Lung Cancer

Although cardiovascular disease (CVD) is known to often strike the mortal blow in patients with cancer, a national analysis puts in stark relief the burden of CV-related hospitalizations in this vulnerable population.

Results show that between 2004 and 2017, CV admissions increased 23.2% among patients with a cancer diagnosis, whereas admissions fell 10.9% among those without cancer.

Admissions increased steadily across all cancer types, except prostate cancer, with heart failure being the most common reason for admission.

“Hospital admissions is really important because we know that the size of this group is increasing, given that they live longer and many of the treatments that we offer cause cardiovascular disease or increase the risk of having cardiovascular events. So, from a health care planning perspective, I think it’s really important to see what the burden is likely to be in the next few years,” senior author Mamas Mamas, MD, Keele University, England, told this news organization.

For physicians and the wider population, he said, the findings underscore the need to shift the conversation from saying that patients with cancer are at increased CVD risk to asking how to mitigate this risk. “Because I would say that this increase in cardiovascular admissions, that’s a failure from a preventative perspective.”

The study was published in the European Heart Journal: Quality of Care & Clinical Outcomes.

Individual cancer types

The researchers, led by Ofer Kobo, MD, also with Keele University, used the National Inpatient Sample to identify 42.5 million weighted cases of CV admissions for acute myocardial infarction (AMI), pulmonary embolism, ischemic stroke, heart failure, atrial fibrillation (AFib) or atrial flutter, and intracranial hemorrhage from January 2004 to December 2017. Of these, 1.9 million had a record of cancer.

Patients with cancer were older; had a higher prevalence of valvular disease, anemia, and coagulopathy; and had a lower prevalence of hypertension, diabetes mellitus, and obesity than did patients without cancer.

The most common cancer type was hematologic cancers (26.1%), followed by lung (18.7%), gastrointestinal (12.4%), prostate (11.6%), breast (6.7%), and other in 24.4%.

The admission rate increased across all six admission causes – between 7% for AMI and ischemic stroke and 46% for AFib.

Heart failure was the chief reason for admission among all patients. Annual rates per 100,000 U.S. population increased in patients with cancer (from 13.6 to 16.6; P for trend = .02) and declined in those without (from 352.2 to 349.8; P for trend < .001).

“In the past, patients would be started on medications, and perhaps the importance of monitoring [left ventricular] LV function wasn’t as widely known, whereas now we’re much more aggressive in looking at it and much more aggressive at trying to prevent it,” Dr. Mamas said. “But even with this greater identification and attempting to modify regimens, we’re still getting quite substantial increases in heart failure admissions in this population. And what really surprised me is that it wasn’t just in the breast cancer population, but it was nearly across the board.”

He noted that patients are at highest risk from CV events within the first 2 years of cancer diagnosis. “So that’s really the time where you’ve got to be really aggressive in looking and working up their cardiovascular profile.”

Patients with hematologic cancers (9.7-13.5), lung (7.4-8.9), and gastrointestinal cancer (4.6-6.3) had the highest crude admission rates of CV hospitalizations per 100,000 U.S. population.

The CV admission rate went up from 2.5 to 3.7 per 100,000 U.S. population for breast cancer, and in prostate cancer, the rate dropped from 5.8 to 4.8 per 100,000 U.S. population.

Of note, patients with hematologic cancers also had the highest rate of heart failure hospitalization across all cancer types, which, coupled with their increasing admission rates, likely reflects their exposure to a “constellation of cardiotoxic therapies” as well as pathologic processes related to the cancers themselves, the authors suggest.

In-hospital mortality rates were higher among patients with cancer than those without, ranging from 5% for patients with breast cancer to 9.6% for patients with lung cancer versus 4.2% for those without cancer.

Among patients with cancer, the odds ratio for mortality was highest in those admitted with AFib (4.43), followed by pulmonary embolism (2.36), AMI (2.31), ischemic stroke (2.29), and heart failure (2.24).

In line with prior work and general population trends, in-hospital deaths in primary CV admissions trended lower among patients with cancer over the study period.

Mitigating risk

Commenting on the study, Joerg Herrmann, MD, director of the cardio-oncology clinic at Mayo Clinic, Rochester, Minn., said that the data are “extremely important” because they reflect admissions during a new era of cancer therapy. “Targeted therapies all came out about the turn of the millennium, so we’re not really looking at cancer patients treated with only old and ancient strategies.”

This may be one reason for the increased admissions, but because the study lacked information on specific cancer treatments and the date of cancer diagnosis, it’s not possible to tease out whether the uptick is related to cardiotoxicity or because the oncology outcomes have improved so much that this is a growing population, he said.

One clear implication, however, is that whoever is working on the hospital service will see more patients with a cancer diagnosis, Dr. Herrmann observed.

“Though some may have tried to maybe not get involved with this topic as much, it really calls for some broader scope to get familiar with this very entity,” he said. “And that plays out, in particular, in those patients with a diagnosis of active cancer.”

Dr. Herrmann and colleagues previously reported that patients with active leukemia or lymphoma who were hospitalized with acute coronary syndrome were less likely to receive guideline-directed therapies, even at the Mayo Clinic.

Similarly, a 2020 report by Dr. Mamas and colleagues found that patients with a variety of active cancers derived similar benefit from primary percutaneous coronary intervention for ST-segment–elevation MI as those without cancer but received the treatment less commonly.

Although there’s a greater appreciation that patients with cancer benefit equally from aggressive treatment, much more can be done to mitigate CV risk, Dr. Mamas noted. Valuable coronary information captured by MRI and CT done as part of the cancer investigation is often overlooked. For example, “we know that breast calcification and vascular calcification in the breast are very strong predictors of cardiovascular outcomes and yet people aren’t using this information.”

There are numerous shared risk factors in the development of cancer and coronary artery disease, and patients with cancer often have much worse CV risk profiles but aren’t routinely risk stratified from a CV perspective, he said.

Dr. Mamas said that his team is also studying whether CVD risk prediction tools like the Framingham Risk Score, which were derived from noncancer populations, work as well in patients with cancer. “Often, when you look at the performance of these tools in populations that weren’t covered, they’re much worse.”

“A lot of cancer survivors worry about the recurrence of their cancer and will religiously go and have repeated scans, religiously check themselves, and have all these investigations but don’t think about the actual risk that is greater for them, which is cardiovascular risk,” he said.

The authors report no study funding or relevant financial relationships.

A version of this article first appeared on Medscape.com.

Although cardiovascular disease (CVD) is known to often strike the mortal blow in patients with cancer, a national analysis puts in stark relief the burden of CV-related hospitalizations in this vulnerable population.

Results show that between 2004 and 2017, CV admissions increased 23.2% among patients with a cancer diagnosis, whereas admissions fell 10.9% among those without cancer.

Admissions increased steadily across all cancer types, except prostate cancer, with heart failure being the most common reason for admission.

“Hospital admissions is really important because we know that the size of this group is increasing, given that they live longer and many of the treatments that we offer cause cardiovascular disease or increase the risk of having cardiovascular events. So, from a health care planning perspective, I think it’s really important to see what the burden is likely to be in the next few years,” senior author Mamas Mamas, MD, Keele University, England, told this news organization.

