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(Small Cell Lung Cancer)

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SCLC (Small Cell Lung Cancer)AmrubicinIfinatamab deruxtecanLurbinectedinTopotecanRecruitingAustraliaAustriaBelgiumBrazilCanadaChinaCzechiaFranceGermanyGreeceHungaryItalyJapanKorea, Republic ofNetherlandsPolandPortugalRomaniaSpainSwitzerlandTaiwanTurkeyUnited KingdomUnited States 8NCT06203210Phase 3IDeate-Lung02
A Study of Ifinatamab Deruxtecan Versus Treatment of Physician’s Choice in Subjects With Relapsed Small Cell Lung Cancer

A Study of Ifinatamab Deruxtecan Versus Treatment of Physician’s Choice in Subjects With Relapsed Small Cell Lung Cancer

SCLC (Small Cell Lung Cancer)DurvalumabOther: PlaceboTremelimumabActiveNot Yet RecruitingArgentinaBelgiumCanadaChinaCzechiaGermanyIndiaItalyJapanKorea, Republic ofNetherlandsPolandRussian FederationSpainTaiwanTurkeyUnited KingdomUnited StatesVietnam 9NCT03703297Phase 3ADRIATIC
Study of Durvalumab + Tremelimumab, Durvalumab, and Placebo in Limited Stage Small-Cell Lung Cancer in Patients Who Have Not Progressed Following Concurrent Chemoradiation Therapy

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NSCLC (Non-Small Cell Lung Cancer)Other CancersSCLC (Small Cell Lung Cancer)(vic-)trastuzumab duocarmazineRecruitingUnited States 0NCT02146170
Tissue Procurement and Natural History Study of People With Non-Small Cell Lung Cancer, Small Cell Lung Cancer, Extrapulmonary Small Cell Cancer, Pulmonary Neuroendocrine Tumors, and Thymic Epithelial Tumors

Tissue Procurement and Natural History Study of People With Non-Small Cell Lung Cancer, Small Cell Lung Cancer, Extrapulmonary Small Cell Cancer, Pulmonary Neuroendocrine Tumors, and Thymic Epithelial Tumors

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Dato-DXd Shows Strong Efficacy in TROP2-Positive Advanced NSCLC

KEY TAKEAWAYS

  • This TROPION-Lung 01 phase 3 trial aimed to determine if TROP2 NMR determined by QCS could be a predictive biomarker for Dato-DXd treatment.
  • Researchers concluded Dato-DXd showed strong efficacy in TROP2-positive NSQ/non-AGA advanced NSCLC, warranting further investigation.

Datopotamab deruxtecan (Dato-DXd) is a TROP2-directed antibody-drug conjugate (ADC). Unlike other TROP2 ADCs, it has a plasma-stable linker that requires active internalization to release the cytotoxic payload. Previous studies have shown that visual scoring of immunohistochemical (IHC) assays by pathologists to assess target expression is not predictive of therapeutic response to TROP2-directed ADCs in patients with non-small cell lung cancer (NSCLC).

M.C. Garassino and the team aimed to investigate whether a more precise and quantitative assessment of TROP2 expression on the cell membrane and cytoplasm would be predictive of therapeutic response to Dato-DXd.

Researchers utilized digitized TROP2 IHC-stained whole-slide images (WSI) of tissue samples from patients with NSCLC to develop the Quantitative Continuous Scoring (QCS) model. QCS uses a fully supervised deep learning algorithm trained on pathologist annotations. It identifies tumor areas and cellular compartments (membrane and cytoplasm) of individual tumor cells across the WSI. The QCS model measured TROP2 expression in the membrane relative to the cytoplasm of tumor cells, termed the normalized membrane ratio (NMR).

