bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of HIV and CD4 count stratification on all cause mortality for adenocarcinoma and squamous cell lung cancers in the antiretroviral therapy era: Analysis of National Veterans Affairs and Kaiser Permanente Northern cohorts.
Authors: Chiao Elizabeth Y. , Malgave Devesh , Hartman Christine , Kramer Jennifer , Hechter Rulin , Sakoda Lori C. , Leyden Wendy , Pak Katherine , Lea Alexandra , Zafeiropoulou Efthalia , Rivera Ado , Richardson Peter , Dong Yongquan , White Donna L. , Lin Lilie L. , Boyer Matthew J , Silverberg Michael 
Published: June 2024

8070 Background: Since the widespread introduction of antiretroviral therapy (ART), people living with HIV (PWH) have experienced substantially decreased morbidity and mortality. However, PWH are at higher risk for lung cancer and have decreased cancer survival rates compared to people without HIV (PWoH). Few studies have evaluated histology-specific lung cancer survival by stage and HIV immune control. Methods: A retrospective cohort study was conducted with newly diagnosed non-small cell lung cancer (NSCLC), including PWH with PWoH, identified between 2008 and 2020 from the US Department of Veterans Affairs and Kaiser Permanente, California. Adjusted hazard ratios for 5-year survival by CD4 count (≥ 500 cells/mm3, <500 cells/mm3, ref: PwOH) were estimated using Cox models stratified by subtype (adenocarcinoma, squamous) and TNM (I, II/III, IV) stage. Results: This cohort consisted of 562 PWH (53% adenocarcinoma, 33% squamous cell) and 91,370 PWoH (52% adenocarcinoma, 33% squamous cell, 15% not specified). The PWH cohort tended to be younger (62 vs. 69 years), male (97% vs. 83%), and non-Hispanic Black race (48% vs. 14%), compared to PWoH. Among PWH, 41% had CD4 ≥500 cells/mm3, 59% had CD4 <500 cells/mm3 . The median survival in years for PWoH, PWH CD4 count ≥500 cell/mm3and <500 cells/mm3 were: 2.4 ±0.10, 2.3 ± 0.17, 2.0±0.17, respectively for adenocarcinoma, and 2.1±0.01, 2.3±0.21, 1.6±0.17 respectively for squamous cell carcinoma. The table shows the adjusted HR for all-cause mortality for Adenocarcinoma and Squamous Cell Carcinoma comparing PWH ≥500 and PWH<500 to PWoH (as reference) stratified by stage. Conclusions: Although it is well known that low CD counts (<200) are associated with poor cancer outcomes, higher CD4 counts (CD<500) at the time of lung cancer diagnosis may still play a role in the treatment outcomes of NSCLC. PWH who have CD4 counts ≥500 appear to have similar survival compared to PWoH, but CD4<500, those with (vs. without) HIV have higher rates of mortality for both adenocarcinoma and squamous cell histologies. Adjusted hazard ratios (HR)* with 95% confidence intervals (CI) for 5-year all-cause-mortality associated with HIV by CD4 count (reference: PWoH), across Adenocarcinoma and Squamous Cell Cancer histology and baseline cancer stage. [Table: see text]
An interpretable AI-derived radiology signature to identify patients at risk of progression on the PACIFIC regimen for unresectable non-small cell lung cancer.
