656 Time to diagnostic clarity for suspected checkpoint-inhibitor pneumonitis in patients with lung cancer

2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A693-A693
Author(s):  
Eric Olson ◽  
Andrew Faucheux ◽  
JiaHao Liang ◽  
Janardhana Ponnatapura ◽  
Jeffrey Lantz ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Median Time ◽  
Checkpoint Inhibitor ◽  
Diagnostic Algorithm ◽  
Ground Glass ◽  
Patient Registries ◽  
Lung Cancers ◽  
Lung Cancer Patients ◽  
Infectious Risk ◽  
Acute Interstitial Pneumonia

BackgroundOptimal diagnostic algorithm to differentiate checkpoint inhibitor pneumonitis (CIP) from mimics is uncertain; patients with respiratory comorbidities often receive prolonged corticosteroids until diagnostic clarification. Drawbacks to empiric use of corticosteroids include decreased immunotherapy (IO) efficacy and increased infectious risk. This retrospective study systematically collected data on patients treated for lung cancer who were suspected to have severe CIP.MethodsThis single-center retrospective cohort study collected data on all lung cancer patients who received > 1 dose of an immune checkpoint inhibitor between 6/1/18 and 2/1/20 (n=210), were subsequently hospitalized and received > 1 dose of systemic corticosteroids for any indication (n=97). Data were collected on clinical factors including comorbidities, cancer stage, IO cycles, biomarkers, diagnostic work-up, antibiotics, steroids, progression, and survival. A blinded radiologist reviewed all imaging of suspected CIP cases and categorized their radiographic patterns.ResultsIn our high-risk cohort of 97 patients, median follow-up was 23 months with progression in 54 patients (56%) at median 11 months and death in 67 patients (69%) at median 14mo. Twelve patients (12%) were suspected to have severe CIP after IO treatment for lung cancer; CIP was confirmed in 5/12 and ruled-out (mimics) in 7/12 after 30 and 3 median IO cycles, respectively. Most suspected patients underwent CXR, CTA chest, blood cultures, and received empiric antibiotics. Common radiographic patterns were ground-glass opacities, organizing pneumonia, hypersensitivity pneumonitis, and acute interstitial pneumonia/acute respiratory distress syndrome (AIP/ARDS) among confirmed cases (4/5) and ground-glass opacities, organizing pneumonias, bronchiolitis, AIP/ARDS among mimics (4/7). The median time to confirm CIP or rule out a mimic was 5 ± 4 days. Median time to onset of symptoms differed substantially for confirmed and mimic cases: 17 months and 1 month, respectively.ConclusionsCIP mimics were more common than confirmed cases in routine clinical practice, particularly among patients hospitalized for respiratory symptoms <1 month after initiating immunotherapy for lung cancers. In these cases, it is reasonable to empirically cover possible CIP with shorter (~1 week) courses of steroids until diagnostic clarity is achieved. CT imaging should be obtained as it is sensitive though not specific for CIP. CIP mimics may contribute to the higher incidence of CIP reported by real-world patient registries than by clinical trials.Ethics ApprovalThe study was approved by Wake Forest Baptist Medical Center‘s Ethics Board, IRB approval number 00044126

scholarly journals Role of Omentin in Obesity Paradox in Lung Cancer

Cancers ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 275
Author(s):  
Sheetal Parida ◽  
Sumit Siddharth ◽  
Dipali Sharma
Keyword(s):  
Lung Cancer ◽  
Obesity Paradox ◽  
Health Concern ◽  
Case Control Studies ◽  
Aberrant Expression ◽  
Lung Cancers ◽  
Lung Cancer Patients ◽  
Significant Enrichment ◽  
Normal Lungs ◽  
Related Mortality

Lung cancer remains the second-most-common cancer worldwide and is associated with the highest number of cancer-related mortality. While tobacco smoking is the most important risk factor for lung cancer, many other lifestyles and occupational factors significantly contribute. Obesity is a growing global health concern and contributes to ~30% cancer-related mortality, but unlike other lifestyle diseases, lung cancer is negatively associated with obesity. We meta-analyzed multiple case-control studies confirming increased survival and better outcomes in overweight and obese lung cancer patients. Tumor heterogeneity analysis showed significant enrichment of adipocytes and preadipocytes in normal lungs compared to lung cancers. Interestingly, one of the understudied adipokine, omentin, was significantly and consistently lower in lung neoplasms compared to normal lungs. Omentin has been examined in relation to osteoarthritis, inflammatory bowel disease, cardiovascular diseases, diabetes, chronic liver disease, psoriasis and some other cancers. Aberrant expression of omentin has been reported in solid tumors; however, little is known about its role in lung cancer. We found omentin to be consistently downregulated in lung cancers, and it exhibited a negative correlation with important transcription factors FOXA1, EN1, FOXC1 and ELK4. We, therefore, suggest that omentin may serve as a prognostic factor in lung cancer and explain the “obesity paradox” in lung cancer.

scholarly journals Risk score for non-small cell lung cancer patients starting checkpoint inhibitor treatment

