenting at stage IV, 72.7% were black and 76.0% resided in a zip code with a median income < $40,000. This study demonstrated no significant delays in progressing through checkpoints of lung cancer diagnosis and treatment on the basis of race or income approximation. Black patients and patients in low-income households were diagnosed with lung cancer at a more advanced stage. Efforts to close the gap in lung cancer disparities should be focused on targeting screening and early identification toward social groups that may be at highest risk of late presentation. Institutional focus on patient navigation through these stages should be paramount. There were no delays in progression to lung cancer diagnostic and therapeutic milestones based on race or income approximation.","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-30DOI: 10.1016/j.cllc.2024.08.009
Julie Wu, Theodore Thomas, Hannah F. Tavalire, Frances Vecchio, Tassos C. Kyriakides, Kristina Crothers, Michael J. Kelley, Drew Moghanaki, Scott Shofer, Fred Hendler, Lawrence Feldman
{"title":"Letter to the Editor in Response to “Adherence to Annual Lung Cancer Screening in a Centralized Academic Program”","authors":"Julie Wu, Theodore Thomas, Hannah F. Tavalire, Frances Vecchio, Tassos C. Kyriakides, Kristina Crothers, Michael J. Kelley, Drew Moghanaki, Scott Shofer, Fred Hendler, Lawrence Feldman","doi":"10.1016/j.cllc.2024.08.009","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.08.009","url":null,"abstract":"","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-24DOI: 10.1016/j.cllc.2024.08.012
Sanuki Tissera, Baki Billah, Margaret Brand, Md Nazmul Karim, Phillip Antippa, Robert Blum, Michelle Caldecott, Matthew Conron, Wasek Faisal, Susan Harden, Inger Olesen, Phil Parente, Gary Richardson, Evangeline Samuel, Katharine See, Craig Underhill, Gavin Wright, John Zalcberg, Rob G. Stirling
Lung cancer in Australia contributes 9% of all new cancer diagnoses and is the leading cause of cancer death and burden. Clinical practice guidelines provide evidence-based treatment recommendations for best practice management. We aimed to determine the extent of delivery of guideline-concordant treatment (GCT) and to identify modifiable variables influencing receipt of GCT and survival. Data was sourced from the Victorian Lung Cancer Registry (VLCR) in Victoria, Australia. Descriptive statistics were used to summarize patient and disease characteristics according to treatment type: GCT versus non-GCT versus no/declined treatment. Statistical analyses included multiple logistic regression, multiple COX regression and Kaplan-Meier survival estimates. 52% of patients were treated with GCT, 32.8% non-GCT and 15.2% declined or received no treatment. GCT treated patients were younger, never smoked, had no comorbidities, had better performance status, had early stage cancer, were discussed at a multidisciplinary meeting or had treatment at a higher volume hospital. Overall, patients that received GCT had a 24% lower risk of mortality compared to patients that received non-GCT. Modifiable variables impacting likelihood of receiving GCT included age, smoking status and treating hospital characteristics. Several modifiable variables were identified with positive impacts on survival including increased treatment of the elderly, smoking cessation, delivery of GCT, and treatment in higher volume hospitals. The measurement and reporting of delivery of GCT has positive impacts on survival and therefore merits consideration as an evidence-based quality indicator in the reporting of lung cancer quality and safety outcomes.
