scholarly journals Prognostic Value of Intraoperative Pleural Lavage Cytology as an Independent Prognostic Factor in Non-Small Cell Lung Cancer: A Retrospective Study

2021 ◽  
Author(s):  
Sirawee Ekkasak ◽  
Pisut Pongchaikul ◽  
Montien Ngodngamthaweesuk
Keyword(s):  
Lung Cancer ◽  
Survival Rate ◽  
Clinical Outcomes ◽  
Primary Lung Cancer ◽  
Metastatic Tumour ◽  
Metastatic Rate ◽  
Lavage Cytology ◽  
Clinical Records ◽  
Nsclc Patients ◽  
Complete Operation

Abstract BackgroundThe aim of this study is to demonstrate that intraoperative PLC has a role in predicting clinical outcomes in NSCLC patients.MethodsIntraoperative PLC was performed in NSCLC patients who had no pleural effusion before the operation. PLC was performed three times for each patient. PLC1 was performed after the thoracotomy; PLC2 was performed immediately after complete operation; and PLC3 was performed after complete operation and washed the pleural cavity with 5,000 ml of normal saline solution. Clinical records of 178 patients in Ramathibodi Hospital from 2012 to 2016 were retrospectively reviewed and analysed for the relevance of intraoperative PLC and clinical outcomes.Results178 patients were included in this study; 67 patients were male (37.6%). Metastatic tumour from primary lung cancer occurred in 56 patients (31.4%). Positive intraoperative PLC was significantly associated with higher metastatic rate (p < 0.05). Survival rate in the positive intraoperative PLC group was significantly worse than that in the negative PLC group (p < 0.05).ConclusionsThis study shows positive intraoperative PLC was statistically significant for increasing metastatic rate and decreasing survival rate in NSCLC patients. Intraoperative PLC could provide important information for the prediction of disease progression and treatment planning.

scholarly journals 562 Real-world assessment of current treatment patterns and clinical outcomes among patients with EGFR and ALK wild type non-small cell lung cancer (NSCLC) in the US

2021 ◽  
Vol 9 (Suppl 3) ◽  
pp. A591-A591
Author(s):  
Lyudmila Bazhenova ◽  
Jonathan Kish ◽  
Beilei Cai ◽  
Nydia Caro ◽  
Bruce Feinberg
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Clinical Outcomes ◽  
Treatment Patterns ◽  
Small Cell ◽  
Wild Type ◽  
Small Cell Lung ◽  
First Line ◽  
The Us ◽  
Nsclc Patients

