1
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Wei C, Sun H, Hu J, Ma Z, Cao B. Association of pathological response with long-term survival outcomes after neoadjuvant immunotherapy: A meta-analysis. Int Immunopharmacol 2024; 133:112078. [PMID: 38685176 DOI: 10.1016/j.intimp.2024.112078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 04/09/2024] [Accepted: 04/09/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Complete pathological response (pCR) and major pathological response (MPR) have been proven to have a close association with improved event-free survival (EFS) and overall survival (OS) for patients accepting chemotherapy or chemoradiotherapy. However, further study focusing on neoadjuvant immunotherapy is limited. Here we provided an updated and comprehensive evaluation of the association between pathological response and long-term survival outcomes at patient level and trial level for neoadjuvant immunotherapy. METHODS We systematically searched and assessed studies in PubMed, Embase, the Cochrane Library and relevant conference abstracts from inception to June 1, 2023. Studies reported EFS/OS results by pCR/MPR status were eligible. RESULTS Forty-three studies comprising a total of 4100 patients were eligible for the analysis, which included 39 studies for the patient-level analysis and 5 randomized controlled trials for the trial-level analysis. Our results highlighted that pCR was associated with improved EFS (HR, 0.48 [95 % CI, 0.39-0.60]) and OS (HR, 0.55 [95 % CI, 0.41-0.74]). The magnitude of HRs by MPR status were similar to the results by pCR status (EFS HR, 0.31 [95 % CI, 0.18-0.53]) and OS HR, 0.43 [95 % CI, 0.19-0.96]). However, no association between pCR and EFS at trial level was found (P = 0.8, R2 = 0). CONCLUSION Our meta-analysis demonstrates a strong association between pathological response and long-term survival outcomes at patient level across studies applying neoadjuvant immunotherapy in most solid tumors but we fail to validate the relationship at trial level. Therefore, an accepted surrogate endpoint applied to both patient and trial levels are waited for further search.
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Affiliation(s)
- Chenyu Wei
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Haolin Sun
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Jiexuan Hu
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Zhongjun Ma
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Bangwei Cao
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
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2
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Ferrari V, Helissey C. Revolutionizing Localized Lung Cancer Treatment: Neoadjuvant Chemotherapy plus Immunotherapy for All? J Clin Med 2024; 13:2715. [PMID: 38731244 PMCID: PMC11084409 DOI: 10.3390/jcm13092715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/24/2024] [Accepted: 05/01/2024] [Indexed: 05/13/2024] Open
Abstract
Lung cancer poses a significant public health challenge, with resectable non-small cell lung cancer (NSCLC) representing 20 to 25% of all NSCLC cases, staged between I and IIIA. Despite surgical interventions, patient survival remains unsatisfactory, with approximately 50% mortality within 5 years across early stages. While perioperative chemotherapy offers some benefit, outcomes vary. Therefore, novel therapeutic approaches are imperative to improve patient survival. The combination of chemotherapy and immunotherapy emerges as a promising avenue. In this review, we explore studies demonstrating the benefits of this combination therapy, its impact on surgical procedures, and patient quality of life. However, challenges persist, particularly for patients failing to achieve pathologic complete response (pCR), those with stage II lung cancer, and individuals with specific genetic mutations. Additionally, identifying predictive biomarkers remains challenging. Nevertheless, the integration of immunotherapy and chemotherapy in the preoperative setting presents a new paradigm in managing resectable lung cancer, heralding more effective and personalized treatments for patients.
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Affiliation(s)
| | - Carole Helissey
- Department of Medical Oncology and Clinical Research Unit, Military Hospital Bégin, 94160 Saint-Mandé, France
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3
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Waser NA, Quintana M, Schweikert B, Chaft JE, Berry L, Adam A, Vo L, Penrod JR, Fiore J, Berry DA, Goring S. Pathological response in resectable non-small cell lung cancer: a systematic literature review and meta-analysis. JNCI Cancer Spectr 2024; 8:pkae021. [PMID: 38521542 PMCID: PMC11101053 DOI: 10.1093/jncics/pkae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 12/06/2023] [Accepted: 03/15/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Surrogate endpoints for overall survival in patients with resectable non-small cell lung cancer receiving neoadjuvant therapy are needed to provide earlier treatment outcome indicators and accelerate drug approval. This study's main objectives were to investigate the association among pathological complete response, major pathological response, event-free survival and overall survival and to determine whether treatment effects on pathological complete response and event-free survival correlate with treatment effects on overall survival. METHODS A comprehensive systematic literature review was conducted to identify neoadjuvant studies in resectable non-small cell lung cancer. Analysis at the patient level using frequentist and Bayesian random effects (hazard ratio [HR] for overall survival or event-free survival by pathological complete response or major pathological response status, yes vs no) and at the trial level using weighted least squares regressions (hazard ratio for overall survival or event-free survival vs pathological complete response, by treatment arm) were performed. RESULTS In both meta-analyses, pathological complete response yielded favorable overall survival compared with no pathological complete response (frequentist, 20 studies and 6530 patients: HR = 0.49, 95% confidence interval = 0.42 to 0.57; Bayesian, 19 studies and 5988 patients: HR = 0.48, 95% probability interval = 0.43 to 0.55) and similarly for major pathological response (frequentist, 12 studies and 1193 patients: HR = 0.36, 95% confidence interval = 0.29 to 0.44; Bayesian, 11 studies and 1018 patients: HR = 0.33, 95% probability interval = 0.26 to 0.42). Across subgroups, estimates consistently showed better overall survival or event-free survival in pathological complete response or major pathological response compared with no pathological complete response or no major pathological response. Trial-level analyses showed a moderate to strong correlation between event-free survival and overall survival hazard ratios (R2 = 0.7159) but did not show a correlation between treatment effects on pathological complete response and overall survival or event-free survival. CONCLUSION There was a strong and consistent association between pathological response and survival and a moderate to strong correlation between event-free survival and overall survival following neoadjuvant therapy for patients with resectable non-small cell lung cancer.
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Affiliation(s)
| | | | | | - Jamie E Chaft
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Ahmed Adam
- Insights, Evidence and Value, ICON plc, Burlington, ON, Canada
| | - Lien Vo
- Health Economics and Outcomes Research, Bristol Myers Squibb, Lawrenceville, NJ, USA
| | - John R Penrod
- Health Economics and Outcomes Research, Bristol Myers Squibb, Lawrenceville, NJ, USA
| | - Joseph Fiore
- Health Economics and Outcomes Research, Bristol Myers Squibb, Lawrenceville, NJ, USA
| | | | - Sarah Goring
- Insights, Evidence and Value, ICON plc, Burlington, ON, Canada
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4
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Banna GL, Hassan MA, Signori A, Giunta EF, Maniam A, Anpalakhan S, Acharige S, Ghose A, Addeo A. Neoadjuvant Chemo-Immunotherapy for Early-Stage Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis. JAMA Netw Open 2024; 7:e246837. [PMID: 38625698 PMCID: PMC11022115 DOI: 10.1001/jamanetworkopen.2024.6837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/15/2024] [Indexed: 04/17/2024] Open
Abstract
Importance Randomized clinical trials (RCTs) with neoadjuvant immune checkpoint inhibitors (ICIs) plus chemotherapy (ICI-chemotherapy) for patients with early-stage non-small cell lung cancer (NSCLC) have reported consistent associations with event-free survival (EFS) and pathologic complete response (pCR) pending longer follow-up for overall survival data. Objective To assess the pooled benefit of ICI-chemotherapy in 2-year EFS and pCR among patients with NSCLC and examine the impact of clinical, pathologic, and treatment-related factors. Data Sources Full-text articles and abstracts in English were searched in EMBASE, PubMed, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews through November 1, 2023, and in oncology conference proceedings from January 1, 2008, to November 1, 2023. Study Selection Phase 2 or 3 RCTs with neoadjuvant ICI-chemotherapy with or without adjuvant ICIs vs neoadjuvant chemotherapy alone with or without placebo or observation in patients with previously untreated NSCLC staged IB to IIIB were included. Data Extraction and Synthesis Data extraction of prespecified data elements was performed by 2 reviewers using a structured data abstraction electronic form. A random-effects model was used for meta-analysis. The meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Main Outcomes and Measures Two-year EFS and pCR were the outcomes of interest in patients who received neoadjuvant ICI-chemotherapy (experimental arm) or neoadjuvant chemotherapy alone (control arm). Aggregated pooled hazard ratios (HRs) for time-to-event outcomes (2-year EFS) and risk ratios (RRs) for dichotomous outcomes (pCR) with their respective 95% CIs were calculated. Results Eight trials with 3387 patients were included, with some concerns of risk of bias as assessed by the Cochrane Collaboration method, mainly related to outcomes measurements. Neoadjuvant ICI-chemotherapy was associated with improved 2-year EFS (HR, 0.57; 95% CI, 0.50-0.66; P < .001) and increased pCR rate (RR, 5.58; 95% CI, 4.27-7.29; P < .001) in the experimental vs control treatment arms. This association was not significantly modified by the main patient characteristics; tumor- or treatment-related factors, including tumor programmed cell death ligand 1 (PD-L1) status; type of platinum-compound chemotherapy; number of cycles of neoadjuvant ICI-chemotherapy; or addition of adjuvant ICIs. Patients whose tumor cells were negative for PD-L1 were at higher risk of relapse (HR, 0.75; 95% CI, 0.62-0.91) than were those with low (HR, 0.61; 95% CI, 0.37-0.71) or high PD-L1 (HR, 0.40; 95% CI, 0.27-0.58) (P = .005). Conclusions and Relevance In this systematic review and meta-analysis of neoadjuvant ICI-chemotherapy RCTs in patients with early-stage NSCLC, 3 cycles of neoadjuvant platinum-based ICI-chemotherapy were associated with a meaningful improvement in 2-year EFS and pCR.