{"title":"Stage-Specific Guideline Concordant Treatment Impacts on Survival in Nonsmall Cell Lung Cancer: A Novel Quality Indicator","authors":"Sanuki Tissera, Baki Billah, Margaret Brand, Md Nazmul Karim, Phillip Antippa, Robert Blum, Michelle Caldecott, Matthew Conron, Wasek Faisal, Susan Harden, Inger Olesen, Phil Parente, Gary Richardson, Evangeline Samuel, Katharine See, Craig Underhill, Gavin Wright, John Zalcberg, Rob G. Stirling","doi":"10.1016/j.cllc.2024.08.012","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.08.012","url":null,"abstract":"Lung cancer in Australia contributes 9% of all new cancer diagnoses and is the leading cause of cancer death and burden. Clinical practice guidelines provide evidence-based treatment recommendations for best practice management. We aimed to determine the extent of delivery of guideline-concordant treatment (GCT) and to identify modifiable variables influencing receipt of GCT and survival. Data was sourced from the Victorian Lung Cancer Registry (VLCR) in Victoria, Australia. Descriptive statistics were used to summarize patient and disease characteristics according to treatment type: GCT versus non-GCT versus no/declined treatment. Statistical analyses included multiple logistic regression, multiple COX regression and Kaplan-Meier survival estimates. 52% of patients were treated with GCT, 32.8% non-GCT and 15.2% declined or received no treatment. GCT treated patients were younger, never smoked, had no comorbidities, had better performance status, had early stage cancer, were discussed at a multidisciplinary meeting or had treatment at a higher volume hospital. Overall, patients that received GCT had a 24% lower risk of mortality compared to patients that received non-GCT. Modifiable variables impacting likelihood of receiving GCT included age, smoking status and treating hospital characteristics. Several modifiable variables were identified with positive impacts on survival including increased treatment of the elderly, smoking cessation, delivery of GCT, and treatment in higher volume hospitals. The measurement and reporting of delivery of GCT has positive impacts on survival and therefore merits consideration as an evidence-based quality indicator in the reporting of lung cancer quality and safety outcomes.","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patient-generated health data (PGHD), which includes patient-reported outcomes (PROs) and wearable device data, may have prognostic value for cancer patients. We tested that hypothesis using data from several prospective trials where patients with locally advanced non-small cell lung cancer (LA-NSCLC) were treated with definitive chemoradiotherapy. Cox proportional hazards models were utilized to identify the baseline patient-reported symptom that best predicted progression-free survival (PFS) duration in a trial that involved PRO-CTCAE collection (Cohort 1). Using data from trials that included EORTC QLQ-C30 questionnaires and wearable devices (Cohort 2), the same symptom was tested as a predictor of PFS. Baseline physical inactivity was also tested as a predictor of PFS. A simple risk stratification tool utilizing PROs and physical activity was proposed. In Cohort 1 (n = 50), anorexia was the only pretreatment PRO that was significantly associated with PFS after Bonferroni correction (HR = 3.94, = .002). In Cohort 2 (n = 58), baseline anorexia was also significantly associated with PFS (HR = 2.48, = .018), as was physical inactivity (HR = 3.11, < .001). Median PFS duration for patients in Cohort 2 with anorexia or physical inactivity was 6 months, compared to 18 months for other patients (HR = 3.08, < .001). Median overall survival duration for patients with anorexia or physical inactivity was 19 months, compared to 65 months for other patients (HR = 2.44, = .021). PGHD, including PROs and wearable device data, can provide valuable prognostic information for LA-NSCLC patients treated with definitive chemoradiotherapy. These findings should be validated using larger datasets.