For physicians and the wider population, he said, the findings underscore the need to shift the conversation from saying that patients with cancer are at increased CVD risk to asking how to mitigate this risk. “Because I would say that this increase in cardiovascular admissions, that’s a failure from a preventative perspective.”

The study was published in the European Heart Journal: Quality of Care & Clinical Outcomes.

Individual cancer types

The researchers, led by Ofer Kobo, MD, also with Keele University, used the National Inpatient Sample to identify 42.5 million weighted cases of CV admissions for acute myocardial infarction (AMI), pulmonary embolism, ischemic stroke, heart failure, atrial fibrillation (AFib) or atrial flutter, and intracranial hemorrhage from January 2004 to December 2017. Of these, 1.9 million had a record of cancer.

Patients with cancer were older; had a higher prevalence of valvular disease, anemia, and coagulopathy; and had a lower prevalence of hypertension, diabetes mellitus, and obesity than did patients without cancer.

The most common cancer type was hematologic cancers (26.1%), followed by lung (18.7%), gastrointestinal (12.4%), prostate (11.6%), breast (6.7%), and other in 24.4%.

The admission rate increased across all six admission causes – between 7% for AMI and ischemic stroke and 46% for AFib.

Heart failure was the chief reason for admission among all patients. Annual rates per 100,000 U.S. population increased in patients with cancer (from 13.6 to 16.6; P for trend = .02) and declined in those without (from 352.2 to 349.8; P for trend < .001).

“In the past, patients would be started on medications, and perhaps the importance of monitoring [left ventricular] LV function wasn’t as widely known, whereas now we’re much more aggressive in looking at it and much more aggressive at trying to prevent it,” Dr. Mamas said. “But even with this greater identification and attempting to modify regimens, we’re still getting quite substantial increases in heart failure admissions in this population. And what really surprised me is that it wasn’t just in the breast cancer population, but it was nearly across the board.”

He noted that patients are at highest risk from CV events within the first 2 years of cancer diagnosis. “So that’s really the time where you’ve got to be really aggressive in looking and working up their cardiovascular profile.”

Patients with hematologic cancers (9.7-13.5), lung (7.4-8.9), and gastrointestinal cancer (4.6-6.3) had the highest crude admission rates of CV hospitalizations per 100,000 U.S. population.

The CV admission rate went up from 2.5 to 3.7 per 100,000 U.S. population for breast cancer, and in prostate cancer, the rate dropped from 5.8 to 4.8 per 100,000 U.S. population.

Of note, patients with hematologic cancers also had the highest rate of heart failure hospitalization across all cancer types, which, coupled with their increasing admission rates, likely reflects their exposure to a “constellation of cardiotoxic therapies” as well as pathologic processes related to the cancers themselves, the authors suggest.

In-hospital mortality rates were higher among patients with cancer than those without, ranging from 5% for patients with breast cancer to 9.6% for patients with lung cancer versus 4.2% for those without cancer.

Among patients with cancer, the odds ratio for mortality was highest in those admitted with AFib (4.43), followed by pulmonary embolism (2.36), AMI (2.31), ischemic stroke (2.29), and heart failure (2.24).

In line with prior work and general population trends, in-hospital deaths in primary CV admissions trended lower among patients with cancer over the study period.

Mitigating risk

Commenting on the study, Joerg Herrmann, MD, director of the cardio-oncology clinic at Mayo Clinic, Rochester, Minn., said that the data are “extremely important” because they reflect admissions during a new era of cancer therapy. “Targeted therapies all came out about the turn of the millennium, so we’re not really looking at cancer patients treated with only old and ancient strategies.”

This may be one reason for the increased admissions, but because the study lacked information on specific cancer treatments and the date of cancer diagnosis, it’s not possible to tease out whether the uptick is related to cardiotoxicity or because the oncology outcomes have improved so much that this is a growing population, he said.

One clear implication, however, is that whoever is working on the hospital service will see more patients with a cancer diagnosis, Dr. Herrmann observed.

“Though some may have tried to maybe not get involved with this topic as much, it really calls for some broader scope to get familiar with this very entity,” he said. “And that plays out, in particular, in those patients with a diagnosis of active cancer.”

Dr. Herrmann and colleagues previously reported that patients with active leukemia or lymphoma who were hospitalized with acute coronary syndrome were less likely to receive guideline-directed therapies, even at the Mayo Clinic.

Similarly, a 2020 report by Dr. Mamas and colleagues found that patients with a variety of active cancers derived similar benefit from primary percutaneous coronary intervention for ST-segment–elevation MI as those without cancer but received the treatment less commonly.

Although there’s a greater appreciation that patients with cancer benefit equally from aggressive treatment, much more can be done to mitigate CV risk, Dr. Mamas noted. Valuable coronary information captured by MRI and CT done as part of the cancer investigation is often overlooked. For example, “we know that breast calcification and vascular calcification in the breast are very strong predictors of cardiovascular outcomes and yet people aren’t using this information.”

There are numerous shared risk factors in the development of cancer and coronary artery disease, and patients with cancer often have much worse CV risk profiles but aren’t routinely risk stratified from a CV perspective, he said.

Dr. Mamas said that his team is also studying whether CVD risk prediction tools like the Framingham Risk Score, which were derived from noncancer populations, work as well in patients with cancer. “Often, when you look at the performance of these tools in populations that weren’t covered, they’re much worse.”

“A lot of cancer survivors worry about the recurrence of their cancer and will religiously go and have repeated scans, religiously check themselves, and have all these investigations but don’t think about the actual risk that is greater for them, which is cardiovascular risk,” he said.

The authors report no study funding or relevant financial relationships.

A version of this article first appeared on Medscape.com.

Although cardiovascular disease (CVD) is known to often strike the mortal blow in patients with cancer, a national analysis puts in stark relief the burden of CV-related hospitalizations in this vulnerable population.

Results show that between 2004 and 2017, CV admissions increased 23.2% among patients with a cancer diagnosis, whereas admissions fell 10.9% among those without cancer.

Admissions increased steadily across all cancer types, except prostate cancer, with heart failure being the most common reason for admission.

“Hospital admissions is really important because we know that the size of this group is increasing, given that they live longer and many of the treatments that we offer cause cardiovascular disease or increase the risk of having cardiovascular events. So, from a health care planning perspective, I think it’s really important to see what the burden is likely to be in the next few years,” senior author Mamas Mamas, MD, Keele University, England, told this news organization.

For physicians and the wider population, he said, the findings underscore the need to shift the conversation from saying that patients with cancer are at increased CVD risk to asking how to mitigate this risk. “Because I would say that this increase in cardiovascular admissions, that’s a failure from a preventative perspective.”

The study was published in the European Heart Journal: Quality of Care & Clinical Outcomes.

Individual cancer types

The researchers, led by Ofer Kobo, MD, also with Keele University, used the National Inpatient Sample to identify 42.5 million weighted cases of CV admissions for acute myocardial infarction (AMI), pulmonary embolism, ischemic stroke, heart failure, atrial fibrillation (AFib) or atrial flutter, and intracranial hemorrhage from January 2004 to December 2017. Of these, 1.9 million had a record of cancer.