Authors: Haji Maghsoudi Omid , Chung Liam IL Young , Lee Seyoung , Lee Jeeyeon , Kim Haseok , Hiremath Amogh , Zhang Kai , Cantor Diego , Yadav Monica , Kim Hye Sung , Yu Jisang , Kim Yuchan , Hong Ilene , Kang Grace , Cho Amy , Velichko Yury , Velcheti Vamsidhar , Madabhushi Anant , Braman Nathaniel , Chae Young Kwang 
Published: June 2024

8079 Background: Advances in the treatment of unresectable NSCLC have emerged through the combination of chemotherapy, radiotherapy, and immune checkpoint inhibitors (ICI), also known as the PACIFIC regimen. Despite this protocol’s benefits, it lacks predictive biomarkers and many patients will ultimately fail to respond. Artificial intelligence (AI) has shown promise in identifying patients responsive to ICI, but its ability to identify patients who may not benefit from such combination regimens remains underexplored. We introduce an AI-enabled approach leveraging interpretable imaging biomarkers, such as tumor heterogeneity and twistedness of the tumor-associated vasculature, to identify patients who will fail to benefit from chemo-radio-immunotherapy (CRIT) using pretreatment scans. Methods: We analyzed CT data from 148 NSCLC patients with predominantly stage III (91%) disease from two institutions. Target lesions were delineated by a trained radiologist. The Picture Health Px platform was utilized to segment the lungs and pulmonary vessels. Subsequently, a number of interpretable imaging features from the tumor and surrounding tissues were extracted. A Cox proportional hazards model of feature clusters was developed on the training set (n = 101) to stratify patients into benefit groups associated with progression-free survival (PFS). A cohort of 47 patients receiving CRIT were held out for testing. Results: The imaging-derived high-risk group defined by the model was associated with decreased PFS in the test set, with a hazard ratio (HR) of 4.99 (95% CI: 2.04-12.18; p < 0.005) and concordance index (C-index) of 0.66. The risk groups identified by the model outperformed PD-L1 negative status in identifying likely progressors (C-index = 0.52; HR = 1.49 [0.51-4.54], p = 0.47), and were additionally independently prognostic of PD-L1 status when compared in a multivariable analysis (p < 0.001). The primary features driving the model were measurements of the radius and tortuosity of the tumor-associated vasculature, as well as heterogeneity metrics of the tumor. Conclusions: An AI imaging tool that stratifies patients by risk after CRIT from baseline radiology was developed. The tool was able to strongly identify a subset of patients at very high risk of progression if treated with CRIT. These risk groups outperformed PD-L1 and thus may address biomarker gaps in the CRIT setting. With further clinical validation, radiology-based risk stratification could be used to identify a subset of unresectable NSCLC patients for whom alternatives to the standard of care should be explored.
Outcome of chemo-immunotherapy for extensive-stage small-cell lung cancer according to potential clinical trial eligibility: 3-year outcomes from prospective cohort study.
Authors: Tamiya Motohiro , Fujimoto Daichi , Hata Akito , Matsumoto Hirotaka , Sugisaka Jun , Yokoyama Toshihide , Taniguchi Yoshihiko , Uchida Junji , Hara Satoshi , Saito Go , Miura Satoru , Suzuki Hidekazu , Ikeda Satoshi , Hiraoka Ryota , Yanai Masaaki , Yamamoto Nobuyuki , Akamatsu Hiroaki 
Published: June 2024

8087 Background: Chemo-immunotherapy is the standard 1st-line therapy for patients with extensive-stage small-cell lung cancer (ES-SCLC). Our large previous real-world prospective analysis showed outcomes of chemo-immunotherapy for these patients according to potential clinical trial eligibility with a minimum follow-up period of 1 year. However, long-term outcomes have not been studied in the real-world setting. Methods: We conducted a 32-hospital prospective cohort study of consecutive patients with ES-SCLC who received carboplatin and etoposide with atezolizumab as 1st-line therapy between September 2019 and September 2020. Patients who met eligibility criteria for pivotal phase 3 clinical trials were considered “trial-eligible.” We present 3-year outcomes from this study. Results: In total, 207 patients with ES-SCLC were analyzed. The median (range) time from the start of treatment to data cutoff (September 30, 2023) was 42.2 (35.8.-48.2) months. The median age was 72 years, and 64 patients (31%) were elderly (≥75 years). Most patients (89%) had a performance status (PS) of 0 or 1. As a result, 132 (64%) were categorized as trial-eligible patients. The 3-year PFS and OS probability of all patients was 6.1 % (95%CI:3.5-10.4%) and 20.9 % (95%CI:15.6-27.3%), respectively. Patients achieving 3-year OS included significantly higher proportions of trial-eligible patients (30 out of 132 versus 5 out of 75, respectively; p = 0.002). Kaplan-Meier estimates of the 3-year OS rate were 26.7% for the trial-eligible group and 9.5 % for the trial-ineligible group. Conclusions: This is the first real-world study to show the long-term efficacy of chemo-immunotherapy for ES-SCLC by using the largest prospective cohort of its kind. Additionally, this study demonstrated that trial eligibility was associated with long-term efficacy. Our study suggests that long-term clinical outcomes among trial-eligible patients may not translate to ineligible patients.
