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Abstract: Objectives To assess the impact of lung resection extent on early-stage non-small cell lung cancer with a history of any cancer. Methods Retrospective multicentric cohort study including patients with ≤2 cm pathologic size lung cancer with a history of any cancer, operated on from 2015 to 2021 across nine European centers (one per country). Overall survival (OS), disease-free survival (DFS) and lung cancer specific death (LCSD) between both groups were assessed before and after propensity score (PS) −matching. Risk factors for oncologic outcomes were analyzed using parsimonious model cox proportional hazard regression. Kaplan Meier and cumulative incidence function assessed the outcomes. Log-rank test and Gray’ test compared the groups. Linearized risk was used to assess recurrences. Results Of the 1910 patients with early-stage lung cancer patients, 540 (28.2%) had a prior cancer. Lobectomy and segmentectomy were performed in 409 (75.7%) and 131 (24.3%) patients respectively. 5-year OS rates: lobectomy 81.5%, segmentectomy 80.8%, p = 0.8; DFS: lobectomy 76.9%, segmentectomy 74.4%, p = 0.6 and LCSD: lobectomy 8.0%, segmentectomy 4.9%, p = 0.2. These finding were similar in the matched cohort. Locoregional recurrence (linearized risk: lobectomy 0.111, segmentectomy 0.066) and distant recurrence (linearized risk: lobectomy 0.093, segmentectomy 0.055) were not worse in the segmentectomy group. In multivariable analysis, prior cancer negatively impacted only lung cancer specific death HR:1.27 (95%CI:1.00–1.60). Conclusion Compared to lobectomy, segmentectomy has not shown a worse oncologic outcome in patients with history of any prior cancer.
Keywords: segmentectomy, cancer, early-stage, non-small lung, canceroutcome
Published in DiRROS: 27.07.2026; Views: 233; Downloads: 114
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Abstract: BRAF and cMET exon 14 skipping are rare mutations of NSCLC. The treatment sequence in these cases for the first and second line is not clear. An international registry was created for patients with advanced NSCLC harboring BRAF or cMET exon 14 skipping mutations, diagnosed from January 2017 to June 2022. Clinicopathological and molecular data and treatment patterns were recorded. Data on 58 patients, from eight centers across five countries, were included in the final analysis. We found that 40 patients had the cMET exon 14 skipping mutation and 18 had the BRAF V600E mutation. In total, 53 and 28 patients received first- and second-line treatments, respectively, among which 52.8% received targeted therapy (TT) in the first line and 53.5% in the second line. The overall response rate (ORR) and disease control rate (DCR) for first-line treatment with TT vs. other treatment such as immune checkpoint inhibitors ± chemotherapy (IO ± CT) were 55.6% vs. 21.7% (p = 0.0084) and 66.7% vs. 39.1% (p = 0.04), respectively. The type of treatment in first-line TT vs. other affected time to treatment discontinuation (TTD) was 11.6 m vs. 4.6 m (p= 0.006). The overall survival for the whole group was 15.4 m and was not statistically affected by the type of treatment (19.2 m vs. 13.5 m; p = 0.83).
Keywords: non-small-cell lung cancer, BRAF V600 mutation, cMET exon 14 skipping mutation, real-world data, targeted therapy, first-line therapy
Published in DiRROS: 25.02.2026; Views: 593; Downloads: 320
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Abstract: Cytokine release syndrome (CRS) is a well-described immune-related adverse event following chimeric antigen receptor T-cell therapy (CAR-T) but has rarely been reported following therapy with immune checkpoint inhibitors (ICI). We present a clinical case of severe CRS after ICI therapy for advanced non-small-cell lung cancer (NSCLC). After the third cycle of ipilimumab and nivolumab the patient presented with fever, hypotension and somnolence, leading to acute respiratory failure, acute kidney and hepatic failure, capillary leak syndrome, requiring ICU (intensive care unit) care. She recovered after receiving tocilizumab and steroid therapy. Subsequently, we found 17 clinical cases of advanced NSCLC patients in peer review, experiencing CRS as an adverse event of treatment with ICI. We review those cases in detail and compare the similarities and outcomes. Conclusion: CRS is a serious, life-threatening complication that is rare after ICI therapy for solid cancers but becoming increasingly frequent since ICI therapies are broadening indications. When presented with clinical symptoms, considering CRS is crucial, as early recognition is key to timely intervention and favorable outcome for the patient.
