首页 > 最新文献

Journal of Thoracic Oncology最新文献

英文 中文
Phase II randomized study of maintenance atezolizumab (A) versus atezolizumab + talazoparib (AT) in patients with SLFN11 positive extensive stage small cell lung cancer. S1929. 针对 SLFN11 阳性广泛期小细胞肺癌患者的维持性阿特珠单抗 (A) 与阿特珠单抗 + Talazoparib (AT) 的 II 期随机研究。S1929.
IF 21 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-04 DOI: 10.1016/j.jtho.2024.10.021
Nagla Abdel Karim, Jieling Miao, Karen L Reckamp, Carl M Gay, Lauren A Byers, Ying-Qi Zhao, Mary W Redman, Daniel R Carrizosa, Wei-Lien Wang, William J Petty, Kathan Mehta, Bryan A Faller, Edem S Agamah, Samer S Kasbari, Rajini K Malisetti, Atul Kumar, John Schallenkamp, Krishna C Alluri, Jhanelle E Gray, Karen Kelly

Purpose: To evaluate whether the addition of a poly (ADP-ribose) polymerase inhibitor (PARPi) talazoparib to maintenance immune checkpoint inhibitor (ICI) atezolizumab following frontline chemoimmunotherapy improved outcomes in patients with Schlafen 11 (SLFN11)-positive extensive stage small cell lung cancer (ES-SCLC).

Methods: Patients with newly diagnosed SLFN11 expressing (H-score ≥ 1, evaluated centrally) ES-SCLC were randomized to maintenance atezolizumab (A) versus atezolizumab plus talazoparib (AT) following frontline chemotherapy plus atezolizumab. The primary objective was to compare progression-free survival (PFS) using a 1-sided 10% level stratified log-rank test. Secondary endpoints included objective response rate (ORR), overall survival (OS), and toxicity. Target sample size was 84 eligible patients.

Results: From June 15, 2020 to December 15, 2022, 106 eligible patients were randomized (54 to AT and 52 to A). PFS was improved with AT versus A (hazard ratio [HR], 0.66; 80% confidence interval [CI]: 0.50-0.86; 1-sided P = 0.019) with a median PFS of 2.9 and 2.4 months; OS was not different between groups (HR, 0.98; 80% CI: 0.71-1.36; 1-sided P = 0.47). Grade ≥ 3 non-hematologic treatment-related adverse events (TRAEs) occurred in 17% of patients with AT and 14% of patients with A. Grade ≥ 3 hematological TRAEs were more common in AT (50%) than in A (4%) (P < 0.001).

Conclusion: Maintenance AT improved PFS in patients with SLFN11-positive ES-SCLC that did not progress following initial chemo-immunotherapy. Hematologic toxicity, primarily grade 3 anemia, was increased with AT, as expected. Prospective biomarker-selection was demonstrated, paving the way for future evaluation of novel therapies in molecularly defined SCLC populations.