Patients with cancer were older; had a higher prevalence of valvular disease, anemia, and coagulopathy; and had a lower prevalence of hypertension, diabetes mellitus, and obesity than did patients without cancer.

The most common cancer type was hematologic cancers (26.1%), followed by lung (18.7%), gastrointestinal (12.4%), prostate (11.6%), breast (6.7%), and other in 24.4%.

The admission rate increased across all six admission causes – between 7% for AMI and ischemic stroke and 46% for AFib.

Heart failure was the chief reason for admission among all patients. Annual rates per 100,000 U.S. population increased in patients with cancer (from 13.6 to 16.6; P for trend = .02) and declined in those without (from 352.2 to 349.8; P for trend < .001).

“In the past, patients would be started on medications, and perhaps the importance of monitoring [left ventricular] LV function wasn’t as widely known, whereas now we’re much more aggressive in looking at it and much more aggressive at trying to prevent it,” Dr. Mamas said. “But even with this greater identification and attempting to modify regimens, we’re still getting quite substantial increases in heart failure admissions in this population. And what really surprised me is that it wasn’t just in the breast cancer population, but it was nearly across the board.”

He noted that patients are at highest risk from CV events within the first 2 years of cancer diagnosis. “So that’s really the time where you’ve got to be really aggressive in looking and working up their cardiovascular profile.”

Patients with hematologic cancers (9.7-13.5), lung (7.4-8.9), and gastrointestinal cancer (4.6-6.3) had the highest crude admission rates of CV hospitalizations per 100,000 U.S. population.

The CV admission rate went up from 2.5 to 3.7 per 100,000 U.S. population for breast cancer, and in prostate cancer, the rate dropped from 5.8 to 4.8 per 100,000 U.S. population.

Of note, patients with hematologic cancers also had the highest rate of heart failure hospitalization across all cancer types, which, coupled with their increasing admission rates, likely reflects their exposure to a “constellation of cardiotoxic therapies” as well as pathologic processes related to the cancers themselves, the authors suggest.

In-hospital mortality rates were higher among patients with cancer than those without, ranging from 5% for patients with breast cancer to 9.6% for patients with lung cancer versus 4.2% for those without cancer.

Among patients with cancer, the odds ratio for mortality was highest in those admitted with AFib (4.43), followed by pulmonary embolism (2.36), AMI (2.31), ischemic stroke (2.29), and heart failure (2.24).

In line with prior work and general population trends, in-hospital deaths in primary CV admissions trended lower among patients with cancer over the study period.

Mitigating risk

Commenting on the study, Joerg Herrmann, MD, director of the cardio-oncology clinic at Mayo Clinic, Rochester, Minn., said that the data are “extremely important” because they reflect admissions during a new era of cancer therapy. “Targeted therapies all came out about the turn of the millennium, so we’re not really looking at cancer patients treated with only old and ancient strategies.”

This may be one reason for the increased admissions, but because the study lacked information on specific cancer treatments and the date of cancer diagnosis, it’s not possible to tease out whether the uptick is related to cardiotoxicity or because the oncology outcomes have improved so much that this is a growing population, he said.

One clear implication, however, is that whoever is working on the hospital service will see more patients with a cancer diagnosis, Dr. Herrmann observed.

“Though some may have tried to maybe not get involved with this topic as much, it really calls for some broader scope to get familiar with this very entity,” he said. “And that plays out, in particular, in those patients with a diagnosis of active cancer.”

Dr. Herrmann and colleagues previously reported that patients with active leukemia or lymphoma who were hospitalized with acute coronary syndrome were less likely to receive guideline-directed therapies, even at the Mayo Clinic.

Similarly, a 2020 report by Dr. Mamas and colleagues found that patients with a variety of active cancers derived similar benefit from primary percutaneous coronary intervention for ST-segment–elevation MI as those without cancer but received the treatment less commonly.

Although there’s a greater appreciation that patients with cancer benefit equally from aggressive treatment, much more can be done to mitigate CV risk, Dr. Mamas noted. Valuable coronary information captured by MRI and CT done as part of the cancer investigation is often overlooked. For example, “we know that breast calcification and vascular calcification in the breast are very strong predictors of cardiovascular outcomes and yet people aren’t using this information.”

There are numerous shared risk factors in the development of cancer and coronary artery disease, and patients with cancer often have much worse CV risk profiles but aren’t routinely risk stratified from a CV perspective, he said.

Dr. Mamas said that his team is also studying whether CVD risk prediction tools like the Framingham Risk Score, which were derived from noncancer populations, work as well in patients with cancer. “Often, when you look at the performance of these tools in populations that weren’t covered, they’re much worse.”

“A lot of cancer survivors worry about the recurrence of their cancer and will religiously go and have repeated scans, religiously check themselves, and have all these investigations but don’t think about the actual risk that is greater for them, which is cardiovascular risk,” he said.

The authors report no study funding or relevant financial relationships.

A version of this article first appeared on Medscape.com.

About one in four patients with non–small cell lung cancer (NSCLC) have an unsatisfactory antibody response to the Omicron variant following COVID-19 vaccination, according to a new study.

The study was published in the Journal of Clinical Oncology.

“Booster vaccination increased binding and neutralizing antibody titers to Omicron, but antibody titers declined after 3 months. These data highlight the concern for patients with cancer given the rapid spread of SARS-CoV-2 Omicron variant,” wrote the authors, who were led by Rafi Ahmed, PhD, Emory University, Atlanta.

Researchers found that 18% had no detectable antibody at all and active treatment type had no association with vaccine response.

Researchers examined antibody titers among 82 NSCLC patients and 53 healthy volunteers. They collected blood samples longitudinally for analysis. While most patients had binding and neutralizing antibody titers that were comparable with healthy volunteers, 25% had poor responses, which led to six- to sevenfold lower titers than healthy controls. There was no association between worse vaccine responses and history of programmed death–1 monotherapy, chemotherapy, or both in combination. Receipt of a booster vaccine improved binding and neutralizing antibody titers to both the wild type and the Omicron variant, but 2-4 months after the booster there was a five- to sevenfold decrease in neutralizing titers to both the wild type and Omicron variant.

“This study indicates both the need to monitor our patients with lung cancer for response to COVID-19 mRNA vaccines, identify the nonresponders for follow-up and further attempts at immunization, and continue collecting and analyzing clinicodemographic information and biospecimens from our patients,” wrote the authors of an accompanying editorial.

Although the findings reveal potential concerns, the good news is that most patients NSCLC patients do respond normally to COVID-19 vaccination, said John D. Minna, MD, University of Texas Southwestern Medical Center, Dallas, lead author of the editorial.

He offered some advice to physicians. “You can test your patients using currently available [Clinical Laboratory Improvement Amendments]–approved lab tests to determine what their antibody titers are. This should be done after boosting since titers will go down after time. We know that if a patient has lung cancer and they do get infected with SARS-CoV-2 that potentially they could develop serious COVID-19 disease. Besides giving antiviral treatment, it is important that they be closely monitored for symptoms of progression so if they need to be hospitalized it can be done in a prudent manner,” said Dr. Minna, who is director of the Hamon Center for Therapeutic Oncology Research at the University of Texas Southwestern Medical Center.

