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Second malignancy in advanced or recurrent non-small cell lung cancer after the advent of molecular targeted drugs
Yoshihiro Masui1, Takehito Shukuya1, Shunichi Kataoka1
1Department of Respiratory Medicine, Graduate School of Medicine, Juntendo University, Tokyo, Japan.
Objectives:
This study aimed to investigate the characteristics of patients with recurrent or advanced non-small cell lung cancer (NSCLC) treated with tyrosine kinase inhibitors (TKIs) or immune-checkpoint inhibitors (ICIs) who developed secondary malignancies, as well as evaluate the impact of these secondary malignancies on the course of lung cancer.
Materials And Methods:
This study included 112 patients with postoperative recurrent or advanced NSCLC, who received TKIs, ICIs, or immune combination therapy as the primary treatment modality between April 1, 2013, and March 31, 2020, and achieved long-term survival (≥2 years). Secondary malignancies were defined as newly diagnosed cancers in other organs occurring after NSCLC treatment initiation.
Results:
Among the 112 patients, 10 (8.9%) developed 12 carcinomas, including third primary malignancies. Univariate analysis, considering secondary malignancies as the outcome, revealed a non-significant trend towards a higher incidence of secondary malignancies in smokers compared to non-smokers.
Conclusion:
This study found that 8.9% of patients with advanced NSCLC who received TKIs, ICIs, or immune combination therapy and survived ≥2 years developed secondary malignancies. This underscores the importance of early diagnosis and treatment, even during lung cancer treatment, to identify suspicious lesions in other organs either via imaging or physical examinations.
Insights
A small percentage of advanced non-small cell lung cancer patients treated with targeted or immune therapies developed secondary cancers. Early detection of new suspicious lesions is crucial during long-term lung cancer treatment.
Area of Science:
- Oncology
- Cancer Research
- Clinical Medicine
Background:
- Advanced non-small cell lung cancer (NSCLC) requires long-term treatment.
- Tyrosine kinase inhibitors (TKIs) and immune-checkpoint inhibitors (ICIs) are key therapies for NSCLC.
- Understanding secondary malignancies in NSCLC patients is vital.
Purpose of the Study:
- To investigate secondary malignancies in NSCLC patients treated with TKIs or ICIs.
- To evaluate the impact of these secondary cancers on NSCLC progression.
- To characterize patients who develop new primary cancers during NSCLC treatment.
Main Methods:
- Retrospective analysis of 112 patients with recurrent or advanced NSCLC.
- Patients received TKIs, ICIs, or combination immunotherapy (2013-2020).
- Long-term survivors (≥2 years) were analyzed for secondary malignancies.
Main Results:
- 10 out of 112 patients (8.9%) developed 12 secondary malignancies.
- Smokers showed a non-significant trend towards higher secondary malignancy incidence.
- No significant impact on lung cancer course was detailed in this abstract.
Conclusions:
- 8.9% of long-term surviving advanced NSCLC patients developed secondary cancers.
- Early detection of suspicious lesions is critical during NSCLC therapy.
- Vigilance for new malignancies improves patient outcomes.
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