Évolution en 10ans du cancer bronchique non à petites cellules en fonction du sexe. Résultats de l’étude KBP-2010-CPHG du Collège des pneumologues des hôpitaux généraux

Debieuvre, D.; Locher, C.; Neidhardt, Anne-Catherine; Goupil, F.; Lemaire, Bertrand; Blanchet-Legens, Anne-Sophie; Renault, David; Tavernier, J.; Tagu, P.; Mahmoud, Hamdy; Figueredo, M.; Grivaux, M

doi:10.1016/j.rmr.2013.10.644

Cited by 26 publications

(5 citation statements)

References 18 publications

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“…16 The clinical characteristics of the patients included in this study were similar to those of patients with newly diagnosed NSCLC except for the smoking status, since 98% of the patients had a history of smoking. 17,18 This is in agreement with data highlighting the link between smoking history and a better response to ICI therapy [19][20][21] and with the absence of approval in France for ICI for first-line treatment of EGFR-mutated and ALK-rearranged NSCLC. Of note, 26% of longterm responders had a poor PS at the beginning of the ICI therapy, which confirms that these patients can derive a prolonged benefit from ICI.…”

Section: Discussionsupporting

confidence: 86%

Pursuit or discontinuation of anti-PD1 after 2 years of treatment in long-term responder patients with non-small cell lung cancer

Ardin,

Humez,

Leroy

et al. 2023

Ther Adv Med Oncol

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Background: The optimal duration of immune checkpoint inhibitor (ICI) treatment for patients with advanced non-small cell lung cancer (NSCLC) remains to be determined. Treatment durations in cornerstone phase 3 clinical trials vary between a fixed 2-year duration and pursuit until disease progression. Clinical practices may thus differ according to the attending physician. Objectives: Here we provide real-world data about treatment decisions at 2 years, with subsequent clinical outcomes. Design and Methods: This multicentric observational study included patients with advanced NSCLC whose disease was controlled after 2 years of pembrolizumab or nivolumab. The primary outcome was the decision to discontinue ICI treatment or not, along with factors motivating this decision. Secondary outcomes included progression-free survival (PFS) (according to treatment continuation or not) and adverse events. Results: A total of 91 patients were included, of which 60 (66%) had been pre-treated. The programmed death-ligand 1 expression level was ⩾50% in 43 patients (47%). In 61 patients (67%), ICI was continued after 2 years of treatment. This decision was significantly associated with the care center ( p < 0.001) but neither with the tumor response at 2 years, as evaluated by CT scan or PET scan, nor with clinical status, immune-related adverse events, or previous locally treated oligo-progressive disease under ICI. Two years after the 2-year decision, PFS was 68.5%, [95% confidence interval (CI) (53.3–88.0)] in the ‘ICI discontinuation’ group and 64.1% [95% CI (51.9–79.2)] in the ‘ICI pursuit’ group; hazard ratio for relapse was 1.14 [95% CI (0.54–2.30), p = 0.77]. The overall survival rate at 24 months after discontinuation was 89.2% [95% CI (78.4–100)] for the ‘discontinuation’ group and 93.1% [95% CI (85.8–100)] for the ‘pursuit’ group. Given insufficient power, overall survival could not be compared. Conclusion: The decision to continue ICI or not after 2 years of treatment depends mainly on the care center and does not seem to impact survival. Larger, randomized data sets are required to confirm this result.

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Section: Discussionsupporting

confidence: 86%

Pursuit or discontinuation of anti-PD1 after 2 years of treatment in long-term responder patients with non-small cell lung cancer

Ardin,

Humez,

Leroy

et al. 2023

Ther Adv Med Oncol

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“…ACCL tends to occur in younger patients, with an approximate male/female ratio of 1:1 ( 7 , 8 ). However, there is a marked predominance of males in the incidence of other lung cancers ( 8 , 9 ). All smoking information was collected in the present study, and the majority of the cohort (67.6%) were found to be never smokers.…”

