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One in four NSCLC patients respond poorly to COVID-19 vaccine
according to a new study.
The study was published in the Journal of Clinical Oncology.
“Booster vaccination increased binding and neutralizing antibody titers to Omicron, but antibody titers declined after 3 months. These data highlight the concern for patients with cancer given the rapid spread of SARS-CoV-2 Omicron variant,” wrote the authors, who were led by Rafi Ahmed, PhD, Emory University, Atlanta.
Researchers found that 18% had no detectable antibody at all and active treatment type had no association with vaccine response.
Researchers examined antibody titers among 82 NSCLC patients and 53 healthy volunteers. They collected blood samples longitudinally for analysis. While most patients had binding and neutralizing antibody titers that were comparable with healthy volunteers, 25% had poor responses, which led to six- to sevenfold lower titers than healthy controls. There was no association between worse vaccine responses and history of programmed death–1 monotherapy, chemotherapy, or both in combination. Receipt of a booster vaccine improved binding and neutralizing antibody titers to both the wild type and the Omicron variant, but 2-4 months after the booster there was a five- to sevenfold decrease in neutralizing titers to both the wild type and Omicron variant.
“This study indicates both the need to monitor our patients with lung cancer for response to COVID-19 mRNA vaccines, identify the nonresponders for follow-up and further attempts at immunization, and continue collecting and analyzing clinicodemographic information and biospecimens from our patients,” wrote the authors of an accompanying editorial.
Although the findings reveal potential concerns, the good news is that most patients NSCLC patients do respond normally to COVID-19 vaccination, said John D. Minna, MD, University of Texas Southwestern Medical Center, Dallas, lead author of the editorial.
He offered some advice to physicians. “You can test your patients using currently available [Clinical Laboratory Improvement Amendments]–approved lab tests to determine what their antibody titers are. This should be done after boosting since titers will go down after time. We know that if a patient has lung cancer and they do get infected with SARS-CoV-2 that potentially they could develop serious COVID-19 disease. Besides giving antiviral treatment, it is important that they be closely monitored for symptoms of progression so if they need to be hospitalized it can be done in a prudent manner,” said Dr. Minna, who is director of the Hamon Center for Therapeutic Oncology Research at the University of Texas Southwestern Medical Center.
No clinical details have emerged that might predict which patients have an insufficient response to vaccination. “When we started these studies, a lot of us thought that anyone who did not develop a good antibody response would be weak or sicker. For example, [patients with] late-stage disease, or having had a lot of therapy, or perhaps immune checkpoint blockade. However, none of these things are correlated. The main advice we are giving our lung cancer patients are to get vaccinated, get boosted (double boosted), and just do the smart thing to protect yourself from exposure,” he said.
For example, when traveling on a plane, patients should wear a mask. They should also avoid large indoor events. He also recommended that, following vaccination and boosters, patients seek out CLIA-certified tests to get their titer checked.
“Upon any COVID infection, even if their titer is at or above 80%, patients should see their physician to consider treatment with Paxlovid (nirmatrelvir/ritonavir), which has emergency use authorization. For patients with a lower titer, it’s important to seek out a physician and consider Paxlovid and possibly antibody therapy. But these are individual decisions to be made with your doctor,” Dr. Minna said.
The next important research question is what happens to T-cell immune response following vaccination. “We know that a good cellular immune response is also important in preventing infection and severe infection, but we don’t yet know which persons (with or without cancer) have good T-cell responses. This information will also likely impact what we tell our patients and will add to the antibody data,” he said.
Studies are ongoing to determine specific T-cell responses to mRNA vaccines, and how well those T-cell responses respond to SARS-CoV-2 infection in the laboratory.
according to a new study.
The study was published in the Journal of Clinical Oncology.
“Booster vaccination increased binding and neutralizing antibody titers to Omicron, but antibody titers declined after 3 months. These data highlight the concern for patients with cancer given the rapid spread of SARS-CoV-2 Omicron variant,” wrote the authors, who were led by Rafi Ahmed, PhD, Emory University, Atlanta.
Researchers found that 18% had no detectable antibody at all and active treatment type had no association with vaccine response.
Researchers examined antibody titers among 82 NSCLC patients and 53 healthy volunteers. They collected blood samples longitudinally for analysis. While most patients had binding and neutralizing antibody titers that were comparable with healthy volunteers, 25% had poor responses, which led to six- to sevenfold lower titers than healthy controls. There was no association between worse vaccine responses and history of programmed death–1 monotherapy, chemotherapy, or both in combination. Receipt of a booster vaccine improved binding and neutralizing antibody titers to both the wild type and the Omicron variant, but 2-4 months after the booster there was a five- to sevenfold decrease in neutralizing titers to both the wild type and Omicron variant.
“This study indicates both the need to monitor our patients with lung cancer for response to COVID-19 mRNA vaccines, identify the nonresponders for follow-up and further attempts at immunization, and continue collecting and analyzing clinicodemographic information and biospecimens from our patients,” wrote the authors of an accompanying editorial.
Although the findings reveal potential concerns, the good news is that most patients NSCLC patients do respond normally to COVID-19 vaccination, said John D. Minna, MD, University of Texas Southwestern Medical Center, Dallas, lead author of the editorial.
