scholarly journals Socio-economic inequalities in stage at diagnosis, and in time intervals on the lung cancer pathway from first symptom to treatment: systematic review and meta-analysis

Thorax ◽  
2016 ◽  
Vol 72 (5) ◽  
pp. 430-436 ◽  
Author(s):  
Lynne F Forrest ◽  
Sarah Sowden ◽  
Greg Rubin ◽  
Martin White ◽  
Jean Adams
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Meta Analysis ◽  
Stage At Diagnosis ◽  
Time Intervals ◽  
Economic Inequalities

The timeliness of lung cancer care: A systematic review of systematic/scoping reviews on time intervals and their impacts on cancer outcomes.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18572-e18572
Author(s):  
Jianrong Zhang ◽  
Jasmeen Oberoi ◽  
Napin Karnchanachari ◽  
Paige Druce ◽  
Maarten J. IJzerman ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Patient Survival ◽  
Disease Stage ◽  
Current Evidence ◽  
Stage At Diagnosis ◽  
Time Intervals ◽  
Scoping Reviews ◽  
The Impact ◽  
Over Time

e18572 Background: Lung cancer is characterized by the aggressive nature and lack of early noticeable symptoms, highlighting the importance of timely care for lung cancer. This systematic review of systematic and scoping reviews provides the summary of review-level results related to the length of time intervals and the impact of these intervals on oncological outcomes. Methods: Eligible articles included published systematic or scoping reviews and meta-analyses that used systematic searching to investigate the length of time intervals and their impact on patient survival and disease stage at diagnosis in original studies on lung cancer, based on at least one interval involving the date of diagnosis as the start/endpoint. Articles were searched via PubMed, Embase, Web of Science, and the Cochrane Library (date range: from database inception to 6 August 2020) (PROSPERO identifier: CRD42020203530). Results: From 1395 identified publications, we included a total of 8 systematic/scoping reviews published in 2002-2018 (7 on length of intervals, 5 on survival/stage impact). For the length of intervals, these reviews found that intervals across countries/medical facilities are heterogeneous and often longer than recommended by guidelines. For the survival/stage impact, the results from these reviews indicated mixed (positive, negative, or no) associations between time intervals and patient survival/disease stage at diagnosis. We further summarized study-level results and confirmed the finding of mixed associations based on 36 eligible original studies from over 100 studies included in these reviews. Methodologically, review authors pointed out large variations in time intervals (96 unique variations) and methods used to measure intervals. Based on the reviews, we found that the intervals in studies were normally investigated cross-sectionally, rather than temporarily (to demonstrate the trend of intervals’ length over time). Conclusions: Current evidence indicates that patients with lung cancer may experience diagnosis and treatment delays, however, the association results between the length of intervals and lung cancer survival and stage are paradoxical. To minimize avoidable delays, future studies should keep updating the length of intervals and provide the trend analysis of the intervals over time, as part of cancer surveillance to guide future policy making and clinical practice. To improve the quality of future original studies and systematic reviews, specific guidelines and corresponding studies related to study design and methodology (e.g. types of time intervals, measures of time intervals, statistical analysis strategy) are warranted, especially underscoring the effect of “waiting time paradox” when investigating the impact of time intervals on patient outcomes.

Efficacy and Safety of Antigen-specific Immunotherapy in the Treatment of Patients with Non-small-cell Lung Cancer: A Systematic Review and Meta-analysis

2019 ◽  
Vol 19 (3) ◽  
pp. 199-209 ◽  
Author(s):  
Bing-Di Yan ◽  
Xiao-Feng Cong ◽  
Sha-Sha Zhao ◽  
Meng Ren ◽  
Zi-Ling Liu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Adverse Events ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Specific Immunotherapy ◽  
Meta Analysis ◽  
Small Cell ◽  
Efficacy And Safety ◽  
Small Cell Lung

Background and Objective: We performed this systematic review and meta-analysis to assess the efficacy and safety of antigen-specific immunotherapy (Belagenpumatucel-L, MAGE-A3, L-BLP25, and TG4010) in the treatment of patients with non-small-cell lung cancer (NSCLC). </P><P> Methods: A comprehensive literature search on PubMed, Embase, and Web of Science was conducted. Eligible studies were clinical trials of patients with NSCLC who received the antigenspecific immunotherapy. Pooled hazard ratios (HRs) with 95% confidence intervals (95%CIs) were calculated for overall survival (OS), progression-free survival (PFS). Pooled risk ratios (RRs) were calculated for overall response rate (ORR) and the incidence of adverse events. </P><P> Results: In total, six randomized controlled trials (RCTs) with 4,806 patients were included. Pooled results showed that, antigen-specific immunotherapy did not significantly prolong OS (HR=0.92, 95%CI: 0.83, 1.01; P=0.087) and PFS (HR=0.93, 95%CI: 0.85, 1.01; P=0.088), but improved ORR (RR=1.72, 95%CI: 1.11, 2.68; P=0.016). Subgroup analysis based on treatment agents showed that, tecemotide was associated with a significant improvement in OS (HR=0.85, 95%CI: 0.74, 0.99; P=0.03) and PFS (HR=0.70, 95%CI: 0.49, 0.99, P=0.044); TG4010 was associated with an improvement in PFS (HR=0.87, 95%CI: 0.75, 1.00, P=0.058). In addition, NSCLC patients who were treated with antigen-specific immunotherapy exhibited a significantly higher incidence of adverse events than those treated with other treatments (RR=1.11, 95%CI: 1.00, 1.24; P=0.046). </P><P> Conclusion: Our study demonstrated the clinical survival benefits of tecemotide and TG4010 in the treatment of NSCLC. However, these evidence might be limited by potential biases. Therefore, further well-conducted, large-scale RCTs are needed to verify our findings.

scholarly journals Liquid Biopsy for Small Cell Lung Cancer either De Novo or Transformed: Systematic Review of Different Applications and Meta-Analysis

Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2265
Author(s):  
Elio Gregory Pizzutilo ◽  
Martino Pedrani ◽  
Alessio Amatu ◽  
Lorenzo Ruggieri ◽  
Calogero Lauricella ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Liquid Biopsy ◽  
De Novo ◽  
Meta Analysis ◽  
Small Cell ◽  
Genomic Profiling ◽  
Small Cell Lung

Background: The potential added value of liquid biopsy (LB) is not well determined in the case of small cell lung cancer (SCLC), an aggressive tumor that can occur either de novo or from the histologic transformation of non-small cell lung cancer (NSCLC). Methods: A systematic review of studies adopting LB in patients with SCLC have been performed to assess the clinical utility of circulating tumor DNA (ctDNA) or circulating tumor cells (CTCs). Results: After a screening of 728 records, 62 studies (32 evaluating CTCs, 27 ctDNA, and 3 both) met predetermined eligibility criteria. Only four studies evaluated LB in the diagnostic setting for SCLC, while its prognostic significance was evaluated in 38 studies and prominently supported by both ctDNA and CTCs. A meta-analysis of 11 studies as for CTCs enumeration showed an HR for overall survival of 2.63 (1.71–4.05), with a potential publication bias. The feasibility of tumor genomic profiling and the predictive role of LB in terms of response/resistance to chemotherapy was assessed in 11 and 24 studies, respectively, with greater consistency for those regarding ctDNA. Intriguingly, several case reports suggest that LB can indirectly capture the transition to SCLC in NSCLC treated with EGFR tyrosine kinase inhibitors. Conclusions: While dedicated trials are needed, LB holds potential clinical roles in both de novo and transformed SCLC. CtDNA analysis appears the most valuable and practicable tool for both disease monitoring and genomic profiling.

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