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Cope S, Keeping ST, Goldgrub R, Ayers D, Jansen JP, Penrod JR, Korytowsky B, Juarez-Garcia A, Yuan Y. Indirect comparison of nivolumab ± ipilimumab (CheckMate 032) versus other treatments for recurrent small-cell lung cancer. J Comp Eff Res 2019; 8:733-751. [PMID: 31237143 DOI: 10.2217/cer-2018-0130] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Aim: To estimate the comparative efficacy of nivolumab ± ipilimumab versus alternative treatments for small-cell lung cancer after at least one prior line of chemotherapy. Materials & m ethods: A systematic literature review identified six randomized controlled trials (RCTs) that could be connected in a network. The Kaplan-Meier survival curves from these RCTs were synthesized using network meta-analysis models. Aggregate-level matching was used to connect CheckMate 032 to the RCTs. Results: CheckMate 032 was connected to the network by Amrubicin Clinical Trial-1. Nivolumab ± ipilimumab had a more durable tumor response and more favorable long-term survival versus topotecan via intravenous and versus amrubicin. Conclusion: Compared with chemotherapies for recurrent small-cell lung cancer, nivolumab ± ipilimumab improves response duration, which may translate to long-term survival benefits.
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Affiliation(s)
- Shannon Cope
- Precision Xtract, Vancouver, BC, V6H 3Y4, Canada
| | | | | | - Dieter Ayers
- Precision Xtract, Vancouver, BC, V6H 3Y4, Canada
| | | | - John R Penrod
- Bristol-Myers Squibb, Princeton Pike, Lawrence Township, NJ 08648, USA
| | - Beata Korytowsky
- Bristol-Myers Squibb, Princeton Pike, Lawrence Township, NJ 08648, USA
| | | | - Yong Yuan
- Bristol-Myers Squibb, Princeton Pike, Lawrence Township, NJ 08648, USA
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52
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Hu J, Wang Y, Zhang Y, Yu Y, Chen H, Liu K, Yao M, Wang K, Gu W, Shou T. Comprehensive genomic profiling of small cell lung cancer in Chinese patients and the implications for therapeutic potential. Cancer Med 2019; 8:4338-4347. [PMID: 31199602 PMCID: PMC6675718 DOI: 10.1002/cam4.2199] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/27/2019] [Accepted: 04/10/2019] [Indexed: 12/21/2022] Open
Abstract
Background Small cell lung cancer (SCLC) is one of the deadliest malignancies and accounts for nearly 15% of lung cancers. Previous study had revealed the genomic characterization of SCLC in Western patients. However, little is known about that in Chinese SCLC patients. Methods Formalin‐fixed paraffin‐embedded tumor tissues and matched blood samples from 122 Chinese SCLC patients were collected for next generation sequencing to detect 450 cancer‐related genes. All pathological diagnoses were confirmed by independent pathologists. Results The most frequently altered genes were TP53 (93.4%), RB1 (78.7%), LRP1B (18.9%), KMT2D (15.6%), FAT1 (11.5%), KMT2C (11.5%), SPTA1 (11.5%), STK24 (11.5%), FAM135B (10.7%), and NOTCH1 (10.7%). The gene fusion/rearrangement detection rate was 16.4%, and mostly occurred in chromosomes 7 and 17. The rate of co‐occurring mutations of TP53 and RB1 in these Chinese SCLC patients was 74.6%, and lower than the reported Western patients (90.9%, P = 0.007). The most common gene mutations (83.6%) were found in cell cycle signaling pathway in Chinese SCLC patients. Mutation of Wnt and Notch signaling pathways in the Chinese cohort were lower than Western cohort (P = 0.0013 and 0.0068). A significant association was found between high tumor mutation burden and mutations involved in FAT1, TP53, SPTA1, KEAP1, KMT2D, MAGI2, NOTCH2, NOTCH3, FLT1, KDM6A, and FAT4. Conclusions In this study, we characterized the genomic alterations profile of Chinese SCLC patients. Compared with westerners, the genetic alterations of Chinese SCLC patients presented different patterns. Our data might provide useful information in targeted therapy and drug development for Chinese SCLC patients.