目的:评估在前线化疗免疫疗法后,在维持性免疫检查点抑制剂(ICI)阿替佐珠单抗的基础上添加多聚(ADP-核糖)聚合酶抑制剂(PARPi)talazoparib是否能改善施拉芬11(SLFN11)阳性广泛期小细胞肺癌(ES-SCLC)患者的预后:新诊断的SLFN11表达(H评分≥1,中心评估)ES-SCLC患者在一线化疗加阿特珠单抗后,随机接受阿特珠单抗(A)与阿特珠单抗加他拉唑帕尼(AT)的维持治疗。首要目标是比较无进展生存期(PFS),采用单侧10%水平分层对数秩检验。次要终点包括客观反应率(ORR)、总生存期(OS)和毒性。目标样本量为84名符合条件的患者:2020年6月15日至2022年12月15日,106名符合条件的患者接受了随机治疗(54人接受AT治疗,52人接受A治疗)。AT与A相比,PFS有所改善(危险比[HR]为0.66;80%置信区间[CI]为0.50-0.86;1%置信区间[CI]为0.50):中位 PFS 分别为 2.9 个月和 2.4 个月;OS 组间无差异(HR,0.98;80% 置信区间 [CI]:0.71-1.36;单侧 P = 0.47)。17%的AT患者和14%的A患者发生了≥3级的非血液学治疗相关不良事件(TRAEs),≥3级的血液学TRAEs在AT(50%)中比在A(4%)中更常见(P<0.001):结论:SLFN11阳性ES-SCLC患者在接受初始化疗免疫治疗后,如果病情没有进展,维持AT可改善患者的PFS。正如预期的那样,AT会增加血液毒性,主要是3级贫血。前瞻性生物标志物选择得到了证实,为今后在分子定义的SCLC人群中评估新型疗法铺平了道路。
{"title":"Phase II randomized study of maintenance atezolizumab (A) versus atezolizumab + talazoparib (AT) in patients with SLFN11 positive extensive stage small cell lung cancer. S1929.","authors":"Nagla Abdel Karim, Jieling Miao, Karen L Reckamp, Carl M Gay, Lauren A Byers, Ying-Qi Zhao, Mary W Redman, Daniel R Carrizosa, Wei-Lien Wang, William J Petty, Kathan Mehta, Bryan A Faller, Edem S Agamah, Samer S Kasbari, Rajini K Malisetti, Atul Kumar, John Schallenkamp, Krishna C Alluri, Jhanelle E Gray, Karen Kelly","doi":"10.1016/j.jtho.2024.10.021","DOIUrl":"https://doi.org/10.1016/j.jtho.2024.10.021","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether the addition of a poly (ADP-ribose) polymerase inhibitor (PARPi) talazoparib to maintenance immune checkpoint inhibitor (ICI) atezolizumab following frontline chemoimmunotherapy improved outcomes in patients with Schlafen 11 (SLFN11)-positive extensive stage small cell lung cancer (ES-SCLC).</p><p><strong>Methods: </strong>Patients with newly diagnosed SLFN11 expressing (H-score ≥ 1, evaluated centrally) ES-SCLC were randomized to maintenance atezolizumab (A) versus atezolizumab plus talazoparib (AT) following frontline chemotherapy plus atezolizumab. The primary objective was to compare progression-free survival (PFS) using a 1-sided 10% level stratified log-rank test. Secondary endpoints included objective response rate (ORR), overall survival (OS), and toxicity. Target sample size was 84 eligible patients.</p><p><strong>Results: </strong>From June 15, 2020 to December 15, 2022, 106 eligible patients were randomized (54 to AT and 52 to A). PFS was improved with AT versus A (hazard ratio [HR], 0.66; 80% confidence interval [CI]: 0.50-0.86; 1-sided P = 0.019) with a median PFS of 2.9 and 2.4 months; OS was not different between groups (HR, 0.98; 80% CI: 0.71-1.36; 1-sided P = 0.47). Grade ≥ 3 non-hematologic treatment-related adverse events (TRAEs) occurred in 17% of patients with AT and 14% of patients with A. Grade ≥ 3 hematological TRAEs were more common in AT (50%) than in A (4%) (P < 0.001).</p><p><strong>Conclusion: </strong>Maintenance AT improved PFS in patients with SLFN11-positive ES-SCLC that did not progress following initial chemo-immunotherapy. Hematologic toxicity, primarily grade 3 anemia, was increased with AT, as expected. Prospective biomarker-selection was demonstrated, paving the way for future evaluation of novel therapies in molecularly defined SCLC populations.</p>","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":null,"pages":null},"PeriodicalIF":21.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical Utility of Tumor-Naïve Presurgical Circulating Tumor DNA Detection in Early-Stage NSCLC 早期非小细胞肺癌手术前ctDNA检测的临床实用性
IF 21 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-01 DOI: 10.1016/j.jtho.2024.07.002

Objectives

The use of tumor-informed circulating tumor DNA (ctDNA) testing in patients with early-stage disease before surgery is limited, mainly owing to restricted tissue access and extended turnaround times. This study aimed to evaluate the clinical value of a tumor-naïve, methylation-based cell-free DNA assay in a large cohort of patients with resected NSCLC.