He offered some advice to physicians. “You can test your patients using currently available [Clinical Laboratory Improvement Amendments]–approved lab tests to determine what their antibody titers are. This should be done after boosting since titers will go down after time. We know that if a patient has lung cancer and they do get infected with SARS-CoV-2 that potentially they could develop serious COVID-19 disease. Besides giving antiviral treatment, it is important that they be closely monitored for symptoms of progression so if they need to be hospitalized it can be done in a prudent manner,” said Dr. Minna, who is director of the Hamon Center for Therapeutic Oncology Research at the University of Texas Southwestern Medical Center.
No clinical details have emerged that might predict which patients have an insufficient response to vaccination. “When we started these studies, a lot of us thought that anyone who did not develop a good antibody response would be weak or sicker. For example, [patients with] late-stage disease, or having had a lot of therapy, or perhaps immune checkpoint blockade. However, none of these things are correlated. The main advice we are giving our lung cancer patients are to get vaccinated, get boosted (double boosted), and just do the smart thing to protect yourself from exposure,” he said.
For example, when traveling on a plane, patients should wear a mask. They should also avoid large indoor events. He also recommended that, following vaccination and boosters, patients seek out CLIA-certified tests to get their titer checked.
“Upon any COVID infection, even if their titer is at or above 80%, patients should see their physician to consider treatment with Paxlovid (nirmatrelvir/ritonavir), which has emergency use authorization. For patients with a lower titer, it’s important to seek out a physician and consider Paxlovid and possibly antibody therapy. But these are individual decisions to be made with your doctor,” Dr. Minna said.
The next important research question is what happens to T-cell immune response following vaccination. “We know that a good cellular immune response is also important in preventing infection and severe infection, but we don’t yet know which persons (with or without cancer) have good T-cell responses. This information will also likely impact what we tell our patients and will add to the antibody data,” he said.
Studies are ongoing to determine specific T-cell responses to mRNA vaccines, and how well those T-cell responses respond to SARS-CoV-2 infection in the laboratory.
according to a new study.
The study was published in the Journal of Clinical Oncology.
“Booster vaccination increased binding and neutralizing antibody titers to Omicron, but antibody titers declined after 3 months. These data highlight the concern for patients with cancer given the rapid spread of SARS-CoV-2 Omicron variant,” wrote the authors, who were led by Rafi Ahmed, PhD, Emory University, Atlanta.
Researchers found that 18% had no detectable antibody at all and active treatment type had no association with vaccine response.
Researchers examined antibody titers among 82 NSCLC patients and 53 healthy volunteers. They collected blood samples longitudinally for analysis. While most patients had binding and neutralizing antibody titers that were comparable with healthy volunteers, 25% had poor responses, which led to six- to sevenfold lower titers than healthy controls. There was no association between worse vaccine responses and history of programmed death–1 monotherapy, chemotherapy, or both in combination. Receipt of a booster vaccine improved binding and neutralizing antibody titers to both the wild type and the Omicron variant, but 2-4 months after the booster there was a five- to sevenfold decrease in neutralizing titers to both the wild type and Omicron variant.
“This study indicates both the need to monitor our patients with lung cancer for response to COVID-19 mRNA vaccines, identify the nonresponders for follow-up and further attempts at immunization, and continue collecting and analyzing clinicodemographic information and biospecimens from our patients,” wrote the authors of an accompanying editorial.
Although the findings reveal potential concerns, the good news is that most patients NSCLC patients do respond normally to COVID-19 vaccination, said John D. Minna, MD, University of Texas Southwestern Medical Center, Dallas, lead author of the editorial.
He offered some advice to physicians. “You can test your patients using currently available [Clinical Laboratory Improvement Amendments]–approved lab tests to determine what their antibody titers are. This should be done after boosting since titers will go down after time. We know that if a patient has lung cancer and they do get infected with SARS-CoV-2 that potentially they could develop serious COVID-19 disease. Besides giving antiviral treatment, it is important that they be closely monitored for symptoms of progression so if they need to be hospitalized it can be done in a prudent manner,” said Dr. Minna, who is director of the Hamon Center for Therapeutic Oncology Research at the University of Texas Southwestern Medical Center.
No clinical details have emerged that might predict which patients have an insufficient response to vaccination. “When we started these studies, a lot of us thought that anyone who did not develop a good antibody response would be weak or sicker. For example, [patients with] late-stage disease, or having had a lot of therapy, or perhaps immune checkpoint blockade. However, none of these things are correlated. The main advice we are giving our lung cancer patients are to get vaccinated, get boosted (double boosted), and just do the smart thing to protect yourself from exposure,” he said.
For example, when traveling on a plane, patients should wear a mask. They should also avoid large indoor events. He also recommended that, following vaccination and boosters, patients seek out CLIA-certified tests to get their titer checked.
“Upon any COVID infection, even if their titer is at or above 80%, patients should see their physician to consider treatment with Paxlovid (nirmatrelvir/ritonavir), which has emergency use authorization. For patients with a lower titer, it’s important to seek out a physician and consider Paxlovid and possibly antibody therapy. But these are individual decisions to be made with your doctor,” Dr. Minna said.
The next important research question is what happens to T-cell immune response following vaccination. “We know that a good cellular immune response is also important in preventing infection and severe infection, but we don’t yet know which persons (with or without cancer) have good T-cell responses. This information will also likely impact what we tell our patients and will add to the antibody data,” he said.
