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Sebri V, Marzorati C, Dorangricchia P, Monzani D, Grasso R, Prelaj A, Provenzano L, Mazzeo L, Dumitrascu AD, Sonnek J, Szewczyk M, Watermann I, Trovò F, Dollis N, Sarris E, Garassino MC, Bestvina CM, Pedrocchi A, Ambrosini E, Kosta S, Felip E, Soleda M, Roca AA, Rodríguez‐Morató J, Nuara A, Lourie Y, Fernandez‐Pinto M, Aguaron A, Pravettoni G. The impact of decision tools during oncological consultation with lung cancer patients: A systematic review within the I3LUNG project. Cancer Med 2024; 13:e7159. [PMID: 38741546 PMCID: PMC11091486 DOI: 10.1002/cam4.7159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/17/2024] [Accepted: 03/22/2024] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION To date, lung cancer is one of the most lethal diagnoses worldwide. A variety of lung cancer treatments and modalities are available, which are generally presented during the patient and doctor consultation. The implementation of decision tools to facilitate patient's decision-making and the management of their healthcare process during medical consultation is fundamental. Studies have demonstrated that decision tools are helpful to promote health management and decision-making of lung cancer patients during consultations. The main aim of the present work within the I3LUNG project is to systematically review the implementation of decision tools to facilitate medical consultation about oncological treatments for lung cancer patients. METHODS In the present study, we conducted a systematic review following the PRISMA guidelines. We used an electronic computer-based search involving three databases, as follows: Embase, PubMed, and Scopus. 10 articles met the inclusion criteria and were included. They explicitly refer to decision tools in the oncological context, with lung cancer patients. RESULTS The discussion highlights the most encouraging results about the positive role of decision aids during medical consultations about oncological treatments, especially regarding anxiety, decision-making, and patient knowledge. However, no one main decision aid tool emerged as essential. Opting for a more recent timeframe to select eligible articles might shed light on the current array of decision aid tools available. CONCLUSION Future review efforts could utilize alternative search strategies to explore other lung cancer-specific outcomes during medical consultations for treatment decisions and the implementation of decision aid tools. Engaging with experts in the fields of oncology, patient decision-making, or health communication could provide valuable insights and recommendations for relevant literature or research directions that may not be readily accessible through traditional search methods. The development of guidelines for future research were provided with the aim to promote decision aids focused on patients' needs.
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Affiliation(s)
- Valeria Sebri
- Applied Research Division for Cognitive and Psychological ScienceIEO, European Institute of Oncology IRCCSMilanItaly
| | - Chiara Marzorati
- Applied Research Division for Cognitive and Psychological ScienceIEO, European Institute of Oncology IRCCSMilanItaly
| | - Patrizia Dorangricchia
- Applied Research Division for Cognitive and Psychological ScienceIEO, European Institute of Oncology IRCCSMilanItaly
| | - Dario Monzani
- Laboratory of Behavioral Observation and Research on Human Development, Department of Psychology, Educational Science and Human MovementUniversity of PalermoPalermoItaly
| | - Roberto Grasso
- Applied Research Division for Cognitive and Psychological ScienceIEO, European Institute of Oncology IRCCSMilanItaly
- Department of Oncology and Hemato‐OncologyUniversity of MilanMilanItaly
| | - Arsela Prelaj
- Thoracic Oncology Unit, Medical Oncology Department 1Fondazione IRCCS Istituto Nazionale TumoriMilanItaly
- Department of Electronics, Information, and BioengineeringPolitecnico di MilanoMilanItaly