No clinical details have emerged that might predict which patients have an insufficient response to vaccination. “When we started these studies, a lot of us thought that anyone who did not develop a good antibody response would be weak or sicker. For example, [patients with] late-stage disease, or having had a lot of therapy, or perhaps immune checkpoint blockade. However, none of these things are correlated. The main advice we are giving our lung cancer patients are to get vaccinated, get boosted (double boosted), and just do the smart thing to protect yourself from exposure,” he said.

For example, when traveling on a plane, patients should wear a mask. They should also avoid large indoor events. He also recommended that, following vaccination and boosters, patients seek out CLIA-certified tests to get their titer checked.

“Upon any COVID infection, even if their titer is at or above 80%, patients should see their physician to consider treatment with Paxlovid (nirmatrelvir/ritonavir), which has emergency use authorization. For patients with a lower titer, it’s important to seek out a physician and consider Paxlovid and possibly antibody therapy. But these are individual decisions to be made with your doctor,” Dr. Minna said.

The next important research question is what happens to T-cell immune response following vaccination. “We know that a good cellular immune response is also important in preventing infection and severe infection, but we don’t yet know which persons (with or without cancer) have good T-cell responses. This information will also likely impact what we tell our patients and will add to the antibody data,” he said.

Studies are ongoing to determine specific T-cell responses to mRNA vaccines, and how well those T-cell responses respond to SARS-CoV-2 infection in the laboratory.

About one in four patients with non–small cell lung cancer (NSCLC) have an unsatisfactory antibody response to the Omicron variant following COVID-19 vaccination, according to a new study.

The study was published in the Journal of Clinical Oncology.

“Booster vaccination increased binding and neutralizing antibody titers to Omicron, but antibody titers declined after 3 months. These data highlight the concern for patients with cancer given the rapid spread of SARS-CoV-2 Omicron variant,” wrote the authors, who were led by Rafi Ahmed, PhD, Emory University, Atlanta.

Researchers found that 18% had no detectable antibody at all and active treatment type had no association with vaccine response.

Researchers examined antibody titers among 82 NSCLC patients and 53 healthy volunteers. They collected blood samples longitudinally for analysis. While most patients had binding and neutralizing antibody titers that were comparable with healthy volunteers, 25% had poor responses, which led to six- to sevenfold lower titers than healthy controls. There was no association between worse vaccine responses and history of programmed death–1 monotherapy, chemotherapy, or both in combination. Receipt of a booster vaccine improved binding and neutralizing antibody titers to both the wild type and the Omicron variant, but 2-4 months after the booster there was a five- to sevenfold decrease in neutralizing titers to both the wild type and Omicron variant.

“This study indicates both the need to monitor our patients with lung cancer for response to COVID-19 mRNA vaccines, identify the nonresponders for follow-up and further attempts at immunization, and continue collecting and analyzing clinicodemographic information and biospecimens from our patients,” wrote the authors of an accompanying editorial.

Although the findings reveal potential concerns, the good news is that most patients NSCLC patients do respond normally to COVID-19 vaccination, said John D. Minna, MD, University of Texas Southwestern Medical Center, Dallas, lead author of the editorial.

He offered some advice to physicians. “You can test your patients using currently available [Clinical Laboratory Improvement Amendments]–approved lab tests to determine what their antibody titers are. This should be done after boosting since titers will go down after time. We know that if a patient has lung cancer and they do get infected with SARS-CoV-2 that potentially they could develop serious COVID-19 disease. Besides giving antiviral treatment, it is important that they be closely monitored for symptoms of progression so if they need to be hospitalized it can be done in a prudent manner,” said Dr. Minna, who is director of the Hamon Center for Therapeutic Oncology Research at the University of Texas Southwestern Medical Center.

No clinical details have emerged that might predict which patients have an insufficient response to vaccination. “When we started these studies, a lot of us thought that anyone who did not develop a good antibody response would be weak or sicker. For example, [patients with] late-stage disease, or having had a lot of therapy, or perhaps immune checkpoint blockade. However, none of these things are correlated. The main advice we are giving our lung cancer patients are to get vaccinated, get boosted (double boosted), and just do the smart thing to protect yourself from exposure,” he said.

For example, when traveling on a plane, patients should wear a mask. They should also avoid large indoor events. He also recommended that, following vaccination and boosters, patients seek out CLIA-certified tests to get their titer checked.

“Upon any COVID infection, even if their titer is at or above 80%, patients should see their physician to consider treatment with Paxlovid (nirmatrelvir/ritonavir), which has emergency use authorization. For patients with a lower titer, it’s important to seek out a physician and consider Paxlovid and possibly antibody therapy. But these are individual decisions to be made with your doctor,” Dr. Minna said.

The next important research question is what happens to T-cell immune response following vaccination. “We know that a good cellular immune response is also important in preventing infection and severe infection, but we don’t yet know which persons (with or without cancer) have good T-cell responses. This information will also likely impact what we tell our patients and will add to the antibody data,” he said.

Studies are ongoing to determine specific T-cell responses to mRNA vaccines, and how well those T-cell responses respond to SARS-CoV-2 infection in the laboratory.

About one in four patients with non–small cell lung cancer (NSCLC) have an unsatisfactory antibody response to the Omicron variant following COVID-19 vaccination, according to a new study.

The study was published in the Journal of Clinical Oncology.

“Booster vaccination increased binding and neutralizing antibody titers to Omicron, but antibody titers declined after 3 months. These data highlight the concern for patients with cancer given the rapid spread of SARS-CoV-2 Omicron variant,” wrote the authors, who were led by Rafi Ahmed, PhD, Emory University, Atlanta.

Researchers found that 18% had no detectable antibody at all and active treatment type had no association with vaccine response.

Researchers examined antibody titers among 82 NSCLC patients and 53 healthy volunteers. They collected blood samples longitudinally for analysis. While most patients had binding and neutralizing antibody titers that were comparable with healthy volunteers, 25% had poor responses, which led to six- to sevenfold lower titers than healthy controls. There was no association between worse vaccine responses and history of programmed death–1 monotherapy, chemotherapy, or both in combination. Receipt of a booster vaccine improved binding and neutralizing antibody titers to both the wild type and the Omicron variant, but 2-4 months after the booster there was a five- to sevenfold decrease in neutralizing titers to both the wild type and Omicron variant.

“This study indicates both the need to monitor our patients with lung cancer for response to COVID-19 mRNA vaccines, identify the nonresponders for follow-up and further attempts at immunization, and continue collecting and analyzing clinicodemographic information and biospecimens from our patients,” wrote the authors of an accompanying editorial.

Although the findings reveal potential concerns, the good news is that most patients NSCLC patients do respond normally to COVID-19 vaccination, said John D. Minna, MD, University of Texas Southwestern Medical Center, Dallas, lead author of the editorial.

