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OBJECTIVES To assess the complication rate in participants of the screen arm of the NELSON lung cancer screening trial who underwent surgical resection and to investigate, based on a literature review, whether the complication rate, length of hospital stay, re-thoracotomy and mortality rates after a surgical procedure were different from those of the non-screening series, taking co-morbidity into account. METHODS Between April 2004 and December 2008, 198 subjects underwent thoracic surgery. Co-morbid conditions were retrieved from the medical records. Postoperative complications were classified as minor and major. RESULTS In total, 182 thoracotomies, 5 thoracotomies after video-assisted thoracoscopic surgery (VATS) and 11 VATS procedures were performed. In these patients, 36% had chronic obstructive lung disease, 16% coronary artery disease, 14% diabetes mellitus and 11% peripheral vascular disease. Following thoracotomy, 47% (88/187) had ≥1 minor (7–57% in literature) and 10% (18/187) ≥1 major complication (2–26% in literature); following VATS, 38% (6/16) had ≥1 minor complication, but no major complications. Seventeen per cent (3/18) of major complications and 21% (20/96) of minor complications were seen in subjects operated for benign disease. The re-thoracotomy rate was 3% and there was no 30-day mortality after thoracotomy or VATS (0–8.3% in literature). The mortality rate of 0% after surgical procedures is low when compared with the non-screening series (0–8.3%); the rate of complications (53%) is within range when compared with the non-screening series (8.5–58%). CONCLUSIONS In conclusion, mortality rates after surgical procedures are lower in the NELSON lung cancer screening trial than those in the non-screening series. The rate of complications is within the same range as in the non-screening series. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the role of conventional bronchoscopy in the diagnostic examination of suspicious screen-detected pulmonary nodules. Findings reveal that 318 suspicious lesions were assessed by bronchoscopy. It indicates that bronchoscopy detected one percent of all cancers identified.

Background: Anti-angiogenic agents, such as nintedanib and ramucirumab, when combined with docetaxel, are subsequent treatment options in patients with non-small cell lung cancer (NSCLC) who have failed on first-line chemotherapy or immunochemotherapy. However, to date, there are no validated predictive biomarkers for efficacy of anti-angiogenic therapies in this setting. The aim of this study was to explore whether genetic or genomic markers, alone or combined with clinical covariates, could be used to predict overall survival (OS) in patients with NSCLC who are eligible for treatment with nintedanib plus docetaxel., Methods: LUME-BioNIS (NCT02671422) was a prospective, non-interventional study that assessed the efficacy and safety of nintedanib plus docetaxel in patients with relapsed/refractory NSCLC. The primary outcome was OS in relation to exploratory molecular biomarkers, alone or in combination with clinical covariates. Exploratory multivariate and univariate analyses were undertaken on putative biomarkers including clinical variables, somatic mutations, gene expression, immunological, and proliferation markers. Sub-analyses in patients with prior immunotherapy were performed., Results: Of 260 enrolled patients, most patients received nintedanib plus docetaxel in the second-line (68.8%) or third-line (25.8%). After a median follow-up of 19.7 months, median OS was 8.1 months (95% confidence interval: 7.1-9.5). Univariate subgroup analysis indicated that the presence of liver/adrenal metastases, Eastern Cooperative Oncology Group performance status (ECOG PS) ≥1, time since start of first-line therapy (<9 months), and response to first-line therapy had potential prognostic significance for OS. In multivariate analysis, the presence of brain/liver metastases and the presence of >2 metastatic sites at baseline were associated with OS. In univariate analyses in patients with prior immunotherapy, RNA expression levels of genes involved in cell proliferation, DNA damage repair, interferon signaling, and abundance of neutrophils had potential prognostic significance for OS., Conclusions: Nintedanib plus docetaxel had promising activity and manageable safety in a real-world clinical setting. No new predictive biomarkers were identified to help select patients who may particularly benefit from anti-angiogenic therapy., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tlcr.amegroups.com/article/view/10.21037/tlcr-24-326/coif). M.R. reports funding, article processing charges and medical writing support funding (Ashfield MedComms) for this study from Boehringer Ingelheim; consulting fees, payments, honoraria, meeting and travel support from Amgen, AstraZeneca, BeiGene, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, GSK, Merck, Mirati Therapeutics, MSD, Novartis, Pfizer, Regeneron, and Roche; participates on data safety monitoring boards or advisory boards for Daiichi Sankyo and Sanofi; and receives medical writing support funding (Articulate Science, LLC) from Daiichi Sankyo. K.S. reports funding, article processing charges and medical writing support funding (Ashfield MedComms) for this study from Boehringer Ingelheim; payment and honoraria from AstraZeneca, Bristol Myers Squibb, and MSD; and meeting and travel support from AstraZeneca. S.M. reports funding, article processing charges and medical writing support funding (Ashfield MedComms) for this study from Boehringer Ingelheim. S.C.v.W. reports funding, article processing charges and medical writing support funding (Ashfield MedComms) for this study from Boehringer Ingelheim. B.M. reports funding, article processing charges and medical writing support funding (Ashfield MedComms) for this study from Boehringer Ingelheim; travel grants from AstraZeneca, Bristol Myers Squibb, MSD, and Roche; and personal fees from BeiGene and Takeda. H.B. reports funding, article processing charges and medical writing support funding (Ashfield MedComms) for this study from Boehringer Ingelheim; consulting fees, payments and honoraria from Boehringer Ingelheim; and employment with Staburo GmbH. A.V.S. reports funding, article processing charges and medical writing support funding (Ashfield MedComms) for this study from Boehringer Ingelheim; and employment by Boehringer Ingelheim. R.M.L. reports funding, article processing charges and medical writing support funding (Ashfield MedComms) for this study from Boehringer Ingelheim; consulting fees and employment by Boehringer Ingelheim. A.M.E. reports funding, article processing charges and medical writing support funding (Ashfield MedComms) for this study from Boehringer Ingelheim; and employment by Boehringer Ingelheim. T.K. reports funding, article processing charges and medical writing support funding (Ashfield MedComms) for this study from Boehringer Ingelheim; and employment by Boehringer Ingelheim and Merck Healthcare KGaA. K.K. reports funding, article processing charges and medical writing support funding (Ashfield MedComms) for this study from Boehringer Ingelheim; consulting fees from AbbVie, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi Sankyo, Debiopharm, Diaceutics, Eli Lilly, Merck Serono, MSD, Novartis, Pfizer, Regeneron, Roche, Roche Diagnostics, Ventana, and Sanofi; payment and honoraria from AstraZeneca, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Merck Serono, MSD, Novartis, Pfizer, Roche, Roche Diagnostics, Ventana, Medscape, and Prime Oncology; and leadership roles on the IASLC Pathology Committee. The authors have no other conflicts of interest to declare., (2024 AME Publishing Company. All rights reserved.)