Clinical Edge Journal Scan

Key clinical point: Body weight gain and loss are significantly associated with a higher risk for hip fracture in patients with type 2 diabetes (T2D), irrespective of the body mass index.

Major finding: Compared with stable weight, body weight loss of ≥10% (adjusted hazard ratio [aHR] 1.605; 95% CI 1.493-1.725) and 5%-10% (aHR 1.237; 95% CI 1.177-1.300) and gain of ≥10% (aHR 1.457; 95% CI 1.318-1.612) and 5%-≤10% (aHR 1.234; 95% CI 1.156-1.318) were associated with a higher risk for hip fracture.

Study details: Findings are from a nationwide cohort study including 1,447,579 patients aged >40 years with T2D who reported 11,848 hip fracture events.

Disclosures: The study was supported by a National Research Foundation of Korea grant funded by the Korean government. The authors declared no conflicts of interest.

Source: Lee SW et al. Weight change and the risk of hip fractures in patients with type 2 diabetes: A nationwide cohort study. Osteoporos Int. 2022 (Apr 19). Doi: 10.1007/s00198-022-06398-8

Key clinical point: Body weight gain and loss are significantly associated with a higher risk for hip fracture in patients with type 2 diabetes (T2D), irrespective of the body mass index.

Major finding: Compared with stable weight, body weight loss of ≥10% (adjusted hazard ratio [aHR] 1.605; 95% CI 1.493-1.725) and 5%-10% (aHR 1.237; 95% CI 1.177-1.300) and gain of ≥10% (aHR 1.457; 95% CI 1.318-1.612) and 5%-≤10% (aHR 1.234; 95% CI 1.156-1.318) were associated with a higher risk for hip fracture.

Study details: Findings are from a nationwide cohort study including 1,447,579 patients aged >40 years with T2D who reported 11,848 hip fracture events.

Disclosures: The study was supported by a National Research Foundation of Korea grant funded by the Korean government. The authors declared no conflicts of interest.

Source: Lee SW et al. Weight change and the risk of hip fractures in patients with type 2 diabetes: A nationwide cohort study. Osteoporos Int. 2022 (Apr 19). Doi: 10.1007/s00198-022-06398-8

Key clinical point: Body weight gain and loss are significantly associated with a higher risk for hip fracture in patients with type 2 diabetes (T2D), irrespective of the body mass index.

Major finding: Compared with stable weight, body weight loss of ≥10% (adjusted hazard ratio [aHR] 1.605; 95% CI 1.493-1.725) and 5%-10% (aHR 1.237; 95% CI 1.177-1.300) and gain of ≥10% (aHR 1.457; 95% CI 1.318-1.612) and 5%-≤10% (aHR 1.234; 95% CI 1.156-1.318) were associated with a higher risk for hip fracture.

Study details: Findings are from a nationwide cohort study including 1,447,579 patients aged >40 years with T2D who reported 11,848 hip fracture events.

Disclosures: The study was supported by a National Research Foundation of Korea grant funded by the Korean government. The authors declared no conflicts of interest.

Source: Lee SW et al. Weight change and the risk of hip fractures in patients with type 2 diabetes: A nationwide cohort study. Osteoporos Int. 2022 (Apr 19). Doi: 10.1007/s00198-022-06398-8

Key clinical point: Treatment intensification with quadruple therapy showed similar glucose lowering efficacy as once weekly glucagon-like peptide-1 receptor agonist (GLP-1RA)-based triple therapy in patients with poorly controlled type 2 diabetes mellitus (T2D). However, low C-peptide levels reduced the therapeutic efficacy of GLP-1RA therapy but not quadruple therapy.

Major finding: At 24 weeks, both quadruple and GLP-1RA-based triple therapies significantly reduced glycated hemoglobin level (both therapies: mean reduction −1.1%; P < .001); however, the glucose-lowering effects of GLP-1RA vs quadruple therapy were weaker in patients with low C-peptide levels (mean −0.1% vs −1.3%; P = .04).

Study details: Findings are from a real-world study including 96 patients with poorly controlled T2D refractory to triple oral therapy who underwent treatment intensification with quadruple oral therapy (n = 50) or once-weekly GLP-1RA-based triple therapy (n = 46).

Disclosures: The study received no specific funding. The authors declared no conflicts of interest.