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Affiliation(s)
- Giuseppe Luigi Banna
- Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom
- Faculty of Science and Health, School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom
| | - Mona Ali Hassan
- Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom
| | - Alessio Signori
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Emilio Francesco Giunta
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori “Dino Amadori,” Meldola, Italy
| | - Akash Maniam
- Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom
| | - Shobana Anpalakhan
- Department of Oncology, Southampton General Hospital, Southampton, United Kingdom
| | - Shyamika Acharige
- Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom
| | - Aruni Ghose
- Department of Medical Oncology, Barts Cancer Centre, St Bartholomew’s Hospital, London, United Kingdom
| | - Alfredo Addeo
- Oncology Service, Geneva University Hospital, Geneva, Switzerland
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5
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Hu M, Li X, Lin H, Lu B, Wang Q, Tong L, Li H, Che N, Hung S, Han Y, Shi K, Li C, Zhang H, Liu Z, Zhang T. Easily applicable predictive score for MPR based on parameters before neoadjuvant chemoimmunotherapy in operable NSCLC: a single-center, ambispective, observational study. Int J Surg 2024; 110:2275-2287. [PMID: 38265431 PMCID: PMC11020048 DOI: 10.1097/js9.0000000000001050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/21/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Neoadjuvant chemoimmunotherapy (NACI) is promising for resectable nonsmall cell lung cancer (NSCLC), but predictive biomarkers are still lacking. The authors aimed to develop a model based on pretreatment parameters to predict major pathological response (MPR) for such an approach. METHODS The authors enrolled operable NSCLC treated with NACI between March 2020 and May 2023 and then collected baseline clinical-pathology data and routine laboratory examinations before treatment. The efficacy and safety data of this cohort was reported and variables were screened by Logistic and Lasso regression and nomogram was developed. In addition, receiver operating characteristic curves, calibration curves, and decision curve analysis were used to assess its power. Finally, internal cross-validation and external validation was performed to assess the power of the model. RESULTS In total, 206 eligible patients were recruited in this study and 53.4% (110/206) patients achieved MPR. Using multivariate analysis, the predictive model was constructed by seven variables, prothrombin time (PT), neutrophil percentage (NEUT%), large platelet ratio (P-LCR), eosinophil percentage (EOS%), smoking, pathological type, and programmed death ligand-1 (PD-L1) expression finally. The model had good discrimination, with area under the receiver operating characteristic curve (AUC) of 0.775, 0.746, and 0.835 for all datasets, cross-validation, and external validation, respectively. The calibration curves showed good consistency, and decision curve analysis indicated its potential value in clinical practice. CONCLUSION This real world study revealed favorable efficacy in operable NSCLC treated with NACI. The proposed model based on multiple clinically accessible parameters could effectively predict MPR probability and could be a powerful tool in personalized medication.
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Affiliation(s)
| | - Xiaomi Li
- Department of Oncology, Beijing Institute of Tuberculosis and Chest Tumor, Beijing, People’s Republic of China
| | | | | | | | | | | | | | - Shaojun Hung
- Department of Thoracic Surgery, Beijing Chest Hospital, Capital Medical University
| | - Yi Han
- Department of Thoracic Surgery, Beijing Chest Hospital, Capital Medical University
| | - Kang Shi
- Department of Thoracic Surgery, Beijing Chest Hospital, Capital Medical University
| | | | | | - Zhidong Liu
- Department of Thoracic Surgery, Beijing Chest Hospital, Capital Medical University
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6
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Deutsch JS, Cimino-Mathews A, Thompson E, Provencio M, Forde PM, Spicer J, Girard N, Wang D, Anders RA, Gabrielson E, Illei P, Jedrych J, Danilova L, Sunshine J, Kerr KM, Tran M, Bushong J, Cai J, Devas V, Neely J, Balli D, Cottrell TR, Baras AS, Taube JM. Association between pathologic response and survival after neoadjuvant therapy in lung cancer. Nat Med 2024; 30:218-228. [PMID: 37903504 PMCID: PMC10803255 DOI: 10.1038/s41591-023-02660-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 10/23/2023] [Indexed: 11/01/2023]
Abstract
Neoadjuvant immunotherapy plus chemotherapy improves event-free survival (EFS) and pathologic complete response (0% residual viable tumor (RVT) in primary tumor (PT) and lymph nodes (LNs)), and is approved for treatment of resectable lung cancer. Pathologic response assessment after neoadjuvant therapy is the potential analog to radiographic response for advanced disease. However, %RVT thresholds beyond pathologic complete response and major pathologic response (≤10% RVT) have not been explored. Pathologic response was prospectively assessed in the randomized, phase 3 CheckMate 816 trial (NCT02998528), which evaluated neoadjuvant nivolumab (anti-programmed death protein 1) plus chemotherapy in patients with resectable lung cancer. RVT, regression and necrosis were quantified (0-100%) in PT and LNs using a pan-tumor scoring system and tested for association with EFS in a prespecified exploratory analysis. Regardless of LN involvement, EFS improved with 0% versus >0% RVT-PT (hazard ratio = 0.18). RVT-PT predicted EFS for nivolumab plus chemotherapy (area under the curve = 0.74); 2-year EFS rates were 90%, 60%, 57% and 39% for patients with 0-5%, >5-30%, >30-80% and >80% RVT, respectively. Each 1% RVT associated with a 0.017 hazard ratio increase for EFS. Combining pathologic response from PT and LNs helped differentiate outcomes. When compared with radiographic response and circulating tumor DNA clearance, %RVT best approximated EFS. These findings support pathologic response as an emerging survival surrogate. Further assessment of the full spectrum of %RVT in lung cancer and other tumor types is warranted. ClinicalTrials.gov registration: NCT02998528 .
