scholarly journals Survival analysis of advanced lung cancer patients undergoing personalised treatment or chemotherapy in a real clinic

2021 ◽  
Author(s):  
Justyna Błach ◽  
Paweł Krawczyk ◽  
Juliusz Pankowski ◽  
Jarosław Buczkowski ◽  
Izabela Chmielewska ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Clinical Trials ◽  
Cancer Patients ◽  
Advanced Lung Cancer ◽  
Crossover Effect ◽  
Term Survival ◽  
Alk Inhibitors ◽  
Lung Cancer Patients ◽  
Risk Of Death

IntroductionThe importance of modern treatments for the extension of overall survival in advanced lung cancer (LC) patients is rarely reported in clinical trials (crossover effect). Recent clinical trials have compared experimental treatment methods and shown that chemotherapy is no longer a comparator. We studied the relevance of innovative treatment to the extension of overall survival in Polish lung cancer patients.Material and methodsWe described the outcome in 1463 patients diagnosed and treated for advanced LC. The study included patients receiving all available forms of treatment, i.e. chemotherapy, immunotherapy, EGFR tyrosine kinase inhibitors, ALK inhibitors, and best supportive care (BSC).ResultsMedian OS (mOS) for the whole group of patients was 6.5 months. mOS was significantly higher in patients with SCC (8.0 months) and AC (7.0 months) compared to patients with SCLC (6 months) and NSCLC NOS (3.5 months). mOS was 30 months for EGFR TKI-treated patients, 34 months for patients receiving second-line immunotherapy, 8.5 months for chemotherapy patients, and 1.0 month for patients who received BSC. mOS for patients treated with ALK inhibitors and first-line immunotherapy was not reached. The use of targeted therapies or immunotherapies significantly (p < 0.0001) reduced the risk of death compared to chemotherapy (HR = 0.373, 95% CI: 0.288–0.484 and HR = 0.313, 95% CI: 0.255–0.385).ConclusionsThe use of modern therapies in one of the treatment lines compared to chemotherapy significantly increased the long-term survival of advanced LC patients (34.5 vs. 8.5 months, HR = 0.336, 95% CI: 0.284– 0.397, p < 0.0001). Correct and early LC diagnosis is required, because patients with late diagnosis have a particularly poor prognosis.

scholarly journals Association of Brain Metastases With Immune Checkpoint Inhibitors Efficacy in Advanced Lung Cancer: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Yanning Wang ◽  
Qianning Zhang ◽  
Chuansheng Chen ◽  
Yuxuan Hu ◽  
Liyun Miao ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Overall Survival ◽  
Brain Metastases ◽  
Cancer Patients ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Advanced Lung Cancer ◽  
Lung Cancer Patients ◽  
Hazard Ratios

BackgroundIn pivotal immunotherapy trials, the efficacy of immune checkpoint inhibitors as treatments for lung cancer patients with brain metastases remains controversial. The aim of this study was to assess the relative efficacy of immunotherapy versus standard systemic therapy in advanced lung cancer patients with and without brain metastases.MethodsSystematic searches of PubMed, Embase, Cochrane database, and conference proceedings up to Aug 6, 2020 without year and language restrictions. The main outcomes were the overall survival in patients with and without brain metastases measured by hazard ratios, and the difference in efficacy between patients with and without brain metastases was measured by ratio of hazard ratios.ResultsNine eligible randomized controlled trials involving 6241 patients (682 [11%] with brain metastases and 5559 [89%] without brain metastases) were included in the analysis. A survival benefit of immunotherapy was observed for both patients with brain metastases (HR, 0.75; 95%CI, 0.53-0.97; P = .026) and patients without brain metastases (HR, 0.75; 95%CI, 0.67-0.83; P &lt;.001). However, patients without brain metastases benefit more from immunotherapy than patients with brain metastases (HR, 1.37; 95%CI, 1.15-1.63; P = .001). Additionally, subgroup analyses indicated that tumor type affect the efficacy of immunotherapy in patients with brain metastases (HR, 1.04 vs 1.54; interaction, P = .041).ConclusionsImmunotherapy can significantly improve overall survival for advanced lung cancer patients with asymptomatic brain metastases, especially in patients with non-small-cell lung cancer, but the magnitude of benefit is brain metastases dependent.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020206597.