Studies are ongoing to determine specific T-cell responses to mRNA vaccines, and how well those T-cell responses respond to SARS-CoV-2 infection in the laboratory.
FROM THE JOURNAL OF CLINICAL ONCOLOGY
Incidence of checkpoint inhibitor-related myocarditis in lung cancer patients
Key clinical point: A prospective cohort study found the cumulative incidence of myocarditis among patients treated with immune checkpoint inhibitors (ICI) to be 3%.
Major finding: Three cases (2 definite and 1 possible) of myocarditis were reported over a follow-up of 6 months, with all cases being mild and without major adverse cardiac events. The mean time to onset of myocarditis was 144 ± 3 days.
Study details: The data come from a real-world prospective cohort study involving 99 patients with lung cancer treated with ICI at a French university hospital.
Disclosures: No funding information was available. The authors reported no conflicts of interest.
Source: Faubry C et al. A prospective study to detect immune checkpoint inhibitors associated with myocarditis among patients treated for lung cancer. Front Cardiovasc Med. 2022;9:878211 (Jun 6). Doi: 10.3389/fcvm.2022.878211
Key clinical point: A prospective cohort study found the cumulative incidence of myocarditis among patients treated with immune checkpoint inhibitors (ICI) to be 3%.
Major finding: Three cases (2 definite and 1 possible) of myocarditis were reported over a follow-up of 6 months, with all cases being mild and without major adverse cardiac events. The mean time to onset of myocarditis was 144 ± 3 days.
Study details: The data come from a real-world prospective cohort study involving 99 patients with lung cancer treated with ICI at a French university hospital.
Disclosures: No funding information was available. The authors reported no conflicts of interest.
Source: Faubry C et al. A prospective study to detect immune checkpoint inhibitors associated with myocarditis among patients treated for lung cancer. Front Cardiovasc Med. 2022;9:878211 (Jun 6). Doi: 10.3389/fcvm.2022.878211
Key clinical point: A prospective cohort study found the cumulative incidence of myocarditis among patients treated with immune checkpoint inhibitors (ICI) to be 3%.
Major finding: Three cases (2 definite and 1 possible) of myocarditis were reported over a follow-up of 6 months, with all cases being mild and without major adverse cardiac events. The mean time to onset of myocarditis was 144 ± 3 days.
Study details: The data come from a real-world prospective cohort study involving 99 patients with lung cancer treated with ICI at a French university hospital.
Disclosures: No funding information was available. The authors reported no conflicts of interest.
Source: Faubry C et al. A prospective study to detect immune checkpoint inhibitors associated with myocarditis among patients treated for lung cancer. Front Cardiovasc Med. 2022;9:878211 (Jun 6). Doi: 10.3389/fcvm.2022.878211
Airflow limitation tied to increased risk for lung cancer
Key clinical point: Airflow limitation is linked to an increased risk for lung cancer, with the association being pronounced in ever smokers.
Major finding: Airflow limitation vs no limitation was associated with a higher risk for lung cancer (adjusted hazard ratio [aHR] 1.7; 95% CI 1.4-2.3). The association was greater among current smokers (HR 2.2; 95% CI 1.5-3.2) and former smokers (HR 2.1; 95% CI 1.4-3.2) compared with never smokers (HR 0.9; 95% CI 0.4-2.1).
Study details: The data come from a prospective population-based cohort study involving 98,630 participants.
Disclosures: No funding information was available. HJM Groen, R Vliegenthart, and W Timens declared receiving personal fees from pharmaceutical companies outside this work. The other authors reported no disclosures.
Source: Du Y et al. Airflow limitation increases lung cancer risk in smokers: The Lifelines Cohort Study. Cancer Epidemiol Biomarkers Prev. 2022;31(7):1442–1449 (May 9). Doi: 10.1158/1055-9965.EPI-21-1365
Key clinical point: Airflow limitation is linked to an increased risk for lung cancer, with the association being pronounced in ever smokers.
Major finding: Airflow limitation vs no limitation was associated with a higher risk for lung cancer (adjusted hazard ratio [aHR] 1.7; 95% CI 1.4-2.3). The association was greater among current smokers (HR 2.2; 95% CI 1.5-3.2) and former smokers (HR 2.1; 95% CI 1.4-3.2) compared with never smokers (HR 0.9; 95% CI 0.4-2.1).
Study details: The data come from a prospective population-based cohort study involving 98,630 participants.
Disclosures: No funding information was available. HJM Groen, R Vliegenthart, and W Timens declared receiving personal fees from pharmaceutical companies outside this work. The other authors reported no disclosures.
Source: Du Y et al. Airflow limitation increases lung cancer risk in smokers: The Lifelines Cohort Study. Cancer Epidemiol Biomarkers Prev. 2022;31(7):1442–1449 (May 9). Doi: 10.1158/1055-9965.EPI-21-1365
Key clinical point: Airflow limitation is linked to an increased risk for lung cancer, with the association being pronounced in ever smokers.
Major finding: Airflow limitation vs no limitation was associated with a higher risk for lung cancer (adjusted hazard ratio [aHR] 1.7; 95% CI 1.4-2.3). The association was greater among current smokers (HR 2.2; 95% CI 1.5-3.2) and former smokers (HR 2.1; 95% CI 1.4-3.2) compared with never smokers (HR 0.9; 95% CI 0.4-2.1).
