Impact of primary tumor resection in oligometastatic non-small cell lung cancer: Experience of a resource-limited cancer center in southern Brazil.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e20552-e20552
Author(s):  
Paulo Ricardo Santos Nunes Filho ◽  
Caroline Albuquerque Moreira da Silva ◽  
Maria Teresa Ruiz Tsukazan ◽  
Andre Poisl Fay ◽  
Carlos H. Barrios ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Clinical Benefit ◽  
Primary Tumor ◽  
Tumor Resection ◽  
Local Therapy ◽  
Small Cell ◽  
Small Cell Lung ◽  
Resource Limited

e20552 Background: Stage IV non-small cell lung cancer (NSCLC) with low volume disease represents a more indolent phenotype within the biological spectrum of lung cancer. Recent data suggest that aggressive local therapy may impact clinical benefit in this subgroup of patients, with 5-year overall survival (OS) rate around 20%. Methods: We analyzed patients with oligometetastatic (≤3 metastasis) NSCLC treated with primary tumor resection at Hospital São Lucas da PUCRS. Clinico-pathological features and survival data were retrospectively collected using standard templates. The primary endpoint was OS. Survival was estimated using the Kaplan-Meier method and log-rank test was used to univariate analysis. Results: Between April 1991 and December 2015, 25 patients with oligometastatic NSCLC underwent surgery of the primary tumor. Clinico-pathological data are summarized in Table 1. Overall, median OS was 16 months (95% CI: 8.87-23.13 months) with a 5-years survival rate of 7%. Age less than 65 years old was associated with longer OS (HR 0.34 95%CI 0.13-0.92 p = 0.02). Patients with brain metastasis had a non-significant lower OS than those without (16 vs. 24 months, respectively). Conclusions: This analysis suggests that in a resource-limited center, where immunotherapies and targeted-therapies are not available, local therapy for oligometastatic NSCLC did not provide the same clinical benefit seen in the same population from high-income countries. See table. [Table: see text]

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

scholarly journals OTHR-07. Systematic Review and Meta-analysis of Lung Cancer Brain Metastasis and Primary Tumor PD-L1 Expression Discordance

2021 ◽  
Vol 3 (Supplement_3) ◽  
pp. iii15-iii16
Author(s):  
Raees Tonse ◽  
Muni Rubens ◽  
Haley Appel ◽  
Martin C Tom ◽  
Matthew D Hall ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Brain Metastasis ◽  
Tumor Cell ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Primary Tumor ◽  
Small Cell ◽  
Receptor Expression ◽  
Small Cell Lung

Abstract Background Novel immunotherapeutic strategies, such as those targeting the PD-1/PD-L1 axis, are promising in patients with metastatic lung cancer and are often administered when tumors show PD-L1 positivity. The objective of this study was to analyze PD-L1 receptor discordance in tumor cell between the primary tumor and lung cancer brain metastasis (LCBM). Methods A systematic review of series published prior to April 2021 obtained from the Medline database of biopsied or resected LCBM evaluating PD-L1 discordance was performed using PRISMA guidelines. Weighted random effects models were used to calculate pooled estimates. Results Six full-text articles (n=247 patients) with a median of 32 patients in each study (range: 24–73 patients) reported PD-L1 receptor expression analyses of both primary lung tumors and brain metastases. The majority of patients (81%) were smokers, with 67% non-small cell lung cancer and 33% small cell lung cancer. The pooled estimate for overall PD-LI receptor concordance between primary and LCBM was 76% (95% CI: 52%-90). The positivity rate varied when analyzed by various cutoff levels of PD-L1 expression; for <1% expression, it was 41% (95% CI: 22%-62%) for primary vs. 58% (95% CI: 35%-78%) for LCBM; for PD-L1 expression of 1–50%, it was 24% (95% CI: 13%-40%) vs. 19% (95% CI: 10%-33%); and for PD-L1 >50% it was 12% (95% CI: 4%-33%) vs. 21% (95% CI: 14%-29%) (p=0.425). The pooled estimate for overall PD-LI receptor discordance between primary and LCBM was 17% (95% CI: 10%-27%). Meta-regression analysis showed that age, sex, smoking status, and histology were not associated with PD-LI receptor discordance. Conclusions PD-L1 status discordance in tumor cell occurs in approximately 20% of LCBM, with the greatest discordance in the <1% expression category. Awareness of this discordance is important for the selection of immune checkpoint inhibitor therapy as well as in the analysis of patterns of failures.

Comparison of prognostic values of primary tumor and nodal 18F-fluorodeoxyglucose uptake in non-small cell lung cancer with N1 disease

2019 ◽  
Vol 29 (10) ◽  
pp. 5288-5297
Author(s):  
Chae Hong Lim ◽  
Seung Hyup Hyun ◽  
Seung Hwan Moon ◽  
Young Seok Cho ◽  
Joon Young Choi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Primary Tumor ◽  
Small Cell ◽  
Small Cell Lung ◽  
18F Fluorodeoxyglucose

scholarly journals In-house Implementation of Tumor Mutational Burden Testing to Predict Durable Clinical Benefit in Non-small Cell Lung Cancer and Melanoma Patients

Cancers ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 1271 ◽  
Author(s):  
Heeke ◽  
Benzaquen ◽  
Long-Mira ◽  
Audelan ◽  
Lespinet ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Clinical Benefit ◽  
Small Cell ◽  
Small Cell Lung ◽  
Mutational Burden ◽  
Potential Biomarker ◽  
Tumor Mutational Burden ◽  
Melanoma Patients

Tumor mutational burden (TMB) has emerged as an important potential biomarker for prediction of response to immune-checkpoint inhibitors (ICIs), notably in non-small cell lung cancer (NSCLC). However, its in-house assessment in routine clinical practice is currently challenging and validation is urgently needed. We have analyzed sixty NSCLC and thirty-six melanoma patients with ICI treatment, using the FoundationOne test (FO) in addition to in-house testing using the Oncomine TML (OTML) panel and evaluated the durable clinical benefit (DCB), defined by >6 months without progressive disease. Comparison of TMB values obtained by both tests demonstrated a high correlation in NSCLC (R2 = 0.73) and melanoma (R2 = 0.94). The association of TMB with DCB was comparable between OTML (area-under the curve (AUC) = 0.67) and FO (AUC = 0.71) in NSCLC. Median TMB was higher in the DCB cohort and progression-free survival (PFS) was prolonged in patients with high TMB (OTML HR = 0.35; FO HR = 0.45). In contrast, we detected no differences in PFS and median TMB in our melanoma cohort. Combining TMB with PD-L1 and CD8-expression by immunohistochemistry improved the predictive value. We conclude that in our cohort both approaches are equally able to assess TMB and to predict DCB in NSCLC.

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