Lancet Respiratory Medicine最新文献

{"title":"Stereotactic body radiotherapy with sequential tislelizumab and chemotherapy as neoadjuvant therapy in patients with resectable non-small-cell lung cancer in China (SACTION01): a single-arm, single-centre, phase 2 trial.","authors":"Ze-Rui Zhao, Shi-Liang Liu, Ting Zhou, Gang Chen, Hao Long, Xiao-Dong Su, Xu Zhang, Jian-Hua Fu, Peng Lin, Lan-Jun Zhang, Tie-Hua Rong, Jia-Di Wu, Zhi-Chao Li, Hui-Lin Su, Ji-Yang Chen, Yun-Peng Yang, Yong-Bin Lin, Mian Xi, Hong Yang","doi":"10.1016/S2213-2600(24)00215-7","DOIUrl":"10.1016/S2213-2600(24)00215-7","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant immunotherapy with chemotherapy improves outcomes in patients with resectable non-small-cell lung cancer (NSCLC). Given its immunomodulating effect, we investigated whether stereotactic body radiotherapy (SBRT) enhances the effect of immunochemotherapy.</p><p><strong>Methods: </strong>The SACTION01 study was a single-arm, open-label, phase 2 trial that recruited patients who were 18 years or older and had resectable stage IIA-IIIB NSCLC from the Sun Yat-sen University Cancer Center, Guangzhou, China. Eligible patients received SBRT (24 Gy in three fractions) to the primary tumour followed by two cycles of 200 mg intravenous PD-1 inhibitor, tislelizumab, plus platinum-based chemotherapy. Surgical resection was performed 4-6 weeks after neoadjuvant treatment. The primary endpoint was major pathological response (MPR), defined as no more than 10% residual viable tumour in the resected tumour. All analyses were conducted on an intention-to-treat basis, including all patients who were scheduled for neoadjuvant treatment. The trial was registered with ClinicalTrials.gov (NCT05319574) and is ongoing but closed to recruitment.</p><p><strong>Findings: </strong>Between May 18, 2022, and June 20, 2023, 46 patients (42 men and four women) were enrolled and scheduled for neoadjuvant treatment. MPR was observed in 35 (76%, 95% CI 61-87) of 46 patients. The second cycle of immunochemotherapy was withheld in four (9%) patients due to pneumonia (n=2), colitis (n=1), and increased creatinine (n=1). Grade 3 or worse adverse events related to neoadjuvant treatment occurred in 12 (26%, 95% CI 14-41) patients. The most frequent treatment-related adverse event (TRAE) was alopecia (16 [35%] patients), and the most frequent grade 3 or worse TRAE was neutropenia (six [13%]). There was one treatment-related death, caused by neutropenia. No deaths within 90 days of surgery were reported.</p><p><strong>Interpretation: </strong>Preoperative SBRT followed by immunochemotherapy is well tolerated, feasible, and leads to a clinically significant MPR rate. Future randomised trials are warranted to support these findings.</p><p><strong>Funding: </strong>BeiGene.</p>","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":" ","pages":"988-996"},"PeriodicalIF":38.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300410","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}

{"title":"Top ten research priorities for breathlessness research: UK James Lind Alliance priority setting partnership","authors":"Rachael A Evans, David KH Lo, Charles C Reilly, Martin R Davies, Samantha Walker, Erika J Kennington","doi":"10.1016/s2213-2600(24)00376-x","DOIUrl":"https://doi.org/10.1016/s2213-2600(24)00376-x","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"17 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142742723","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}

{"title":"A new era in the treatment of acute exacerbations of asthma and COPD","authors":"Clarus Leung, Don D Sin","doi":"10.1016/s2213-2600(24)00323-0","DOIUrl":"https://doi.org/10.1016/s2213-2600(24)00323-0","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"83 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142742417","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}

{"title":"Idiopathic inflammatory myopathies related lung disease in adults","authors":"Sameep Sehgal, Aditi Patel, Soumya Chatterjee, Anthony P Fernandez, Carol Farver, Ruchi Yadav, Yuebing Li, Sonye K Danoff, Didem Saygin, Julio A Huapaya, Erin M Wilfong, Kristin B Highland","doi":"10.1016/s2213-2600(24)00267-4","DOIUrl":"https://doi.org/10.1016/s2213-2600(24)00267-4","url":null,"abstract":"Interstitial lung disease (ILD) is common in idiopathic inflammatory myopathies in adults, especially in patients with antisynthetase syndrome and anti-MDA5 antibody-associated dermatomyositis. Pulmonary manifestations can range from subclinical ILD to rapidly progressive respiratory failure. Coexistent myositis, characteristic skin lesions, arthritis, and Raynaud's phenomenon are common. However, 16–65% of patients present with isolated lung disease. Detection of myositis-specific and myositis-associated antibodies can aid in diagnosis and disease characterisation. Chest imaging and pathology most commonly show non-specific interstitial pneumonia and organising pneumonia patterns. Immunosuppression is the mainstay of management with aggressive combination treatment for rapidly progressive disease and incremental escalation as needed for chronic ILD. The addition of antifibrotic agents is an option in progressive fibrotic disease, and lung transplantation can be considered in severe, end-stage disease. Most patients respond to treatment, but short-term mortality remains high for patients with rapidly progressive disease associated with anti-MDA5 antibody ILD.","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"259 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752874","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}