2018 ◽  
Vol Volume 10 ◽  
pp. 5537-5544 ◽  
Author(s):  
Stefan Diem ◽  
Mirjam Fässler ◽  
Omar Hasan Ali ◽  
Marco Siano ◽  
Rebekka Niederer ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cancer Patients ◽  
Risk Score ◽  
Cell Lung Cancer ◽  
Checkpoint Inhibitor ◽  
Small Cell ◽  
Small Cell Lung ◽  
Lung Cancer Patients ◽  
Inhibitor Treatment

scholarly journals Soluble c-Met Is a Reliable and Sensitive Marker to Detect c-Met Expression Level in Lung Cancer

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Huilai Lv ◽  
Baoen Shan ◽  
Ziqiang Tian ◽  
Yong Li ◽  
Yuefeng Zhang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Tissue Sample ◽  
Sample Collection ◽  
Lung Cancers ◽  
Lung Cancer Patients ◽  
Lung Cancer Therapy ◽  
Reliable Marker ◽  
Soluble C ◽  
Sensitive Marker

c-Met has been demonstrated as an attractive target in lung cancer therapy. Current studies showed that detection of c-Met status in tumor is critical in Met-targeted therapy. However not all patients are suitable for tissue sample collection. It is important to discover novel surrogate markers to detect c-Met status. In the study, soluble c-Met (s-Met) in plasma from 146 Chinese lung cancer patients and 40 disease-free volunteers was measured by enzyme-linked immunosorbent. In parallel, expression of c-Met in those tumors was also assessed by immunohistochemistry. Results showed that, in 146 lung cancer patients, 93 were c-Met expression positive and 74 of 93 were overexpressed. In c-Met-overexpressed patients, plasma s-Met was significantly increased. And further studies showed that plasma s-Met linearly correlated with c-Met expression in tumor. After tumor was removed in Met-overexpressed patients via resection, plasma s-Met significantly decreased to basal level. In addition, plasma s-Met showed to be poorly correlated with tumor size in Met-overexpressed patients. These results demonstrated that plasma s-Met is a sensitive and reliable marker to detect c-Met overexpression in lung cancers, and it is independent of tumor volume.

scholarly journals Radiopathologic correlation of collision lung cancer with ground-glass opacity

2018 ◽  
Vol 27 (1) ◽  
pp. 45-48
Author(s):  
Shinsuke Uchida ◽  
Koji Tsuta ◽  
Masahiko Kusumoto ◽  
Kouya Shiraishi ◽  
Takashi Kohno ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Ground Glass Opacity ◽  
Ground Glass ◽  
Adenocarcinoma In Situ ◽  
Invasive Adenocarcinoma ◽  
Ki 67 ◽  
Lung Cancers ◽  
Collision Tumors ◽  
Minimally Invasive Adenocarcinoma ◽  
Epidermal Growth

Pulmonary collision tumors have been described as a special entity of synchronous multiple lung cancer. There have been no reports detailing the chronological changes in primary collision lung cancers on chest computed tomography. We report a case of ground-glass lung nodules gradually colliding with each other. The collision tumors of the lung were composed of minimally invasive adenocarcinoma and adenocarcinoma in situ with epidermal growth factor mutations. Immunohistochemically, the Ki-67 labeling indices were different in the 2 components. Ki-67 staining was useful to distinguish the 2 components. The 2 dominant ground-glass tumors grew slowly with radiologic and pathologic heterogeneity.

Comprehensive cancer genomics-based screening of new therapeutic targets and biomarkers for lung cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e21031-e21031
Author(s):  
Yataro Daigo ◽  
Atsushi Takano ◽  
Yusuke Nakamura
Keyword(s):  
Lung Cancer ◽  
Cancer Cells ◽  
Cancer Patients ◽  
Therapeutic Target ◽  
Cancer Genomics ◽  
Cancer Biomarkers ◽  
Lung Cancer Cells ◽  
Lung Cancers ◽  
Lung Cancer Patients ◽  
Target Molecules

e21031 Background: Since the clinical outcome of advanced lung cancer patients is still poor after standard therapies, development of new anti-cancer drugs with minimum risk of adverse effects and cancer biomarkers for precision medicine is urgently required. Methods: We have been screening new therapeutic target molecules and molecular biomarkers for lung cancers as follows; i) To identify overexpressed genes in lung cancers by the gene expression profile analysis, ii) To verify the target genes for their scarce expression in normal tissues, iii) To validate the clinicopathologic importance of their protein expression by tissue microarray covering 263 lung cancers, and iv) To confirm their function for the growth and/or invasive ability of the lung cancer cells by siRNAs and gene transfection assays. Results: We identified dozens of candidate target molecules and selected a gene encoding protein with a GAP domain, LAPG1 (lung cancer-associated protein with Gap domain 1). Immunohistochemical analysis showed that LAPG1 expression was observed in 69.9% of lung cancers. Moreover positivity of LAPG1 expression was associated with poor prognosis of lung cancer patients. Knockdown of LAPG1 expression by siRNAs suppressed growth of lung cancer cells. Introduction of LAPG1 increased the invasive activity of mammalian cells, indicating that LAPG1 could be a prognostic biomarker and therapeutic target for lung cancers. Conclusions: Comprehensive cancer genomics-based screening could be useful for selection of new cancer biomarkers and molecular targets for developing small molecules, antibodies, nucleic acid drugs, and immunotherapies.

Sign in / Sign up

Export Citation Format

Share Document