Toxicities associated with checkpoint inhibitor immunotherapy: The Karmanos Cancer Center experience.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e14575-e14575
Author(s):  
Misako Nagasaka ◽  
Roba S Alhasan ◽  
Marcus Crosby ◽  
Nithin Thummala ◽  
Seongho Kim ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Clinical Trial ◽  
Small Cell Lung Cancer ◽  
Cell Carcinoma ◽  
Cell Lung Cancer ◽  
Primary Tumor ◽  
Standard Of Care ◽  
Small Cell ◽  
Categorical Variables ◽  
Small Cell Lung

e14575 Background: PD-1 inhibitors work by re-instating the natural anti-cancer immune-mediated cytotoxicity. Although this new class of therapy offers hope for many advanced stage cancer patients (pts), data on pts who are more likely to experience adverse events (AE) are not available. Methods: Data from pts who received at least one dose of PD-1 inhibitors before August 31, 2016, were captured from our institution’s pharmacy database. AE of anemia, neutropenia, thrombocytopenia, acute kidney injury, hypothyroidism, transaminitis, pneumonitis, colitis and fatigue were recorded and graded based on CTCAEv4. Baseline pt characteristics were statistically compared between subjects who received PD-1 inhibitors on a clinical trial vs as part of standard of care (on vs. off-study) by Fisher’s exact test for categorical variables and Kruskal-Wallis test for continuous variables. Univariable and multivariable logistic regression models were fit to assess associations between toxicities (Grade0-1 vs. Grade2+) and predictors (age, agent, primary tumor, and trial status). Results: 231 pts received at least one dose of PD-1 inhibitors prior to data cut-off. Median age was 65 (24-92) off trial (n = 125) and 59. 5 (25-79) on trial (n = 106). There were 117 (51%) non-small cell lung cancer (NSCLC), 41 (18%) renal cell carcinoma (RCC) and 73 (32%) others. 24 (10%) melanoma, 18 (8%) Hodgkin’s lymphoma (HL), 9 (4%) head and neck squamous cell carcinoma (HNSCC), 8 (4%) small cell lung cancer (SCLC) were included in others. 129 (56%) had nivolumab alone, 50 (22%) had pembrolizumab alone and the rest 52 (23%) received combination treatment. Pts participating in a clinical trial had higher odds to experience grade 2 or more pneumonitis than those not on a trial (unadjusted p = 0.038). On trial pts had lower odds to experience grade 2 or more fatigue than those receiving the agent as standard of care (unadjusted p = 0.026) which remained significant after adjusting age, agent (single agent vs combination) and primary tumor (adjusted p = 0.004). Conclusions: In our observation, pneumonitis was seen more on clinical trials whereas fatigue was seen less.

Prognostic value of different standard uptake values (SUV) of primary tumor measured with FDG-PET in resectable non-small cell lung cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 7214-7214
Author(s):  
W. K. De Jong ◽  
H. F. Van der Heijden ◽  
J. Pruim ◽  
W. J. Oyen ◽  
H. J. Groen
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Carcinoma ◽  
Cell Lung Cancer ◽  
Primary Tumor ◽  
Fdg Pet ◽  
Prognostic Value ◽  
Small Cell ◽  
Whole Body ◽  
Small Cell Lung

7214 Background: The SUV is a measure for the preferential uptake of a radiopharmaceutical in a tumor compared with a homogenous distribution in a body. SUV can be based on the maximum value (SUVmax) or on the mean value in a region outlined by isodensity contours, e.g., 70% and 50%. The prognostic value of the different SUVs in non-small cell lung cancer (NSCLC) is not clear. We evaluated the prognostic value of SUVmax, SUV 70% and SUV 50% in patients (pts) with resectable NSCLC. Methods: All consecutive pts who underwent an attenuation corrected whole body FDG-PET scan were selected. All data were reconstructed iteratively. Only pts with stage I through IIIA NSCLC were included. By adjusting the isocontour in the region of interest, the SUVmax, SUV 70% and SUV 50% of the primary tumor were calculated. Cox regression analysis was used to calculate the relation between the different SUVs and survival. Results: Eighty-four pts (67 males, median age 64 years, range 38–86) were included. Histology was squamous cell carcinoma (n = 43), adenocarcinoma (n = 27), large cell carcinoma (n = 13), and 1 patient with bronchoalveolar carcinoma. Nineteen pts had stage IA, 28 stage IB, 4 stage IIA, 19 stage IIB, and 14 stage IIIA. Median (range) SUVmax, SUV 70%, and SUV 50% were 6.9 (1.6–32.5), 5.5 (1.0–23.2), and 4.5 (0.9–21.9), respectively. Analysis of residuals of SUVmax as a continuous variable suggests no cut-off point and no indication of time-dependency. By univariate analysis, all pts with a SUV higher than the median value had a worse survival than pts with a SUV lower than median (Hazard ratio’s for SUVmax, SUV70% and SUV 50% were 2.3 (p = 0.024), 2.5 (p = 0.015), and 2.7 (p = 0.010), respectively). Conclusions: SUVmax, SUV 70% and SUV 50% measured with FDG-PET have a similar prognostic impact. No cut-off point for SUVmax has been observed. No significant financial relationships to disclose.

scholarly journals Integration of immunotherapy into adjuvant therapy for resected non-small-cell lung cancer: ALCHEMIST chemo-IO (ACCIO)

Immunotherapy ◽  
2021 ◽  
Author(s):  
Jacob M Sands ◽  
Sumithra J Mandrekar ◽  
David Kozono ◽  
Geoffrey R Oxnard ◽  
Shauna L Hillman ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Clinical Trial ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Standard Of Care ◽  
Small Cell ◽  
Disease Stage ◽  
Small Cell Lung ◽  
Platinum Based Chemotherapy ◽  
Biomarker Analysis

