Publications by authors named "Cascone T"

Imaging-based spatial transcriptomics (ST) is evolving rapidly as a pivotal technology in studying the biology of tumors and their associated microenvironments. However, the strengths of the commercially available ST platforms in studying spatial biology have not been systematically evaluated using rigorously controlled experiments. In this study, we used serial 5-m sections of formalin-fixed, paraffin-embedded surgically resected lung adenocarcinoma and pleural mesothelioma tumor samples in tissue microarrays to compare the performance of the single cell ST platforms CosMx, MERFISH, and Xenium (uni/multi-modal) platforms in reference to bulk RNA sequencing, multiplex immunofluorescence, GeoMx Digital Spatial Profiler, and hematoxylin and eosin staining data for the same samples.

View Article and Find Full Text PDF
Article Synopsis
  • - Drug resistance in EGFR-mutant non-small cell lung cancer (NSCLC) is complicated by mechanisms like pathway reactivation and fusion of receptor tyrosine kinases (RTKs), leading to challenges in treatment with tyrosine kinase inhibitors (TKIs).
  • - A study involving multiple institutions analyzed 27 patients with RTK fusions identified through genetic testing, focusing on their response to dual TKI therapy, with results showing a 24% objective response rate and an 80% disease control rate overall.
  • - The majority of patients had ALK or RET fusions, and those who received dual TKI treatment had a slightly lower response rate (21.4%) but no new side effects were reported, suggesting this approach
View Article and Find Full Text PDF

Background: Neoadjuvant immune checkpoint inhibitors (ICIs) have improved survival outcomes compared with chemotherapy in resectable non-small cell lung cancer (NSCLC). However, the impact of actionable genomic alterations (AGAs) on the efficacy of neoadjuvant ICIs remains unclear. We report the influence of AGAs on treatment failure (TF) in patients with resectable NSCLC treated with neoadjuvant ICIs.

View Article and Find Full Text PDF
Article Synopsis
  • Dual immune checkpoint blockade (ICB) using CTLA4 and PD-(L)1 inhibitors shows improved anti-tumor effectiveness and immune toxicity compared to PD-(L)1 inhibitors alone in advanced non-small-cell lung cancer (NSCLC) patients.
  • Patients with mutations in STK11 and/or KEAP1 genes benefit more from the combination treatment compared to those receiving only PD-(L)1 inhibitors, as shown in the POSEIDON trial.
  • The loss of KEAP1 serves as a strong predictor for the success of dual ICB, as it leads to a more favorable outcome by changing the tumor's immune environment to better engage CD4 and CD8 T cells for anti-tumor activity. *
View Article and Find Full Text PDF
Article Synopsis
  • Researchers found that the bacteria in our guts, called the gut microbiome, can affect how lung cancer develops and how well treatment works.
  • In experiments with mice, losing a certain protein made the gut bacteria less diverse and increased inflammation, which can help tumors grow.
  • They also noticed that lung cancer patients with more of a specific type of bacteria in their guts responded worse to certain cancer treatments, suggesting that gut bacteria might be important for cancer therapy.
View Article and Find Full Text PDF

Lung cancer is the leading cause of cancer death in the US and globally. The mortality from lung cancer has been declining, due to a reduction in incidence and advances in treatment. Although recent success in developing targeted and immunotherapies for lung cancer has benefitted patients, it has also expanded the complexity of potential treatment options for health care providers.

View Article and Find Full Text PDF

Advances in the multidisciplinary care of early stage resectable NSCLC (rNSCLC) are emerging at an unprecedented pace. Numerous phase 3 trials produced results that have transformed patient outcomes for the better, yet these findings also require important modifications to the patient treatment journey trajectory and reorganization of care pathways. Perhaps, most notably, the need for multispecialty collaboration for this patient population has never been greater.

View Article and Find Full Text PDF

Introduction: Germline mutations driving lung cancer have been infrequently reported in the literature, with EGFR T790M being a known germline mutation identified in 1% of NSCLCs. Typically, a somatic EGFR mutation is acquired to develop lung adenocarcinoma. Osimertinib has become a standard-of-care treatment for EGFR T790M-positive lung cancer.

View Article and Find Full Text PDF
Article Synopsis
  • A phase 3 trial found that neoadjuvant treatment with nivolumab plus chemotherapy improved event-free survival in patients with resectable non-small-cell lung cancer (NSCLC) compared to chemotherapy alone, with 70.2% of the nivolumab group remaining event-free at 18 months, versus 50.0% in the chemotherapy group.!* -
  • Patients receiving nivolumab also had a significantly higher rate of pathological complete response (25.3%) compared to those on chemotherapy (4.7%), indicating better treatment efficacy.!* -
  • The safety profile was similar between both groups, with 32.5% of nivolumab patients experiencing grade 3 or 4 treatment-related adverse events
View Article and Find Full Text PDF

While we recognize the prognostic importance of clinicopathological measures and circulating tumor DNA (ctDNA), the independent contribution of quantitative image markers to prognosis in non-small cell lung cancer (NSCLC) remains underexplored. In our multi-institutional study of 394 NSCLC patients, we utilize pre-treatment computed tomography (CT) and F-fluorodeoxyglucose positron emission tomography (FDG-PET) to establish a habitat imaging framework for assessing regional heterogeneity within individual tumors. This framework identifies three PET/CT subtypes, which maintain prognostic value after adjusting for clinicopathologic risk factors including tumor volume.