Tumors with a majority of cells displaying a TROP2 NMR below a specific value determined in biomarker development were defined as TROP2 QCS-NMR+. They optimized QCS-NMR for PFS in the biomarker-evaluable patient subgroup with non-squamous (NSQ) NSCLC without actionable genomic alterations (non-AGA) in the phase 3 TROPION-Lung01 trial (Dato-DXd vs docetaxel in 2L+ advanced/metastatic NSCLC). They then assessed the association of TROP2 QCS-NMR status with clinical outcomes in all biomarker-evaluable patients.

Of the 604 patients randomized in TROPION-Lung01, 352 were biomarker evaluable. This included 221 patients in the NSQ/non-AGA subgroup. There were no significant differences in baseline characteristics between the randomized and biomarker-evaluable populations, with similar overall PFS outcomes. Sixty-three percent of evaluable patients were TROP2 QCS-NMR+, which was most common in NSQ/AGA (75%), followed by NSQ/non-AGA (63%) and SQ (43%) subgroups.

Dato-DXd showed higher ORR and longer median PFS vs docetaxel in TROP2 QCS-NMR+ subgroups. Overall/grade 3+ adverse event rates were similar regardless of TROP2 QCS-NMR status.

In an exploratory biomarker-defined population, Dato-DXd demonstrated strong efficacy in patients with TROP2 QCS-NMR+ NSQ/non-AGA advanced/metastatic NSCLC. TROP2 NMR determined by QCS demonstrated potential as a predictive biomarker for Dato-DXd.

The trial was sponsored by Daiichi Sankyo.

Source: https://cattendee.abstractsonline.com/meeting/20598/presentation/3197

Clinical Trial: https://clinicaltrials.gov/study/NCT04656652

Garassino MC, Sands J, Paz-Ares L, et al. (2024). “Normalized membrane ratio of TROP2 by quantitative continuous scoring is predictive of clinical outcomes in TROPION-Lung 01.” Presented at: World Conference on Lung Cancer (WCLC); September 8, 2024; Singapore.

Perioperative Nivolumab Improves EFS in Resectable NSCLC

KEY TAKEAWAYS

  • The CheckMate 77T and CheckMate 816 phase 3 trials aimed to evaluate the contribution of the adjuvant phase of the perioperative nivolumab treatment regimen in resectable NSCLC.
  • Researchers noticed perioperative nivolumab improved EFS vs. neoadjuvant nivolumab in patients with resectable NSCLC.

Neoadjuvant nivolumab plus chemotherapy, as demonstrated in the CheckMate 816 trial, significantly improves event-free survival (EFS) and pathological complete response (pCR) in patients with resectable non-small cell lung cancer (NSCLC).

This regimen is currently the only approved neoadjuvant immunotherapy-containing treatment for this condition. The CheckMate 77T trial built upon this standard of care (SOC) by demonstrating clinically meaningful improvements in EFS and pCR when comparing perioperative nivolumab to a placebo.

Patrick Forde and the team spearheaded a study that aimed to evaluate the contribution of the adjuvant phase of the perioperative nivolumab treatment regimen using individual patient-level data from the CheckMate 77T and CheckMate 816 trials.

This analysis included patients from CheckMate 77T who received neoadjuvant nivolumab plus chemotherapy, followed by definitive surgery and at least one dose of adjuvant nivolumab.
Patients were compared to patients from CheckMate 816 who received neoadjuvant nivolumab plus chemotherapy followed by definitive surgery. The database lock dates were April 26, 2024, for CheckMate 77T and October 20, 2021, for CheckMate 816. These dates were chosen to provide similar median follow-up times of 33.3 and 29.5 months, respectively.

Inverse probability of treatment weighting (IPTW) was used to adjust for potential cross-trial imbalances in baseline covariates. This was done using propensity score weights to determine the stabilised average treatment effect for the treated (ATT) and the stabilised average treatment effect (ATE).

Assessments included EFS landmarked from the time of definitive surgery in both the weighted and unweighted analysis populations, and in subgroups (unweighted) defined by PD-L1 expression, clinical stage, and pCR status. Safety was also assessed.

