1,721,046 research outputs found
The expanding scenario of advanced non-small-cell lung cancer between emerging evidence and clinical tasks
Full text link: This Editorial by De Giglio, Ricciuti and Metro introduces the series Treatment of advanced non-small-cell lung cancer: one size does not fit all: https://www.drugsincontext.com/special_issues/treatment-of-advanced-non-small-cell-lung-cancer-one-size-does-not-fit-all/
Clinical consideration for choosing combination therapies in advanced non-small-cell lung cancer: Age, Eastern Cooperative Organization performance status 2, steroids and antibiotics
No full textImmune checkpoint inhibition completely changed our approach of cancer therapeutics and led to interesting response rate in a wide spectrum of tumors. However, only a portion of patients benefits from immune checkpoint blockers. To improve response rates, monoclonal antibodies targeting costimulatory receptors called PD-1 or CTLA-4 are combined together or with different therapies such as chemotherapy or antiangiogenic drugs. Some of these combinations are already approved and used in daily practice, but the safety and efficacy in particular populations such as older patients, Eastern Cooperative Organization performance status 2 or patients taking corticosteroids or antibiotics remain unclear. This special report focuses on the data available for these populations with a focus on non-small-cell lung cancer
ORP measurements for oxidation control processes in a large wastewater treatment plant
No full textORP oxidation contro
Phytoremediation of chromium contaminated soils by selected species: in vitro and in vivo lab scale experiences
No full textconstructed wetlands application
Phytoremediation of chromium contaminated soils by selected species: in vitro and in vivo lab scale experiences
No full textBone-specific response according to MDA criteria predicts immunotherapy efficacy among advanced non-small cell lung cancer (NSCLC) patients
Full text linkPurpose: The presence of bone metastasis at baseline has been associated with dismal prognosis under immunotherapy in advanced non-small cell lung cancer (NSCLC). Response Evaluation Criteria in Solid Tumors (RECIST) criteria may be limited for bone-specific response evaluation. Whether their assessment through MD Anderson (MDA) criteria predict immunotherapy efficacy is unknown. Materials and methods: We conducted a single-center retrospective study to assess the use of MDA criteria in evaluating bone metastasis in NSCLC treated with immunotherapy. Radiological imaging were reviewed to classify bone lesions as osteolytic, osteoblastic, or mixed. Bone response to treatment data was classified according to MDA criteria. Results: 222 patients received single-agent immunotherapy. The presence of bone metastasis increased the risk of death both in the univariate (HR: 1.46, 95% CI, 1.05–2.03, p = 0.024) and in the multivariate model (HR: 1.61, 95% CI, 1.10–2.36, p = 0.015). According to MDA criteria, 57.3% of patients had progressive disease as best response, 29.5% stable disease, 11.4% partial response and 1.6% complete response. Bone-specific objective response was associated with a significantly increased median overall survival (11.3 vs. 3.1 months, p = 0.027) and longer median progression-free survival (6 vs. 2.1 months, p = 0.056). The median time to bone failure (TBF) was 2.4 months (IQR, 1.67–3.0). In 25.7% of cases, TBF was shorter than progression-free survival according to RECIST 1.1 criteria. TBF was positively correlated with overall survival (HR = 0.73, p = 0.00019). Conclusions: MDA criteria represent a reliable tool in assessing bone-specific response, offering a more accurate evaluation with the aim to earlier predict survival outcomes or treatment failure compared to RECIST criteria for advanced NSCLC patients receiving immunotherapy
A Podcast on Pre- or Perioperative Chemoimmunotherapy for Stage III Non-Small Cell Lung Cancer: Shared Agreement from the Thoracic Surgeon and Oncologist Perspectives
Full text linkManagement of stage II-III non-small cell lung cancer (NSCLC) has been dramatically revolutionized by studies testing the addition of immunotherapy (IO) to chemotherapy in the pre- or perioperative setting. That is because the integration of chemoimmunotherapy (chemo-IO) with surgery has consistently shown a significant improvement in pathological complete response (path CR) rate, event-free survival, and, more recently, overall survival, versus preoperative chemotherapy alone. Particularly, resectable stage III NSCLCs represent a disease entity with a high risk of distant recurrence after radical surgery, for whom pre- or perioperative chemo-IO should be considered as the preferential treatment option. However, owing to the heterogeneity of stage III NSCLC, a standard definition of resectability is not established yet, being often subjective according to the expertise and clinical background of the thoracic surgeon. In addition, careful patient selection on the basis of tumor biomarkers, meticulous staging of the disease, and accurate monitoring of treatment-related adverse events are critical factors that could prevent the ineligibility for surgery of patients treated with pre- or perioperative chemo-IO. Finally, the impact of downstaging for initially borderline resectable tumors, as well as the exact number of preoperative chemo-IO cycles needed and the indications for adjuvant IO, still need to be fully elucidated. In this podcast, we will touch upon the above-mentioned topics from the perspectives of the thoracic surgeon and the oncologist, and suggest a shared agreement between two of the main actors involved in the treatment of resectable stage III NSCLCs.Podcast audio available for this publication
STK11/LKB1 and KEAP1 mutations in non-small cell lung cancer: Prognostic rather than predictive?
No full textImmune checkpoint inhibitors (ICIs), either alone or combined with chemotherapy, represent the cornerstone of the treatment of advanced non-small cell lung cancer (NSCLC) without targetable gene alterations. Programmed death ligand-1 expression currently represents the only available biomarker to predict response to ICI, although its reliability is debated. However, most patients still do not derive benefit from immunotherapy, making the identification of further predictive biomarkers extremely needed. Serine/threonine kinase 11 (STK11)/liver kinase B1 (LKB1) and Kelch-like ECH-associated protein 1 (KEAP1) mutations occur in 25–30% and 11–27% of advanced NSCLC, respectively. Several studies associated their presence with poor outcomes in patients treated with ICI. However, more recent evidence showed poor outcomes among NSCLC with STK11/LKB1 and/or KEAP1 mutations regardless of the treatment received. We reviewed the literature to provide a comprehensive, timely and structured overview of the role of STK11/LKB1 and KEAP1 mutations in NSCLC. Although conflicting outcomes have been reported by studies evaluating their impact in KRAS wild-type patients or regardless of KRAS mutation, the correlation between STK11/LKB1 and KEAP1 mutations and poor outcomes with ICI appears to be consistent in presence of concurrent KRAS mutations. The main limitations of most studies are represented by the inclusion of other gene mutations (e.g. TP53) together with STK11 and KEAP1 mutations as a group and by the lack of comparison arms including patients who received other treatments (e.g. chemotherapy). Studies evaluating the impact of STK11 and KEAP1 mutations on the outcomes with ICI and other therapies showed a similar effect regardless of the treatment received, suggesting a prognostic, rather than predictive, value
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