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Affiliation(s)
- Julie Stein Deutsch
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ashley Cimino-Mathews
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Elizabeth Thompson
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Patrick M Forde
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Nicolas Girard
- Institut du Thorax Curie-Montsouris, Institut Curie, Paris, France
| | - Daphne Wang
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robert A Anders
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Edward Gabrielson
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peter Illei
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jaroslaw Jedrych
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ludmila Danilova
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Joel Sunshine
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Mia Tran
- Bristol Myers Squibb, Princeton, NJ, USA
| | | | | | | | | | | | | | - Alex S Baras
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Janis M Taube
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- The Mark Foundation Center for Advanced Genomics and Imaging, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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7
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Liu Y, Xiong L, Chen Y, Cai R, Xu X, Wang T, Guo Y, Ruan L, Fang Y, Zhang Q, Shen B, Ye J, Zhou G. Complete pathological remission and tertiary lymphoid structures are associated with the efficacy of resectable NSCLC receiving neoadjuvant chemoimmunotherapy: A double-center retrospective study. Hum Vaccin Immunother 2023; 19:2285902. [PMID: 38010104 PMCID: PMC10760371 DOI: 10.1080/21645515.2023.2285902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/16/2023] [Indexed: 11/29/2023] Open
Abstract
This study aimed to investigate the relationship between complete pathological remission (PCR), tertiary lymphoid structure (TLS) maturation and expression and clinical outcomes of patients with resectable non-small cell lung cancer (NSCLC) receiving neoadjuvant chemoimmunotherapy. Totally 80 patients with resectable NSCLC (stage IB-IIIB) receiving neoadjuvant chemoimmunotherapy were analyzed. We used the Kaplan-Meier method to plot survival curves and the log-rank test to compare differences. Among all patients included, 45 patients (56.25%) achieved major pathological response (MPR), including 30 patients (37.50%) with PCR. The proportion of patients diagnosed with stage IB, II, IIIA and IIIB was 1.25%, 10.00%, 52.50% and 36.25%, respectively. We divided patients into PCR group and non-PCR group respectively according to whether they achieved PCR. We found that patients achieving PCR had significantly improved disease-free survival (DFS) (mDFS: NR vs. 20.24 months, P = .020). TLS expression was low in 43 cases (53.75%) and high in 37 cases (46.25%). TLS maturation was low in 55 cases (68.75%) and high in 25 cases (31.25%). The DFS of patients with TLS high-maturation (34.07 vs. 22.30 months, P = .024) and TLS high-expression (34.07 vs. 22.30 months, P = .041) was significantly longer. In most subgroups, the PCR, TLS high-maturation and TLS high-expression group respectively achieved a better clinical outcome relative to the non-PCR, TLS low-maturation and TLS low-expression group. In patients with resectable NSCLC receiving neoadjuvant chemoimmunotherapy, the acquirement of PCR may predict better DFS. In addition, high expression and maturation of TLS may be prognostic factors.
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Affiliation(s)
- Ying Liu
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China
| | - Lei Xiong
- Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yue Chen
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China
| | - Ruoxue Cai
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China
| | - Xinyu Xu
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China
| | - Tian Wang
- The Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yiyu Guo
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China
| | - Luxi Ruan
- Nanjing Jiangning Hospital, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Ying Fang
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China
| | - Quanan Zhang
- Nanjing Jiangning Hospital, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Bo Shen
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China
| | - Jinjun Ye
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China
| | - Guoren Zhou
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China
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8
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Gan Y, Liu Z, Tang Z, Yao X, Zeng B, Zhu H. Efficacy of neoadjuvant therapy for lung squamous cell carcinoma and lung adenocarcinoma: A retrospective comparative study. Oncol Lett 2023; 26:546. [PMID: 38020306 PMCID: PMC10660168 DOI: 10.3892/ol.2023.14133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 10/06/2023] [Indexed: 12/01/2023] Open
Abstract
Preoperative neoadjuvant therapy is widely used in cancer treatment; however, its efficacy in different subtypes of non-small cell lung cancer (NSCLC) is unknown. The present study compared the clinical efficacy of preoperative neoadjuvant therapy for two major NSCLC subtypes. Patients with NSCLC who underwent preoperative neoadjuvant therapy between January 2016 and August 2022 were reviewed. Patients were stratified according to histology and treatment strategy. Retrospective analysis was performed by comparing the basic clinical characteristics of the patients, clinicopathological characteristics of the tumors, imaging data and pathological responses to treatment. A total of 36 cases of lung squamous cell carcinoma (LUSC) and 31 cases of lung adenocarcinoma (LUAD) were included. After neoadjuvant chemotherapy combined with immunotherapy, the pathological response rates were higher for patients with LUSC than LUAD, but there was no statistically significant difference between the two subgroups (P=0.06). However, the pathological complete response rates after neoadjuvant chemotherapy combined with immunotherapy were significantly higher for LUSC than those after chemotherapy alone (P=0.01). These preliminary findings suggested that preoperative chemotherapy combined with immunotherapy could improve the pathological response of patients, particularly in those with LUSC. The present study provided new insights into the treatment of NSCLC.
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Affiliation(s)
- Yi Gan
- Department of Thoracic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Zhihao Liu
- Department of Thoracic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Zhiwei Tang
- Department of Thoracic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Xiaojing Yao
- Department of Thoracic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Bo Zeng
- Department of Thoracic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Haoshuai Zhu
- Department of Thoracic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, P.R. China
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9
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Yu S, Zhai S, Gong Q, Xiang C, Gong J, Wu L, Pu X. Neoadjuvant Immunotherapy and Non-Small Cell Lung Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Am J Clin Oncol 2023; 46:517-528. [PMID: 37749786 PMCID: PMC10589427 DOI: 10.1097/coc.0000000000001046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
OBJECTIVES To systematically evaluate the effectiveness and safety of neoadjuvant immunotherapy for patients with non-small cell lung cancer (NSCLC). METHODS Randomized controlled trials of neoadjuvant immunotherapy in treating patients with NSCLC were comprehensively retrieved from electronic databases, eligible studies, previous systematic reviews and meta-analyses, guidelines, and conference abstracts. The meta-analysis was performed by the Stata/SE 12.0 software. RESULTS Eleven randomized controlled trials were eventually included. The results of the meta-analysis showed that neoadjuvant immunochemotherapy significantly improved the objective response rate compared with neoadjuvant chemotherapy (CT; 62.46% vs 41.88%, P = 0.003), but the objective response rate of neoadjuvant double-immunotherapy was roughly comparable to that of neoadjuvant single-immunotherapy (15.74% vs 10.45%, P = 0.387). Major pathologic response (MPR) rate and pathologic complete response (pCR) rate of neoadjuvant immunochemotherapy and neoadjuvant double-immunotherapy were significantly superior to neoadjuvant CT alone and neoadjuvant single-immunotherapy, respectively. Compared with neoadjuvant CT alone, neoadjuvant immunochemotherapy increased the down-staging rate (40.16% vs 26.70%, P = 0.060), the surgical resection rate (83.69% vs 73.07%, P = 0.231), and R0 resection rate (86.19% vs 77.98%, P = 0.502), but there were no statistically significant differences. Neoadjuvant immunochemotherapy did not increase the postoperative complications rate than neoadjuvant CT alone (40.20% vs 41.30%, P = 0.920). In terms of safety, neoadjuvant immunochemotherapy and neoadjuvant double-immunotherapy did not increase the incidence of treatment-related adverse events (TRAEs) and the grade 3 or higher TRAEs. CONCLUSIONS In summary, neoadjuvant immunochemotherapy had better clinical efficacy than neoadjuvant CT for patients with NSCLC. MPR rate and pCR rate of neoadjuvant immunochemotherapy and neoadjuvant double-immunotherapy were significantly superior to neoadjuvant CT and neoadjuvant single-immunotherapy, respectively, for patients with NSCLC, showing that MPR rate and pCR rate were probably considered as alternative endpoints for survival benefit. TRAEs were comparable between the corresponding groups. The long-term survival outcome of neoadjuvant immunotherapy for patients with NSCLC needs to be further confirmed to better guide clinical practice.
