Regular follow up for patients irradiated for early stage nonsmall cell lung cancer too!

IntroductionImmunotherapy is the new standard of care in advanced nonsmall cell lung cancer (NSCLC). Recently published data show that treatment discontinuation after 12 months of nivolumab treatment is associated with shorter survival. Therefore, the ideal duration of immunotherapy remains unclear, and finding markers of beneficial outcomes is of great importance. Here, we determine the proportion of complete metabolic responses (CMR) in patients who have not progressed after 24 months of immunotherapy.MethodsThis is a retrospective analysis of 45 patients with positron emission tomography using 2-[18F]fluoro-2-deoxy-D-glucose imaging for assessment of residual metabolic activity after at least 24 months. CMR was defined as uptake in tumor lesions below background levels, using mediastinum as a reference. ResultsOut of 45 patients, 29 patients had a CMR (64%). CMR was observed more frequently in non-first-line patients. Patients with CMR were younger (median 65.7 vs 75.5, p=0.03). Fourteen patients with CMR have discontinued therapy and have not progressed until time of analysis; however, median follow-up was only 5.6 (range 0.8–17.0) months.ConclusionAfter a minimum of 24 months of palliative immunotherapy for NSCLC, CMR occurred in almost two thirds of patients. Potentially, achievement of CMR might identify patients, for whom palliative immunotherapy may be safely discontinued.

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Lymph node evaluation in totally thoracoscopic lobectomy with two-port for clinical early-stage nonsmall-cell lung cancer: Single-center experience of 1086 cases

Indian Journal of Cancer ◽

10.4103/0019-509x.172511 ◽

2015 ◽

Vol 52 (6) ◽

pp. 134 ◽

Cited By ~ 3

Author(s):

W Jiao ◽

R Yang ◽

Y Zhao ◽

T Qiu ◽

Y Wang ◽

...

Keyword(s):

Lung Cancer ◽

Lymph Node ◽

Cell Lung Cancer ◽

Early Stage ◽

Nonsmall Cell Lung Cancer ◽

Single Center ◽

Thoracoscopic Lobectomy ◽

Single Center Experience ◽

Lymph Node Evaluation

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Updated long-term outcomes of salvage surgery after stereotactic body radiotherapy for early-stage non-small-cell lung cancer

Interactive CardioVascular and Thoracic Surgery ◽

10.1093/icvts/ivaa194 ◽

2020 ◽

Vol 31 (6) ◽

pp. 892-894

Author(s):

Keiji Yamanashi ◽

Masatsugu Hamaji ◽

Yukinori Matsuo ◽

Noriko Kishi ◽

Toyofumi Fengshi Chen-Yoshikawa ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Stereotactic Body Radiotherapy ◽

Salvage Surgery ◽

Early Stage ◽

Small Cell ◽

Small Cell Lung

Abstract There is dearth of data regarding the long-term survival outcomes of salvage surgery after stereotactic body radiotherapy for early-stage non-small-cell lung cancer, as previous studies have included a short follow-up period. There is also scarce information on the management of re-relapse in previous studies. This study examined the long-term survival outcomes of patients who underwent salvage surgery for isolated local relapse (LR). We reviewed consecutive patients who underwent salvage surgery for isolated LR after stereotactic body radiotherapy for early-stage non-small-cell lung cancer between 1999 and 2015. All patients were followed up until death or at least 5 years from salvage surgery. Twelve patients were included for analysis. The median follow-up from isolated LR was 62.4 (range: 14.3–152.1) months. The 5-year overall survival rate was 58.3%, updated from 79.5% in our previous report. During the interim, new re-relapses did not occur, whereas there were 5 additional deaths. The median survival after re-relapse was 32.6 months. Our follow-up report confirmed that our patient selection for salvage surgery appeared to be appropriate and that long-term follow-up is required to assess the outcomes of patients undergoing salvage surgery. Long-term follow-up would provide detailed information on late re-relapses, treatment and outcomes of re-relapses and mortality from any causes.

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Immunotherapy in patients with early stage resectable nonsmall cell lung cancer

Current Opinion in Oncology ◽

10.1097/cco.0000000000000497 ◽

2019 ◽

Vol 31 (1) ◽

pp. 13-17 ◽

Cited By ~ 7

Author(s):

Katrien Ghysen ◽

Johan Vansteenkiste

Keyword(s):

Lung Cancer ◽

Cell Lung Cancer ◽

Early Stage ◽

Nonsmall Cell Lung Cancer

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Reduction of Elevated Plasma Osteopontin Levels With Resection of Non–Small-Cell Lung Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2009.25.5711 ◽

2010 ◽

Vol 28 (6) ◽

pp. 936-941 ◽

Cited By ~ 39

Author(s):

Justin D. Blasberg ◽

Harvey I. Pass ◽

Chandra M. Goparaju ◽

Raja M. Flores ◽

Suzie Lee ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Early Stage ◽

Small Cell ◽

Enzyme Linked Immunosorbent Assay ◽

Small Cell Lung ◽

Early Stage Nsclc ◽

Independent Cohort

Purpose Plasma osteopontin (OPN) levels in advanced non–small-cell lung cancer (NSCLC) correlate with therapeutic response and survival, but the utility of plasma OPN for diagnosis and monitoring of early-stage NSCLC has not been investigated. We hypothesize that plasma OPN levels are elevated in early-stage NSCLC and decrease with resection. Patients and Methods Presurgery plasma OPN levels (in ng/mL) were measured by enzyme-linked immunosorbent assay (ELISA) in a discovery set of 60 patients with early-stage NSCLC and were compared with data from 56 cancer-free smokers. Presurgery OPN was validated in an independent cohort of 96 patients with resectable NSCLC. The presurgery levels in the latter cohort were compared with matched postsurgery levels. Perioperative OPN levels were correlated with demographics, tumor characteristics, and perioperative events. OPN was monitored during follow-up. Results Discovery set presurgery NSCLC OPN (271 ± 31 ng/mL) was higher than smokers (40 ± 2 ng/mL; P = .001). Presurgery OPN was similar in the NSCLC validation cohort (324 ng/mL ± 20 ng/mL; P = .134). Postsurgery OPN (256 ng/mL ± 21 ng/mL) measured at mean of 9.8 weeks (range, 2 to 46 weeks) was lower than presurgery OPN (P = .005). Time from surgery significantly impacted postsurgery OPN: OPN ≤ 6 weeks postsurgery (303 n/mL ± 26 ng/mL) was higher than OPN greater than 6 weeks postsurgery (177 ng/mL ± 29 ng/mL; P = .003). Multivariate analysis noted correlations between albumin and creatinine to presurgery OPN and use of thoracotomy to postsurgery OPN. Recurrence rate was 5% at 29 weeks mean follow-up. OPN at recurrence was elevated from postsurgery nadir. Conclusion Plasma OPN levels are elevated in early-stage NSCLC. They are reduced after resection and appear to increase with recurrence. Plasma OPN may have utility as a biomarker in early-stage NSCLC.

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