{"title":"Associations between life-course FEV1/FVC trajectories and respiratory symptoms up to middle age: analysis of data from two prospective cohort studies","authors":"Jennifer L Perret, Dinh S Bui, Carrie Pistenmaa, Don Vicendese, Sadiya S Khan, MeiLan K Han, Raul San José Estépar, Adrian J Lowe, Caroline J Lodge, Wassim W Labaki, Jonathan V Pham, Nur Sabrina Idrose, Chamara V Senaratna, Daniel J Tan, Garun S Hamilton, Bruce R Thompson, Maitri Munsif, Alexander Arynchyn, David R Jacobs, Michael J Abramson, Shyamali C Dharmage","doi":"10.1016/s2213-2600(24)00265-0","DOIUrl":"https://doi.org/10.1016/s2213-2600(24)00265-0","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Life-course lung function trajectories leading to airflow obstruction, as measured by impaired FEV&lt;sub&gt;1&lt;/sub&gt;/FVC (forced vital capacity), precede the onset of chronic obstructive pulmonary disease (COPD). We aimed to investigate whether individuals on impaired FEV&lt;sub&gt;1&lt;/sub&gt;/FVC trajectories have an increased burden of respiratory symptoms, including those who do not meet the spirometric criteria for COPD.&lt;h3&gt;Methods&lt;/h3&gt;We analysed serial life-course data from two population-based cohort studies separately, which included respiratory symptoms and spirometry: the Tasmanian Longitudinal Health Study (TAHS, Australia) cohort was recruited at age 6–7 years and followed up until middle age (mean age 53 years; range 51–55); and the Coronary Artery Risk Development in Young Adults (CARDIA, USA) cohort was recruited at a mean age of 25 years (range 18–30) and followed up to a mean age of 55 years (range 47–64). Participants' symptom profiles at ages 53 and 55 years were derived by latent class analysis. Symptom profiles were compared across pre-bronchodilator FEV&lt;sub&gt;1&lt;/sub&gt;/FVC trajectories derived by group-based modelling, then restricted to those without COPD defined by post-bronchodilator airflow obstruction (FEV&lt;sub&gt;1&lt;/sub&gt;/FVC &lt;5th percentile) at ages 51–55 years and 47–64 years.&lt;h3&gt;Findings&lt;/h3&gt;Six FEV&lt;sub&gt;1&lt;/sub&gt;/FVC trajectories previously derived for TAHS were replicated in CARDIA. Optimal models identified five symptom profiles in TAHS (n=2421) and six in CARDIA (n=3153). For both cohorts, the most impaired FEV&lt;sub&gt;1&lt;/sub&gt;/FVC trajectory (early low, rapid decline in TAHS; low peak, rapid decline in CARDIA) was associated with predominant wheeze (multinomial odds ratio [mOR] 6·71 [95% CI 4·10–10·90] in TAHS and 9·90 [4·52–21·70] in CARDIA) and nearly all respiratory symptoms (4·95 [2·52–9·74] and 14·80 [5·97–36·60]) at age 51–55 years in TAHS and age 47–64 years in CARDIA, compared with the average trajectory. Among individuals belonging to the three most impaired trajectories, the associations with predominant wheeze increased with worsening FEV&lt;sub&gt;1&lt;/sub&gt;/FVC impairment and persisted when considering only those without spirometry-defined COPD. Additionally, for those belonging to the two rapid decline trajectories, both wheezing and usual phlegm or bronchitis were reported by 54 (20%) of 265 participants younger than 14 years in TAHS and by 31 (25%) of 123 participants aged 30 years or younger in CARDIA.&lt;h3&gt;Interpretation&lt;/h3&gt;In two independent cohorts that collected similar data, people on impaired FEV&lt;sub&gt;1&lt;/sub&gt;/FVC trajectories often had a longstanding history of both wheeze and phlegm or bronchitis, and wheeze was the predominant symptom in individuals aged 47–64 years among those who had not already progressed to COPD.&lt;h3&gt;Funding&lt;/h3&gt;National Health and Medical Research Council (Australia); The University of Melbourne; Clifford Craig Medical Research Trust; Victorian, Queensland &amp; Tasmanian Asthma Foundati","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"259 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142742748","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}

