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Immune checkpoint inhibitors (ICIs) show promising clinical activity in advanced cancers. However, the safety and efficacy of PD-1/PD-L1 blockade in patients with preexisting antinuclear antibodies (ANA) are unclear. 191 patients treated with nivolumab, pembrolizumab, atezolizumab, or durvalumab for unresectable advanced cancers between September 2014 and December 2018 were identified retrospectively. Patients were divided into positive (ANA titers ≥ 1:160) and negative ANA groups (ANA titers

NSCLC patients with EGFR mutations respond to EGFR-TKIs; however, the management of refractory tumors to EGFR-TKIs remains unclear. We demonstrated that repeated genetic testing might be useful for detecting resistance mechanisms as well as for decision-making in EGFR mutated NSCLC patients, following the emergence of resistance to the initial EGFR-TKIs.A 69-year-old man was diagnosed with lung adenocarcinoma with an EGFR exon 19 deletion. After tumor re-growth treated with erlotinib and chemotherapy, he was diagnosed with an SCLC transformation and administered chemotherapy to treat the SCLC. After the resistance of chemotherapy, the EGFR-T790M mutation by liquid biopsy was detected and treated him with osimertinib, which resulted in a clinical response. Keywords: Repeated genetic testing, Drug resistance, EGFR-T790M, SCLC transformation, Liquid biopsy

Introduction Anti-programmed cell death-1 (PD-1) and anti-programmed cell death ligand-1 (PD-L1) monotherapies have shown promising clinical activity in advanced cancers. Many studies of immune-related adverse events (irAEs) have been reported. Although, the safety and efficacy of PD-1/PD-L1 blockade in patients with preexisting positive antinuclear antibodies (ANA) and autoimmune disease (AD) remains unclear. Methods: 216 patients who received nivolumab, pembrolizumab, atezolizumab or durvalumab for unresectable advanced cancers between September 2014 and December 2018 were retrospectively identified. The patients were divided into the positive (ANA titers≥1:80) and negative (titers≤1:40) ANA groups. Development and characteristics of irAEs, the response rate (RR) and disease control rate (DCR) were estimated. We also focused on the patients with preexisting AD and assessed their clinical courses. Results: 17 out of 190 patients had positive ANA. 8 patients developed irAEs of any grade in the positive ANA group while 65 developed in the negative group, which showed no significant difference among the two groups. No significant differences were shown in the development of endocrine, pulmonary and cutaneous irAEs, while the presence of positive ANA was significantly higher in patients who developed colitis (3/17) than in patients who did not (2/173, P

Secondary sarcopenia is defined as a decrease in muscle mass due to disease or malnutrition. Several studies have reported that secondary sarcopenia is an indicator of postoperative recurrence. We hypothesized that there is a correlation between the effect of immune checkpoint inhibitors (ICIs) and sarcopenia. We retrospectively analyzed 38 patients with advanced non-small cell lung cancer (NSCLC) who were treated with ICIs between February 2016 and April 2018. Patients were divided into two groups according to the change rate of the psoas major muscle area (PMMA) at the L2&ndash, L3 position and investigated the correlation between the change rate of the PMMA and the efficacy of ICIs was investigated. The objective response and disease control rates were lower in patients with sarcopenia than in those without sarcopenia. Patients with sarcopenia exhibited a significantly shorter median progression-free survival (PFS) than non-sarcopenia patients. Moreover, focusing on good Eastern Cooperative Oncology Group performance status patients, sarcopenia patients showed a shorter PFS than non-sarcopenia patients. Patients with sarcopenia are associated with poor outcomes for immunotherapy among those with advanced NSCLC, based on retrospective analysis. Further research is needed to validate the clinical biomarkers involved in ICI responders.