Key clinical point: Platinum-doublet chemotherapy as the second-line treatment may offer an overall survival (OS) advantage over cytotoxic chemotherapy without platinum in relapsed patients with unresectable stage III non–small-cell lung cancer (NSCLC).

Major finding: The platinum group had a longer survival than the nonplatinum group (median OS 21.5 vs. 10.5 months; hazard ratio [HR] 0.54; P < .001). The platinum group also had longer survival than the nonplatinum group, when assessed from the beginning of chemoradiotherapy (median OS 34.9 vs. 21.8 months; HR 0.58; P = .001).

Study details: The data come from a retrospective cohort study that included 320 patients with unresectable stage III NSCLC from a Japanese lung cancer registry.

Disclosures: The study was funded by the Japan Society for Respiratory Endoscopy, Japanese Association for Thoracic Surgery, Japanese Association for Chest Surgery, Japanese Respiratory Society, and Japan Lung Cancer Society. E Miyawaki, K Takahashi, E Miyaoka, I Yoshino, and H Date did not report any disclosures. The other authors reported ties with one or more pharmaceutical companies.

Source: Miyawaki E et al. Efficacy of platinum agents for stage III non–small-cell lung cancer following platinum-based chemoradiotherapy: a retrospective study. BMC Cancer. 2022;22:342 (Mar 29). Doi: 10.1186/s12885-022-09441-3

Key clinical point: Platinum-doublet chemotherapy as the second-line treatment may offer an overall survival (OS) advantage over cytotoxic chemotherapy without platinum in relapsed patients with unresectable stage III non–small-cell lung cancer (NSCLC).

Major finding: The platinum group had a longer survival than the nonplatinum group (median OS 21.5 vs. 10.5 months; hazard ratio [HR] 0.54; P < .001). The platinum group also had longer survival than the nonplatinum group, when assessed from the beginning of chemoradiotherapy (median OS 34.9 vs. 21.8 months; HR 0.58; P = .001).

Study details: The data come from a retrospective cohort study that included 320 patients with unresectable stage III NSCLC from a Japanese lung cancer registry.

Disclosures: The study was funded by the Japan Society for Respiratory Endoscopy, Japanese Association for Thoracic Surgery, Japanese Association for Chest Surgery, Japanese Respiratory Society, and Japan Lung Cancer Society. E Miyawaki, K Takahashi, E Miyaoka, I Yoshino, and H Date did not report any disclosures. The other authors reported ties with one or more pharmaceutical companies.

Source: Miyawaki E et al. Efficacy of platinum agents for stage III non–small-cell lung cancer following platinum-based chemoradiotherapy: a retrospective study. BMC Cancer. 2022;22:342 (Mar 29). Doi: 10.1186/s12885-022-09441-3

Key clinical point: Platinum-doublet chemotherapy as the second-line treatment may offer an overall survival (OS) advantage over cytotoxic chemotherapy without platinum in relapsed patients with unresectable stage III non–small-cell lung cancer (NSCLC).

Major finding: The platinum group had a longer survival than the nonplatinum group (median OS 21.5 vs. 10.5 months; hazard ratio [HR] 0.54; P < .001). The platinum group also had longer survival than the nonplatinum group, when assessed from the beginning of chemoradiotherapy (median OS 34.9 vs. 21.8 months; HR 0.58; P = .001).

Study details: The data come from a retrospective cohort study that included 320 patients with unresectable stage III NSCLC from a Japanese lung cancer registry.

Disclosures: The study was funded by the Japan Society for Respiratory Endoscopy, Japanese Association for Thoracic Surgery, Japanese Association for Chest Surgery, Japanese Respiratory Society, and Japan Lung Cancer Society. E Miyawaki, K Takahashi, E Miyaoka, I Yoshino, and H Date did not report any disclosures. The other authors reported ties with one or more pharmaceutical companies.

Source: Miyawaki E et al. Efficacy of platinum agents for stage III non–small-cell lung cancer following platinum-based chemoradiotherapy: a retrospective study. BMC Cancer. 2022;22:342 (Mar 29). Doi: 10.1186/s12885-022-09441-3

Key clinical point: A Japanese real-world study found no overall survival (OS) benefit with adjuvant tegafur-uracil (UFT) chemotherapy compared with no chemotherapy in patients with completely resected stage I non–small-cell lung cancer (NSCLC).

Major finding: There was no significant difference in OS between the UFT and no chemotherapy groups (multivariate analysis: P = .3285; univariate analysis: P = .7554), with the exception of a subgroup with a tumor size of >3 cm and without ground-glass attenuation who benefitted from UFT (univariate analysis: hazard ratio 0.71; log-rank P = .0414).

