Prognostic Factors in Advanced Non-Small Cell Lung Cancer Patients Treated with Immunotherapy

Rocco, Danilo; Della Gravara, Luigi; Ragone, Angela; Sapio, Luigi; Naviglio, Silvio; Gridelli, Cesare

doi:10.3390/cancers15194684

Cited by 8 publications

(6 citation statements)

References 148 publications

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“…Lung cancer remains a predominant cause of cancer-induced fatalities across the globe, representing nearly one-fourth of these tragic deaths [ 3 ]. Cancer is complex and therefore requires treatments that are dependent on several factors, such as the stage of the disease, its specific location within the body, the patient’s overall health and age, and other underlying medical conditions.…”

Section: Lung Cancer Etiology and Current Practicementioning

confidence: 99%

Inhaled Medicines for Targeting Non-Small Cell Lung Cancer

Al Khatib,

El-Tanani,

Al-Obaidi

2023

Pharmaceutics

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Throughout the years, considerable progress has been made in methods for delivering drugs directly to the lungs, which offers enhanced precision in targeting specific lung regions. Currently, for treatment of lung cancer, the prevalent routes for drug administration are oral and parenteral. These methods, while effective, often come with side effects including hair loss, nausea, vomiting, susceptibility to infections, and bleeding. Direct drug delivery to the lungs presents a range of advantages. Notably, it can significantly reduce or even eliminate these side effects and provide more accurate targeting of malignancies. This approach is especially beneficial for treating conditions like lung cancer and various respiratory diseases. However, the journey towards perfecting inhaled drug delivery systems has not been without its challenges, primarily due to the complex structure and functions of the respiratory tract. This comprehensive review will investigate delivery strategies that target lung cancer, specifically focusing on non-small-cell lung cancer (NSCLC)—a predominant variant of lung cancer. Within the scope of this review, active and passive targeting techniques are covered which highlight the roles of advanced tools like nanoparticles and lipid carriers. Furthermore, this review will shed light on the potential synergies of combining inhalation therapy with other treatment approaches, such as chemotherapy and immunotherapy. The goal is to determine how these combinations might amplify therapeutic results, optimizing patient outcomes and overall well-being.

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Section: Lung Cancer Etiology and Current Practicementioning

confidence: 99%

Inhaled Medicines for Targeting Non-Small Cell Lung Cancer

Al Khatib,

El-Tanani,

Al-Obaidi

2023

Pharmaceutics

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“…The literature highlights the importance of prognostic assessment, especially long-term, in patients with NSCLC, and the need to implement new biomarkers or validated and standardized factors with a prognostic and predictive role. These are extremely important data to guide the treatment plan [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

The Nine-Year Survival of Patients Operated for Non-Small-Cell Lung Carcinoma in a Tertiary Centre: The Impact of the Tumour Stage and Other Patient-Related Parameters

Vlăsceanu,

Mahler,

Marghescu

et al. 2024

Medicina

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Background and Objectives: The mainstay treatment of non-small-cell lung carcinoma is still surgery, but its impact on survival beyond nine years has never been reported/analysed in Romania. Therefore, we studied the clinical characteristics and the short- and long-term survival of a population of 1369 patients diagnosed and treated in a single institution, with the variables included in the database being collected retrospectively. Materials and Methods: In this paper, we aimed to study a number of factors that might influence prognosis and survival in non-small bronchopulmonary carcinoma. Consequently, we analysed a series of parameters such as the age of patients, their sex, the histopathological type, the tumour stage, the presence of bronchial invasion, and the completeness of surgical resection. Results: All patients underwent major lung resection for curative purposes (pneumonectomy, lobectomy, or bilobectomy) between January 2015 and January 2023. The vital status of patients included in the study was obtained by checking the DGEP (General Directorate for Persons Record) database and verifying the reporting of “non-deceased” by the hospital administrative database, as well as by telephone interviews (with patients or their relatives). On univariate analysis, predictors of worse survival were the following: male sex (the hazard of death was 1.54 times higher in men); pT (compared to pT1 tumours, pT2 tumours have a 1.60 times higher hazard of death, pT3 tumours have a 2.16 times higher hazard, and pT4 tumours have a 2.97 times higher hazard); maximum tumour size (a 10 mm increase in tumour size is associated with a 10% increase in the hazard of death); the degree of differentiation (compared to patients with G1 tumours, those with G3 tumours have a 2.16 times higher hazard of death); resectability (compared to R0, R1 B+ has a 1.84 times higher hazard of death, R1 V+ has a 1.82 times higher hazard of death, and R1 B+&V+ has a 2.40 times higher hazard of death). Conclusions: As a result, long-term survival can be achieved after complete surgery for NSCLC, and factors that classically predict overall survival suggest that both the initial tumour aggressiveness and host characteristics act beyond the period usually considered in oncology.