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Affiliation(s)
- Shaofu Yu
- Department of Clinical Pharmacy, the Second People’s Hospital of Huaihua
- The Second Department of Thoracic Medical Oncology, Hunan Cancer Hospital, Changsha
| | - Shasha Zhai
- Department of Trauma Surgery, the First Affiliated Hospital of Hunan University of Medicine, Huaihua
| | - Qian Gong
- Department of Clinical Pharmacy, Hunan Cancer Hospital, Changsha, Hunan, China
| | - Chunhong Xiang
- Department of Clinical Pharmacy, the Second People’s Hospital of Huaihua
| | - Jianping Gong
- Department of Clinical Pharmacy, the Second People’s Hospital of Huaihua
| | - Lin Wu
- The Second Department of Thoracic Medical Oncology, Hunan Cancer Hospital, Changsha
| | - Xingxiang Pu
- The Second Department of Thoracic Medical Oncology, Hunan Cancer Hospital, Changsha
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Shen J, Gu L, Qi Y, Yao Y, Lu S, Chen Z. Real-world outcomes of immunotherapy-based neoadjuvant therapy in resectable non-small cell lung cancer. Front Immunol 2023; 14:1268251. [PMID: 37818382 PMCID: PMC10560710 DOI: 10.3389/fimmu.2023.1268251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/12/2023] [Indexed: 10/12/2023] Open
Abstract
Objectives Recent clinical studies have demonstrated that immunotherapy-based neoadjuvant therapy have promising effectiveness for patients with resectable non-small cell lung cancer (NSCLC) in terms of pathologic response. Therefore, we performed this study to investigate whether immunotherapy-based neoadjuvant therapy is effective and safe for patients with resectable NSCLC. Materials and methods This open-label observational two-arm clinical study was performed at Shanghai Chest Hospital in China with patients who had resectable NSCLC and received two to three cycles of immunotherapy-based neoadjuvant therapy or neoadjuvant chemotherapy alone, followed by surgical resection. The primary endpoint was a major pathologic response (MPR). The secondary endpoints include a complete pathological response (pCR), a radiologic response to neoadjuvant therapy (TRR), event-free survival (EFS), and overall survival (OS). Results A total of 51 patients was included in this clinical study, of which 31 patients received immunotherapy-based neoadjuvant therapy and 20 patients received neoadjuvant chemotherapy alone. The percentage of patients achieving a major pathologic response was 41.9% with immunotherapy-based neoadjuvant therapy and 15.0% (95% CI, 0.008 to 0.468; P = 0.043) with neoadjuvant chemotherapy alone. The percentage of patients with pathologic complete response was 19.4% in the immunotherapy-based group and 5% (95% CI, -0.069 to 0.318; P = 0.223) in the chemotherapy group. The radiographic response rate was 71% after immunotherapy-based neoadjuvant therapy and 60% (95% CI, -0.143 to 0.359; P = 0.417) after neoadjuvant chemotherapy. At a median follow-up of 28 months, the median EFS and OS endpoints were not reached. Conclusions Neoadjuvant immunotherapy offers a considerable advantage over chemotherapy alone for resectable NSCLC in terms of the major pathologic response. Moreover, it did not enhance the risk of adverse events or hinder surgical resection.
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Affiliation(s)
| | | | | | | | - Shun Lu
- Department of Shanghai Lung Cancer Center, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhiwei Chen
- Department of Shanghai Lung Cancer Center, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Provencio M, Nadal E, González-Larriba JL, Martínez-Martí A, Bernabé R, Bosch-Barrera J, Casal-Rubio J, Calvo V, Insa A, Ponce S, Reguart N, de Castro J, Mosquera J, Cobo M, Aguilar A, López Vivanco G, Camps C, López-Castro R, Morán T, Barneto I, Rodríguez-Abreu D, Serna-Blasco R, Benítez R, Aguado de la Rosa C, Palmero R, Hernando-Trancho F, Martín-López J, Cruz-Bermúdez A, Massuti B, Romero A. Perioperative Nivolumab and Chemotherapy in Stage III Non-Small-Cell Lung Cancer. N Engl J Med 2023; 389:504-513. [PMID: 37379158 DOI: 10.1056/nejmoa2215530] [Citation(s) in RCA: 87] [Impact Index Per Article: 87.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
BACKGROUND Approximately 20% of patients with non-small-cell lung cancer (NSCLC) receive a diagnosis of stage III disease. There is no current consensus regarding the most appropriate treatment for these patients. METHODS In this open-label, phase 2 trial, we randomly assigned patients with resectable stage IIIA or IIIB NSCLC to receive neoadjuvant nivolumab plus platinum-based chemotherapy (experimental group) or chemotherapy alone (control group), followed by surgery. Patients in the experimental group who had R0 resections received adjuvant treatment with nivolumab for 6 months. The primary end point was a pathological complete response (0% viable tumor in resected lung and lymph nodes). Secondary end points included progression-free survival and overall survival at 24 months and safety. RESULTS A total of 86 patients underwent randomization; 57 were assigned to the experimental group and 29 were assigned to the control group. A pathological complete response occurred in 37% of the patients in the experimental group and in 7% in the control group (relative risk, 5.34; 95% confidence interval [CI], 1.34 to 21.23; P = 0.02). Surgery was performed in 93% of the patients in the experimental group and in 69% in the control group (relative risk, 1.35; 95% CI, 1.05 to 1.74). Kaplan-Meier estimates of progression-free survival at 24 months were 67.2% in the experimental group and 40.9% in the control group (hazard ratio for disease progression, disease recurrence, or death, 0.47; 95% CI, 0.25 to 0.88). Kaplan-Meier estimates of overall survival at 24 months were 85.0% in the experimental group and 63.6% in the control group (hazard ratio for death, 0.43; 95% CI, 0.19 to 0.98). Grade 3 or 4 adverse events occurred in 11 patients in the experimental group (19%; some patients had events of both grades) and 3 patients in the control group (10%). CONCLUSIONS In patients with resectable stage IIIA or IIIB NSCLC, perioperative treatment with nivolumab plus chemotherapy resulted in a higher percentage of patients with a pathological complete response and longer survival than chemotherapy alone. (Funded by Bristol Myers Squibb and others; NADIM II ClinicalTrials.gov number, NCT03838159; EudraCT number, 2018-004515-45.).
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Affiliation(s)
- Mariano Provencio
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Ernest Nadal
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - José L González-Larriba
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Alex Martínez-Martí
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Reyes Bernabé
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Joaquim Bosch-Barrera
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Joaquín Casal-Rubio
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Virginia Calvo
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Amelia Insa
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Santiago Ponce
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Noemí Reguart
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Javier de Castro
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Joaquín Mosquera
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Manuel Cobo
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Andrés Aguilar
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Guillermo López Vivanco
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Carlos Camps
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Rafael López-Castro
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Teresa Morán
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Isidoro Barneto
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Delvys Rodríguez-Abreu
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Roberto Serna-Blasco
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Raquel Benítez
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Carlos Aguado de la Rosa
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Ramón Palmero
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Florentino Hernando-Trancho
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Javier Martín-López
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Alberto Cruz-Bermúdez
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Bartomeu Massuti
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
| | - Atocha Romero
- From Hospital Universitario Puerta de Hierro-Majadahonda (M.P., V.C., R.S.-B., J.M.-L., A.C.-B., A.R.), Hospital Universitario Clínico San Carlos (J.L.G.-L., C.A.R., F.H.-T.), Hospital Universitario 12 de Octubre (S.P.), Hospital Universitario La Paz (J.C.), and the Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (R. Benítez), Madrid, Institut Català d'Oncologia, L'Hospitalet de Llobregat (E.N., R.P.), Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebrón (A.M.-M.), the Medical Oncology Department Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumors, Institut de Investigacions Biomèdiques (N.R.), and Instituto Oncológico Dr. Rosell, Dexeus University Hospital (A.A.), Barcelona, Hospital Universitario Virgen del Rocio, Seville (R. Bernabé), Institut Català d'Oncologia, Hospital Universitari Dr. Josep Trueta, Girona (J.B.-B.), Complejo Hospitalario Universitario de Vigo, Pontevedra (J.C.-R.), Fundación Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Valencia (A.I.), and Hospital General Universitario de Valencia, Universidad de Valencia and Centro de Investigación Biomédica en Red Cáncer (C.C.), Valencia, Complejo Hospitalario Universitario A Coruña, A Coruña (J.M.), the Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, Instituto de Investigación Biomédica de Málaga, Málaga (M.C.), Hospital Universitario Cruces, Barakaldo (G.L.V.), Hospital Clínico Universitario de Valladolid, Valladolid (R.L.-C.), the Medical Oncology Department, Catalan Institute of Oncology, Badalona-Germans Trias i Pujol Hospital, Badalona Applied Research Group in Oncology, Fundació Institut de Investigado de Ciences de la Salut Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona (T.M.), Hospital Universitario Reina Sofia, Córdoba (I.B.), Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), and Hospital Universitario Dr. Balmis Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante (B.M.) - all in Spain
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12
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Nadler E, Vasudevan A, Wentworth C, Robert N, Penrod JR, Fiore J, Vo L. Real-world relationship of early end points to survival end points in patients with resectable non-small-cell lung cancer. Future Oncol 2023; 19:1785-1800. [PMID: 37665271 DOI: 10.2217/fon-2023-0170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
Abstract
Aim: Pathologic response has been shown to be a promising surrogate for survival in non-small-cell lung cancer. We examined the real-world relationship between these end points in patients with resectable stage IB-IIIA non-small-cell lung cancer receiving neoadjuvant chemotherapy/chemoradiotherapy (CT/CRT). Methods: Electronic health records/medical charts were analyzed. Overall and event-free survival (OS/EFS) were assessed by Kaplan-Meier stratified by pathologic response. Associations between the end points were assessed by Cox analyses. Results: A total of 425 patients were selected for the study; 147 and 278 received CT and CRT, respectively. Pathologic complete response (pCR) was associated with longer OS (adjusted HR = 0.50; 95% CI: 0.29-0.85) and EFS (adjusted HR = 0.44; 95% CI: 0.28-0.68) versus no pCR, and EFS was associated with OS (HR = 0.51, 95% CI: 0.38, 0.69). Conclusion: In patients receiving neoadjuvant CT/CRT, pCR and EFS were associated with improved survival in this real-world dataset.