View Article and Find Full Text PDF

Importance: To date, no meta-analyses have comprehensively assessed the association of neoadjuvant chemoimmunotherapy with clinical outcomes in non-small cell lung cancer (NSCLC) in randomized and nonrandomized settings. In addition, there exists controversy concerning the efficacy of neoadjuvant chemoimmunotherapy for patients with NSCLC with programmed cell death 1 ligand 1 (PD-L1) levels less than 1%.

Objective: To compare neoadjuvant chemoimmunotherapy with chemotherapy by adverse events and surgical, pathological, and efficacy outcomes using recently published randomized clinical trials and nonrandomized trials.

View Article and Find Full Text PDF

[F]Fluorodeoxyglucose positron emission tomography (FDG-PET) and computed tomography (CT) are indispensable components in modern medicine. Although PET can provide additional diagnostic value, it is costly and not universally accessible, particularly in low-income countries. To bridge this gap, we have developed a conditional generative adversarial network pipeline that can produce FDG-PET from diagnostic CT scans based on multi-center multi-modal lung cancer datasets (n = 1,478).

View Article and Find Full Text PDF
Article Synopsis
  • - The study investigates whether pathologic complete response (pCR) and major pathologic response (MPR) can reliably predict event-free survival (EFS) and overall survival (OS) in neoadjuvant trials for non-small cell lung cancer (NSCLC).
  • - A total of seven clinical trials involving 2385 patients were analyzed, demonstrating a strong correlation between pCR/MPR and 2-year EFS, but weaker associations with OS.
  • - The conclusion suggests that while pCR and MPR are good indicators of EFS, their predictive value for OS is less clear; further research is needed for more accurate data and understanding of patient outcomes.
View Article and Find Full Text PDF

Background: Resistance to immune checkpoint inhibitors and targeted treatments for cancer is common; thus, novel immunotherapy agents are needed. Urelumab is a monoclonal antibody agonist that binds to CD137 receptors expressed on T cells. Here, we report two studies that evaluated urelumab in combination with cetuximab or nivolumab in patients with select, advanced solid tumors.

View Article and Find Full Text PDF

Understanding the cellular processes that underlie early lung adenocarcinoma (LUAD) development is needed to devise intervention strategies. Here we studied 246,102 single epithelial cells from 16 early-stage LUADs and 47 matched normal lung samples. Epithelial cells comprised diverse normal and cancer cell states, and diversity among cancer cells was strongly linked to LUAD-specific oncogenic drivers.

View Article and Find Full Text PDF

Introduction: Adjuvant immunotherapy (IO) following concurrent chemotherapy and photon radiation therapy confers an overall survival (OS) benefit for patients with inoperable locally advanced non-small cell lung carcinoma (LA-NSCLC); however, outcomes of adjuvant IO after concurrent chemotherapy with proton beam therapy (CPBT) are unknown. We investigated OS and toxicity after CPBT with adjuvant IO versus CPBT alone for inoperable LA-NSCLC.

Materials And Methods: We analyzed 354 patients with LA-NSCLC who were prospectively treated with CPBT with or without adjuvant IO from 2009 to 2021.

View Article and Find Full Text PDF
Article Synopsis
  • Amivantamab-vmjw is a bispecific antibody approved for treating advanced non-small cell lung cancer (NSCLC) with EGFR exon 20 mutations, but its safety and efficacy in other EGFR mutations, especially when used with other therapies, are less understood.
  • A study analyzed data from multiple cancer centers for 61 NSCLC patients treated with amivantamab, focusing on factors like response rates, safety, and treatment duration alongside existing therapies.
  • Results indicated that 45.2% of patients had a clinical response, with higher success rates in atypical mutation cohorts, and adverse events were consistent with previous findings, suggesting amivantamab's potential effectiveness even in various EGFR mutations when combined with other treatments.
View Article and Find Full Text PDF

Background: Predicting relapse and overall survival (OS) in early-stage non-small-cell lung cancer (NSCLC) patients remains challenging. Therefore, we hypothesized that detection of circulating tumor DNA (ctDNA) can identify patients with increased risk of relapse and that integrating radiological tumor volume measurement along with ctDNA detectability improves prediction of outcome.

Patients And Methods: We analyzed 366 serial plasma samples from 85 patients who underwent surgical resections and assessed ctDNA using a next-generation sequencing liquid biopsy assay, and measured tumor volume using a computed tomography-based three-dimensional annotation.

View Article and Find Full Text PDF

Background: In non-small cell lung cancer (NSCLC), the immune checkpoint inhibitors (ICI) revolution is rapidly moving from metastatic to early-stage, however, the impact of clinicopathological variables and optimal treatment sequencing remain unclear.

Methods: Randomized controlled trials (RCTs) in patients with early-stage NSCLC treated with ICI as single agent or in combination with platinum-based chemotherapy (PCT) were included. Primary outcomes were pathological complete response (pCR), event free survival (EFS) (neoadjuvant/perioperative), and disease-free survival (DFS) (adjuvant).

View Article and Find Full Text PDF