Efficacy and safety of lurbinectedin (LUR) with irinotecan (IRI) in patients (Pts) with relapsed small cell lung cancer (SCLC): Results from a phase 2 expansion cohort.
Authors: Paz-Ares Luis G. , Falcon Gonzalez Alejandro , Navarro Alejandro , Sanchez-Gastaldo Amparo , Cote Gregory Michael , Bockorny Bruno , Molina-Cerrillo Javier , Artal Angel , Baena Javier , Gil Ana , Ponce Aix Santiago , Bote de Cabo Helena , Martinez Sara , Martinez Julia Martinez , Lopez-Vilariño Jose Antonio , Kahatt Carmen Maria , Zeaiter Ali Hassan , Gomez Javier , Zugazagoitia Jon 
Published: June 2024

8094 Background: LUR has been approved in the US and elsewhere for treatment of adult pts with metastatic SCLC and disease progression on or after platinum-based chemotherapy. Preclinical studies found synergy for LUR with IRI (Galmarini C. Cancer Res 2013; 73: Abst 5499). The phase 1b/2 study PM1183-A-014-15 (NCT02611024) evaluated the LUR/IRI combination in pretreated pts with advanced solid tumors. The phase 1b part defined the recommended dose at LUR 2.0 mg/m2 on Day (D)1 + IRI 75 mg/m2 on D1,D8 every three weeks with primary G-CSF prophylaxis, and found promising results for the combination in SCLC pts after first-line therapy (Ponce Aix S. Ann Oncol 2019; 30: Abst 471P). Methods: Eligibility criteria for this cohort of the phase 2 part of this study included: confirmed SCLC, progression after one platinum-containing regimen, controlled brain metastases and ECOG PS ≤ 1. The primary endpoint was overall response rate (ORR). Results: 101 evaluable pts were enrolled. Baseline characteristics included: median age 63 (range, 45-77 y), 60.4% males, 76.2% ECOG PS 1, 28.7% CNS involvement, 39.6% bulky disease and 41.6% pretreated with immunotherapy. Chemotherapy-free interval (CTFI) was <90 d in 51.4% of pts (26.7% had CTFI<30 d. Median CTFI was 85 d (range, 0-323 d). Median number of cycles per pt was 6 (range, 1-34); 25.7% received >10 cycles. Efficacy results by independent review committee are summarized in the table. Treatment-related adverse events (AEs) were observed in 99.0% of pts (grade ≥3 in 69.3%). Most relevant grade ≥3 events/abnormalities were neutropenia (52.5%), anemia (27.7%), diarrhea (19.8%), fatigue (18.8%), and febrile neutropenia (9.9%). Treatment-related SAEs occurred in 25.0% of pts and 5.0% discontinued due to treatment-related AEs. No treatment-related deaths occurred. Conclusions: The LUR/IRI combination showed promising antitumor activity and a manageable safety profile in these pts with poor prognosis, particularly those with CTFI>30 d. These encouraging results reinforce the rationale for including this combination as an experimental arm in the ongoing pivotal phase 3 LAGOON trial (NCT05153239) in relapsed SCLC with CTFI>30 d. Clinical trial information: NCT02611024 . [Table: see text]
Repotrectinib in tyrosine kinase inhibitor (TKI)-naïve patients (pts) with advanced ROS1 fusion-positive (ROS1+) NSCLC in the phase 1/2 TRIDENT-1 trial: Clinical update, treatment beyond progression and subsequent therapies.