Source: Kim M et al. the efficacy of treatment intensification by quadruple oral therapy compared to GLP-1RA therapy in poorly controlled type 2 diabetes mellitus patients: A real-world data study. Diabetes Metab J. 2022 (Apr 29). Doi: 10.4093/dmj.2021.0373

Key clinical point: Treatment intensification with quadruple therapy showed similar glucose lowering efficacy as once weekly glucagon-like peptide-1 receptor agonist (GLP-1RA)-based triple therapy in patients with poorly controlled type 2 diabetes mellitus (T2D). However, low C-peptide levels reduced the therapeutic efficacy of GLP-1RA therapy but not quadruple therapy.

Major finding: At 24 weeks, both quadruple and GLP-1RA-based triple therapies significantly reduced glycated hemoglobin level (both therapies: mean reduction −1.1%; P < .001); however, the glucose-lowering effects of GLP-1RA vs quadruple therapy were weaker in patients with low C-peptide levels (mean −0.1% vs −1.3%; P = .04).

Study details: Findings are from a real-world study including 96 patients with poorly controlled T2D refractory to triple oral therapy who underwent treatment intensification with quadruple oral therapy (n = 50) or once-weekly GLP-1RA-based triple therapy (n = 46).

Disclosures: The study received no specific funding. The authors declared no conflicts of interest.

Source: Kim M et al. the efficacy of treatment intensification by quadruple oral therapy compared to GLP-1RA therapy in poorly controlled type 2 diabetes mellitus patients: A real-world data study. Diabetes Metab J. 2022 (Apr 29). Doi: 10.4093/dmj.2021.0373

Key clinical point: Treatment intensification with quadruple therapy showed similar glucose lowering efficacy as once weekly glucagon-like peptide-1 receptor agonist (GLP-1RA)-based triple therapy in patients with poorly controlled type 2 diabetes mellitus (T2D). However, low C-peptide levels reduced the therapeutic efficacy of GLP-1RA therapy but not quadruple therapy.

Major finding: At 24 weeks, both quadruple and GLP-1RA-based triple therapies significantly reduced glycated hemoglobin level (both therapies: mean reduction −1.1%; P < .001); however, the glucose-lowering effects of GLP-1RA vs quadruple therapy were weaker in patients with low C-peptide levels (mean −0.1% vs −1.3%; P = .04).

Study details: Findings are from a real-world study including 96 patients with poorly controlled T2D refractory to triple oral therapy who underwent treatment intensification with quadruple oral therapy (n = 50) or once-weekly GLP-1RA-based triple therapy (n = 46).

Disclosures: The study received no specific funding. The authors declared no conflicts of interest.

Source: Kim M et al. the efficacy of treatment intensification by quadruple oral therapy compared to GLP-1RA therapy in poorly controlled type 2 diabetes mellitus patients: A real-world data study. Diabetes Metab J. 2022 (Apr 29). Doi: 10.4093/dmj.2021.0373

Key clinical point: Prolonged treatment with proton pump inhibitors (PPI) is associated with a higher risk for type 2 diabetes (T2D), thus unnecessary prescription, particularly for long-term use, should be avoided.

Major finding: The risk for T2D was higher among patients receiving PPI for 8 weeks to 6 months (odds ratio [OR] 1.19; 95% CI 1.15-1.24), 6 months to 2 years (OR 1.43; 95% CI 1.38-1.49), and >2 years (OR 1.56; 95% CI 1.49-1.64) than those receiving PPI for <8 weeks (P_trend < .001), particularly among younger patients and those with worse clinical complexity.

Study details: Findings are from a nested case-control study including 777,420 patients aged ≥40 years who received PPI, of which 50,535 were diagnosed with T2D and matched with control participants.

Disclosures: The study was funded by the Italian Ministry of Education, University, and Research. G Corrao declared being an advisory board member, receiving research support, and participating in numerous projects funded by various sources.

Source: Ciardullo S et al. Prolonged use of proton pump inhibitors and risk of type 2 diabetes: Results from a large population-based nested case-control study. J Clin Endocrinol Metab. 2022 (Apr 16). Doi: 10.1210/clinem/dgac231

Key clinical point: Prolonged treatment with proton pump inhibitors (PPI) is associated with a higher risk for type 2 diabetes (T2D), thus unnecessary prescription, particularly for long-term use, should be avoided.

Major finding: The risk for T2D was higher among patients receiving PPI for 8 weeks to 6 months (odds ratio [OR] 1.19; 95% CI 1.15-1.24), 6 months to 2 years (OR 1.43; 95% CI 1.38-1.49), and >2 years (OR 1.56; 95% CI 1.49-1.64) than those receiving PPI for <8 weeks (P_trend < .001), particularly among younger patients and those with worse clinical complexity.