Non-small-cell lung cancer (NSCLC) causes significant mortality each year. After successful resection of disease stage IB (>4 cm) to IIIA (per AJCC 7), adjuvant platinum-based chemotherapy improves median overall survival and is the standard of care, but many patients still experience recurrence of disease. An adjuvant regimen with greater efficacy could substantially improve outcomes. Pembrolizumab, a programmed cell death-1 inhibitor, has become an important option in the treatment of metastatic NSCLC. ALCHEMIST is a clinical trial platform of the National Cancer Institute that includes biomarker analysis for resected NSCLC and supports therapeutic trials including A081801 (ACCIO), a three-arm study that will evaluate both concurrent chemotherapy plus pembrolizumab and sequential chemotherapy followed by pembrolizumab to standard of care adjuvant platinum-based chemotherapy. Clinical trial registration: NCT04267848 (ClinicalTrials.gov)

Landmark Studies of Targeted Therapies for Advanced Non-Small Cell Lung Cancer: A Guide for Pulmonologists

2020 ◽  
Vol 16 (1) ◽  
pp. 5-10
Author(s):  
Adrien Costantini ◽  
Theodoros Katsikas ◽  
Clementine Bostantzoglou
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Standard Of Care ◽  
Genetic Alterations ◽  
Small Cell ◽  
Extensive Literature ◽  
Small Cell Lung ◽  
Anaplastic Lymphoma ◽  
Mutational Status

Over the past decade, major breakthroughs in the understanding of lung cancer histology and mutational pathways have radically changed diagnosis and management. More specifically, in non-small cell lung cancer (NSCLC), tumour characterisation has shifted from differentiating based solely on histology to characterisation that includes genetic profiling and mutational status of Epidermal Growth Factor (EGFR), Anaplastic Lymphoma Kinase (ALK), c-ros oncogene 1 (ROS1) and BRAF. These genetic alterations can be targeted by specific drugs that result in improved progression-free survival, as well as higher response rates and are currently standard of care for NSCLC patients harbouring these mutations. In this a narrative, non-systematic review we aim to handpick through the extensive literature and critically present the ground-breaking studies that lead to the institution of tailored treatment options as the standard of care for the main targetable genetic alterations.

Impact of Clinical Trial Participation on Survival of Patients with Metastatic Non-Small Cell Lung Cancer

2021 ◽  
Author(s):  
Cristina M. Merkhofer ◽  
Keith D. Eaton ◽  
Renato G. Martins ◽  
Scott D. Ramsey ◽  
Bernardo H.L. Goulart
Keyword(s):  
Lung Cancer ◽  
Clinical Trial ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Trial Participation ◽  
Clinical Trial Participation ◽  
Small Cell Lung

A re-evaluation of squamous cell carcinoma antigen (SCC) as a serum marker for non-small cell lung cancer

2007 ◽  
Vol 25 (2) ◽  
pp. 187-189 ◽  
Author(s):  
Katsunori Kagohashi ◽  
Hiroaki Satoh ◽  
Hiroichi Ishikawa ◽  
Morio Ohtsuka ◽  
Kiyohisa Sekizawa
Keyword(s):  
Lung Cancer ◽  
Squamous Cell Carcinoma ◽  
Small Cell Lung Cancer ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cell Lung Cancer ◽  
Serum Marker ◽  
Small Cell ◽  
Squamous Cell Carcinoma Antigen ◽  
Small Cell Lung

Analysis of primary tumor metabolic volume during chemoradiotherapy in locally advanced non-small cell lung cancer

2017 ◽  
Vol 194 (2) ◽  
pp. 107-115 ◽  
Author(s):  
Olarn Roengvoraphoj ◽  
Cherylina Wijaya ◽  
Chukwuka Eze ◽  
Minglun Li ◽  
Maurice Dantes ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Primary Tumor ◽  
Locally Advanced ◽  
Small Cell ◽  
Small Cell Lung ◽  
Metabolic Volume

Phase II clinical trial of didemnin B in previously treated small cell lung cancer

1994 ◽  
Vol 12 (3) ◽  
pp. 243-249 ◽  
Author(s):  
Dong M. Shin ◽  
Paul Y. Holoye ◽  
Arthur Forman ◽  
Rodger Winn ◽  
Roman Perez-Soler ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Clinical Trial ◽  
Small Cell Lung Cancer ◽  
Phase Ii ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Phase Ii Clinical Trial ◽  
Didemnin B ◽  
Small Cell Lung ◽  
Previously Treated

scholarly journals Front Line Applications and Future Directions of Immunotherapy in Small-Cell Lung Cancer

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 506
Author(s):  
Selina K. Wong ◽  
Wade T. Iams
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Checkpoint Inhibitors ◽  
Standard Of Care ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line ◽  
Limited Stage ◽  
Extensive Stage

After being stagnant for decades, there has finally been a paradigm shift in the treatment of small-cell lung cancer (SCLC) with the emergence and application of immune checkpoint inhibitors (ICIs). Multiple trials of first-line ICI-chemotherapy combinations have demonstrated survival benefit compared to chemotherapy alone in patients with extensive-stage SCLC, establishing this as the new standard of care. ICIs are now being applied in the potentially curative limited-stage setting, actively being investigated as concurrent treatment with chemoradiation and as adjuvant treatment following completion of chemoradiation. This review highlights the evidence behind the practice-changing addition of ICIs in the first-line setting of extensive-stage SCLC, the potentially practice-changing immunotherapy trials that are currently underway in the limited-stage setting, and alternate immunotherapeutic strategies being studied in the treatment of SCLC.

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