Survival trends among non‐small‐cell lung cancer patients over a decade: impact of initial therapy at academic centers

Lou, Yanyan; Dholaria, Bhagirathbhai; Soyano, Aixa; Hodge, David O.; Cochuyt, Jordan J.; Manochakian, Rami; Ko, Stephen; Thomas, Mathew; Johnson, Margaret M.; Patel, Neal; Miller, Robert C.; Adjei, Alex A.; Ailawadhi, Sikander

doi:10.1002/cam4.1749

Cited by 26 publications

(27 citation statements)

References 29 publications

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“…In recent years, more and more personalized treatment options for NSCLC have been developed as an add‐on to existing conventional chemotherapies, and thereby median overall survival has increased significantly within the past decade, ie. from 12.4 months for patients diagnosed in 2004–2009 to 14.8 months for patients diagnosed in 2010–2013 ( P < 0.001), according to the recent literature …”

Section: Introductionmentioning

confidence: 75%

Oncogene addiction and tumor mutational burden in non‐small‐cell lung cancer: Clinical significance and limitations

2019

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Lung cancer incidence has increased worldwide over the past decades, with nonsmall cell lung cancer (NSCLC) accounting for the vast majority (85%) of lung cancer specimens. It is estimated that lung cancer causes about 1.7 million global deaths per year worldwide. Multiple trials have been carried out, with the aim of finding new effective treatment options. Lately, special focus has been placed on immune checkpoint (PD1/PD-L1) inhibitors which impact the tumor immune microenvironment. Tumor mutational burden (TMB) has been found to predict response to immune checkpoint inhibitors. Conversely, recent studies have weakened the significance of TMB as a predictor of response to therapy and survival. In this review article, we discuss the significance of TMB, as well as possible limitations. Furthermore, we give a concise overview of mutations frequently found in NSCLC, and discuss the significance of oncogene addiction in lung cancer as an essential driver of tumorigenesis and tumor progression. Key points1. Tumor mutational burden (TMB) predicts response to immune checkpoint inhibitors 2. Recent studies have shown, however, that TMB has significant limitations 3. Oncogene addicted cancers are driven by one predominant driver mutation 4. Targeted agents are used as first-line treatment in certain types of NSCLC

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Section: Introductionmentioning

confidence: 75%

Oncogene addiction and tumor mutational burden in non‐small‐cell lung cancer: Clinical significance and limitations

2019

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“…Many previous studies have noted that cancer outcomes differ based on where patients receive treatment 23–25. A recent risk-adjusted observational study of Medicare beneficiaries showing a significant reduction in overall survival for patients treated at community hospitals compared with the National Cancer Institute, academic centres, and free-standing cancer hospitals exempt from prospective payment systems 26.…”

Section: Discussionmentioning

confidence: 99%

TIDieR checklist evaluation of clinical trial intervention reporting for recent FDA-approved anticancer medications

Wayant

Bindernagel

Vassar

2019

BMJ EBM

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ImportanceClear and comprehensive descriptions of clinical trial interventions are necessary to translate new results into clinical practice. The TIDieR checklist was developed to be a minimum set of key items considered essential to high-quality reporting of clinical trial interventions.ObjectiveTo determine the quality of reporting of recent Food and Drug Administration (FDA)-approved oncology interventions.DesignCross-sectional investigation.Setting/Participants/InterventionRecent, FDA-approved haematology/oncology anticancer interventions.Main outcome measureQuality of reporting.ResultsAcross all included trials (n=96), a median of 8–9 (out of 12) TIDieR items were reported. Seven TIDieR items had >90% adherence, including individual-level and study-level modifications of drugs and dosing schedules. Three items were less often reported: intervention provider, including training and expertise (7/192, 3.6%); trial institution infrastructure (0/192, 0.0%); and how intervention compliance was assessed (59/192, 30.7%). Publication of a protocol improved intervention reporting (p<0.001).ConclusionsIn this analysis of clinical trials of recent, FDA-approved anticancer interventions, we found good adherence to the TIDieR checklist. These studies were homogeneous in their structure and included information; some TIDieR items were always or never/rarely reported. Clinical trial effect sizes may not translate to real-world practice for a number of reasons. Thus, to aid the translation of trial effect sizes to real-world practice, we recommend authors adhere to the TIDieR checklist and describe the infrastructure of trial centres and describe who provided the intervention, along with their expertise.