Keywords: on-small-cell lung cancer, immune checkpoint inhibitors, cytokine release syndrome, immune- related adverse events, case report
Published in DiRROS: 22.08.2025; Views: 785; Downloads: 493
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Abstract: Background. Stereotactic body radiation therapy (SBRT) precisely and non-invasively delivers ablative radiationdose to tumors in early-stage lung cancer patients who are not candidates for surgery or refuse it. The aim of researchwas to evaluate local control, overall survival (OS), local progression free survival (LPFS), distant metastases free survival(DMFS), disease free survival (DFS) and toxicity in early-stage lung cancer patients treated with SBRT in a single tertiarycancer centre.Patients and methods. We retrospectively evaluated medical records and radiation treatment plan parametersof 228 tumors irradiated in 206 early-stage lung cancer patients between 2016 and 2021 at the Institute of OncologyLjubljana.Results. After 25 months of median follow up, 68 of 206 (33%) patients died. Median OS was 46 months (CI 36 −56),1-year, 2-year and 3-year OS were 87%, 74% and 62% and 5-year OS was 31%. A total of 45 disease progressions havebeen identified in 41 patients. Local progress only was noticed in 5 (2%) patients, systemic progress in 32 (16%) andcombined systemic and local in 4 (2%) patients. Local control rate (LCR) at 1 year was 98%, at 2 and 3 years 96%and 95% at 5 years. The 1-, 2- and 3-year LPFS were 98%, 96% and 94%, respectively and 5-year LPFS was 82%. One,2-, 3- and 5-year DFS w ere 89%, 81%, 72% and 49%, respectively. Among 28 toxicities recorded only one was Grade4 (pneumonitis), all others were Grade 1 or 2. No differences in LCR, LPFS, DFS were found in univariate analysis com-paring patient, tumor, and treatment characteristics. For OS the only statistically significant difference was found inpatients with more than 3 comorbidities compared to those with less comorbidities.Conclusions. Early lung cancer treated with SBRT at single tertiary cancer centre showed that LCR, LPFS, DFS, DMFSand OS were comparable to published studies. Patients with many comorbidities had significantly worse overallsurvival compared to those with less comorbidities. No other significant differences by patient, tumor, or treatmentcharacteristics were found for DMFS, LPFS, and DFS. Toxicity data confirmed that treatment was well tolerated.
Keywords: stereotactic body radiotherapy, early-stage lung cancer, lung cancer
Published in DiRROS: 25.07.2024; Views: 1411; Downloads: 866
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Abstract: Background. Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are effective treatments for EGFR mutation-positive (EGFRm) non-small cell lung cancer (NSCLC). However, routine clinical practice is different between countries/institutions. Patients and methods. The REFLECT study (NCT04031898) is a retrospective medical chart review that explored real-life treatment and outcomes of EGFRm NSCLC patients receiving first-line (1L) first-/second-generation (1G/2G) EGFR TKIs in 8 countries. This study included adult patients with documented advanced/metastatic EGFRm NSCLC with 1L 1G/2G EGFR TKIs initiated between Jan 2015 – Jun 2018. We reviewed data on clinical characteristics, treatments, EGFR/T790M testing patterns, and survival outcomes. Here, we report data from 120 medical charts in 3 study sites from Slovenia. Results. The Slovenian cohort (median age 70 years, 74% females) received 37% erlotinib, 32% afatinib, 31% gefitinib. At the time of data collection, 94 (78%) discontinuations of 1L TKI, and 89 (74%) progression events on 1L treatment were reported. Among patients progressing on 1L, 73 (82%) were tested for T790M mutation yielding 50 (68%) positive results, and 62 (85%) received 2L treatment. 82% of patients received osimertinib. Attrition rate between 1L and 2L was 10%. The median (95% CI) real-world progression free survival on 1L EGFR TKIs was 15.6 (12.6, 19.2) months; median overall survival (95% CI) was 28.9 (25.0, 34.3) months. Conclusions. This real-world study provides valuable information about 1G/2G EGFR TKIs treatment outcomes and attrition rates in Slovenian EGFRm NSCLC patients. The reduced attrition rate and improved survival outcomes empha-size the importance of 1L treatment decision.
Keywords: real-world study, non-small cell lung cancer, epidermal growth factor receptor, lung cancer
Published in DiRROS: 25.07.2024; Views: 1299; Downloads: 752
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