Study details: The data come from a prospective population-based cohort study involving 98,630 participants.
Disclosures: No funding information was available. HJM Groen, R Vliegenthart, and W Timens declared receiving personal fees from pharmaceutical companies outside this work. The other authors reported no disclosures.
Source: Du Y et al. Airflow limitation increases lung cancer risk in smokers: The Lifelines Cohort Study. Cancer Epidemiol Biomarkers Prev. 2022;31(7):1442–1449 (May 9). Doi: 10.1158/1055-9965.EPI-21-1365
Network meta-analysis evaluates optimal postoperative chemotherapy in early resected NSCLC
Key clinical point: Adjuvant postoperative chemotherapy improved relapse-free survival (RFS) and overall survival (OS) in patients with early-stage resected non–small-cell lung cancer (NSCLC), with the cisplatin-vinorelbine regimen being the most effective therapeutic method with tolerable toxicity.
Major finding: Compared with the observation (control) group, the chemotherapy group showed a significant RFS (hazard ratio [HR] 0.67; P < .0001) and OS (HR 0.80; P < .0001) advantage, with the benefits being most prominent with the cisplatin-vinorelbine regimen (RFS: HR 0.63; 95% CI 0.43-0.87; and OS: HR 0.74; 95% CI 0.63-0.87). Hematological toxicities and nausea or vomiting were not higher with cisplatin-vinorelbine vs other chemotherapy regimens.
Study details: The data come from a systematic review with network meta-analysis of 20 randomized controlled trials including 5483 participants.
Disclosures: This study was funded by the Chinese National Natural Science Foundation Project. The authors declared no conflicts of interest.
Source: Pang LL et al. Investigation of the optimal platinum-based regimen in the postoperative adjuvant chemotherapy setting for early-stage resected non-small lung cancer: A Bayesian network meta-analysis. BMJ Open. 2022;12:e057098 (Jun 13). Doi: 10.1136/bmjopen-2021-057098
Key clinical point: Adjuvant postoperative chemotherapy improved relapse-free survival (RFS) and overall survival (OS) in patients with early-stage resected non–small-cell lung cancer (NSCLC), with the cisplatin-vinorelbine regimen being the most effective therapeutic method with tolerable toxicity.
Major finding: Compared with the observation (control) group, the chemotherapy group showed a significant RFS (hazard ratio [HR] 0.67; P < .0001) and OS (HR 0.80; P < .0001) advantage, with the benefits being most prominent with the cisplatin-vinorelbine regimen (RFS: HR 0.63; 95% CI 0.43-0.87; and OS: HR 0.74; 95% CI 0.63-0.87). Hematological toxicities and nausea or vomiting were not higher with cisplatin-vinorelbine vs other chemotherapy regimens.
Study details: The data come from a systematic review with network meta-analysis of 20 randomized controlled trials including 5483 participants.
Disclosures: This study was funded by the Chinese National Natural Science Foundation Project. The authors declared no conflicts of interest.
Source: Pang LL et al. Investigation of the optimal platinum-based regimen in the postoperative adjuvant chemotherapy setting for early-stage resected non-small lung cancer: A Bayesian network meta-analysis. BMJ Open. 2022;12:e057098 (Jun 13). Doi: 10.1136/bmjopen-2021-057098
Key clinical point: Adjuvant postoperative chemotherapy improved relapse-free survival (RFS) and overall survival (OS) in patients with early-stage resected non–small-cell lung cancer (NSCLC), with the cisplatin-vinorelbine regimen being the most effective therapeutic method with tolerable toxicity.
Major finding: Compared with the observation (control) group, the chemotherapy group showed a significant RFS (hazard ratio [HR] 0.67; P < .0001) and OS (HR 0.80; P < .0001) advantage, with the benefits being most prominent with the cisplatin-vinorelbine regimen (RFS: HR 0.63; 95% CI 0.43-0.87; and OS: HR 0.74; 95% CI 0.63-0.87). Hematological toxicities and nausea or vomiting were not higher with cisplatin-vinorelbine vs other chemotherapy regimens.
Study details: The data come from a systematic review with network meta-analysis of 20 randomized controlled trials including 5483 participants.
Disclosures: This study was funded by the Chinese National Natural Science Foundation Project. The authors declared no conflicts of interest.
Source: Pang LL et al. Investigation of the optimal platinum-based regimen in the postoperative adjuvant chemotherapy setting for early-stage resected non-small lung cancer: A Bayesian network meta-analysis. BMJ Open. 2022;12:e057098 (Jun 13). Doi: 10.1136/bmjopen-2021-057098
Concurrent ADT for prostate cancer improves survival in subsequently diagnosed lung cancer
Key clinical point: Androgen deprivation therapy (ADT) for previously diagnosed prostate cancer may improve survival in patients subsequently diagnosed with lung cancer.
Major finding: Patients who received vs did not receive ADT for previously diagnosed prostate cancer showed improved survival after lung cancer diagnosis (adjusted hazard ratio of death 0.88; P = .022) and a shorter latency period to the diagnosis of lung cancer (40 vs 47 months; P < .001).
Study details: This study evaluated 367,750 patients with lung cancer, of which 11,061 patients had an initial prostate cancer diagnosis and subsequent lung cancer diagnosis, 3017 had an initial lung cancer diagnosis and subsequent prostate cancer diagnosis, and the remaining patients had isolated lung cancer diagnosis.
