Prospective Assessment of The Accuracy, Reliability and Cost-Effectiveness of Staging Non-Small Cell Lung Cancer (NSCLC) Only with The Combination of Pet/Ct and Brain MRI

e19038 Background: Up to one-third of non-small cell lung cancer (NSCLC) patients are diagnosed with brain metastasis. Our study aims to evaluate the role of whole body and brain FDG-PET/CT in detecting asymptomatic brain metastasis in this population. Methods: We performed a retrospective chart review of 282 consecutive non-small cell lung cancer patients between February of 2005 and June of 2008. 60 patients with brain metastasis were identified. Information regarding tumor histology and presence of neurological symptoms at the time of discovery of brain metastasis was collected. In addition, data was acquired from brain MRI and PET/CT (with IV contrast) reports including: study date, findings and any change in staging secondary to the study. Results: The median age was 63 years (47 % women). 39 (65%) of the patients had neurological symptoms at the time of discovery of brain metastasis. PET/CT scan with IV contrast was performed in 53 patients with brain metastasis. For patients who had a PET/CT scan, the histological types were: adenocarcinoma (58.4%), unclassified (22.6%), squamous (13.2%), large cell (3.8%) and other (1.8%). PET/CT scan had a sensitivity of 97.8% in detecting CNS metastasis seen on brain MRI. 19/53 patients were found to have asymptomatic brain metastasis on PET/CT scan (2 stage I, 1 stage II, 2 stage III and 13 stage IV). Overall, PET/CT scan resulted in upstaging of 5 asymptomatic and 6 symptomatic patients or 11/53 (20.7%). Conclusions: PET/CT scan with IV contrast has a high sensitivity in detecting brain metastasis in patients with NSCLC when compared to brain MRI. It is effective in detecting asymptomatic brain metastasis in this population. Those patients, who initially were thought to have non-metastatic disease, are spared inappropriate aggressive surgery or radiation. No significant financial relationships to disclose.

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PET/CT Imaging of Small Cell Lung Cancer Using 89Zr-DFO-SC16.56

Case Medical Research ◽

10.31525/ct1-nct04199741 ◽

2019 ◽

Author(s):

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Ct Imaging ◽

Small Cell ◽

Small Cell Lung ◽

Pet Ct

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Cost–effectiveness of second-line nivolumab for platinum-treated advanced non-small-cell lung cancer

Journal of Comparative Effectiveness Research ◽

10.2217/cer-2020-0053 ◽

2020 ◽

Vol 9 (18) ◽

pp. 1301-1309

Author(s):

Longfeng Zhang ◽

Xiaofang Zeng ◽

Hongfu Cai ◽

Na Li ◽

Maobai Liu ◽

...

Keyword(s):

Lung Cancer ◽

Cost Effectiveness ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Phase Iii ◽

Second Line ◽

Small Cell Lung ◽

The Cost ◽

Quality Adjusted Life

Aim: To analyze the economic impact of nivolumab and chemotherapy in patients with non-small-cell lung cancer (NSCLC) who developed disease progression after platinum-containing dual-drug chemotherapy. Materials & methods: The partitioned survival model was used to analyze the cost-utility of two NSCLC treatments by nivolumab and docetaxel. The clinical data resulted from the Phase III clinical trial. The cost parameters were derived from our previous studies, and the utility parameters were derived from the literature. Results: The quality-adjusted life-years of nivolumab and docetaxel were 0.778 and 0.336. The lifetime direct medical expenses of nivolumab and docetaxel were US$44,707.17 and US$12,826.72. The incremental cost–effectiveness ratio was $72,127.71/quality-adjusted life-year. Conclusion: The combination of chemotherapy, nivolumab is not a cost-effective choice in the second-line treatment of NSCLC.

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