Study details: In a real-world observational cohort study, patients treated with adjuvant UFT (n = 1549) were compared with those treated without any adjuvant chemotherapy (n = 3338).

Disclosures: The study was funded by Taiho Pharmaceutical. The authors reported ties with one or more pharmaceutical companies, including Taiho.

Source: Shukuya T et al. Efficacy of adjuvant chemotherapy with tegafur/uracil in patients with completely resected, node-negative non-small cell lung cancer – real-world data in the era of molecularly targeted agents and immunotherapy. JTO Clin Res Rep. 2022 (Apr 6). Doi:  10.1016/j.jtocrr.2022.100320

Key clinical point: A Japanese real-world study found no overall survival (OS) benefit with adjuvant tegafur-uracil (UFT) chemotherapy compared with no chemotherapy in patients with completely resected stage I non–small-cell lung cancer (NSCLC).

Major finding: There was no significant difference in OS between the UFT and no chemotherapy groups (multivariate analysis: P = .3285; univariate analysis: P = .7554), with the exception of a subgroup with a tumor size of >3 cm and without ground-glass attenuation who benefitted from UFT (univariate analysis: hazard ratio 0.71; log-rank P = .0414).

Study details: In a real-world observational cohort study, patients treated with adjuvant UFT (n = 1549) were compared with those treated without any adjuvant chemotherapy (n = 3338).

Disclosures: The study was funded by Taiho Pharmaceutical. The authors reported ties with one or more pharmaceutical companies, including Taiho.

Source: Shukuya T et al. Efficacy of adjuvant chemotherapy with tegafur/uracil in patients with completely resected, node-negative non-small cell lung cancer – real-world data in the era of molecularly targeted agents and immunotherapy. JTO Clin Res Rep. 2022 (Apr 6). Doi:  10.1016/j.jtocrr.2022.100320

Key clinical point: A Japanese real-world study found no overall survival (OS) benefit with adjuvant tegafur-uracil (UFT) chemotherapy compared with no chemotherapy in patients with completely resected stage I non–small-cell lung cancer (NSCLC).

Major finding: There was no significant difference in OS between the UFT and no chemotherapy groups (multivariate analysis: P = .3285; univariate analysis: P = .7554), with the exception of a subgroup with a tumor size of >3 cm and without ground-glass attenuation who benefitted from UFT (univariate analysis: hazard ratio 0.71; log-rank P = .0414).

Study details: In a real-world observational cohort study, patients treated with adjuvant UFT (n = 1549) were compared with those treated without any adjuvant chemotherapy (n = 3338).

Disclosures: The study was funded by Taiho Pharmaceutical. The authors reported ties with one or more pharmaceutical companies, including Taiho.

Source: Shukuya T et al. Efficacy of adjuvant chemotherapy with tegafur/uracil in patients with completely resected, node-negative non-small cell lung cancer – real-world data in the era of molecularly targeted agents and immunotherapy. JTO Clin Res Rep. 2022 (Apr 6). Doi:  10.1016/j.jtocrr.2022.100320

Key clinical point: Patients with lung cancer have a high prevalence of frailty, which significantly increases the risk for mortality compared with nonfrail patients with lung cancer.

Major finding: The prevalence of frailty in patients with lung cancer was 45% (95% CI 28%-61%). Frailty vs. no frailty in patients with lung cancer was associated with a 3-fold higher mortality risk (hazard ratio 3.02; P < .001).

Study details: The data come from a meta-analysis of 16 studies including 4183 patients with lung cancer (mean age 65-80.75 years).

Disclosures: The study received no funding. L Bencivenga reported receiving research grants from multiple organizations. The other authors reported no conflicts of interest.

Source: Komici K et al. Frailty in patients with lung cancer: A systematic review and meta-analysis. Chest. 2022 (Feb 22). Doi: 10.1016/j.chest.2022.02.027

Key clinical point: Patients with lung cancer have a high prevalence of frailty, which significantly increases the risk for mortality compared with nonfrail patients with lung cancer.

Major finding: The prevalence of frailty in patients with lung cancer was 45% (95% CI 28%-61%). Frailty vs. no frailty in patients with lung cancer was associated with a 3-fold higher mortality risk (hazard ratio 3.02; P < .001).

Study details: The data come from a meta-analysis of 16 studies including 4183 patients with lung cancer (mean age 65-80.75 years).

Disclosures: The study received no funding. L Bencivenga reported receiving research grants from multiple organizations. The other authors reported no conflicts of interest.

Source: Komici K et al. Frailty in patients with lung cancer: A systematic review and meta-analysis. Chest. 2022 (Feb 22). Doi: 10.1016/j.chest.2022.02.027

Key clinical point: Patients with lung cancer have a high prevalence of frailty, which significantly increases the risk for mortality compared with nonfrail patients with lung cancer.