Disclosures: This study received no external funding. B Nazha and TK Owonikoko reported receiving advisory or consulting fees from various sources.
Source: Nazha B et al. Concurrent androgen deprivation therapy for prostate cancer improves survival for synchronous or metachronous non-small cell lung cancer: A SEER–Medicare database analysis. Cancers (Basel). 2022; 14(13);3206 (Jun 30). Doi: 10.3390/cancers14133206
Key clinical point: Androgen deprivation therapy (ADT) for previously diagnosed prostate cancer may improve survival in patients subsequently diagnosed with lung cancer.
Major finding: Patients who received vs did not receive ADT for previously diagnosed prostate cancer showed improved survival after lung cancer diagnosis (adjusted hazard ratio of death 0.88; P = .022) and a shorter latency period to the diagnosis of lung cancer (40 vs 47 months; P < .001).
Study details: This study evaluated 367,750 patients with lung cancer, of which 11,061 patients had an initial prostate cancer diagnosis and subsequent lung cancer diagnosis, 3017 had an initial lung cancer diagnosis and subsequent prostate cancer diagnosis, and the remaining patients had isolated lung cancer diagnosis.
Disclosures: This study received no external funding. B Nazha and TK Owonikoko reported receiving advisory or consulting fees from various sources.
Source: Nazha B et al. Concurrent androgen deprivation therapy for prostate cancer improves survival for synchronous or metachronous non-small cell lung cancer: A SEER–Medicare database analysis. Cancers (Basel). 2022; 14(13);3206 (Jun 30). Doi: 10.3390/cancers14133206
Key clinical point: Androgen deprivation therapy (ADT) for previously diagnosed prostate cancer may improve survival in patients subsequently diagnosed with lung cancer.
Major finding: Patients who received vs did not receive ADT for previously diagnosed prostate cancer showed improved survival after lung cancer diagnosis (adjusted hazard ratio of death 0.88; P = .022) and a shorter latency period to the diagnosis of lung cancer (40 vs 47 months; P < .001).
Study details: This study evaluated 367,750 patients with lung cancer, of which 11,061 patients had an initial prostate cancer diagnosis and subsequent lung cancer diagnosis, 3017 had an initial lung cancer diagnosis and subsequent prostate cancer diagnosis, and the remaining patients had isolated lung cancer diagnosis.
Disclosures: This study received no external funding. B Nazha and TK Owonikoko reported receiving advisory or consulting fees from various sources.
Source: Nazha B et al. Concurrent androgen deprivation therapy for prostate cancer improves survival for synchronous or metachronous non-small cell lung cancer: A SEER–Medicare database analysis. Cancers (Basel). 2022; 14(13);3206 (Jun 30). Doi: 10.3390/cancers14133206
NSCLC: rhG-CSF tied to increased metastasis risk following postoperative chemotherapy
Key clinical point: The use of recombinant human granulocyte colony-stimulating factor (rhG-CSF) increases the risk for distant organ metastasis in patients with non—small-cell lung cancer (NSCLC) receiving chemotherapy, with the risk being much higher in patients without vs with chemotherapy-induced myelosuppression.
Major finding: Use vs non-use of rhG-CSF more than doubled the risk for distant organ metastasis (48.37% vs 26.23%; adjusted hazard ratio [HR] 2.33; P < .01), with the risk being much higher in patients presenting without vs with myelosuppression (HR 3.34; 95% CI 1.86-6.02 vs HR 0.71; 95% CI 0.17-2.94; Pinteraction < .01).
Study details: Findings are from a retrospective cohort study including 307 patients with NSCLC who underwent surgery and postoperative systemic chemotherapy, of which 246 patients received rhG-CSF treatment during chemotherapy.
Disclosures: This study was funded by the National Natural Science Foundation of China and others. The authors declared no conflicts of interest.
Source: Wang Y et al. rhG-CSF is associated with an increased risk of metastasis in NSCLC patients following postoperative chemotherapy. BMC Cancer. 2022;22:741 (Jul 7). Doi: 10.1186/s12885-022-09850-4
Key clinical point: The use of recombinant human granulocyte colony-stimulating factor (rhG-CSF) increases the risk for distant organ metastasis in patients with non—small-cell lung cancer (NSCLC) receiving chemotherapy, with the risk being much higher in patients without vs with chemotherapy-induced myelosuppression.
Major finding: Use vs non-use of rhG-CSF more than doubled the risk for distant organ metastasis (48.37% vs 26.23%; adjusted hazard ratio [HR] 2.33; P < .01), with the risk being much higher in patients presenting without vs with myelosuppression (HR 3.34; 95% CI 1.86-6.02 vs HR 0.71; 95% CI 0.17-2.94; Pinteraction < .01).
Study details: Findings are from a retrospective cohort study including 307 patients with NSCLC who underwent surgery and postoperative systemic chemotherapy, of which 246 patients received rhG-CSF treatment during chemotherapy.
Disclosures: This study was funded by the National Natural Science Foundation of China and others. The authors declared no conflicts of interest.
