Impact of interstitial lung abnormality on survival after adjuvant durvalumab with chemoradiotherapy for locally advanced non-small cell lung cancer

Kashihara, Tairo; Nakayama, Yuko; Okuma, Kae; Takahashi, Ayaka; Kaneda, Tomoya; Katagiri, Mika; Nakayama, Hiroki; Kubo, Yuko; Ito, Kimiteru; Nakamura, Satoshi; Takahashi, Kana; Inaba, Koji; Murakami, Naoya; Saitô, Tetsuo; Okamoto, Hiroyuki; Itami, Jun; Kusumoto, Masahiko; Ohe, Yuichiro; Igaki, Hiroshi

doi:10.1016/j.radonc.2022.109454

Cited by 6 publications

(3 citation statements)

References 33 publications

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“…Elucidating optimal treatment strategies for these patients is essential for advancing the standard of care and improving outcomes for all patients affected by this condition. Recent research efforts have focused on exploring the efficacy and safety of concurrent ICIs with radiotherapy or chemoradiotherapy in advanced NSCLC, potentially improving the survival rate for those who missed the opportunity to receive ICIs after cCRT [ 33 – 35 ]. Here, our study provides a systematic review and meta-analysis of available data concerning the efficacy and safety of concurrent ICIs with radiotherapy or chemoradiotherapy in advanced NSCLC.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of concurrent immune checkpoint inhibitors combined with radiotherapy or chemoradiotherapy for advanced non-small cell lung cancer: A systematic review and single-arm meta-analysis

Cui,

Li,

et al. 2024

PLoS ONE

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Background The recent usage of immunotherapy combined with chemoradiotherapy has improved survival in advanced non-small cell lung cancer (NSCLC) patients. However, determining the most effective therapy combination remains a topic of debate. Research suggests immune checkpoint inhibitors (ICIs) post-chemoradiotherapy enhance survival, but the impact of concurrent ICIs during chemoradiotherapy on rapid disease progression is unclear. This meta-analysis aims to assess the effectiveness and safety of concurrent ICIs with radiotherapy or chemoradiotherapy in advanced non-small cell lung cancer. Methods We searched PubMed, Embase, the Cochrane Library, and Web of Science for relevant studies, extracting data on overall response rate (ORR), progression-free survival (PFS), overall survival (OS), and adverse events (AEs). Results The analysis included ten studies with 490 participants. Stage III NSCLC ORR was 81.8%, while Stage IV ORR was 39.9%. One-year PFS and OS for Stage III were 68.2% and 82.6%, compared to 27.9% and 72.2% for Stage IV. Common adverse events included anemia (46.6%), nausea (47.6%), rash (36.4%), and radiation pneumonitis (36.3%). Conclusions Our meta-analysis shows concurrent ICIs with chemoradiotherapy are effective and safe in advanced NSCLC, particularly in stage III patients at risk of progression before starting ICIs after chemoradiotherapy. The findings support further phase III trials. The review protocol was registered on PROSPERO (CRD42023493685) and is detailed on the NIHR HTA programme website.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of concurrent immune checkpoint inhibitors combined with radiotherapy or chemoradiotherapy for advanced non-small cell lung cancer: A systematic review and single-arm meta-analysis

Cui,

Li,

et al. 2024

PLoS ONE

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“…These differ from modern standard treatments and may have implications for survival analysis. Retrospective studies on cases with durvalumab have been reported recently 26 , and high-quality future prospective trials are warranted…”

Section: Discussionmentioning

confidence: 99%

Subpleural fibrotic interstitial lung abnormalities are implicated in non-small cell lung cancer radiotherapy outcomes