Authors: Drilon Alexander E. , Dziadziuszko Rafal , Camidge David Ross , Lin Jessica Jiyeong , Besse Benjamin , Kim Sang-We , Lee Ki Hyeong , Solomon Benjamin J. , Nagasaka Misako , Goto Koichi , Wolf Juergen , De Langen Adrianus Johannes , Cheema Parneet Kaur , Yang Nong , Velcheti Vamsidhar , Elamin Yasir Y , Xu Yuanfang , Calvet Christophe , Ades Felipe , Cho Byoung Chul 
Published: June 2024

8522 Background: Repotrectinib, a next-generation ROS1 TKI, has demonstrated durable clinical activity in the pivotal phase 1/2 TRIDENT-1 trial (NCT03093116). We report updated efficacy with a median follow-up of 33.9 months (mo) [~10 mo of additional follow-up], the first analyses of progression patterns, treatment beyond progression, and an update on subsequent anticancer therapies. Methods: Recommended phase 2 dose was 160 mg QD for 14 days, then 160 mg BID. Phase 2 primary endpoint was confirmed objective response rate (cORR) by blinded independent central review (BICR) per RECIST v1.1. Secondary endpoints included duration of response (DOR), progression-free survival (PFS), intracranial ORR (icORR), and safety. Treatment beyond BICR-assessed progression and sites of progression (per investigator) were also assessed. Safety assessments included all treated pts. Results: As of 15 Oct 2023, median follow-up in the TKI-naïve cohort (n = 71) was 33.9 (range, 24.0–76.5) months (mo). cORR was 79% (95% CI, 68–88); median DOR was 34.1 (95% CI, 27.4–not estimable [NE]) mo and 70% (95% CI, 57–83) of responders maintained a response of ≥ 24 mo. Median PFS was 35.7 (95% CI, 24.6–NE) mo and 63% (95% CI, 51–75) of pts were progression-free at 24 mo. Of 9 pts with measurable baseline brain metastases, icORR was 89% (95% CI, 52–100). Results for pts who received repotrectinib beyond progression are shown in the table. Of pts with disease progression per investigator (n = 37), the most common sites were lung (49%) and lymph nodes (35%). Of 42 (59%) pts who discontinued repotrectinib for any reason, 11 (26%) received single-agent TKI as the first subsequent anticancer therapy, 10 (24%) received chemo with/without immunotherapy (IO), and 2 (5%) received IO alone. Among all pts who received ≥ 1 dose of repotrectinib (n = 565), grade ≥ 3 treatment-emergent adverse events occurred in 323 (57%) pts and treatment-related adverse events in 162 (29%) pts. Treatment-emergent dizziness occurred in 63% of pts and was mostly grade 1-2. Conclusions: With a median follow-up of ~3 years in TRIDENT-1, repotrectinib continued to demonstrate durable clinical activity in ROS1 TKI-naïve pts. Progression patterns and treatment beyond progression were described for the first time. Clinical trial information: NCT03093116 . [Table: see text]
Unraveling CASTOR1's tumor suppressive role: Genetic ablation of CASTOR1 and KRAS-driven mouse model of non-small cell lung cancer.
