Factors associated with delayed treatment initiation in an unselected cohort of patients with small-cell lung cancer.

BackgroundAnti-programmed death-1 (anti-PD-1) therapy has shown clinical success in patients with advanced non-small cell lung cancer (NSCLC). However, it is difficult to evaluate the early response to anti-PD-1 therapy. We determined whether changes in 3′-deoxy-3′-[18F]-fluorothymidine (18F-FLT) PET parameters before and soon after treatment initiation predicted the therapeutic effect of anti-PD-1 antibody.MethodsTwenty-six patients with advanced NSCLC treated with anti-PD-1 antibody were enrolled prospectively and underwent 18F-FLT PET before and at 2 and 6 weeks after treatment initiation. Changes in maximal standardized uptake value (ΔSUVmax), proliferative tumor volume (ΔPTV) and total lesion proliferation (ΔTLP) of the lesions were calculated and evaluated for their associations with the clinical response to therapy.ResultsThe disease control rate was 64%. Patients with non-progressive disease (non-PD) had significantly decreased TLP at 2 weeks, and decreased SUVmax, PTV, and TLP at 6 weeks, compared with those with PD, while three of eight (37.5%) patients who responded had increased TLP from baseline at 2 weeks (ie, pseudoprogression). Among the parameters that changed between baseline and 2 weeks, ΔPTV0-2 and ΔTLP0-2 had the highest accuracy (76.0%) to predict PD. Among the parameters that changed between baseline and 6 weeks, ΔSUVmax0-6, ΔPTV0-6 and ΔTLP0-6 had the highest accuracy (90.9%) to predict PD. ΔTLP0-2 (≥60%, HR 3.41, 95% CI 1.34–8.65, p=0.010) and ΔTLP0-6 (≥50%, HR 31.4, 95% CI 3.55 to 276.7, p=0.0019) were indicators of shorter progression-free survival.ConclusionsChanges in 18F-FLT PET parameters may have value as an early predictive biomarker for the response to anti-PD-1 therapy in patients with NSCLC. However, it should be noted that pseudoprogression was observed in 18F-FLT PET imaging at 2 weeks after treatment initiation.Trial registration numberjRCTs051180147.

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Clinical factors associated with mortality within three months after radiosurgery of asymptomatic brain metastases from non-small cell lung cancer

Journal of Neuro-Oncology ◽

10.1007/s11060-018-03002-0 ◽

2018 ◽

Vol 140 (3) ◽

pp. 705-715 ◽

Cited By ~ 3

Author(s):

Bina Kakusa ◽

Summer Han ◽

Sonya Aggarwal ◽

Boxiang Liu ◽

Gordon Li ◽

...

Keyword(s):

Lung Cancer ◽

Brain Metastases ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Clinical Factors ◽

Small Cell Lung ◽

Factors Associated

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P2.16-32 Survival Implications and Factors Associated with the Anatomic Level of Incomplete Non-Small-Cell Lung Cancer (NSCLC) Resection

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2018.08.1507 ◽

2018 ◽

Vol 13 (10) ◽

pp. S844

Author(s):

Y. Lee ◽

M. Smeltzer ◽

M. Ray ◽

N. Faris ◽

C. Fehnel ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Small Cell Lung ◽

Factors Associated

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Dose-volume parameters predict radiation pneumonitis after induction chemoradiotherapy followed by surgery for non-small cell lung cancer: a retrospective analysis

BMC Cancer ◽

10.1186/s12885-019-6359-9 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Kuniaki Katsui ◽

Takeshi Ogata ◽

Kenta Watanabe ◽

Norihisa Katayama ◽

Junichi Soh ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Radiation Pneumonitis ◽