Study details: Findings are from a nested case-control study including 777,420 patients aged ≥40 years who received PPI, of which 50,535 were diagnosed with T2D and matched with control participants.

Disclosures: The study was funded by the Italian Ministry of Education, University, and Research. G Corrao declared being an advisory board member, receiving research support, and participating in numerous projects funded by various sources.

Source: Ciardullo S et al. Prolonged use of proton pump inhibitors and risk of type 2 diabetes: Results from a large population-based nested case-control study. J Clin Endocrinol Metab. 2022 (Apr 16). Doi: 10.1210/clinem/dgac231

Key clinical point: Prolonged treatment with proton pump inhibitors (PPI) is associated with a higher risk for type 2 diabetes (T2D), thus unnecessary prescription, particularly for long-term use, should be avoided.

Major finding: The risk for T2D was higher among patients receiving PPI for 8 weeks to 6 months (odds ratio [OR] 1.19; 95% CI 1.15-1.24), 6 months to 2 years (OR 1.43; 95% CI 1.38-1.49), and >2 years (OR 1.56; 95% CI 1.49-1.64) than those receiving PPI for <8 weeks (P_trend < .001), particularly among younger patients and those with worse clinical complexity.

Study details: Findings are from a nested case-control study including 777,420 patients aged ≥40 years who received PPI, of which 50,535 were diagnosed with T2D and matched with control participants.

Disclosures: The study was funded by the Italian Ministry of Education, University, and Research. G Corrao declared being an advisory board member, receiving research support, and participating in numerous projects funded by various sources.

Source: Ciardullo S et al. Prolonged use of proton pump inhibitors and risk of type 2 diabetes: Results from a large population-based nested case-control study. J Clin Endocrinol Metab. 2022 (Apr 16). Doi: 10.1210/clinem/dgac231

Key clinical point: Treatment intensification with 300 units/mL insulin glargine (Gla-300) in patients with type 2 diabetes mellitus (T2D) receiving glucagon-like peptide-1 receptor agonists (GLP-1 RA) significantly improved glycemic control without increasing the risk for hypoglycemia.

Major finding: Addition of Gla-300 to GLP-1 RA therapy significantly reduced glycated hemoglobin (HbA1c) level (mean change −0.97% ± 1.6%; P < .0001) and significantly increased the proportion of patients achieving glycemic control (HbA1c <7.0%: change 17.34%; HbA1c <8.0%: change 31.73%; both P < .001), with no significant changes in overall incidence or event rate of hypoglycemia.

Study details: The data come from a retrospective analysis of 271 insulin-naive patients with T2D receiving GLP-1 RA who underwent treatment intensification with Gla-300.

Disclosures: This study was funded by Sanofi. TS Bailey declared receiving research support and consulting and speaking honoraria from various sources, including Sanofi. C Nicholls, J Gill, and J Westerbacka declared being employees and stockholders of Sanofi.

Source: Bailey TS et al. Real-world outcomes of addition of insulin glargine 300 U/mL (Gla-300) to GLP-1 RA therapy in people with type 2 diabetes: The DELIVER-G study. Diabetes Obes Metab. 2022 (May 1). Doi: 10.1111/dom.14739

Key clinical point: Treatment intensification with 300 units/mL insulin glargine (Gla-300) in patients with type 2 diabetes mellitus (T2D) receiving glucagon-like peptide-1 receptor agonists (GLP-1 RA) significantly improved glycemic control without increasing the risk for hypoglycemia.

Major finding: Addition of Gla-300 to GLP-1 RA therapy significantly reduced glycated hemoglobin (HbA1c) level (mean change −0.97% ± 1.6%; P < .0001) and significantly increased the proportion of patients achieving glycemic control (HbA1c <7.0%: change 17.34%; HbA1c <8.0%: change 31.73%; both P < .001), with no significant changes in overall incidence or event rate of hypoglycemia.

Study details: The data come from a retrospective analysis of 271 insulin-naive patients with T2D receiving GLP-1 RA who underwent treatment intensification with Gla-300.

Disclosures: This study was funded by Sanofi. TS Bailey declared receiving research support and consulting and speaking honoraria from various sources, including Sanofi. C Nicholls, J Gill, and J Westerbacka declared being employees and stockholders of Sanofi.

Source: Bailey TS et al. Real-world outcomes of addition of insulin glargine 300 U/mL (Gla-300) to GLP-1 RA therapy in people with type 2 diabetes: The DELIVER-G study. Diabetes Obes Metab. 2022 (May 1). Doi: 10.1111/dom.14739

Key clinical point: Treatment intensification with 300 units/mL insulin glargine (Gla-300) in patients with type 2 diabetes mellitus (T2D) receiving glucagon-like peptide-1 receptor agonists (GLP-1 RA) significantly improved glycemic control without increasing the risk for hypoglycemia.

