Effects of a mucosal coating spray in non-small cell lung cancer patients with nasal mucositis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e21160-e21160
Author(s):  
Fang Wang ◽  
Hui Liu ◽  
Zhen Zeng ◽  
Shasha Wang ◽  
Haifeng Qin
Keyword(s):  
Lung Cancer ◽  
Targeted Therapy ◽  
Small Cell Lung Cancer ◽  
Oral Mucositis ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Oral Liquid ◽  
Nsclc Patients

e21160 Background: Targeted therapy opens a new era in the treatment of non-small cell lung cancer (NSCLC). At the same time, it also faces a serious problem, that is, the adverse events brought by new drugs, which not only affect the quality of patients’ life, but may even endanger their lives. Nasal mucositis (NM) may cause significant discomfort for the patients, and even result in the interruption of treatment. Episil (mucosal coating spray) oral liquid is a preservative-free oral liquid gel that can be used for the management of pain associated with oral lesions of various etiologies. Our study prospectively assessed effects of mucosal coating spray oral liquid in NSCLC patients with NM. There is no similar studies at home and abroad. Methods: Our study enrolled 15 patients who experience nasal mucositis after targeted therapy (Table). We designed a specific questionnaire according to Oral Mucositis Daily QuestionnaireOMDQ), Oral Mucositis Assessment Scale (OMAS), and the Patient-Reported Oral Mucositis Symptom (PROMS) to evaluate the change of life quality in NSCLC patients. All the patients needed to complete the questionnaire included in the statistical analysis. Evaluations were made before and after 5 treatment days. Results: All the patients were evaluated. Among patients, 87% suffered from NM grade 2 and 33% were with bleeding at study start, quality of life scores improved significantly after 5 treatment days with mucosal coating spray. Only 1 patient’s pain score reduced not that well because of nonstandard medication. No drug-related adverse reactions were found. Conclusions: Mucosal coating spray can effectively improve the nasal mucositis caused by targeted therapy in NSCLC patients. It may provide a new and effective therapy strategy for them, but large sample and additional clinical trials are also needed, especially for bevacizumab as one agent of combination protocol.

Impact of performance evaluation on the quality of care in non-small cell lung cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6531-6531
Author(s):  
Tawee Tanvetyanon ◽  
Ji-Hyun Lee ◽  
William J. Fulp ◽  
Paul B. Jacobsen ◽  
Keyword(s):  
Lung Cancer ◽  
Performance Evaluation ◽  
Quality Of Care ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Care Quality ◽  
Small Cell ◽  
Small Cell Lung ◽  
Nsclc Patients

6531 Background: Improvement in the quality of care can translate into an improvement in the patient outcome. Evaluation of care quality among oncology practices has been associated with an improvement in the care of breast or colorectal cancer patients previously. Lung cancer is the leading cause of cancer death. Recently quality of care indicators specific for non-small cell lung cancer (NSCLC) have been developed. We investigated the impact of oncology practice evaluation on care quality in NSCLC. Methods: In 2008, members of the Florida Initiative for Quality Cancer Care submitted medical records of randomly sampled, new NSCLC patients who were seen in 2006 for review as baseline practice performance. Results were then circulated among members and voluntary improvement projects independently undertaken in each practice. In 2010, a repeat evaluation was conducted of new NSCLC patients first seen in 2009 to characterize change(s). Results: 10 practices (7 private and 3 university-based) contributed 1,091 patient records for analysis: 518 in 2006 and 573 in 2009. Baseline characteristics of patients were well balanced; however, the proportion of Medicaid or unfunded patients was higher in 2009 than in 2006 (14.8% vs. 7.7%, p=0.002). Of the 7 quality indicators measured, 4 showed a significant improvement when adjusted by practice site and patient characteristics (Table). Notable improvements included the use of brain staging before chemoradiation for stage III patients, performance status documentation and the use of cisplatin for adjuvant therapy. Conclusions: Performance evaluation is associated with an improvement in selected indicators of the quality of care in NSCLC. [Table: see text]

Efficacy of nivolumab (Nivo) as 2+ line treatment and quality of life (QoL) in advanced refractory non-small cell lung cancer (NSCLC) patients: Interim results of observational prospective study.

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. e21126-e21126
Author(s):  
Konstantin K. Laktionov ◽  
Alla L. Arzumanyan ◽  
Larisa Bolotina ◽  
Valeriy Vladimirovich Breder ◽  
Natalia N. Buevich ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Prospective Study ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Line Treatment ◽  
Small Cell Lung ◽  
Nsclc Patients

Biomarker utilization in non-small cell lung cancer, are we treating after testing?