He offered some advice to physicians. “You can test your patients using currently available [Clinical Laboratory Improvement Amendments]–approved lab tests to determine what their antibody titers are. This should be done after boosting since titers will go down after time. We know that if a patient has lung cancer and they do get infected with SARS-CoV-2 that potentially they could develop serious COVID-19 disease. Besides giving antiviral treatment, it is important that they be closely monitored for symptoms of progression so if they need to be hospitalized it can be done in a prudent manner,” said Dr. Minna, who is director of the Hamon Center for Therapeutic Oncology Research at the University of Texas Southwestern Medical Center.

No clinical details have emerged that might predict which patients have an insufficient response to vaccination. “When we started these studies, a lot of us thought that anyone who did not develop a good antibody response would be weak or sicker. For example, [patients with] late-stage disease, or having had a lot of therapy, or perhaps immune checkpoint blockade. However, none of these things are correlated. The main advice we are giving our lung cancer patients are to get vaccinated, get boosted (double boosted), and just do the smart thing to protect yourself from exposure,” he said.

For example, when traveling on a plane, patients should wear a mask. They should also avoid large indoor events. He also recommended that, following vaccination and boosters, patients seek out CLIA-certified tests to get their titer checked.

“Upon any COVID infection, even if their titer is at or above 80%, patients should see their physician to consider treatment with Paxlovid (nirmatrelvir/ritonavir), which has emergency use authorization. For patients with a lower titer, it’s important to seek out a physician and consider Paxlovid and possibly antibody therapy. But these are individual decisions to be made with your doctor,” Dr. Minna said.

The next important research question is what happens to T-cell immune response following vaccination. “We know that a good cellular immune response is also important in preventing infection and severe infection, but we don’t yet know which persons (with or without cancer) have good T-cell responses. This information will also likely impact what we tell our patients and will add to the antibody data,” he said.

Studies are ongoing to determine specific T-cell responses to mRNA vaccines, and how well those T-cell responses respond to SARS-CoV-2 infection in the laboratory.

Key clinical point: A prospective cohort study found the cumulative incidence of myocarditis among patients treated with immune checkpoint inhibitors (ICI) to be 3%.

Major finding: Three cases (2 definite and 1 possible) of myocarditis were reported over a follow-up of 6 months, with all cases being mild and without major adverse cardiac events. The mean time to onset of myocarditis was 144 ± 3 days.

Study details: The data come from a real-world prospective cohort study involving 99 patients with lung cancer treated with ICI at a French university hospital.

Disclosures: No funding information was available. The authors reported no conflicts of interest.

Source: Faubry C et al. A prospective study to detect immune checkpoint inhibitors associated with myocarditis among patients treated for lung cancer. Front Cardiovasc Med. 2022;9:878211 (Jun 6). Doi: 10.3389/fcvm.2022.878211

Key clinical point: A prospective cohort study found the cumulative incidence of myocarditis among patients treated with immune checkpoint inhibitors (ICI) to be 3%.

Major finding: Three cases (2 definite and 1 possible) of myocarditis were reported over a follow-up of 6 months, with all cases being mild and without major adverse cardiac events. The mean time to onset of myocarditis was 144 ± 3 days.

Study details: The data come from a real-world prospective cohort study involving 99 patients with lung cancer treated with ICI at a French university hospital.

Disclosures: No funding information was available. The authors reported no conflicts of interest.

Source: Faubry C et al. A prospective study to detect immune checkpoint inhibitors associated with myocarditis among patients treated for lung cancer. Front Cardiovasc Med. 2022;9:878211 (Jun 6). Doi: 10.3389/fcvm.2022.878211

Key clinical point: A prospective cohort study found the cumulative incidence of myocarditis among patients treated with immune checkpoint inhibitors (ICI) to be 3%.

Major finding: Three cases (2 definite and 1 possible) of myocarditis were reported over a follow-up of 6 months, with all cases being mild and without major adverse cardiac events. The mean time to onset of myocarditis was 144 ± 3 days.

Study details: The data come from a real-world prospective cohort study involving 99 patients with lung cancer treated with ICI at a French university hospital.

Disclosures: No funding information was available. The authors reported no conflicts of interest.

Source: Faubry C et al. A prospective study to detect immune checkpoint inhibitors associated with myocarditis among patients treated for lung cancer. Front Cardiovasc Med. 2022;9:878211 (Jun 6). Doi: 10.3389/fcvm.2022.878211

Key clinical point: Airflow limitation is linked to an increased risk for lung cancer, with the association being pronounced in ever smokers.

Major finding: Airflow limitation vs no limitation was associated with a higher risk for lung cancer (adjusted hazard ratio [aHR] 1.7; 95% CI 1.4-2.3). The association was greater among current smokers (HR 2.2; 95% CI 1.5-3.2) and former smokers (HR 2.1; 95% CI 1.4-3.2) compared with never smokers (HR 0.9; 95% CI 0.4-2.1).

Study details: The data come from a prospective population-based cohort study involving 98,630 participants.

Disclosures: No funding information was available. HJM Groen, R Vliegenthart, and W Timens declared receiving personal fees from pharmaceutical companies outside this work. The other authors reported no disclosures.

Source: Du Y et al. Airflow limitation increases lung cancer risk in smokers: The Lifelines Cohort Study. Cancer Epidemiol Biomarkers Prev. 2022;31(7):1442–1449  (May 9). Doi: 10.1158/1055-9965.EPI-21-1365

Key clinical point: Airflow limitation is linked to an increased risk for lung cancer, with the association being pronounced in ever smokers.

Major finding: Airflow limitation vs no limitation was associated with a higher risk for lung cancer (adjusted hazard ratio [aHR] 1.7; 95% CI 1.4-2.3). The association was greater among current smokers (HR 2.2; 95% CI 1.5-3.2) and former smokers (HR 2.1; 95% CI 1.4-3.2) compared with never smokers (HR 0.9; 95% CI 0.4-2.1).

Study details: The data come from a prospective population-based cohort study involving 98,630 participants.

Disclosures: No funding information was available. HJM Groen, R Vliegenthart, and W Timens declared receiving personal fees from pharmaceutical companies outside this work. The other authors reported no disclosures.

Source: Du Y et al. Airflow limitation increases lung cancer risk in smokers: The Lifelines Cohort Study. Cancer Epidemiol Biomarkers Prev. 2022;31(7):1442–1449  (May 9). Doi: 10.1158/1055-9965.EPI-21-1365

Key clinical point: Airflow limitation is linked to an increased risk for lung cancer, with the association being pronounced in ever smokers.

Major finding: Airflow limitation vs no limitation was associated with a higher risk for lung cancer (adjusted hazard ratio [aHR] 1.7; 95% CI 1.4-2.3). The association was greater among current smokers (HR 2.2; 95% CI 1.5-3.2) and former smokers (HR 2.1; 95% CI 1.4-3.2) compared with never smokers (HR 0.9; 95% CI 0.4-2.1).

Study details: The data come from a prospective population-based cohort study involving 98,630 participants.

Disclosures: No funding information was available. HJM Groen, R Vliegenthart, and W Timens declared receiving personal fees from pharmaceutical companies outside this work. The other authors reported no disclosures.

