35 Changing patterns of hospital admissions for lung cancer patients in Ireland, 2005 to 2014

Abstract This study was conducted to determine whether there was an effect on the hospital admissions of newly diagnosed lung cancer (NDLC) patients in Turkey during the COVID-19 pandemic. In this retrospective study, NDLC patients were recorded from the Hospital Information Management System between January,1 2015-December, 31, 2020, at our tertiary hospital. The number of NDLC patients diagnosed in 2020 was compared with each year of 2017-2019. Between 2017 and 2020, 15,150 NDLC cases were analyzed. The number of NDLC patients by year were; 4,030 patients in 2017, 4,004 patients in 2018, 4,391 patients in 2019, and 2,725 in 2020, respectively. In 2020, NDLC patients decreased by 38%, 32%, 32% compared to 2019, 2018, and 2017, respectively. The late admission of lung cancer patients might result in the advanced stage, missing the chance for surgery, and decreased survival. Precautions should be considered to diagnose and treat lung cancer patients in specialized centers during a pandemic due to epidemic diseases such as COVID-19.

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Molecular and Clinical Features of Hospital Admissions in Patients with Thoracic Malignancies on Immune Checkpoint Inhibitors

Cancers ◽

10.3390/cancers13112653 ◽

2021 ◽

Vol 13 (11) ◽

pp. 2653

Author(s):

Dan Zhao ◽

Haiqing Li ◽

Isa Mambetsariev ◽

Chen Chen ◽

Rebecca Pharaon ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Patients ◽

Immune Checkpoint ◽

Immune Checkpoint Inhibitors ◽

Hospital Admissions ◽

Checkpoint Inhibitors ◽

Stage Iv ◽

Cox Models ◽

Lung Cancer Patients ◽

Thoracic Malignancies

Lung cancer patients undergoing systemic treatment with immune checkpoint inhibitors (ICIs) can lead to severe immune-related adverse events (irAEs) that may warrant immediate hospitalization. Patients with thoracic malignancies hospitalized at City of Hope while undergoing treatment with ICIs were identified. Pathology and available next-generation sequencing (NGS) data, including the programmed death-ligand 1 (PD-L1) status and clinical information, including hospitalizations, invasive procedures, and the occurrence of irAEs, were collected. Unpaired T-tests, Chi-square/Fisher’s exact test, and logistic regression were used to analyze our cohort. The overall survival (OS) was calculated and compared using univariate and multivariate COX models. Ninety patients with stage IV lung cancer were admitted after ICI treatment. Of those patients, 28 (31.1%) had documented irAEs. Genomic analyses showed an enrichment of LRP1B mutations (n = 5/6 vs. n = 7/26, 83.3% vs. 26.9%; odds ratio (OR) (95% confidence interval (CI): 13.5 (1.7–166.1); p < 0.05) and MLL3 mutations (n = 4/6, 66.7% vs. n = 5/26, 19.2%; OR (95% CI): 8.4 (1.3–49.3), p < 0.05) in patients with irAE occurrences. Patients with somatic genomic alterations (GAs) in MET (median OS of 2.7 vs. 7.2 months; HR (95% CI): 3.1 (0.57–17.1); p < 0.05) or FANCA (median OS of 3.0 vs. 12.4 months; HR (95% CI): 3.1 (0.70–13.8); p < 0.05) demonstrated a significantly shorter OS. Patients with irAEs showed a trend toward improved OS (median OS 16.4 vs. 6.8 months, p = 0.19) compared to hospitalized patients without documented irAEs. Lung cancer patients who required treatment discontinuance or interruption due to irAEs (n = 19) had significantly longer OS (median OS 18.5 vs. 6.2 months; HR (95% CI): 0.47 (0.28–0.79); p < 0.05). Our results showed a significant survival benefit in lung cancer patients hospitalized due to irAEs that necessitated a treatment interruption. Patients with positive somatic GAs in MET and FANCA were associated with significantly worse OS compared to patients with negative GAs.

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