Source: Wang Y et al. rhG-CSF is associated with an increased risk of metastasis in NSCLC patients following postoperative chemotherapy. BMC Cancer. 2022;22:741 (Jul 7). Doi: 10.1186/s12885-022-09850-4
Key clinical point: The use of recombinant human granulocyte colony-stimulating factor (rhG-CSF) increases the risk for distant organ metastasis in patients with non—small-cell lung cancer (NSCLC) receiving chemotherapy, with the risk being much higher in patients without vs with chemotherapy-induced myelosuppression.
Major finding: Use vs non-use of rhG-CSF more than doubled the risk for distant organ metastasis (48.37% vs 26.23%; adjusted hazard ratio [HR] 2.33; P < .01), with the risk being much higher in patients presenting without vs with myelosuppression (HR 3.34; 95% CI 1.86-6.02 vs HR 0.71; 95% CI 0.17-2.94; Pinteraction < .01).
Study details: Findings are from a retrospective cohort study including 307 patients with NSCLC who underwent surgery and postoperative systemic chemotherapy, of which 246 patients received rhG-CSF treatment during chemotherapy.
Disclosures: This study was funded by the National Natural Science Foundation of China and others. The authors declared no conflicts of interest.
Source: Wang Y et al. rhG-CSF is associated with an increased risk of metastasis in NSCLC patients following postoperative chemotherapy. BMC Cancer. 2022;22:741 (Jul 7). Doi: 10.1186/s12885-022-09850-4
NSCLC: Meta-analysis cautions concomitant use of gastric acid suppressants and immunotherapy
Key clinical point: The concomitant use of gastric acid suppressants (GAS) may be associated with poor survival outcomes in patients with non—small-cell lung cancer (NSCLC) receiving programmed death-1/ligand-1 (PD-1/PD-L1) inhibitors.
Major finding: Use of PD-1/PD-L1 inhibitors with vs without GAS worsened progression-free survival by 32% (hazard ratio [HR] 1.32; P < .001) and overall survival by 36% (HR 1.36; P < .001).
Study details: The data come from a meta-analysis of 10 retrospective studies and 1 prospective cohort study including 5892 patients with NSCLC who were receiving PD-1/PD-L1 inhibitors.
Disclosures: This study was supported by Anhui University Natural Science Research Project, China. The authors declared no conflicts of interest.
Source: Wang M et al. Influence of concomitant gastric acid suppressants use on the survival of patients with non-small cell lung cancer treated with programmed death-1/ligand-1 inhibitors: A meta-analysis. Int Immunopharmacol. 2022;110:108955 (Jun 21). Doi: 10.1016/j.intimp.2022.108955
Key clinical point: The concomitant use of gastric acid suppressants (GAS) may be associated with poor survival outcomes in patients with non—small-cell lung cancer (NSCLC) receiving programmed death-1/ligand-1 (PD-1/PD-L1) inhibitors.
Major finding: Use of PD-1/PD-L1 inhibitors with vs without GAS worsened progression-free survival by 32% (hazard ratio [HR] 1.32; P < .001) and overall survival by 36% (HR 1.36; P < .001).
Study details: The data come from a meta-analysis of 10 retrospective studies and 1 prospective cohort study including 5892 patients with NSCLC who were receiving PD-1/PD-L1 inhibitors.
Disclosures: This study was supported by Anhui University Natural Science Research Project, China. The authors declared no conflicts of interest.
Source: Wang M et al. Influence of concomitant gastric acid suppressants use on the survival of patients with non-small cell lung cancer treated with programmed death-1/ligand-1 inhibitors: A meta-analysis. Int Immunopharmacol. 2022;110:108955 (Jun 21). Doi: 10.1016/j.intimp.2022.108955
Key clinical point: The concomitant use of gastric acid suppressants (GAS) may be associated with poor survival outcomes in patients with non—small-cell lung cancer (NSCLC) receiving programmed death-1/ligand-1 (PD-1/PD-L1) inhibitors.
Major finding: Use of PD-1/PD-L1 inhibitors with vs without GAS worsened progression-free survival by 32% (hazard ratio [HR] 1.32; P < .001) and overall survival by 36% (HR 1.36; P < .001).
Study details: The data come from a meta-analysis of 10 retrospective studies and 1 prospective cohort study including 5892 patients with NSCLC who were receiving PD-1/PD-L1 inhibitors.
Disclosures: This study was supported by Anhui University Natural Science Research Project, China. The authors declared no conflicts of interest.
Source: Wang M et al. Influence of concomitant gastric acid suppressants use on the survival of patients with non-small cell lung cancer treated with programmed death-1/ligand-1 inhibitors: A meta-analysis. Int Immunopharmacol. 2022;110:108955 (Jun 21). Doi: 10.1016/j.intimp.2022.108955
Additional postoperative radiotherapy prolongs survival in stage I-IIA SCLC
Key clinical point: The addition of postoperative radiotherapy (PORT) to surgery and adjuvant chemotherapy prolonged overall survival by 39% and cancer-specific survival by 53% in patients with early small cell lung cancer (SCLC).
Major finding: PORT vs no PORT was associated with a significantly extended median overall survival (8.58 vs 5.17 years; hazard ratio [HR] 0.61; P = .032) and cancer-specific survival (11.33 vs 8.08 years; HR 0.47; P = .0086).
Study details: The data come from a population-based retrospective cohort study involving 278 patients with stage I-IIA SCLC who underwent surgery and received adjuvant chemotherapy.
Disclosures: This study was funded by the National Natural Science Foundation of China and others. The authors declared no conflicts of interest.