After weighting, baseline characteristics were balanced between the perioperative nivolumab (N=139) and neoadjuvant nivolumab (N=147) analysis populations. Perioperative nivolumab demonstrated an EFS benefit from the time of surgery compared to neoadjuvant nivolumab (HR [95% CI]: unweighted, 0.59 [0.38-0.92]; weighted [ATT], 0.56 [0.35-0.90]; weighted [ATE], 0.61 [0.39-0.97]). This landmark EFS benefit with perioperative versus neoadjuvant nivolumab was also observed in patients with PD-L1 <1% or ≥1% and across clinical stages (IB/II or III).

Furthermore, landmark EFS favoured perioperative nivolumab in patients both with and without pCR. Grade 3-4 treatment-related adverse events occurred in 27% of patients receiving perioperative nivolumab and 35% of those receiving neoadjuvant nivolumab.

This landmark IPTW EFS analysis indicated that perioperative nivolumab improves EFS compared to neoadjuvant nivolumab in patients with resectable NSCLC. This includes patients with PD-L1 <1% or those without pCR.

While the limitations of propensity score weighted analysis mean that the results should be interpreted with caution, this remains the first individual patient-level data cross-trial analysis of phase 3, international, randomized trials to assess the contribution of the adjuvant phase of a perioperative immunotherapy-based regimen.

These findings further support perioperative nivolumab as a treatment option for patients with resectable NSCLC.

The trial was sponsored by Bristol-Myers Squibb.

Source: https://cattendee.abstractsonline.com/meeting/20598/presentation/3196

Clinical Trials: https://clinicaltrials.gov/study/NCT04025879
https://clinicaltrials.gov/study/NCT02998528

Forde PM, Peters S, Donington J, et al. (2024). “Perioperative vs Neoadjuvant Nivolumab for Resectable NSCLC: Patient-Level Data Analysis of CheckMate 77T vs CheckMate 816.” Presented at: World Conference on Lung Cancer (WCLC); September 8, 2024; Singapore.

Ivonescimab Shows Promise in NSCLC Treatment

KEY TAKEAWAYS

  • The HARMONi-2 phase 3 trial aimed to compare the efficacy and safety of ivonescimab and pembrolizumab as 1L treatment in patients with PD-L1 positive NSCLC.
  • The primary endpoint was PFS.
  • Researchers noticed Ivonescimab significantly improved PFS over pembrolizumab in patients with PD-L1-positive advanced NSCLC.

Non-small cell lung cancer (NSCLC) is a leading cause of cancer-related mortality globally. Immune checkpoint inhibitors, particularly those targeting the programmed death-1 (PD-1) pathway, have revolutionized the treatment landscape for advanced NSCLC.

However, a significant proportion of patients do not achieve durable responses. Ivonescimab is a novel bispecific antibody targeting both PD-1 and vascular endothelial growth factor (VEGF), demonstrating promising results in earlier-phase studies.

Caicun Zhou and the team aimed to compare the efficacy and safety of ivonescimab with pembrolizumab, a standard-of-care PD-1 inhibitor, as a first-line (1L) treatment for patients with PD-L1-positive advanced NSCLC.

The study was a randomized, controlled trial conducted across 55 centers. Eligible patients with untreated locally-advanced or metastatic NSCLC, ECOG performance status 0-1, PD-L1 positive (tumor proportion score [TPS] ≥1%), but negative for EGFR mutations or ALK rearrangements were randomized 1:1 to receive either ivonescimab 20 mg/kg or pembrolizumab 200 mg every 3 weeks.

Randomization was stratified by histology, clinical stage, and PD-L1 expression level. The primary endpoint was progression-free survival (PFS) as assessed by a blinded independent radiographic review committee using RECIST v1.1 criteria. Secondary endpoints included overall survival (OS), investigator-assessed PFS, objective response rate (ORR), duration of response (DoR), disease control rate (DCR), and safety.

