Safety and Survival Outcomes in Lung Cancer Patients Receiving Carboplatin: Impact of Uncapped Dosage

Chemotherapy ◽  
2021 ◽  
pp. 1-6
Author(s):  
Antoine Le Bozec ◽  
Coralie Boulanger ◽  
Céline Mongaret ◽  
Antonin Maréchal ◽  
Maxime Dewolf ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Progression Free Survival ◽  
Survival Outcomes ◽  
Hematologic Toxicity ◽  
Target Area ◽  
Lung Cancer Patients ◽  
Calvert Formula ◽  
Significant Difference ◽  
Carboplatin Dose

The prescription of carboplatin is commonly based on the Calvert formula, and low serum creatinine values can lead to an overestimation of the glomerular filtration rate and of the carboplatin dose. Limited data recommend to cap carboplatin dose at 800 mg, but the risk of suboptimal carboplatin dose is concerning. This study compared hematologic toxicity occurrence and survival outcomes in lung cancer patients receiving carboplatin &#x3e; or &#x3c;800 mg based on the Calvert formula (target area under the curve = 5 mg/mL min). Our results show more severe cytopenia in patients receiving carboplatin &#x3e;800 mg with significant difference for all grades of thrombocytopenia in the uncapped group (37% patients vs. 3%, <i>p</i> = 0.02). For metastatic non-small-cell lung cancer patients, we also observed hematologic toxicity in the uncapped group with more severe anemia (30% of patients vs. 0%, <i>p</i> = 0.03) and all grades of thrombocytopenia (39 vs. 0%, <i>p</i> = 0.02) than the capped group. Concerning the secondary endpoint, we obtained a trend of lower progression-free survival and overall survival in patients receiving carboplatin &#x3e;800 mg, but no significant difference appears for the both survival criteria. This study aims to improve the determination of carboplatin dosage to know the real impact of carboplatin capping and to find the optimum balance between excessive toxicity and substandard therapeutics outcomes.

scholarly journals Results of Radiation Therapy as Local Ablative Therapy for Oligometastatic Non-Small Cell Lung Cancer

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5773
Author(s):  
David L. Billing ◽  
Andreas Rimner
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Progression Free Survival ◽  
Standard Of Care ◽  
Survival Outcomes ◽  
Ablative Therapy ◽  
Lung Cancer Patients ◽  
Local Ablative Therapy ◽  
The Impact

Oligometastatic cancer is characterized by a limited number of metastatic deposits. Compared with lung cancer patients who have more widespread disease, oligometastatic lung cancer patients have more favorable survival outcomes. Therefore, it has been hypothesized that local ablative therapy (LAT) directed at the metastatic deposits in addition to standard-of-care systemic therapy may further improve survival outcomes in oligometastatic lung cancer patients. One LAT modality that has been utilized in oligometastatic lung cancer is radiation therapy. In particular, ultra-hypofractionated radiotherapy, also known as stereotactic body radiotherapy (SBRT), has been shown to provide excellent local control with a favorable safety profile. Here, we reviewed the retrospective studies and prospective trials that have deployed radiation therapy as LAT in oligometastatic lung cancer, including randomized studies showing benefits for progression-free survival and overall survival with the addition of LAT. We also discuss the impact of targeted therapies and immunotherapy on radiation as LAT.

Pretreatment lung immune prognostic index as biomarker in advanced non-small-cell lung cancer patients receiving first line pembrolizumab

Immunotherapy ◽  
2021 ◽  
Author(s):  
Antonello Veccia ◽  
Vincenzo Sforza ◽  
Emanuela Vattemi ◽  
Alessandro Inno ◽  
Stefania Kinspergher ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cancer Patients ◽  
Cell Lung Cancer ◽  
Prognostic Index ◽  
Progression Free Survival ◽  
Small Cell ◽  
Small Cell Lung ◽  
Lung Cancer Patients ◽  
C Statistic