Lower Lobe ◽

Small Cell ◽

Lung Dose ◽

Small Cell Lung ◽

Factors Associated ◽

Dose Volume

Abstract Background The relationship between lung dose-volume histogram (DVH) parameters and radiation pneumonitis (RP) associated with induction concurrent chemoradiotherapy (CCRT) followed by surgery in patients with non-small cell lung cancer (NSCLC) is unclear, particularly when concerning irradiation of the whole lung prior to resection. We performed this study to identify factors associated with grade ≥ 2 RP in such patients. Methods Patients who received induction CCRT (chemotherapy: cisplatin and docetaxel; radiotherapy: 46 Gy/23 fractions) between May 2003 and May 2017 were reviewed. The mean lung dose (MLD) and the percentage of the lung volume that received ≥5 Gy (V5) and ≥ 20 Gy (V20) were calculated. Factors associated with the development of grade ≥ 2 RP were analyzed. Results One hundred and eight patients were included in this study, 34 (31.5%) of whom experienced grade ≥ 2 RP. A V20 ≥ 21%, an MLD ≥10 Gy, and a lower lobe tumor location were significant predictors of grade ≥ 2 RP on univariate analysis (p = 0.007, 0.002, and 0.004, respectively). Moreover, an MLD ≥10 Gy and lower lobe location were significant predictors of grade ≥ 2 RP on multivariate analysis (p = 0.026 and 0.0043, respectively). The cumulative incidence rates of grade ≥ 2 RP at 6 months were 15.7 and 45.6% in patients with MLDs < 10 Gy and ≥ 10 Gy, respectively, and were 23.5 and 55.6% in patients with upper/middle lobe- vs. lower lobe-located tumors, respectively. Conclusions MLD and lower lobe location were predictors of grade ≥ 2 RP in patients who received induction CCRT. It is necessary to reduce the MLD to the greatest extent possible to prevent the occurrence of this adverse event.

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Socioeconomic Factors Associated with Lack of Treatment in Early Stage Non-Small Cell Lung Cancer

Cancer Investigation ◽

10.1080/07357907.2019.1666136 ◽

2019 ◽

Vol 37 (9) ◽

pp. 506-511

Author(s):

Shraddha M. Dalwadi ◽

Jun Zhang ◽

Eric H. Bernicker ◽

E. Brian Butler ◽

Bin S. Teh ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Socioeconomic Factors ◽

Cell Lung Cancer ◽

Early Stage ◽

Small Cell ◽

Small Cell Lung ◽

Factors Associated

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Determining the factors associated with 1-year survival in small cell lung cancer using national audit, chemotherapy and radiotherapy data

Lung Cancer ◽

10.1016/s0169-5002(19)30245-4 ◽

2019 ◽

Vol 127 ◽

pp. S83-S84

Author(s):

G. Jones ◽

A. Khakwani ◽

T. Mckeever ◽

R. Hubbard ◽

D. Baldwin

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

National Audit ◽

Small Cell Lung ◽

Factors Associated

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Effect of time interval from diagnosis to treatment for non-small cell lung cancer on survival: a national cohort study in Taiwan

BMJ Open ◽

10.1136/bmjopen-2019-034351 ◽

2020 ◽

Vol 10 (4) ◽

pp. e034351 ◽

Cited By ~ 1

Author(s):

Chang-Hung Tsai ◽

Pei-Tseng Kung ◽

Wei-Yin Kuo ◽

Wen-Chen Tsai

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cancer Diagnosis ◽

Cell Lung Cancer ◽

Treatment Initiation ◽

Small Cell ◽

Time Interval ◽

Newly Diagnosed ◽

Small Cell Lung ◽

National Cohort

ObjectivesThis study aimed to determine if treatment delay after non-small cell lung cancer (NSCLC) diagnosis impacts patient survival rate.Study designThis study is a natural experiment in Taiwan. A retrospective cohort investigation was conducted from 2004 to 2010, which included 42 962 patients with newly diagnosed NSCLC.MethodsWe identified 42 962 patients with newly diagnosed NSCLC in the Taiwan Cancer Registry from 2004 to 2010. We calculated the time interval between diagnosis and treatment initiation. All patients were followed from the index date to death or the end of 2012. Cox proportional hazard models were used to examine the relationship between mortality and time interval.ResultsWe included 42 962 patients (15 799 men and 27 163 women) with newly diagnosed NSCLC. The mortality rate exhibited a significantly positive correlation to time interval from cancer diagnosis to treatment initiation. The adjusted HRs ranged from 1.04 to 1.08 in all subgroups time interval more than 7 days compared with the counterpart subgroup of the interval from cancer diagnosis to treatment ≤7 days. The trend was also noted regardless of the patients with lung cancer in stage I, stage II and stage III.ConclusionsThere is a major association between time to treat and mortality of patients with NSCLC, especially in stages I and II. We suggest that efforts should be made to minimise the interval from diagnosis to treatment while further study is ongoing to determine causation.

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