Risultati per: Gestione del carcinoma polmonare (cancro al polmone) non a piccole cellule

Nuovi bersagli. Grazie all’intelligenza artificiale e al machine learning si cercano vie alternative contro l’accumulo delle proteine e per rallentare la malattia

In Reply We appreciate the comments made by Lee et al and Bayatfard et al on our recent article. We applied concurrent cisplatin in the conventional 30-mg/m2 dose weekly when we designed this trial. This dose was routinely used in the treatment of head and neck neoplasms, including nasopharyngeal carcinoma. A secondary analysis of a prospective trial revealed that a cumulative cisplatin dose of 200 mg/m2 is sufficient for patients with locoregionally advanced nasopharyngeal carcinoma who undergo concurrent chemoradiotherapy. Prospective evidence on the optimal concurrent cisplatin dose after induction chemotherapy is lacking. Results from a large-sample retrospective study showed that cumulative cisplatin doses between 100 mg/m2 and 200 mg/m2 achieved satisfactory outcomes. In our study, the median cumulative cisplatin dose during radiation therapy was 180 mg/m2. Therefore, we consider that for patients with locoregionally advanced nasopharyngeal carcinoma who receive induction chemotherapy, the doses of concurrent cisplatin do not influence therapeutic effects.

Cutaneous squamous cell carcinoma (cSCC) is the second most common type of skin cancer and, according to recent data from Europe, has possibly overtaken melanoma as the leading cause of skin cancer–related death. Accurate data from the US remain elusive, limiting the ability to conduct large-scale analyses of cSCC. Much of the issue lies in assembling a complete clinical record for individual patients and in processing text from notes and pathology reports into a usable format. The ability of large language models to do these tasks holds great promise to capture more of the patient record in the near future and provide highly granular data. Even once there is better integration of these tools, new approaches to provide high-quality data are necessary as it is painfully evident that methods relying on International Classification of Disease codes alone are poor at identifying distinct skin cancers, let alone differentiating basal cell carcinoma from cSCC.

To the Editor A recent randomized clinical trial reported that after induction chemotherapy (IC), patients with stages III to IVB (American Joint Committee on Cancer Staging Manual, 7th Edition) nasopharyngeal carcinoma (NPC) receiving radiation therapy alone had noninferior oncologic outcomes and fewer acute adverse events, compared with those receiving concurrent chemoradiotherapy (CCRT). We have several comments about this impactful study.

This Consensus Statement develops recommendations for reporting measures and types of statistical analyses to be used in retrospective observational studies of cutaneous squamous cell carcinoma.

The Cancer and Leukemia Group B (CALGB140503; also known as ALLIANCE) is a phase 3 trial that demonstrated that peripheral (outer third of lung) non–small cell lung carcinoma (NSCLC) with tumor size 2 cm or smaller and lymph node (LN) negative for metastasis, sublobar resection (defined as wedge resection or segmentectomy) compared to lobectomy was not inferior in disease-free survival (DFS) and overall survival (OS). The Japan Clinical Oncology Group (JCOG0802; also known as West Japan Oncology Group WJOG4607L study) is also a phase 3 trial that revealed that peripheral NSCLC with tumor size 2 cm or smaller with consolidation to tumor ratio more than 0.5 and LN negative for metastasis, segmentectomy (wedge resection was not allowed) compared to lobectomy was not inferior in relapse-free survival (RFS) and OS. Both trials are practice changing and challenged the prior standard of care of lobectomy for peripheral tumors 3 cm and smaller and LN negative for metastasis as established by the Lung Cancer Study Group.

To the Editor We read the article by Dai et al with great interest. Omitting chemotherapy in patients receiving induction chemotherapy (IC) is a hot topic in nasopharyngeal carcinoma treatment, particularly in the intensity-modulated radiotherapy era. Yet, concurrent cisplatin is still recommended in advanced-stage disease, and the cumulative dose of concurrent cisplatin recommended is at least 200 mg/m2 in the latest American Society of Clinical Oncology/Chinese Society of Clinical Oncology guidelines. The authors in the current study gave 30-mg/m2 cisplatin per week and only 12.1% of patients had received 7 weeks of cisplatin, which makes a total 210 mg/m2. For patients receiving IC, at least a total 160-mg/m2 dose of cisplatin is recommended, which had been received by 85.8% of patients. Could the inadequate cumulative concurrent cisplatin dose be the reason why the IC in combination with radiotherapy (IC-RT) arm was noninferior to the IC with induction chemotherapy combined with chemoradiotherapy (IC-CCRT) arm? Therefore, we would kindly like the authors to separately analyze the results of patients receiving adequate doses of concurrent cisplatin.

New England Journal of Medicine, Volume 391, Issue 8, Page 710-721, August 22/29, 2024.