Method

We analyzed presurgical plasma samples from 895 patients with EGFR and anaplastic lymphoma kinase-wild-type, clinical stage I or II NSCLC. The ctDNA status was evaluated for its prognostic significance in relation to tumor volume, metabolic activity, histologic diagnosis, histologic subtypes, and clinical-to-pathologic TNM upstaging.

Results

Presurgical ctDNA detection was observed in 55 of 414 patients (13%) with clinical stage I lung adenocarcinoma (LUAD) and was associated with poor recurrence-free survival (2-year recurrence-free survival 69% versus 91%; log-rank p < 0.001), approaching that of clinical stage II LUAD. Presurgical ctDNA detection was not prognostic in patients with clinical stage II LUAD or non-LUAD. Within LUAD, tumor volume and positron emission tomography avidity interacted to predict presurgical ctDNA detection. Moreover, presurgical ctDNA detection was predictive of the postsurgical discovery of International Association for the Study of Lung Cancer grade 3 tumors (p < 0.001) and pathologic TNM upstaging (p < 0.001). Notably, presurgical ctDNA detection strongly correlated with higher programmed death-ligand 1 expression in tumors (positive rates 28% versus 55%, p < 0.001), identifying a subgroup likely to benefit from anti–programmed death-ligand 1 therapies.