Major finding: Addition of Gla-300 to GLP-1 RA therapy significantly reduced glycated hemoglobin (HbA1c) level (mean change −0.97% ± 1.6%; P < .0001) and significantly increased the proportion of patients achieving glycemic control (HbA1c <7.0%: change 17.34%; HbA1c <8.0%: change 31.73%; both P < .001), with no significant changes in overall incidence or event rate of hypoglycemia.

Study details: The data come from a retrospective analysis of 271 insulin-naive patients with T2D receiving GLP-1 RA who underwent treatment intensification with Gla-300.

Disclosures: This study was funded by Sanofi. TS Bailey declared receiving research support and consulting and speaking honoraria from various sources, including Sanofi. C Nicholls, J Gill, and J Westerbacka declared being employees and stockholders of Sanofi.

Source: Bailey TS et al. Real-world outcomes of addition of insulin glargine 300 U/mL (Gla-300) to GLP-1 RA therapy in people with type 2 diabetes: The DELIVER-G study. Diabetes Obes Metab. 2022 (May 1). Doi: 10.1111/dom.14739

Key clinical point: Severe hypoglycemia (SH) is associated with a greater risk for corrected QT (QTc) prolongation in patients with type 2 diabetes mellitus (T2D), especially in younger participants (age <61.9 years), irrespective of other risk factors.

Major finding: Patients with T2D and SH had a higher risk for QTc prolongation (adjusted risk ratio [aRR] 1.66; 95% CI 1.16-2.38), with the risk being higher in patients with 1 (aRR 1.57; 95% CI 1.04-2.39) and ≥2 (aRR 2.01; 95% CI 1.07-3.78) vs no SH episodes and the association remaining significant in younger (aRR 2.63; P = .001) but not in older (P = .170) patients.

Study details: This prospective cohort study included 8277 patients with T2D from the ACCORD study, of which 324 had ≥1 SH episodes and 517 developed QTc prolongation over a 5-year median follow-up.

Disclosures: The study received no specific funding. GC Fonarow reported being a consultant for various organizations.

Source: Kaze AD et al. Severe hypoglycemia and incidence of QT interval prolongation among adults with type 2 diabetes. J Clin Endocrinol Metab. 2022 (Apr 9). Doi: 10.1210/clinem/dgac195

Key clinical point: Severe hypoglycemia (SH) is associated with a greater risk for corrected QT (QTc) prolongation in patients with type 2 diabetes mellitus (T2D), especially in younger participants (age <61.9 years), irrespective of other risk factors.

Major finding: Patients with T2D and SH had a higher risk for QTc prolongation (adjusted risk ratio [aRR] 1.66; 95% CI 1.16-2.38), with the risk being higher in patients with 1 (aRR 1.57; 95% CI 1.04-2.39) and ≥2 (aRR 2.01; 95% CI 1.07-3.78) vs no SH episodes and the association remaining significant in younger (aRR 2.63; P = .001) but not in older (P = .170) patients.

Study details: This prospective cohort study included 8277 patients with T2D from the ACCORD study, of which 324 had ≥1 SH episodes and 517 developed QTc prolongation over a 5-year median follow-up.

Disclosures: The study received no specific funding. GC Fonarow reported being a consultant for various organizations.

Source: Kaze AD et al. Severe hypoglycemia and incidence of QT interval prolongation among adults with type 2 diabetes. J Clin Endocrinol Metab. 2022 (Apr 9). Doi: 10.1210/clinem/dgac195

Key clinical point: Severe hypoglycemia (SH) is associated with a greater risk for corrected QT (QTc) prolongation in patients with type 2 diabetes mellitus (T2D), especially in younger participants (age <61.9 years), irrespective of other risk factors.

Major finding: Patients with T2D and SH had a higher risk for QTc prolongation (adjusted risk ratio [aRR] 1.66; 95% CI 1.16-2.38), with the risk being higher in patients with 1 (aRR 1.57; 95% CI 1.04-2.39) and ≥2 (aRR 2.01; 95% CI 1.07-3.78) vs no SH episodes and the association remaining significant in younger (aRR 2.63; P = .001) but not in older (P = .170) patients.

Study details: This prospective cohort study included 8277 patients with T2D from the ACCORD study, of which 324 had ≥1 SH episodes and 517 developed QTc prolongation over a 5-year median follow-up.