BackgroundTreatment for advanced non-small cell lung cancer (NSCLC) has dramatically advanced in the past 5 years with the advent of immunotherapy (IO). This study sought to describe treatment patterns and clinical outcomes in a representative sample of NSCLC patients.MethodsPatients were identified by physicians from a voluntary sample of community practices across the US. Stage IIIB/IV NSCLC patients with EGFR/ALK wild-type initiating any first-line (1L) systemic therapy between 01/01/2016 and 12/31/2019 with at least 2 months of follow-up (unless deceased) were included, and were followed until November 2020. Sampling quotas included 250 patients who initiated 1L in 2016/2017 and 250 patients who did so in 2018/2019. Best tumor response was collected from patient charts during each line of therapy (LOT). Progression-free survival (PFS) and overall survival (OS) were calculated from initiation of 1L by Kaplan-Meier method. Baseline characteristics and clinical outcomes are described and presented by treatment regimen received.ResultsOf 500 submitted patients, 497 were included post QA/QC. Across all patients, mean age at 1L initiation was 65 years, 57.3% were male, 92.9% had stage IV disease, and 68.6% were ECOG-OS 0/1 (Table 1). Overall, 60.2% (n=299), 33.2% (n=165), and 6.6% (n=33) received 1, 2, or =3 LOTs during the study period. Most common 1L regimens (%) were platinum-doublet chemotherapy plus IO (PDC+IO) (40.6%), PDC (29.4%), IO monotherapy (20.7%), PDC+bevacizumab (6.2%); while most common 2L regimens were IO monotherapy (42.4%), single-agent chemotherapy (SAC) (18.2%), SAC+VEGF inhibitor (15.7%), PDC (8.1%), and PDC+bevacizumab (5.6%). Over 90% of pts who received IO monotherapy had PD-L1 >50%. Moving from 2016/2017 to 2018/2019, utilization of 1L PDC declined from 45.0% to 13.7% while utilization of 1L PDC+IO increased from 27.3% to 54.0%. Among those who received only one LOT (n=299), 44.5% were still on 1L, 14.0% stopped receiving 1L, and 41.5% were deceased. Overall response rates were 67.3%, 35.6%, 60.2%, and 61.3% for 1L PDC+IO, PDC, IO monotherapy, and PDC+bevacizumab, respectively (Table 1). First-line median PFS/OS (months) was 15.6/26.5, 5.3/13.7, 17.8/NR, and 10.8/18.6, respectively for PDC+IO, PDC, IO monotherapy, and PDC+bevacizumab (table 1).Abstract 562 Table 1ConclusionsData from 2016 to 2020 was used provide a contemporary assessment of treatment patterns among EGFR/ALK wild-type NSCLC patients. Although 1L treatment utilization shifted to IO-based regimens in recent years, 41.5% of patients did not survive to receive second-line therapy, 1L PFS did not exceed 1.5 years, and median OS remained limited across all 1L treatment groups.Ethics ApprovalOn August 20, 2020, Western Institutional Review Board (WIRB) approved a request for a waiver of authorization for use and disclosure of protected health information (PHI) for this research. The study is exempt under 45 CFR § 46.104(d)(4).

scholarly journals Factors Affecting the Survival of Patients with Oligometastatic Non-Small-Cell Lung Cancer: A Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Yu Shi ◽  
Jianxin Yang ◽  
Ninghua Yao ◽  
Minghai Shao ◽  
Wenxiu Ding ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Sensitivity Analysis ◽  
Overall Survival ◽  
Survival Rate ◽  
Small Cell Lung Cancer ◽  
Meta Analysis ◽  
Small Cell ◽  
Overall Survival Rate ◽  
Small Cell Lung ◽  
Nsclc Patients

Background. The aim was to investigate the potential factors related with overall survival of oligometastatic non-small-cell lung cancer (NSCLC) patients. Methods. A literature search was conducted in databases including PubMed, Embase, and Cochrane library up to March 2017. The hazard radio (HR) as well as the corresponding 95% confidence interval (CI) were calculated, and all the statistics analysis was performed by the R 3.12. Heterogeneity was analyzed using I-squared and Cochran Q tests. Furthermore, sensitivity analysis was performed to evaluate the stability of results. Results. In total, 6 articles were included in the meta-analysis. Nodal status was significantly correlated with the overall survival rate of NSCLC oligometastatic patients (HR: 1.69, 95% CI: 1.23–2.32, Z=3.20, P=0.001). No significant relationship was found between overall survival rate of NSCLC oligometastatic patients and the indicators including sex, stage, smoker, age, and histology. Notably, sensitivity analysis on data evaluating relationship between patients survival and the stage and histology showed that results were reversed after removing one of the studies. Conclusions. Nodal status might be associated with the overall survival of oligometastatic NSCLC patients.

The spatiotemporal evolution of early-stage non-small-cell lung cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 8539-8539 ◽  
Author(s):  
Siwei Wang ◽  
Jingyuan Zhang ◽  
Weizhang Xu ◽  
Hua Bao ◽  
Xiaojun Fan ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Clinical Outcomes ◽  
Early Stage ◽  
Metastatic Lymph Node ◽  
Small Cell ◽  
Driver Mutations ◽  
Intratumor Heterogeneity ◽  
Small Cell Lung ◽  
Nsclc Patients

