Supplementary Figure from Comprehensive Genome Profiling in Patients With Metastatic Non–Small Cell Lung Cancer: The Precision Medicine Phase II Randomized SAFIR02-Lung Trial
Supplementary Figure from Comprehensive Genome Profiling in Patients With Metastatic Non–Small Cell Lung Cancer: The Precision Medicine Phase II Randomized SAFIR02-Lung Trial
Supplementary Data from Comprehensive Genome Profiling in Patients With Metastatic Non–Small Cell Lung Cancer: The Precision Medicine Phase II Randomized SAFIR02-Lung Trial
Supplementary Table from Comprehensive Genome Profiling in Patients With Metastatic Non–Small Cell Lung Cancer: The Precision Medicine Phase II Randomized SAFIR02-Lung Trial
<div>AbstractPurpose:<p>Targeted therapies (TT) and immune checkpoint blockers (ICB) have revolutionized the approach to non–small cell lung cancer (NSCLC) treatment in the era of precision medicine. Their impact as switch maintenance therapy based on molecular characterization is unknown.</p>Patients and Methods:<p>SAFIR02-Lung/IFCT 1301 was an open-label, randomized, phase II trial, involving 33 centers in France. We investigated eight TT (substudy-1) and one ICB (substudy-2), compared with standard-of-care as a maintenance strategy in patients with advanced <i>EGFR</i>, <i>ALK</i> wild-type (wt) NSCLC without progression after first-line chemotherapy, based on high-throughput genome analysis. The primary outcome was progression-free survival (PFS).</p>Results:<p>Among the 175 patients randomized in substudy-1, 116 received TT (selumetinib, vistusertib, capivasertib, AZD4547, AZD8931, vandetanib, olaparib, savolitinib) and 59 standard-of-care. Median PFS was 2.7 months [95% confidence interval (CI), 1.6–2.9] with TT versus 2.7 months (1.6–4.1) with standard-of-care (HR, 0.97; 95% CI, 0.7–1.36; <i>P</i> = 0.87). There were no significant differences in PFS within any molecular subgroup. In substudy-2, 183 patients were randomized, 121 received durvalumab and 62 standard-of-care. Median PFS was 3.0 months (2.3–4.4) with durvalumab versus 3.0 months (2.0–5.1) with standard-of-care (HR, 0.86; 95% CI, 0.62–1.20; <i>P</i> = 0.38). Preplanned subgroup analysis showed an enhanced benefit with durvalumab in patients with PD-L1 tumor proportion score (TPS) ≥1%, (<i>n</i> = 29; HR, 0.29; 95% CI, 0.11–0.75) as compared with PD-L1 <1% (<i>n</i> = 31; HR, 0.71; 95% CI, 0.31–1.60; <i>P</i><sub>interaction</sub> = 0.036).</p>Conclusions:<p>Molecular profiling can feasibly be implemented to guide treatment choice for the maintenance strategy in EGFR/ALK wt NSCLC; in this study it did not lead to substantial treatment benefits beyond durvalumab for PD-L1 ≥ 1 patients.</p></div>
Background: Cannabis has been hypothesized to be a risk factor for tobacco-related cancers including lung cancer (LC) but has been rarely studied in a large cohort so far. Aims and objectives: Report characteristics of cannabis users as compared to ever-smokers in a large cohort study. Methods: Between 01/01 and 12/31/2020, all patients diagnosed with a LC were included in the KBP-CPHG-2020 cohort in 82 French non-academic centers. Cannabis use (CU) was defined as patients acknowledging more than 20 joints in lifetime; ever-smoker (ES) as patients who smoke more than 100 cigarettes during lifetime. Results: 8,999 patients were included: 311 (3.5%) acknowledged CU, and 7,364 (83.7%) were ES. CU were mainly heavy consumers with a mean (SD) of 22.6 (26.60) joints/week (or 3.0 (3.55) joints/day), with a mean duration of use of 24.8 (12.7) years. CU started cannabis at mean (SD) age of 21.2 (8.6) years. CU and ES had a similar cigarette smoking consumption (21 (11) cigarettes daily), while they had started tobacco smoking earlier (mean age 16.9 (4.5) vs19.3 (6.6) y-o). CU were younger at LC diagnosis (mean age 52.9 (8.9) vs 67.7 (9.5) y-o). At diagnosis CU presented with stage IV cancer in 64.7% of cases, with ECOG 0 or 1 in 78.8% of cases similarly to ES (59.3% and 74.8% respectively). Weight losses were also equivalent (3.8 kg). Histology was significantly different between CU and ES: adenocarcinoma was more frequent in CU (61.1% vs 53.0%) and squamous cell cancer less frequent (15.8% vs 24.3%). Molecular pattern differs only for KRAS mutation, less frequent in CU than ES (29.8% vs 39.7%). Conclusion: CU smokers were really younger at LC diagnosis and had a significantly different histological profile than ES.