Disclosures: The study received no specific funding. GC Fonarow reported being a consultant for various organizations.

Source: Kaze AD et al. Severe hypoglycemia and incidence of QT interval prolongation among adults with type 2 diabetes. J Clin Endocrinol Metab. 2022 (Apr 9). Doi: 10.1210/clinem/dgac195

Key clinical point: Once-weekly tirzepatide vs insulin degludec effectuates superior glycemic control, as measured by continuous glucose monitoring, in patients with inadequately controlled type 2 diabetes (T2D) on metformin with or without a sodium-glucose cotransporter-2 (SGLT2) inhibitor.

Major finding: At 52 weeks, patients receiving 5 mg tirzepatide (estimated treatment difference [ETD] 12%; P = .031), 10 mg (ETD 24%; P < .0001), and 15 mg (ETD 25%; P < .0001) vs insulin degludec spent significantly more time in the tight target range (blood glucose concentration 71-140 mg/dL).

Study details: This substudy of the SURPASS-3 trial included 243 insulin-naive patients with type T2D inadequately controlled on metformin with or without an SGLT2 inhibitor who were randomly assigned to receive once-weekly tirzepatide (5, 10, or 15 mg; n = 188) or insulin degludec (n = 55).

Disclosures: The study was funded by Eli Lilly and Company. Two authors reported being consultants or receiving advisory board member or speaker honoraria from various sources, including Eli Lilly. The other authors are employees and shareholders of Eli Lilly.

Source: Battelino T et al. Efficacy of once-weekly tirzepatide versus once-daily insulin degludec on glycaemic control measured by continuous glucose monitoring in adults with type 2 diabetes (SURPASS-3 CGM): A substudy of the randomised, open-label, parallel-group, phase 3 SURPASS-3 trial. Lancet Diabetes Endocrinol. 2022;10(6):407-417 (Apr 22). Doi: 10.1016/S2213-8587(22)00077-8

Key clinical point: Once-weekly tirzepatide vs insulin degludec effectuates superior glycemic control, as measured by continuous glucose monitoring, in patients with inadequately controlled type 2 diabetes (T2D) on metformin with or without a sodium-glucose cotransporter-2 (SGLT2) inhibitor.

Major finding: At 52 weeks, patients receiving 5 mg tirzepatide (estimated treatment difference [ETD] 12%; P = .031), 10 mg (ETD 24%; P < .0001), and 15 mg (ETD 25%; P < .0001) vs insulin degludec spent significantly more time in the tight target range (blood glucose concentration 71-140 mg/dL).

Study details: This substudy of the SURPASS-3 trial included 243 insulin-naive patients with type T2D inadequately controlled on metformin with or without an SGLT2 inhibitor who were randomly assigned to receive once-weekly tirzepatide (5, 10, or 15 mg; n = 188) or insulin degludec (n = 55).

Disclosures: The study was funded by Eli Lilly and Company. Two authors reported being consultants or receiving advisory board member or speaker honoraria from various sources, including Eli Lilly. The other authors are employees and shareholders of Eli Lilly.

Source: Battelino T et al. Efficacy of once-weekly tirzepatide versus once-daily insulin degludec on glycaemic control measured by continuous glucose monitoring in adults with type 2 diabetes (SURPASS-3 CGM): A substudy of the randomised, open-label, parallel-group, phase 3 SURPASS-3 trial. Lancet Diabetes Endocrinol. 2022;10(6):407-417 (Apr 22). Doi: 10.1016/S2213-8587(22)00077-8

Key clinical point: Once-weekly tirzepatide vs insulin degludec effectuates superior glycemic control, as measured by continuous glucose monitoring, in patients with inadequately controlled type 2 diabetes (T2D) on metformin with or without a sodium-glucose cotransporter-2 (SGLT2) inhibitor.

Major finding: At 52 weeks, patients receiving 5 mg tirzepatide (estimated treatment difference [ETD] 12%; P = .031), 10 mg (ETD 24%; P < .0001), and 15 mg (ETD 25%; P < .0001) vs insulin degludec spent significantly more time in the tight target range (blood glucose concentration 71-140 mg/dL).

Study details: This substudy of the SURPASS-3 trial included 243 insulin-naive patients with type T2D inadequately controlled on metformin with or without an SGLT2 inhibitor who were randomly assigned to receive once-weekly tirzepatide (5, 10, or 15 mg; n = 188) or insulin degludec (n = 55).

Disclosures: The study was funded by Eli Lilly and Company. Two authors reported being consultants or receiving advisory board member or speaker honoraria from various sources, including Eli Lilly. The other authors are employees and shareholders of Eli Lilly.

