Publications by authors named "Kader Chouahnia"

Article Synopsis
  • A tyrosine-kinase inhibitor (TKI) is recommended as the primary treatment for non-small-cell lung cancer (NSCLC) patients with an epidermal growth-factor receptor mutation, and the effectiveness of combining it with chemotherapy (ChT) is being researched.
  • A meta-analysis of four phase III trials involving 1,413 NSCLC patients indicated that the combination of EGFR-TKI and ChT resulted in significantly longer progression-free survival (PFS) and overall survival (OS) compared to EGFR-TKI alone.
  • The combination treatment showed especially improved PFS for patients with brain metastases, but more research is necessary to determine which patients are most likely to benefit from this combined approach.
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  • Recent studies show that using stented cryopreserved aortic allografts for tracheobronchial replacement is effective, especially for patients with severe tracheal cancer.
  • The study analyzed 13 patients with extensive tracheal cancer from a larger registry, focusing on their surgical outcomes and complications.
  • Findings indicate that the procedure had no 30-day mortality, a high rate of complete resection, and 84.6% of patients were alive at the last follow-up, although some experienced late complications.
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: We aimed to evaluate the prognostic value of imaging biomarkers on 18F-FDG PET/CT in extensive-stage small-cell lung cancer (ES-SCLC) patients undergoing first-line chemo-immunotherapy. In this multicenter and retrospective study, we considered two cohorts, depending on the type of first-line therapy: chemo-immunotherapy (CIT) versus chemotherapy alone (CT). All patients underwent baseline 18-FDG PET/CT before therapy between June 2016 and September 2021.

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Patients with resectable stage IIIA - N2 lung cancer represent a very heterogeneous population with variable risks of postoperative recurrence depending on the type of N2 involvement (unisite N2, multisite N2, bulky N2, extra-capsular rupture, incomplete resection…). This heterogeneity associated with the difficulty of carrying out prospective randomized studies with sufficient power in stages IIIA - 2, results in the absence of clear and consensual recommendations (except for stages IIIA - N2 resectable R0, since LungART and PORT-C studies). The objective of this article is to make an update on the place of postoperative radiotherapy in the management of stages IIIA - N2 following the publication of two recent randomized trials (PORT-C and LungART) but also compare them fort a better understanding of the current issues raised by these first published results.

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Background: New mutational detection techniques like next-generation sequencing have resulted in an increased number of cases with uncommon mutation and compound mutations [3%-14% of all epidermal growth factor receptor (EGFR) mutations]. In rare exon 18 mutations (3%-6%), G719X and E709X represent the majority, but CMut associating these exon 18 points mutations are even rarer, making the understanding of the impact of epidermal growth factor receptor tyrosine kinase inhibitors still limited. Three generations of EGFR tyrosine kinase inhibitors (TKIs) are available to target EGFR mutations, but according to the types of mutations, the sensitivity to TKI is different.

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  • The TRITON-01 study assessed the safety and efficacy of using stented aortic matrices for airway replacement in patients, confirming it can be a standard treatment option.
  • Over a 12-year period, 35 patients underwent this procedure, showing a low 30-day mortality rate of 2.9% and a 22.9% morbidity rate.
  • At a median follow-up of nearly 30 months, over 75% of patients survived, with no deaths linked to the bioprosthesis and 28.6% achieving stent-free survival.
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Immunotherapy has gained great interest in thoracic malignancies in the last decade, first in non-small cell lung cancer (NSCLC), but also more recently in small-cell lung cancer (SCLC) and malignant pleural mesothelioma (MPM). However, while 15-20% of patients will greatly benefit from immune checkpoint blockers (ICBs), a vast majority will rapidly exhibit resistance. Reasons for this are multiple: non-immunogenic tumors, immunosuppressive tumor microenvironment or defects in immune cells trafficking to the tumor sites being some of the most frequent.

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Purpose: The most frequent mutation in advanced non-small-cell lung cancer (NSCLC), Kirsten rat-sarcoma viral oncogene (KRAS) is found in 20-25% of these patients' tumors. While phase III trials on therapies targeting KRAS, especially KRAS, are ongoing, the clinical efficacy of anti-programmed death protein-1 (PD-1) or its ligand (PD-L1) against KRAS-mutant NSCLCs remains a topic of debate.

Methods: This meta-analysis examined randomized-trial data comparing first- or second-line anti-PD-(L)1 with or without chemotherapy vs.

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  • Platin-based chemotherapy has historically been the standard treatment for extensive-stage small-cell lung cancer (ES-SCLC), with recent interest in combining it with immune checkpoint inhibitors (ICI+CT) for potential benefits, although results are mixed.
  • A meta-analysis of randomized trials involving 2,775 patients showed that ICI+CT significantly improved overall survival and progression-free survival compared to chemotherapy alone, particularly with anti-PD-L1 and anti-PD-1 treatments, but not with anti-CTLA-4.
  • Despite the benefits, ICI+CT was associated with more serious adverse events, and patients with brain metastases at diagnosis did not experience better outcomes from ICI+CT compared to standard chemotherapy.
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In 2018, dosing regimens of the two most prescribed immune check point inhibitors (ICI), nivolumab (Opdivo) and pembrolizumab (Keytruda), in the treatment of lung cancer were changed from weight-based dosing to fixed dosing. The aim of this study was to compare the economic impact of this change in our university hospital group and then across Ile-de-France, the most inhabited French region. A budget impact analysis (BIA) has been performed on the French public health insurance data.