Conclusion

These findings support the integration of ctDNA testing into routine diagnostic workflows in early-stage NSCLC without the need for tumor tissue profiling. Furthermore, it is clinically useful in identifying patients at high risk who might benefit from innovative treatments, including neoadjuvant immune checkpoint inhibitors.
目的:主要由于组织获取受限和周转时间延长,早期患者手术前使用肿瘤信息循环肿瘤DNA(ctDNA)检测受到限制。本研究旨在评估基于甲基化的无细胞DNA检测法在一大批切除的非小细胞肺癌(NSCLC)患者中的临床价值:我们分析了895名表皮生长因子受体(EGFR)和ALK-wild型、临床I期或II期NSCLC患者的手术前血浆样本。评估了ctDNA状态与肿瘤体积、代谢活性、组织学、组织学亚型和临床病理TNM分期的关系,以确定其预后意义:结果:在414例临床I期肺腺癌(LUAD)患者中,有55例(13%)在手术前检测到ctDNA,且与无复发生存率(RFS)相关(2年RFS为69%对91%;log-rank PC):这些研究结果支持将ctDNA检测纳入早期NSCLC的常规诊断流程,而无需进行肿瘤组织分析。此外,ctDNA检测在临床上还有助于鉴别可能从创新治疗(包括新辅助免疫检查点抑制剂)中获益的高危患者。
{"title":"Clinical Utility of Tumor-Naïve Presurgical Circulating Tumor DNA Detection in Early-Stage NSCLC","authors":"","doi":"10.1016/j.jtho.2024.07.002","DOIUrl":"10.1016/j.jtho.2024.07.002","url":null,"abstract":"<div><h3>Objectives</h3><div>The use of tumor-informed circulating tumor DNA (ctDNA) testing in patients with early-stage disease before surgery is limited, mainly owing to restricted tissue access and extended turnaround times. This study aimed to evaluate the clinical value of a tumor-naïve, methylation-based cell-free DNA assay in a large cohort of patients with resected NSCLC.</div></div><div><h3>Method</h3><div>We analyzed presurgical plasma samples from 895 patients with <em>EGFR</em> and anaplastic lymphoma kinase-wild-type, clinical stage I or II NSCLC. The ctDNA status was evaluated for its prognostic significance in relation to tumor volume, metabolic activity, histologic diagnosis, histologic subtypes, and clinical-to-pathologic TNM upstaging.</div></div><div><h3>Results</h3><div>Presurgical ctDNA detection was observed in 55 of 414 patients (13%) with clinical stage I lung adenocarcinoma (LUAD) and was associated with poor recurrence-free survival (2-year recurrence-free survival 69% versus 91%; log-rank <em>p</em> &lt; 0.001), approaching that of clinical stage II LUAD. Presurgical ctDNA detection was not prognostic in patients with clinical stage II LUAD or non-LUAD. Within LUAD, tumor volume and positron emission tomography avidity interacted to predict presurgical ctDNA detection. Moreover, presurgical ctDNA detection was predictive of the postsurgical discovery of International Association for the Study of Lung Cancer grade 3 tumors (<em>p</em> &lt; 0.001) and pathologic TNM upstaging (<em>p</em> &lt; 0.001). Notably, presurgical ctDNA detection strongly correlated with higher programmed death-ligand 1 expression in tumors (positive rates 28% versus 55%, <em>p</em> &lt; 0.001), identifying a subgroup likely to benefit from anti–programmed death-ligand 1 therapies.</div></div><div><h3>Conclusion</h3><div>These findings support the integration of ctDNA testing into routine diagnostic workflows in early-stage NSCLC without the need for tumor tissue profiling. Furthermore, it is clinically useful in identifying patients at high risk who might benefit from innovative treatments, including neoadjuvant immune checkpoint inhibitors.</div></div>","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":null,"pages":null},"PeriodicalIF":21.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Game is Afoot – Seeking Early-Stage Lung Cancer Circulating Tumor DNA 游戏开始了--寻找早期肺癌循环肿瘤 DNA
IF 21 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-01 DOI: 10.1016/j.jtho.2024.08.014
{"title":"The Game is Afoot – Seeking Early-Stage Lung Cancer Circulating Tumor DNA","authors":"","doi":"10.1016/j.jtho.2024.08.014","DOIUrl":"10.1016/j.jtho.2024.08.014","url":null,"abstract":"","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":null,"pages":null},"PeriodicalIF":21.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comment on “Impact of EML4-ALK Variants and Co-Occurring TP53 Mutations on Duration of First-Line ALK Tyrosine Kinase Inhibitor Treatment and Overall Survival in ALK Fusion-Positive NSCLC: Real-World Outcomes From the GuardantINFORM Database” 关于 "EML4-ALK变异和并发TP53突变对ALK酪氨酸激酶抑制剂一线治疗时间和ALK融合阳性NSCLC总生存期的影响:来自 GuardantINFORM 数据库的真实世界结果"
IF 21 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-01 DOI: 10.1016/j.jtho.2024.07.023
{"title":"Comment on “Impact of EML4-ALK Variants and Co-Occurring TP53 Mutations on Duration of First-Line ALK Tyrosine Kinase Inhibitor Treatment and Overall Survival in ALK Fusion-Positive NSCLC: Real-World Outcomes From the GuardantINFORM Database”","authors":"","doi":"10.1016/j.jtho.2024.07.023","DOIUrl":"10.1016/j.jtho.2024.07.023","url":null,"abstract":"","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":null,"pages":null},"PeriodicalIF":21.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142587291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of EML4-ALK Variants and Co-Occurring TP53 Mutations on Duration of First-Line ALK Tyrosine Kinase Inhibitor Treatment and Overall Survival in ALK Fusion-Positive NSCLC: Real-World Outcomes From the GuardantINFORM database EML4-ALK变异和同时出现的TP53突变对ALK酪氨酸激酶抑制剂一线治疗时间和ALK融合阳性NSCLC患者总生存期的影响:来自 GuardantINFORM 数据库的真实世界结果。
IF 21 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-01 DOI: 10.1016/j.jtho.2024.07.009

Introduction

Tyrosine kinase inhibitors (TKIs) are first-line treatment options for ALK-positive (ALK+) NSCLC. Factors such as variant allele frequencies (VAFs), EML4-ALK fusion variant, and concurrent TP53 mutations (TP53mt) in circulating tumor DNA (ctDNA) may affect treatment outcomes. We evaluated their effects on time to discontinuation (TTD) of first-line treatment with next-generation ALK TKIs in a real-world setting.

