Publications by authors named "Scott Gettinger"

Background: Brigatinib, a selective ALK inhibitor, demonstrated preclinical activity against a range of crizotinib-resistant ALK alterations in NSCLC. We examined associations between brigatinib efficacy and tumor- and plasma-detected driver mutations in crizotinib-resistant ALK fusion-positive NSCLC.

Patients And Methods: Tumor tissue and plasma circulating tumor DNA (ctDNA) from patients with crizotinib-exposed ALK-positive NSCLC receiving brigatinib in phase 1/2 and phase 2 ALTA trials were analyzed by next-generation sequencing.

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Thymomas and thymic carcinomas are rare mediastinal tumors that originate in the thymus. Patients with thymoma may experience symptoms associated with autoimmune paraneoplastic diseases (such as myasthenia gravis), which typically do not occur in patients with thymic carcinoma. The NCCN Guidelines for Thymomas and Thymic Carcinomas provide guidance for the diagnosis, treatment, and surveillance of patients with thymoma and thymic carcinoma.

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Background: Pembrolizumab monotherapy is an established front-line treatment for advanced non-small cell lung cancer (NSCLC) with programmed cell death-ligand 1 (PD-L1) tumor proportion score (TPS)≥50%. However, real-world data on its long-term efficacy remains sparse.

Methods: This study assessed 5-year outcomes of first-line pembrolizumab monotherapy in a large, multicenter, real-world cohort of patients with advanced NSCLC and PD-L1 TPS≥50%, referred to as Pembro-real 5Y.

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Purpose: National Cancer Institute-Molecular Analysis for Therapy Choice (NCI-MATCH) was a multicohort phase 2 trial that assigned patients with advanced pretreated cancers to molecularly targeted therapies on the basis of tumor genomic testing. NCI-MATCH Arm A evaluated afatinib, an EGFR tyrosine kinase inhibitor (TKI) approved for advanced non-small cell lung cancer, in patients with tumors other than lung cancer harboring mutations.

Methods: Patients with advanced pretreated cancers other than lung cancer found to have selected actionable mutations were offered participation in Arm A.

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Article Synopsis
  • The NCCN Guidelines for Non-Small Cell Lung Cancer offer comprehensive recommendations for diagnosing and managing NSCLC, including ongoing monitoring and treatment options.
  • Recent updates include new targeted therapies approved by the FDA, reflecting the latest clinical data.
  • The guidelines specifically highlight treatment strategies for advanced or metastatic NSCLC that have actionable molecular biomarkers.
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In this phase 2 multicenter study, we evaluated the efficacy and safety of lifileucel (LN-145), an autologous tumor-infiltrating lymphocyte cell therapy, in patients with metastatic non-small cell lung cancer (mNSCLC) who had received prior immunotherapy and progressed on their most recent therapy. The median number of prior systemic therapies was 2 (range, 1-6). Lifileucel was successfully manufactured using tumor tissue from different anatomic sites, predominantly lung.

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Article Synopsis
  • * Pleural mesothelioma is the most common type, accounting for about 85% of all cases.
  • * The NCCN Guidelines for Mesothelioma: Pleural provide updated recommendations on diagnosis, treatment, and follow-up, with recent revisions focusing on disease classification and systemic therapy options.
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Unlabelled: The majority of EGFR mutant lung adenocarcinomas respond well to EGFR tyrosine kinase inhibitors (TKI). However, most of these responses are partial, with drug-tolerant residual disease remaining even at the time of maximal response. This residual disease can ultimately lead to relapses, which eventually develop in most patients.

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  • * Multi-omics analyses of blood and tissue samples from a clinical trial revealed that higher immune scores correlate with better responses to ICIs, while certain immune cells, like regulatory T cells, negatively impact survival.
  • * Variations in immune cell density and proximity to tumor cells influence survival outcomes, and soluble proteins found in the blood could serve as indicators for treatment effectiveness and overall survival in SqNSCLC patients.
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Introduction: Patients with metastatic EGFR-mutant NSCLC inevitably have disease progression while on tyrosine kinase inhibitor (TKI) therapy. Co-occurring tumor suppressor gene (TSG) alterations have been associated with poor outcomes, however, detailed analyses of their impact on patient outcomes are limited.

Methods: Patients with EGFR-mutant NSCLC treated with EGFR TKIs who had tumor genomic profiling were included.

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Mesothelioma is a rare cancer originating in mesothelial surfaces of the peritoneum, pleura, and other sites. These NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) focus on peritoneal mesothelioma (PeM). The NCCN Guidelines for PeM provide recommendations for workup, diagnosis, and treatment of primary as well as previously treated PeM.

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Background: Interactions between immune and tumor cells are critical to determining cancer progression and response. In addition, preclinical prediction of immune-related drug efficacy is limited by interspecies differences between human and mouse, as well as inter-person germline and somatic variation. To address these gaps, we developed an autologous system that models the tumor microenvironment (TME) from individual patients with solid tumors.