Ito

Katano

Okada

et al. 2023

Radiology and Oncology

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Background The relationship between interstitial lung abnormalities (ILAs) and the outcomes of lung cancer radiotherapy is unclear. This study investigated whether specific ILA subtypes are risk factors for radiation pneumonitis (RP). Patients and methods This retrospective study analysed patients with non-small cell lung cancer treated with radical-intent or salvage radiotherapy. Patients were categorised into normal (no abnormalities), ILA, and interstitial lung disease (ILD) groups. The ILA group was further subclassified into non-subpleural (NS), subpleural non-fibrotic (SNF), and subpleural fibrotic (SF) types. The Kaplan–Meier and Cox regression methods were used to determine RP and survival rates and compare these outcomes between groups, respectively. Results Overall, 175 patients (normal, n = 105; ILA-NS, n = 5; ILA-SNF, n = 28; ILA-SF, n = 31; ILD, n = 6) were enrolled. Grade ≥2 RP was observed in 71 (41%) patients. ILAs (hazard ratio [HR]: 2.33, p = 0.008), intensity-modulated radiotherapy (HR: 0.38, p = 0.03), and lung volume receiving 20 Gy (HR: 54.8, p = 0.03) contributed to the cumulative incidence of RP. Eight patients with grade 5 RP were in the ILA group, seven of whom had ILA-SF. Among radically treated patients, the ILA group had worse 2-year overall survival (OS) than the normal group (35.3% vs 54.6%, p = 0.005). Multivariate analysis revealed that the ILA-SF group contributed to poor OS (HR: 3.07, p =0.02). Conclusions ILAs, particularly ILA-SF, may be important risk factors for RP, which can worsen prognosis. These findings may aid in making decisions regarding radiotherapy.

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“…The association between ILA and CSS in cancer patients was explored in two articles (12,17) with 341 individuals. We found significant correlation between ILA and CSS in lung cancer patients (HR=4.00, 95% CI: 1.94-8.25, P<0.001) using a fixed effect model (I 2 = 0%, P= 0.594) (Figure 5).…”

Section: Ila and Cancer-specific Survivalmentioning

confidence: 99%

Prognostic impact of interstitial lung abnormalities in lung cancer: a systematic review and meta-analysis

Tang,

Sun,

Guo

et al. 2024

Front. Oncol.

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BackgroundNewly identified as a radiological concept, interstitial lung abnormalities (ILA) is emerging as a prognostic factor for lung cancer. Yet, debates persist regarding the prognostic significance of ILA in lung cancer. Our inaugural meta-analysis aimed to investigate the correlation between ILA and lung cancer outcomes, offering additional insights for clinicians in predicting patient prognosis.MethodsArticles meeting the criteria were found through PubMed, the Cochrane Library, EMBASE, and Web of Science by February 29, 2024. The outcomes evaluated were the survival rates such as overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), and cancer-specific survival (CSS).ResultsA total of 12 articles with 4416 patients were included in this meta-analysis. The pooled results showed that lung cancer patients with interstitial lung abnormalities had an inferior OS (n=11; HR=2.22; 95% CI=1.68-2.95; P<0.001; I2 = 72.0%; Ph<0.001), PFS (n=3; HR=1.59; 95% CI=1.08-2.32; P=0.017; I2 = 0%; Ph=0.772), and CSS (n=2; HR=4.00; 95% CI=1.94-8.25; P<0.001; I2 = 0%; Ph=0.594) than those without, however, the ILA was not significantly associated with the DFS (n=2; HR=2.07; 95% CI=0.94-7.02; P=0.066; I2 = 90.4%; Ph=0.001). Moreover, lung cancer patients with ILA were significantly correlated with male (OR=2.43; 95% CI=1.48-3.98; P<0.001), smoking history (OR=2.11; 95% CI=1.37-3.25; P<0.001), advanced age (OR=2.50; 95% CI=1.56-4.03; P<0.001), squamous carcinoma (OR=0.42; 95% CI=0.24-0.71; P=0.01), and EGFR mutation (OR=0.50; 95% CI=0.32-0.78; P=0.002). The correlation between ILA and race, stage, ALK, however, was not significant.ConclusionILA was a availability factors of prognosis in patients with lung cancers. These findings highlight the importance of early pulmonary fibrosis, namely ILA for prognosis in patients with lung cancer, and provide a partial rationale for future clinical work.

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Impact of interstitial lung abnormality on survival after adjuvant durvalumab with chemoradiotherapy for locally advanced non-small cell lung cancer

Cited by 6 publications

References 33 publications

Efficacy and safety of concurrent immune checkpoint inhibitors combined with radiotherapy or chemoradiotherapy for advanced non-small cell lung cancer: A systematic review and single-arm meta-analysis

Efficacy and safety of concurrent immune checkpoint inhibitors combined with radiotherapy or chemoradiotherapy for advanced non-small cell lung cancer: A systematic review and single-arm meta-analysis

Subpleural fibrotic interstitial lung abnormalities are implicated in non-small cell lung cancer radiotherapy outcomes

Prognostic impact of interstitial lung abnormalities in lung cancer: a systematic review and meta-analysis

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