scholarly journals A Pilot Study to Evaluate Early Predictive Value of Thorax Perfusion-CT in Advanced NSCLC

Cancers ◽  
2021 ◽  
Vol 13 (21) ◽  
pp. 5566
Author(s):  
Francisco Aya ◽  
Mariana Benegas ◽  
Nuria Viñolas ◽  
Roxana Reyes ◽  
Ivan Vollmer ◽  
...  
Keyword(s):  
Pilot Study ◽  
Advanced Nsclc ◽  
Antiangiogenic Therapy ◽  
Advanced Treatment ◽  
Small Cell Lung ◽  
Early Assessment ◽  
Perfusion Computed Tomography ◽  
Treatment Naïve ◽  
Antiangiogenic Drugs

Background: The role of perfusion computed tomography (pCT) in detecting changes in tumor vascularization as part of a response to antiangiogenic therapy in non-small cell lung cancer (NSCLC) remains unclear. Methods: In this prospective pilot study (IMPACT trial, NCT02316327), we aimed to determine the ability of pCT to detect early changes in blood flow (BF), blood volume (BV), and permeability (PMB), and to explore whether these changes could predict the response at day +42 in patients with advanced, treatment-naive, non-squamous NSCLC treated with cisplatin and gemcitabine plus bevacizumab. Results: All of the perfusion parameters showed a consistent decrease during the course of treatment. The BV difference between baseline and early assessment was significant (p = 0.013), whereas all perfusion parameters showed significant differences between baseline and day +42 (p = 0.003, p = 0.049, and p = 0.002, respectively). Among the 16 patients evaluable for efficacy, a significant decline in BV at day +7 from baseline was observed in tumors with no response (p = 0.0418). Conclusions: Our results confirm that pCT can capture early changes in tumor vasculature. A substantial early decline of BV from baseline might identify tumors less likely responsive to antiangiogenic-drugs.

Updates in Local-Regionally Advanced Non–Small Cell Lung Cancer

2019 ◽  
pp. 553-562 ◽  
Author(s):  
Anne S. Tsao ◽  
Shruti Jolly ◽  
Jay M. Lee
Keyword(s):  
Lung Cancer ◽  
Clinical Trials ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Advanced Nsclc ◽  
Early Stage ◽  
Standard Of Care ◽  
Small Cell ◽  
Small Cell Lung

The landscape for therapy in local-regionally advanced non–small cell lung cancer (NSCLC) has shifted dramatically in the last year as a result of the PACIFIC trial, which demonstrated a significant survival benefit with the addition of 1 year of durvalumab after concurrent chemoradiation. This is a new standard of care for unresectable local-regionally advanced NSCLC and is the first trial to show that immunotherapy can increase survival in earlier-stage NSCLC. Several clinical trials are underway or in development to explore the role of adding immunotherapy to concurrent chemoradiation, followed by a year of immunotherapy or to even replace chemotherapy in this treatment paradigm. In resectable disease, adjuvant chemotherapy is still the standard of care for stage IB (tumors ≥ 4 cm) through stage III disease. However, new studies are investigating the role of adding immunotherapy to neoadjuvant chemotherapy or as adjuvant therapy for 1 year after resection. Molecular profiling for early-stage disease is not currently the standard of care, but several national clinical trials are studying the benefit of adding adjuvant-targeted therapies. This article will detail the current standard practices in early-stage and local-regionally advanced NSCLC and describe the evolving strategies that are under investigation that may further refine our current practice.

scholarly journals Next-Generation Sequencing with Liquid Biopsies from Treatment-Naïve Non-Small Cell Lung Carcinoma Patients

Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2049
Author(s):  
Paul Hofman
Keyword(s):  
Lung Cancer ◽  
Next Generation Sequencing ◽  
Lung Carcinoma ◽  
Advanced Nsclc ◽  
Small Cell Lung Carcinoma ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Treatment Naïve ◽  
Generation Sequencing

Recently, the liquid biopsy (LB), a non-invasive and easy to repeat approach, has started to compete with the tissue biopsy (TB) for detection of targets for administration of therapeutic strategies for patients with advanced stages of lung cancer at tumor progression. A LB at diagnosis of late stage non-small cell lung carcinoma (NSCLC) is also being performed. It may be asked if a LB can be complementary (according to the clinical presentation or systematics) or even an alternative to a TB for treatment-naïve advanced NSCLC patients. Nucleic acid analysis with a TB by next-generation sequencing (NGS) is gradually replacing targeted sequencing methods for assessment of genomic alterations in lung cancer patients with tumor progression, but also at baseline. However, LB is still not often used in daily practice for NGS. This review addresses different aspects relating to the use of LB for NGS at diagnosis in advanced NSCLC, including its advantages and limitations.

