Clinical Edge Journal Scan

Key clinical point: High circulating D-dimer levels are a risk factor for mortality and venous thromboembolism (VTE) events in patients with lung cancer.

Major finding: The meta-analysis showed that high vs. low circulating D-dimer levels were associated with a higher risk for lung cancer mortality (hazard ratio [HR] 1.62; 95% CI 1.39-1.88). Additionally, the external validation cohort demonstrated that elevated D-dimer levels were associated with a higher risk for overall mortality (HR 1.39; 95% CI 1.13-1.72) and VTE events (HR 3.98; P = .002).

Study details: The data come from a meta-analysis of 19 cohort studies (n = 5819) and an external validation cohort (n = 540).

Disclosures: The study was funded by the Social Development Project of Jiangsu Province, China, and the Project of Hygiene and Health Committee of Jiangsu Province, China. The authors declared no conflicts of interest.

Source: Li J et al. Circulating D-dimers increase the risk of mortality and venous thromboembolism in patients with lung cancer: A systematic analysis combined with external validation. Front Med (Lausanne). 2022;9:853941 (Mar 2). Doi: 10.3389/fmed.2022.853941

Key clinical point: High circulating D-dimer levels are a risk factor for mortality and venous thromboembolism (VTE) events in patients with lung cancer.

Major finding: The meta-analysis showed that high vs. low circulating D-dimer levels were associated with a higher risk for lung cancer mortality (hazard ratio [HR] 1.62; 95% CI 1.39-1.88). Additionally, the external validation cohort demonstrated that elevated D-dimer levels were associated with a higher risk for overall mortality (HR 1.39; 95% CI 1.13-1.72) and VTE events (HR 3.98; P = .002).

Study details: The data come from a meta-analysis of 19 cohort studies (n = 5819) and an external validation cohort (n = 540).

Disclosures: The study was funded by the Social Development Project of Jiangsu Province, China, and the Project of Hygiene and Health Committee of Jiangsu Province, China. The authors declared no conflicts of interest.

Source: Li J et al. Circulating D-dimers increase the risk of mortality and venous thromboembolism in patients with lung cancer: A systematic analysis combined with external validation. Front Med (Lausanne). 2022;9:853941 (Mar 2). Doi: 10.3389/fmed.2022.853941

Key clinical point: High circulating D-dimer levels are a risk factor for mortality and venous thromboembolism (VTE) events in patients with lung cancer.

Major finding: The meta-analysis showed that high vs. low circulating D-dimer levels were associated with a higher risk for lung cancer mortality (hazard ratio [HR] 1.62; 95% CI 1.39-1.88). Additionally, the external validation cohort demonstrated that elevated D-dimer levels were associated with a higher risk for overall mortality (HR 1.39; 95% CI 1.13-1.72) and VTE events (HR 3.98; P = .002).

Study details: The data come from a meta-analysis of 19 cohort studies (n = 5819) and an external validation cohort (n = 540).

Disclosures: The study was funded by the Social Development Project of Jiangsu Province, China, and the Project of Hygiene and Health Committee of Jiangsu Province, China. The authors declared no conflicts of interest.

Source: Li J et al. Circulating D-dimers increase the risk of mortality and venous thromboembolism in patients with lung cancer: A systematic analysis combined with external validation. Front Med (Lausanne). 2022;9:853941 (Mar 2). Doi: 10.3389/fmed.2022.853941

Key clinical point: Addition of an antiangiogenic drug to second-line therapy may boost overall survival (OS) and progression-free survival (PFS) in patients with advanced non–small-cell lung cancer (NSCLC).

Major finding: The antiangiogenic drug plus second-line therapy vs. second-line therapy alone improved OS by 7% (hazard ratio [HR] 0.93; P = .005) and PFS by 20% (HR 0.80; P < .0001). The antiangiogenic group had a greater frequency of grade ≥3 toxicity.

Study details: The findings come from a patient data meta-analysis of 16 randomized controlled trials including 8629 participants.

Disclosures: The study did not receive any external funding. R Herbst, M Reck, EB Garon, GV Scagliotti, R Ramlau, N Hanna, J Vansteenkiste, K Yoh, HJM Groen, JV Heymach, and RS Heist were authors for some of the individual trials included in the meta-analysis. The other authors declared no conflicts of interest.

Source: Remon J et al. ANtiangiogenic Second-line Lung cancer Meta-Analysis on individual patient data in non-small cell lung cancer: ANSELMA. Eur J Cancer. 2022;166:112-125 (Mar 11). Doi:  10.1016/j.ejca.2022.02.002

Key clinical point: Addition of an antiangiogenic drug to second-line therapy may boost overall survival (OS) and progression-free survival (PFS) in patients with advanced non–small-cell lung cancer (NSCLC).

Major finding: The antiangiogenic drug plus second-line therapy vs. second-line therapy alone improved OS by 7% (hazard ratio [HR] 0.93; P = .005) and PFS by 20% (HR 0.80; P < .0001). The antiangiogenic group had a greater frequency of grade ≥3 toxicity.

