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Clinical Lung Cancer

Yi-Long Wu, Roy S Herbst, Helen Mann, Yuri Rukazenkov, Marcelo Marotti, Masahiro Tsuboi
INTRODUCTION: Currently, the role of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors as adjuvant therapy for early-stage non-small-cell lung cancer after complete surgical tumor resection remains under investigation. We present the rationale and study design for the ADAURA ( identifier, NCT02511106) trial, a multicenter, double-blind, randomized, placebo-controlled study. PATIENTS AND METHODS: Study entry will be limited to adults aged ≥ 18 years (and in Japan and Taiwan, age ≥ 20 years) with primary nonsquamous stage IB-IIIA non-small-cell lung cancer with central confirmation of an EGFR exon 19 deletion or L858R mutation...
May 1, 2018: Clinical Lung Cancer
Alexander L Chin, Kiran A Kumar, Haiwei H Guo, Peter G Maxim, Heather Wakelee, Joel W Neal, Maximillian Diehn, Billy W Loo, Michael F Gensheimer
BACKGROUND: Emerging data support aggressive local treatment of oligometastatic non-small-cell lung cancer (NSCLC) patients. We sought to determine whether the metabolic burden of disease found by fluorodeoxyglucose positron emission tomography at the time of high-dose radiotherapy (RT) for oligometastatic NSCLC can serve as a prognostic biomarker. MATERIALS AND METHODS: We conducted a retrospective cohort study of 67 RT treatment courses in 55 patients with oligometastatic NSCLC who had undergone high-dose RT to all sites of active disease at our institution...
April 19, 2018: Clinical Lung Cancer
Meredith Giuliani, Ashwathy S Mathew, Houda Bahig, Scott V Bratman, Edith Filion, Daniel Glick, Alexander V Louie, Srinivas Raman, Anand Swaminath, Andrew Warner, Vivian Yau, David Palma
BACKGROUND: Lung stereotactic body radiotherapy (SBRT) is considered a standard curative treatment for medically inoperable early stage non-small-cell lung cancer (NSCLC). Patients with ultracentral tumors (signifying tumors whose planning target volume touches or overlaps the central bronchial tree, esophagus, or pulmonary artery) may be at higher risk of serious toxicities such as bronchial stricture and collapse, esophageal strictures, tracheal-esophageal fistula, and hemorrhage. The primary objective of the study is to determine the maximum tolerated dose of radiotherapy for ultracentral NSCLC...
April 18, 2018: Clinical Lung Cancer
Gouji Toyokawa, Yuichi Yamada, Tetsuzo Tagawa, Fumihiko Kinoshita, Yuka Kozuma, Taichi Matsubara, Naoki Haratake, Shinkichi Takamori, Takaki Akamine, Fumihiko Hirai, Yoshinao Oda, Yoshihiko Maehara
BACKGROUND: Spread through air spaces (STAS) is a recently recognized invasive pattern of lung cancer defined by the World Health Organization as micropapillary clusters, solid nests, or single cells spreading within air spaces beyond the edge of the main tumor. Although STAS has been shown to be a significant prognosticator for the postoperative survival in early-stage lung cancer treated with limited resection, its prognostic impact on the survival in completely resected adenocarcinomas with lymph node metastasis remains unclear...
April 18, 2018: Clinical Lung Cancer
Yiwei Liu, Zhengwei Dong, Tao Jiang, Likun Hou, Fengying Wu, Guanghui Gao, Yayi He, Jing Zhao, Xuefei Li, Chao Zhao, Wei Zhang, Qinrui Tian, Yingying Pan, Yan Wang, Shuo Yang, Chunyan Wu, Shengxiang Ren, Caicun Zhou, Jun Zhang, Fred R Hirsch
INTRODUCTION: Programmed death-ligand 1 (PD-L1) expression using immunohistochemistry is approved by the US Food and Drug Administration to guide treatment with anti-programmed death-1/PD-L1 monoantibodies. However, intratumoral heterogeneity of PD-L1 expression and the accordance between primary and metastatic lesions remains unresolved. MATERIALS AND METHODS: PD-L1 expression was evaluated in tumor cells and tumor-infiltrating lymphocytes (TILs) of surgically resected lung adenosquamous carcinoma...