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 9609-9609
Author(s):  
Elias Makhoul ◽  
Jong Taek Kim ◽  
Wenjuan Zhang ◽  
Jean Raphael Lopategui ◽  
Ani Sarkis Balmanoukian ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Targeted Therapy ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Targeted Therapies ◽  
Small Cell ◽  
Molecular Testing ◽  
Small Cell Lung ◽  
Nsclc Patients

9609 Background: Targeted therapy in EGFR and ALK mutated non-small cell lung cancer (NSCLC) has been the standard of care for nearly a decade with subsequent FDA approvals for ROS1 and BRAF V600 mutated NSCLC occurring in 2016 and 2017. However, recent studies have shown suboptimal utilization of genomic profiling results in these patients. In 1 recent study of community oncologists, ~70% of EGFR/ALK+ patients received appropriate targeted therapy, while patients with other gene mutations (including BRAF and ROS1) only received targeted therapy ~30% of the time. Left unanswered was what patients were receiving instead and why. Additionally, it is unknown if this finding is generalizable to the academic setting. We aimed to investigate whether in our patient population, NSCLC patients with actionable mutations received associated FDA approved therapies and if not why. Methods: The pathology database was queried for all NSCLC with molecular testing (including qPCR, FISH and NGS) from 2009 to 2019. Patients with sensitizing EGFR, ALK, ROS1 or BRAF mutations that were detected after the first FDA approval for their respective targeted therapies were included for analysis with those lost to follow up subsequently excluded. Basic demographic and clinical variables were collected as well as treatment records. Results: 2160 NSCLC patients were evaluated (2160 EGFR, 1417 ALK, 810 ROS1, 589 BRAF). 468 patients were identified with targetable mutations (411 EGFR, 46 ALK, 5 ROS1, 6 BRAF). No patient had more than 1 targetable mutation. Of those patients, 248 were at an advanced stage and had clinical follow up (202 EGFR, 37 ALK, 4 ROS1, 5 BRAF). Of those patients 197/202 (97.5%), 33/37 (89.2%), 3/4 (75%) and 1/5 (20%) received EGFR, ALK, ROS1 or BRAF targeted therapy respectively. Across biomarkers 14/248 patients (5.6%) did not receive subsequent targeted therapy. 10 patients (5 EGFR, 3 ALK, 1 ROS1 and 1 BRAF) passed away before targeted therapy could be initiated. Physician choice and missed findings accounted for the remaining four cases. Conclusions: The vast majority of advanced NSCLC patients analyzed in this study received appropriate targeted therapy matched to genomic findings. The main reason (~4% of total cases) that patients did not receive therapy was due to rapidly progressive disease and death before it could be initiated. These findings are at odds with those published from the community setting. This may be due to multiple factors, including clinician education, ease of access to targeted therapies across patient populations and incomplete data in the previous study populations.

scholarly journals Evaluation of the Lung Immune Prognostic Index in Non-Small Cell Lung Cancer Patients Treated With Systemic Therapy: A Retrospective Study and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Litang Huang ◽  
Hedong Han ◽  
Li Zhou ◽  
Xi Chen ◽  
Qiuli Xu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Targeted Therapy ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Systemic Therapy ◽  
Meta Analysis ◽  
Prognostic Index ◽  
Small Cell ◽  
Small Cell Lung ◽  
Nsclc Patients

The lung immune prognostic index (LIPI) has been shown to be an important prognostic marker for various tumors. However, the prognostic value of LIPI among non-small cell lung cancer (NSCLC) patients treated with systemic therapy remains controversial. We aimed to evaluate survival status according to LIPI among NSCLC patients receiving different forms of systemic therapy at our institution. We also performed a meta-analysis of articles from PubMed and Embase to illustrate this question. For our cohort, we found that good LIPI was associated with better overall survival (OS) among 91 patients on immunotherapy, 329 patients on targeted therapy, and 570 patients on chemotherapy. For the meta-analysis, a total of eight studies with 8,721 patients were included. Pooled results showed that a higher LIPI (those with 1 or 2 factors) was associated with poor overall progression-free survival (PFS) (hazard ratio [HR], 1.57; 95% confidence interval [CI], 1.45−1.71) and OS (HR, 2.01; 95% CI, 1.75−2.31). Subgroup analyses showed that a higher LIPI was related to poor survival among patients prescribed different systemic therapies: immunotherapy (OS HR, 2.50; 95% CI, 1.99–3.13; PFS HR, 1.77; 95% CI, 1.56–2.01), chemotherapy (OS HR, 1.58; 95% CI, 1.34–1.86; PFS HR, 1.38; 95% CI, 1.23–1.55), and targeted therapy (OS HR; 2.15, 95% CI, 1.57–2.96; PFS HR, 1.60; 95% CI, 1.25–2.06). The study shows that the LIPI is a clinically significant prognostic factor for NSCLC patients receiving systemic therapy.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD420209009.

