Factors Affecting Long-Term Survival in Locally Advanced NSCLC Patients With Pathologic Complete Response After Induction Therapy Followed by Surgical Resection

2020 ◽  
Author(s):  
Carolina Sassorossi ◽  
Filippo Lococo ◽  
Luca Pogliani ◽  
Diomira Tabacco ◽  
Amedeo Iaffaldano ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Advanced Nsclc ◽  
Locally Advanced ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Term Survival ◽  
Factors Affecting ◽  
Locally Advanced Nsclc ◽  
Nsclc Patients

scholarly journals P2.02-012 Long-Term Survival of Phase II of Full-Dose Oral Vinorelbine Combined with Cisplatin & Radiotherapy in Locally Advanced NSCLC

2017 ◽  
Vol 12 (1) ◽  
pp. S853
Author(s):  
Óscar Juan ◽  
Sergio Vazquez ◽  
Joaquin Casal Rubio ◽  
Jose Luis Fírvida ◽  
Francisco Aparisi ◽  
...  
Keyword(s):  
Phase Ii ◽  
Advanced Nsclc ◽  
Locally Advanced ◽  
Oral Vinorelbine ◽  
Term Survival ◽  
Long Term Survival ◽  
Full Dose ◽  
Locally Advanced Nsclc ◽  
Dose Oral

Effect of adjuvant chemotherapy following pathologic complete response on long-term survival in rectal cancer: A propensity score matched analysis.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 717-717 ◽  
Author(s):  
Ali Mokdad ◽  
Sergio Huerta ◽  
Rebecca M Minter ◽  
John C. Mansour ◽  
Michael A. Choti ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Clinical Stage ◽  
Locally Advanced ◽  
Pathologic Complete Response ◽  
Rectal Adenocarcinoma ◽  
Complete Response ◽  
Term Survival

717 Background: The role of adjuvant chemotherapy following resection in patients with rectal cancer that achieve pathologic complete response (pCR) after neoadjuvant therapy is unclear. Current data have been limited by small sample size series. This study examined the impact of adjuvant chemotherapy following pCR on overall survival in a national cohort of patients. Methods: Patients with rectal adenocarcinoma were identified in the National Cancer Data Base between 2006 and 2012. Those with locally advanced tumor (clinical stage II or III) that achieved pCR (defined as ypT0N0 in surgical specimens) after neoadjuvant chemoradiotherapy (nCRT) were included in the study. We matched by propensity score patients that received adjuvant chemotherapy (ACT) and patients that did not receive postoperative treatment (no-ACT) controlling for demographic as well as perioperative patient and tumor characteristics. Overall survival was compared using a Cox proportional hazards model. Results: We identified 2,543 patients (ACT: 732, no-ACT: 1,811 patients) with resected locally advanced rectal adenocarcinoma that achieved pCR after nCRT. Among patients that received ACT, 711 were matched with 711 patients in the no-ACT group. Adjuvant chemotherapy was associated with improved overall survival compared to no-ACT (hazard ratio[HR] = 0.46, 95% confidence interval [CI] = 0.29 – 0.75). Overall survivals at 1, 3, and 5 years in the ACT and no-ACT groups were 100% vs 98% (P=0.1), 98% vs 94% (P<0.01), and 94% vs 89% (P<0.01), respectively. In subgroup analyses, adjuvant chemotherapy improved overall survival in patients with clinical stage II (HR = 0.43, 95% CI = 0.22 – 0.85) as well as stage III tumor (OR = 0.50, 95% CI = 0.26 – 0.98). Among patients that received adjuvant chemotherapy, there was no difference in overall survival between single agent and multiagent regimens (HR = 1.37, 95% CI = 0.57 – 3.29). Conclusions: Adjuvant chemotherapy may providea small long-term survival benefit in patients with resected locally advanced rectal cancer and pCR after nCRT.

scholarly journals Prognostic Factors and Long-Term Survival in Locally Advanced NSCLC with Pathological Complete Response after Surgical Resection Following Neoadjuvant Therapy

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3572
Author(s):  
Filippo Lococo ◽  
Carolina Sassorossi ◽  
Dania Nachira ◽  
Marco Chiappetta ◽  
Leonardo Petracca Ciavarella ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Advanced Nsclc ◽  
Cox Regression ◽  
Pathological Complete Response ◽  
Locally Advanced ◽  
Complete Response ◽  
Long Term Results ◽  
Cox Regression Analysis ◽  
Locally Advanced Nsclc

Background: Outcomes for locally advanced NSCLC with pathological complete response (pCR), i.e., pT0N0 after induction chemoradiotherapy (IT), have been seldom investigated. Herein, long-term results, in this highly selected group of patients, have been evaluated with the aim to identify prognostic predictive factors. Methods: Patients affected by locally advanced NSCLC (cT1-T4/N0-2/M0) who underwent IT, possibly following surgery, from January 1992 to December 2019, were considered for this retrospective analysis. Survival rates and prognostic factors have been studied with Kaplan-Meier analysis, log-rank and Cox regression analysis. Results: Three-hundred and forty-three consecutive patients underwent IT in the considered period. Out of them, 279 were addressed to surgery; among them, pCR has been observed in 62 patients (18% of the total and 22% of the operated patients). In the pCR-group, clinical staging was IIb in 3 (5%) patients, IIIa in 28 (45%) patients and IIIb in 31 (50%). Surgery consisted of (bi)lobectomy in the majority of cases (80.7%), followed by pneumonectomy (19.3%). Adjuvant therapy was administered in 33 (53.2%) patients. Five-year overall survival and disease-free survival have been respectively 56.18% and 48.84%. The relative risk of death, observed with the Cox regression analysis, was 4.4 times higher (95% confidence interval (CI): 1.632–11.695, p = 0.03) for patients with N2 multi-station disease, 2.6 times higher (95% CI: 1.066–6.407, p = 0.036) for patients treated with pneumonectomy and 3 times higher (95% CI: 1.302–6.809, p = 0.01) for patients who did not receive adjuvant therapy. Conclusions: Rewarding long-term results could be expected in locally advanced NSCLC patients with pCR after IT followed by surgery. Baseline N2 single-station disease and adjuvant therapy after surgery seem to be associated with better prognosis, while pneumonectomy is associated with poorer outcomes.