Sequence of stereotactic ablative radiotherapy and immune checkpoint blockade in the treatment of metastatic lung cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e20665-e20665 ◽  
Author(s):  
Ramya Pinnamaneni ◽  
Aparna Madhukeshwar Hegde ◽  
Sulochana Devi Cherukuri ◽  
Hyder Husain Arastu ◽  
Mark Bowling ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Immune Checkpoint ◽  
Synergistic Effects ◽  
Immune Checkpoint Blockade ◽  
Advanced Lung Cancer ◽  
Stereotactic Ablative Radiotherapy ◽  
Lung Cancer Patients ◽  
Immune Checkpoint Proteins

e20665 Background: Monoclonal antibodies targeting immune checkpoint proteins have recently been shown to elicit robust and durable responses in patients with advanced lung cancer. However, with response rates ranging from 15-20%, immunomodulatory strategies are needed to improve outcomes. Stereotactic ablative radiotherapy (SABR) may be a promising immunomodulatory strategy given its synergistic effects without added toxicity. Several pre-clinical trials combining SABR and immunotherapy have shown improvement in progression free and overall survival. Given this, it has been our multidisciplinary programmatic approach to bring in SABR in patients receiving immunotherapy for a potential immune boost. Methods: This is a retrospective study evaluating the overall survival (OS) of all lung cancer patients who received Nivolumab with SABR at our institution. We included lung cancer patients of all pathologic subtypes who received Nivolumab. We identified patients who received SABR, to sites of symptomatic metastatic disease, within 30 days preceding (Before) or during (Sandwich) Nivolumab treatment. Results: Out of 76 lung cancer patients treated with Nivolumab, 22 received RT- 10 Before and 12 Sandwich. At a median follow up time of 10.6 months (mo), median OS for patients with no RT was 4.8 mo, Before was 5.2 mo and Sandwich was not reached (NR) (p = 0.06). The 1 year OS for the Sandwich arm was 52.1%. When compared to no RT, the Before arm had a statistically insignificant reduction in mortality (HR 0.59, 95% CI 0.25 – 1.41, p = 0.24). The Sandwich arm had a statistically significant reduction in mortality (HR 0.37, 95% CI 0.14 – 0.94, p = 0.04). Conclusions: There is an improvement in OS when SABR is administered as a Sandwich approach during Nivolumab treatment, likely due to SABR-induced neoantigen release, increased PDL1 expression and subsequent abscopal effect. Further prospective studies are needed to evaluate optimal sequencing, dose and site of RT with immunotherapy. [Table: see text]

Immunotherapy in Advanced Non-Small Cell Lung Cancer

2020 ◽  
Vol 41 (03) ◽  
pp. 400-408 ◽  
Author(s):  
Joy Huang ◽  
Karen L. Reckamp
Keyword(s):  
Lung Cancer ◽  
Clinical Trials ◽  
Small Cell Lung Cancer ◽  
Cancer Patients ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Advanced Lung Cancer ◽  
Small Cell Lung ◽  
Lung Cancer Patients ◽  
Programmed Death