Source: Battelino T et al. Efficacy of once-weekly tirzepatide versus once-daily insulin degludec on glycaemic control measured by continuous glucose monitoring in adults with type 2 diabetes (SURPASS-3 CGM): A substudy of the randomised, open-label, parallel-group, phase 3 SURPASS-3 trial. Lancet Diabetes Endocrinol. 2022;10(6):407-417 (Apr 22). Doi: 10.1016/S2213-8587(22)00077-8

Key clinical point: NFE2L2 and KEAP1 mutations account for 31.6% of all advanced squamous cell non-small cell lung cancer (NSCLC) cases, and these mutations are associated with worse real-world progression-free survival (PFS) after first-line therapy.

Major finding: NFE2L2 and KEAP1 mutations were detected in 31.6% of patients. Patients harboring these mutations had a shorter real-world PFS after first-line therapy (4.54 vs 6.25 months with wild-type disease; P = .0027).

Study details: The data come from a retrospective cohort study of 703 patients with advanced squamous cell NSCLC from a real-world US clinicogenomic database.

Disclosures: The study was funded by Takeda Development Center Americas, Inc. Y Wu, Y Yin, V Crossland, S Vincent, N Lineberry, and DV Faller are employees of Takeda Development Center Americas, Inc. PK Paik reported ties with various pharmaceutical companies.

Source: Wu Y et al. Survival outcomes and treatment patterns in patients with NFE2L2 and/or KEAP1 mutation-positive advanced squamous cell NSCLC using a real-world clinico-genomic database. Clin Lung Cancer. 2022 (May 10). Doi: 10.1016/j.cllc.2022.05.008

Key clinical point: NFE2L2 and KEAP1 mutations account for 31.6% of all advanced squamous cell non-small cell lung cancer (NSCLC) cases, and these mutations are associated with worse real-world progression-free survival (PFS) after first-line therapy.

Major finding: NFE2L2 and KEAP1 mutations were detected in 31.6% of patients. Patients harboring these mutations had a shorter real-world PFS after first-line therapy (4.54 vs 6.25 months with wild-type disease; P = .0027).

Study details: The data come from a retrospective cohort study of 703 patients with advanced squamous cell NSCLC from a real-world US clinicogenomic database.

Disclosures: The study was funded by Takeda Development Center Americas, Inc. Y Wu, Y Yin, V Crossland, S Vincent, N Lineberry, and DV Faller are employees of Takeda Development Center Americas, Inc. PK Paik reported ties with various pharmaceutical companies.

Source: Wu Y et al. Survival outcomes and treatment patterns in patients with NFE2L2 and/or KEAP1 mutation-positive advanced squamous cell NSCLC using a real-world clinico-genomic database. Clin Lung Cancer. 2022 (May 10). Doi: 10.1016/j.cllc.2022.05.008

Key clinical point: NFE2L2 and KEAP1 mutations account for 31.6% of all advanced squamous cell non-small cell lung cancer (NSCLC) cases, and these mutations are associated with worse real-world progression-free survival (PFS) after first-line therapy.

Major finding: NFE2L2 and KEAP1 mutations were detected in 31.6% of patients. Patients harboring these mutations had a shorter real-world PFS after first-line therapy (4.54 vs 6.25 months with wild-type disease; P = .0027).

Study details: The data come from a retrospective cohort study of 703 patients with advanced squamous cell NSCLC from a real-world US clinicogenomic database.

Disclosures: The study was funded by Takeda Development Center Americas, Inc. Y Wu, Y Yin, V Crossland, S Vincent, N Lineberry, and DV Faller are employees of Takeda Development Center Americas, Inc. PK Paik reported ties with various pharmaceutical companies.

Source: Wu Y et al. Survival outcomes and treatment patterns in patients with NFE2L2 and/or KEAP1 mutation-positive advanced squamous cell NSCLC using a real-world clinico-genomic database. Clin Lung Cancer. 2022 (May 10). Doi: 10.1016/j.cllc.2022.05.008

Key clinical point: A new breath biomarker-based diagnostic method shows promise by identifying 16 cancer-derived volatile organic compounds (VOC) that have high sensitivity and specificity in patients with lung cancer.

Major finding: In the discovery phase, 16 VOC with peak intensity most altered before vs after surgery were identified. In the validation phase, the 16 VOC-based diagnostic model demonstrated an area under the curve of 0.952, sensitivity of 89.2%, specificity of 89.1%, and accuracy of 89.1%.