March 31, 2018: Clinical Lung Cancer
Francis T Delaney, Kwun M Fong, Joseph C Lee
No abstract text is available yet for this article.
March 24, 2018: Clinical Lung Cancer
Giuseppe Giaccone, Rachel E Sanborn, Saiama N Waqar, Alex Martinez-Marti, Santiago Ponce, Huiling Zhen, Gerard Kennealey, Susan Erickson-Viitanen, Eric Schaefer
BACKGROUND: Dysregulation of the Janus kinase (JAK)/signal transducers and activators of transcription pathway contributes to abnormal inflammatory responses and poor prognosis in non-small-cell lung cancer (NSCLC). We evaluated the JAK1/JAK2 inhibitor ruxolitinib plus pemetrexed/cisplatin first-line in patients with stage IIIB/IV or recurrent nonsquamous NSCLC with systemic inflammation (modified Glasgow prognostic score [mGPS] 1/2). PATIENTS AND METHODS: Part 1 was an open-label, safety run-in, in which we assessed ruxolitinib (15 mg twice daily [b...
March 23, 2018: Clinical Lung Cancer
Peter Paximadis, Jennifer L Beebe-Dimmer, Julie George, Anne G Schwartz, Antoinette Wozniak, Shirish Gadgeel
INTRODUCTION: The diagnosis of stage I small-cell lung cancer (SCLC) is increasing in incidence with the advent of low-dose screening computed tomography. Surgery is considered the standard of care but there are very few data to guide clinical decision-making. The purpose of this study was to compare outcomes for patients receiving definitive surgery, stereotactic body radiation therapy (SBRT), or external beam radiation therapy (EBRT) for stage I SCLC. PATIENTS AND METHODS: Patients with a primary diagnosis of stage I SCLC were identified in the National Cancer Database...
March 23, 2018: Clinical Lung Cancer
Álvaro Taus, Laura Camacho, Pedro Rocha, Max Hardy-Werbin, Lara Pijuan, Gabriel Piquer, Eva López, Alba Dalmases, Raquel Longarón, Sergi Clavé, Marta Salido, Joan Albanell, Beatriz Bellosillo, Edurne Arriola
BACKGROUND: The assessment of epidermal growth factor receptor (EGFR) mutations is crucial for the management of patients with lung adenocarcinoma. Circulating tumor DNA (ctDNA)-based assessment offers advantages over tumor as a minimally invasive method able to capture tumor heterogeneity. PATIENTS AND METHODS: Consecutive patients diagnosed with EGFR-mutant lung adenocarcinoma in tumor biopsy were included in this study. Plasma samples were obtained at different time points during the course of the disease...
March 23, 2018: Clinical Lung Cancer
Fred R Hirsch, Keith M Kerr, Paul A Bunn, Edward S Kim, Coleman Obasaju, Maurice Pérol, Philip Bonomi, Jeffrey D Bradley, David Gandara, James R Jett, Corey J Langer, Ronald B Natale, Silvia Novello, Luis Paz-Ares, Suresh S Ramalingam, Martin Reck, Craig H Reynolds, Egbert F Smit, Mark A Socinski, David R Spigel, Thomas E Stinchcombe, Johan F Vansteenkiste, Heather Wakelee, Nick Thatcher
Patients with non-small-cell lung cancer, including squamous-cell lung cancer (SqCLC), typically present at an advanced stage. The current treatment landscape, which includes chemotherapy, radiotherapy, surgery, immunotherapy, and targeted agents, is rapidly evolving, including for patients with SqCLC. Prompt molecular and immune biomarker testing can serve to guide optimal treatment choices, and immune biomarker testing is becoming more important for this patient population. In this review we provide an overview of current and emerging practices and technologies for molecular and immune biomarker testing in advanced non-small-cell lung cancer, with a focus on SqCLC...
