OC-0199: Cardiac sparing in advanced stage NSCLC patients: at what cost?

2020 ◽  
Vol 152 ◽  
pp. S99-S100
Author(s):  
R. Van Der Bel ◽  
B. Stam ◽  
D. Eekhout ◽  
A. Tijhuis ◽  
K. Kiers ◽  
...  
2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Tereza Vaclova ◽  
Ursula Grazini ◽  
Lewis Ward ◽  
Daniel O’Neill ◽  
Aleksandra Markovets ◽  
...  

AbstractAdvanced non-small-cell lung cancer (NSCLC) patients with EGFR T790M-positive tumours benefit from osimertinib, an epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI). Here we show that the size of the EGFR T790M-positive clone impacts response to osimertinib. T790M subclonality, as assessed by a retrospective NGS analysis of 289 baseline plasma ctDNA samples from T790M‐positive advanced NSCLC patients from the AURA3 phase III trial, is associated with shorter progression-free survival (PFS), both in the osimertinib and the chemotherapy-treated patients. Both baseline and longitudinal ctDNA profiling indicate that the T790M subclonal tumours are enriched for PIK3CA alterations, which we demonstrate to confer resistance to osimertinib in vitro that can be partially reversed by PI3K pathway inhibitors. Overall, our results elucidate the impact of tumour heterogeneity on response to osimertinib in advanced stage NSCLC patients and could help define appropriate combination therapies in these patients.


2017 ◽  
Vol 193 (5) ◽  
pp. 402-409 ◽  
Author(s):  
Giuseppe Della Gala ◽  
Maarten L. P. Dirkx ◽  
Nienke Hoekstra ◽  
Dennie Fransen ◽  
Nico Lanconelli ◽  
...  

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e21117-e21117
Author(s):  
Andreas Bello ◽  
Neeharika Srivastava Makani

e21117 Background: Non-small cell lung cancer (NSCLC) is the most prevalent form of lung cancer. Many studies have evaluated the association of social determinants with outcomes in early-stage NSCLC. These studies have shown statistically and clinically significant associations between overall survival (OS) and other social factors (e.g marital status, educational attainment). The aim of our study was to better understand the role of various social determinants of health (SDH) on OS in advanced-stage NSCLC patients in a community oncology practice in Florida. Methods: In this retrospective study, 125 patients with stage III and IV NSCLC were recruited between January 1st, 2014 until December 31st, 2018. We performed both categorical and continuous analyses (Pearson’s chi-square and Kruskal-Wallis test, respectively) to evaluate the association between median OS and several independent variables, including; gender, race, marital status, insurance status, living status, receiving financial assistance (FA), alcohol use, and smoking histories. OS is defined as the date of diagnosis up to the date of death. Other confounders that were analyzed included histology, treatment modality, comorbidities, and performance status of the patients. Results: Of the total study population (n = 125), 60% identified as male with a mean age of 73 years for the study population. The majority of patients (89%) identified as white; 56% were married, and 81% lived with someone. 66% of patients had an HMO insurance plan, and 51% of patients obtained FA to help with treatment care costs. 47% of patients identified as former smokers and 54% denied any alcohol use. The median OS for the patient population was 0.756 years. Chi-square analyses revealed that patients who received FA were more likely to live longer than median OS as opposed to patients that did not receive FA (OR = 2.41, 95% CI [1.18, 4.96], p = 0.050). Kruskal-Wallis analyses demonstrated that patients receiving FA had nearly a two-fold increase in median OS compared to patients without financial assistance (median OS = 1.01 years vs. 0.545 years, respectively; p = 0.013). However, other social determinants evaluated did not have a significant impact on relative OS in advanced-stage NSCLC. Conclusions: Ultimately, our study concludes that receiving FA has a significant association with increased OS in advanced-stage NSCLC patients. This study highlights the importance of reducing the financial burden of advanced-stage NSCLC patients and how FA impacts patient outcomes. Future prospective cohort studies with a larger sample size are warranted to identify other SDH, as well as the underlying mechanisms affecting median OS, in patients with advanced-stage NSCLC.