Study details: The discovery phase involved a prospective cohort study of 84 patients with lung cancer who were tested for 28 VOC before and after surgery. The promising VOC were further assessed in the validation phase which included 157 patients with lung cancer and 368 healthy controls.

Disclosures: The research was funded by the National Natural Science Foundation of China and others. The authors declared no competing interests.

Source: Wang P et al. Identification of lung cancer breath biomarkers based on perioperative breathomics testing: A prospective observational study. EClinicalMedicine. 2022;47:101384 (Apr 26). Doi: 10.1016/j.eclinm.2022.101384

Key clinical point: A new breath biomarker-based diagnostic method shows promise by identifying 16 cancer-derived volatile organic compounds (VOC) that have high sensitivity and specificity in patients with lung cancer.

Major finding: In the discovery phase, 16 VOC with peak intensity most altered before vs after surgery were identified. In the validation phase, the 16 VOC-based diagnostic model demonstrated an area under the curve of 0.952, sensitivity of 89.2%, specificity of 89.1%, and accuracy of 89.1%.

Study details: The discovery phase involved a prospective cohort study of 84 patients with lung cancer who were tested for 28 VOC before and after surgery. The promising VOC were further assessed in the validation phase which included 157 patients with lung cancer and 368 healthy controls.

Disclosures: The research was funded by the National Natural Science Foundation of China and others. The authors declared no competing interests.

Source: Wang P et al. Identification of lung cancer breath biomarkers based on perioperative breathomics testing: A prospective observational study. EClinicalMedicine. 2022;47:101384 (Apr 26). Doi: 10.1016/j.eclinm.2022.101384

Key clinical point: A new breath biomarker-based diagnostic method shows promise by identifying 16 cancer-derived volatile organic compounds (VOC) that have high sensitivity and specificity in patients with lung cancer.

Major finding: In the discovery phase, 16 VOC with peak intensity most altered before vs after surgery were identified. In the validation phase, the 16 VOC-based diagnostic model demonstrated an area under the curve of 0.952, sensitivity of 89.2%, specificity of 89.1%, and accuracy of 89.1%.

Study details: The discovery phase involved a prospective cohort study of 84 patients with lung cancer who were tested for 28 VOC before and after surgery. The promising VOC were further assessed in the validation phase which included 157 patients with lung cancer and 368 healthy controls.

Disclosures: The research was funded by the National Natural Science Foundation of China and others. The authors declared no competing interests.

Source: Wang P et al. Identification of lung cancer breath biomarkers based on perioperative breathomics testing: A prospective observational study. EClinicalMedicine. 2022;47:101384 (Apr 26). Doi: 10.1016/j.eclinm.2022.101384

Key clinical point: In patients with stage I lung cancer treated with stereotactic body radiation therapy (SBRT), a model incorporating noncancerous imaging features on chest computed tomography (CT) and clinical features vs clinical features alone performed better at predicting overall survival (OS).

Major finding: The model that incorporated both clinical and imaging features vs the model that incorporated only clinical features performed better at predicting 5-year OS (area under the curve 0.75 vs 0.61; P < .01). Independent risk factors for shorter OS were elevated coronary artery calcium score, increased pulmonary artery-to-aorta ratio, and decreased thoracic skeletal muscle index.

Study details: The data come from a retrospective study involving 282 patients with stage I lung cancer treated with SBRT. Several clinical markers were assessed from pretreatment chest CT images.

Disclosures: No funding information was available. The corresponding author FJ Fintelmann reported no relevant financial relationships.

Source: Tahir I et al. Utility of noncancerous chest CT features for predicting overall survival and noncancer death in patients with stage I lung cancer treated with stereotactic body radiotherapy. AJR Am J Roentgenol. 2022 (Apr 13). Doi: 10.2214/AJR.22.27484

Key clinical point: In patients with stage I lung cancer treated with stereotactic body radiation therapy (SBRT), a model incorporating noncancerous imaging features on chest computed tomography (CT) and clinical features vs clinical features alone performed better at predicting overall survival (OS).

Major finding: The model that incorporated both clinical and imaging features vs the model that incorporated only clinical features performed better at predicting 5-year OS (area under the curve 0.75 vs 0.61; P < .01). Independent risk factors for shorter OS were elevated coronary artery calcium score, increased pulmonary artery-to-aorta ratio, and decreased thoracic skeletal muscle index.

Study details: The data come from a retrospective study involving 282 patients with stage I lung cancer treated with SBRT. Several clinical markers were assessed from pretreatment chest CT images.

Disclosures: No funding information was available. The corresponding author FJ Fintelmann reported no relevant financial relationships.

