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Duan R, Kwan M, Kordon A, Hu C, Vanjani N, Thomas TO, Patel JD, Yadav P, Abazeed M, Gharzai LA. Stage IIIA Non-Small Cell Lung Cancer Treatment and Outcomes: A Single Institution Retrospective Analysis. Int J Radiat Oncol Biol Phys 2023; 117:e16. [PMID: 37784754 DOI: 10.1016/j.ijrobp.2023.06.681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Treatment of locally advanced non-small cell lung cancer (NSCLC) remains challenging, with a multitude of treatment options available for Stage III patients. We hypothesized that Stage IIIA outcomes differ by treatment received. MATERIALS/METHODS We performed a retrospective review of NSCLC patients ≥18 years old with Stage IIIA disease treated 1/1/2010-03/01/2022. Demographics, treatment received, treatment outcomes, and failure patterns were collected. Progression-free survival (PFS) and overall survival (OS) were assessed using Kaplan-Meier analysis. Kruskal-Wallis ANOVA was used to compare groups. RESULTS Of 352 patients identified, 160 had Stage IIIA NSCLC with a median follow-up of 29.1 months. Patients had a median age of 63 years, 79 (49.4%) were male, and 137 (85.6%) were current/former smokers (with 30 median pack-years). Patients were treated as follows: 17 (11%) surgery alone (S), 91 (57%) definitive radiation ± chemotherapy (CRT), 52 (33%) neoadjuvant therapy followed by surgery (Neo). 6 (12%) of the Neo group received chemoimmunotherapy, and 21 (51%) of the 41 CRT patients received adjuvant immunotherapy. Between the three groups, there were no significant differences in tumor size as measured by T-staging (p = 0.83) and baseline FEV1/FVC (p = 0.92). Median PFS was 33.5mo (95% CI 13.2-NA) for group S, 18.4mo (95% CI 12.7-42.2) for CRT, and 19.7mo (95% CI 13.9-NA) for Neo with no significant intergroup difference (p = 0.72). Median OS was 33.5mo (95% CI 13.2-NA) for S, 48.7mo (95% CI 36.0-88.9) for CRT, and 50.9mo (95% CI 41.9-NA) for Neo with no significant intergroup difference (p = 0.94). Among the 17 primary surgical patients, 11 (65%) experienced failure: 6 (35%) local, 5 (29%) regional, and 7 (41%) distant. Among the 91 CRT patients, 57 (63%) experienced failure: 40 (44%) local, 35 (38%) regional, and 28 (31%) distant. Among the 52 Neo patients, 26 (50%) experienced failure: 14 (27%) local, 15 (29%) regional, and 17 (33%) distant. There were no significant differences in rates of local failure (p = 0.26), regional failure (p = 0.59), distant failure (p = 0.79), or any failure (p = 0.41) among the three treatment groups. The most common locations for distant failure were pleural effusions (n = 15, 29%), CNS (n = 14, 27%), and bone (n = 11, 21%). CONCLUSION In this single institution retrospective study, we find no significant differences in PFS, OS, and failure patterns between patients with Stage IIIA NSCLC treated with definitive (chemo)radiation and neoadjuvant therapy. Numeric improvement in PFS in surgery-only patients is consistent with expected patient selection of this group. Further work in the immunotherapy era is needed.