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Background: The impact of aging on the effectiveness of immune checkpoint inhibitors (ICIs) remains controversial, and little is known on the subject in adults aged ≥ 75 years.

Objective: The objective of this comprehensive meta-analysis was to assess the efficacy of ICIs in patients aged ≥ 75 years.

Methods: We performed a meta-analysis of published randomized controlled trials concerning ICIs (as monotherapy or in combination) versus standard therapy in patients with advanced solid tumors between January 2010 and January 2020.

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  • Erlotinib is a first-line treatment for non-small-cell lung cancer (NSCLC) with an EGFR mutation, but its combination with anti-VEGF inhibitors is debated.
  • A meta-analysis of five studies involving 1230 patients showed that adding anti-VEGF to erlotinib significantly improved progression-free survival (PFS) and duration of response (DOR).
  • While the combination treatment showed benefits for PFS, there is still a need for more mature data to determine its overall survival (OS) advantages compared to erlotinib alone.
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Background: To develop, validate, and assess the clinical impact of a clinical score to predict a 6-month mortality risk among older cancer patients.

Results: The mean age was 81.2 ± 6.

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Aims: Single-agent anti-PD-1/PD-L1 clinical efficacy against < 1% PD-L1-expressing non-small-cell lung cancers (NSCLCs) is controversial.

Methods: This meta-analysis examined randomized-trial data comparing first-line PD-1/PD-L1-inhibitor + chemotherapy (CT) vs CT alone for advanced < 1% PD-L1 NSCLCs. Outcome measures included overall survival (OS), progression-free survival (PFS) and objective response rate (ORR).

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Background: Results from large randomized controlled trials combining docetaxel, abiraterone, celecoxib, or bisphosphonates with androgen deprivation therapy (ADT) in hormone-sensitive prostate cancer have emerged. However, in our knowledge, few data are available in patients older than 70 years. Therefore, we undertook a meta-analysis of all published phase III studies.

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Background: Immunotherapy represents a new therapeutic approach in non-small cell lung carcinoma (NSCLC) with the potential for prolonged benefits. Because of the systemic nature and heterogeneity of tumoral diseases, as well as the immune restoration process induced by immunotherapy, the assessment of therapeutic efficacy is challenging, and the role of FDG PET is not well established. We evaluated the potential of FDG PET to monitor NSCLC patients treated with a checkpoint inhibitor.

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Lymphoepithelioma-like carcinoma of the lung (LELC) is a rare, Epstein-Barr virus-associated tumor. LELC occurs mostly in young, Asian nonsmokers. A few hundred cases have been reported, mostly from retrospective Asian studies.

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Importance: Airway transplantation could be an option for patients with proximal lung tumor or with end-stage tracheobronchial disease. New methods for airway transplantation remain highly controversial.

Objective: To establish the feasibility of airway bioengineering using a technique based on the implantation of stented aortic matrices.

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Purpose: Texture indices (TI) calculated from 18F-FDG PET tumor images show promise for predicting response to therapy and survival. Their calculation involves a resampling of standardized uptake values (SUV) within the tumor. This resampling can be performed differently and significantly impacts the TI values.

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Article Synopsis
  • Tyrosine-kinase inhibitors (TKIs) improve progression-free survival (PFS) for patients with advanced non-small-cell lung cancer (NSCLC) with EGFR mutations, but the impact on overall survival (OS) is less clear.
  • A meta-analysis of phase III randomized controlled trials found that while both TKIs and chemotherapy had similar OS outcomes, TKIs significantly enhanced PFS.
  • The analysis included 2962 patients across multiple studies and noted side effects associated with TKIs, such as rash and diarrhea, highlighting the differences in treatment responses.
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Purpose: To study whether volume-based indices of fluorine 18 fluorodeoxyglucose positron emission tomographic (PET)/computed tomographic (CT) imaging is an accurate tool to predict the amount of residual viable tumor after induction chemotherapy in patients with locally advanced non-small cell lung cancer (NSCLC).

Materials And Methods: This study was approved by institutional review board with waivers of informed consent. Twenty-two patients with locally advanced NSCLC underwent surgery after induction chemotherapy.

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Background. Physical activity (PA) reduces incidence of colorectal cancer (CRC). Its influence on cancer-specific (CSS) and overall survival (OS) is controversial.

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After more than 50 years of research, airway transplantation remains a major challenge in the fields of thoracic surgery and regenerative medicine. Five principal types of tracheobronchial substitutes, including synthetic prostheses, bioprostheses, allografts, autografts and bioengineered conduits have been evaluated experimentally in numerous studies. However, none of these works have provided a standardized technique for the replacement of the airways.

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Purpose: We sought to determine whether metabolic volume-based measurements on FDG PET/CT scans could provide additional information for predicting outcome in patients with stage III non-small-cell lung cancer (NSCLC) treated with induction chemotherapy.

Methods: Included in the study were 32 patients with stage III NSCLC who were treated with induction platinum-based chemotherapy followed in 21 by surgery. All patients had an FDG PET/CT scan before and after the induction chemotherapy.

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