Methods

Adults with advanced or metastatic NSCLC and ctDNA-detected ALK fusion who received first-line next-generation ALK TKI monotherapy were identified in GuardantINFORM. Effects of ALK fusion VAF, EML4-ALK variants, and TP53mt detection on TTD were evaluated.

Results

A total of 307 patients with ALK fusion in baseline ctDNA received first-line alectinib (n = 280), brigatinib (n = 15), lorlatinib (n = 9), or ceritinib (n = 3); 150 patients (49%) had ALK-fusion VAF greater than or equal to 1%. Among 232 patients with EML4-ALK fusions (v1, 50%; v3, 36%), TP53mt co-occurred with v1 in 42 (18%) and v3 in 32 (14%). Patients with VAF less than 1% versus greater than or equal to 1% had a median TTD of 32.2 (95% confidence interval [CI]: 20.7–not estimable [NE]) versus 14.7 months (10.4–19.9; hazard ratio [HR] = 1.57 [95% CI: 1.09–2.26]; p = 0.0146). Median TTD was 13.1 (9.5–19.9) versus 27.6 months (17.3–NE) in patients with versus without TP53mt detected (HR = 1.53 [1.07–2.19]; p = 0.0202) and 20.3 (14.4–NE) versus 11.5 months (7.4–31.1) in patients with v1 versus v3 (HR = 1.29 [0.83–2.01]; p = 0.2641). Patients with TP53mt and v3 had a median TTD of 7.4 months (95% CI: 4.2–31.1).