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Affiliation(s)
- Jing Hu
- Department of Medical Oncology, First People's Hospital of Yunnan Province, Kunming, China.,Department of Medical Oncology, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Yu Wang
- Tumor Research and Therapy Center, Shandong Provincial Hospital Affiliated to Shandong University, Ji'nan, China
| | | | | | | | | | | | - Kai Wang
- OrigiMed, Shanghai, China.,Precision Medicine Center, Shulan (Hangzhou) Hospital, Hangzhou, China
| | - Weiguang Gu
- Department of Medical Oncology, Southern Medical University Nanfang Hospital, Foshan, China.,Department of Medical Oncology, People's Hospital of Nan Hai District, Foshan, China
| | - Tao Shou
- Department of Medical Oncology, First People's Hospital of Yunnan Province, Kunming, China.,Department of Medical Oncology, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
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53
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Schulze AB, Evers G, Kerkhoff A, Mohr M, Schliemann C, Berdel WE, Schmidt LH. Future Options of Molecular-Targeted Therapy in Small Cell Lung Cancer. Cancers (Basel) 2019; 11:E690. [PMID: 31108964 PMCID: PMC6562929 DOI: 10.3390/cancers11050690] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 04/29/2019] [Accepted: 05/14/2019] [Indexed: 12/31/2022] Open
Abstract
Lung cancer is the leading cause of cancer-related deaths worldwide. With a focus on histology, there are two major subtypes: Non-small cell lung cancer (NSCLC) (the more frequent subtype), and small cell lung cancer (SCLC) (the more aggressive one). Even though SCLC, in general, is a chemosensitive malignancy, relapses following induction therapy are frequent. The standard of care treatment of SCLC consists of platinum-based chemotherapy in combination with etoposide that is subsequently enhanced by PD-L1-inhibiting atezolizumab in the extensive-stage disease, as the addition of immune-checkpoint inhibition yielded improved overall survival. Although there are promising molecular pathways with potential therapeutic impacts, targeted therapies are still not an integral part of routine treatment. Against this background, we evaluated current literature for potential new molecular candidates such as surface markers (e.g., DLL3, TROP-2 or CD56), apoptotic factors (e.g., BCL-2, BET), genetic alterations (e.g., CREBBP, NOTCH or PTEN) or vascular markers (e.g., VEGF, FGFR1 or CD13). Apart from these factors, the application of so-called 'poly-(ADP)-ribose polymerases' (PARP) inhibitors can influence tumor repair mechanisms and thus offer new perspectives for future treatment. Another promising therapeutic concept is the inhibition of 'enhancer of zeste homolog 2' (EZH2) in the loss of function of tumor suppressors or amplification of (proto-) oncogenes. Considering the poor prognosis of SCLC patients, new molecular pathways require further investigation to augment our therapeutic armamentarium in the future.
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Affiliation(s)
- Arik Bernard Schulze
- Department of Medicine A, Hematology, Oncology and Pulmonary Medicine, University Hospital Muenster, 48149 Muenster, Germany.
| | - Georg Evers
- Department of Medicine A, Hematology, Oncology and Pulmonary Medicine, University Hospital Muenster, 48149 Muenster, Germany.
| | - Andrea Kerkhoff
- Department of Medicine A, Hematology, Oncology and Pulmonary Medicine, University Hospital Muenster, 48149 Muenster, Germany.
| | - Michael Mohr
- Department of Medicine A, Hematology, Oncology and Pulmonary Medicine, University Hospital Muenster, 48149 Muenster, Germany.
| | - Christoph Schliemann
- Department of Medicine A, Hematology, Oncology and Pulmonary Medicine, University Hospital Muenster, 48149 Muenster, Germany.
| | - Wolfgang E Berdel
- Department of Medicine A, Hematology, Oncology and Pulmonary Medicine, University Hospital Muenster, 48149 Muenster, Germany.
| | - Lars Henning Schmidt
- Department of Medicine A, Hematology, Oncology and Pulmonary Medicine, University Hospital Muenster, 48149 Muenster, Germany.