Source: Li J et al. Additional postoperative radiotherapy prolonged the survival of patients with i-iia small cell lung cancer: Analysis of the SEER database. J Oncol. 2022;6280538 (Jun 18). Doi: 10.1155/2022/6280538
Key clinical point: The addition of postoperative radiotherapy (PORT) to surgery and adjuvant chemotherapy prolonged overall survival by 39% and cancer-specific survival by 53% in patients with early small cell lung cancer (SCLC).
Major finding: PORT vs no PORT was associated with a significantly extended median overall survival (8.58 vs 5.17 years; hazard ratio [HR] 0.61; P = .032) and cancer-specific survival (11.33 vs 8.08 years; HR 0.47; P = .0086).
Study details: The data come from a population-based retrospective cohort study involving 278 patients with stage I-IIA SCLC who underwent surgery and received adjuvant chemotherapy.
Disclosures: This study was funded by the National Natural Science Foundation of China and others. The authors declared no conflicts of interest.
Source: Li J et al. Additional postoperative radiotherapy prolonged the survival of patients with i-iia small cell lung cancer: Analysis of the SEER database. J Oncol. 2022;6280538 (Jun 18). Doi: 10.1155/2022/6280538
Key clinical point: The addition of postoperative radiotherapy (PORT) to surgery and adjuvant chemotherapy prolonged overall survival by 39% and cancer-specific survival by 53% in patients with early small cell lung cancer (SCLC).
Major finding: PORT vs no PORT was associated with a significantly extended median overall survival (8.58 vs 5.17 years; hazard ratio [HR] 0.61; P = .032) and cancer-specific survival (11.33 vs 8.08 years; HR 0.47; P = .0086).
Study details: The data come from a population-based retrospective cohort study involving 278 patients with stage I-IIA SCLC who underwent surgery and received adjuvant chemotherapy.
Disclosures: This study was funded by the National Natural Science Foundation of China and others. The authors declared no conflicts of interest.
Source: Li J et al. Additional postoperative radiotherapy prolonged the survival of patients with i-iia small cell lung cancer: Analysis of the SEER database. J Oncol. 2022;6280538 (Jun 18). Doi: 10.1155/2022/6280538
Stage III NSCLC: Preoperative FDG PET/CT tied to longer survival
Key clinical point: Use of preoperative fluorine 18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is linked to a longer overall survival in patients with stage IIIA or IIIB resectable non—small-cell lung cancer (NSCLC).
Major finding: Among patients who underwent vs did not undergo preoperative 18F-FDG PET/CT, those with stage IIIB and stage IIIA disease had 20% (adjusted hazard ratio [aHR] 0.80; 95% CI 0.71-0.90) and 10% (aHR 0.90; 95% CI 0.79-0.94) lower risks for mortality, respectively. Patients with stage I-II disease did not have a lower risk for mortality (aHR 1.19; 95% CI 0.89-1.30).
Study details: The data come from a Taiwanese retrospective cohort study of patients with resectable stage I-IIIB NSCLC who underwent (n = 6,754) and did not undergo (n = 6,754) preoperative 18F-FDG PET/CT.
Disclosures: This study was funded by the Lo-Hsu Medical Foundation and Lotung Poh-Ai Hospital, Taiwan. SY Wu is a member of the Taiwan Radiological Society and Taiwan Society for Therapeutic Radiology and Oncology. The other authors reported no relevant relationships.
Source: Chen W-M et al. Use of preoperative FDG PET/CT and survival of patients with resectable non–small cell lung cancer. Radiology. 2022 (Jun 21). Doi: 10.1148/radiol.212798
Key clinical point: Use of preoperative fluorine 18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is linked to a longer overall survival in patients with stage IIIA or IIIB resectable non—small-cell lung cancer (NSCLC).
Major finding: Among patients who underwent vs did not undergo preoperative 18F-FDG PET/CT, those with stage IIIB and stage IIIA disease had 20% (adjusted hazard ratio [aHR] 0.80; 95% CI 0.71-0.90) and 10% (aHR 0.90; 95% CI 0.79-0.94) lower risks for mortality, respectively. Patients with stage I-II disease did not have a lower risk for mortality (aHR 1.19; 95% CI 0.89-1.30).
Study details: The data come from a Taiwanese retrospective cohort study of patients with resectable stage I-IIIB NSCLC who underwent (n = 6,754) and did not undergo (n = 6,754) preoperative 18F-FDG PET/CT.
Disclosures: This study was funded by the Lo-Hsu Medical Foundation and Lotung Poh-Ai Hospital, Taiwan. SY Wu is a member of the Taiwan Radiological Society and Taiwan Society for Therapeutic Radiology and Oncology. The other authors reported no relevant relationships.
Source: Chen W-M et al. Use of preoperative FDG PET/CT and survival of patients with resectable non–small cell lung cancer. Radiology. 2022 (Jun 21). Doi: 10.1148/radiol.212798
Key clinical point: Use of preoperative fluorine 18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is linked to a longer overall survival in patients with stage IIIA or IIIB resectable non—small-cell lung cancer (NSCLC).
