Data documento
02/05/2024

Título
EGFR Mutations and PD-L1 Expression in Early-Stage Non-Small Cell Lung Cancer: A Real-World Data From a Single Center in Brazil

Autor(es)
Alves Pinto I, - de Oliveira Cavagna R, - Virginio da Silva AL, - Dias JM, - Santana IV, - Souza LC, - Ferreira da Silva FA, - Biazotto Fernandes MF, - Junqueira Pinto GD, - Negreiros IS, - Santiago Gonçalves MF, - de Paula FE, - Berardinelli GN, - Casagrande GMS, - Oliveira da Silva M, - Albino da Silva EC, - de Oliveira MA, - Jacinto AA, - Duval da Silva V, - Reis RM, - De Marchi P, - Leal LF.

Resumo
Background: Targeted and immunotherapies are currently moving toward early-stage settings for patients with non-small cell lung cancer (NSCLC). Predictive biomarkers data are scarce in this scenario. We aimed to describe the frequency of EGFR mutations and PD-L1 expression levels in early-stage non-squamous patients with NSCLC from a large, single Brazilian oncology center. Methods: We retrospectively evaluated patients with NSCLC diagnosed at an early-stage (IB to IIIA-AJCC seventh edition) at Barretos Cancer Hospital (n = 302). EGFR mutational status was assessed in FFPE tumor tissues using distinct methodologies (NGS, Cobas, or Sanger sequencing). PD-L1 expression was evaluated by immunohistochemistry (clone 22C3) and reported as Tumor Proportion Score (TPS), categorized as <1%, 1-49%, and ≥50%. We evaluated the association between EGFR mutational status and PD-L1 expression with sociodemographic and clinicopathological parameters by Fisher’s test, qui-square test, and logistic regression. Survival analysis was assessed by the Kaplan-Meier method and Cox regression model. Results: EGFR mutations were detected in 17.3% (n = 48) of cases and were associated with female sex, never smokers, and longer overall and event-free survival. PD-L1 positivity was observed in 36.7% (n = 69) of cases [TPS 1-49% n = 44(23.4%); TPS ≥50% n = 25(13.3%)]. PD-L1 positivity was associated with smoking, weight loss, and higher disease stages (IIB/IIIA). Conclusion: The frequencies of EGFR mutations and PD-L1 positivity were described for early-stage non-squamous patients with NSCLC. These results will be essential for guiding treatment strategies with the recent approvals of osimertinib and immunotherapy in the adjuvant setting.

Citação
Alves Pinto I, de Oliveira Cavagna R, Virginio da Silva AL, Dias JM, Santana IV, Souza LC, Ferreira da Silva FA, Biazotto Fernandes MF, Junqueira Pinto GD, Negreiros IS, Santiago Gonçalves MF, de Paula FE, Berardinelli GN, Casagrande GMS, Oliveira da Silva M, Albino da Silva EC, de Oliveira MA, Jacinto AA, Duval da Silva V, Reis RM, De Marchi P, Leal LF. EGFR Mutations and PD-L1 Expression in Early-Stage Non-Small Cell Lung Cancer: A Real-World Data From a Single Center in Brazil. Oncologist. 2022 Nov 3;27(11):e899-e907. doi: 10.1093/oncolo/oyac167. PMID: 36099421; PMCID: PMC9632322.

Data documento
02/05/2024

Título
Sarcopenia in Children With Wilms Tumor: A Marker of Undernutrition Which May Impact Adversely on Clinical Outcomes

Autor(es)
de Oliveira WE Jr, - Murra MS, - Tufi LMB, - Cavalcante CEB, - de Oliveira MA, - da Costa RFA, - Rosa BR, - da Silva RZM, - Ribeiro RC, - Ladas EJ, - Barr RD.

Palavras chave
sarcopenia - psoas muscle area - Wilms tumor

Resumo
The therapeutic approach to Wilms tumor (WT) is multidisciplinary and leads to significant patient impairment, increasing the risk of nutritional compromise and malnutrition. Children with cancer are vulnerable to sarcopenia which has been recognized as a negative impact of anticancer therapy. Recent studies have highlighted the reduction in the total psoas muscle area (TPMA) to be associated with a poor prognosis inmany pediatric diseases, including cancer. This study aims to evaluate changes in the TPMA compartment during the treatment of children with WT. An observational, longitudinal, and retrospective study was undertaken in a single institution evaluating children (1 to 14 y, n=38) with WT between 2014 and 2020. TPMA was assessed by the analysis of previously collected, electronically stored computed tomography images of the abdomen obtained at 3 time points: diagnosis, preoperatively, and 1 year after surgery. For all patients, TPMA/age were calculated with a specific online calculator. Our data show a high incidence of sarcopenia (55.3%) at diagnosis which increased after 4 to 6 weeks of neoadjuvant chemotherapy (73.7%) and remained high (78.9%) 1 year after the surgical procedure. Using TPMA/age Z-score curves we have found significant and rapid muscle loss in children with WT, with little or no recovery in the study period.

Citação
de Oliveira WE Jr, Murra MS, Tufi LMB, Cavalcante CEB, de Oliveira MA, da Costa RFA, Rosa BR, da Silva RZM, Ribeiro RC, Ladas EJ, Barr RD. Sarcopenia in Children With Wilms Tumor: A Marker of Undernutrition Which May Impact Adversely on Clinical Outcomes. J Pediatr Hematol Oncol. 2023 Oct 1;45(7):e817-e822. doi: 10.1097/MPH.0000000000002732. Epub 2023 Jul 31. PMID: 37526408.