Background The standard first-line systemic treatment for patients with non-oncogene addicted adv... more Background The standard first-line systemic treatment for patients with non-oncogene addicted advanced nonsquamous non-small cell lung cancer (NSCLC) is immunotherapy with immune checkpoint inhibitors (ICI) and/or chemotherapy (ChT). Therapy after failing ICI +/− ChT remains an open question, and docetaxel plus nintedanib represent a valid second line option. Patients and methods A multicenter retrospective trial of real-life treatment patterns and outcomes of patients with advanced lung adenocarcinoma treated with docetaxel plus nintedanib after the failure of ICI and/or ChT was performed. Patients from 2 Slovenian and 1 Croatian oncological center treated between June 2014 and August 2022 were enrolled. We assessed objective response (ORR), disease control rate (DCR), median progression free survival (PFS), median overall survival (OS), and safety profile of treatment. Results There were 96 patients included in the analysis, with ORR of 18.8%, DCR of 57.3%, median PFS of 3.0 month...
e21110 Background: In extensive stage small-cell lung cancer (ES-SCLC) immune check-point inhibit... more e21110 Background: In extensive stage small-cell lung cancer (ES-SCLC) immune check-point inhibitors, atezolizumab and durvalumab, when combined with chemotherapy in the first-line setting show better efficacy than chemotherapy alone with safety profile similar as the adverse events of individual agents. Methods: We administered atezolizumab, etoposide and platinum, either carboplatin or cisplatin, in the first-line treatment in 24 newly diagnosed patients with ES-SCLC. Patients were treated until disease progression or unacceptable toxicity. Results: Out of 24 treated patients 13 were males and 11 were females, median age 61 (ranging from 44 to 80). Majority of patients were ECOG 1. Median number of atezolizumab doses was 8 (ranging from 2 to 11). We observed median progression free survival of 6 months (95%CI 4,28-7,72), while median overall survival was not reached. 10 patients (41%) are still undergoing treatment and 9 patients (37%) have died. Immune-related adverse events occu...
Introduction: Tissue sampling of peripheral pulmonary neoplasms for patohistology and analysis of... more Introduction: Tissue sampling of peripheral pulmonary neoplasms for patohistology and analysis of prognostic biomarkers can be challenging. Radial endobronchial ultrasound (R-EBUS) is one of the modern bronchoscopic modalities used for more precise localization of the peripheral lesions. Novel therapeutic strategies rely on different prognostic biomarkers status. Aim: to explore the sufficiency of specimens for patohistology and prognostic biomarkers analysis obtained by ultra-thin bronchoscope combined with R-EBUS. Material and Methods: Retrospective analysis of bronchoscopy cases positive on malignancies where R-EBUS was used for visualization of peripheral tumors. Samples with malignant cells found were analyzed regarding the ability to provide exact histology type and predictive biomarkers information. Results: 80 consecutive cases with pathologic ultrasound pattern were analyzed. Malignant disease was diagnosed in 49 cases (61%). Mean lesion diameter was 24mm (range 15 to 40mm). The most common histology types were adenocarcinoma, squamous cell carcinoma, and small cell carcinoma – 78%, 12%, and 4% respectively. Extrathoracic malignancies were diagnosed in 6% of cases. The tissue was sufficient for prognostic biomarker analysis in 91% of the cases – whereas EGFR, ALK, ROS1, and PDL-1 testing was performed. In 9% of cases, samples were sufficient for histologic typing only. Conclusion: bronchoscopy with R-EBUS is a useful diagnostic method for peripheral lung tumors. Obtained samples are sufficient for histology typing and prognostic biomarkers analysis in most cases as well.
Aim: Alongside the proven efficacy, immunotherapy in treatment of malignant diseases can cause im... more Aim: Alongside the proven efficacy, immunotherapy in treatment of malignant diseases can cause immune-related adverse events different from commonly known chemotherapy-related toxicities. Case presentation: During nivolumab treatment of metastatic squamous cell lung cancer, the patient developed a symptomatic inflammatory myositis confirmed with muscle biopsy and primary hypothyroidism. After initiation of corticosteroids and thyroid hormone replacement, the clinical and laboratory improvement occurred. To the best of our knowledge, this is the first description of a case of nivolumab-induced synchronous manifestation of immune-related myositis and hypothyroidism. Conclusion: Immunotherapy can trigger a wide spectrum of immune-related adverse events that could occur simultaneously. If not detected and treated, these events could become severe or even fatal and require clinicians’ awareness and routine check-ups.