Major finding: The prevalence of frailty in patients with lung cancer was 45% (95% CI 28%-61%). Frailty vs. no frailty in patients with lung cancer was associated with a 3-fold higher mortality risk (hazard ratio 3.02; P < .001).

Study details: The data come from a meta-analysis of 16 studies including 4183 patients with lung cancer (mean age 65-80.75 years).

Disclosures: The study received no funding. L Bencivenga reported receiving research grants from multiple organizations. The other authors reported no conflicts of interest.

Source: Komici K et al. Frailty in patients with lung cancer: A systematic review and meta-analysis. Chest. 2022 (Feb 22). Doi: 10.1016/j.chest.2022.02.027

Key clinical point: Adjuvant pembrolizumab boosts disease-free survival (DFS) in patients with early-stage non–small-cell lung cancer (NSCLC) after complete resection.

Major finding: DFS was 53.6 months in the pembrolizumab group vs. 42.0 months in the placebo group (hazard ratio 0.76; P = .0014). The DFS benefit was generally consistent across patients with programmed death ligand-1 tumor proportion score of <1%, 1%-49%, and ≥50%.

Study details: The data come from an interim analysis of the phase 3 PEARLS/KEYNOTE-091 trial, in which 1177 adults with stage IB, II, or IIIA NSCLC were randomly assigned to receive 200 mg pembrolizumab (n = 590) or placebo (n = 587) every 3 weeks.

Disclosures: The trial was funded by Merck Sharp & Dohme Corp. L Paz-Ares, MER O’Brien, U Dafni, K Oselin, D Isla, A Martinez-Marti, M Faehling, M Tsuboi, K Nakagawa, J Yang, SM Keller, RA Stahel, S Peters, and B Besse reported ties with one or more pharmaceutical companies, including Merck Sharp & Dohme. The other authors reported no conflicts of interest.

Source: Paz-Ares L et al. VP3-2022: Pembrolizumab (pembro) versus placebo for early-stage non-small cell lung cancer (NSCLC) following complete resection and adjuvant chemotherapy (chemo) when indicated: Randomized, triple-blind, phase III EORTC-1416-LCG/ETOP 8-15 – PEARLS/KEYNOTE-091 study. Ann Oncol. 2022;33(4):451-453 (Mar 17). Doi: 10.1016/j.annonc.2022.02.224

Key clinical point: Adjuvant pembrolizumab boosts disease-free survival (DFS) in patients with early-stage non–small-cell lung cancer (NSCLC) after complete resection.

Major finding: DFS was 53.6 months in the pembrolizumab group vs. 42.0 months in the placebo group (hazard ratio 0.76; P = .0014). The DFS benefit was generally consistent across patients with programmed death ligand-1 tumor proportion score of <1%, 1%-49%, and ≥50%.

Study details: The data come from an interim analysis of the phase 3 PEARLS/KEYNOTE-091 trial, in which 1177 adults with stage IB, II, or IIIA NSCLC were randomly assigned to receive 200 mg pembrolizumab (n = 590) or placebo (n = 587) every 3 weeks.

Disclosures: The trial was funded by Merck Sharp & Dohme Corp. L Paz-Ares, MER O’Brien, U Dafni, K Oselin, D Isla, A Martinez-Marti, M Faehling, M Tsuboi, K Nakagawa, J Yang, SM Keller, RA Stahel, S Peters, and B Besse reported ties with one or more pharmaceutical companies, including Merck Sharp & Dohme. The other authors reported no conflicts of interest.

Source: Paz-Ares L et al. VP3-2022: Pembrolizumab (pembro) versus placebo for early-stage non-small cell lung cancer (NSCLC) following complete resection and adjuvant chemotherapy (chemo) when indicated: Randomized, triple-blind, phase III EORTC-1416-LCG/ETOP 8-15 – PEARLS/KEYNOTE-091 study. Ann Oncol. 2022;33(4):451-453 (Mar 17). Doi: 10.1016/j.annonc.2022.02.224

Key clinical point: Adjuvant pembrolizumab boosts disease-free survival (DFS) in patients with early-stage non–small-cell lung cancer (NSCLC) after complete resection.

Major finding: DFS was 53.6 months in the pembrolizumab group vs. 42.0 months in the placebo group (hazard ratio 0.76; P = .0014). The DFS benefit was generally consistent across patients with programmed death ligand-1 tumor proportion score of <1%, 1%-49%, and ≥50%.