| | - Leonardo Provenzano
- Medical Oncology DepartmentFondazione IRCCS Istituto Nazionale dei Tumori di MilanoMilanItaly
| | - Laura Mazzeo
- Thoracic Oncology Unit, Medical Oncology Department 1Fondazione IRCCS Istituto Nazionale TumoriMilanItaly
- Department of Electronics, Information, and BioengineeringPolitecnico di MilanoMilanItaly
| | - Andra Diana Dumitrascu
- Thoracic Oncology Unit, Medical Oncology Department 1Fondazione IRCCS Istituto Nazionale TumoriMilanItaly
| | - Jana Sonnek
- Lungen Clinic Grosshansdorf, Airway Research Center NorthGerman Center for Lung ResearchGrosshansdorfGermany
| | - Marlen Szewczyk
- Lungen Clinic Grosshansdorf, Airway Research Center NorthGerman Center for Lung ResearchGrosshansdorfGermany
| | - Iris Watermann
- Lungen Clinic Grosshansdorf, Airway Research Center NorthGerman Center for Lung ResearchGrosshansdorfGermany
| | | | | | | | - Marina Chiara Garassino
- Knapp Center for Biomedical DiscoveryUniversity of Chicago Medicine & Biological SciencesChicagoIllinoisUSA
| | - Christine M. Bestvina
- Knapp Center for Biomedical DiscoveryUniversity of Chicago Medicine & Biological SciencesChicagoIllinoisUSA
| | - Alessandra Pedrocchi
- Department of Electronics, Information and BioengineeringNeuroengineering and Medical Robotics Laboratory NearLabMilanItaly
| | - Emilia Ambrosini
- Department of Electronics, Information and BioengineeringNeuroengineering and Medical Robotics Laboratory NearLabMilanItaly
| | - Sokol Kosta
- Department of Electronic SystemsAalborg UniversityCopenhagenDenmark
| | - Enriqueta Felip
- Vall d'Hebron University HospitalBarcelonaSpain
- Vall d'Hebron Institute of OncologyBarcelonaSpain
| | | | | | | | | | | | | | | | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological ScienceIEO, European Institute of Oncology IRCCSMilanItaly
- Department of Oncology and Hemato‐OncologyUniversity of MilanMilanItaly
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Carbonell C, Frigola J, Pardo N, Callejo A, Iranzo P, Valdivia A, Priano I, Cedrés S, Martinez-Marti A, Navarro A, Lenza L, Soleda M, Gonzalo-Ruiz J, Vivancos A, Sansó M, Carcereny E, Morán T, Amat R, Felip E. Dynamic changes in circulating tumor DNA assessed by shallow whole-genome sequencing associate with clinical efficacy of checkpoint inhibitors in NSCLC. Mol Oncol 2023; 17:779-791. [PMID: 36852704 PMCID: PMC10158763 DOI: 10.1002/1878-0261.13409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/17/2023] [Accepted: 02/27/2023] [Indexed: 03/01/2023] Open
Abstract
Immune checkpoint inhibitors (ICIs) targeting the PD-1/PD-L1 axis are the main therapeutic option for patients with advanced non-small cell lung cancer (NSCLC) without a druggable oncogenic alteration. Nevertheless, only a portion of patients benefit from this type of treatment. Here, we assessed the value of shallow whole-genome sequencing (sWGS) on plasma samples to monitor ICI benefit. We applied sWGS on cell-free DNA (cfDNA) extracted from plasma samples of 45 patients with metastatic NSCLC treated with ICIs. Over 150 samples were obtained before ICI treatment initiation and at several time points throughout treatment. From sWGS data, we computed the tumor fraction (TFx) and somatic copy number alteration (SCNA) burden and associated them with ICI benefit and clinical features. TFx at baseline correlated with metastatic lesions at the bone and the liver, and high TFx (≥ 10%) associated with ICI benefit. Moreover, its assessment in on-treatment samples was able to better predict clinical efficacy, regardless of the TFx levels at baseline. Finally, for a subset of patients for whom SCNA burden could be computed, increased burden correlated with diminished benefit following ICI treatment. Thus, our data indicate that the analysis of cfDNA by sWGS enables the monitoring of two potential biomarkers-TFx and SCNA burden-of ICI benefit in a cost-effective manner, facilitating multiple serial-sample analyses. Larger cohorts will be needed to establish its clinical potential.
