Diagnostic accuracy of whole-body MRI versus standard imaging pathways for metastatic disease in newly diagnosed non-small-cell lung cancer: the prospective Streamline L trial

Immune-checkpoint inhibitors (ICIs) have been proven to have great efficacy in non-small cell lung cancer (NSCLC) as single agents or in combination therapy, being capable to induce deep and durable remission. However, severe adverse events may occur and about 40% of patients do not benefit from the treatment. Predictive factors of response to ICIs are needed in order to customize treatment. The aim of this study is to evaluate the correlation between quantitative positron emission tomography (PET) parameters defined before starting ICI therapy and responses to treatment and patient outcome. We retrospectively analyzed 92 NSCLC patients treated with nivolumab, pembrolizumab or atezolizumab. Basal PET/computed tomography (CT) scan parameters (whole-body metabolic tumor volume—wMTV, total lesion glycolysis—wTLG, higher standardized uptake volume maximum and mean—SUVmax and SUVmean) were calculated for each patient and correlated with outcomes. Patients who achieved disease control (complete response + partial response + stable disease) had significantly lower MTV median values than patients who had not (progressive disease) (77 vs. 160.2, p = 0.039). Furthermore, patients with MTV and TLG values lower than the median values had improved OS compared to patients with higher MTV and TLG (p = 0.03 and 0.05, respectively). No relation was found between the other parameters and outcome. In conclusion, baseline metabolic tumor burden, measured with MTV, might be an independent predictor of treatment response to ICI and a prognostic biomarker in NSCLC patients.

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C2-06: Integrated PET/CT versus 3T whole body MR imaging: efficacy comparison in non-small cell lung cancer staging

Journal of Thoracic Oncology ◽

10.1097/01.jto.0000283200.64200.6d ◽

2007 ◽

Vol 2 (8) ◽

pp. S363-S364

Author(s):

Kyung-Min Shin ◽

Chin A. Yi ◽

Kyung Soo Lee ◽

Byung-Tae Kim ◽

Hojoong Kim ◽

...

Keyword(s):

Lung Cancer ◽

Mr Imaging ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Cancer Staging ◽

Small Cell ◽

Whole Body ◽

Small Cell Lung ◽

Pet Ct

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P-616 Ramifications of severe organ dysfunction in newly diagnosed patients with small cell lung cancer

Lung Cancer ◽

10.1016/s0169-5002(05)81109-2 ◽

2005 ◽

Vol 49 ◽

pp. S280-S281

Author(s):

K. Giordano ◽

A. Jatoi ◽

A. Adjei ◽

E. Creagan ◽

G. Croghan ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Organ Dysfunction ◽

Cell Lung Cancer ◽

Small Cell ◽

Newly Diagnosed ◽

Small Cell Lung

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The Diagnostic Role of Sputum miRNA in Non-Small Cell Lung Cancer

10.21203/rs.3.rs-62275/v1 ◽

2020 ◽

Author(s):

Zaoxiu Hu ◽

Yonghe Zhao ◽

Yanlong Yang ◽

Zhenghai Shen ◽

Yunchao Huang

Keyword(s):

Lung Cancer ◽

Diagnostic Accuracy ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Early Stage ◽

Small Cell ◽

Stage I ◽

Small Cell Lung ◽

Diagnostic Role

Abstract Objective: Recent studies indicated sputum miRNAs may provide a promising approach for non-small cell lung cancer (NSCLC) diagnosis. But some results were still inconsistent. So, we performed meta-analysis to evaluate the diagnostic role of sputum miRNAs for the detection of NSCLC.Methods: Eligible studies that estimated the diagnostic accuracy of sputum miRNAs in NSCLC were searched in Pubmed, Embase and Web of Science and Chinese National Knowledge Infrastructure (CNKI). Data from the eligible studies were collected and pooled; sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratios, weighted symmetric summary ROC curve and the area under the curve (AUC) were calculated by bi-variate random effects model. The between-study heterogeneity was evaluated by Q test and I2 statistics.Results: 30 studies from 16 articles were included for analysis. The overall analysis yielded the sensitivity of 0.77 (95% CI: 0.73–0.81) and specificity of 0.87 (95% CI: 0.83–0.90), with an area under the SROC curve (AUC) of 0.89 (95% CI: 0.86–0.91). Subgroup analysis revealed the diagnostic accuracy in multiple miRNAs studies was higher than single miRNA (the sensitivity, specifcity and an AUC of multiple miRNAs were 0.76, 0.88 and 0.90; and for single miRNA, it was 0.74, 0.74, and 0.80). The diagnostic performance in early stage NSCLC was also very high (the sensitivity, specifcity and an AUC of stage I/II was 0.76, 0.88 and 0.91; and for stage I, it was 0.79, 0.85, and 0.87). We also found miR-210, miR-21, miR-31 and miR-126-3p might serve as potential biomarkers for lung cancer.Conclusion: Sputum miRNAs was useful noninvasive biomarkers for NSCLC diagnosis.