Study details: The data come from an interim analysis of the phase 3 PEARLS/KEYNOTE-091 trial, in which 1177 adults with stage IB, II, or IIIA NSCLC were randomly assigned to receive 200 mg pembrolizumab (n = 590) or placebo (n = 587) every 3 weeks.

Disclosures: The trial was funded by Merck Sharp & Dohme Corp. L Paz-Ares, MER O’Brien, U Dafni, K Oselin, D Isla, A Martinez-Marti, M Faehling, M Tsuboi, K Nakagawa, J Yang, SM Keller, RA Stahel, S Peters, and B Besse reported ties with one or more pharmaceutical companies, including Merck Sharp & Dohme. The other authors reported no conflicts of interest.

Source: Paz-Ares L et al. VP3-2022: Pembrolizumab (pembro) versus placebo for early-stage non-small cell lung cancer (NSCLC) following complete resection and adjuvant chemotherapy (chemo) when indicated: Randomized, triple-blind, phase III EORTC-1416-LCG/ETOP 8-15 – PEARLS/KEYNOTE-091 study. Ann Oncol. 2022;33(4):451-453 (Mar 17). Doi: 10.1016/j.annonc.2022.02.224

Key clinical point: A Dutch population-based study demonstrated the survival benefits of tyrosine kinase inhibitor (TKI) therapy in patients with stage IV non–small-cell lung cancer (NSCLC) harboring activating mutations in the epidermal growth factor receptor (EGFR) gene.

Major finding: The median overall survival ranged from 3.5 months in the EGFR- group aged >65 years (for whom TKI is not indicated) to 23.6 months in the EGFR+ group aged <50 years treated with TKIs. In the EGFR+ group, TKI use vs. nonuse reduced mortality risk by 53% (hazard ratio 0.47; 95% CI 0.42-0.51).

Study details: The data come from a retrospective cohort study that included 31,291 patients with nonsquamous stage IV NSCLC from the population-based Netherlands Cancer Registry.

Disclosures: The study received no funding. MJ Aarts, HJM Groen, and JGJV Aerts reported ties with one or more pharmaceutical companies. The other authors reported no conflicts of interest.

Source: ten Berge DMHJ et al. A population-based study describing characteristics, survival and the effect of TKI treatment on patients with EGFR mutated stage IV NSCLC in the Netherlands. Eur J Cancer. 2022;165:195-204 (Mar 3). Doi: 10.1016/j.ejca.2022.01.038

Key clinical point: A Dutch population-based study demonstrated the survival benefits of tyrosine kinase inhibitor (TKI) therapy in patients with stage IV non–small-cell lung cancer (NSCLC) harboring activating mutations in the epidermal growth factor receptor (EGFR) gene.

Major finding: The median overall survival ranged from 3.5 months in the EGFR- group aged >65 years (for whom TKI is not indicated) to 23.6 months in the EGFR+ group aged <50 years treated with TKIs. In the EGFR+ group, TKI use vs. nonuse reduced mortality risk by 53% (hazard ratio 0.47; 95% CI 0.42-0.51).

Study details: The data come from a retrospective cohort study that included 31,291 patients with nonsquamous stage IV NSCLC from the population-based Netherlands Cancer Registry.

Disclosures: The study received no funding. MJ Aarts, HJM Groen, and JGJV Aerts reported ties with one or more pharmaceutical companies. The other authors reported no conflicts of interest.

Source: ten Berge DMHJ et al. A population-based study describing characteristics, survival and the effect of TKI treatment on patients with EGFR mutated stage IV NSCLC in the Netherlands. Eur J Cancer. 2022;165:195-204 (Mar 3). Doi: 10.1016/j.ejca.2022.01.038

Key clinical point: A Dutch population-based study demonstrated the survival benefits of tyrosine kinase inhibitor (TKI) therapy in patients with stage IV non–small-cell lung cancer (NSCLC) harboring activating mutations in the epidermal growth factor receptor (EGFR) gene.

Major finding: The median overall survival ranged from 3.5 months in the EGFR- group aged >65 years (for whom TKI is not indicated) to 23.6 months in the EGFR+ group aged <50 years treated with TKIs. In the EGFR+ group, TKI use vs. nonuse reduced mortality risk by 53% (hazard ratio 0.47; 95% CI 0.42-0.51).

Study details: The data come from a retrospective cohort study that included 31,291 patients with nonsquamous stage IV NSCLC from the population-based Netherlands Cancer Registry.

Disclosures: The study received no funding. MJ Aarts, HJM Groen, and JGJV Aerts reported ties with one or more pharmaceutical companies. The other authors reported no conflicts of interest.

