scholarly journals Treatment and outcomes for early non-small-cell lung cancer: a retrospective analysis of a Portuguese hospital database

2021 ◽  
pp. LMT46
Author(s):  
Marta Soares ◽  
Luís Antunes ◽  
Patrícia Redondo ◽  
Marina Borges ◽  
Ruben Hermans ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Squamous Cell ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Stage I ◽  
Small Cell Lung ◽  
Stage Iiia ◽  
Iiia Nsclc ◽  
One Year

Aim: This observational study evaluated treatment patterns and survival for patients with stage I–IIIA non-small-cell lung cancer (NSCLC). Materials & methods: Adults newly diagnosed with NSCLC in 2012–2016 at IPO-Porto hospital were included. Treatment data were available for patients diagnosed in 2015–2016. Results: 495 patients were included (median age: 67 years). The most common treatments were surgery alone or with another therapy (stage I: 66%) and systemic anticancer therapy plus radiotherapy (stage II: 54%; stage IIIA: 59%). One-year OS (95% CI) for patients with stage I, II and IIIA NSCLC (diagnosed 2012–2016) were 92% (88–96), 71% (62–82) and 69% (63–75), respectively; one-year OS (95% CI) for treated patients with stage I–II or stage IIIA NSCLC (diagnosed 2015–2016) were 89% (81–97) and 86% (75–98) for non-squamous cell and 76% (60–95) and 49% (34–70) for squamous cell NSCLC. Conclusion: Treatment advances are strongly needed for stage I–IIIA NSCLC, especially for patients with squamous cell histology.

scholarly journals Negativation of PD-L1 Postoperatively in Initially Inoperable Stage III Non-Small Cell Lung Cancer Treated with Pembrolizumab: Two Case Reports

2019 ◽  
Vol 12 (2) ◽  
pp. 421-425
Author(s):  
Fadi Nasr ◽  
Ahmad Al Ghoche ◽  
Roland Eid ◽  
Lewis Nasr ◽  
Saada Diab ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Incidental Finding ◽  
Case Reports ◽  
Small Cell ◽  
Stage Iii ◽  
Small Cell Lung ◽  
Stage Iiia ◽  
Iiia Nsclc

Stage III non-small cell lung cancer is a border line stage between localized and metastatic disease. PDL-1 is gaining an important role in the therapeutic arsenal of lung cancer, the most frequent cancer worldwide. We report for the first time a negativation of PDL-1 status in 2 cases of stage IIIA NSCLC with conversion to operable disease after using immunotherapy. The first patient was a 59-year old female diagnosed incidentally to have stage IIIA inoperable NSCLC that was treated with combination chemo-immunotherapy, and converted to operable disease with a negative PD-L1 in the postoperative setting. The second case is that of a 56-year old male that also had an inoperable stage IIIA NSCLC treated with chemotherapy first line followed by pembrolizumab at progression, then operated after surgical conversion, with negative PD-L1 postoperatively. In front of these findings, further work should be done to elucidate if the reverse of the PDL-1 status and the conversion to operability were due to the use of immunotherapy or to an incidental finding. If confirmed, it may have a therapeutic impact.

Association of delays in time to surgery for resectable stage IIIA non-small cell lung cancer with survival.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e20056-e20056
Author(s):  
Susan E Combs ◽  
Katherine Tullio ◽  
Nathan A. Pennell
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Mortality Risk ◽  
Continuous Variable ◽  
Small Cell ◽  
Small Cell Lung ◽  
Stage Iiia ◽  
Curative Intent ◽  
Iiia Nsclc

