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Major Pathologic Response and Prognostic Score Predict Survival in Patients With Lung Cancer Receiving Neoadjuvant Chemotherapy

INTRODUCTION: Complete pathologic response (CPR) is an acceptable surrogate for survival in clinical trials but it occurs infrequently in patients with NSCLC receiving neoadjuvant chemotherapy (NCT). Therefore, we studied the impact of major pathologic response (MPR) for predicting survival of patie...

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Autores principales: Pataer, Apar, Weissferdt, Annikka, Correa, Arlene M., Vaporciyan, Ara A., Sepesi, Boris, Heymach, John V., Berezowska, Sabina, Cascone, Tina, Swisher, Stephen G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9646962/
https://www.ncbi.nlm.nih.gov/pubmed/36389133
http://dx.doi.org/10.1016/j.jtocrr.2022.100420
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author Pataer, Apar
Weissferdt, Annikka
Correa, Arlene M.
Vaporciyan, Ara A.
Sepesi, Boris
Heymach, John V.
Berezowska, Sabina
Cascone, Tina
Swisher, Stephen G.
author_facet Pataer, Apar
Weissferdt, Annikka
Correa, Arlene M.
Vaporciyan, Ara A.
Sepesi, Boris
Heymach, John V.
Berezowska, Sabina
Cascone, Tina
Swisher, Stephen G.
author_sort Pataer, Apar
collection PubMed
description INTRODUCTION: Complete pathologic response (CPR) is an acceptable surrogate for survival in clinical trials but it occurs infrequently in patients with NSCLC receiving neoadjuvant chemotherapy (NCT). Therefore, we studied the impact of major pathologic response (MPR) for predicting survival of patients with NSCLC receiving NCT. We also tested a newly reported scoring system—the prognostic score (PRSC)—which combines T category, lymph node status, and MPR status. METHODS: We analyzed CPR and MPR, defined as 0% and less than or equal to 10% viable tumor cells, respectively, in 339 patients with NSCLC with various histologic types who had been treated with NCT followed by complete surgical resection. We evaluated the relationships between CPR, MPR, or PRSC and overall survival using the Kaplan-Meier method and Cox regression multivariate models, accounting for known prognostic factors, such as age, gender, histologic subtype, and pathologic stage. RESULTS: Among all 339 patients, the Kaplan-Meier method revealed that patients with CPR and MPR had better survival. MPR identified a favorable group of patients who experienced survival similar to patients with CPR. Nevertheless, patients with no MPR had a significantly reduced probability of survival. Furthermore, univariate and multivariate Cox proportional hazards regression analysis revealed that MPR and PRSC were significantly associated with overall survival. CONCLUSIONS: Our data suggest that MPR can be used as an end point for overall survival in different histologic types for evaluation of therapeutic agents in clinical trials exploring NCT. We also confirmed that PRSC had a prognostic impact, differentiating patients into three prognostic groups, but not superior compared with MPR alone or the TNM8 systems.
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spelling pubmed-96469622022-11-15 Major Pathologic Response and Prognostic Score Predict Survival in Patients With Lung Cancer Receiving Neoadjuvant Chemotherapy Pataer, Apar Weissferdt, Annikka Correa, Arlene M. Vaporciyan, Ara A. Sepesi, Boris Heymach, John V. Berezowska, Sabina Cascone, Tina Swisher, Stephen G. JTO Clin Res Rep Original Article INTRODUCTION: Complete pathologic response (CPR) is an acceptable surrogate for survival in clinical trials but it occurs infrequently in patients with NSCLC receiving neoadjuvant chemotherapy (NCT). Therefore, we studied the impact of major pathologic response (MPR) for predicting survival of patients with NSCLC receiving NCT. We also tested a newly reported scoring system—the prognostic score (PRSC)—which combines T category, lymph node status, and MPR status. METHODS: We analyzed CPR and MPR, defined as 0% and less than or equal to 10% viable tumor cells, respectively, in 339 patients with NSCLC with various histologic types who had been treated with NCT followed by complete surgical resection. We evaluated the relationships between CPR, MPR, or PRSC and overall survival using the Kaplan-Meier method and Cox regression multivariate models, accounting for known prognostic factors, such as age, gender, histologic subtype, and pathologic stage. RESULTS: Among all 339 patients, the Kaplan-Meier method revealed that patients with CPR and MPR had better survival. MPR identified a favorable group of patients who experienced survival similar to patients with CPR. Nevertheless, patients with no MPR had a significantly reduced probability of survival. Furthermore, univariate and multivariate Cox proportional hazards regression analysis revealed that MPR and PRSC were significantly associated with overall survival. CONCLUSIONS: Our data suggest that MPR can be used as an end point for overall survival in different histologic types for evaluation of therapeutic agents in clinical trials exploring NCT. We also confirmed that PRSC had a prognostic impact, differentiating patients into three prognostic groups, but not superior compared with MPR alone or the TNM8 systems. Elsevier 2022-09-30 /pmc/articles/PMC9646962/ /pubmed/36389133 http://dx.doi.org/10.1016/j.jtocrr.2022.100420 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Pataer, Apar
Weissferdt, Annikka
Correa, Arlene M.
Vaporciyan, Ara A.
Sepesi, Boris
Heymach, John V.
Berezowska, Sabina
Cascone, Tina
Swisher, Stephen G.
Major Pathologic Response and Prognostic Score Predict Survival in Patients With Lung Cancer Receiving Neoadjuvant Chemotherapy
title Major Pathologic Response and Prognostic Score Predict Survival in Patients With Lung Cancer Receiving Neoadjuvant Chemotherapy
title_full Major Pathologic Response and Prognostic Score Predict Survival in Patients With Lung Cancer Receiving Neoadjuvant Chemotherapy
title_fullStr Major Pathologic Response and Prognostic Score Predict Survival in Patients With Lung Cancer Receiving Neoadjuvant Chemotherapy
title_full_unstemmed Major Pathologic Response and Prognostic Score Predict Survival in Patients With Lung Cancer Receiving Neoadjuvant Chemotherapy
title_short Major Pathologic Response and Prognostic Score Predict Survival in Patients With Lung Cancer Receiving Neoadjuvant Chemotherapy
title_sort major pathologic response and prognostic score predict survival in patients with lung cancer receiving neoadjuvant chemotherapy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9646962/
https://www.ncbi.nlm.nih.gov/pubmed/36389133
http://dx.doi.org/10.1016/j.jtocrr.2022.100420
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