AbstractTraditionally, lung cancer has been treated as an immune-resistant disease with platinum-based chemotherapy serving as the first-line treatment for metastatic disease. The efficacy of immunotherapy has been established for patients with advanced lung cancer in clinical trials, and it has since become the standard of care for patients without targetable mutations, with or without chemotherapy. Previously, lung cancer patients experienced limited responses to immune-based therapy. As clinical trials continued to explore immunotherapy options with checkpoint inhibitors, results showed that immune therapies can create durable responses with manageable toxicities. Patients with advanced non-small cell lung cancer (NSCLC) can experience improved survival when administered immunotherapy over chemotherapy. The first successful immunotherapy treatments developed exploit programmed death 1/programmed death ligand 1 (PD-1/PD-L1) and cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), immune checkpoint pathways. Combination therapies of PD-1/PD-L1 inhibitors and chemotherapy or PD-1/PD-L1 and CTLA-4 checkpoint pathway inhibitors have also demonstrated improved outcomes for patients with NSCLC. Combination therapy with PD-1 or PD-L1 therapy and chemotherapy has shown benefit for small cell lung cancer patients as well. As immunotherapy changes the treatment paradigm of lung cancer, researchers continue to investigate different combinations, timing, duration, and biomarkers to better understand and improve the efficacy of immune-based therapy for patients with lung cancer.

Radiation pneumonitis (RP) in lung cancer patients treated with chemotherapy (CT) and thoracic radiation (TR): Retrospective analyses of patients treated at a comprehensive cancer center

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19642-19642
Author(s):  
P. Vishnu ◽  
S. Srinivasan ◽  
L. Heilbrun ◽  
R. Venkataramanamoorthy ◽  
A. Wozniak ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Clinical Trials ◽  
Cancer Patients ◽  
Hospitalization Rate ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Lung Cancer Patients ◽  
Pulmonary Disorder ◽  
Demographic Features

19642 Background: Combined CT and TR is the current standard for locally advanced non-small cell lung cancer (NSCLC) and SCLC. Severe RP, an important adverse effect of TR, is reported in clinical trials to occur in 10% of patients receiving CT and TR. The rate in routine care may be higher as patients are not selected based on lung function. We conducted a retrospective study to assess the incidence of RP in lung cancer patients treated with CT and TR. Methods: Retrospective identification of patients who underwent combined modality therapy (concurrent or sequential CT and TR) for lung cancer (NSCLC & SCLC) at our cancer center between January 2001 and December 2004. Demographic features, RP incidence and grade (RTOG criteria), hospitalization rate and overall survival (OS) were assessed. Results: 51 patients who met the selection criteria were analyzed. The demographic features were - males 61%; Caucasians - 53%; African Americans - 39%; history of pulmonary disorder - 45%; NSCLC - 82%; CT - 62% received Cisplatin/Etoposide, while 24% received Carboplatin/Paclitaxel; 92% received concurrent CT and TR. The median dose of TR was 5940 cGy. 20 patients (39%) developed RP; 13 (25%) had grade = 3 RP. Median time to development of RP was 4.4 months. Rate of RP in females and males was 50% vs. 32% (p=0.25). Rate of RP in patients with pulmonary disorder at baseline was 52% vs. 29% in others (p=0.15). 1 year hospitalization rate was 75% and 42% in RP and non-RP patients (p=0.025). For all 51 patients, the median overall survival (OS) was 16.4 months (95% CI 11.8 - 23.3). Length of OS did not differ significantly (p = 0.36) between the 20 patients who had RP vs. the 31 who had no RP (median OS: 22.2 vs. 14.5 months, respectively). Conclusions: The RP rate in these 51 lung cancer patients treated off- protocol with CT and TR is higher than that reported in clinical trials. Despite higher morbidity in patients with RP (i.e., increased hospitalization), survival duration did not differ significantly based on RP status. No significant financial relationships to disclose.

Impact of age and frailty markers on overall survival among hospitalized patients with lung cancer treated with immunotherapy.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e21151-e21151
Author(s):  
Eric Olson ◽  
Gregory Russell ◽  
Jeffrey Lantz ◽  
Nathan Roberts ◽  
Andy Shipe Dothard ◽  
...  
Keyword(s):  
Lung Cancer ◽  
At Risk ◽  
Overall Survival ◽  
High Risk ◽  
Cancer Patients ◽  
Geriatric Assessment ◽  
Hospitalized Patients ◽  
Advanced Lung Cancer ◽  
Lung Cancer Patients ◽  
Risk Patients