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Affiliation(s)
- Eric Nadler
- Charles Sammons Cancer Center, Baylor University Medical Center, US Oncology Network, Dallas, TX 75246, USA
| | | | | | | | | | - Joseph Fiore
- Bristol Myers Squibb, Lawrenceville, NJ 08648, USA
| | - Lien Vo
- Bristol Myers Squibb, Lawrenceville, NJ 08648, USA
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13
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Wu Y, Verma V, Gay CM, Chen Y, Liang F, Lin Q, Wang J, Zhang W, Hui Z, Zhao M, Wang J, Chang JY. Neoadjuvant immunotherapy for advanced, resectable non-small cell lung cancer: A systematic review and meta-analysis. Cancer 2023; 129:1969-1985. [PMID: 36994945 DOI: 10.1002/cncr.34755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 02/16/2023] [Accepted: 02/22/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Neoadjuvant immunotherapy (nIT) is a rapidly emerging paradigm for advanced resectable non-small cell lung cancer (NSCLC). The objectives of this PRISMA/MOOSE/PICOD-guided systematic review and meta-analysis were (1) to assess the safety and efficacy of nIT, (2) to compare the safety and efficacy of neoadjuvant chemoimmunotherapy (nCIT) versus chemotherapy alone (nCT), and (3) to explore predictors of pathologic response with nIT and their association with outcomes. METHODS Eligibility was resectable stage I-III NSCLC and the receipt of programmed death-1/programmed cell death ligand-1 (PD-L1)/cytotoxic T-lymphocyte-associated antigen-4 inhibitors before resection; other forms and modalities of neoadjuvant and/or adjuvant therapies were allowed. For statistical analysis, the Mantel-Haenszel fixed-effect or random-effect model was used, depending on the heterogeneity (I2 ). RESULTS Sixty-six articles met the criteria (eight randomized studies, 39 prospective nonrandomized studies, and 19 retrospective studies). The pooled pathologic complete response (pCR) rate was 28.1%. The estimated grade ≥3 toxicity rate was 18.0%. Compared with nCT, nCIT achieved higher rates of pCR (odds ratio [OR], 7.63; 95% confidence interval [CI], 4.49-12.97; p < .001), progression-free survival (PFS) (hazard ratio [HR] 0.51; 95% CI, 0.38-0.67; p < .001), and overall survival (OS) (HR, 0.51; 95% CI, 0.36-0.74; p = .0003) but yielded similar toxicity rates (OR, 1.01; 95% CI, 0.67-1.52; p = .97). The results remained robust on sensitivity analysis when all retrospective publications were removed. pCR was associated with improved PFS (HR, 0.25; 0.15-0.43; p < .001) and OS (HR, 0.26; 95% CI, 0.10-0.67; p = .005). PD-L1 expressors (≥1%) were more likely to achieve a pCR (OR, 2.93; 95% CI, 1.22-7.03; p = .02). CONCLUSIONS In patients with advanced resectable NSCLC, neoadjuvant immunotherapy was safe and efficacious. nCIT improved pathologic response rates and PFS/OS over nCT, particularly in patients who had tumors that expressed PD-L1, without increasing toxicities. PLAIN LANGUAGE SUMMARY This meta-analysis of 66 studies showed that neoadjuvant immunotherapy for advanced resectable non-small cell lung cancer is safe and efficacious. Compared with chemotherapy alone, chemoimmunotherapy improved pathologic response rates and survival, particularly for patients who had tumors that expressed programmed cell death ligand-1, without increasing toxicities.
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Affiliation(s)
- Yajing Wu
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Hebei Clinical Research Center for Radiation Oncology, Shijiazhuang, China
| | - Vivek Verma
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Carl M Gay
- Department of Head/Neck and Thoracic Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Yujia Chen
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Hebei Clinical Research Center for Radiation Oncology, Shijiazhuang, China
| | - Fei Liang
- Department of Biostatistics, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qiang Lin
- Department of Oncology, North China Petroleum Bureau General Hospital, Hebei Medical University, Renqiu, China
| | - Jianing Wang
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Hebei Clinical Research Center for Radiation Oncology, Shijiazhuang, China
| | - Wei Zhang
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Hebei Clinical Research Center for Radiation Oncology, Shijiazhuang, China
| | - Zhouguang Hui
- Department of VIP Medical Services & Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical, Beijing, China
| | - Min Zhao
- Department of Oncology, Hebei Chest Hospital, Shijiazhuang, China
| | - Jun Wang
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Hebei Clinical Research Center for Radiation Oncology, Shijiazhuang, China
| | - Joe Y Chang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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14
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Soo CI, Ong DB, Chin KK, Sia LC, Munusamy V, Ibrahim NH, Loh TC, Tan JL, Poh ME, Wong CK, Pang YK, Liam CK. Pathological complete response in an advance stage IIIB non-small cell lung cancer secondary to neoadjuvant osimertinib targeted therapy: A case report and review of literature. Respirol Case Rep 2023; 11:e01181. [PMID: 37350988 PMCID: PMC10282595 DOI: 10.1002/rcr2.1181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 06/03/2023] [Indexed: 06/24/2023] Open
Abstract
Neoadjuvant chemotherapy is a therapeutic option for potentially resectable non-small cell lung cancer (NSCLC). The role of neoadjuvant targeted therapy (NTT) remains less explored. This case highlights the use of neoadjuvant osimertinib in a case of advanced NSCLC. A 67-year-old woman had a left lower lobe lung mass measuring 5.0 × 5.1 × 7.0 cm with an enlarged subcarinal lymph node (LN) on her positron emission tomography scan. Following biopsy, a diagnosis of stage IIIB N2 (cT3N2M0) EGFR exon 19 deletion mutation-positive lung adenocarcinoma was established. NTT using osimertinib 80 mg once daily was commenced. Subsequent re-imaging at 3 months (ycT2bN2M0), 6 months (ycT1cN2M0) and 9 months showed tumour downstaging and resolution of the subcarinal LN (ycT1cN0M0). She underwent left lower lobectomy with systematic nodal dissection. All surgical specimens demonstrated no evidence of malignant cells (ypT0N0). Osimertinib could be the preferred NTT for potentially resectable NSCLC.