Source: ten Berge DMHJ et al. A population-based study describing characteristics, survival and the effect of TKI treatment on patients with EGFR mutated stage IV NSCLC in the Netherlands. Eur J Cancer. 2022;165:195-204 (Mar 3). Doi: 10.1016/j.ejca.2022.01.038

Key clinical point: The third-generation tyrosine kinase inhibitor (TKI) lorlatinib demonstrated real-world safety and effectiveness in patients with advanced ROS1-rearranged (ROS1+) non–small-cell lung cancer (NSCLC) after failure of at least one ROS1 TKI.

Major finding: Median progression-free survival was 7.1 (95% CI 5.0-9.9) months and median overall survival was 19.6 (95% CI 12.3-27.5) months. The overall response rate was 45% and the disease control rate was 82%. There were no new safety signals.

Study details: The data come from a retrospective real-world LORLATU cohort study that included patients with advanced ROS1+ NSCLC (n = 80) from a French expanded access program.

Disclosures: The study was funded by French Thoracic Cancer Intergroup and Pfizer. S Baldacci, B Besse, D Moro-Sibilot, J Cadranel, V Westeel, B Roch, and J Bennouna reported ties with one or more pharmaceutical companies, including Pfizer. The other authors reported no conflicts of interest.

Source: Girard N et al. Lorlatinib for advanced ROS1+ non–small-cell lung cancer: Results of the IFCT-1803 LORLATU study. ESMO Open. 2022;7(2):100418 (Feb 25). Doi: 10.1016/j.esmoop.2022.100418

Key clinical point: The third-generation tyrosine kinase inhibitor (TKI) lorlatinib demonstrated real-world safety and effectiveness in patients with advanced ROS1-rearranged (ROS1+) non–small-cell lung cancer (NSCLC) after failure of at least one ROS1 TKI.

Major finding: Median progression-free survival was 7.1 (95% CI 5.0-9.9) months and median overall survival was 19.6 (95% CI 12.3-27.5) months. The overall response rate was 45% and the disease control rate was 82%. There were no new safety signals.

Study details: The data come from a retrospective real-world LORLATU cohort study that included patients with advanced ROS1+ NSCLC (n = 80) from a French expanded access program.

Disclosures: The study was funded by French Thoracic Cancer Intergroup and Pfizer. S Baldacci, B Besse, D Moro-Sibilot, J Cadranel, V Westeel, B Roch, and J Bennouna reported ties with one or more pharmaceutical companies, including Pfizer. The other authors reported no conflicts of interest.

Source: Girard N et al. Lorlatinib for advanced ROS1+ non–small-cell lung cancer: Results of the IFCT-1803 LORLATU study. ESMO Open. 2022;7(2):100418 (Feb 25). Doi: 10.1016/j.esmoop.2022.100418

Key clinical point: The third-generation tyrosine kinase inhibitor (TKI) lorlatinib demonstrated real-world safety and effectiveness in patients with advanced ROS1-rearranged (ROS1+) non–small-cell lung cancer (NSCLC) after failure of at least one ROS1 TKI.

Major finding: Median progression-free survival was 7.1 (95% CI 5.0-9.9) months and median overall survival was 19.6 (95% CI 12.3-27.5) months. The overall response rate was 45% and the disease control rate was 82%. There were no new safety signals.

Study details: The data come from a retrospective real-world LORLATU cohort study that included patients with advanced ROS1+ NSCLC (n = 80) from a French expanded access program.

Disclosures: The study was funded by French Thoracic Cancer Intergroup and Pfizer. S Baldacci, B Besse, D Moro-Sibilot, J Cadranel, V Westeel, B Roch, and J Bennouna reported ties with one or more pharmaceutical companies, including Pfizer. The other authors reported no conflicts of interest.

Source: Girard N et al. Lorlatinib for advanced ROS1+ non–small-cell lung cancer: Results of the IFCT-1803 LORLATU study. ESMO Open. 2022;7(2):100418 (Feb 25). Doi: 10.1016/j.esmoop.2022.100418

Key clinical point: Higher vs. lower plasma levels of cell-free DNA (cfDNA) were associated with a greater proportion of lesions and progression events and worse survival in patients with advanced anaplastic lymphoma kinase gene-positive (ALK+) non–small-cell lung cancer (NSCLC).

Major finding: There was a positive correlation between plasma cfDNA levels and the number of lesions (Spearman’s correlation 0.30; P < .0001). Patients who had greater than the median vs. less than or equal to the median plasma levels of the cfDNA biomarker had a higher risk for disease progression events (alectinib group: adjusted hazard ratio [aHR] 2.04 [P = .0305]; crizotinib group: aHR 1.83 [P = .0169]) and mortality (alectinib group: HR 2.52 [P = .0333]; crizotinib group: HR 2.63 [P = .0096]).

