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SCOPUS: re.j, info:eu-repo/semantics/published

Introduction Few validated prognostic factors are available for survival in patients with lung cancer. [18F]-fluoro-2-deoxy-d-glucose positron emission tomography has been shown to be of additional value to conventional imaging for staging lung cancer. The prognostic value of this lung tumor metabolic activity was studied in a first systematic review of studies published until 2006. Methods As further studies have appeared since 2006, this report has as objective to confirm and to estimate with less variability the prognostic value of primary tumor standardized uptake value (SUV) measured with [18F]-fluoro-2-deoxy-d-glucose positron emission tomography on the basis of an updated search of eligible studies. Results Ten additional studies were eligible for the updated review and eight of them provided, in the publication, data allowing survival results aggregation. All together, 21 studies were analyzed. Comparing patients with low and high SUV, using preferentially the median SUV value of each study as threshold, we obtained a poor prognostic value for high SUV compared with low SUV with an overall combined hazard ratio of 2.08, significantly different from one with a 95% confidence interval ranging from 1.69 to 2.56. No interaction between older and newer studies was detectable (P = 0.60) as well as between studies having selected non metastatic patients or studies without selection criterion related to stage (P = 0.46). Conclusions We confirmed the results of our previous review showing that SUV is potentially a very interesting factor for predicting patient outcome. We believe that a meta-analysis based on individual patient data would be of great value as allowing to assess the independent prognostic value, to take into account some factors responsible for heterogeneity between studies (SUV assessment method, disease stage, and histology), and to update survival data. We are planning to conduct such a meta-analysis on behalf of the International Association for the Study of Lung Cancer Staging Project.

Background: Epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancer (NSCLC) predict better outcome to EGFR tyrosine kinase inhibitors. The most common mutations are exon 19 deletions (most frequently E746–A750) and L858R point mutation in exon 21. Here, we evaluated the accuracy of novel EGFR mutation-specific antibodies in a Japanese cohort with NSCLC and compared with direct DNA sequencing and clinical outcome. Materials and Methods: Immunohistochemistry (IHC) using antibodies specific for the E746–A750 and L858R mutations in EGFR was performed on tissue microarrays of tumors from 70 gefitinib treated NSCLC patients. Extracted DNA was sequenced for mutational analysis of EGFR exons 18 to 21. Results: DNA sequencing showed EGFR mutations in 41 patients (58.6%) and exon 19 deletions in 18 patients (25.7%), 11 of 18 (61%) had a deletion in the range of E746–A750 and 12 (17.1%) had exon 21 mutations (L858R). IHC showed, for the E746–A750 and L858R mutations, sensitivity (81.8 and 75%), specificity (100 and 96.6%), positive predictive value (100 and 81.8%), and negative predictive value (96.7 and 94.9%). Analysis for objective response rates and survival were not correlated to IHC staining, although the combined staining showed nonsignificant trends toward better overall survival for patients with EGFR mutations. Conclusions: The mutation-specific IHC antibodies have high sensitivity and specificity for predefined EFGR mutations and may be suitable for screening for these predefined mutations. However, negative IHC results require further mutation analyses before excluding EGFR-targeted therapy.

Thèse présentée sous la forme d'une "thèse article"; Introduction: The evaluation of the expression of Programmed cell Death Ligand 1 (PD-L1) by the tumor cells in immunohistochemistry is a mandatory diagnostic step in the treatment of lung cancer. It is important to dispose of validated antibodies that can reliably detect PD-L1 positive cells. Different antibodies have already been studied. In this present study, we compared a new clone (QR1, Quartett) with reference clones to determine if it can be used in place of those. Materials and methods: We made a Tissue Micro Array from 110 lung adenocarcinomas and analysed it on immunohistochemistry with 4 different clones: QR1, 22c3, Sp263 and E1L3N. We analysed the correlation between the samples duplicates for each clone and then a correlation and the concordance between the clones was calculated.Results: 101 patients were exploitable; the duplicates for each clone had a strong correlation. The correlation was the strongest (r = 0.82) between QR1 and 22c3 and less strong with the other clones. 78%, 79% and 97% of the QR1 cases were concordant with 22c3 for the thresholds of