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“…The numerous chemo- and immunotherapy regimens that were applied might explain the long interval in our case; most of the therapies had controlled the disease for a half year or more. Recent advances in treatment have improved the survival of patients with NSCLC [22], and the chance of relatively long survival for patients with distant metastatic lesions that cannot be curatively resected has increased [21]. The prognosis of NSCLC with GI metastasis is typically poor; median overall survival time is approximately 3 months; and advanced age, extra-GI metastasis, and GI perforation are associated with a poor prognosis [3, 20, 23].…”

Section: Discussionmentioning

confidence: 99%

Metachronous rectal metastasis from pulmonary adenocarcinoma after 11 years of chemo-, immuno-, and radiotherapy for recurrent lesions: a case report

et al. 2019

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BackgroundRectal metastasis from pulmonary adenocarcinoma is rare, and it has been regarded as an end-stage phenomenon. Recently, however, advances in lung cancer treatment have improved the chance of long-term survival of patients with unresectable distant metastases. We describe the occurrence and management of metastatic spread of a pulmonary carcinoma to the rectum.Case presentationThe patient was a 79-year-old woman who had undergone thoracoscopic left lobectomy for pulmonary adenocarcinoma and then, over the next 11 years, various drugs (carboplatin + paclitaxel (as adjuvant therapy), gefitinib, gemcitabine + vinorelbine, S1 (an oral 5-fluorouracil-based drug), carboplatin + pemetrexed + bevacizumab, erlotinib, nivolumab, afatinib, and carboplatin+ S1) were administered, especially for hilar and mediastinal lymph node recurrences. During the eleventh postoperative year, left and right iliac bone metastases were detected, and radiation therapy was undertaken for local control of these lesions. When 18F-fluorodeoxyglucose positron emission tomography was performed for evaluation of the disease, tracer accumulation in the upper rectum was seen. Colonoscopic examination of the rectum revealed an intramural mass with central ulceration, and the mass was diagnosed histologically as an adenocarcinoma. The bone metastases appeared to be controlled, and the patient’s performance status was good, but she had suffered constipation for about a year and desired treatment. Thus, laparoscopic low anterior resection was performed. Histopathologic analysis revealed a moderately differentiated adenocarcinoma existing mainly between the submucosa and serosa, and immunohistochemical analysis showed the tumor to be positive for cytokeratin (CK) 7, negative for CK20, positive for thyroid transcription factor-1, and negative for special AT-rich sequence-binding protein 2 and caudal type homeobox 2, confirming the diagnosis of rectal metastasis from the primary pulmonary adenocarcinoma. The patient recovered well without any change in her functional status. Systemic chemotherapy was resumed, and she continues to do well, now 6 months after surgery.ConclusionsSurgery may be a good option for the management of an isolated rectal metastasis from pulmonary cancer in patients whose functional status is good.

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Survival trends among non‐small‐cell lung cancer patients over a decade: impact of initial therapy at academic centers

Cited by 26 publications

References 29 publications

Oncogene addiction and tumor mutational burden in non‐small‐cell lung cancer: Clinical significance and limitations

Oncogene addiction and tumor mutational burden in non‐small‐cell lung cancer: Clinical significance and limitations

TIDieR checklist evaluation of clinical trial intervention reporting for recent FDA-approved anticancer medications

Metachronous rectal metastasis from pulmonary adenocarcinoma after 11 years of chemo-, immuno-, and radiotherapy for recurrent lesions: a case report

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