{"title":"Untapping the Prognostic Value of Patient-Generated Health Data in Locally Advanced Non-small Cell Lung Cancer","authors":"Nitin Ohri, William Bodner, Madhur Garg, Brendon Stiles, Balazs Halmos, Shalom Kalnicki","doi":"10.1016/j.cllc.2024.08.010","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.08.010","url":null,"abstract":"Patient-generated health data (PGHD), which includes patient-reported outcomes (PROs) and wearable device data, may have prognostic value for cancer patients. We tested that hypothesis using data from several prospective trials where patients with locally advanced non-small cell lung cancer (LA-NSCLC) were treated with definitive chemoradiotherapy. Cox proportional hazards models were utilized to identify the baseline patient-reported symptom that best predicted progression-free survival (PFS) duration in a trial that involved PRO-CTCAE collection (Cohort 1). Using data from trials that included EORTC QLQ-C30 questionnaires and wearable devices (Cohort 2), the same symptom was tested as a predictor of PFS. Baseline physical inactivity was also tested as a predictor of PFS. A simple risk stratification tool utilizing PROs and physical activity was proposed. In Cohort 1 (n = 50), anorexia was the only pretreatment PRO that was significantly associated with PFS after Bonferroni correction (HR = 3.94, = .002). In Cohort 2 (n = 58), baseline anorexia was also significantly associated with PFS (HR = 2.48, = .018), as was physical inactivity (HR = 3.11, < .001). Median PFS duration for patients in Cohort 2 with anorexia or physical inactivity was 6 months, compared to 18 months for other patients (HR = 3.08, < .001). Median overall survival duration for patients with anorexia or physical inactivity was 19 months, compared to 65 months for other patients (HR = 2.44, = .021). PGHD, including PROs and wearable device data, can provide valuable prognostic information for LA-NSCLC patients treated with definitive chemoradiotherapy. These findings should be validated using larger datasets.","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142222837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.1016/j.cllc.2024.08.008
Haiyan Zeng, Lizza E.L. Hendriks, José Belderbos, Lloyd Brandts, Inge Compter, Ludwig Dubois, Matthew Holt, Ruud Houben, Sanne Schagen, Xin Zhang, Teresa Prezzemolo, Dirk De Ruysscher
Blood samples were collected to explore potential serum biomarkers associated with neurocognitive function in small-cell lung cancer (SCLC) patients who received prophylactic cranial irradiation (PCI). This pre-specified study included patients with blood samples available, who participated in a phase III trial (NCT01780675). Blood samples were collected before PCI and 3-days post-initiating PCI. Neurocognitive decline was defined as a decrease of ≥ 5 points on total recall in the Hopkins Verbal Learning Test—Revised (HVLT-R) assessed from pre-PCI to 4-months post-PCI. Biomarkers were screened using univariate logistic regression analysis. < .1 was considered statistically significant. Forty-eight enrolled patients who had blood samples at baseline were included and 27 were available for analysis as the other 21 did not assess neurocognitive function at 4-months. Lower levels of Tie-2 (OR = 0.999, 90% CI 0.998-1.000, = .062), and higher levels of MIP-1b (OR = 1.022, 90% CI 1.000-1.044, = .093), CCL-17 (OR = 1.004, 90% CI 1.001-1.006, = .029), and IL-1α (OR = 1.597, 90% CI 1.077-2.367, = .05) before PCI were correlated with neurocognitive decline at 4-months. Decrease of VEGF-C (OR = 0.972, 90% CI 0.949-0.996, = .055), CCL-17 (OR = 0.993, 90% CI 0.988-0.999, = .036), IL-1α (OR = 0.788, 90% CI 0.635-0.979, = .071), and VEGF (OR = 0.981, 90% CI 0.965-0.997, = .051) 3-days postinitiating PCI were also associated with neurocognitive decline at 4-months. Biomarker levels before PCI and changes in their levels 3-days post-initiating PCI may be linked to subsequent neurocognitive decline at 4-months. If validated, these biomarkers could be used to predict the risk of neurocognitive decline and act as a decision aid for personalized PCI in SCLC.
