Objective Assessment of ECOG Performance Status in Locally Advanced NSCLC Patients with the Use of TUG and Actigraphy

18107 Background: Brain metastases (BM) is a major problem in NSCLC. To evaluate the influence on survival in locally advanced NSCLC treated with radical RT, a retrospective analyses was performed of the patients treated at our institution. Methods: From June 1995 to Dec. 2003 200 patients with non-resectable NSCLC stage IIB-IIIAB received radical 3-D conformal radiotherapy with a planned dose =60Gy/30 F. Data on brain metastases were retrospectively obtained from the patient files. All patients were followed to death except in few cases in which data was obtained from other hospitals. End points were occurrence of BM and BM free survival (BM-RFS). A Cox multivariate analysis was performed including possible prognostic factors. Results: Stage at RT: IIB 8 (4%), IIIA 66(33%), IIIB+recurrent disease 126 (63%). Male/female ratio was 126 /74. The median survival was 15.5 months. The 2 yrs. survival was 34%. 42 (21%) cases of BM were observed. The median time to BM was 8.5 ms. with 86% occurring within 2 yrs. In 28 (67%) of the cases BM was the first site of failure, and in 10 (24%) BM remained the only site of failure. More women than men experienced BM 25 (34%) vs. 17 (14%), p= 0.0013. The survival after diagnosis of BM was 2.8 ms. The patients having BM as and these had better prognosis then patients experiencing BM at a later stage 5.3 vs 1.9 ms. (p<0.0001). The prognosis after BM as first failure were no worse than patients having other sites as first distant failure (3.6 ms, p=0.3). In a Cox multivariate analysis only female gender was associated with poorer BM-RFS while use of neoadjuvant chemotherapy, adeno.-histologi, age, stage at RT, and performance status at RT were insignificant factors. Conclusions: A significant number of cases with locally advanced NSCLC experienced BM especially in females. The survival after diagnosis of BM as first failure were no worse than patients experiencing other distant sites as first failure. The results indicates a that PCI should be considered to this group of patients No significant financial relationships to disclose.

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Impact of chemoradiotherapy (CRT) on immune-related tumor microenvironment and the efficacy of anti-PD-1 therapy after the recurrence of CRT in unresectable locally advanced NSCLC patients.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e21719 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e21719-e21719

Author(s):

Masayuki Shirasawa ◽

Tatsuya Yoshida ◽

Noriko Motoi ◽

Yuji Matsumoto ◽

Yuki Shinno ◽

...

Keyword(s):

Tumor Microenvironment ◽

Advanced Nsclc ◽

Locally Advanced ◽

Antibody Therapy ◽

Progression Free Survival ◽

Expression Levels ◽

Locally Advanced Nsclc ◽

The Status ◽

History Of ◽

Nsclc Patients

e21719 Background: Chemoradiotherapy (CRT) followed by durvalumab as maintenance therapy prolonged progression-free survival (PFS) and overall survival (OS) in unresectable locally advanced NSCLC (LA-NSCLC). Additionally, the history of radiotherapy and CRT has been reported to increase the efficacy of PD-1 blockade in advanced NSCLC patients. We evaluated the efficacy of anti-PD-(L)1 antibody therapy after CRT failure, and how CRT changes the status of PD-L1 expression on tumors and tumor infiltrated lymphocytes (TILs) in tumor microenvironment (TME) in unresectable LA-NSCLC patients. Methods: We retrospectively reviewed unresectable LA-NSCLC patients treated with CRT between December 2007 and December 2018, and evaluated the efficacy of PD-1 blockade after CRT failure. We also analyzed PD-L1 (clone: 22C3) expression on tumor cells, and CD8 positive TILs using the paired specimens that had been obtained pre-CRT and post-CRT failure. Results: We identified 422 patients who received CRT. Median follow-up was 36.1 months (range 2.7–138.1 months). Among these patients, sixty-five patients who had progressed post-CRT received anti-PD- (L)1 therapy (PD-1 therapy: 61 patients, PD-L1 therapy: 4 patients). Response rate (RR) and PFS of anti-PD-(L)1 therapy were 48% (95% CI, 35–60) and 8.7 (95% CI, 4.5–13.0) months. The RR and PFS did not differ according to PD-L1 expression levels (Table). Of the 18 patients, 9, 7, and 2 showed upregulation in PD-L1 expression or down- or no change, respectively, post-CRT. In contrast, the density of CD8 positive TILs in TME increased by CRT treatment ([pre-CRT]: median, 110 ± 239 /mm2 vs. [post-CRT]: median, 470 ± 533 /mm2, p = 0.025). Conclusions: The clinical outcome of anti-PD-(L)1 therapy after CRT failure in LA-NSCLC patients could be better than advanced NSCLC patients, but did not differ according to PD-L1 expression levels. The efficacy of PD-(L)1 therapy enhanced by CRT treatment could be due to the infiltration of CD8 T-cells into TME. [Table: see text]

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P3.13-015 18F-FDG-PET/CT after Induction Chemotherapy for Prediction of Survival after Radical Chemo-Radiotherapy in Locally Advanced NSCLC Patients

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2017.09.1750 ◽

2017 ◽

Vol 12 (11) ◽

pp. S2321

Author(s):

J. Fledelius ◽

A.A. Khalil ◽

K. Hjorthaug ◽

O. Hansen ◽

J. Frøkiær

Keyword(s):

Induction Chemotherapy ◽

Fdg Pet ◽

Advanced Nsclc ◽

Locally Advanced ◽

Pet Ct ◽

Locally Advanced Nsclc ◽

Prediction Of Survival ◽

18F Fdg ◽

Fdg Pet Ct ◽

Nsclc Patients

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

Clinical Lung Cancer ◽

10.1016/j.cllc.2020.06.023 ◽

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

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Acute-Onset Pneumonitis while Administering the First Dose of Durvalumab

Case Reports in Oncology ◽

10.1159/000502202 ◽

2019 ◽

Vol 12 (2) ◽

pp. 621-624 ◽

Cited By ~ 5

Author(s):

Erwin H.J. Tonk ◽

Anne S.R. van Lindert ◽

Joost J.C. Verhoeff ◽

Karijn P.M. Suijkerbuijk

Keyword(s):

Lung Cancer ◽

Advanced Nsclc ◽

Locally Advanced ◽

Acute Onset ◽

Small Cell ◽

Steroid Treatment ◽

Consolidation Therapy ◽

Small Cell Lung ◽

Locally Advanced Nsclc ◽

Nsclc Patients

In locally advanced non-small cell lung cancer (NSCLC) patients, consolidation therapy with durvalumab (an anti-PD-L1 monoclonal antibody) has proven to significantly increase both progression free and overall survival after chemoradiotherapy. Here, we describe a case of acute pneumonitis during durvalumab administration for locally advanced NSCLC, causing persistent symptomatology and steroid treatment to date. To our knowledge, acute-onset pneumonitis during infusion of a PD-L1 inhibitor has not been described previously. This case illustrates that ICI-induced pneumonitis can occur anytime during treatment, especially after chemoradiation.

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