Study details: The data come from an exploratory retrospective analysis including treatment-naive patients from the phase 3 ALEX trial who were randomly assigned to receive twice-daily 600 mg alectinib (n = 152) or 250 mg crizotinib (n = 151).

Disclosures: The study was funded by F. Hoffmann-La Roche Ltd. The authors reported ties with one or more pharmaceutical companies.

Source: Dziadziuszko R et al. Circulating cell-free DNA as a prognostic biomarker in patients with advanced ALK+ non–small cell lung cancer in the global phase III ALEX trial. Clin Cancer Res. 2022 (Mar 1)1. Doi: 10.1158/1078-0432.CCR-21-2840

Key clinical point: Higher vs. lower plasma levels of cell-free DNA (cfDNA) were associated with a greater proportion of lesions and progression events and worse survival in patients with advanced anaplastic lymphoma kinase gene-positive (ALK+) non–small-cell lung cancer (NSCLC).

Major finding: There was a positive correlation between plasma cfDNA levels and the number of lesions (Spearman’s correlation 0.30; P < .0001). Patients who had greater than the median vs. less than or equal to the median plasma levels of the cfDNA biomarker had a higher risk for disease progression events (alectinib group: adjusted hazard ratio [aHR] 2.04 [P = .0305]; crizotinib group: aHR 1.83 [P = .0169]) and mortality (alectinib group: HR 2.52 [P = .0333]; crizotinib group: HR 2.63 [P = .0096]).

Study details: The data come from an exploratory retrospective analysis including treatment-naive patients from the phase 3 ALEX trial who were randomly assigned to receive twice-daily 600 mg alectinib (n = 152) or 250 mg crizotinib (n = 151).

Disclosures: The study was funded by F. Hoffmann-La Roche Ltd. The authors reported ties with one or more pharmaceutical companies.

Source: Dziadziuszko R et al. Circulating cell-free DNA as a prognostic biomarker in patients with advanced ALK+ non–small cell lung cancer in the global phase III ALEX trial. Clin Cancer Res. 2022 (Mar 1)1. Doi: 10.1158/1078-0432.CCR-21-2840

Key clinical point: Higher vs. lower plasma levels of cell-free DNA (cfDNA) were associated with a greater proportion of lesions and progression events and worse survival in patients with advanced anaplastic lymphoma kinase gene-positive (ALK+) non–small-cell lung cancer (NSCLC).

Major finding: There was a positive correlation between plasma cfDNA levels and the number of lesions (Spearman’s correlation 0.30; P < .0001). Patients who had greater than the median vs. less than or equal to the median plasma levels of the cfDNA biomarker had a higher risk for disease progression events (alectinib group: adjusted hazard ratio [aHR] 2.04 [P = .0305]; crizotinib group: aHR 1.83 [P = .0169]) and mortality (alectinib group: HR 2.52 [P = .0333]; crizotinib group: HR 2.63 [P = .0096]).

Study details: The data come from an exploratory retrospective analysis including treatment-naive patients from the phase 3 ALEX trial who were randomly assigned to receive twice-daily 600 mg alectinib (n = 152) or 250 mg crizotinib (n = 151).

Disclosures: The study was funded by F. Hoffmann-La Roche Ltd. The authors reported ties with one or more pharmaceutical companies.

Source: Dziadziuszko R et al. Circulating cell-free DNA as a prognostic biomarker in patients with advanced ALK+ non–small cell lung cancer in the global phase III ALEX trial. Clin Cancer Res. 2022 (Mar 1)1. Doi: 10.1158/1078-0432.CCR-21-2840

Key clinical point: Pyrotinib-based therapy could prolong survival in patients with lapatinib-resistant, human epidermal growth factor receptor 2 positive (HER2+) metastatic breast cancer, including those with brain metastases and those who benefitted from prior lapatinib.

Major finding: The overall survival was not reached, and the median progression-free survival (PFS) was 8 months (95% CI 5.1-10.9) in the overall cohort and 7.1 (95% CI 5.6-8.6) months in patients with brain metastases. Patients who benefitted from lapatinib therapy ≥6 vs. <6 months prior had a longer PFS after pyrotinib treatment (P = .034). Diarrhea was the most common grade 3-4 adverse event (14.5%).

Study details: This real-world study included 76 patients with HER2+ metastatic breast cancer who received pyrotinib-based therapy after lapatinib progression.

Disclosures: This work was financially supported by the National Key Research and Development Program of China, High-level Innovation Team of Nanjing Medical University, and other sources. The authors declared no conflicts of interest.