Source: Du Y et al. Airflow limitation increases lung cancer risk in smokers: The Lifelines Cohort Study. Cancer Epidemiol Biomarkers Prev. 2022;31(7):1442–1449  (May 9). Doi: 10.1158/1055-9965.EPI-21-1365

Key clinical point: Adjuvant postoperative chemotherapy improved relapse-free survival (RFS) and overall survival (OS) in patients with early-stage resected non–small-cell lung cancer (NSCLC), with the cisplatin-vinorelbine regimen being the most effective therapeutic method with tolerable toxicity.

Major finding: Compared with the observation (control) group, the chemotherapy group showed a significant RFS (hazard ratio [HR] 0.67; P < .0001) and OS (HR 0.80; P < .0001) advantage, with the benefits being most prominent with the cisplatin-vinorelbine regimen (RFS: HR 0.63; 95% CI 0.43-0.87; and OS: HR 0.74; 95% CI 0.63-0.87). Hematological toxicities and nausea or vomiting were not higher with cisplatin-vinorelbine vs other chemotherapy regimens.

Study details: The data come from a systematic review with network meta-analysis of 20 randomized controlled trials including 5483 participants.

Disclosures: This study was funded by the Chinese National Natural Science Foundation Project. The authors declared no conflicts of interest.

Source: Pang LL et al. Investigation of the optimal platinum-based regimen in the postoperative adjuvant chemotherapy setting for early-stage resected non-small lung cancer: A Bayesian network meta-analysis. BMJ Open. 2022;12:e057098 (Jun 13). Doi: 10.1136/bmjopen-2021-057098

Key clinical point: Adjuvant postoperative chemotherapy improved relapse-free survival (RFS) and overall survival (OS) in patients with early-stage resected non–small-cell lung cancer (NSCLC), with the cisplatin-vinorelbine regimen being the most effective therapeutic method with tolerable toxicity.

Major finding: Compared with the observation (control) group, the chemotherapy group showed a significant RFS (hazard ratio [HR] 0.67; P < .0001) and OS (HR 0.80; P < .0001) advantage, with the benefits being most prominent with the cisplatin-vinorelbine regimen (RFS: HR 0.63; 95% CI 0.43-0.87; and OS: HR 0.74; 95% CI 0.63-0.87). Hematological toxicities and nausea or vomiting were not higher with cisplatin-vinorelbine vs other chemotherapy regimens.

Study details: The data come from a systematic review with network meta-analysis of 20 randomized controlled trials including 5483 participants.

Disclosures: This study was funded by the Chinese National Natural Science Foundation Project. The authors declared no conflicts of interest.

Source: Pang LL et al. Investigation of the optimal platinum-based regimen in the postoperative adjuvant chemotherapy setting for early-stage resected non-small lung cancer: A Bayesian network meta-analysis. BMJ Open. 2022;12:e057098 (Jun 13). Doi: 10.1136/bmjopen-2021-057098

Key clinical point: Adjuvant postoperative chemotherapy improved relapse-free survival (RFS) and overall survival (OS) in patients with early-stage resected non–small-cell lung cancer (NSCLC), with the cisplatin-vinorelbine regimen being the most effective therapeutic method with tolerable toxicity.

Major finding: Compared with the observation (control) group, the chemotherapy group showed a significant RFS (hazard ratio [HR] 0.67; P < .0001) and OS (HR 0.80; P < .0001) advantage, with the benefits being most prominent with the cisplatin-vinorelbine regimen (RFS: HR 0.63; 95% CI 0.43-0.87; and OS: HR 0.74; 95% CI 0.63-0.87). Hematological toxicities and nausea or vomiting were not higher with cisplatin-vinorelbine vs other chemotherapy regimens.

Study details: The data come from a systematic review with network meta-analysis of 20 randomized controlled trials including 5483 participants.

Disclosures: This study was funded by the Chinese National Natural Science Foundation Project. The authors declared no conflicts of interest.

Source: Pang LL et al. Investigation of the optimal platinum-based regimen in the postoperative adjuvant chemotherapy setting for early-stage resected non-small lung cancer: A Bayesian network meta-analysis. BMJ Open. 2022;12:e057098 (Jun 13). Doi: 10.1136/bmjopen-2021-057098

Key clinical point: Androgen deprivation therapy (ADT) for previously diagnosed prostate cancer may improve survival in patients subsequently diagnosed with lung cancer.

Major finding: Patients who received vs did not receive ADT for previously diagnosed prostate cancer showed improved survival after lung cancer diagnosis (adjusted hazard ratio of death 0.88; P  =  .022) and a shorter latency period to the diagnosis of lung cancer (40 vs 47 months; P < .001).

Study details: This study evaluated 367,750 patients with lung cancer, of which 11,061 patients had an initial prostate cancer diagnosis and subsequent lung cancer diagnosis, 3017 had an initial lung cancer diagnosis and subsequent prostate cancer diagnosis, and the remaining patients had isolated lung cancer diagnosis.

Disclosures: This study received no external funding. B Nazha and TK Owonikoko reported receiving advisory or consulting fees from various sources.

Source: Nazha B et al. Concurrent androgen deprivation therapy for prostate cancer improves survival for synchronous or metachronous non-small cell lung cancer: A SEER–Medicare database analysis. Cancers (Basel). 2022; 14(13);3206 (Jun 30). Doi: 10.3390/cancers14133206

Key clinical point: Androgen deprivation therapy (ADT) for previously diagnosed prostate cancer may improve survival in patients subsequently diagnosed with lung cancer.

Major finding: Patients who received vs did not receive ADT for previously diagnosed prostate cancer showed improved survival after lung cancer diagnosis (adjusted hazard ratio of death 0.88; P  =  .022) and a shorter latency period to the diagnosis of lung cancer (40 vs 47 months; P < .001).

Study details: This study evaluated 367,750 patients with lung cancer, of which 11,061 patients had an initial prostate cancer diagnosis and subsequent lung cancer diagnosis, 3017 had an initial lung cancer diagnosis and subsequent prostate cancer diagnosis, and the remaining patients had isolated lung cancer diagnosis.

Disclosures: This study received no external funding. B Nazha and TK Owonikoko reported receiving advisory or consulting fees from various sources.

Source: Nazha B et al. Concurrent androgen deprivation therapy for prostate cancer improves survival for synchronous or metachronous non-small cell lung cancer: A SEER–Medicare database analysis. Cancers (Basel). 2022; 14(13);3206 (Jun 30). Doi: 10.3390/cancers14133206

Key clinical point: Androgen deprivation therapy (ADT) for previously diagnosed prostate cancer may improve survival in patients subsequently diagnosed with lung cancer.

Major finding: Patients who received vs did not receive ADT for previously diagnosed prostate cancer showed improved survival after lung cancer diagnosis (adjusted hazard ratio of death 0.88; P  =  .022) and a shorter latency period to the diagnosis of lung cancer (40 vs 47 months; P < .001).

Study details: This study evaluated 367,750 patients with lung cancer, of which 11,061 patients had an initial prostate cancer diagnosis and subsequent lung cancer diagnosis, 3017 had an initial lung cancer diagnosis and subsequent prostate cancer diagnosis, and the remaining patients had isolated lung cancer diagnosis.