Current progress and quality of radiomic studies for predicting EGFR mutation in patients with non-small cell lung cancer using PET/CT images: a systematic review

2021 ◽  
pp. 20201272
Author(s):  
Meilinuer Abdurixiti ◽  
Mayila Nijiati ◽  
Rongfang Shen ◽  
Qiu Ya ◽  
Naibijiang Abuduxiku ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Egfr Mutation ◽  
Small Cell ◽  
Small Cell Lung ◽  
Mutation Status ◽  
Pet Ct ◽  
Nsclc Patients

Objectives: To assess the methodological quality of radiomic studies based on positron emission tomography/computed tomography (PET/CT) images predicting epidermal growth factor receptor (EGFR) mutation status in patients with non-small cell lung cancer (NSCLC). Methods: We systematically searched for eligible studies in the PubMed and Web of Science datasets using the terms “radiomics”, “PET/CT”, “NSCLC”, and “EGFR”. The included studies were screened by two reviewers independently. The quality of the radiomic workflow of studies was assessed using the Radiomics Quality Score (RQS). Interclass correlation coefficient (ICC) was used to determine inter rater agreement for the RQS. An overview of the methodologies used in steps of the radiomics workflow and current results are presented. Results: Six studies were included with sample sizes of 973 ranging from 115 to 248 patients. Methodologies in the radiomic workflow varied greatly. The first-order statistics were the most reproducible features. The RQS scores varied from 13.9 to 47.2%. All studies were scored below 50% due to defects on multiple segmentations, phantom study on all scanners, imaging at multiple time points, cut-off analyses, calibration statistics, prospective study, potential clinical utility, and cost-effectiveness analysis. The ICC results for majority of RQS items were excellent. The ICC for summed RQS was 0.986 [95% confidence interval (CI): 0.898–0.998]. Conclusions: : The PET/CT based radiomics signature could serve as a diagnostic indicator of EGFR mutation status in NSCLC patients. However, the current conclusions should be interpreted with care due to the suboptimal quality of the studies. Consensus for standardization of PET/CT based radiomic workflow for EGFR mutation status in NSCLC patients is warranted to further improve research. Advances in knowledge: Radiomics can offer clinicians better insight into the prediction of EGFR mutation status in NSCLC patients, whereas the quality of relative studies should be improved before application to the clinical setting.

scholarly journals The experience of weight loss and its associated burden in patients with non-small cell lung cancer: results of an online survey

2017 ◽  
Vol 2 (2) ◽  
Author(s):  
Ana Maria Rodriguez ◽  
Julia Braverman ◽  
Dimple Aggarwal ◽  
John Friend ◽  
Elizabeth Duus
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Weight Loss ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Online Survey ◽  
Small Cell ◽  
Small Cell Lung ◽  
Nsclc Patients

Background: The main objectives of this study were to characterize and compare the burden of non-small cell lung cancer (NSCLC) patients reporting considerable unintentional weight loss (≥ 5% in the past 6 months or ≥ 2% for a BMI < 20 kg/m2) to those who did not.Methods: Ninety-five advanced NSCLC patients were surveyed from the online patient-powered community PatientsLikeMe, which included health-related quality of life (QLQ-C15-PAL), anorexia-cachexia symptoms/concerns (FAACT A/CS domain), distress levels, clinical/demographic characteristics, and impact of weight loss (open-ended questions).Results: Thirty-five patients (37%) had considerable weight loss at the time of the survey and 60 (63%) did not. Mean age was 59 years, and most were female (81%) and American (81%). Patients with weight loss reported significantly (p < 0.05) lower overall quality of life (55.2 vs. 66.9), worsened anorexia-cachexia symptoms/concerns (30.7 vs. 36.0), and higher symptomology, specifically fatigue (64.8 vs. 49.1), nausea (19.5 vs. 9.2), and appetite loss (41.0 vs. 23.9) – than patients without weight loss. In addition, significantly more patients who lost weight reported moderate/high distress levels than patients who did not (71% vs. 38%). For patients with weight loss, changes in food taste, fatigue, and decrease in appetite were the most frequently reported symptoms with the greatest impact on their lives, and main worries included loss of energy and disease progression.Conclusions: Weight loss represents a substantial problem for NSCLC patients and symptoms associated with weight loss significantly impact patient lives. Interventions targeted at maintaining/increasing body weight may help to alleviate these findings.