March 21, 2018: Clinical Lung Cancer
Matthew P Deek, Sinae Kim, Robert Beck, Nikhil Yegya-Raman, John Langenfeld, Joyti Malhotra, Omar Mahmoud, Joseph Aisner, Salma K Jabbour
BACKGROUND: We evaluated trends in administration of concurrent chemoradiation therapy (CRT) and how variations in start dates of chemotherapy and radiotherapy affected overall survival (OS) in patients with non-small cell lung cancer (NSCLC) undergoing a course of definitive CRT. MATERIALS AND METHODS: Cases of NSCLC treated with definitive CRT were obtained from the National Cancer Database. A survival analysis was performed with Kaplan-Meier curves and Cox proportional hazards models...
March 17, 2018: Clinical Lung Cancer
Sabine Visser, Mark de Mol, Kiki Cheung, Jermo J van Toor, Nico C van Walree, Bruno H Stricker, Brenda L Den Oudsten, Joachim G J V Aerts
INTRODUCTION: In patients with advanced non-small-cell lung cancer, the treatment benefits and risks need to be constantly weighed. We explored patient-reported satisfaction with therapy (SWT) and assessed its value in addition to quality of life (QoL) and adverse events (AEs). PATIENTS AND METHODS: In a prospective multicenter cohort study, patients with stage IIIB/IV non-small-cell lung cancer received platinum-pemetrexed chemotherapy. They completed the World Health Organization Quality of Life-BREF (WHOQoL-BREF) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) before and during chemotherapy...
March 17, 2018: Clinical Lung Cancer
Charissa R Kim, Bumyang Kim, Matthew S Ning, Jay P Reddy, Zhongxing Liao, Chad Tang, James W Welsh, Frank E Mott, Ya-Chen Tina Shih, Daniel R Gomez
INTRODUCTION: A previous study showed that use of positron emission tomography (PET)/computed tomography (CT) for surveillance after treatment of non-small-cell lung cancer (NSCLC) does not yield a detection or survival benefit over the use of chest CT. However, PET/CT remains a common method of follow-up imaging. Here we estimated and compared the costs of PET/CT versus CT for surveillance of patients with stage III NSCLC and identified patient and provider demographic characteristics associated with preference for use of PET/CT...
March 17, 2018: Clinical Lung Cancer
Yi-Long Wu, Lecia V Sequist, Eng-Huat Tan, Sarayut L Geater, Sergey Orlov, Li Zhang, Ki Hyeong Lee, Chun-Ming Tsai, Terufumi Kato, Carlos H Barrios, Martin Schuler, Vera Hirsh, Nobuyuki Yamamoto, Kenneth O'Byrne, Michael Boyer, Tony Mok, Barbara Peil, Angela Märten, James Chih-Hsin Yang, Luis Paz-Ares, Keunchil Park
BACKGROUND: Afatinib is approved in the US, Europe, and several other regions for first-line treatment for epidermal growth factor receptor mutation-positive (EGFRm+ ) non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Treatment-naive patients with advanced EGFRm+ NSCLC were randomized to afatinib (40 mg/d) versus cisplatin/pemetrexed (LUX-Lung 3 [LL3]) or cisplatin/gemcitabine (LUX-Lung 6 [LL6]), or versus gefitinib (250 mg/d; LUX-Lung 7 [LL7]). We report subgroup analyses according to age, including 65 years or older versus younger than 65 years (preplanned; LL3/LL6) and additional cutoffs up to 75 years and older (exploratory; LL7)...
March 17, 2018: Clinical Lung Cancer
Navika D Shukla, Ameen A Salahudeen, Gregory A Taylor, Suresh S Ramalingam, Everett E Vokes, Glenwood D Goss, Roy H Decker, Karen Kelly, Giorgio V Scagliotti, Tony S Mok, Heather A Wakelee
Cancer cooperative groups have historically played a critical role in the advancement of non-small-cell lung cancer therapy. Representatives from cooperative groups worldwide convene at the International Lung Cancer Congress annually. The International Lung Cancer Congress had its 17th anniversary in the summer of 2016. The present review highlights the thoracic malignancy studies discussed by presenters. The included studies are merely a sample of the trials of thoracic malignancies ongoing globally.