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Affiliation(s)
- Chun Ian Soo
- Division of Respiratory Medicine, Department of MedicineUniversity MalayaKuala LumpurMalaysia
| | | | - Ka Kiat Chin
- Division of Respiratory Medicine, Department of MedicineUniversity MalayaKuala LumpurMalaysia
| | - Leng Cheng Sia
- Division of Respiratory Medicine, Department of MedicineUniversity MalayaKuala LumpurMalaysia
| | - Vijayan Munusamy
- Division of Respiratory Medicine, Department of MedicineUniversity MalayaKuala LumpurMalaysia
| | - Nur Husna Ibrahim
- Division of Respiratory Medicine, Department of MedicineUniversity MalayaKuala LumpurMalaysia
| | - Thian Chee Loh
- Division of Respiratory Medicine, Department of MedicineUniversity MalayaKuala LumpurMalaysia
| | - Jiunn Liang Tan
- Division of Respiratory Medicine, Department of MedicineUniversity MalayaKuala LumpurMalaysia
| | - Mau Ern Poh
- Division of Respiratory Medicine, Department of MedicineUniversity MalayaKuala LumpurMalaysia
| | - Chee Kuan Wong
- Division of Respiratory Medicine, Department of MedicineUniversity MalayaKuala LumpurMalaysia
| | - Yong Kek Pang
- Division of Respiratory Medicine, Department of MedicineUniversity MalayaKuala LumpurMalaysia
| | - Chong Kin Liam
- Division of Respiratory Medicine, Department of MedicineUniversity MalayaKuala LumpurMalaysia
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15
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Blakely CM, Weder W, Bubendorf L, He J, Majem M, Shyr Y, Chaft JE. Primary endpoints to assess the efficacy of novel therapeutic approaches in epidermal growth factor receptor-mutated, surgically resectable non-small cell lung cancer: A review. Lung Cancer 2023; 177:59-72. [PMID: 36736076 DOI: 10.1016/j.lungcan.2023.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/20/2022] [Accepted: 01/01/2023] [Indexed: 01/04/2023]
Abstract
While the discovery of oncogenic driver mutations has personalized the metastatic non-small cell lung cancer (NSCLC) treatment landscape with effective targeted therapies, implementation of new treatments in resectable NSCLC has been limited due to the long follow-up needed for overall survival (OS). Until recently, treatment for patients with early-stage resectable NSCLC has been limited to perioperative chemotherapy, which provides modest benefits. However, the regulatory acceptance of two surrogate endpoints for OS has allowed recent approval of both adjuvant osimertinib and atezolizumab, providing patients with new treatment options to improve outcomes. In phase 3 oncology trials, OS has historically been viewed as the gold-standard efficacy measure, but disease-free survival and event-free survival (EFS) are now validated surrogate endpoints for OS in clinical trials and should be considered when mature OS data is unavailable. Another potential surrogate endpoint in the adjuvant NSCLC setting is circulating tumor DNA (ctDNA)-based minimal residual disease (MRD), although prospective validation is needed. For neoadjuvant targeted therapies, EFS, major pathologic response and ctDNA-based MRD are potential surrogate endpoints. To fully translate the success of the personalized treatment advances in the metastatic setting to earlier-stage disease, prospective validation studies of these potential surrogate endpoints that can accelerate the evaluation of drug efficacy are needed. A collaborative effort is also needed from all clinical and regulatory parties to collate surrogate endpoint data for large-scale validation. In this review we discuss the trends in surrogate endpoints used in oncology trials, with a focus on considerations for selecting appropriate primary endpoints in early-stage resectable EGFR-mutant NSCLC, an area of unmet need for novel treatment options.
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Affiliation(s)
- Collin M Blakely
- Department of Medicine and Helen Diller Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Walter Weder
- Department of Thoracic Surgery, University of Zurich (director Emeritus), Thoraxchirurgie, Klinik Bethanien, Zürich, Switzerland
| | - Lukas Bubendorf
- Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Switzerland
| | - Jianxing He
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Margarita Majem
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Yu Shyr
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jamie E Chaft
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY 10021, USA.
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16
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Yan W, Zhong WZ, Liu YH, Chen Q, Xing W, Zhang Q, Liu L, Ge D, Chen K, Yang F, Lin X, Song L, Shi W, Wu YL. Adebrelimab (SHR-1316) in Combination With Chemotherapy as Perioperative Treatment in Patients With Resectable Stage II to III NSCLCs: An Open-Label, Multicenter, Phase 1b Trial. J Thorac Oncol 2023; 18:194-203. [PMID: 36191882 DOI: 10.1016/j.jtho.2022.09.222] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/15/2022] [Accepted: 09/20/2022] [Indexed: 01/25/2023]
Abstract
INTRODUCTION This study evaluated adebrelimab (a programmed death-ligand 1 antibody) plus nab-paclitaxel and carboplatin as perioperative treatment for resectable NSCLC. METHODS Eligible patients had resectable stage II to III NSCLCs without driver gene. Patients received neoadjuvant treatment with three cycles of intravenous adebrelimab (20 mg/kg on day 1), nab-paclitaxel (100 mg/m2 on days 1, 8, and 15), and carboplatin (area under the curve 5 mg/mL per min on day 1), of each 21-day cycle before surgical resection, and followed by 16 cycles of adebrelimab (20 mg/kg on day 1 in 3 wk) adjuvant treatment. The primary end point was major pathologic response (MPR) per blinded independent pathologic review. RESULTS A total of 37 patients were enrolled and received planned neoadjuvant therapy. There were 34 patients (91.9%) who underwent surgery. As of data cutoff on January 25, 2022, 19 of the 37 patients (51.4%, 95% confidence interval [CI]: 35.9-66.6) achieved MPR per blinded independent pathologic review and 11 patients (29.7%, 95% CI: 17.5-45.8) achieved pathologic complete response. Furthermore, 26 patients (70.3%, 95% CI: 54.2-82.5) had an objective response per Response Evaluation Criteria in Solid Tumors version 1.1. The 12-month event-free survival rate was 77.8% (95% CI: 54.1-90.3). In addition, 29 patients (78.4%) had grade greater than or equal to three treatment-related adverse events (AEs) and nine (24.3%) had treatment-related serious AEs. No treatment-related deaths occurred. Grade greater than or equal to three surgery-related AEs within 30 or 90 days after surgery were both reported in five patients (14.7%). CONCLUSIONS Adebrelimab plus nab-paclitaxel and carboplatin as perioperative therapy led to a substantial proportion of MPR and high resectability, with manageable toxicities. On the basis of the phase 1b results, phase 3 trial was initiated.
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Affiliation(s)
- Wanpu Yan
- Department of Thoracic Oncology I, Beijing Cancer Hospital, Beijing, People's Republic of China
| | - Wen-Zhao Zhong
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital & Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China
| | - Yan-Hui Liu
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital & Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China
| | - Qixun Chen
- Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Wenqun Xing
- Thoracic Surgery Ward, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, People's Republic of China
| | - Qin Zhang
- Department of Thoracic Surgery, Jiangsu Cancer Hospital, Nanjing, People's Republic of China
| | - Lunxu Liu
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Di Ge
- Thoracic Surgery, Zhongshan Hospital Fudan University, Shanghai, People's Republic of China
| | - Keneng Chen
- Department of Thoracic Oncology I, Beijing Cancer Hospital, Beijing, People's Republic of China
| | - Fan Yang
- Thoracic Surgery, Peking University People's Hospital, Beijing, People's Republic of China
| | - Xiang Lin
- Jiangsu Hengrui Pharmaceuticals Co., Ltd., Shanghai, People's Republic of China
| | - Li Song
- Jiangsu Hengrui Pharmaceuticals Co., Ltd., Shanghai, People's Republic of China
| | - Wei Shi
- Jiangsu Hengrui Pharmaceuticals Co., Ltd., Shanghai, People's Republic of China
| | - Yi-Long Wu
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital & Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.
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17
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Fang M, Hang Q, Jiang H, Cai L, Hu J, Ying H, Gu Q, Yu X, Liu J, Lai X. Efficacy and safety evaluation of neoadjuvant immunotherapy plus chemotherapy for resectable non-small cell lung cancer in real world. Front Oncol 2023; 12:1055610. [PMID: 36713546 PMCID: PMC9877512 DOI: 10.3389/fonc.2022.1055610] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/19/2022] [Indexed: 01/13/2023] Open
Abstract
Objectives The combination of immunotherapy and chemotherapy has shown great efficacy in stage IV non-small cell lung cancer (NSCLC) and is now widely used in clinical treatment strategy. This study retrospectively analyzed the efficacy and safety of neoadjuvant immunotherapy plus chemotherapy for resectable NSCLC in real world. Methods We retrospectively analyzed patients with NSCLC who received neoadjuvant immunotherapy plus chemotherapy and underwent complete tumor resection in Zhejiang Cancer Hospital between January 2019 and January 2021. Tumor staging was based on the eighth TNM classification system of the American Joint Committee on Cancer staging criteria. The safety and toxicity (including operative and postoperative complications) and the efficacy [including objective response rate (ORR), disease control rate (DCR), tumor major pathological remission (MPR), and pathological complete response (pCR)] were evaluated. Results In total, 368 patients with NSCLC were administered with neoadjuvant immunotherapy. Of them, 211 patients were included in this retrospective study. Most patients had stage II-III disease, with 75 (35.5%) and 88 (41.7%) patients diagnosed with clinical stages IIB and IIIA, respectively. A total of 206 patients (97.6%) received at least two doses of neoadjuvant immunotherapy plus chemotherapy. In addition, 121 patients (57.3%) have achieved MPR, and 80 patients (37.9%) have achieved pCR, with ORR at 69.2% and DCR at 97.7%. Treatment-related adverse events occurred in 46.4% of patients, and the incidence rate of grade 3 or 4 treatment-related adverse events was 13.3% (13/98). Moreover, adverse events of any grade of surgical complication occurred in 15.6% of patients. One-year disease-free survival was 80.6% (170/211). Conclusions Neoadjuvant immunotherapy plus chemotherapy has significant efficacy with a high pCR and tolerable adverse effects for patients with resectable stage II-III NSCLC in real world.