Between November 2022 and August 2023, 398 patients were randomized to receive either ivonescimab (n=198) or pembrolizumab (n=200). At the pre-planned interim analysis, the median PFS was significantly longer with ivonescimab compared to pembrolizumab (11.14 months vs. 5.82 months; stratified HR, 0.51; 95% CI, 0.38-0.69; P<0.0001).

The PFS benefit of ivonescimab was observed across various subgroups, including those defined by histology, PD-L1 expression levels, and presence of liver or brain metastases. Ivonescimab exhibited a manageable safety profile, with no new safety signals identified.

The incidence of treatment-related serious adverse events (TRSAEs) was 20.8% with ivonescimab and 16.1% with pembrolizumab. Grade ≥3 immune-related adverse events (irAEs) were observed in 7.1% and 8.0% of patients in the ivonescimab and pembrolizumab arms, respectively.

The study demonstrated that ivonescimab provides a statistically significant and clinically meaningful improvement in PFS compared to pembrolizumab in patients with PD-L1-positive advanced NSCLC. Ivonescimab also showed a manageable safety profile. These findings support ivonescimab as a promising new 1L treatment option for this patient population.

The trial was sponsored by Akeso.

Source: https://cattendee.abstractsonline.com/meeting/20598/presentation/3194

Clinical Trial: https://clinicaltrials.gov/study/NCT05499390

Zhou C, Chen J, Wu L, et al. (2024). “Phase 3 study of ivonescimab (AK112) vs pembrolizumab as first-line treatment for PD-L1-positive advanced NSCLC: primary analysis of HARMONi-2.” Presented at: World Conference on Lung Cancer (WCLC); September 8, 2024; Singapore.

Firmonertinib in TKI-Naive EGFR PACC+ NSCLC

Firmonertinib in TKI-Naive EGFR PACC+ NSCLC

KEY TAKEAWAYS

  • The FURTHER phase 1b trial aimed to evaluate the efficacy and safety of firmonertinib in TKI-naive patients with advanced EGFR PACC-mutant NSCLC.
  • The primary endpoint was confirmed ORR.
  • Firmonertinib demonstrated promising efficacy and acceptable safety in this patient population. Further investigation is warranted.

P-loop and αC-helix compressing (PACC) mutations constitute approximately 12% of EGFR mutations in non-small cell lung cancer (NSCLC). These mutations, similar to ex20ins mutations, narrow the drug-binding pocket of ATP competitive EGFR inhibitors, posing a challenge for treatment. Firmonertinib, an oral, highly brain-penetrant EGFR inhibitor, has shown activity and selectivity across EGFR mutations, including PACC and ex20ins mutations.

Xiuning Le and the team aimed to evaluate the efficacy and safety of firmonertinib in patients with EGFR PACC-mutated NSCLC.

The global Phase 1b FURTHER study (FURMO-002; NCT05364073) involved 2 stages: a dose-escalation/backfill Stage 1 and a dose-expansion Stage 2. In Stage 2, Cohort 4 (PACC cohort), TKI-naive patients with EGFR PACC-mutant NSCLC were randomized to receive firmonertinib at either 160 mg or 240 mg once daily.

Key eligibility criteria included documented EGFR PACC mutation, measurable disease as defined by RECIST 1.1, and no prior EGFR TKI therapy. The primary endpoint was confirmed objective response rate (ORR) per RECIST 1.1 by blinded independent central review (BICR). Secondary endpoints included duration of response (DoR) and CNS ORR.