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Immunotherapy-based regimens are an established standard of care for the first-line treatment of driver-negative (EGFR/ALK/ROS WT) advanced non-small cell lung cancer. With multiple immune-based regimens approved in the first-line setting, clinicians are faced in practice with a variety of treatment choices. This article summarizes the most up-to-date trial data on treatments for driver-negative advanced non-small cell lung cancer, including immunotherapy monotherapy, chemoimmunotherapy, and combination immunotherapy, providing a framework for clinicians based on PD-L1 and smoking status.

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Article Synopsis
  • Clinical trials for new treatments often produce complex adverse event (AE) data which traditional tabular methods struggle to effectively convey; thus, new visualization techniques are required for better understanding of treatment toxicity.* -
  • The authors created dynamic visualizations, like circular and butterfly plots, to categorize and compare AEs by severity and treatment, applied in a clinical trial involving lung cancer patients comparing nivolumab alone versus with ipilimumab.* -
  • Results indicated that the combined treatment led to significantly higher rates of severe AEs across several body systems, demonstrating that innovative graphical methods can yield clearer insights into treatment-related toxicities than standard reporting formats.*
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Article Synopsis
  • The NCCN Guidelines outline best practices for treating patients with Non-Small Cell Lung Cancer (NSCLC).
  • The focus is on neoadjuvant (before surgery) and adjuvant (after surgery) systemic therapy options for patients whose cancer can be surgically removed.
  • These insights aim to help healthcare providers choose effective treatment paths for eligible patients with resectable NSCLC.
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Background: An important issue for patients with cancer treated with novel therapeutics is how they weigh the effects of treatment on survival and quality of life (QOL). We compared QOL in patients enrolled to SWOG S1400I, a substudy of the LungMAP biomarker-driven master protocol.

Methods: SWOG S1400I was a randomized phase III trial comparing nivolumab plus ipilimumab vs nivolumab for treatment of immunotherapy-naïve disease in advanced squamous cell lung cancer.

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  • Brigatinib shows long-term effectiveness and safety for NSCLC patients with ALK rearrangements, based on phase 1/2 and ALTA trials.
  • In these studies, patients previously treated with crizotinib demonstrated median progression-free survival (PFS) of 9.2 months (arm A) and 15.6 months (arm B) along with overall survival up to 40.6 months in arm B.
  • Long-term results indicate manageable safety profiles with no new safety concerns emerging, confirming brigatinib as a viable treatment option for patients resistant to crizotinib.
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Introduction: Alectinib is a preferred first-line treatment option for advanced -positive NSCLC. Combination regimens of alectinib with immune checkpoint inhibitors are being evaluated for synergistic effects.

Methods: Adults with treatment-naive, stage IIIB/IV, or recurrent -positive NSCLC were enrolled into a two-stage phase 1b study.

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NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Non-Small Cell Lung Cancer (NSCLC) provide recommended management for patients with NSCLC, including diagnosis, primary treatment, surveillance for relapse, and subsequent treatment. Patients with metastatic lung cancer who are eligible for targeted therapies or immunotherapies are now surviving longer. This selection from the NCCN Guidelines for NSCLC focuses on targeted therapies for patients with metastatic NSCLC and actionable mutations.

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Purpose: To assess the cost effectiveness of microwave ablation (MWA) and stereotactic body radiotherapy (SBRT) for patients with inoperable stage I non-small cell lung cancer (NSCLC).

Materials And Methods: A literature search was performed in MEDLINE with broad search clusters. A decision-analytic model was constructed over a 5-year period.

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Introduction: In the phase 3 study entitled ALK in Lung cancer Trial of brigAtinib in 1st Line (ALTA-1L), which is a study of brigatinib in ALK inhibitor-naive advanced ALK-positive NSCLC, brigatinib exhibited superior progression-free survival (PFS) versus crizotinib in the two planned interim analyses. Here, we report the final efficacy, safety, and exploratory results.

Methods: Patients were randomized to brigatinib 180 mg once daily (7-d lead-in at 90 mg once daily) or crizotinib 250 mg twice daily.

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Background: Activating fusions of the NTRK1, NTRK2 and NTRK3 genes are drivers of carcinogenesis and proliferation across a broad range of tumour types in both adult and paediatric patients. Recently, the FDA granted tumour-agnostic approvals of TRK inhibitors, larotrectinib and entrectinib, based on significant and durable responses in multiple primary tumour types. Unfortunately, testing rates in clinical practice remain quite low.

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Immune checkpoint inhibitors are currently employed for the treatment of various malignancies, including advanced melanoma and non-small cell lung cancer. As more patients are treated with checkpoint inhibitors, situations will arise in which early-stage disease may be subjected, intentionally or unintentionally, to these agents. This is especially relevant for patients presenting with multiple primary malignant tumors (MPMTs).

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Importance: Nivolumab plus ipilimumab is superior to platinum-based chemotherapy in treatment-naive advanced non-small cell lung cancer (NSCLC). Nivolumab is superior to docetaxel in advanced pretreated NSCLC.

Objective: To determine whether the addition of ipilimumab to nivolumab improves survival in patients with advanced, pretreated, immunotherapy-naive squamous (Sq) NSCLC.

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