scholarly journals Splenic Volume as a Surrogate Marker of Immune Checkpoint Inhibitor Efficacy in Metastatic Non Small Cell Lung Cancer

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 3020
Author(s):  
Loïck Galland ◽  
Julie Lecuelle ◽  
Laure Favier ◽  
Cléa Fraisse ◽  
Aurélie Lagrange ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Immune Checkpoint ◽  
Advanced Nsclc ◽  
Small Cell ◽  
Small Cell Lung ◽  
Prognostic Role ◽  
Splenic Volume

Monoclonal antibodies targeting PD1/PD-L1 are game changers in advanced non-small cell lung cancer (NSCLC), but biomarkers are lacking. We previously reported the prognostic role of splenic volume in digestive cancer and its correlation with the presence of immunosuppressive cells. The aim of this study was to evaluate the prognostic role of splenic volume in NSCLC patients treated with immune checkpoint inhibitors (ICIs). We conducted a retrospective study of 276 patients receiving ICIs for advanced NSCLC in the Georges François Leclerc Cancer Center. The association between splenic volume at baseline and at two months of therapy and progression-free survival (PFS) during ICI treatment or overall survival (OS) from ICI initiation was evaluated using univariate and multivariable Cox analyses. Splenic volume during treatment and the change in splenic volume were associated with poor PFS (respectively p = 0.02 and p = 0.001) and with OS (respectively p < 1.10−3 and p < 1.10−3). Baseline splenic volume at the first evaluation was also associated with poor OS (p = 0.001). LDH rate and dNLR were positively correlated with splenic volume, as well as with its evolution. After the adjustment of clinical variables, splenic volumes remained a predictive marker of immunotherapy efficacy. Splenic volume is a prognostic biomarker in patients with advanced NSCLC treated with ICIs.

scholarly journals A Multicenter Pilot Study Examining the Role of Circulating Tumor Cells as a Blood-Based Tumor Marker in Patients with Extensive Small-Cell Lung Cancer

2014 ◽  
Vol 4 ◽  
Author(s):  
Chao H. Huang ◽  
Jo A. Wick ◽  
Gurusingham Sitta Sittampalam ◽  
Victor Sanjit Nirmalanandhan ◽  
Apar Kishor Ganti ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Pilot Study ◽  
Small Cell Lung Cancer ◽  
Tumor Marker ◽  
Tumor Cells ◽  
Circulating Tumor Cells ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung

scholarly journals CDKN2A loss-of-function predicts immunotherapy resistance in non-small cell lung cancer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Stanley I. Gutiontov ◽  
William Tyler Turchan ◽  
Liam F. Spurr ◽  
Sherin J. Rouhani ◽  
Carolina Soto Chervin ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Clinical Outcomes ◽  
Cell Lung Cancer ◽  
Advanced Nsclc ◽  
Immune Checkpoint Blockade ◽  
Small Cell ◽  
Loss Of Function ◽  
Small Cell Lung

AbstractImmune checkpoint blockade (ICB) improves outcomes in non-small cell lung cancer (NSCLC) though most patients progress. There are limited data regarding molecular predictors of progression. In particular, there is controversy regarding the role of CDKN2A loss-of-function (LOF) in ICB resistance. We analyzed 139 consecutive patients with advanced NSCLC who underwent NGS prior to ICB initiation to explore the association of CDKN2A LOF with clinical outcomes. 73% were PD-L1 positive (≥ 1%). 48% exhibited high TMB (≥ 10 mutations/megabase). CDKN2A LOF was present in 26% of patients and was associated with inferior PFS (multivariate hazard ratio [MVA-HR] 1.66, 95% CI 1.02–2.63, p = 0.041) and OS (MVA-HR 2.08, 95% CI 1.21–3.49, p = 0.0087) when compared to wild-type (WT) patients. These findings held in patients with high TMB (median OS, LOF vs. WT 10.5 vs. 22.3 months; p = 0.069) and PD-L1 ≥ 50% (median OS, LOF vs. WT 11.1 vs. 24.2 months; p = 0.020), as well as in an independent dataset. CDKN2A LOF vs. WT tumors were twice as likely to experience disease progression following ICB (46% vs. 21%; p = 0.021). CDKN2A LOF negatively impacts clinical outcomes in advanced NSCLC treated with ICB, even in high PD-L1 and high TMB tumors. This novel finding should be prospectively validated and presents a potential therapeutic target.

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