Major finding: Among patients who underwent vs did not undergo preoperative 18F-FDG PET/CT, those with stage IIIB and stage IIIA disease had 20% (adjusted hazard ratio [aHR] 0.80; 95% CI 0.71-0.90) and 10% (aHR 0.90; 95% CI 0.79-0.94) lower risks for mortality, respectively. Patients with stage I-II disease did not have a lower risk for mortality (aHR 1.19; 95% CI 0.89-1.30).
Study details: The data come from a Taiwanese retrospective cohort study of patients with resectable stage I-IIIB NSCLC who underwent (n = 6,754) and did not undergo (n = 6,754) preoperative 18F-FDG PET/CT.
Disclosures: This study was funded by the Lo-Hsu Medical Foundation and Lotung Poh-Ai Hospital, Taiwan. SY Wu is a member of the Taiwan Radiological Society and Taiwan Society for Therapeutic Radiology and Oncology. The other authors reported no relevant relationships.
Source: Chen W-M et al. Use of preoperative FDG PET/CT and survival of patients with resectable non–small cell lung cancer. Radiology. 2022 (Jun 21). Doi: 10.1148/radiol.212798
NSCLC: Cell-free RNA beneficial for early detection and prognosi
Key clinical point: Circulating cell-free RNA (cfRNA) of the candidate transcript MORF4L2 demonstrates very good sensitivity and specificity for distinguishing patients with non—small-cell lung cancer (NSCLC) from healthy individuals.
Major finding: A greater concentration of MORF4L2 cfRNA was seen in patients with NSCLC compared with healthy donors (P < .0001). A cutoff value of 537.5 copies/mL of plasma was useful in distinguishing patients with NSCLC from healthy donors with very good sensitivity (0.73; 95% CI 0.61-0.82) and specificity (0.87; 95% CI 0.73-0.96). Low vs high levels of MORF4L2 cfRNA at baseline were associated with a better overall survival (hazard ratio 0.25; P = .009).
Study details: The data come from a cohort study of 41 patients with stage IV NSCLC, 38 patients with early-stage (stage I-III) NSCLC, and 39 healthy blood donors.
Disclosures: This study was supported by the European Transcan-2 project CEVIR (Cancer EVolution and Identification of Relapse-initiating cells) and the German Cancer Consortium. M Metzenmacher, JT Siveke, and M Schuler reported ties with ≥1 pharmaceutical companies. The other authors reported no conflicts of interest.
Source: Metzenmacher M et al. The clinical utility of cfRNA for disease detection and surveillance: A proof of concept study in non-small cell lung cancer. Thorac Cancer. 2022 (Jun 16). Doi: 10.1111/1759-7714.14540
Key clinical point: Circulating cell-free RNA (cfRNA) of the candidate transcript MORF4L2 demonstrates very good sensitivity and specificity for distinguishing patients with non—small-cell lung cancer (NSCLC) from healthy individuals.
Major finding: A greater concentration of MORF4L2 cfRNA was seen in patients with NSCLC compared with healthy donors (P < .0001). A cutoff value of 537.5 copies/mL of plasma was useful in distinguishing patients with NSCLC from healthy donors with very good sensitivity (0.73; 95% CI 0.61-0.82) and specificity (0.87; 95% CI 0.73-0.96). Low vs high levels of MORF4L2 cfRNA at baseline were associated with a better overall survival (hazard ratio 0.25; P = .009).
Study details: The data come from a cohort study of 41 patients with stage IV NSCLC, 38 patients with early-stage (stage I-III) NSCLC, and 39 healthy blood donors.
Disclosures: This study was supported by the European Transcan-2 project CEVIR (Cancer EVolution and Identification of Relapse-initiating cells) and the German Cancer Consortium. M Metzenmacher, JT Siveke, and M Schuler reported ties with ≥1 pharmaceutical companies. The other authors reported no conflicts of interest.
Source: Metzenmacher M et al. The clinical utility of cfRNA for disease detection and surveillance: A proof of concept study in non-small cell lung cancer. Thorac Cancer. 2022 (Jun 16). Doi: 10.1111/1759-7714.14540
Key clinical point: Circulating cell-free RNA (cfRNA) of the candidate transcript MORF4L2 demonstrates very good sensitivity and specificity for distinguishing patients with non—small-cell lung cancer (NSCLC) from healthy individuals.
Major finding: A greater concentration of MORF4L2 cfRNA was seen in patients with NSCLC compared with healthy donors (P < .0001). A cutoff value of 537.5 copies/mL of plasma was useful in distinguishing patients with NSCLC from healthy donors with very good sensitivity (0.73; 95% CI 0.61-0.82) and specificity (0.87; 95% CI 0.73-0.96). Low vs high levels of MORF4L2 cfRNA at baseline were associated with a better overall survival (hazard ratio 0.25; P = .009).
Study details: The data come from a cohort study of 41 patients with stage IV NSCLC, 38 patients with early-stage (stage I-III) NSCLC, and 39 healthy blood donors.
Disclosures: This study was supported by the European Transcan-2 project CEVIR (Cancer EVolution and Identification of Relapse-initiating cells) and the German Cancer Consortium. M Metzenmacher, JT Siveke, and M Schuler reported ties with ≥1 pharmaceutical companies. The other authors reported no conflicts of interest.
Source: Metzenmacher M et al. The clinical utility of cfRNA for disease detection and surveillance: A proof of concept study in non-small cell lung cancer. Thorac Cancer. 2022 (Jun 16). Doi: 10.1111/1759-7714.14540