e21151 Background: Although predictive of chemotherapy toxicity, geriatric assessment measures are not systematically collected in clinical practice and may or may not be predictive for immune-related adverse events. Furthermore, hospitalization during immune checkpoint inhibitor (ICI) treatment for advanced lung cancer has variable prognostic significance. This study aimed to evaluate whether age and documented patient characteristics mapped to geriatric assessment domains (frailty markers, FM) predict survival in this setting. Methods: A single-center retrospective cohort of advanced stage lung cancer patients who received >1 dose of an ICI from 6/1/18 to 2/1/20, were later hospitalized, and received ≥ 1 dose of systemic corticosteroids (n=97) was analyzed. Chart review ascertained documentation of any of the following FMs prior to ICI initiation: inability to walk one block, unintentional weight loss, decreased social activities, recent falls, need for assistance with medications, visual or hearing impairments, living alone, and concern regarding social support. Patients were stratified according to age and three FM categories (0 FM [low risk], ≥1 FMs [at risk], and ≥2 FMs [high risk]). Overall survival (OS) analysis was calculated from first dose of ICI to date of death or last follow-up. Cox’s proportional hazards models were used to assess the relationship between FMs and age on OS; hazard ratios (HR) and 95% confidence intervals (CI) were calculated. Results: Analysis of < 75 and ≥ 75 yo revealed a median OS of 15.1 and 5.4 months respectively (HR 2.76, CI 1.62-4.72). Controlled for performance status (PS), older age (≥75 yo) was associated with a higher risk of death (HR 2.39, CI 1.32-4.31). FMs were associated with higher mortality, adjusted for PS and age (at risk patients HR 1.81, CI 1.03-3.16; high risk patients HR 2.02, CI 1.07-3.78). PS prior to starting ICI was not associated with OS. Conclusions: Age ≥ 75 yo is associated with short survival among lung cancer patients hospitalized while receiving ICI. Pre-treatment FMs documented as part of usual care were associated with worse OS, even after controlling for PS and age. This study shows promise for use of machine learning algorithms to stratify risk in hospitalized patients undergoing treatment for lung cancer with ICIs. These data would allow providers to better target serious illness conversations and end-of-life resources.[Table: see text]

scholarly journals Analysis of advanced lung cancer patients diagnosed following emergency admission

2014 ◽  
Vol 45 (4) ◽  
pp. 1098-1107 ◽  
Author(s):  
Daichi Fujimoto ◽  
Ryoko Shimizu ◽  
Takeshi Morimoto ◽  
Ryoji Kato ◽  
Yuki Sato ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Independent Predictor ◽  
Receptor Gene ◽  
Performance Status ◽  
Emergency Admission ◽  
Hazard Ratio ◽  
Advanced Lung Cancer ◽  
Lung Cancer Patients

Data on prognosis and predictors of overall survival in advanced lung cancer patients diagnosed following emergency admission (DFEA) are currently lacking.We retrospectively analysed data from 771 patients with advanced nonsmall cell lung cancer between April 2004 and April 2012.Of the 771 patients, 103 (13%) were DFEA. DFEA was not an independent predictor of overall survival by multivariate Cox proportional hazard models, whereas good performance status (PS), epidermal growth factor receptor gene mutation, stage IIIB, adenocarcinoma and chemotherapy were independent predictors of overall survival (hazard ratio (95% CI) 0.36 (0.29–0.44), p<0.001; 0.49 (0.38–0.63), p<0.001; 0.64 (0.51–0.80), p<0.001; 0.81 (0.67–0.99), p=0.044; and 0.40 (0.31–0.52), p<0.001, respectively). Good PS just prior to opting for chemotherapy, but not at emergency admission, was a good independent predictor of overall survival in DFEA patients (hazard ratio (95% CI) 0.26 (0.12–0.55); p<0.001).DFEA is relatively common. DFEA and PS at emergency admission were not independent predictors of overall survival, but good PS just prior to opting for chemotherapy was an independent predictor of longer overall survival. Efforts to improve patient PS after admission should be considered vital in such circumstances.