Source: Hua Y et al. Treatment with pyrotinib-based therapy in lapatinib-resistant HER2-positive metastatic breast cancer: a multicenter real-world study. Ther Adv Med Oncol. 2022;14 :1-9 (Mar 24). Doi: 10.1177/17588359221085232

Key clinical point: Pyrotinib-based therapy could prolong survival in patients with lapatinib-resistant, human epidermal growth factor receptor 2 positive (HER2+) metastatic breast cancer, including those with brain metastases and those who benefitted from prior lapatinib.

Major finding: The overall survival was not reached, and the median progression-free survival (PFS) was 8 months (95% CI 5.1-10.9) in the overall cohort and 7.1 (95% CI 5.6-8.6) months in patients with brain metastases. Patients who benefitted from lapatinib therapy ≥6 vs. <6 months prior had a longer PFS after pyrotinib treatment (P = .034). Diarrhea was the most common grade 3-4 adverse event (14.5%).

Study details: This real-world study included 76 patients with HER2+ metastatic breast cancer who received pyrotinib-based therapy after lapatinib progression.

Disclosures: This work was financially supported by the National Key Research and Development Program of China, High-level Innovation Team of Nanjing Medical University, and other sources. The authors declared no conflicts of interest.

Source: Hua Y et al. Treatment with pyrotinib-based therapy in lapatinib-resistant HER2-positive metastatic breast cancer: a multicenter real-world study. Ther Adv Med Oncol. 2022;14 :1-9 (Mar 24). Doi: 10.1177/17588359221085232

Key clinical point: Pyrotinib-based therapy could prolong survival in patients with lapatinib-resistant, human epidermal growth factor receptor 2 positive (HER2+) metastatic breast cancer, including those with brain metastases and those who benefitted from prior lapatinib.

Major finding: The overall survival was not reached, and the median progression-free survival (PFS) was 8 months (95% CI 5.1-10.9) in the overall cohort and 7.1 (95% CI 5.6-8.6) months in patients with brain metastases. Patients who benefitted from lapatinib therapy ≥6 vs. <6 months prior had a longer PFS after pyrotinib treatment (P = .034). Diarrhea was the most common grade 3-4 adverse event (14.5%).

Study details: This real-world study included 76 patients with HER2+ metastatic breast cancer who received pyrotinib-based therapy after lapatinib progression.

Disclosures: This work was financially supported by the National Key Research and Development Program of China, High-level Innovation Team of Nanjing Medical University, and other sources. The authors declared no conflicts of interest.

Source: Hua Y et al. Treatment with pyrotinib-based therapy in lapatinib-resistant HER2-positive metastatic breast cancer: a multicenter real-world study. Ther Adv Med Oncol. 2022;14 :1-9 (Mar 24). Doi: 10.1177/17588359221085232

Key clinical point: In patients with pT1aN0M0, human epidermal growth factor receptor 2 positive (HER2+) invasive breast cancer adding systemic therapy after surgical excision had clinical outcomes similar to local therapy alone.

Major finding: Overall survival was similar in all patients with pT1aN0M0 HER2-positive breast cancer who received local therapy+systemic therapy or only local therapy (P = .206), including the matched cohort of patients with hormone receptor positive (P = .107) and negative (P = .369) breast cancer.

Study details: This retrospective cohort study included 8948 patients with HER2+, pT1aN0M0 breast cancer, of which 4026 patients received local therapy only and 4922 patients received local therapy+adjuvant chemotherapy/HER2 therapy.

Disclosures: This study did not report any source of funding. CW Towe declared serving as consultant, providing expert testimony, and receiving research funding from several sources.

Source: Cao L et al. A comparison of local therapy alone with local plus systemic therapy for stage I pT1aN0M0 HER2+ breast cancer: A National Cancer Database analysis. Cancer. 2022 (Apr 1). Doi: 10.1002/cncr.34200

Key clinical point: In patients with pT1aN0M0, human epidermal growth factor receptor 2 positive (HER2+) invasive breast cancer adding systemic therapy after surgical excision had clinical outcomes similar to local therapy alone.

Major finding: Overall survival was similar in all patients with pT1aN0M0 HER2-positive breast cancer who received local therapy+systemic therapy or only local therapy (P = .206), including the matched cohort of patients with hormone receptor positive (P = .107) and negative (P = .369) breast cancer.

Study details: This retrospective cohort study included 8948 patients with HER2+, pT1aN0M0 breast cancer, of which 4026 patients received local therapy only and 4922 patients received local therapy+adjuvant chemotherapy/HER2 therapy.

Disclosures: This study did not report any source of funding. CW Towe declared serving as consultant, providing expert testimony, and receiving research funding from several sources.

