ASCO 2021: Summary Overview and Outlook 13|Special Research Express on Non-Small Cell Lung Cancer

Germline mutations in patients with non-small cell lung cancer ( NSCLC )

background

Currently, lung cancer is one of the leading causes of cancer-related deaths worldwide.

method

A total of 1562 NSCLC patients were included in this study.

result

In general, the median age of the subjects was 63 years old (range 12-91).

The most common P/LP mutant genes are MUTYH (n = 11, 0.

in conclusion

Among 1562 NSCLC patients, 94 (6.

Original source: Germline mutations in patients with non-small cell lung cancer.

Verification of National Comprehensive Cancer Network Guidelines (NCCN) in a single institution

background

Invasive mediastinal staging is necessary to identify locally advanced NSCLC.

method

The study reviewed all patients who underwent curative pneumonectomy due to pathologically proven NSCLC from October 2018 to December 2019.

The indications for staging are one or more of the following: mediastinal lymph node short axis>1.

result

A total of 457 lung resections were performed.

in conclusion

The current NCCN staging guidelines accurately reflect the N2 disease risk of NSCLC.

Original Source: Verification of National Comprehensive Cancer Network Guidelines (NCCN) in a single institution

Anlotinib successfully treats 14 patients with advanced non-small cell lung cancer in China

background

Pulmonary lymphatic carcinoma (PLC) occurs in 6%-8% of malignant tumors with intrathoracic metastases.

Anlotinib has shown a key effect on lymphangiogenesis and lymphatic metastasis in a mouse model of lung adenocarcinoma, and may be a treatment option for tumor lymphatic metastasis.

method

The study retrospectively investigated NSCLC patients who received anlotinib monotherapy or combination therapy for PLC in our hospital from May 2018 to November 2020.

result

A total of 14 patients were selected, with a median age of 64 years.

Among the 14 patients, 8 patients achieved partial response (PR), 5 patients were in stable condition (SD), and 1 patient was in progress.
ORR and DCR were 57.
1% and 92.
9%, respectively.
The median PFS was 3.
1 months (95%CI: 2.
0-4.
2), and the median OS of 1, 2, and ≥3 lines were 13 months, 7.
2 months, and 5.
2 months, respectively.
Compared with patients with TP53 wild-type tumors, patients with TP53 mutant tumors had significantly longer median PFS and OS (≥3 lines) (median PFS: 7 vs.
1.
1 months, median OS (≥3 lines): 6.
8 vs.
1.
9 months).
No differences in PFS and OS (≥3 lines) were found between EGFR or ALK changes and the corresponding wild-type patients.

The most frequently reported AEs are hypertension (11,78.
6%), hand-foot syndrome (6,42.
9%), diarrhea (5,35.
7%), fatigue (4,28.
6%), hoarseness (3,21.
4%), Proteinuria (2, 14.
3%) and stomatitis (2, 14.
3%).

in conclusion

Anlotinib has a good effect on patients with pulmonary lymphatic cancer.
Compared with previous studies, Anlotinib has brought considerable survival benefits to patients, especially for patients with TP53 mutations.
AEs are controllable.
These indicate that Anlotinib can become a promising treatment for PLC.
More clinical data is needed to verify this finding.

Original source: Anlotinib successfully treated 14 Chinese patients with advanced non-small cell lung cancer for lung lymphatic cancer

Does the order matter? Real-world data on the results of continuous treatment regimens involving anti-PDx-1 in advanced and metastatic non-small cell lung cancer

background

In 2020, 65% of newly diagnosed advanced (adv) or metastatic (met) NSCLC patients in the United States will start the first-line (1L) system of anti-PDx-1 regimen, and 53% of the second-line (2L).
As the approved scope of anti-PDx-1 is getting wider and wider, it is used more and more in different treatment lines and different treatment plan combinations.
Choosing the initial and follow-up treatment plan may be a challenge, especially because of the limited research based on the results of the order.
.
This analysis uses real-world data to summarize treatment decisions in the cancer center network and correlates them with the time to second disease progression (PFS2) and overall survival (OS).

method

Non-identifying data on advanced/intermediate NSCLC patients was selected from Inteliquet’s Cancer Center Research Alliance partners, which includes academic and community oncology practices and comprehensive delivery networks across the United States.
The analysis was limited to patients who started 1L system therapy in 2017 and 2018 (index events), progressed and started 2L.
1L/2L/both must be based on anti-PDx-1 treatment.
Patients with known operable driver mutations were excluded.
The data for the next 24 months are used to determine the treatment plan and time to progress.
The proportional hazard regression was used to evaluate the PFS2 and OS of the 1L and 2L combination treatment regimens.
The analysis adjusted the age, gender, PS and treatment facility at the time of diagnosis.

result

132 patients met the study criteria.
53% were women, the median age range at diagnosis was 60-69 years, 73% were diagnosed as stage IV, 76% had PS at diagnosis 0-2.
After 24 months, 86% were alive and all Everyone made one progress, and 44% made a second progress.
The table summarizes the most frequently observed treatment patterns.

in conclusion

The same treatment plan shows different results in different orders.
Starting with platinum dual drugs, then IO PT, compared with the same starting and then IO MT, there are obvious benefits for OS and PFS2.
Compared with the reverse order, the use of IO MT first, followed by platinum dual drug, has obvious disadvantages in terms of OS.
Compared with the baseline, 1L IO PT has insignificant improvement in PFS2, but not in OS.

Original source: Does the order matter? Real-world data on the results of continuous treatment regimens involving anti-PDx-1 in advanced and metastatic non-small cell lung cancer.