Impact of previous anti-angiogenesis treatment in nivolumab-treated advanced non-small cell lung cancer

Aim:To in vestigate how previous systemic therapy such as an ti-a ngioge nesis can in flue nee can cer imm uno therapy for non-small cell l ung can cer(NSCLC).Methods:A total of 134 patie nts with adva need NSCLC who were treated with ni volumab were retrospectively reviewed.Correlation between status of prior anti-angiogenesis treatment and clinical characteristics were determined.Impact of prior an ti-a ngioge nesis on therapeutic outcome of ni volumab was in vestigated for tumor efficacy such as progressi on-free survival(PFS).Results:Sixtee n patie nts were treated with at least one an ti-a ngioge nesis age nt prior to ni volumab.The prior use of an tian gioge nesis age nt was associated with stage IV disease,non-squamous histology,and two or more lines of systemic therapy.Media n PFS was sig nifica ntly shorter in the prior an ti-a ngioge nesis group tha n in no prior an ti-a ngioge nesis group(8.3 vs.11.3 weeks,log-rank P 0.006).Multivariate analyses demonstrated that only prior anti-angiogenesis status was associated with worse PFS.There is also a slight trend for worse disease control rate(P 0.101,Fisher's exact test)and overall survival(P 0.200,log-ra nk)in prior an ti-a ngioge nesis group.Conclusion:This retrospective study suggests that prior anti-angiogenesis treatment negatively impacts the therapeutic outcome of immunotherapy in advanced NSCLC.

Brain metastasis as exclusion criteria in extensive-stage small cell lung cancer trials:a trend over decades

Aim:To investigate the frequencies and trends of brain metastases(BMs)as exclusion criteria in extensive-stage small cell lung cancer(ES-SCLC)trials.Methods:We conducted a comprehensive search to identify prospective clinical trials in patients with ES-SCLC.PubMed searches were conducted with the key words“small cell lung cancer”and“extensive”.The online archives of 20 oncology journals were also searched.Recent review articles in ES-SCLC were also investigated for additional articles.Eligible studies must have enrolled primarily ES-SCLC and been published in English.Studies involving brain/chest radiation and brain metastasis-specific trials were excluded.Studies were categorized into allowed/undefined,conditional,or complete exclusion of BM.Results:In total,491 published studies were identified by PubMed(240),journal websites(198),and review articles(53).Early publication year(1970-1999)and first-line/maintenance setting were associated with higher incidence of complete exclusion of cases with BMs(P<0.0001 and 0.0233,respectively).Incidence of complete exclusion was 27%in the 1990s,and then decreased to 12%in the 2000s and 8%in the 2010s.Conclusion:A significant number of ES-SCLC trials continues to exclude patients with BM.Future studies need to ease eligibility regarding BM according to ASCO/Friends recommendations.