Source: Cao L et al. A comparison of local therapy alone with local plus systemic therapy for stage I pT1aN0M0 HER2+ breast cancer: A National Cancer Database analysis. Cancer. 2022 (Apr 1). Doi: 10.1002/cncr.34200

Key clinical point: In patients with pT1aN0M0, human epidermal growth factor receptor 2 positive (HER2+) invasive breast cancer adding systemic therapy after surgical excision had clinical outcomes similar to local therapy alone.

Major finding: Overall survival was similar in all patients with pT1aN0M0 HER2-positive breast cancer who received local therapy+systemic therapy or only local therapy (P = .206), including the matched cohort of patients with hormone receptor positive (P = .107) and negative (P = .369) breast cancer.

Study details: This retrospective cohort study included 8948 patients with HER2+, pT1aN0M0 breast cancer, of which 4026 patients received local therapy only and 4922 patients received local therapy+adjuvant chemotherapy/HER2 therapy.

Disclosures: This study did not report any source of funding. CW Towe declared serving as consultant, providing expert testimony, and receiving research funding from several sources.

Source: Cao L et al. A comparison of local therapy alone with local plus systemic therapy for stage I pT1aN0M0 HER2+ breast cancer: A National Cancer Database analysis. Cancer. 2022 (Apr 1). Doi: 10.1002/cncr.34200

Key clinical point: Imaging can be dependably used for estimating the size of clinical T1 tumors to plan lumpectomy; however, overestimation by preoperative imaging size (PIS) should be considered for larger tumors.

Major finding: Significant correlation was observed between PIS and postoperative pathology size (PPS), highest when estimated with ultrasound (correlation coefficient [r] 0.628) followed by mammography (r 0.571; both P < .001). Although ultrasound underestimated T1 (mean difference between PIS and PPS [MD] −3.47 mm; 95% CI −4.02 to −2.91 mm) and T2 (MD −2.20 mm; 95% CI −3.39 to −1.02 mm) tumors, mammogram underestimated T1 tumors (MD −2.91; 95% CI −3.51 to −2.32) and overestimated T2 tumors (MD 0.90; 95% CI −0.44 to 2.24), all within the range of concordance.

Study details: This study identified 1512 tumors in 1502 patients with invasive breast cancer who underwent their first surgery.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Kapur H et al. Accuracy of preoperative imaging estimates: Opportunities to de-escalate surgery for early invasive breast cancer. Am J Surg. 2022 (Mar 30). Doi:  10.1016/j.amjsurg.2022.03.053

Key clinical point: Imaging can be dependably used for estimating the size of clinical T1 tumors to plan lumpectomy; however, overestimation by preoperative imaging size (PIS) should be considered for larger tumors.

Major finding: Significant correlation was observed between PIS and postoperative pathology size (PPS), highest when estimated with ultrasound (correlation coefficient [r] 0.628) followed by mammography (r 0.571; both P < .001). Although ultrasound underestimated T1 (mean difference between PIS and PPS [MD] −3.47 mm; 95% CI −4.02 to −2.91 mm) and T2 (MD −2.20 mm; 95% CI −3.39 to −1.02 mm) tumors, mammogram underestimated T1 tumors (MD −2.91; 95% CI −3.51 to −2.32) and overestimated T2 tumors (MD 0.90; 95% CI −0.44 to 2.24), all within the range of concordance.

Study details: This study identified 1512 tumors in 1502 patients with invasive breast cancer who underwent their first surgery.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Kapur H et al. Accuracy of preoperative imaging estimates: Opportunities to de-escalate surgery for early invasive breast cancer. Am J Surg. 2022 (Mar 30). Doi:  10.1016/j.amjsurg.2022.03.053

Key clinical point: Imaging can be dependably used for estimating the size of clinical T1 tumors to plan lumpectomy; however, overestimation by preoperative imaging size (PIS) should be considered for larger tumors.

Major finding: Significant correlation was observed between PIS and postoperative pathology size (PPS), highest when estimated with ultrasound (correlation coefficient [r] 0.628) followed by mammography (r 0.571; both P < .001). Although ultrasound underestimated T1 (mean difference between PIS and PPS [MD] −3.47 mm; 95% CI −4.02 to −2.91 mm) and T2 (MD −2.20 mm; 95% CI −3.39 to −1.02 mm) tumors, mammogram underestimated T1 tumors (MD −2.91; 95% CI −3.51 to −2.32) and overestimated T2 tumors (MD 0.90; 95% CI −0.44 to 2.24), all within the range of concordance.

Study details: This study identified 1512 tumors in 1502 patients with invasive breast cancer who underwent their first surgery.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Kapur H et al. Accuracy of preoperative imaging estimates: Opportunities to de-escalate surgery for early invasive breast cancer. Am J Surg. 2022 (Mar 30). Doi:  10.1016/j.amjsurg.2022.03.053