Section: Discussionmentioning

confidence: 99%

Primary adenoid cystic carcinoma of the lung: Clinicopathological features, treatment and results

et al. 2015

Oncology Letters

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Adenoid cystic carcinoma of the lung (ACCL) is a rare salivary gland-type malignant neoplasm that occurs infrequently as a primary tumor of the airway. Owing to its low incidence, the clinicopathological features, immunohistochemical expression spectrum, treatment and long-term survival have not been fully elucidated. The present study retrospectively assessed the clinical features, immunohistochemical characters, treatment strategy and long-term survival of 34 patients diagnosed with ACCL at the Beijing Chest Hospital, Capital Medical University (Beijing, China) between January 1993 and June 2014. ACCL tended to occur in younger patients, with an approximate male/female ratio of 1:1. The majority of ACCL arose from the central airway. Positive immunochemical staining was found in wide-spectrum keratin (n=17), cytokeratin (CK)7 (n=11), p63 (11/12), S-100 (7/8), vimentin (10/12) and smooth muscle actin (6/9). No staining of thyroid transcription factor-1 (0/14), synaptophysin (0/7), cluster of differentiation 56 (0/7), CK20 (0/4) or chromogranin A (0/4) was observed. In the operable group (n=26), the addition of adjuvant radiotherapy to a positive margin resection (R1 resection) obtained long-term survival times equivalent to that found in patients with a negative margin resection (R0 resection). No significant survival benefit from post-operative radiotherapy was observed in the R0 resection group. For advanced cases, palliative radiotherapy and chemotherapy did not work efficiently. In addition, epidermal growth factor receptor mutation was a rare event in the ACCL patients. The results indicated that surgical resection is the optimal management for ACCL whenever feasible. Adjuvant radiotherapy with R1 resection is able to obtain long-term survival times comparable with those found using an R0 resection. The recommendation of post-operative radiotherapy for all patients with ACCL undergoing resection appears controversial. Owing to a poor response to radiotherapy and chemotherapy, more focus should be placed on the study of advanced ACCL in order to improve overall survival.

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“…La tendance inverse s'observe dans les pays nanti. En effet, selon l'Etude KBP-2010-CPHG, 68,8% des patients atteints de cancer bronchopulmonaires avaient un score de performans status entre 0 et 1 [ 16 ]. Nous avons constaté une prédominance masculine de l'altération de l’état générale.…”

Section: Discussionunclassified

Aspects cliniques des cancers bronchopulmonaires primitifs au service d'oncologie du CHUA-HUJRA Antananarivo

Refeno¹,

Hasiniatsy²,

Andrianandrasana³

et al. 2015

Pan Afr Med J

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Le retard de diagnostic des cancers broncho-pulmonaires est l'une des sources du retard de leur prise en charge dans les pays en développement. A notre connaissance, l'aspect clinique des cancers broncho-pulmonaires au Centre Hospitalier Universitaire d'Antananarivo-Hôpital Universitaire Joseph Ravoahangy Andrianavalona (CHUA-HUJRA) n'a jamais été étudié. L'objectif était de décrire les aspects cliniques des cancers broncho-pulmonaires primitifs dans le plus grand centre de cancérologie de Madagascar. C'est une étude rétrospective et descriptive des patients atteints de cancers broncho-pulmonaires primitifs vus au service d'oncologie du CHUA-HUJRA du 1er janvier 2008 au 31 décembre 2013. Nous avons recensé 101 patients (80 hommes et 21 femmes). Les circonstances de découverte sont principalement la toux chronique (n = 29), la dyspnée (n = 16) et l'association d'une hémoptysie à la toux chronique (n = 12). Soixante et onze patients avaient un index de performans status ≥ à 2 au moment du diagnostic. On a retrouvé des bacilles de Koch actives dans le crachat de deux patients. Le délai moyen entre l'apparition des premiers signes et la première consultation était de 11 mois. Le délai moyen entre la première consultation et le diagnostic anatomopathologique était de 3 mois. Le cancer broncho-pulmonaire peut avoir des manifestations cliniques non spécifiques parfois trompeuses qui peuvent retarder leur prise en charge. De ce fait, il doit être recherché devant tout signe respiratoire persistant. Par ailleurs, le délai de prise en charge pré-hospitalière et hospitalière de ces cancers doit être amélioré.

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Évolution en 10ans du cancer bronchique non à petites cellules en fonction du sexe. Résultats de l’étude KBP-2010-CPHG du Collège des pneumologues des hôpitaux généraux

Abstract: The percentage of women with NSCLC has increased in 10years in France. In 2010, the main gender differences persist, but have decreased with the increasing proportion of non-smokers and adenocarcinomas in men. Various hypotheses to explain these changes are discussed.

Cited by 26 publications

References 18 publications

Pursuit or discontinuation of anti-PD1 after 2 years of treatment in long-term responder patients with non-small cell lung cancer

Pursuit or discontinuation of anti-PD1 after 2 years of treatment in long-term responder patients with non-small cell lung cancer

Primary adenoid cystic carcinoma of the lung: Clinicopathological features, treatment and results

Aspects cliniques des cancers bronchopulmonaires primitifs au service d'oncologie du CHUA-HUJRA Antananarivo

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