Authors: Wang Xian , Sun Shenyu , Loo Suet Kee , Chen Luping , Ding Ling , Li Tingting , Wang Man-Tzu , Burns Timothy F. , Stabile Laura P. , Gao Shou-Jiang 
Published: June 2024

8528 Background: Cytosolic Arginine Sensor for mTORC1 Subunit 1 (CASTOR1) has emerged as a potent suppressor of mTORC1 activity, playing a pivotal role in various cancer contexts. Previously implicated as a tumor suppressor in multiple cancers, CASTOR1 is tightly regulated in cancer, including inhibition by viral miRNAs in KSHV-induced cancer and degradation via AKT-phosphorylation and RNF167-mediated ubiquitination. Notably, CASTOR1's role extends beyond normal cellular contexts, as evidenced by its tumor-suppressive function in breast cancer xenograft models and its prognostic value in lung adenocarcinoma (LUAD) and squamous cell carcinoma (LUSC). This study aims to elucidate CASTOR1’s role in a transgenic Kras-driven LUAD mouse model, shedding light on its tumor-suppressive potential. Methods: Utilizing a novel CASTOR1 knockout (KO) mouse model crossed with the Kras (LSL-KrasG12D/+) NSCLC model, we established a new mouse model with simultaneous Kras activation and homozygous CASTOR1 ablation. Tumor incidence and growth were monitored in Kras mice harboring wild-type (WT) and KO CASTOR1. Further investigations examined the proliferative dynamics and activation status of various oncogenic pathways, and assessed mTORC1 inhibitor sensitivities in human LUAD cell lines with altered CASTOR1 expression levels. Results: CASTOR1 deficiency markedly heightened lung tumor incidence and size, concomitant with an elevated proliferative index. Intriguingly, a novel antibody identified robust pCASTOR1 levels in CASTOR1 WT mouse LUAD tumors, positively correlated with tumor stage and inversely related to total CASTOR1 abundance, hinting at an active degradation mechanism promoting tumor progression. Elevated mTORC1 signaling, evidenced by increased levels of p4EBP and pS6, underscored the pathway's activation consequent to CASTOR1 loss, likely driving tumor development. Furthermore, heightened pERK levels in CASTOR1 KO tumors unveiled a novel feedback loop intertwining CASTOR1/mTORC1 and the Kras/ERK pathway. Notably, treatment with mTORC1 inhibitors sensitized organoids of Kras tumors with mTORC1 hyperactivation to Kras G12D inhibitor. Conclusions: Our findings elucidate CASTOR1's tumor-suppressive role in Kras-dependent mouse LUAD tumors, suggesting the potential efficacy of combined Kras and mTORC1 inhibition in LUAD subsets characterized by hyperactivated Kras and diminished CASTOR1 levels or mTORC1 hyperactivity.
Association of combination tumor texture and vessel tortuosity with progression free survival across PD-L1 subgroups in durvalumab treated non-small cell lung cancer (NSCLC): Blinded validation results from CP1108.
Authors: Khorrami Mohammadhadi , Mutha Pushkar , Viswanathan Vidya Sankar , Gupta Amit , Velcheti Vamsidhar , Madabhushi Anant 
Published: June 2024

8600 Background: Immunotherapy (IO) has shown a durable response with minimal toxicity in the treatment of metastatic NSCLC. However, only 30-50% of these patients (pts) actually respond. Despite initial optimism surrounding PD-L1 expression as a potential biomarker, IO provides benefit across PD-L1 low (<25%) and high (≥25%) status. This highlights a critical need for more effective biomarkers to guide treatment decisions. Here, we present blinded validation results of a CT-based biomarker of change in quantitative vessel tortuosity (1) (Δ-QVT) and texture radiomics (2) (Δ-Rad) between baseline (B) and 6 weeks post-treatment (TP1) for predicting response, overall survival (OS) and progression free survival (PFS) in CP1108 (NCT01693562). Methods: CT scans at B and TP1 were retrospectively analyzed from two studies (a) a multi-center training set (Str, N=110) of metastatic NSCLC pts treated with first line IO and (b) a blinded NSCLC cohort of N = 151 pts treated with Durvalumab in CP1108 study (Sv). In Sv, N=75 pts were PD-L1 high (Sv+) whereas N=65 pts were PD-L1 low (Sv-). An in-house MATLAB based algorithm was used to extract intra-tumoral, peri-tumoral texture and QVT features from up to two largest measurable tumors in each CT. A classifier (MCombo) was trained on Str to predict best overall response defined as per the RECIST v1.1 criteria using combination of Δ-QVT and Δ-Rad features. Area under the receiver operating characteristic (AUC) was used to evaluate MCombo against RECIST response whereas univariable and multivariable Cox regression models with log-rank test, hazard ratio (HR) with confidence interval (CI) and concordance index (C-index) were used to study the association of MCombo with OS and PFS in Sv, Sv+, and Sv-. Results: MCombo predicted objective response with an AUC of 0.78 in Sv and was statistically significantly associated with PFS (Table) in Sv, Sv+, and Sv-. MCombo was associated with OS in Sv, Sv+, but not in Sv-. Multivariable analysis with PD-L1 status, histological subtype, ECOG status, liver metastasis, line of therapy and sex showed independent association of MCombo across OS and PFS. Conclusions: Our results indicate that combination of radiomics and vessel tortuosity biomarker from CT is independently prognostic of response and PFS across PD-L1 levels. Prospective validation of this biomarker is needed. 1. Alilou et al. Sci Adv 2022. 2. Khorrami et al. Cancer Immunol Res 2020. [Table: see text]
Characterization of DNA damage repair (DDR) alterations and the tumor immune microenvironment (TIME) in advanced non-small cell lung cancer (NSCLC).