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“…Microbiota diversity correlates with the development of iRAEs during immunotherapy. As demonstrated for the survival and prognosis, it appears that patients with a low diversity of gut microbiota exhibit skin iRAEs more often than patients with a gut microbiota enriched with many bacterial types [1,9].…”

Section: Gut Microbiota and Iraesmentioning

confidence: 99%

“…Among ICIs, monoclonal antibodies (mabs) against CTLA4 (cytotoxic T lymphocyte-associated protein 4) and against PD1 (programmed death type 1) or its ligand PDL1 (programmed death ligand type 1) can be used. Ipilimumab, Nivolumab, Pembrolizumab, Cemiplimab, Durvalumab, and Atezolizumab are at present the ICIs used in clinical practice [1]. Not all NSCLC patients benefit from immunotherapy at the beginning of the treatment, while others progress after the initial response to the treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Biomarker identification still represents an open challenge for the identification of immunotherapy predictors of response. Examples of different biomarkers include: the neutrophil-to-lymphocyte ratio, tumor-infiltrating lymphocytes, tumor mutation burden, and the gut microbiota [1][2][3]. This latter is composed by all commensal microorganisms present in our gastrointestinal tract, including bacteria, fungi, viruses, and protozoans, while the term microbiome refers to the total genetic material possessed by the microbiota.…”

Section: Introductionmentioning

confidence: 99%

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Gut Microbiota Are a Novel Source of Biomarkers for Immunotherapy in Non-Small-Cell Lung Cancer (NSCLC)

Del Giudice,

Staropoli,

Tassone

et al. 2024

Cancers

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Despite the recent availability of immune checkpoint inhibitors, not all patients affected by Non-Small-Cell Lung Cancer (NSCLC) benefit from immunotherapy. The reason for this variability relies on a variety of factors which may allow for the identification of novel biomarkers. Presently, a variety of biomarkers are under investigation, including the PD1/PDL1 axis, the tumor mutational burden, and the microbiota. The latter is made by all the bacteria and other microorganisms hosted in our body. The gut microbiota is the most represented and has been involved in different physiological and pathological events, including cancer. In this light, it appears that all conditions modifying the gut microbiota can influence cancer, its treatment, and its treatment-related toxicities. The aim of this review is to analyze all the conditions influencing the gut microbiota and, therefore, affecting the response to immunotherapy, iRAEs, and their management in NSCLC patients. The investigation of the landscape of these biological events can allow for novel insights into the optimal management of NSCLC immunotherapy.

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Prognostic Factors in Advanced Non-Small Cell Lung Cancer Patients Treated with Immunotherapy

Cited by 8 publications

References 148 publications

Inhaled Medicines for Targeting Non-Small Cell Lung Cancer

Inhaled Medicines for Targeting Non-Small Cell Lung Cancer

The Nine-Year Survival of Patients Operated for Non-Small-Cell Lung Carcinoma in a Tertiary Centre: The Impact of the Tumour Stage and Other Patient-Related Parameters

Gut Microbiota Are a Novel Source of Biomarkers for Immunotherapy in Non-Small-Cell Lung Cancer (NSCLC)

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