Study details: The findings come from a patient data meta-analysis of 16 randomized controlled trials including 8629 participants.

Disclosures: The study did not receive any external funding. R Herbst, M Reck, EB Garon, GV Scagliotti, R Ramlau, N Hanna, J Vansteenkiste, K Yoh, HJM Groen, JV Heymach, and RS Heist were authors for some of the individual trials included in the meta-analysis. The other authors declared no conflicts of interest.

Source: Remon J et al. ANtiangiogenic Second-line Lung cancer Meta-Analysis on individual patient data in non-small cell lung cancer: ANSELMA. Eur J Cancer. 2022;166:112-125 (Mar 11). Doi:  10.1016/j.ejca.2022.02.002

Key clinical point: Addition of an antiangiogenic drug to second-line therapy may boost overall survival (OS) and progression-free survival (PFS) in patients with advanced non–small-cell lung cancer (NSCLC).

Major finding: The antiangiogenic drug plus second-line therapy vs. second-line therapy alone improved OS by 7% (hazard ratio [HR] 0.93; P = .005) and PFS by 20% (HR 0.80; P < .0001). The antiangiogenic group had a greater frequency of grade ≥3 toxicity.

Study details: The findings come from a patient data meta-analysis of 16 randomized controlled trials including 8629 participants.

Disclosures: The study did not receive any external funding. R Herbst, M Reck, EB Garon, GV Scagliotti, R Ramlau, N Hanna, J Vansteenkiste, K Yoh, HJM Groen, JV Heymach, and RS Heist were authors for some of the individual trials included in the meta-analysis. The other authors declared no conflicts of interest.

Source: Remon J et al. ANtiangiogenic Second-line Lung cancer Meta-Analysis on individual patient data in non-small cell lung cancer: ANSELMA. Eur J Cancer. 2022;166:112-125 (Mar 11). Doi:  10.1016/j.ejca.2022.02.002

Key clinical point: Patients with advanced nonsquamous non–small-cell lung cancer (NSCLC) receiving first-line immune checkpoint inhibitors plus chemotherapy (ICI-chemo) have better overall survival (OS) than those receiving first-line bevacizumab plus chemotherapy (bev-chemo).

Major finding: Patients who received first-line ICI-chemo had a 21% longer OS than those who received bev-chemo (hazard ratio 0.79; 95% CI 0.66-0.94). There were no differences between the 2 groups in progression-free survival, objective response rate, and grade ≥3 treatment-related adverse events.

Study details: The data come from a network meta-analysis of 15 randomized controlled trials including 6561 patients with advanced nonsquamous NSCLC.

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

Source: Zhai J et al. First-line PD-1/PD-L1 inhibitors plus chemotherapy versus bevacizumab plus chemotherapy for advanced non-squamous non-small cell lung cancer: A Bayesian network meta-analysis of randomized controlled trials. Cancer Med. 2022 (Mar 22). Doi: 10.1002/cam4.4589

Key clinical point: Patients with advanced nonsquamous non–small-cell lung cancer (NSCLC) receiving first-line immune checkpoint inhibitors plus chemotherapy (ICI-chemo) have better overall survival (OS) than those receiving first-line bevacizumab plus chemotherapy (bev-chemo).

Major finding: Patients who received first-line ICI-chemo had a 21% longer OS than those who received bev-chemo (hazard ratio 0.79; 95% CI 0.66-0.94). There were no differences between the 2 groups in progression-free survival, objective response rate, and grade ≥3 treatment-related adverse events.

Study details: The data come from a network meta-analysis of 15 randomized controlled trials including 6561 patients with advanced nonsquamous NSCLC.

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

Source: Zhai J et al. First-line PD-1/PD-L1 inhibitors plus chemotherapy versus bevacizumab plus chemotherapy for advanced non-squamous non-small cell lung cancer: A Bayesian network meta-analysis of randomized controlled trials. Cancer Med. 2022 (Mar 22). Doi: 10.1002/cam4.4589

Key clinical point: Patients with advanced nonsquamous non–small-cell lung cancer (NSCLC) receiving first-line immune checkpoint inhibitors plus chemotherapy (ICI-chemo) have better overall survival (OS) than those receiving first-line bevacizumab plus chemotherapy (bev-chemo).

Major finding: Patients who received first-line ICI-chemo had a 21% longer OS than those who received bev-chemo (hazard ratio 0.79; 95% CI 0.66-0.94). There were no differences between the 2 groups in progression-free survival, objective response rate, and grade ≥3 treatment-related adverse events.

Study details: The data come from a network meta-analysis of 15 randomized controlled trials including 6561 patients with advanced nonsquamous NSCLC.

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

Source: Zhai J et al. First-line PD-1/PD-L1 inhibitors plus chemotherapy versus bevacizumab plus chemotherapy for advanced non-squamous non-small cell lung cancer: A Bayesian network meta-analysis of randomized controlled trials. Cancer Med. 2022 (Mar 22). Doi: 10.1002/cam4.4589

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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