收集血样是为了探索与接受预防性颅脑照射（PCI）的小细胞肺癌（SCLC）患者神经认知功能相关的潜在血清生物标记物。这项预先指定的研究包括参加 III 期试验（NCT01780675）的有血样的患者。血液样本在PCI前和PCI启动后3天采集。神经认知能力下降的定义是：从PCI前到PCI后4个月，霍普金斯言语学习测验修订版（HVLT-R）总回忆能力下降≥5分。使用单变量逻辑回归分析筛选生物标志物。< .1 为具有统计学意义。纳入了 48 名在基线时采集了血液样本的入组患者，其中 27 名患者可用于分析，因为另外 21 名患者在 4 个月后未对神经认知功能进行评估。较低水平的 Tie-2（OR = 0.999，90% CI 0.998-1.000，= .062）和较高水平的 MIP-1b（OR = 1.022，90% CI 1.000-1.044，= .093）、CCL-17（OR = 1.004，90% CI 1.001-1.006，= .029）和 PCI 前的 IL-1α（OR=1.597，90% CI 1.077-2.367，= .05）与 4 个月时的神经认知功能下降相关。VEGF-C（OR = 0.972，90% CI 0.949-0.996，= .055）、CCL-17（OR = 0.993，90% CI 0.988-0.999，= .036）、IL-1α（OR = 0.788，90% CI 0.635-0.979, = .071）和 VEGF（OR = 0.981, 90% CI 0.965-0.997, = .051）也与启动 PCI 后 3 天的神经认知功能下降有关。PCI前的生物标志物水平及其启动PCI后3天的水平变化可能与随后4个月的神经认知功能下降有关。如果得到验证，这些生物标志物可用于预测神经认知功能衰退的风险，并作为SCLC患者个性化PCI的辅助决策工具。
{"title":"Association of Serum Biomarkers With Neurocognitive Decline After PCI in Small Cell Lung Cancer: An Exploratory Study of the Phase III NCT01780675 Trial","authors":"Haiyan Zeng, Lizza E.L. Hendriks, José Belderbos, Lloyd Brandts, Inge Compter, Ludwig Dubois, Matthew Holt, Ruud Houben, Sanne Schagen, Xin Zhang, Teresa Prezzemolo, Dirk De Ruysscher","doi":"10.1016/j.cllc.2024.08.008","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.08.008","url":null,"abstract":"Blood samples were collected to explore potential serum biomarkers associated with neurocognitive function in small-cell lung cancer (SCLC) patients who received prophylactic cranial irradiation (PCI). This pre-specified study included patients with blood samples available, who participated in a phase III trial (NCT01780675). Blood samples were collected before PCI and 3-days post-initiating PCI. Neurocognitive decline was defined as a decrease of ≥ 5 points on total recall in the Hopkins Verbal Learning Test—Revised (HVLT-R) assessed from pre-PCI to 4-months post-PCI. Biomarkers were screened using univariate logistic regression analysis. < .1 was considered statistically significant. Forty-eight enrolled patients who had blood samples at baseline were included and 27 were available for analysis as the other 21 did not assess neurocognitive function at 4-months. Lower levels of Tie-2 (OR = 0.999, 90% CI 0.998-1.000, = .062), and higher levels of MIP-1b (OR = 1.022, 90% CI 1.000-1.044, = .093), CCL-17 (OR = 1.004, 90% CI 1.001-1.006, = .029), and IL-1α (OR = 1.597, 90% CI 1.077-2.367, = .05) before PCI were correlated with neurocognitive decline at 4-months. Decrease of VEGF-C (OR = 0.972, 90% CI 0.949-0.996, = .055), CCL-17 (OR = 0.993, 90% CI 0.988-0.999, = .036), IL-1α (OR = 0.788, 90% CI 0.635-0.979, = .071), and VEGF (OR = 0.981, 90% CI 0.965-0.997, = .051) 3-days postinitiating PCI were also associated with neurocognitive decline at 4-months. Biomarker levels before PCI and changes in their levels 3-days post-initiating PCI may be linked to subsequent neurocognitive decline at 4-months. If validated, these biomarkers could be used to predict the risk of neurocognitive decline and act as a decision aid for personalized PCI in SCLC.","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142222836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-18DOI: 10.1016/j.cllc.2024.08.002
Ju Ae Park, Sriya Yalamanchili, Zeliene Brown, Andrew Myers, Michael J Weyant, Amit K Mahajan, Christopher Patrick Connolly, Kei Suzuki
Introduction: Lung cancer survival is significantly improved with early detection. However, lung cancer screening (LCS) uptake remains low despite national recommendations. Our aim was to determine whether implementation of an electronic medical record (EMR) alert and order set would increase LCS uptake.