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Affiliation(s)
- R Duan
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - M Kwan
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - A Kordon
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - C Hu
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - N Vanjani
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - T O Thomas
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - J D Patel
- Lurie Cancer Center, Northwestern University-Feinberg School of Medicine, Chicago, IL
| | - P Yadav
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - M Abazeed
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - L A Gharzai
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
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Teo P, Randall J, Bajaj A, Lou B, Shah J, Gopalakrishnan M, Kamen A, Das I, Abazeed M. Lung Tumor Motion and its Impact on Deep Learning Prediction of Local Recurrence. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Saba N, Wong S, Stokes W, Rupji M, Liu Y, Rudra S, Bates J, Steuer C, Remick J, Cummings K, Joshi N, Woody N, Geiger J, Patel M, Schmitt N, El-Deiry M, Chen G, Wieland A, Abazeed M, Adelstein D, Ahmed R, Higgins K, Beitler J, Shin D, Curran W, McDonald M, Koyfman S. CA209-9KY: Phase II Study of IMRT Re-Irradiation and Concurrent/Adjuvant Nivolumab (Nivo) in Patients With Loco Regionally Recurrent or Second Primary Head and Neck Squamous Cell Carcinoma (HNSCC) ― Toxicity and Quality of Life (QoL) Results. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Chua M, Sim A, Ong E, Huang L, Low K, Tan T, Fong K, Lim S, Tan G, Lim T, Lim D, Iyer N, Wee J, Hwang J, Bei J, Abazeed M. An Immune-Based Genomic Classifier (GC) Prognosticates for Survival in Endemic Nasopharyngeal Carcinoma. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gopal P, Yard B, Petty A, Castrillon J, Patel J, Abazeed M. Genome-Scale and Systematic Variant Profiling Delineates the Radiogenomic Landscape of Cancer. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abazeed M, Bera T, Castrillon J, Petty A, Yard B, Gopal P. OC-0400 The mutational landscape of cancer’s sensitivity to ionizing radiation. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06887-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Yard B, Castrillon J, Petty A, Gopal P, Abazeed M. Mapping The Radiogenomic Atlas Of Cancer By Massively Parallel Reverse Genetic Profiling. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ong E, Sim A, Huang L, Low K, Yee WW, Susanti D, Wang H, Tan T, Fong K, Soong Y, Tan G, Lim T, Wee J, Lim D, Iyer N, Hwang J, Abazeed M, Bei J, Chua M. 267O Distinct phenotypes of locoregionally advanced (LA-NPC) harbor disparate survival outcomes and are associated with germline variants. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Yard B, Petty A, Castrillon J, Gopal P, Abazeed M. SP-0018: Genome-scale and systematic variant profiling delineates the radiogenomic landscape of cancer. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00044-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sedor G, Torres-Roca J, Abazeed M, Scott J. Classification of Radiosensitivity Index by Gaussian Mixture Modelling to Inform Radiotherapy Dose and Discover Disease Subclassifications. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Sarihan E, Koyfman S, Woody N, Matia B, Joshi N, Geiger J, Lamarre E, Prendes B, Ku J, Lorenz R, Scharpf J, Burkey B, Adelstein D, Abazeed M. Supplanting the Conventional Risk Groups of Oral Cavity Cancers with Gene Expression-Based Signatures. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Sharrett J, Sarihan E, Magnelli A, Woody N, Stephans K, Abazeed M. Anatomically Restricted Dose Escalated SBRT to the Pancreas Effects High Local Control and Rapid and Substantial Pain Relief. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Yard B, Petty A, Abazeed M. Systematic Annotation of Genetic Variants that Determine Sensitivity to Radiation: A Pan-Cancer Encyclopedia. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Rogacki K, Gopal P, Petty A, Peacock C, Abazeed M. Divison of Labor and Plasticity in a Phenotypically Diverse Intratumoral Ecosystem Promotes Therapeutic Resistance in Small Cell Lung Carcinoma. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Gopal P, Abazeed M. High-Throughput Phenotyping of BRAF Mutations Reveals Categories of Mutations That Confer Resistance to Radiation. