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BACKGROUND: Immune checkpoint inhibitors (ICIs) have changed the treatment paradigm of advanced-stage non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC). The aim of this study was to evaluate the effectiveness and tolerance of ICIs in a real-world patient population and to investigate the predictive factors associated with survival outcomes. METHODS: Medical records of patients with advanced lung cancer who started ICI monotherapy were reviewed for data collection. Treatment outcomes included objective response rate, progression-free survival (PFS), and overall survival (OS). Immune-related adverse events (irAEs) were assessed. Multiple Cox regression models were fit to investigate the predictive factors for survival outcomes. RESULTS: We included 220 patients (median 66.5 years). Seventy-nine (35.9%) patients had Eastern Cooperative Oncology Group (ECOG) performance-status (PS) score ≥2. Median follow-up was 11.4 months. In NSCLC, median PFS was 3.8 months (4.7 months for first line and 3.7 months for subsequent line). Median OS was 12.4 months (15.6 months for first line therapy and 11.5 months for subsequent line). In SCLC, median PFS was 1.8 months, and median OS was 4.6 months. A quarter of patients developed irAEs. There was 1 disease flare among 17 patients with pre-existing autoimmune diseases. ECOG PS of 0 to 1 and body mass index (BMI) ≥ 25 kg/m² (but not occurrence of irAE) were independently associated with improved OS in NSCLC, with a hazard ratio of 0.41 (95% confidence interval [CI], 0.29-0.59) and 0.62 (95% CI, 0.44-0.87), respectively. CONCLUSIONS: The clinical benefit of ICIs appears to persist in a real-world population of relatively older age, including those with poor PS and pre-existing autoimmune diseases. ECOG PS of 0 to 1 and BMI ≥ 25 kg/m² were independently associated with improved OS. [ABSTRACT FROM AUTHOR]

Introduction: There is limited data on the use of SBRT in reirradiation of lung tumors. We reviewed outcomes following SBRT after previous thoracic radiotherapy at the University of Minnesota Medical Center. Methods: From August 2006 through October 2012, fourteen lung tumors in thirteen patients with either biopsy confirmed or presumed non-small cell lung cancer in patients who were medically unable to undergo biopsy, were retreated with SBRT. Eligible patient charts were reviewed to evaluate survival, recurrence patterns and toxicity following reirradiation. Results: The median age of patients at the time of SBRT was 67.9 years. The median duration of follow-up was 11.4 months. Ten patients received prior conventional thoracic irradiation (median dose 6120 cGy). Two patients received prior SBRT with curative intent. The median time to reirradiation with SBRT was 19.7 months. Following reirradiation with SBRT, four patients (33%) are alive and disease free. Eight patients (67%) experienced progressive disease. There were five distant and two regional recurrences. There was one isolated local recurrence. Local control was 92% with a median survival of 24 months (95% CI: 8-38 months). 1- and 2-year overall survival were 80% (95% CI: 41%-95%) and 36% (95% CI: 6%-68%) respectively. There was one grade 2 and one grade 3 toxicity. No grade 4 or 5 toxicities were seen. Conclusions: SBRT is a reasonable salvage therapy for lung tumor recurrence or second primary lung malignancy in patients previously treated with thoracic radiotherapy, offering good local control and resulting in acceptable toxicity. Further evaluation of this treatment option is warranted. [ABSTRACT FROM AUTHOR]