scholarly journals TARGETED THERAPY OF NON-SMALL-CELL LUNG CANCER PATIENTS: MOST COMMON ADVERSE EVENTS AND METHODS OF THEIR CORRECTIONS

2017 ◽  
Vol 22 (6) ◽  
pp. 300-306
Author(s):  
Elena V. Reutova ◽  
K. P Laktionov ◽  
M. S Ardzinba
Keyword(s):  
Lung Cancer ◽  
Targeted Therapy ◽  
Adverse Events ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Serious Adverse Events ◽  
Long Term Treatment ◽  
Nsclc Patients

Major advances in the treatment of non-small-cell lung cancer (NSCLC) patients are associated with the targeted therapy. It is both highly effective in the presence of activating mutations in the tumor and generally well-tolerated. Serious adverse events are recorded much less than with chemotherapy. There are significant differences in the toxicity profile. Both early detection and proper and timely correction of complications of targeted therapies are necessary for the successful long-term treatment of metastatic NSCLC patients.

scholarly journals Pretreatment platelet/lymphocyte ratio (PLR) is a significant predictive marker for EGFR targeted therapy in patients with non-small-cell lung cancer

2019 ◽  
Author(s):  
Kejun Liu ◽  
Weiwei Zhang ◽  
Qinquan Tan ◽  
Guanming Jiang ◽  
Jun Jia
Keyword(s):  
Lung Cancer ◽  
Targeted Therapy ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Nsclc Patients ◽  
Egfr Tkis

Abstract Non-small-cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) gene mutation is benefited from targeted therapy. There is no other superior predictive factor for targeted therapy except EGFR in the clinical. In this study, we analyzed the effect of pretreatment platelet/lymphocyte ratio (PLR) in NSCLC patients. In the present study, a total of 96 patients with EGFR mutations were included in this study. All patients received EGFR targeted therapy, until disease progression, unacceptable toxicity or other factors. The following evaluation was conducted about 3 days before initial treatment: detailed clinical history, physical examination, radiographic results, pathological diagnosis and laboratory parameters including complete blood cell counts and albumin levels. We found that pretreatment PLR is significantly associated to the PFS of NSCLC patients with EGFR targeted therapy. Patients in the PLR ≥190 group had shorter PFS than those in the PLR <190 group (P= 0.009). Furthermore, the 1-year PFS rate in the PLR ≥190 group were inferior to the low value group (P= 0.016). Multivariate analysis confirmed the role of PLR on predicting the efficacy of targeted therapy for advanced NSCLC. In addition, we found that PLR was also an predictive biomarker for grade 3/4 adverse events of diarrhea. In conclusion, high pretreatment PLR was an independent indicator for predicting a poor PFS for NSCLC patients receiving EGFR-TKIs treatment. Further studies are needed to identify the impact of PLR on results of EGFR-TKIs treatment.

scholarly journals Anti-PD-1/PD-L1 Therapy for Non-Small-Cell Lung Cancer: Toward Personalized Medicine and Combination Strategies

2018 ◽  
Vol 2018 ◽  
pp. 1-17 ◽  
Author(s):  
Hongshu Sui ◽  
Ningxia Ma ◽  
Ying Wang ◽  
Hui Li ◽  
Xiaoming Liu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Targeted Therapy ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Diagnostic Assays ◽  
Programmed Death ◽  
Companion Diagnostic ◽  
Nsclc Patients

Lung cancer remains a leading cause of cancer-related mortality worldwide with the poor prognosis. Encouragingly, immune checkpoint blockade targeting programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) has dramatically changed the landscape for treatments in patients with non-small-cell lung cancer (NSCLC). However, only a small proportion of NSCLC patients responded to monotherapy of anti-PD-1/PDL1 agents; together, the development of resistance to anti-PD-1/PD-L1 therapy that leads to failure of anti-PD-1/PD-L1 therapy has significantly limited a broad applicability of the findings in clinical practices. Nowadays, several companion diagnostic assays for PDL1 expression have been introduced for identifying patients who may benefit the immunotherapy. In addition, results from clinical trials explored combinatory therapeutic strategies with conventional and/or targeted therapy reported a higher efficacy with an acceptable safety profile in NSCLC treatments, as compared to the monotherapy of these agents alone. In this review article, we summarized several anti-PD-1/PD-L1 agents licensed for NSCLC treatment, with a focus on predictive biomarkers and companion diagnostic assays for identification of NSCLC patients for immunotherapy anti-PD-1/PDL1 antibodies. Of a great interest, potentials of the combinatory therapy of anti-PD-1/PDL1 therapy with a conventional or targeted therapy, or other immunotherapy such as CAR-T cell therapy were emphasized in the article.

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