scholarly journals Serum CYFRA 21-1 but not Vimentin is Associated with Poor Prognosis in Advanced Lung Cancer Patients

2019 ◽  
Vol 13 (1) ◽  
pp. 31-38
Author(s):  
Nobuhiro Kanaji ◽  
Kyuichi Kadota ◽  
Akira Tadokoro ◽  
Takuya Inoue ◽  
Naoki Watanabe ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Tumor Marker ◽  
Cancer Patients ◽  
Poor Prognosis ◽  
Advanced Lung Cancer ◽  
Vimentin Expression ◽  
Intermediate Filament Proteins ◽  
Lung Cancer Patients ◽  
Significant Difference

Background: Cytokeratins and Vimentin are intermediate filament proteins. Vimentin expression in tissue samples has been reported to be associated with a poor prognosis in non-small cell lung cancer patients who underwent surgery. CYFRA 21-1 (Cytokeratin 19 Fragment) is a well known tumor marker. Objective: This study aimed to investigate the usefulness of serum vimentin as a tumor marker and significance of CYFRA 21-1 and vimentin expression on prognosis of advanced lung cancer patients. Methods: One hundred and four advanced lung cancer patients and 19 non-lung cancer patients were included. A total of 157 clinical samples obtained from 113 patients was used for immunostaining of vimentin and measurements of CYFRA 21-1 and vimentin concentrations. Results: Compared to low concentration, high concentration of serum CYFRA 21-1 was associated with shorter overall survival in lung cancer patients. However, there was no difference in the serum vimentin concentration between the patients with lung cancer and those with non-lung cancer. No difference in vimentin concentration was observed between the malignant and non-malignant pleural effusions. Immunostaining revealed that of the 43 tumor samples, 21 were positive and 22 were negative for vimentin. No significant difference was found in overall survival between patients with positive and negative for vimentin. Conclusion: An elevated serum CYFRA 21-1 concentration was associated with shorter overall survival in advanced lung cancer patients. However, serum vimentin was not as useful as a tumor marker of lung cancer. The vimentin positivity in tumor samples might not predict patients’ prognosis in patients with advanced lung cancer.

A retrospective cohort study of inpatient chemotherapy utilization in hospitalized advanced lung cancer patients in the United States.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6611-6611
Author(s):  
Hyunseok Kang ◽  
Sungjin Kim ◽  
Zhengjia Chen ◽  
Bassel F. El-Rayes ◽  
Johann Christoph Brandes ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Performance Status ◽  
The United States ◽  
Advanced Lung Cancer ◽  
Loss Of Function ◽  
Lung Cancer Patients ◽  
Risk Of Death ◽  
Chemotherapy Administration ◽  
Co Morbidity

6611 Background: The administration of chemotherapy to patients with limited performance status and within 6 weeks of death is considered an indicator of poor quality care. We assessed predictors of inpatient chemotherapy use and the risk of death in hospitalized lung cancer patients treated with chemotherapy in the US. Methods: Data were obtained from all US states that contributed to the Nationwide Inpatient Sample (NIS) by Agency for Health Care Research and Quality (AHRQ) in 2006 and 2010. Lung cancer diagnoses and inpatient chemotherapy were identified using Clinical Classification Software (CCS) code which is based on ICD9 and CPT codes. Univariate and multivariate analyses were performed to compare patients based on chemotherapy administration using ANOVA, chi-square test, and logistic regression. Initial analysis in the 2006 NIS data was validated in the 2010 NIS data. Results: 24,025 and 24,323 eligible hospitalized lung cancer patients including 1,005 (4.2 %) and 869 (3.6 %) patients treated with chemotherapy were identified in 2006 and 2010 respectively. Female gender, radiation use, urban location and longer length of stay (LOS) were significantly associated with receipt of chemotherapy. Chemotherapy administration was associated with prolonged hospital stay (14.1 ± 9.8 vs. 8.8 ± 8.1 days, p<.001) and increased odds of death in unadjusted analyses. Adjusted analysis showed significant increased odds of death in chemotherapy-treated patients with metastatic disease (vs. no metastasis); poor performance status indicated by severe loss of function (vs. minor/moderate loss of function) and increased LOS (Table). Conclusions: Inpatient administration of chemotherapy to hospitalized US lung cancer patients is associated with higher mortality and can be explained by treatment given to patients with high co-morbidity and disease burden. [Table: see text]

scholarly journals Is surgical resection of primary tumour superior to exploratory thoracotomy without resection in treating lung cancer patients with unexpected pleural metastasis detected during operation?