Open Medicine ◽  
2010 ◽  
Vol 5 (4) ◽  
pp. 431-436
Author(s):  
Bülent Karagöz ◽  
Oğuz Bilgi ◽  
Emin Kandemir ◽  
Alev Erikçi ◽  
Özkan Sayan ◽  
...  

AbstractTo investigate CD4+CRTH2+ cells in peripheral blood in advanced stage non small cell lung cancer (NSCLC) patients. Forty-six patients with advanced stage NSCLC, who are chemotherapy or radiotherapy naïve, and 17 healthy volunteers, were enrolled in this study. The study was performed using flow cytometry and a complete blood cell counter analyser. CD4+ T cell percentage, CD4/CD8 ratio, CRTH2+CD4+ cell percentages, counts, and mean fluorescein intensity (MFI) and hematological parameters were evaluated in both groups. A survival analysis was performed to compare the patients with high CD4+CRTH2+ cell percentage and those with low CD4+CRTH2+ percentage. CD4+ T cell percentage in total lymphocytes and the CD4/CD8 ratio were lower in the patient group than in the control group. The absolute CD8 T cell count was higher in the patient group than in the control group, whereas the total T cells was not different. The CRTH2+ cell percentage in CD4+ T cells (7.96% ± 6.21% vs 3.37% ± 3.55%; respectively; p: 0,001) and the absolute count of CRTH2+CD4+ cells ( 97 mm-3 ± 109 mm-3 vs 37 mm-3 ± 38 mm-3, respectively; p: 0,033) in the patient group were higher than in the control group, but CRTH2-PE MFI values were not different between groups. Cox regression analysis did not show that CRTH2+CD4+ cell count or percentage is an independent prognostic factor. The study found that CRTH2 expression of CD4+ T cells and CRTH2+CD4+ cell number are higher in the peripheral blood of NSCLC patients than in that of healthy subjects. Further studies that explore the biological significance of high CD4+CRTH2+ cells in lung cancer patients, should be pursued.


2021 ◽  
Vol 8 (11) ◽  
pp. 1644
Author(s):  
I. B. P. Ekaruna ◽  
Ketut Suryana ◽  
Jasminarti D. K. ◽  
N. W. Candrawati ◽  
N. L. P. Eka Arisanti ◽  
...  

Background: The main purpose of treatment in patients with advanced lung cancer is more emphasizing on prolonging survival and improving the patient's quality of life (QOL). Micronutrient deficiency has an impact on the patient's QOL. The purpose of this study was to analyse the relationship between biochemical parameters of nutrient deficiency with QOL in patients with advanced non-small cell carcinoma (NSCLC) at Sanglah hospital.Methods: A cross sectional study was conducted in Sanglah general hospital on March-June 2021. Hemoglobin, albumin, and 2.5 (OH) D levels were obtained from patient's serum. The participant’s QOL was measured with EQ-5D-3L questionnaire. Bivariate analysis using chi-square test or Fisher's exact test, and multivariate analysis using logistic regression.Results: A total of 80 participants were included in this study, and 55% had poor QOL. Seventy percent participants had anemia, 36.3% had hypoalbuminemia, and 26.3% had vitamin D deficiency. The QOL of patients with advanced stage NSCLC was significantly associated with hypoalbuminemia (p=0.000) and vitamin D deficiency (p=0.044). Multivariate analysis showed that the most influential factor on the QOL of patients with advanced stage NSCLC was hypoalbuminemia (AOR 9.158; 95% CI 2.150-30.001; p=0.003).Conclusions: Hypoalbuminemia and vitamin D deficiency were significantly related with QOL of advance NSCLC patients. No relationship was found between anemia and the QOL of advance NSCLC patients. Hypoalbuminemia was the most influential factors related to the QOL of advance NSCLC patients.


Author(s):  
K.J.C. Sanders ◽  
L.E. Hendriks ◽  
E.G.C. Troost ◽  
G.P. Bootsma ◽  
A.M.W.J. Schols ◽  
...  

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