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Grivas P, Koshkin V, Pettiford J, Atkins L, Elson P, Reynolds J, Magi-Galluzzi C, McKenney J, Isse K, Saunders L, Hu M, Fergany A, Haber G, Garcia J, Rini B, Stephenson A, Tendulkar R, Abazeed M, Mian O. Molecular Profiling of Small Cell Bladder Cancer Reveals Gene Expression Determinants of an Aggressive Phenotype. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Yard B, Abazeed M. Systematic Annotation of Genetic Variants That Confer Resistance to Radiation: A Pan-Cancer Encyclopedia. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Yard B, Adams D, Tamayo P, Hammerman P, Abazeed M. A Genetic Basis for Variation in the Vulnerability of Cancer to Ionizing Radiation. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Woody N, Stephans K, Andrews M, Zhuang T, Reddy C, Xia P, Videtic G, Abazeed M. A Biological Basis for Local Failure After Lung Stereotactic Body Radiation Therapy. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abazeed M, Yard B. Targeting the Achilles' Shield of Triple-Negative Breast Cancers by Androgen Blockade. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.2124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Shen Z, Andrews M, Balik S, Magnelli A, Stephans K, Videtic G, Abazeed M, Zhuang T, Xia P. SU-F-J-141: Real-Time Position Management (RPM) System as a Valuable Tool to Predict Tumor Position Deviation in SBRT Lung and Liver Patients with Breath Hold Using Active Breathing Coordinator (ABC). Med Phys 2016. [DOI: 10.1118/1.4956049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Andrews M, Abazeed M, Woody N, Stephans K, Videtic G, Xia P, Zhuang T. SU-F-R-20: Image Texture Features Correlate with Time to Local Failure in Lung SBRT Patients. Med Phys 2016. [DOI: 10.1118/1.4955792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Yard B, Chie E, Peacock C, Adams D, Tamayo P, Abazeed M. Integrative Radiotranscriptomic Analysis of Breast Carcinoma Identifies Androgen Receptor as a Target for Therapeutic Sensitization. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abazeed M, Adams D, Hammerman P, Tamayo P, Yard B, Meyerson M, Schreiber S. Systematic Investigation of Genetic Vulnerabilities Across Cancer Cell Lines Reveals Lineage Specific Radiotherapeutic Determinants. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kittel J, Funchain P, Chute D, Woody N, Hammerman P, Koyfman S, Abazeed M. Comprehensive Functional Genomic Profiling of HPV Unassociated Head and Neck Squamous Cell Cancer Identifies Neomorphic Mutations That Confer Resistance to Therapy. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abazeed M, Xu C, Adams D, Tamayo P, Loeffler J, Suh J, Meyerson M, Wong K, Hammerman P. NRF2 Is a Novel Oncogene and Biomarker of Therapeutic Resistance in Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abazeed M, Adams D, Hurov K, Tamayo P, Creighton C, Sonkin D, Giacomelli A, Schreiber S, Hammerman P, Meyerson M. Integrative Radiogenomic Profiling of Squamous Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abazeed M, Hammerman P, Creighton C, Adams D, Giacomelli A, Meyerson M. NRF2 Pathway Activation Regulates Radiation Resistance in Lung Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abazeed M, Niemierko A, Abazeed A, Loefller J, Oh K. Stereotactic Radiation Treatment in Recurrent High-grade Glioma. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Ahuja D, Geiger A, Ramanjulu JM, Vera MD, SirDeshpande B, Pfizenmayer A, Abazeed M, Krosky DJ, Beidler D, Joullié MM, Toogood PL. Inhibition of protein synthesis by didemnins: cell potency and SAR. J Med Chem 2000; 43:4212-8. [PMID: 11063617 DOI: 10.1021/jm000168v] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Synthetic and naturally occurring didemnins are potent and specific inhibitors of protein synthesis in vitro. Structure-activity analysis indicates a requirement for the intact macrocycle; however, the smaller ring size represented by the didemnin analogue, tamandarin A, is equipotent to didemnin B. Replacement of the N,O-dimethyltyrosine by a N-methylphenylalanine or N-methylleucine residue is also well-tolerated. The rank order for inhibition of protein synthesis in vitro appears to be retained in MCF-7 cells, albeit at much higher potency. This increase in potency is explained for the first time by data indicating that MCF-7 cells can accumulate didemnin B up to 2-3 orders of magnitude compared to the growth medium.
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Affiliation(s)
- D Ahuja
- Willard H. Dow Laboratory, Department of Chemistry, University of Michigan, Ann Arbor, Michigan 48109-1055, USA
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