8539 Background: Lung cancer is a genetically heterogeneous disease. The genomic basis of tumorigenesis and cancer cell spread, as well as intratumor heterogeneity (ITH) and subclonal evolutionary patterns might correlate with patients’ clinical outcomes. In this prospective study, we aimed to investigate such associations through comprehensive spatiotemporal genomic profiling in early-stage non-small cell lung cancers (NSCLCs). Methods: We performed deep targeted sequencing (GeneseeqPrime, 425 genes) of 503 primary tumor regions and 141 metastatic lymph node tumors from surgery and 378 longitudinal plasma biopsies (pre- and post-operation) across 128 Stage I-III NSCLC patients. ITH and phylogenetic tree for each patient were analyzed and correlated with clinical outcomes. Longitudinal and phylogenetic ctDNA analyses were further performed. Results: Spatial ITH varied among patients and was associated with clinical phenotypes. Geographical stratification of clonal structure, with localized confinement of subclones, was linked with slower tumor progression. In contrast, early expansion of subclones to multiregions was associated with rapid tumor growth and lymph node metastases. EGFR and TP53 mutations were nearly always clonal, whereas subclonal mutations in PI3K, WNT and TGF-beta pathway that occurred later in evolution were found in more than 50% of the patients. By tracking these phylogenetic events, we identified five evolutionary subtypes with distinct clinical outcomes, including a rare subtype characterized by independent origin of multiple EGFR driver mutations. ctDNA profiling could capture the spatial ITH to a certain extent with additional unique signatures. Further longitudinal and phylogenetic ctDNA analyses indicated early detection of relapse and adjuvant chemotherapy resistance. Conclusions: ITH is a key factor associated with clinical outcomes of early-stage NSCLC patients, which show diverse evolutionary subtypes underpinning the disease progression such as lymph metastasis and relapse. ctDNA sequencing can be used to capture spatial ITH, predict recurrence and track drug resistance.

Clinical impact of targetable gene alterations on therapeutic outcomes in stage II/III locally advanced non-small cell lung cancer patients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 9038-9038
Author(s):  
Yoshitaka Zenke ◽  
Shingo Matsumoto ◽  
Terufumi Kato ◽  
Shingo Miyamoto ◽  
Takuma Imakita ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Survival Rate ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Stage Ii ◽  
Small Cell Lung ◽  
Free Survival ◽  
Nsclc Patients ◽  
Gene Alterations

9038 Background: The clinical significance of genetic alterations in stage II/III non-small cell lung cancer (NSCLC) patients has not yet been clarified. We have prospectively analyzed NSCLC patients for cancer-related gene alterations and have followed up clinical course of the patients, establishing a large-scale clinico-genomic database in our nationwide genome screening project (LC-SCRUM-Japan). Methods: Submitted tumor samples were subjected to a targeted next-generation sequencing (NGS) system, Oncomine™ Comprehensive Assay. Therapeutic and prognostic data were collected and updated every year. Results: Since March 2015 to May 2019, 5166 non-squamous NSCLC patients from 263 institutions had been enrolled in the LC-SCRUM-Japan, and 754 of them were diagnosed as stage II/III. The median age of the 754 patients was 67 years (range, 21-92), and 503 (67%) were male, 595 (79%) smokers and 631 (84%) stage III. Of 640 available samples, 258 (40%) had targetable gene alterations, comprising 106 KRAS mut, 42 EGFR mut, 29 BRAF mut, 20 MET ex14skip/amp, 16 ALK fus, 12 ROS1 fus, 11 ERBB2 ex20ins, 8 RET fus, 7 EGFR ex20ins, 5 AKT1 mut, 1 NRG1 fus, 1 FGFR2/3 fus. In patients who received surgery (n = 159), 3-year disease-free survival rate was worse in patients with targetable gene alterations than in those without (40% vs 58% months; p = 0.03). In patients who received cytotoxic chemo-radiotherapy (n = 148), the response rate was similar in patients with targetable gene alterations and those without (70% vs. 77%); however, 3-year progression-free survival rate tended to be shorter in patients with targetable gene alterations than in those without (19% vs 35%; p = 0.08). Conclusions: In stage II/III NSCLC, the total frequency of targetable gene alterations was similar to that previously evaluated in our stage IV cohort (45%), and the current standard therapies showed early progression in the targetable gene-altered patients. A novel effective multimodality treatment in combination with targeted therapies is needed for this population.