Conclusion

High ctDNA VAF, EML4-ALK v3, and TP53mt were associated with early discontinuation of first-line ALK TKIs.
简介:酪氨酸激酶抑制剂(TKIs)是ALK阳性(ALK+)非小细胞肺癌(NSCLC)的一线治疗选择。循环肿瘤DNA(ctDNA)中的变异等位基因频率(VAF)、EML4-ALK融合变异和并发TP53突变(TP53mt)等因素可能会影响治疗效果。我们在真实世界中评估了它们对新一代 ALK TKIs 一线治疗停药时间(TTD)的影响:我们在 GuardantINFORM 中确定了接受新一代 ALK TKI 单药一线治疗的晚期/转移性 NSCLC 和 ctDNA 检测到 ALK 融合的成人患者。评估了ALK融合VAF、EML4-ALK变异和TP53mt检测对TTD的影响:基线ctDNA中存在ALK融合的307例患者接受了一线阿来替尼(280例)、布加替尼(15例)、洛拉替尼(9例)或色瑞替尼(3例)治疗;150例患者(49%)的ALK融合VAF≥1%。在232例EML4-ALK融合患者(v1,50%;v3,36%)中,有42例(18%)和32例(14%)TP53mt与v1并发,v3与TP53mt并发。具有 VAF 的患者高ctDNA VAF、EML4-ALK v3和TP53mt与早期停用一线ALK TKIs有关。
{"title":"Impact of EML4-ALK Variants and Co-Occurring TP53 Mutations on Duration of First-Line ALK Tyrosine Kinase Inhibitor Treatment and Overall Survival in ALK Fusion-Positive NSCLC: Real-World Outcomes From the GuardantINFORM database","authors":"","doi":"10.1016/j.jtho.2024.07.009","DOIUrl":"10.1016/j.jtho.2024.07.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Tyrosine kinase inhibitors (TKIs) are first-line treatment options for <em>ALK</em>-positive (<em>ALK</em>+) NSCLC. Factors such as variant allele frequencies (VAFs), <em>EML4-ALK</em> fusion variant, and concurrent <em>TP53</em> mutations (<em>TP53</em>mt) in circulating tumor DNA (ctDNA) may affect treatment outcomes. We evaluated their effects on time to discontinuation (TTD) of first-line treatment with next-generation ALK TKIs in a real-world setting.</div></div><div><h3>Methods</h3><div>Adults with advanced or metastatic NSCLC and ctDNA-detected <em>ALK</em> fusion who received first-line next-generation ALK TKI monotherapy were identified in GuardantINFORM. Effects of <em>ALK</em> fusion VAF, <em>EML4-ALK</em> variants, and <em>TP53</em>mt detection on TTD were evaluated.</div></div><div><h3>Results</h3><div>A total of 307 patients with <em>ALK</em> fusion in baseline ctDNA received first-line alectinib (n = 280), brigatinib (n = 15), lorlatinib (n = 9), or ceritinib (n = 3); 150 patients (49%) had <em>ALK-</em>fusion VAF greater than or equal to 1%. Among 232 patients with <em>EML4-ALK</em> fusions (v1, 50%; v3, 36%), <em>TP53</em>mt co-occurred with v1 in 42 (18%) and v3 in 32 (14%). Patients with VAF less than 1% versus greater than or equal to 1% had a median TTD of 32.2 (95% confidence interval [CI]: 20.7–not estimable [NE]) versus 14.7 months (10.4–19.9; hazard ratio [HR] = 1.57 [95% CI: 1.09–2.26]; <em>p =</em> 0.0146). Median TTD was 13.1 (9.5–19.9) versus 27.6 months (17.3–NE) in patients with versus without <em>TP53</em>mt detected (HR = 1.53 [1.07–2.19]; <em>p =</em> 0.0202) and 20.3 (14.4–NE) versus 11.5 months (7.4–31.1) in patients with v1 versus v3 (HR = 1.29 [0.83–2.01]; <em>p =</em> 0.2641). Patients with <em>TP53</em>mt and v3 had a median TTD of 7.4 months (95% CI: 4.2–31.1).</div></div><div><h3>Conclusion</h3><div>High ctDNA VAF, <em>EML4-ALK</em> v3, and <em>TP53</em>mt were associated with early discontinuation of first-line ALK TKIs.</div></div>","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":null,"pages":null},"PeriodicalIF":21.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tracking Progression of EGFR Mutation Positive NSCLC From Blood: Is This the Prime Time? 从血液中追踪表皮生长因子受体突变阳性 NSCLC 的进展:现在是最佳时机吗?
IF 21 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-01 DOI: 10.1016/j.jtho.2024.08.032
{"title":"Tracking Progression of EGFR Mutation Positive NSCLC From Blood: Is This the Prime Time?","authors":"","doi":"10.1016/j.jtho.2024.08.032","DOIUrl":"10.1016/j.jtho.2024.08.032","url":null,"abstract":"","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":null,"pages":null},"PeriodicalIF":21.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
EML4-ALK Variants and Co-Occurring TP53 Mutations in a Real-World Treatment Setting: Do They Matter? 真实世界治疗环境中的 EML4-ALK 变异和共存 TP53 突变:它们重要吗?
IF 21 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-01 DOI: 10.1016/j.jtho.2024.09.1378
{"title":"EML4-ALK Variants and Co-Occurring TP53 Mutations in a Real-World Treatment Setting: Do They Matter?","authors":"","doi":"10.1016/j.jtho.2024.09.1378","DOIUrl":"10.1016/j.jtho.2024.09.1378","url":null,"abstract":"","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":null,"pages":null},"PeriodicalIF":21.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Equipoise Remains a Major Consideration in the Ethical Evaluation of Phase 3 Randomized Controlled Trials Involving Precision Oncology Approaches in NSCLC 在对涉及 NSCLC 精准肿瘤学疗法的 3 期随机对照试验进行伦理评估时,Equipoise 仍是一个主要考虑因素
IF 21 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-01 DOI: 10.1016/j.jtho.2024.07.004
{"title":"Equipoise Remains a Major Consideration in the Ethical Evaluation of Phase 3 Randomized Controlled Trials Involving Precision Oncology Approaches in NSCLC","authors":"","doi":"10.1016/j.jtho.2024.07.004","DOIUrl":"10.1016/j.jtho.2024.07.004","url":null,"abstract":"","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":null,"pages":null},"PeriodicalIF":21.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Real-World Acute Toxicity and 90-Day Mortality in Patients With Stage I NSCLC Treated With Stereotactic Body Radiotherapy 接受立体定向体放射治疗的 I 期非小细胞肺癌患者的真实急性毒性和 90 天死亡率。
IF 21 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-01 DOI: 10.1016/j.jtho.2024.07.016