Study design: A query of current and former smokers identified 62,630 patients aged 50 and above in the primary care setting between January 1, 2021 and May 5, 2022. We randomly reviewed 3704 charts for LCS eligibility and recorded who received LCS in the form of low-dose computed tomography amongst the eligible patients. We collected demographic information including gender, race, primary language, ethnicity, zip code, and insurance. Data analysis was performed utilizing 2-proportional z tests.
Results: We identified 461 patients who were LCS eligible. Our overall LCS uptake was 19.9% (92/461). Three-time frames were analyzed: (1) prior to EMR alert implementation, (2) after implementation of EMR alert (January 7, 2021), and (3) after implementation of EMR alert and order set (March 3, 2021). Screening uptake was significantly improved with initiation of EMR alert (1/46 [2.2%] to 23/109 [21.1%]; P = .003). LCS uptake remained similarly high after subsequent order set implementation (23/109 [21.1%] and 68/306 [22.2%]; P = .72). Amongst the different demographics, age was significantly associated with screening uptake, with age ≥65 demonstrating statistically significant increased rates of screening (15.6% [41/263] for <65 vs 25.8% [51/198] for ≥65; P = .007).
Conclusion: Implementation of EMR alerts significantly improves LCS uptake in the primary care setting. Such efforts should be considered in other hospital settings to improve LCS uptake.
{"title":"Implementation of an Electronic Medical Record Alert Significantly Increases Lung Cancer Screening Uptake.","authors":"Ju Ae Park, Sriya Yalamanchili, Zeliene Brown, Andrew Myers, Michael J Weyant, Amit K Mahajan, Christopher Patrick Connolly, Kei Suzuki","doi":"10.1016/j.cllc.2024.08.002","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.08.002","url":null,"abstract":"<p><strong>Introduction: </strong>Lung cancer survival is significantly improved with early detection. However, lung cancer screening (LCS) uptake remains low despite national recommendations. Our aim was to determine whether implementation of an electronic medical record (EMR) alert and order set would increase LCS uptake.</p><p><strong>Study design: </strong>A query of current and former smokers identified 62,630 patients aged 50 and above in the primary care setting between January 1, 2021 and May 5, 2022. We randomly reviewed 3704 charts for LCS eligibility and recorded who received LCS in the form of low-dose computed tomography amongst the eligible patients. We collected demographic information including gender, race, primary language, ethnicity, zip code, and insurance. Data analysis was performed utilizing 2-proportional z tests.</p><p><strong>Results: </strong>We identified 461 patients who were LCS eligible. Our overall LCS uptake was 19.9% (92/461). Three-time frames were analyzed: (1) prior to EMR alert implementation, (2) after implementation of EMR alert (January 7, 2021), and (3) after implementation of EMR alert and order set (March 3, 2021). Screening uptake was significantly improved with initiation of EMR alert (1/46 [2.2%] to 23/109 [21.1%]; P = .003). LCS uptake remained similarly high after subsequent order set implementation (23/109 [21.1%] and 68/306 [22.2%]; P = .72). Amongst the different demographics, age was significantly associated with screening uptake, with age ≥65 demonstrating statistically significant increased rates of screening (15.6% [41/263] for <65 vs 25.8% [51/198] for ≥65; P = .007).</p><p><strong>Conclusion: </strong>Implementation of EMR alerts significantly improves LCS uptake in the primary care setting. Such efforts should be considered in other hospital settings to improve LCS uptake.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-17DOI: 10.1016/j.cllc.2024.08.007
Hanbo Pan, Qingquan Luo
{"title":"\"Video Assisted Thoracoscopic Surgery Versus Thoracotomy Following Neoadjuvant Immunochemotherapy in Resectable Stage III Non-Small Cell Lung Cancer Among Chinese Population: A Multicenter Retrospective Cohort Study\".","authors":"Hanbo Pan, Qingquan Luo","doi":"10.1016/j.cllc.2024.08.007","DOIUrl":"https://doi.org/10.1016/j.cllc.2024.08.007","url":null,"abstract":"","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：