As of July 5, 2024, 60 patients were enrolled in the PACC cohort with a median age of 67 years. Of these, 66.7% were female, 71.7% were Asian, 33.3% had brain metastases, 28.3%/71.7% had ECOG scores of 0/1, and 78.3% had no prior metastatic systemic therapy. The BICR cutoff date was June 20, 2024. In first-line metastatic NSCLC patients with EGFR PACC mutations, the ORR by BICR was 81.8% (n=22; 95% CI, 59.7%-94.8%) at 240 mg QD and 47.8% (n=23; 95% CI, 26.8%-69.4%) at 160 mg QD. Confirmed ORR by BICR was 63.6% (n=22; 95% CI, 40.7%-82.8%; 1 uPR pending confirmation) at 240 mg QD and 34.8% (n=23; 95% CI, 16.4%-57.3%; 1 uPR pending confirmation) at 160 mg QD.

Responses were seen across a wide range of PACC mutations. Median DoR was not reached, as 90.9% (n=20 of 22) of patients with confirmed responses remain on treatment (median follow-up 4.2 months).

Among first-line metastatic patients with brain metastases, CNS confirmed ORR by BICR was 46.2% (n=6 of 13) per modified RECIST. The safety profile in the PACC cohort was consistent with previous firmonertinib studies, with the most frequent treatment-related adverse events (TRAEs) being diarrhea, rash, stomatitis, and hepatic enzyme elevation.

Most TRAEs were Grade 1-2, with Grade 3 events occurring in 20.7% and 12.9% of patients at the 240 mg and 160 mg dose levels, respectively. No Grade ≥4 TRAEs or treatment discontinuations due to TRAEs were reported.

FURTHER is the first clinical trial to assess firmonertinib in patients with NSCLC who had EGFR PACC mutations. The study showed promising efficacy in the first-line metastatic setting, especially at the 240 mg dose, with notable CNS antitumor activity and a manageable safety profile. These findings support the need for further investigation of firmonertinib in this patient population.

The trial was sponsored by ArriVent BioPharma, Inc.

Source: https://cattendee.abstractsonline.com/meeting/20598/presentation/3203

Clinical Trial: https://clinicaltrials.gov/study/NCT05364073

Le X, Yu Y, Zhao Y, et al. (2024). “FURTHER: a global, randomized study of firmonertinib at two dose levels in TKI-naive, advanced NSCLC with EGFR PACC mutations.” Presented at: World Conference on Lung Cancer (WCLC); September 8, 2024; Singapore.

Impact of TLS Density and Prognosis in NSCLC

KEY TAKEAWAYS

  • The study aimed to investigate TLS density and distribution in different regions of NSCLC.
  • Researchers found that higher E-TLS density in the IM region predicts poorer NSCLC outcomes, likely due to TLS maturation inhibition by suppressive cells.

Tertiary lymphoid structures (TLS), which are organized clusters of tumor-infiltrating immune cells within the tumor immune microenvironment (TIME), are crucial for the development and anti-tumor immunity in various cancers, such as liver, colon, and gastric cancers.

Although previous research has shown TLS presence in intra-tumoral (IT), invasive margin (IM), and peri-tumoral (PT) regions at different maturity stages, the density of TLS in different regions of non-small cell lung cancer (NSCLC) has not been thoroughly explored.

Shuyue Xin and the team sought to evaluate TLS density across these NSCLC regions and examine its association with patient prognosis.

They performed an inclusive analysis of 82 patients with NSCLC, assessing TLS and tumor-infiltrating immune cells using immunohistochemistry (IHC) staining. Tumor samples were divided into 3 subregions: IT, IM, and PT. TLS were classified as early/primary TLS (E-TLS) or secondary/follicular TLS (F-TLS).

The distribution of TLS in different maturity statuses was evaluated, along with their correlation with clinicopathological characteristics and prognostic value. Nomograms were used to predict the probability of 1-, 3-, and 5-year overall survival (OS) in patients with NSCLC.

Regarding the density of TLS and the proportion of F-TLS, the IT region exhibited significantly higher values (90.2%, 0.45/mm², and 61.0%, respectively) compared to the IM region (72.0%, 0.18/mm², and 39.0%, respectively) and the PT region (67.1%, 0.16/mm², and 40.2%, respectively).