Impact of SWI/SNF complex mutations in patients with non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors: Immuno-oncology biomarker study in LC-SCRUM-Japan (LC-SCRUM-IBIS).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 9530-9530
Author(s):  
Kiyotaka Yoh ◽  
Shingo Matsumoto ◽  
Naoki Furuya ◽  
Kazumi Nishino ◽  
Shingo Miyamoto ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Clinical Outcomes ◽  
Cell Lung Cancer ◽  
Immune Checkpoint ◽  
Checkpoint Inhibitors ◽  
Progression Free Survival ◽  
Small Cell ◽  
Small Cell Lung ◽  
Nsclc Patients

9530 Background: The SWI/SNF chromatin remodeling complex is reported to be involved in sensitivity and resistance to immune checkpoint inhibitor (ICI). However, their role in non-small cell lung cancer (NSCLC) remains unclear. We examined the relationship between SWI/SNF complex mutations and clinical outcomes of ICI in patients with NSCLC. Methods: Of 1017 lung cancer patients enrolled in LC-SCRUM-IBIS, 350 patients were analyzable for whole-exome sequencing (WES). WES data were used to analyze the presence of mutations in 29 major subunits of the SWI/SNF complexes. ARID1A and SMARCA4 mutations were also evaluated in a targeted NGS panel (Oncomine comprehensive assay, OCA). PD-L1 expression by 22C3, tissue tumor mutational burden (tTMB) by WES, STK11 and KEAP1 mutations by WES or OCA were also assessed. Durable clinical benefit (DCB) including CR, PR and SD > 6 mos to ICI, progression-free survival (PFS) and overall survival (OS) were compared in status of each of SWI/SNF complex mutations and other factors. Results: At least one mutation in any subunits of the SWI/SNF complex was present in 28% of NSCLC patients. The most common mutated subcomplexes were SMARCA4 (12%), BAF (7%: ARID1A, 4%), non-canonical BAF (3%), PBAF (3%), and SMARCA2 (2%). Of 101 NSCLC patients treated with PD-1/PD-L1 inhibitors, SMARCA4 mutations tended to be associated with lower DCB (16 vs 31%) and shorter median PFS (1.9 vs 3.6 m) and OS (7.4 vs 18.1m). Patients with ARID1A mutations tended to have better clinical outcomes (DCB, 40 vs 28%) compared to those without mutations. No significant associations were found between PD-L1 expression and SMARCA4 or ARID1A mutations. Patients with STK11/KEAP1 mutations had lower rate of PD-L1 expression (TPS > 50%) (18% vs 48%, P = 0.03) and worse clinical outcomes (DCB, 6 vs 33%) compared to those without mutations. There was no significant association between a tTMB status and clinical outcome. Conclusions: SMARCA4 and ARID1A mutations appear to affect clinical outcomes of ICI in NSCLC patients. These findings indicate that SWI/SNF complex mutations may serve as a predictive biomarker for ICI in NSCLC patients.

Prognostic impact of pleural lavage cytology in patients with primary lung cancer

Lung Cancer ◽  
2016 ◽  
Vol 102 ◽  
pp. 60-64 ◽  
Author(s):  
Kenji Tomizawa ◽  
Masaya Nishino ◽  
Yuichi Sesumi ◽  
Yoshihisa Kobayashi ◽  
Katsuaki Sato ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Primary Lung Cancer ◽  
Prognostic Impact ◽  
Lavage Cytology ◽  
Pleural Lavage Cytology ◽  
Pleural Lavage

scholarly journals Retrospective Comparison of Clinical Outcomes of Thoracoscopy-assisted and Completely Thoracoscopic VATS Lobectomy for Stage IA Primary Lung Cancer

