Publications by authors named "Forde P"

Article Synopsis
  • Co-mutations of KRAS and STK11 genes in advanced non-small cell lung cancer (NSCLC) are linked to resistance against immune checkpoint blockade (ICB) therapies, although their impact in patients receiving neoadjuvant chemoimmunotherapy remains unclear.
  • A study investigated how these gene mutations affect recurrence-free survival in resectable KRAS-mutated NSCLC, revealing that those with co-occurring STK11 mutations had a higher risk of recurrence compared to those without.
  • Analysis of tumor-infiltrating T cells indicated that the presence of STK11 mutations altered T cell behavior, suggesting that certain T cell characteristics might hinder effective anti-tumor immune responses in patients with KRASmut/STK11
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Despite the systemic impact of both cancer and the associated immune response, immuno-PET is predominantly centered on assessment of the immune milieu within the tumor microenvironment. The aim of this study was to assess the value of [F]F-AraG PET imaging as a noninvasive method for evaluation of system-wide immune status of patients with non-small cell lung cancer before starting immunotherapy. Eleven patients with advanced non-small cell lung cancer were imaged with [F]F-AraG before starting immunotherapy.

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Article Synopsis
  • Lung cancer is a significant public health challenge with ongoing difficulties in prevention, diagnosis, and treatment, prompting a review of current research and management strategies.
  • Experts from various fields collaborated to discuss ways to enhance lung cancer care, emphasizing the importance of tobacco cessation, early detection, and addressing treatment side effects.
  • Effective lung cancer management requires global cooperation, better education, improved access to care and trials, and a focus on personalized treatment through innovative research.
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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. *
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Article Synopsis
  • International medical graduates (IMGs) are really important in the fight against cancer in the U.S., making up about a third of all oncologists!
  • IMGs face tough challenges like visa issues, cultural differences, and unfair treatment when applying for jobs, which can make their careers harder!
  • The article calls on healthcare professionals to help support IMGs so they can do their best work in treating cancer patients!
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Purpose: The mesothelin-targeting antibody-drug conjugate anetumab ravtansine was evaluated in combination with the programmed cell death-1 (PD-1) inhibitor pembrolizumab based on the common expression of mesothelin and reports of activity in mesothelioma.

Patients And Methods: A phase 1 safety run-in of the combination of anetumab ravtansine (6.5 mg/kg iv q3weeks) and pembrolizumab (200 mg, IV q3weeks) was conducted, followed by a phase 2 randomization to the combination or pembrolizumab alone at medical centers across the United States and Canada in the National Cancer Institute's Experimental Therapeutics Clinical Trials Network.

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Background: Immune checkpoint inhibitors (ICI) have revolutionized cancer treatment but can trigger immune-related encephalitis. We report one of the largest case series of patients with immune-related encephalitis and review of the literature.

Methods: Retrospective series of patients with immune-related encephalitis and literature review.

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Introduction: Up to 20% of EGFR-mutated NSCLC cases harbor uncommon mutations, including atypical exon 19 and compound mutations. Relatively little is known about the efficacy of osimertinib in these cases.

Methods: Patients treated with first-line osimertinib for NSCLC with rare EGFR exon 19 (non E746_A750del) or compound mutations were included.

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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.

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Importance: Despite a growing population of survivors of lung cancer, there is limited understanding of the survivorship journey. Survivors of lung cancer experience unmet physical, social, emotional, and medical needs regardless of stage at diagnosis or treatment modalities.

Objective: To investigate the association of unmet needs with quality of life (QOL) and financial toxicity (FT) among survivors of lung cancer.

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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.

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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.
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Unlabelled: While tyrosine kinase inhibitors (TKI) have shown remarkable efficacy in anaplastic lymphoma kinase (ALK) fusion-positive advanced non-small cell lung cancer (NSCLC), clinical outcomes vary and acquired resistance remains a significant challenge. We conducted a retrospective study of patients with ALK-positive NSCLC who had clinico-genomic data independently collected from two academic institutions (n = 309). This was paired with a large-scale genomic cohort of patients with ALK-positive NSCLC who underwent liquid biopsies (n = 1,118).

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For patients with non-small-cell lung cancer (NSCLC) tumors without currently targetable molecular alterations, standard-of-care treatment is immunotherapy with anti-PD-(L)1 checkpoint inhibitors, alone or with platinum-doublet therapy. However, not all patients derive durable benefit and resistance to immune checkpoint blockade is common. Understanding mechanisms of resistance-which can include defects in DNA damage response and repair pathways, alterations or functional mutations in STK11/LKB1, alterations in antigen-presentation pathways, and immunosuppressive cellular subsets within the tumor microenvironment-and developing effective therapies to overcome them, remains an unmet need.