Disclosures: This study received no external funding. B Nazha and TK Owonikoko reported receiving advisory or consulting fees from various sources.

Source: Nazha B et al. Concurrent androgen deprivation therapy for prostate cancer improves survival for synchronous or metachronous non-small cell lung cancer: A SEER–Medicare database analysis. Cancers (Basel). 2022; 14(13);3206 (Jun 30). Doi: 10.3390/cancers14133206

Key clinical point: The use of recombinant human granulocyte colony-stimulating factor (rhG-CSF) increases the risk for distant organ metastasis in patients with non—small-cell lung cancer (NSCLC) receiving chemotherapy, with the risk being much higher in patients without vs with chemotherapy-induced myelosuppression.

Major finding: Use vs non-use of rhG-CSF more than doubled the risk for distant organ metastasis (48.37% vs 26.23%; adjusted hazard ratio [HR] 2.33; P < .01), with the risk being much higher in patients presenting without vs with myelosuppression (HR 3.34; 95% CI 1.86-6.02 vs HR 0.71; 95% CI 0.17-2.94; P_interaction < .01).

Study details: Findings are from a retrospective cohort study including 307 patients with NSCLC who underwent surgery and postoperative systemic chemotherapy, of which 246 patients received rhG-CSF treatment during chemotherapy.

Disclosures: This study was funded by the National Natural Science Foundation of China and others. The authors declared no conflicts of interest.

Source: Wang Y et al. rhG-CSF is associated with an increased risk of metastasis in NSCLC patients following postoperative chemotherapy. BMC Cancer. 2022;22:741 (Jul 7). Doi:  10.1186/s12885-022-09850-4

Key clinical point: The use of recombinant human granulocyte colony-stimulating factor (rhG-CSF) increases the risk for distant organ metastasis in patients with non—small-cell lung cancer (NSCLC) receiving chemotherapy, with the risk being much higher in patients without vs with chemotherapy-induced myelosuppression.

Major finding: Use vs non-use of rhG-CSF more than doubled the risk for distant organ metastasis (48.37% vs 26.23%; adjusted hazard ratio [HR] 2.33; P < .01), with the risk being much higher in patients presenting without vs with myelosuppression (HR 3.34; 95% CI 1.86-6.02 vs HR 0.71; 95% CI 0.17-2.94; P_interaction < .01).

Study details: Findings are from a retrospective cohort study including 307 patients with NSCLC who underwent surgery and postoperative systemic chemotherapy, of which 246 patients received rhG-CSF treatment during chemotherapy.

Disclosures: This study was funded by the National Natural Science Foundation of China and others. The authors declared no conflicts of interest.

Source: Wang Y et al. rhG-CSF is associated with an increased risk of metastasis in NSCLC patients following postoperative chemotherapy. BMC Cancer. 2022;22:741 (Jul 7). Doi:  10.1186/s12885-022-09850-4

Key clinical point: The use of recombinant human granulocyte colony-stimulating factor (rhG-CSF) increases the risk for distant organ metastasis in patients with non—small-cell lung cancer (NSCLC) receiving chemotherapy, with the risk being much higher in patients without vs with chemotherapy-induced myelosuppression.

Major finding: Use vs non-use of rhG-CSF more than doubled the risk for distant organ metastasis (48.37% vs 26.23%; adjusted hazard ratio [HR] 2.33; P < .01), with the risk being much higher in patients presenting without vs with myelosuppression (HR 3.34; 95% CI 1.86-6.02 vs HR 0.71; 95% CI 0.17-2.94; P_interaction < .01).

Study details: Findings are from a retrospective cohort study including 307 patients with NSCLC who underwent surgery and postoperative systemic chemotherapy, of which 246 patients received rhG-CSF treatment during chemotherapy.

Disclosures: This study was funded by the National Natural Science Foundation of China and others. The authors declared no conflicts of interest.

Source: Wang Y et al. rhG-CSF is associated with an increased risk of metastasis in NSCLC patients following postoperative chemotherapy. BMC Cancer. 2022;22:741 (Jul 7). Doi:  10.1186/s12885-022-09850-4

Key clinical point: The concomitant use of gastric acid suppressants (GAS) may be associated with poor survival outcomes in patients with non—small-cell lung cancer (NSCLC) receiving programmed death-1/ligand-1 (PD-1/PD-L1) inhibitors.

Major finding: Use of PD-1/PD-L1 inhibitors with vs without GAS worsened progression-free survival by 32% (hazard ratio [HR] 1.32; P < .001) and overall survival by 36% (HR 1.36; P < .001).

Study details: The data come from a meta-analysis of 10 retrospective studies and 1 prospective cohort study including 5892 patients with NSCLC who were receiving PD-1/PD-L1 inhibitors.

Disclosures: This study was supported by Anhui University Natural Science Research Project, China. The authors declared no conflicts of interest.

Source: Wang M et al. Influence of concomitant gastric acid suppressants use on the survival of patients with non-small cell lung cancer treated with programmed death-1/ligand-1 inhibitors: A meta-analysis. Int Immunopharmacol. 2022;110:108955 (Jun 21). Doi:  10.1016/j.intimp.2022.108955

Key clinical point: The concomitant use of gastric acid suppressants (GAS) may be associated with poor survival outcomes in patients with non—small-cell lung cancer (NSCLC) receiving programmed death-1/ligand-1 (PD-1/PD-L1) inhibitors.

Major finding: Use of PD-1/PD-L1 inhibitors with vs without GAS worsened progression-free survival by 32% (hazard ratio [HR] 1.32; P < .001) and overall survival by 36% (HR 1.36; P < .001).

Study details: The data come from a meta-analysis of 10 retrospective studies and 1 prospective cohort study including 5892 patients with NSCLC who were receiving PD-1/PD-L1 inhibitors.

Disclosures: This study was supported by Anhui University Natural Science Research Project, China. The authors declared no conflicts of interest.

Source: Wang M et al. Influence of concomitant gastric acid suppressants use on the survival of patients with non-small cell lung cancer treated with programmed death-1/ligand-1 inhibitors: A meta-analysis. Int Immunopharmacol. 2022;110:108955 (Jun 21). Doi:  10.1016/j.intimp.2022.108955

Key clinical point: The concomitant use of gastric acid suppressants (GAS) may be associated with poor survival outcomes in patients with non—small-cell lung cancer (NSCLC) receiving programmed death-1/ligand-1 (PD-1/PD-L1) inhibitors.

Major finding: Use of PD-1/PD-L1 inhibitors with vs without GAS worsened progression-free survival by 32% (hazard ratio [HR] 1.32; P < .001) and overall survival by 36% (HR 1.36; P < .001).

Study details: The data come from a meta-analysis of 10 retrospective studies and 1 prospective cohort study including 5892 patients with NSCLC who were receiving PD-1/PD-L1 inhibitors.

Disclosures: This study was supported by Anhui University Natural Science Research Project, China. The authors declared no conflicts of interest.