Introduction

Stereotactic body radiotherapy (SBRT) has firmly established its role in stage I NSCLC. Clinical trial results may not fully apply to real-world scenarios. This study aimed to uncover the real-world incidence of acute toxicity and 90-day mortality in patients with SBRT-treated stage I NSCLC and develop prediction models for these outcomes.

Methods

Prospective data from the Dutch Lung Cancer Audit for Radiotherapy (DLCA-R) were collected nationally. Patients with stage I NSCLC (cT1-2aN0M0) treated with SBRT in 2017 to 2021 were included. Acute toxicity was assessed, defined as grade greater than or equal to 2 radiation pneumonitis or grade greater than or equal to 3 non-hematologic toxicity less than or equal to 90 days after SBRT. Prediction models for acute toxicity and 90-day mortality were developed and internally validated.

Results

Among 7279 patients, the mean age was 72.5 years, with 21.6% being above 80 years. Most were male (50.7%), had WHO scores 0 to 1 (73.3%), and had cT1a-b tumors (64.6%), predominantly in the upper lobes (65.2%). Acute toxicity was observed in 280 (3.8%) of patients and 90-day mortality in 122 (1.7%). Predictors for acute toxicity included WHO greater than or equal to 2, lower forced expiratory volume in 1 second and diffusion capacity for carbon monoxide, no pathology confirmation, middle or lower lobe tumor location, cT1c-cT2a stage, and higher mean lung dose (c-statistic 0.68). Male sex, WHO greater than or equal to 2, and acute toxicity predicted higher 90-day mortality (c-statistic 0.73).