A lower density of TLS, particularly E-TLS, in the IM region, was associated with a better prognosis in patients with NSCLC. CD20+ B cells, CD3+ T cells, CD8+cytotoxic T cells, and CD68+ macrophages were significantly overexpressed in the IM region.

There was a significant correlation between CD20+ B cells and CD3+ T cells in the IM region with the density of E-TLS, while no statistically significant correlation was observed with F-TLS. The E-TLS density in the IM region and the TNM stage were identified as independent prognostic factors for patients with NSCLC. Additionally, the nomogram demonstrated good prognostic ability.

The study concluded that a higher density of E-TLS in the IM region correlates with worse prognosis in patients with NSCLC, potentially due to the inhibition of TLS maturation caused by the increased density of suppressive immune cells at the tumor invasion front.

This study was funded by the United Fund of the Second Hospital of Dalian Medical University and Dalian Institute of Chemical Physics, Chinese Academy of Sciences (UF-ZD-202011), and Project of Science and Technology of Liaoning Province (2023-MS-272).

Source: https://pubmed.ncbi.nlm.nih.gov/39192984/

Xin S, Wen S, He P, et al. (2024). “Density of tertiary lymphoid structures and their correlation with prognosis in non-small cell lung cancer.” Front Immunol. 2024;15:1423775. Published 2024 Aug 13. doi:10.3389/fimmu.2024.1423775

Impact of ct-DNA Dynamics on Survival in EGFR-M NSCLC

KEY TAKEAWAYS

  • The study aimed to investigate how baseline detection and early clearance of EGFR ct-DNA in plasma affect survival outcomes in advanced EGFR-m NSCLC.
  • Researchers found that ct-DNA persistence at first follow-up predicts worse PFS and OS.

To determine if circulating tumor DNA (ct-DNA) dynamics of epidermal growth factor receptor (EGFR) mutation in plasma can identify a subset of patients with EGFR-mutant (EGFR-m) non-small cell lung cancer (NSCLC) with inferior survival outcomes, we analyzed and compared survival outcomes among patients with and without baseline presence and early clearance of EGFR ct-DNA in plasma.

A Joel and the team conducted a study involving patients with advanced EGFR-m NSCLC, examining the impact of ct-DNA detection at baseline and its clearance at first follow-up on progression-free survival (PFS) and overall survival (OS).

They performed an inclusive analysis involving 66 patients newly diagnosed with EGFR-m NSCLC. Plasma samples were collected at baseline and at the first response assessment, conducted between 12 and 24 weeks, for ct-DNA extraction. The ct-DNA (EGFR exons 18, 19, 20, and 21) was quantified using droplet digital polymerase chain reaction (dd-PCR) on the QX200 ddPCR system (BioRad, USA). Patients with detectable EGFR ct-DNA at baseline and either undetectable or persistent detectable ct-DNA in follow-up samples were classified as clearers and non-clearers, respectively.

About 53 patients received 1st/2nd generation EGFR tyrosine kinase inhibitors (TKIs), while 13 patients were treated with either a 3rd generation TKI (osimertinib) or chemotherapy plus gefitinib. The baseline ct-DNA-positive group exhibited a higher prevalence of extra thoracic disease (60.4% vs. 48.5%). For the entire cohort, there was no significant difference in median PFS between baseline ct-DNA-negative (13.57 months) and ct-DNA-positive patients (12.32 months) (HR 0.74).

However, a significant improvement in PFS was observed among early ct-DNA clearers compared to non-clearers (12.32 months vs. 9.92 months; HR 0.57). For patients treated with 1st/2nd generation EGFR TKIs, the improvement in median PFS among early ct-DNA clearers versus non-clearers was even more pronounced (11.76 months vs. 6.8 months; HR 0.34).