Authors: Sankar Kamya , Mercer Jacob , Jaeger Ellen B. , Godden Jen , Berkman Jonathan David , Williams Edward , Thompson Michael A. , Patel Shetal Arvind , Reckamp Karen L. , Weinberg Frank 
Published: June 2024

8603 Background: Exploiting the DDR pathway with synthetic lethality agents such as PARP inhibitors has been clinically validated in several cancers. In NSCLC, novel agents leveraging defects in the DDR pathway are being studied alone and in combination with checkpoint inhibitors. To expand on combination approaches and inform biomarker selected strategies, we analyzed DDR alteration prevalence and impact on the TIME in metastatic NSCLC. Methods: We retrospectively analyzed de-identified next-generation sequencing data from patients (pts) with metastatic NSCLC in the Tempus Database. Tumors were sequenced with the Tempus xT DNA and xR RNA assays. DDR pathway genes were defined as previously described (PMID 29617664). Pts were stratified based on the presence (DDRmt) or absence (DDRwt) of a pathogenic somatic alteration or copy number deletion in a DDR pathway gene. The associations of DDR alteration with immune cell infiltration predicted from gene expression patterns, PD-L1 from IHC, TMB (TMB-H, >10 mut/Mb), and microsatellite instability (MSI) were examined. Wilcoxon rank-sum and Pearson’s Chi-squared/Fisher's exact tests were used to assess statistical significance (p<0.05, q<0.05 for false discovery rate correction for multiple testing). Results: Across 14,127 samples, 5,255 (37%) were DDRmt and 8,872 (63%) were DDRwt. The median age at diagnosis was 67 (IQR 60-74). Current/former smokers (83%; n=10,445) had a higher prevalence of DDRmt (86% vs. 82%; p<0.001). The most prevalent DDRmt was SMARCA4 (18%), followed by PTEN (13%), BRCA2 (11%), ATM (9.0%), ERCC3 (6.6%), PMS2 (6.0%), and MUTYH (5.1%). TMB-H was more common (18% [n=931] vs. 11% [n=1001]; p<0.001) and median TMB was higher (5.4 vs. 4.6; p<0.001) in DDRmt pts compared to DDRwt. MSI-H was more prevalent in the DDRmt group (1.1% [n=57] vs. <0.1% [n=7]; p<0.001), while PD-L1 positivity was similar in DDRmt and DDRwt pts (55% [n=1918] vs. 58% [n=3314]; p=0.071). Compared to DDRwt, pts with DDRmt exhibited modest changes in immune cell infiltration patterns (Table). Conclusions: In this large, real-world cohort of pts with metastatic NSCLC, DDRmt was associated with distinct TIME patterns including high TMB, MSI-H, and modest changes in immune cell infiltrates. These findings warrant further studies to understand how DDR pathway alterations mediate changes in the TIME to inform novel combinatorial immunotherapeutic approaches in NSCLC.[Table: see text]