Background The standard first-line systemic treatment for patients with non-oncogene addicted adv... more Background The standard first-line systemic treatment for patients with non-oncogene addicted advanced nonsquamous non-small cell lung cancer (NSCLC) is immunotherapy with immune checkpoint inhibitors (ICI) and/or chemotherapy (ChT). Therapy after failing ICI +/− ChT remains an open question, and docetaxel plus nintedanib represent a valid second line option. Patients and methods A multicenter retrospective trial of real-life treatment patterns and outcomes of patients with advanced lung adenocarcinoma treated with docetaxel plus nintedanib after the failure of ICI and/or ChT was performed. Patients from 2 Slovenian and 1 Croatian oncological center treated between June 2014 and August 2022 were enrolled. We assessed objective response (ORR), disease control rate (DCR), median progression free survival (PFS), median overall survival (OS), and safety profile of treatment. Results There were 96 patients included in the analysis, with ORR of 18.8%, DCR of 57.3%, median PFS of 3.0 month...
e21110 Background: In extensive stage small-cell lung cancer (ES-SCLC) immune check-point inhibit... more e21110 Background: In extensive stage small-cell lung cancer (ES-SCLC) immune check-point inhibitors, atezolizumab and durvalumab, when combined with chemotherapy in the first-line setting show better efficacy than chemotherapy alone with safety profile similar as the adverse events of individual agents. Methods: We administered atezolizumab, etoposide and platinum, either carboplatin or cisplatin, in the first-line treatment in 24 newly diagnosed patients with ES-SCLC. Patients were treated until disease progression or unacceptable toxicity. Results: Out of 24 treated patients 13 were males and 11 were females, median age 61 (ranging from 44 to 80). Majority of patients were ECOG 1. Median number of atezolizumab doses was 8 (ranging from 2 to 11). We observed median progression free survival of 6 months (95%CI 4,28-7,72), while median overall survival was not reached. 10 patients (41%) are still undergoing treatment and 9 patients (37%) have died. Immune-related adverse events occu...
Introduction: Tissue sampling of peripheral pulmonary neoplasms for patohistology and analysis of... more Introduction: Tissue sampling of peripheral pulmonary neoplasms for patohistology and analysis of prognostic biomarkers can be challenging. Radial endobronchial ultrasound (R-EBUS) is one of the modern bronchoscopic modalities used for more precise localization of the peripheral lesions. Novel therapeutic strategies rely on different prognostic biomarkers status. Aim: to explore the sufficiency of specimens for patohistology and prognostic biomarkers analysis obtained by ultra-thin bronchoscope combined with R-EBUS. Material and Methods: Retrospective analysis of bronchoscopy cases positive on malignancies where R-EBUS was used for visualization of peripheral tumors. Samples with malignant cells found were analyzed regarding the ability to provide exact histology type and predictive biomarkers information. Results: 80 consecutive cases with pathologic ultrasound pattern were analyzed. Malignant disease was diagnosed in 49 cases (61%). Mean lesion diameter was 24mm (range 15 to 40mm). The most common histology types were adenocarcinoma, squamous cell carcinoma, and small cell carcinoma – 78%, 12%, and 4% respectively. Extrathoracic malignancies were diagnosed in 6% of cases. The tissue was sufficient for prognostic biomarker analysis in 91% of the cases – whereas EGFR, ALK, ROS1, and PDL-1 testing was performed. In 9% of cases, samples were sufficient for histologic typing only. Conclusion: bronchoscopy with R-EBUS is a useful diagnostic method for peripheral lung tumors. Obtained samples are sufficient for histology typing and prognostic biomarkers analysis in most cases as well.
Aim: Alongside the proven efficacy, immunotherapy in treatment of malignant diseases can cause im... more Aim: Alongside the proven efficacy, immunotherapy in treatment of malignant diseases can cause immune-related adverse events different from commonly known chemotherapy-related toxicities. Case presentation: During nivolumab treatment of metastatic squamous cell lung cancer, the patient developed a symptomatic inflammatory myositis confirmed with muscle biopsy and primary hypothyroidism. After initiation of corticosteroids and thyroid hormone replacement, the clinical and laboratory improvement occurred. To the best of our knowledge, this is the first description of a case of nivolumab-induced synchronous manifestation of immune-related myositis and hypothyroidism. Conclusion: Immunotherapy can trigger a wide spectrum of immune-related adverse events that could occur simultaneously. If not detected and treated, these events could become severe or even fatal and require clinicians’ awareness and routine check-ups.
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Papers by Marta Koršić