The study concluded that baseline detection of ct-DNA for EGFR mutations in plasma was not predictive of first-line (1L) PFS but was associated with extra thoracic disease. Persistence of ct-DNA at the first follow-up correlated with worse PFS and OS compared to those who cleared ct-DNA from plasma, particularly among patients treated with 1st/2nd generation EGFR TKIs.

This study was funded by the Department of Science and Technology and the Government of India.

Source: https://pubmed.ncbi.nlm.nih.gov/39183550/

Joel A, Abarna R, Chacko RT, et al. (2024). “Analysis of the effect of baseline detection and early clearance of ct-DNA, on survival outcomes among patients with advanced EGFR-mutant non-small cell lung cancer.” Analýza efektu detekce časné clearance ct-DNA při baseline na přežití u pacientů s pokročilým EGFR mutovaným nemalobuněčným karcinomem plic. Klin Onkol. 2024;38(1):40-49. doi:10.48095/ccko202440

Segmentectomy vs Lobectomy: Effects on NSCLC Recovery

KEY TAKEAWAYS

  • The study aimed to compare segmentectomy and lobectomy by analyzing postoperative cardiopulmonary function and serum tumor markers.
  • Results showed segmentectomy better preserves lung function and reduces oxidative stress in NSCLC, with minimal impact on tumor markers.

In patients with early non-small cell lung cancer (NSCLC), single-port thoracoscopic anatomical segmentectomy is a common treatment. However, lung function recovery is slow post-surgery. In contrast, anatomical segmental pneumonectomy, which removes less lung tissue, might lead to faster recovery.

Yiting Shi and the team aimed to compare 2 surgical approaches by analyzing postoperative changes in cardiopulmonary function and serum tumor markers.

Researchers conducted a retrospective analysis of 120 patients with NSCLC from October 2020 to October 2023. Patients were divided into 2 groups based on their surgical intervention.The pulmonary segmentectomy group, which underwent uniportal video-assisted thoracoscopic anatomical pulmonary segmentectomy (n=57), and the lobectomy group, which received uniportal video-assisted thoracoscopic anatomical lobectomy (n=63).

Surgical parameters and perioperative stress indicators were recorded for both groups. Additionally, they compared cardiopulmonary function indicators and serum biomarker levels before and three months after surgery.

The segmentectomy group had a longer operation time and higher intraoperative blood loss compared to the lobectomy group. However, the segmentectomy group had shorter postoperative hospital stays, less chest drainage volume, and shorter drainage tube indwelling times (P< 0.001).

Post-treatment, the segmentectomy group showed higher forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, and maximal voluntary ventilation (MVV) compared to the lobectomy group (P< 0.001).

Additionally, stroke volume (SV) and left ventricular ejection fraction (LVEF) were higher in the segmentectomy group (P< 0.001). There were no significant differences in carbohydrate antigen 50 (CA50), carcinoembryonic antigen (CEA), or cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) levels between the groups after treatment (P> 0.05). After 1 day surgery, levels of epinephrine (E), norepinephrine (NE), and cortisol (Cor) were lower in the segmentectomy group (P< 0.001).

The study concluded that anatomical pulmonary segmentectomy for NSCLC better reduces surgery-induced damage to cardiopulmonary function and lowers perioperative oxidative stress compared to uniportal video-assisted thoracoscopic lobectomy. Both surgical approaches, however, have minimal effects on serum tumor marker levels.

No funding information was provided.

Source: https://pubmed.ncbi.nlm.nih.gov/39186341/

Shi Y, Xiao S. (2024). “Effect of Anatomical Pulmonary Segmentectomy and Lobectomy under Uniportal Video-Assisted Thoracoscopic Surgery on Cardiopulmonary Function and Serum Tumor Markers in Patients with Early-Stage Non-Small Cell Lung Cancer.” Ann Ital Chir. 2024;95(4):593-602. doi:10.62713/aic.3462

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