e20056 Background: Delay in time to surgery (TTS) for early stage non-small cell lung cancer (NSCLC) may impact survival; however the effect of delayed TTS for patients with stage IIIA NSCLC is unclear. Methods: Patients with pathologic stage IIIA NSCLC who underwent curative intent resection with documented days from diagnosis to definitive surgery were identified in the National Cancer Database from 2004 to 2012. Patients with surgery on the day of diagnosis or more than 180 days after diagnosis, and those who received pre-operative systemic or radiation therapy were excluded. Association between TTS as a continuous variable by week and month was assessed by cox regression models. Multivariate cox proportional hazard models estimated the mortality risk associated with TTS as a continuous variable with age, sex, race, comorbidity score, pathologic T and N stage. Overall survival (OS) between immediate and delayed groups was estimated by Kaplan-Meier method and log-rank test. Results: Of patients with NSCLC who underwent definitive resection, 16,033 were confirmed to be pathologic stage IIIA. Median follow-up was 25 months, and 61% of patients died with a median survival of 32 months. Median time from diagnosis to surgery was 37 days. Five-year OS for patients with surgery in the first 37 days was 34.7%, compared to 30.1% in patients who had surgery after the first 37 days (p < 0.001). When grouped by increasing weeks of delay, the earliest significant survival difference was noted in patients resected within three weeks of diagnosis, with 5-yr OS of 35.2%, compared to 31.5% for patients treated more than three weeks later (p = 0.002). For each week of additional TTS, the associated risk of mortality increased by 1.2% (HR 1.012, 95% CI 1.007-1.016, p < 0.001) and 5.0% for each month of delay (HR 1.046, 95% CI 1.026-1.065, p < 0.001). In the multivariate model accounting for confounders, the mortality risk associated with delay to surgery increased by 0.75% with each additional week (HR 1.0075, 95% CI 1.003-1.012, p = 0.002). Conclusions: This analysis suggests that delays in time to curative intent resection for patients with stage IIIA NSCLC decreases the 5-year OS and thus the likelihood of cure.

scholarly journals Preoperative nivolumab to evaluate pathological response in patients with stage I non-small cell lung cancer: a study protocol of phase II trial (POTENTIAL)

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043234
Author(s):  
Atsushi Kagimoto ◽  
Yasuhiro Tsutani ◽  
Takahiro Mimae ◽  
Yoshihiro Miyata ◽  
Norihiko Ikeda ◽  
...  
Keyword(s):  
Lung Cancer ◽  
High Risk ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Phase Ii Trial ◽  
Clinical Stage ◽  
Small Cell ◽  
Pathological Response ◽  
Stage I ◽  
Small Cell Lung

IntroductionRecently, inhibition of programmed cell death 1 or its ligand has shown therapeutic effects on non-small cell lung cancer (NSCLC). However, the effectiveness of preoperative nivolumab monotherapy for stage I NSCLC remains unknown. The present study aimed to investigate the pathological response of preoperative treatment with nivolumab for clinically node negative but having a high risk of NSCLC recurrence.Methods and analysisThe Preoperative Nivolumab (Opdivo) to evaluate pathologic response in patients with stage I non-small cell lung cancer: a phase 2 trial (POTENTIAL) study is a multicentre phase II trial investigating efficacy of preoperative nivolumab for clinical stage I patients at high risk of recurrence. This study includes histologically or cytologically confirmed NSCLC patients with clinical N0 who were found on preoperative high-resolution CT to have a pure solid tumour without a ground-glass opacity component (clinical T1b, T1c or T2a) or a solid component measuring 2–4 cm in size (clinical T1c or T2a). Patients with epidermal growth factor receptor (EGFR) mutation (deletion of exon 19 or point mutation on exon21, L858R), anaplastic lymphoma kinase (ALK) translocation or c-ros oncogene 1 (ROS-1) translocation are excluded from this study. Nivolumab (240 mg/body) is administrated intravenously as preoperative therapy every 2 weeks for three cycles. Afterward, lobectomy and mediastinal lymph node dissection (ND 2a-1 or ND 2a-2) are performed. The primary endpoint is a pathological complete response in the resected specimens. The secondary endpoints are safety, response rates and major pathological response. The planed sample size is 50 patients. Patients have been enrolled since April 2019.Ethics and disseminationThis trial was approved by the Institutional Review Board of Hiroshima University Hospital and other participating institutions. This trial will help examine the efficacy of preoperative nivolumab therapy for clinical stage I NSCLC.Trial registration numberjRCT2061180016.

Sign in / Sign up

Export Citation Format

Share Document