Tumor survivin expression in locally advanced non-small cell lung cancer (NSCLC) patients treated with platinum-based chemoradiation followed by surgical resection

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 7595-7595
Author(s):  
M. J. Fidler ◽  
A. Seba ◽  
E. C. Farlow ◽  
S. Basu ◽  
K. Kaiser-Walters ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Advanced Nsclc ◽  
Locally Advanced ◽  
Survivin Expression ◽  
Platinum Based Chemotherapy ◽  
Locally Advanced Nsclc ◽  
Thoracic Radiation ◽  
Pre Treatment ◽  
Nsclc Patients ◽  
Nuclear Survivin

7595 Background: Recently tumor molecular markers have shown promise as prognostic and predictive indicators for survival in early and advanced stage NSCLC patients (pts.) treated with chemotherapy. The objective of this study was to correlate immunohistochemistry (IHC) markers of pre-treatment biopsies in locally advanced NSCLC patients treated with concurrent platinum based chemoradiation followed by surgical resection. Methods: This is a retrospective study that included stage III NSCLC pts who had adequate pre-treatment tumor specimens and were treated with platinum based chemotherapy regimens and concurrent thoracic radiation (40 Gy). Thirty three pts had sufficient pre-treatment tissue for IHC and were identified from a surgical database. Cells were stained by IHC for frequency (0–4) and intensity (0–4) of ERCC1, PTEN, and survivin and analyzed by log-rank and multivariate Cox PH regression for potential relationships to pathologic complete response (pCR), time to recurrence (TTR), and overall survival (OS). Results: Characteristics of 33 pts: 15 females; median age 61; 17 adenocarcinoma, 10 squamous(sq), 5 undifferentiated, 1 adeno-sq. Median OS was 23 months (mo) (5.9–140), and median TTR was 14.7 mo (3.5–121). Following chemoradiation, 9 patients had pCR. pCR was associated with improved TTR, p < .027. ERCC1 and PTEN were not significantly related to OS, TTR, or pCR. High nuclear survivin frequency (>2) was associated with worse OS, HR 0.4, p< .045 and lower nuclear survivin intensity (<4) was marginally associated with pCR, p< .10. Conclusions: In this exploratory analysis, higher survivin expression was associated with worse prognosis in locally advanced NSCLC patients treated with chemoradiation followed by surgery. These results suggest that additional studies of survivin are warranted in NSCLC and that adding survivin inhibitors to chemoradiation is a reasonable strategy for locally advanced NSCLC with high survivin expression. No significant financial relationships to disclose.

Preoperative survivin, ERCC1, and PTEN expression in stage III non-small cell lung cancer (NSCLC) patients (pts) treated with neoadjuvant and definitive chemoradiation and association with overall survival (OS).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 7067-7067
Author(s):  
Marta Batus ◽  
Mary J. Fidler ◽  
Kelly Kaiser Walters ◽  
Mark Pool ◽  
Brett Mahon ◽  
...  
Keyword(s):  
Overall Survival ◽  
Dna Repair ◽  
Locally Advanced ◽  
Concurrent Chemotherapy ◽  
Stage Iii ◽  
Term Survival ◽  
Modest Improvement ◽  
Thoracic Radiation ◽  
Nsclc Patients

7067 Background: Thoracic radiation and concurrent chemotherapy consisting of platinum based doublets has produced modest improvement in long term survival for patient with locally advanced (LA) NSCLC. There is relatively little information regarding molecular profiles and outcome in LA-NSCLC patients (pts) treated with chemoradiation. The objective of this retrospective study is to evaluate potential relationships between expression of DNA repair enzyme ERCC1 and enzymes involved in cell survival – survivin and PTEN. Methods: Stage III NSCLC pts who were treated with chest radiation (40-60Gy) and concurrently with platinum doublet and who had sufficient pretreatment tissue were included in this study. Immunohistochemistry was used to detect nuclear and cytoplasmic expression (frequency 0-4 and intensity 0-4) of survivin, and PTEN, and for nuclear expression of ERCC1. Product of intensity and frequency was calculated for all markers and correlated with overall survival (OS). Results: 97 pts had adequate tumor samples for analysis. 53 women, median age 67. 48 pts with ERCC1 prod <=6 had longer OS than 41 pts with ERCC1 prod >6 (19.6 vs 1.0 months, p=0.034). 16 pts with ERCC1 prod >6, PETN prod <=6 and survivin prod >4 had significantly lower OS than 68 pts with ERCC1<=6, PETN >6 and survivin <=4 (17.2 vs 40.2 months, p<0.001). Conclusions: The association of inferior survival in LA-NSCLC pts whose tumors express high survivin, low PTEN, and high ERCC1, suggests that combining inhibitors of survivin and or of PI3KCA with chemoradiation and developing strategies to inhibit DNA repair might improve outcomes in this group of pts.

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