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Affiliation(s)
- Min Fang
- Department of Thoracic Radiotherapy, Zhejiang Cancer Hospital, Hangzhou, China,Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China,Zhejiang Key Laboratory of Radiation Oncology, Hangzhou, China
| | - Qingqing Hang
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Haitao Jiang
- Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China,Department of Radiology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Lei Cai
- Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China,Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou, China
| | - Jinlin Hu
- Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China,Department of Pathology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Hangjie Ying
- Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China,Zhejiang Cancer Institute, Zhejiang Cancer Hospital, Hangzhou, China
| | - Qing Gu
- Department of Thoracic Radiotherapy, Zhejiang Cancer Hospital, Hangzhou, China,Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Xiaofu Yu
- Department of Thoracic Radiotherapy, Zhejiang Cancer Hospital, Hangzhou, China,Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Jinshi Liu
- Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China,Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou, China,*Correspondence: Xiaojing Lai, ; Jinshi Liu,
| | - Xiaojing Lai
- Department of Thoracic Radiotherapy, Zhejiang Cancer Hospital, Hangzhou, China,Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China,*Correspondence: Xiaojing Lai, ; Jinshi Liu,
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Fei K, Guo G, Wang J, Wang Z, Wang Y, Hao X, Zhong J, Guo Q, Guo W, Su W, Zan L, Xu J, Tan F, Zhuang X, Duan J. Effectiveness of neoadjuvant immunochemotherapy compared to neoadjuvant chemotherapy in non-small cell lung cancer patients: Real-world data of a retrospective, dual-center study. Front Oncol 2023; 13:1145303. [PMID: 37064108 PMCID: PMC10098217 DOI: 10.3389/fonc.2023.1145303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/20/2023] [Indexed: 04/18/2023] Open
Abstract
Background Studying the application of neoadjuvant immunochemotherapy (NICT) in the real world and evaluating its effectiveness and safety in comparison with neoadjuvant chemotherapy (NCT) are critically important. Methods This study included the II-IIIB stage non-small cell lung cancer (NSCLC) patients receiving NCT with or without PD-1 inhibitors and undergoing surgery after neoadjuvant treatments between January 2019 to August 2022. The clinical characteristics and treatment outcomes were retrospectively reviewed and analyzed. Results A total of 66 patients receiving NICT and 101 patients receiving NCT were included in this study. As compared to NCT, NICT showed similar safety while not increasing the surgical difficulty. The ORR in the NICT and NCT groups was 74.2% and 53.5%, respectively, P = 0.009. A total of 44 patients (66.7%) in the NICT group and 21 patients (20.8%) in the NCT group showed major pathology response (MPR) (P <0.001). The pathology complete response (pCR) rate was also significantly higher in NICT group than that in NCT group (45.5% vs. 10.9%, P <0.001). After Propensity Score Matching (PSM), 42 pairs of patients were included in the analysis. The results showed no significant difference in the ORR between the two groups (52.3% vs. 43.2%, P = 0.118), and the proportions of MPR (76.2%) and pCR (50.0%) in NICT group were significantly higher than those of MPR (11.9%) and pCR (4.7%) in the NCT group (P <0.001). The patients with driver mutations might also benefit from NICT. Conclusions As compared to NCT, the NICT could significantly increase the proportions of patients with pCR and MPR without increasing the operation-related bleeding and operation time.
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Affiliation(s)
- Kailun Fei
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Gang Guo
- The Second Clinical Medical College of Shanxi Medical University, Taiyuan, China
- Department of Thoracic Surgery, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China
| | - Jie Wang
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhijie Wang
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Wang
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuezhi Hao
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jia Zhong
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qinxiang Guo
- Department of Medical Oncology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China
| | - Wei Guo
- Department of Medical Oncology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China
| | - Wenzhong Su
- Department of Medical Oncology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China
| | - Likun Zan
- Department of Pathology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China
| | - Jiaxi Xu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fengwei Tan
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Fengwei Tan, ; Xiaofei Zhuang, ; Jianchun Duan,
| | - Xiaofei Zhuang
- Department of Thoracic Surgery, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China
- Department of Cardiothoracic Surgery, Lvliang People’s Hospital, Lvliang, Shanxi, China
- *Correspondence: Fengwei Tan, ; Xiaofei Zhuang, ; Jianchun Duan,
| | - Jianchun Duan
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Medical Oncology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China
- *Correspondence: Fengwei Tan, ; Xiaofei Zhuang, ; Jianchun Duan,
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Shi L, Meng Q, Tong L, Li H, Dong Y, Su C, Liu Z. Pathologic response and safety to neoadjuvant PD-1 inhibitors and chemotherapy in resectable squamous non-small-cell Lung cancer. Front Oncol 2022; 12:956755. [PMID: 36313678 PMCID: PMC9614263 DOI: 10.3389/fonc.2022.956755] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 10/03/2022] [Indexed: 11/30/2022] Open
Abstract
Background Several randomized studies have shown that the combination of programmed cell death 1 (PD-1) inhibitor and chemotherapy is efficacious as a treatment for advanced non-small-cell lung cancer (NSCLC). However, in the neoadjuvant setting, there is scarce evidence of the effectiveness and safety of the combinations in squamous NSCLC. We conducted a retrospective study to evaluate neoadjuvant PD-1 inhibitor plus chemotherapy in resectable squamous NSCLC. Methods Patients from Beijing Chest Hospital, Capital Medical University, between October 2019 and October 2021, treated with PD-1 inhibitors and chemotherapy for resectable squamous NSCLC were retrospectively studied. The primary objectives were to assess the pathological tumor response and safety of neoadjuvant PD-1 inhibitors and chemotherapy. Results 63 patients with resectable squamous NSCLC stage IIA-IIIB were included. Two to four cycles of PD-1 inhibitors (37 cases with camrelizumab, 11 cases with toripalimab, 8 cases with tislelizumab, and 7 cases with sintilimab) and chemotherapy were administered prior to surgery. 42 patients (66.7%) achieved a major pathologic response (MPR), including 25 (39.7%) with a pathologic complete response (pCR). Twenty-one patients (33.3%) experienced grade 3 neoadjuvant treatment-related adverse events (TRAEs), and no patient had grade 4 or 5 TRAE. Conclusion Neoadjuvant PD-1 inhibitors and chemotherapy are feasible therapies for resectable squamous NSCLC. It was associated with a 66.7% MPR rate, 39.7% pCR rate, and tolerable toxicity.