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Whole body PET-CT: M staging in non small- cell lung cancer

Journal of the Belgian Society of Radiology ◽

10.5334/jbr-btr.233 ◽

2013 ◽

Vol 96 (3) ◽

pp. 127

Author(s):

FX Hanin

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Whole Body ◽

Small Cell Lung ◽

Pet Ct

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Clinical Utility of Comprehensive Cell-free DNA Analysis to Identify Genomic Biomarkers in Patients with Newly Diagnosed Metastatic Non–small Cell Lung Cancer

Clinical Cancer Research ◽

10.1158/1078-0432.ccr-19-0624 ◽

2019 ◽

Vol 25 (15) ◽

pp. 4691-4700 ◽

Cited By ~ 88

Author(s):

Natasha B. Leighl ◽

Ray D. Page ◽

Victoria M. Raymond ◽

Davey B. Daniel ◽

Stephen G. Divers ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Clinical Utility ◽

Dna Analysis ◽

Small Cell ◽

Newly Diagnosed ◽

Small Cell Lung ◽

Cell Free Dna ◽

Free Dna

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Managing Patients With Oligometastatic Non–Small-Cell Lung Cancer

Journal of Oncology Practice ◽

10.1200/jop.2017.026500 ◽

2018 ◽

Vol 14 (1) ◽

pp. 23-31 ◽

Cited By ~ 17

Author(s):

Sarah Jo Stephens ◽

Michael J. Moravan ◽

Joseph K. Salama

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Metastatic Disease ◽

Cell Lung Cancer ◽

Checkpoint Inhibitors ◽

Small Cell ◽

Definitive Treatment ◽

Clinical Group ◽

Small Cell Lung ◽

The Uk

Metastatic lung cancer has long been considered incurable, with the goal of treatment being palliation. However, a clinically meaningful number of these patients with limited metastases (approximately 25%) are living long term after definitive treatment to all sites of active disease. These patients with so-called oligometastatic disease likely represent a distinct clinical group who may possess a more indolent biology compared with their more widely metastatic counterparts. Hellman and Weichselbaum proposed the existence of the oligometastatic state, on the basis of the spectrum theory of cancer spread. The literature suggests that an oligometastatic state exists in patients with non–small-cell lung cancer (NSCLC). This observation in the setting of rapidly evolving systemic therapies, including immune checkpoint inhibitors and an increasing number of targeted therapies, represents a unique clinical opportunity. Metastasis-directed therapies to address sites of disease include surgery (metastasectomy) and/or radiation therapy. Available evidence suggests that treating patients with limited or oligometastases may improve outcomes in a meaningful way; however, the majority of the randomized data includes patients with intracranial metastatic disease, and there are limited robust, randomized data available in the setting of NSCLC with only extracranial sites of metastatic disease. Ongoing randomized trials, including NRG-LU002 and the UK Conventional Care Versus Radioablation (Stereotactic Body Radiotherapy) for Extracranial Oligometastases trial, are aimed at evaluating this question further. One of the current limitations of aggressive treatment of oligometastatic NSCLC is the inability to accurately identify these patients before therapy, yet molecular markers, including microRNA profiles, are being investigated as a promising way to identify these patients.

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Yield of Total Body GA-67 Scintigraphy in the Staging of Non-Small Cell Lung Cancer

Tumori Journal ◽

10.1177/030089168907500111 ◽

1989 ◽

Vol 75 (1) ◽

pp. 38-42 ◽

Cited By ~ 5

Author(s):

Gianfranco Buccheri ◽

Ferruccio Vola ◽

Domenico Ferrigno ◽

Antonio Curcio

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

False Negative ◽

Small Cell ◽

Whole Body ◽

Small Cell Lung ◽

Mediastinal Disease ◽

Metastatic Sites ◽

Sensitivity Specificity

One hundred and one patients with histologically proved non-small cell lung cancer underwent whole body gallium-67 (TB Ga-67) scintigraphy as a part of their routine pretreatment evaluation. Twenty-eight of these patients were subsequently operated and pathologically staged for hilar and mediastinal disease. Two other patients underwent mediastinoscopy, but were judged unresectable at that time. All had computed tomography (CT) of the thorax, as well as radionuclide or CT scans of suspicious metastatic areas, and were carefully followed-up. When possible, a biopsy was performed of each suspected metastasis. Primary lung tumors concentrated Ga-67 in 94 patients. Sensitivity, specificity, and accuracy for hilar and mediastinal node metastases were 58%, 89%, and 77%, respectively. There were no false-negative gallium scans as regards secondary involvement of both liver and bone, whereas only 1 of the 4 brain metastases was detected by the technique. Sensitivity, specificity, and accuracy for all metastatic sites were 82%, 38%, and 56%, respectively. Fifty-five patients were classified as having a more advanced stage of disease by TB Ga-67 scintigraphy than at the initial clinical evaluation. However, 42 gallium-staged patients were ultimately re-classified differently according to all available clinical data. Using TB Ga-67 scintigraphy, 21 patients were found to have occult metastases which would not otherwise have been recognized; for the above reason, an unnecessary intervention was avoided in 6 of them.

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