{"title":"Treating eosinophilic exacerbations of asthma and COPD with benralizumab (ABRA): a double-blind, double-dummy, active placebo-controlled randomised trial","authors":"Sanjay Ramakrishnan, Richard E K Russell, Hafiz R Mahmood, Karolina Krassowska, James Melhorn, Christine Mwasuku, Ian D Pavord, Laura Bermejo-Sanchez, Imran Howell, Mahdi Mahdi, Stefan Peterson, Thomas Bengtsson, Mona Bafadhel","doi":"10.1016/s2213-2600(24)00299-6","DOIUrl":"https://doi.org/10.1016/s2213-2600(24)00299-6","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Exacerbations of asthma and chronic obstructive pulmonary disease (COPD) are important events and are associated with critical illness. Eosinophilic inflammation is a treatable trait commonly found during acute exacerbations of asthma and COPD. We hypothesised that for patients with eosinophilic exacerbations, a single injection of benralizumab, a humanised monoclonal antibody against interleukin-5 receptor-α, alone or in combination with prednisolone, will improve clinical outcomes compared with prednisolone, the standard of care.&lt;h3&gt;Methods&lt;/h3&gt;The Acute exacerbations treated with BenRAlizumab trial (ABRA) was a multicentre, phase 2, double-blind, double-dummy, active placebo-controlled randomised trial completed in the UK at Oxford University Hospitals NHS Foundation Trust and Guy's and St Thomas' NHS Foundation Trust. Patients were recruited from urgent care clinics and emergency departments of these two hospitals. At the time of an acute exacerbation of asthma or COPD, adults with blood eosinophil counts of equal to or more than 300 cells per μL were randomly assigned in a 1:1:1 ratio to receive acute treatment with: prednisolone 30 mg once daily for 5 days and 100 mg benralizumab subcutaneous injection once (BENRA plus PRED group); placebo tablets once daily for 5 days and 100 mg benralizumab subcutaneous injection once (BENRA group); or prednisolone 30 mg once daily for 5 days and placebo subcutaneous injection once (PRED group). Randomisation was performed with a centralised interactive computer randomisation service. All patients and study research staff involved in data collection were masked to study blood results and treatment allocation. The co-primary outcomes were proportion of treatment failures over 90 days and total visual analogue scale (VAS) symptoms at day 28 in the pooled benralizumab groups compared with the prednisolone alone group and analysed in the intention-to-treat population. The trial was registered on &lt;span&gt;&lt;span&gt;Clinicaltrials.gov&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt; &lt;span&gt;&lt;span&gt;NCT04098718&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;.&lt;h3&gt;Findings&lt;/h3&gt;Between May 13, 2021, and Feb 5, 2024, 287 patients were screened for study inclusion. 129 were excluded due to not having an exacerbation captured or not meeting the eosinophil exclusion criteria. 158 patients were randomly assigned at acute eosinophilic exacerbation of asthma or COPD where 86 (54%) patients were female and 72 (46%) were male with a mean age of 57 years (range, 18–84). 53 patients were randomly assigned to the PRED group, 53 were randomly assigned to the BENRA group, and 52 were assigned to the ","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"64 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142742722","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}

{"title":"Clean air, climate targets, and respiratory health in Europe","authors":"Vijay Shankar Balakrishnan","doi":"10.1016/s2213-2600(24)00403-x","DOIUrl":"https://doi.org/10.1016/s2213-2600(24)00403-x","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"5 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142742418","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}

{"title":"Respiratory symptoms and lung function trajectories: does wheeze hold the answer?","authors":"Hannah Whittaker, Jennifer K Quint","doi":"10.1016/s2213-2600(24)00337-0","DOIUrl":"https://doi.org/10.1016/s2213-2600(24)00337-0","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"145 11 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142742749","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}

{"title":"Lifetime non-smoker survives stage IV lung cancer four times","authors":"Tony Kirby","doi":"10.1016/s2213-2600(24)00366-7","DOIUrl":"https://doi.org/10.1016/s2213-2600(24)00366-7","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"19 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142713204","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}

{"title":"5 years of COVID-19: equity must lead the next pandemic response in a fractured multipolar world","authors":"David S C Hui, Dorothy Yeboah-Manu, Jean B Nachega, Alfonso J Rodriguez-Morales, Tieble Traore, Markus Maeurer, Guiseppe Ippolito, Adam Zumla, Rizwan Ahmed, Osman Dar, Adeeba Kamarulzaman, Alimuddin Zumla","doi":"10.1016/s2213-2600(24)00382-5","DOIUrl":"https://doi.org/10.1016/s2213-2600(24)00382-5","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"245 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142713203","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}