Conclusions

This nationwide study revealed a low rate of acute toxicity and an acceptable 90-day mortality rate in patients with SBRT-treated stage I NSCLC. Notably, advanced age did not increase acute toxicity or mortality risk. Our predictive models, with satisfactory performance, offer valuable tools for identifying high-risk patients.
简介:立体定向体放射治疗(SBRT立体定向体放射治疗(SBRT)已在 I 期非小细胞肺癌(NSCLC)中发挥了重要作用。临床试验结果可能并不完全适用于实际情况。本研究旨在揭示SBRT治疗的I期NSCLC患者在现实世界中的急性毒性和90天死亡率,并为这些结果建立预测模型:方法:从荷兰肺癌放疗审计(DLCA-R)中收集全国性的前瞻性数据。纳入了2017-2021年接受SBRT治疗的I期NSCLC(cT1-2aN0M0)患者。对急性毒性进行了评估,急性毒性定义为 SBRT 后≤90 天的≥2 级放射性肺炎或≥3 级非血液学毒性。建立了急性毒性和90天死亡率的预测模型,并进行了内部验证:在7279名患者中,平均年龄为72.5岁,21.6%的患者年龄大于80岁。大多数患者为女性(50.7%),WHO评分为0-1分(73.3%),cT1a-b肿瘤(64.6%),主要位于上叶(65.2%)。280名患者(3.8%)出现急性毒性,122名患者(1.7%)90天内死亡。急性毒性的预测因素包括 WHO ≥2、较低的 FEV1 和 DLCO、未经病理确认、中/下叶肿瘤位置、cT1c-cT2a 分期和较高的平均肺剂量(c 统计量为 0.68)。女性性别、WHO ≥2和急性毒性预示着较高的90天死亡率(c统计量为0.73):这项全国性研究显示,SBRT 治疗的 I 期 NSCLC 患者急性毒性发生率低,90 天死亡率可接受。值得注意的是,高龄并未增加急性毒性或死亡率风险。我们的预测模型性能令人满意,为识别高危患者提供了有价值的工具。
{"title":"Real-World Acute Toxicity and 90-Day Mortality in Patients With Stage I NSCLC Treated With Stereotactic Body Radiotherapy","authors":"","doi":"10.1016/j.jtho.2024.07.016","DOIUrl":"10.1016/j.jtho.2024.07.016","url":null,"abstract":"<div><h3>Introduction</h3><div>Stereotactic body radiotherapy (SBRT) has firmly established its role in stage I NSCLC. Clinical trial results may not fully apply to real-world scenarios. This study aimed to uncover the real-world incidence of acute toxicity and 90-day mortality in patients with SBRT-treated stage I NSCLC and develop prediction models for these outcomes.</div></div><div><h3>Methods</h3><div>Prospective data from the Dutch Lung Cancer Audit for Radiotherapy (DLCA-R) were collected nationally. Patients with stage I NSCLC (cT1-2aN0M0) treated with SBRT in 2017 to 2021 were included. Acute toxicity was assessed, defined as grade greater than or equal to 2 radiation pneumonitis or grade greater than or equal to 3 non-hematologic toxicity less than or equal to 90 days after SBRT. Prediction models for acute toxicity and 90-day mortality were developed and internally validated.</div></div><div><h3>Results</h3><div>Among 7279 patients, the mean age was 72.5 years, with 21.6% being above 80 years. Most were male (50.7%), had WHO scores 0 to 1 (73.3%), and had cT1a-b tumors (64.6%), predominantly in the upper lobes (65.2%). Acute toxicity was observed in 280 (3.8%) of patients and 90-day mortality in 122 (1.7%). Predictors for acute toxicity included WHO greater than or equal to 2, lower forced expiratory volume in 1 second and diffusion capacity for carbon monoxide, no pathology confirmation, middle or lower lobe tumor location, cT1c-cT2a stage, and higher mean lung dose (c-statistic 0.68). Male sex, WHO greater than or equal to 2, and acute toxicity predicted higher 90-day mortality (c-statistic 0.73).</div></div><div><h3>Conclusions</h3><div>This nationwide study revealed a low rate of acute toxicity and an acceptable 90-day mortality rate in patients with SBRT-treated stage I NSCLC. Notably, advanced age did not increase acute toxicity or mortality risk. Our predictive models, with satisfactory performance, offer valuable tools for identifying high-risk patients.</div></div>","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":null,"pages":null},"PeriodicalIF":21.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing Acute Toxicity and 90-Day Mortality in Stage I NSCLC: A Real-World Appraisal of Stereotactic Body Radiotherapy Outcomes 评估 I 期 NSCLC 的急性毒性和 90 天死亡率:立体定向体外放射治疗效果的真实世界评估
IF 21 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-01 DOI: 10.1016/j.jtho.2024.08.038
{"title":"Assessing Acute Toxicity and 90-Day Mortality in Stage I NSCLC: A Real-World Appraisal of Stereotactic Body Radiotherapy Outcomes","authors":"","doi":"10.1016/j.jtho.2024.08.038","DOIUrl":"10.1016/j.jtho.2024.08.038","url":null,"abstract":"","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":null,"pages":null},"PeriodicalIF":21.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142587196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of Thoracic Oncology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1