Source: Tahir I et al. Utility of noncancerous chest CT features for predicting overall survival and noncancer death in patients with stage I lung cancer treated with stereotactic body radiotherapy. AJR Am J Roentgenol. 2022 (Apr 13). Doi: 10.2214/AJR.22.27484

Key clinical point: In patients with stage I lung cancer treated with stereotactic body radiation therapy (SBRT), a model incorporating noncancerous imaging features on chest computed tomography (CT) and clinical features vs clinical features alone performed better at predicting overall survival (OS).

Major finding: The model that incorporated both clinical and imaging features vs the model that incorporated only clinical features performed better at predicting 5-year OS (area under the curve 0.75 vs 0.61; P < .01). Independent risk factors for shorter OS were elevated coronary artery calcium score, increased pulmonary artery-to-aorta ratio, and decreased thoracic skeletal muscle index.

Study details: The data come from a retrospective study involving 282 patients with stage I lung cancer treated with SBRT. Several clinical markers were assessed from pretreatment chest CT images.

Disclosures: No funding information was available. The corresponding author FJ Fintelmann reported no relevant financial relationships.

Source: Tahir I et al. Utility of noncancerous chest CT features for predicting overall survival and noncancer death in patients with stage I lung cancer treated with stereotactic body radiotherapy. AJR Am J Roentgenol. 2022 (Apr 13). Doi: 10.2214/AJR.22.27484

Key clinical point: Frontline therapy with anlotinib plus platinum-etoposide chemotherapy shows favorable outcomes in patients with extensive-stage (ES) small-cell lung cancer (SCLC).

Major finding: The median progression-free survival was 8.02 (95% CI 6.90-9.66) months and the overall survival was 15.87 (95% CI 10.38-18.89) months. The objective response rate was 85.71% (95% CI 69.74%-95.19%) and the disease control rate was 94.29% (95% CI 80.84%-99.30%). The incidence of grade 3-4 adverse events was 40%.

Study details: The data come from a phase 2 single-arm trial of anlotinib plus platinum-etoposide in 35 patients with ES-SCLC at a single center in China.

Disclosures: The trial was funded by Chia Tai Tianqing Pharmaceutical Group Co., Ltd. The authors declared no competing interests.

Source: Deng P et al. Anlotinib plus platinum-etoposide as a first-line treatment for extensive-stage small cell lung cancer: A single-arm trial. Cancer Med. 2022 (May 8). Doi: 10.1002/cam4.4736

Key clinical point: Frontline therapy with anlotinib plus platinum-etoposide chemotherapy shows favorable outcomes in patients with extensive-stage (ES) small-cell lung cancer (SCLC).

Major finding: The median progression-free survival was 8.02 (95% CI 6.90-9.66) months and the overall survival was 15.87 (95% CI 10.38-18.89) months. The objective response rate was 85.71% (95% CI 69.74%-95.19%) and the disease control rate was 94.29% (95% CI 80.84%-99.30%). The incidence of grade 3-4 adverse events was 40%.

Study details: The data come from a phase 2 single-arm trial of anlotinib plus platinum-etoposide in 35 patients with ES-SCLC at a single center in China.

Disclosures: The trial was funded by Chia Tai Tianqing Pharmaceutical Group Co., Ltd. The authors declared no competing interests.

Source: Deng P et al. Anlotinib plus platinum-etoposide as a first-line treatment for extensive-stage small cell lung cancer: A single-arm trial. Cancer Med. 2022 (May 8). Doi: 10.1002/cam4.4736

Key clinical point: Frontline therapy with anlotinib plus platinum-etoposide chemotherapy shows favorable outcomes in patients with extensive-stage (ES) small-cell lung cancer (SCLC).

Major finding: The median progression-free survival was 8.02 (95% CI 6.90-9.66) months and the overall survival was 15.87 (95% CI 10.38-18.89) months. The objective response rate was 85.71% (95% CI 69.74%-95.19%) and the disease control rate was 94.29% (95% CI 80.84%-99.30%). The incidence of grade 3-4 adverse events was 40%.

Study details: The data come from a phase 2 single-arm trial of anlotinib plus platinum-etoposide in 35 patients with ES-SCLC at a single center in China.

Disclosures: The trial was funded by Chia Tai Tianqing Pharmaceutical Group Co., Ltd. The authors declared no competing interests.

Source: Deng P et al. Anlotinib plus platinum-etoposide as a first-line treatment for extensive-stage small cell lung cancer: A single-arm trial. Cancer Med. 2022 (May 8). Doi: 10.1002/cam4.4736