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Berland L, Heeke S, Humbert O, Macocco A, Long-Mira E, Lassalle S, Lespinet-Fabre V, Lalvée S, Bordone O, Cohen C, Leroy S, Hofman V, Hofman P, Ilié M. Current views on tumor mutational burden in patients with non-small cell lung cancer treated by immune checkpoint inhibitors. J Thorac Dis 2019; 11:S71-S80. [PMID: 30775030 DOI: 10.21037/jtd.2018.11.102] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
In the last few years, the treatment of patients with non-small cell lung cancer (NSCLC) has impressively benefitted from immunotherapy, in particular from the inhibition of immune checkpoints such as programmed cell death-1 (PD-1) and programmed cell death ligand-1 (PD-L1). However, despite the significant survival benefit for some patients with advanced NSCLC, the objective response rates (ORRs) remain relatively low no more than 20-30% with a large proportion of patients demonstrating primary resistance. Although the selection of NSCLC patients for the first-line treatment is currently guided by the expression of PD-L1 in tumor cells as detected by immunohistochemistry, this is not the case for the second-line setting. Moreover, the sensitivity and specificity of PD-L1 expression is modest which has prompted the search for additional predictive biomarkers. In this context, the assessment of the tumor mutational burden (TMB), defined as the total number of nonsynonymous mutations in the coding regions of genes, has recently emerged as an additional powerful biomarker to select patients for immunotherapy. The purpose of our review is to highlight the recent advances as well as the challenges and perspectives in the field of TMB and immunotherapy for patients with NSCLC.
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Affiliation(s)
- Léa Berland
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, University Hospital Federation OncoAge, Antoine Lacassagne Comprehensive Cancer Center, Université Côte d'Azur, Nice, France.,UFR Médicine, Antoine Lacassagne Comprehensive Cancer Center, Université Côte d'Azur, Nice, France
| | - Simon Heeke
- Institute of Research on Cancer and Ageing of Nice (IRCAN), University Hospital Federation OncoAge, CNRS, INSERM, Antoine Lacassagne Comprehensive Cancer Center, Université Côte d'Azur, Nice, France
| | - Olivier Humbert
- Department of Nuclear Medicine, Antoine Lacassagne Comprehensive Cancer Center, Université Côte d'Azur, Nice, France
| | - Adam Macocco
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, University Hospital Federation OncoAge, Antoine Lacassagne Comprehensive Cancer Center, Université Côte d'Azur, Nice, France.,UFR Médicine, Antoine Lacassagne Comprehensive Cancer Center, Université Côte d'Azur, Nice, France
| | - Elodie Long-Mira
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, University Hospital Federation OncoAge, Antoine Lacassagne Comprehensive Cancer Center, Université Côte d'Azur, Nice, France.,UFR Médicine, Antoine Lacassagne Comprehensive Cancer Center, Université Côte d'Azur, Nice, France
| | - Sandra Lassalle
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, University Hospital Federation OncoAge, Antoine Lacassagne Comprehensive Cancer Center, Université Côte d'Azur, Nice, France.,UFR Médicine, Antoine Lacassagne Comprehensive Cancer Center, Université Côte d'Azur, Nice, France
| | - Virginie Lespinet-Fabre
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, University Hospital Federation OncoAge, Antoine Lacassagne Comprehensive Cancer Center, Université Côte d'Azur, Nice, France
| | - Salomé Lalvée
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, University Hospital Federation OncoAge, Antoine Lacassagne Comprehensive Cancer Center, Université Côte d'Azur, Nice, France
| | - Olivier Bordone
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, University Hospital Federation OncoAge, Antoine Lacassagne Comprehensive Cancer Center, Université Côte d'Azur, Nice, France
| | - Charlotte Cohen
- Department of Thoracic Surgery, Pasteur Hospital, University Hospital Federation OncoAge, Université Côte d'Azur, Nice, France
| | - Sylvie Leroy
- Department of Pulmonary Medicine and Oncology, Pasteur Hospital, University Hospital Federation OncoAge, Université Côte d'Azur, Nice, France
| | - Véronique Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, University Hospital Federation OncoAge, Antoine Lacassagne Comprehensive Cancer Center, Université Côte d'Azur, Nice, France.,UFR Médicine, Antoine Lacassagne Comprehensive Cancer Center, Université Côte d'Azur, Nice, France.,Department of Thoracic Surgery, Pasteur Hospital, University Hospital Federation OncoAge, Université Côte d'Azur, Nice, France
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, University Hospital Federation OncoAge, Antoine Lacassagne Comprehensive Cancer Center, Université Côte d'Azur, Nice, France.,UFR Médicine, Antoine Lacassagne Comprehensive Cancer Center, Université Côte d'Azur, Nice, France.,Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, University Hospital Federation OncoAge, Université Côte d'Azur, Nice, France
| | - Marius Ilié
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, University Hospital Federation OncoAge, Antoine Lacassagne Comprehensive Cancer Center, Université Côte d'Azur, Nice, France.,UFR Médicine, Antoine Lacassagne Comprehensive Cancer Center, Université Côte d'Azur, Nice, France.,Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, University Hospital Federation OncoAge, Université Côte d'Azur, Nice, France
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