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Affiliation(s)
- Caterina Carbonell
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
| | - Joan Frigola
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
| | - Nuria Pardo
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Ana Callejo
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Patricia Iranzo
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Augusto Valdivia
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Ilaria Priano
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Susana Cedrés
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Alex Martinez-Marti
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Alejandro Navarro
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Laura Lenza
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
| | - Mireia Soleda
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
| | - Javier Gonzalo-Ruiz
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
| | - Ana Vivancos
- Cancer Genomics Laboratory, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
| | - Miriam Sansó
- Balearic Islands Health Research Institute (IdISBa), Palma de Mallorca, Spain
| | - Enric Carcereny
- Medical Oncology Department, Catalan Institute of Oncology Badalona, Hospital Universitari Germans Trias i Pujol, Badalona Applied Research Group in Oncology, Institut Germans Trias i Pujol, Barcelona, Spain
| | - Teresa Morán
- Medical Oncology Department, Catalan Institute of Oncology Badalona, Hospital Universitari Germans Trias i Pujol, Badalona Applied Research Group in Oncology, Institut Germans Trias i Pujol, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Spain
| | - Ramon Amat
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
| | - Enriqueta Felip
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
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Frigola J, Carbonell C, Iranzo P, Pardo N, Callejo A, Cedres S, Martinez-Marti A, Navarro A, Soleda M, Jimenez J, Hernandez-Losa J, Vivancos A, Felip E, Amat R. High levels of chromosomal aberrations negatively associate with benefit to checkpoint inhibition in NSCLC. J Immunother Cancer 2022; 10:jitc-2021-004197. [PMID: 35477861 PMCID: PMC9047699 DOI: 10.1136/jitc-2021-004197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) targeting the programmed cell death 1/programmed death-ligand 1 axis have transformed the management of advanced non-small cell lung cancer (NSCLC). However, many patients do not benefit from this type of treatment, and thus several molecular biomarkers of benefit have been explored. The value of somatic copy number alterations (SCNAs) burden remains elusive. PATIENTS AND METHODS We assembled a cohort of 109 patients with NSCLC treated with ICIs and available tumor samples. We performed shallow whole-genome sequencing on 89 patients to determine genome-wide SCNAs and targeted gene expression analysis on 63 patients to study immune infiltration. We analyzed SCNAs burden in different ways (ie, the fraction of the genome altered or number of events) and studied their association with ICIs benefit based on survival analysis. We correlated SCNAs burden and immune infiltration on 35 patients of our cohort and on patients with lung adenocarcinoma from The Cancer Genome Atlas (TCGA). RESULTS High SCNAs burden, computed in diverse ways, is negatively associated with ICIs progression-free survival (PFS), with the fraction of the genome altered (FGA) by arm and chromosome events showing the strongest association with PFS (p=0.002) (n=77). Nevertheless, we found differences in SCNAs across some clinicopathological features (sample site origin). A multivariate analysis adjusted for relevant characteristics showed that the FGA of arm and chromosome alterations was strongly associated with PFS (HR=2.21, p=3.3 x 10-5). Finally, we confirmed that SCNAs burden negatively correlates with tumor immune infiltration (n=35), although this correlation was not found for the males studied. Similar results were observed in the TCGA cohort. CONCLUSIONS SCNAs burden is a potential biomarker of benefit to ICIs in patients with NSCLC, although there appear to be some nuances worth consideration. Further studies will be needed to establish its role as a biomarker of benefit to ICIs.
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Affiliation(s)
- Joan Frigola
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Caterina Carbonell
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Patricia Iranzo
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Nuria Pardo
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Ana Callejo
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Susana Cedres
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Alex Martinez-Marti
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Alejandro Navarro
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Mireia Soleda
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Jose Jimenez
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Ana Vivancos
- Cancer Genomics Laboratory, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Enriqueta Felip
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Ramon Amat
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
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