Source: Wang M et al. Influence of concomitant gastric acid suppressants use on the survival of patients with non-small cell lung cancer treated with programmed death-1/ligand-1 inhibitors: A meta-analysis. Int Immunopharmacol. 2022;110:108955 (Jun 21). Doi:  10.1016/j.intimp.2022.108955

Key clinical point: The addition of postoperative radiotherapy (PORT) to surgery and adjuvant chemotherapy prolonged overall survival by 39% and cancer-specific survival by 53% in patients with early small cell lung cancer (SCLC).

Major finding: PORT vs no PORT was associated with a significantly extended median overall survival (8.58 vs 5.17 years; hazard ratio [HR] 0.61; P  =  .032) and cancer-specific survival (11.33 vs 8.08 years; HR 0.47; P  =  .0086).

Study details: The data come from a population-based retrospective cohort study involving 278 patients with stage I-IIA SCLC who underwent surgery and received adjuvant chemotherapy.

Disclosures: This study was funded by the National Natural Science Foundation of China and others. The authors declared no conflicts of interest.

Source: Li J et al. Additional postoperative radiotherapy prolonged the survival of patients with i-iia small cell lung cancer: Analysis of the SEER database. J Oncol. 2022;6280538 (Jun 18). Doi: 10.1155/2022/6280538

Key clinical point: The addition of postoperative radiotherapy (PORT) to surgery and adjuvant chemotherapy prolonged overall survival by 39% and cancer-specific survival by 53% in patients with early small cell lung cancer (SCLC).

Major finding: PORT vs no PORT was associated with a significantly extended median overall survival (8.58 vs 5.17 years; hazard ratio [HR] 0.61; P  =  .032) and cancer-specific survival (11.33 vs 8.08 years; HR 0.47; P  =  .0086).

Study details: The data come from a population-based retrospective cohort study involving 278 patients with stage I-IIA SCLC who underwent surgery and received adjuvant chemotherapy.

Disclosures: This study was funded by the National Natural Science Foundation of China and others. The authors declared no conflicts of interest.

Source: Li J et al. Additional postoperative radiotherapy prolonged the survival of patients with i-iia small cell lung cancer: Analysis of the SEER database. J Oncol. 2022;6280538 (Jun 18). Doi: 10.1155/2022/6280538

Key clinical point: The addition of postoperative radiotherapy (PORT) to surgery and adjuvant chemotherapy prolonged overall survival by 39% and cancer-specific survival by 53% in patients with early small cell lung cancer (SCLC).

Major finding: PORT vs no PORT was associated with a significantly extended median overall survival (8.58 vs 5.17 years; hazard ratio [HR] 0.61; P  =  .032) and cancer-specific survival (11.33 vs 8.08 years; HR 0.47; P  =  .0086).

Study details: The data come from a population-based retrospective cohort study involving 278 patients with stage I-IIA SCLC who underwent surgery and received adjuvant chemotherapy.

Disclosures: This study was funded by the National Natural Science Foundation of China and others. The authors declared no conflicts of interest.

Source: Li J et al. Additional postoperative radiotherapy prolonged the survival of patients with i-iia small cell lung cancer: Analysis of the SEER database. J Oncol. 2022;6280538 (Jun 18). Doi: 10.1155/2022/6280538

Key clinical point: Use of preoperative fluorine 18-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) is linked to a longer overall survival in patients with stage IIIA or IIIB resectable non—small-cell lung cancer (NSCLC).

Major finding: Among patients who underwent vs did not undergo preoperative ¹⁸F-FDG PET/CT, those with stage IIIB and stage IIIA disease had 20% (adjusted hazard ratio [aHR] 0.80; 95% CI 0.71-0.90) and 10% (aHR 0.90; 95% CI 0.79-0.94) lower risks for mortality, respectively. Patients with stage I-II disease did not have a lower risk for mortality (aHR 1.19; 95% CI 0.89-1.30).

Study details: The data come from a Taiwanese retrospective cohort study of patients with resectable stage I-IIIB NSCLC who underwent (n = 6,754) and did not undergo (n = 6,754) preoperative ¹⁸F-FDG PET/CT.

Disclosures: This study was funded by the Lo-Hsu Medical Foundation and Lotung Poh-Ai Hospital, Taiwan. SY Wu is a member of the Taiwan Radiological Society and Taiwan Society for Therapeutic Radiology and Oncology. The other authors reported no relevant relationships.

Source: Chen W-M et al. Use of preoperative FDG PET/CT and survival of patients with resectable non–small cell lung cancer. Radiology. 2022 (Jun 21). Doi: 10.1148/radiol.212798

Key clinical point: Use of preoperative fluorine 18-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) is linked to a longer overall survival in patients with stage IIIA or IIIB resectable non—small-cell lung cancer (NSCLC).

Major finding: Among patients who underwent vs did not undergo preoperative ¹⁸F-FDG PET/CT, those with stage IIIB and stage IIIA disease had 20% (adjusted hazard ratio [aHR] 0.80; 95% CI 0.71-0.90) and 10% (aHR 0.90; 95% CI 0.79-0.94) lower risks for mortality, respectively. Patients with stage I-II disease did not have a lower risk for mortality (aHR 1.19; 95% CI 0.89-1.30).

Study details: The data come from a Taiwanese retrospective cohort study of patients with resectable stage I-IIIB NSCLC who underwent (n = 6,754) and did not undergo (n = 6,754) preoperative ¹⁸F-FDG PET/CT.

Disclosures: This study was funded by the Lo-Hsu Medical Foundation and Lotung Poh-Ai Hospital, Taiwan. SY Wu is a member of the Taiwan Radiological Society and Taiwan Society for Therapeutic Radiology and Oncology. The other authors reported no relevant relationships.

Source: Chen W-M et al. Use of preoperative FDG PET/CT and survival of patients with resectable non–small cell lung cancer. Radiology. 2022 (Jun 21). Doi: 10.1148/radiol.212798

Key clinical point: Use of preoperative fluorine 18-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) is linked to a longer overall survival in patients with stage IIIA or IIIB resectable non—small-cell lung cancer (NSCLC).

Major finding: Among patients who underwent vs did not undergo preoperative ¹⁸F-FDG PET/CT, those with stage IIIB and stage IIIA disease had 20% (adjusted hazard ratio [aHR] 0.80; 95% CI 0.71-0.90) and 10% (aHR 0.90; 95% CI 0.79-0.94) lower risks for mortality, respectively. Patients with stage I-II disease did not have a lower risk for mortality (aHR 1.19; 95% CI 0.89-1.30).

Study details: The data come from a Taiwanese retrospective cohort study of patients with resectable stage I-IIIB NSCLC who underwent (n = 6,754) and did not undergo (n = 6,754) preoperative ¹⁸F-FDG PET/CT.

Disclosures: This study was funded by the Lo-Hsu Medical Foundation and Lotung Poh-Ai Hospital, Taiwan. SY Wu is a member of the Taiwan Radiological Society and Taiwan Society for Therapeutic Radiology and Oncology. The other authors reported no relevant relationships.

Source: Chen W-M et al. Use of preoperative FDG PET/CT and survival of patients with resectable non–small cell lung cancer. Radiology. 2022 (Jun 21). Doi: 10.1148/radiol.212798