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Background: Despite surgical resection, long-term survival of patients with resectable non-small cell lung cancer (NSCLC) remains poor. Adjuvant chemotherapy, the standard of care for locally advanced NSCLC, provides a marginal 5.4% benefit in survival.

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Objectives: Understand from a real-world cohort the unique clinical and genomic determinants of a durable response to immune checkpoint inhibitors (ICIs).

Materials And Methods: This is a retrospective study of patients with NSCLC who received any ICI-based regimen as first or second line therapy. Long-term responders (LTR) achieved an overall survival (OS) ≥ 3 years from time of treatment start, while nonresponders (NR) were patients who had an OS of 6 to 12 months from time of treatment start.

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Background: Brain metastasis (BRM) is uncommon in gastroesophageal cancer. As such, clinicopathologic and molecular determinants of BRM and impact on clinical outcome remain incompletely understood.

Methods: We retrospectively analyzed clinicopathologic data from advanced esophageal/gastroesophageal junction (E/GEJ) patients at Johns Hopkins from 2003 to 2021.

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Introduction:: The impact of neoadjuvant immune checkpoint inhibitor (ICI)-based therapies on mediastinal nodal recurrence patterns after resection for patients with locally advanced non-small cell lung cancer (NSCLC) is unknown. We reported cases of mediastinal nodal failure after receipt of neoadjuvant ICI and provided a descriptive analysis of patients who experienced mediastinal recurrences.

Methods:: We identified patients with stage I-IIIA NSCLC treated on a prospective trial with nivolumab-based therapies prior to resection between August 2015 and August 2021.

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Purpose: Although immunotherapy is the mainstay of therapy for advanced non-small cell lung cancer (NSCLC), robust biomarkers of clinical response are lacking. The heterogeneity of clinical responses together with the limited value of radiographic response assessments to timely and accurately predict therapeutic effect-especially in the setting of stable disease-calls for the development of molecularly informed real-time minimally invasive approaches. In addition to capturing tumor regression, liquid biopsies may be informative in capturing immune-related adverse events (irAE).

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Purpose: Concomitant autoimmune rheumatic diseases (ARD) can add morbidity and complicate treatment decisions for patients with lung cancer. We evaluated the tumour characteristics at diagnosis and clinical outcomes in lung cancer patients with or without ARD.

Methods: This retrospective cohort study included 10 963 patients with lung cancer, treated at Johns Hopkins.

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Article Synopsis
  • * The CheckMate 816 trial assessed the effectiveness of this treatment approach, measuring residual viable tumor (RVT) percentages and their impact on EFS as an exploratory analysis, finding that less than 5% RVT significantly improved EFS compared to higher levels.
  • * Results indicate that the percentage of RVT could serve as a reliable predictor of survival outcomes, suggesting that further exploration of RVT thresholds in lung cancer and other cancers is needed for treatment optimization. *
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The use of neoadjuvant or perioperative anti-PD(L)1 was recently tested in multiple clinical trials. We performed a systematic review and meta-analysis of randomised trials comparing neoadjuvant or perioperative chemoimmunotherapy to neoadjuvant chemotherapy in resectable NSCLC. Nine reports from 6 studies were included.

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Background: Combination therapies that aim to improve the clinical efficacy to immune checkpoint inhibitors have led to the need for non-invasive and early pharmacodynamic biomarkers. Positron emission tomography (PET) is a promising non-invasive approach to monitoring target dynamics, and programmed death-ligand 1 (PD-L1) expression is a central component in cancer immunotherapy strategies. [F]DK222, a peptide-based PD-L1 imaging agent, was investigated in this study using humanized mouse models to explore the relationship between PD-L1 expression and therapy-induced changes in cancer.

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Article Synopsis
  • - Stereotactic ablative body radiation (SABR) shows promise for treating early-stage non-small cell lung cancer (NSCLC), with 83% of patients remaining alive without tumor progression at a median follow-up of 40 months.
  • - The study examined the immune and pathological effects of SABR by analyzing blood and tumor biopsies from six patients before and after treatment, focusing on immune-cell populations and T-cell receptor changes.
  • - While early post-SABR biopsies revealed viable tumors and maintained immune-cell populations, a subset of patients exhibited a temporary increase in neoantigen-specific T-cells after treatment, suggesting that SABR can provoke a delayed immune response.
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