Haigan ◽  
2006 ◽  
Vol 46 (4) ◽  
pp. 337-343 ◽  
Author(s):  
Yoshinori Yamashita ◽  
Hidenori Mukaida ◽  
Chie Moritani ◽  
Hiromi Egawa ◽  
Mayumi Kaneko
Keyword(s):  
Lung Cancer ◽  
Clinical Outcomes ◽  
Primary Lung Cancer ◽  
Vats Lobectomy ◽  
Retrospective Comparison ◽  
Stage Ia

scholarly journals Ten-Year Experience of Stereotactic Body Radiotherapy at a Single Institution: Impact of Technological Development on the Outcome of Patients With Early Lung Cancer

2020 ◽  
Vol 19 ◽  
pp. 153303382097916
Author(s):  
Keiichiro Koiwai ◽  
Yuuki Endo ◽  
Kai Mizuhata ◽  
Hironobu Ina ◽  
Ayumu Fukazawa ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Survival Rate ◽  
Clinical Outcomes ◽  
Technological Development ◽  
Progression Free Survival ◽  
Strong Impact ◽  
Conventional System ◽  
Free Survival ◽  
Local Progression ◽  
Advanced System

Purpose: Advanced radiotherapeutic techniques and apparatus have been developed and widely applied in stereotactic body radiation therapy for early-stage non-small cell lung cancer, but their clinical benefits have not necessarily been confirmed. This study was performed to review our 10-year experience with therapy for the disease and to evaluate whether the advanced radiotherapeutic system implemented in our hospital 5 years after we began the therapy improved the clinical outcomes of patients. Materials and Methods: Patients who underwent the therapy at our hospital between April 2008 and March 2018 were retrospectively reviewed. They were divided into 2 groups treated with the conventional system or the advanced system, and the characteristics and clinical outcomes were compared between the groups. The same analyses were also performed in propensity-matched patients from the 2 groups. Results: Among the 73 patients eligible for this study, 42 were treated with the conventional system and 31 with the advanced system. All were treated as planned, and severe adverse events were rare. The local progression-free survival rate in the advanced system group was significantly higher than in the conventional system group (P = 0.025). In the propensity-matched patients, both the local progression-free survival rate and the overall survival rate were significantly higher compared in the advanced system group than the conventional system group (P = 0.089 and 0.080, respectively). Conclusion: The advanced system improved the outcomes of patients with the disease, suggesting that technological development has had a strong impact on clinical outcomes.

scholarly journals Smoking and its relation to the histological type, survival, and prognosis among patients with primary lung cancer

1996 ◽  
Vol 114 (6) ◽  
pp. 1298-1302 ◽  
Author(s):  
Flávio Xavier ◽  
Lucélia de Azevedo Henn ◽  
Oliveira Marja ◽  
Luciane Orlandine
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Survival Rate ◽  
Survival Rates ◽  
Primary Lung Cancer ◽  
Histological Type ◽  
Overall Survival Rate ◽  
Porto Alegre ◽  
Overall Survival Rates

The frequency of smoking among patients with primary lung cancer diagnoses admitted to the Hospital de Clinicas de Porto Alegre (HCPA) during the 1980's was investigated. The objective of this study was to analyze cigarette consumption patterns through the number of cigarettes smoked per day and the age at which smoking began, correlating this data to the overall survival rate and histological type of the lung cancer. Methods: This retrospective study analyzed patients with primary lung cancer diagnosed at the HCPA between January 1980 and December 1989. All patients considered underwent follow-up for at least three years. Patient information was obtained either from the hospital's records or by contacting patients via letter or phone. Results: More than 90 percent of the patients were smokers or had smoked previously; most had started smoking before the age of 20.The overall 24-month survival rate after diagnosis varied depending on whether the patient had smoked less than 40 cigarettes per day or not. The percentage of smokers and non-smokers was established for each histological type, with the bronchoalveolar adenocarcinoma type showing the highest percentage of non-smokers (40 percent). Conclusion:The overall survival rates of patients with lung cancer was related to the number of cigarettes smoked, and not to the fact of the patient having smoked or not.The number of smokers among patients with lung cancer was not so high only for the bronchoalveolar adenocarcinoma histological type.

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