March 17, 2018: Clinical Lung Cancer
Henning Reis, Martin Metzenmacher, Moritz Goetz, Nikoleta Savvidou, Kaid Darwiche, Clemens Aigner, Thomas Herold, Wilfried E Eberhardt, Charlotte Skiba, Jörg Hense, Isabel Virchow, Daniela Westerwick, Simon Bogner, Saskia Ting, Stefan Kasper, Martin Stuschke, Felix Nensa, Ken Herrmann, Thomas Hager, Kurt W Schmid, Martin Schuler, Marcel Wiesweg
BACKGROUND: The receptor tyrosine kinase MET is implicated in malignant transformation, tumor progression, metastasis, and acquired treatment resistance. We conducted an analysis of the effect of MET expression and MET genomic aberrations on the outcome of patients with advanced or metastatic pulmonary adenocarcinomas prospectively enrolled in an institutional precision oncology program. PATIENTS AND METHODS: Standardized immunohistochemistry (IHC) analyses of MET and markers of pathway activation were available in 384 patients, and next-generation sequencing-based MET hotspot mutation analyses were available from 892 patients...
March 17, 2018: Clinical Lung Cancer
Juneko E Grilley-Olson, Jared Weiss, Anastasia Ivanova, Liza C Villaruz, Dominic T Moore, Thomas E Stinchcombe, Carrie Lee, Joseph S Shan, Mark A Socinski
INTRODUCTION: Bavituximab is an immunomodulatory chimeric monoclonal antibody that inhibits phosphatidylserine signaling, which promotes innate and adaptive immune responses. In this phase Ib trial we evaluated the safety, tolerability, and preliminary antitumor activity of pemetrexed, carboplatin, bavituximab in advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Patients with advanced nonsquamous NSCLC and performance status 0 or 1 were treated with pemetrexed 500 mg/m2 and carboplatin area under the curve 6 once every 3 weeks for up to 6 cycles, with concurrent bavituximab (0...
March 17, 2018: Clinical Lung Cancer
Zhihua Gong, Junying Chen, Jia-Nan Cheng, Chengdu Sun, Qingzhu Jia, Xinwei Diao, Bo Zhu
BACKGROUND: The benefits of immune checkpoint inhibitors for first-line treatment in patients with lung adenocarcinoma harboring EGFR mutations are unclear. The effects of ICIs depend on the tumor microenvironment (TME). Differences in TME properties between mutant and wild-type EGFR have not been fully characterized. PATIENTS AND METHODS: We collected 105 surgically resected (50 EGFR mutated and 55 EGFR wild-type), treatment-naïve lung adenocarcinoma tissues with clinical data to investigate the landscape and compartmentalization of tumor-infiltrating immune cells with respect to EGFR status by immunohistochemistry...
March 17, 2018: Clinical Lung Cancer
Chee-Keong Toh, Whee-Sze Ong, Wan-Teck Lim, Daniel Shao-Weng Tan, Quan-Sing Ng, Ravindran Kanesvaran, Wei-Jie Seow, Mei-Kim Ang, Eng-Huat Tan
BACKGROUND: It is not known whether clinicopathologic characteristics, treatment, and survival of never-smokers among lung cancer incident cases have changed over time. We assessed the trend and overall survival (OS) of these patients within our institution during a 10-year period. PATIENTS AND METHODS: We reviewed 2 cohorts of non-small-cell lung cancer patients with a diagnosis from 1999 to 2002 and from 2008 to 2011. The patient characteristics and OS were compared by smoking status within each cohort and between the 2 cohorts over time...
March 17, 2018: Clinical Lung Cancer
Terence T Sio, Anussara Prayongrat, Yun Zhang, Qin Lin, Ting Xu, Zhongxing Liao, Jinbo Yue
New randomized data from Japan have raised questions regarding the use of prophylactic cranial irradiation for patients with extensive-stage small-cell lung cancer but without detectable brain metastases on magnetic resonance imaging. In the present focused review, we examine the general role of prophylactic cranial irradiation in the management of small-cell lung cancer and present relevant controversies from both sides of the discussion. Future directions for clinical investigation and research are also highlighted...
March 16, 2018: Clinical Lung Cancer
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