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Affiliation(s)
- Liang Shi
- Department of Medical Oncology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Beijing, China
| | - Qiyi Meng
- Department of Medical Oncology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Beijing, China
| | - Li Tong
- Department of Medical Oncology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Beijing, China
| | - Hongxia Li
- Department of Medical Oncology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Beijing, China
| | - Yujie Dong
- Department of Pathology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Beijing, China
| | - Chongyu Su
- Department of Thoracic Surgery, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Beijing, China
| | - Zhe Liu
- Department of Medical Oncology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Beijing, China
- *Correspondence: Zhe Liu,
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20
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Association of Pathologic Complete Response and Long-Term Survival Outcomes Among Patients Treated With Neoadjuvant Chemotherapy or Chemoradiotherapy for NSCLC: A Meta-Analysis. JTO Clin Res Rep 2022; 3:100384. [PMID: 36118131 PMCID: PMC9472066 DOI: 10.1016/j.jtocrr.2022.100384] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/30/2022] [Accepted: 07/18/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Increased efforts to optimize outcomes for early stage NSCLC through the investigation of novel perioperative treatment strategies are ongoing. An emerging question is the role of pathologic response and its association with long-term clinical outcomes after neoadjuvant therapy. Methods To investigate the association of pathologic complete response (pCR) and event-free survival (EFS) and overall survival (OS), we performed a systematic review and meta-analysis identifying studies reporting on the prognostic impact of pCR after neoadjuvant chemotherapy or chemoradiotherapy. To evaluate this prognostic value, an aggregated data (AD) meta-analyses was conducted to estimate the pooled hazard ratios (HRs) of EFS and OS for pCR. Using reconstructed individual patient data (IPD), pooled Kaplan-Meier curves were obtained to estimate this association in a more granular fashion. Subgroup analyses were conducted to further explore the impacts of study-level characteristics. Results A total of 28 studies comprising 7011 patients were included in the AD meta-analysis, of which, IPD was available for 6274 patients from 24 studies. Results from our AD meta-analysis revealed a pooled pCR rate of 18% (95% confidence interval [CI]: 15%–21%), including significant improvements in OS (HR = 0.50, 95% CI: 0.45–0.56) and EFS (HR = 0.46, 95% CI: 0.37–0.57) on the basis of pCR status. Our IPD analysis revealed a 5-year OS rate of 63% (95% CI: 59.6–67.4) for patients with a pCR compared with 39% (95% CI: 34.5–44.5) for those without a pCR. Conclusions pCR after neoadjuvant chemotherapy plus or minus radiotherapy is associated with significant improvements in EFS and survival for patients with resectable NSCLC.
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Santana-Davila R. Chemo and Immuno-Therapeutic Options for Nonsmall Cell Lung Cancer Lung Cancer. Surg Clin North Am 2022; 102:493-498. [PMID: 35671769 DOI: 10.1016/j.suc.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Over the last decade, the use of immune checkpoint inhibitors (ICI) has dramatically changed the treatment paradigm and outcome of patients with nonsmall cell lung cancer (NSCLC) across all stages of the disease. In this review, we provide a concise history of the use of ICIs in the treatment of NSCLC and review discuss the data behind the different indications.
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Affiliation(s)
- Rafael Santana-Davila
- Fred Hutch Cancer Research Center, University of Washington, Seattle Cancer Care Alliance, 825 Eastlake Avenue East, Seattle, WA 98109, USA.
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22
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Forde PM, Spicer J, Lu S, Provencio M, Mitsudomi T, Awad MM, Felip E, Broderick SR, Brahmer JR, Swanson SJ, Kerr K, Wang C, Ciuleanu TE, Saylors GB, Tanaka F, Ito H, Chen KN, Liberman M, Vokes EE, Taube JM, Dorange C, Cai J, Fiore J, Jarkowski A, Balli D, Sausen M, Pandya D, Calvet CY, Girard N. Neoadjuvant Nivolumab plus Chemotherapy in Resectable Lung Cancer. N Engl J Med 2022; 386:1973-1985. [PMID: 35403841 PMCID: PMC9844511 DOI: 10.1056/nejmoa2202170] [Citation(s) in RCA: 879] [Impact Index Per Article: 439.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Neoadjuvant or adjuvant chemotherapy confers a modest benefit over surgery alone for resectable non-small-cell lung cancer (NSCLC). In early-phase trials, nivolumab-based neoadjuvant regimens have shown promising clinical activity; however, data from phase 3 trials are needed to confirm these findings. METHODS In this open-label, phase 3 trial, we randomly assigned patients with stage IB to IIIA resectable NSCLC to receive nivolumab plus platinum-based chemotherapy or platinum-based chemotherapy alone, followed by resection. The primary end points were event-free survival and pathological complete response (0% viable tumor in resected lung and lymph nodes), both evaluated by blinded independent review. Overall survival was a key secondary end point. Safety was assessed in all treated patients. RESULTS The median event-free survival was 31.6 months (95% confidence interval [CI], 30.2 to not reached) with nivolumab plus chemotherapy and 20.8 months (95% CI, 14.0 to 26.7) with chemotherapy alone (hazard ratio for disease progression, disease recurrence, or death, 0.63; 97.38% CI, 0.43 to 0.91; P = 0.005). The percentage of patients with a pathological complete response was 24.0% (95% CI, 18.0 to 31.0) and 2.2% (95% CI, 0.6 to 5.6), respectively (odds ratio, 13.94; 99% CI, 3.49 to 55.75; P<0.001). Results for event-free survival and pathological complete response across most subgroups favored nivolumab plus chemotherapy over chemotherapy alone. At the first prespecified interim analysis, the hazard ratio for death was 0.57 (99.67% CI, 0.30 to 1.07) and did not meet the criterion for significance. Of the patients who underwent randomization, 83.2% of those in the nivolumab-plus-chemotherapy group and 75.4% of those in the chemotherapy-alone group underwent surgery. Grade 3 or 4 treatment-related adverse events occurred in 33.5% of the patients in the nivolumab-plus-chemotherapy group and in 36.9% of those in the chemotherapy-alone group. CONCLUSIONS In patients with resectable NSCLC, neoadjuvant nivolumab plus chemotherapy resulted in significantly longer event-free survival and a higher percentage of patients with a pathological complete response than chemotherapy alone. The addition of nivolumab to neoadjuvant chemotherapy did not increase the incidence of adverse events or impede the feasibility of surgery. (Funded by Bristol Myers Squibb; CheckMate 816 ClinicalTrials.gov number, NCT02998528.).
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Affiliation(s)
- Patrick M Forde
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Jonathan Spicer
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Shun Lu
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Mariano Provencio
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Tetsuya Mitsudomi
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Mark M Awad
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Enriqueta Felip
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Stephen R Broderick
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Julie R Brahmer
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Scott J Swanson
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Keith Kerr
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Changli Wang
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Tudor-Eliade Ciuleanu
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Gene B Saylors
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Fumihiro Tanaka
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Hiroyuki Ito
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Ke-Neng Chen
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Moishe Liberman
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Everett E Vokes
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Janis M Taube
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Cecile Dorange
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Junliang Cai
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Joseph Fiore
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Anthony Jarkowski
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - David Balli
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Mark Sausen
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Dimple Pandya
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Christophe Y Calvet
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
| | - Nicolas Girard
- From the Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Kimmel Cancer Center, Baltimore (P.M.F., S.R.B., J.R.B., J.M.T.); McGill University Health Center (J.S.), and Centre Hospitalier de l'Université de Montréal (M.L.) - both in Montreal; Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai (S.L.), Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin (C.W.), and Peking University School of Oncology, Beijing Cancer Hospital, Beijing (K.-N.C.) - all in China; Hospital Universitario Puerta de Hierro, Madrid (M.P.); Kindai University Faculty of Medicine, Ohno-Higashi, Osaka-Sayama (T.M.), the University of Occupational and Environmental Health, Kitakyushu (F.T.), and Kanagawa Cancer Center, Yokohama (H.I.) - all in Japan; Dana-Farber Cancer Institute, Boston (M.M.A., S.J.S.); Vall d'Hebron Institute of Oncology, Barcelona (E.F.); Aberdeen Royal Infirmary, Aberdeen, United Kingdom (K.K.); Institutul Oncologic Prof. Dr. Ion Chiricuta and Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania (T.-E.C.); Charleston Oncology, Charleston, SC (G.B.S.); University of Chicago Medicine, Chicago (E.E.V.); Bristol Myers Squibb, Princeton, NJ (C.D., J.C., J.F., A.J., D.B., M.S., D.P., C.Y.C.); and Institut du Thorax Curie-Montsouris, Institut Curie, Paris (N.G.)
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Friedlaender A, Naidoo J, Luigi Banna G, Metro G, Forde P, Addeo A. Role and impact of immune checkpoint inhibitors in neoadjuvant treatment for NSCLC. Cancer Treat Rev 2022; 104:102350. [DOI: 10.1016/j.ctrv.2022.102350] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 12/25/2022]
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