Background: To investigate the role of pretreatment lung immune prognostic index (LIPI) as biomarker in PD-L1 ≥50% non-small-cell lung cancer patients receiving pembrolizumab. Patients & methods: We retrospectively identified 117 patients, divided into 3 prognostic groups according to LIPI score. For each patient, we evaluated 1-year overall survival (OS) and progression-free survival rate. C-statistic and survival receiver operating characteristic curves were used to study discrimination of LIPI. Results: After a median follow-up of 11.7 months, 1-year OS rate was 60.1%, 35.3% and 28.6%, while 1-year progression-free survival rate was 39.1%, 20.6% and 14.3% in good, intermediate and poor LIPI groups, respectively (p < 0.001). The c-statistic and area under the curve of LIPI were 0.63 and 0.662 for OS and 1-year OS, respectively. Conclusions: Higher LIPI score is related to worse survival in advanced non-small-cell lung cancer patients treated with first-line pembrolizumab. However, based on c-statistic and area under the curve, LIPI does not represent a good prognostic survival model.

scholarly journals Venous thromboembolism in non-small cell lung cancer patients who underwent surgery after induction therapy

2020 ◽  
Vol 68 (10) ◽  
pp. 1156-1162
Author(s):  
Yasunori Kaminuma ◽  
Masayuki Tanahashi ◽  
Eriko Suzuki ◽  
Naoko Yoshii ◽  
Hiroshi Niwa
Keyword(s):  
Lung Cancer ◽  
Venous Thromboembolism ◽  
Small Cell Lung Cancer ◽  
Cancer Patients ◽  
Induction Therapy ◽  
Small Cell ◽  
Small Cell Lung ◽  
Free Survival ◽  
Lung Cancer Patients ◽  
Significant Difference

Abstract Objectives Lung cancer patients have been reported to have a high incidence of venous thromboembolism (VTE) and a high recurrence rate of VTE. However, there are no detailed reports of VTE in lung cancer patients who underwent surgery after induction therapy. We examined the incidence and clinical features of VTE in these patients. Methods We retrospectively evaluated 89 patients with non-small cell lung cancer who underwent surgery after induction therapy at our department between April 2009 and March 2018. The incidence of VTE, clinical features, and long-term prognosis were retrospectively examined. Results Among the 89 patients, 4 (4.5%) developed VTE, and there was no significant difference in the background characteristics between patients with and without VTE. All four patients developed VTE during preoperative treatment. In the patients with VTE, anticoagulant therapy with oral anticoagulants was administered after heparinization, and the median duration of anticoagulant therapy was 18.7 months. There were no cases of symptomatic VTE recurrence after surgery, regardless of lung cancer recurrence. Although the overall survival (OS) showed no significant difference between patients with and without VTE, the disease-free survival was significantly shorter in patients with VTE than in those without it (median 6.3 vs. 71.6 months, p < 0.01). Conclusions In induction cases, the incidence of VTE was 4.5%, and it can at least be stated that no symptomatic VTE developed or recurred after surgery. Patients with VTE in induction therapy had short progression-free survival and required careful follow-up after surgery.

scholarly journals Characteristics of asbestos fibers in lung tissue from occupational and environmental asbestos exposure of lung cancer patients in Busan, Korea

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hyun-Sung Jung ◽  
Eun-Kee Park ◽  
Jun-Seok Cha ◽  
Jae-Won Lee ◽  
Jong-Chun Lee ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Lung Tissue ◽  
Asbestos Exposure ◽  
Coefficient Of Determination ◽  
Factors Affecting ◽  
Lung Cancer Patients ◽  
Asbestos Fibers ◽  
Significant Difference ◽  
Occupationally Exposed

AbstractThe Asbestos Injury Relief Act in Korea requires that asbestos exposure be assessed through clinical examination and chest computed tomography (CT). However, a more specific measurement of asbestos characteristics in the lung tissue may be appropriate. We aimed to investigate the asbestos burden and characterize asbestos fibers in patients with lung cancer and ultimately assess the relationship between occupational and environmental asbestos exposure and lung cancer in Korea. We evaluated 37 lung cancer patients (LCPs) from Busan. The factors affecting asbestos burden in LCPs were analyzed using a multiple regression analysis. History of asbestos exposure (environmental/occupational), male sex, and old age were the main factors affecting asbestos burden in lung tissues of LCPs. These factors had an approximate 37% adjusted coefficient of determination. There was a significant difference in the length of asbestos fibers (4.06–37.6 µm vs. 4.26–91.7 µm) and aspect ratio (4.5–151.9 vs. 5.6–735.6) between those who were occupationally exposed to asbestos and those who were environmentally exposed (P < 0.01). Therefore, both environmental/occupational exposure to asbestos should be strongly managed to reduce the risk of lung cancer, and exposure should be assessed according to the characteristics of asbestos fibers in the lung tissue.

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