2020 ◽  
Vol 30 (4) ◽  
pp. 582-587
Author(s):  
Han-Yu Deng ◽  
Xi Zheng ◽  
Da-Xing Zhu ◽  
Qinghua Zhou
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Cohort Studies ◽  
Cancer Patients ◽  
Surgical Resection ◽  
Meta Analysis ◽  
Primary Tumour ◽  
Term Survival ◽  
Lung Cancer Patients ◽  
Pleural Metastasis

Abstract A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was ‘In lung cancer patients with unexpected pleural metastasis detected during operation, is surgical resection of primary tumour superior to exploratory thoracotomy without resection in improving long-term survival?’. Altogether, 1443 papers were found using the reported search, of which 1 meta-analysis and 10 retrospective observational cohort studies represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers were tabulated. One meta-analysis and 9 cohort studies found that surgical resection of the primary tumour, on the discovery of pleural metastases, yielded a better overall survival than exploratory thoracotomy alone, while 1 cohort study showed no difference. Six studies found that main tumour resection was an independent favourable prognostic factor for overall survival in lung cancer patients with unexpected pleural metastasis detected during operation, while 3 cohort studies also showed improved progression-free survival over exploratory thoracotomy. Therefore, we conclude that surgical resection of the primary tumour is superior to exploratory thoracotomy in treating lung cancer patients with unexpected pleural metastasis detected during operation.

PD-1/PD-L1 immunotherapy for advanced lung cancer: An electronic medical database based real world study in China.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e20543-e20543
Author(s):  
Xiao Zhao ◽  
Qiong Sun ◽  
Sheng Jie Sun ◽  
Weiwei Shi ◽  
Shun Chang Jiao
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Clinical Practice ◽  
Adverse Events ◽  
Cancer Patients ◽  
Real World ◽  
Progression Free Survival ◽  
Advanced Lung Cancer ◽  
Free Survival ◽  
Lung Cancer Patients

e20543 Background: Immunotherapy has shown promising results for clinical management of various cancers. We reported our real world experience with PD-1 or PD-L1 immunotherapy in management of advanced lung cancer patients in China. Methods: This is a single-center retrospective study based on the de-identified electronic medical data collected in routine clinical practice. A total of 198 advanced lung cancer (stage IIIA-IV) patients who underwent anti-PD-1/PD-L1 therapy at Chinese People's Liberation Army General Hospital between 2015 and 2018 were included. Progression free survival and overall survival of patients were estimated by Kaplan-Meier methods. The treatment-related adverse events were also analyzed. Results: Median age of patients was 60.0 years (33.0-88.0 years). Most patients were male (150, 75.8%), smokers (116, 61.7%) and had a KPS score ≥70 (169, 97.7%). Of 198 patients, 106 (53.5%) had adenocarcinoma and 54 (17.3%) had squamous cell carcinoma. Thirty-one (15.7%) patients had CNS metastases. Seventy-one (38.8%) patients received two or more prior therapies. Estimated progression free survival was 5.6 months and overall survival was 24.5 months. One-hundred twenty-seven (64.1%) patients had documented to suffer adverse events, most commonly gastrointestinal adverse events and liver damage (Table). Conclusions: Our study showed survival benefits of PD-1/PD-L1 immunotherapy in advanced NSCLC patients in clinical practice. Safety profile was comparable to the previous studies. Our study supports the benefits of PD-1/PD-L1 immunotherapy in clinical management of advanced lung cancer patients. [Table: see text]

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