Evaluating the potential of immunotherapy and chemoimmunotherapy in the treatment of elderly non-small cell lung cancer patients: A real-world study.

BACKGROUND: Immune checkpoint inhibitor (ICI) has become the standard therapy for metastatic non-small cell lung cancer (NSCLC) patients. However, no robust evidence on the efficacy and safety of ICI in elderly NSCLC patients has been established. MATERIALS AND METHODS: This retrospective study aimed to assess the efficacy and safety of ICI in elderly NSCLC patients. NSCLC patients treated with ICI monotherapy or chemoimmunotherapy (CIT) between 2016 and 2022 were divided into two cohorts according to the age: the Elderly cohort (patients aged ≥ 75 years) and the Nonelderly cohort (patients aged < 75 years). The progression-free survival (PFS), tumor response, and frequency of immune-related adverse events (irAEs) were compared between the two cohorts. RESULTS: A total of 111 NSCLC patients were included in this study (41 patients in the Elderly cohort and 70 patients in the Nonelderly cohort). The PFS (5.6 months vs. 6.3 months, P = 0.98), response rate (36.6% vs. 44.9%, P = 0.51), and disease control rate (80.5% vs. 76.8%, P = 0.83) were not significantly different between the two cohorts. In a subgroup analysis, stratified according to PD-L1 expression (low vs. high) and ICI treatment mode (ICI monotherapy vs. CIT), the PFSs of both cohorts were also not significantly different, regardless of PD-L1 expression. Moreover, the frequency of irAEs did not significantly differ between elderly and nonelderly NSCLC patients (21/41 [51.2%] vs. 38/70 [54.3%], P = 0.91). CONCLUSION: The efficacy and safety of ICI in elderly NSCLC patients were not inferior to those in younger patients.

Enteral lorlatinib after alectinib as a treatment option in anaplastic lymphoma kinase-positive non-small cell lung cancer with triple problems: carcinomatous meningitis, poor performance status, and dysphagia-a case report.

Alectinib treatment is effective in patients with anaplastic lymphoma kinase (ALK) gene rearrangement-positive non-small cell lung cancer (NSCLC; hereafter ALK-positive NSCLC) who exhibit central nervous system (CNS) relapse and poor performance status (PS). Lorlatinib treatment is effective upon failure of other ALK inhibitor-based treatments. However, much remains unknown about the efficacy of lorlatinib in patients with ALK-positive NSCLC, who have triple problems, carcinomatous meningitis, poor PS, and dysphagia, after alectinib treatment. Here, we report the remarkable response of a 73-year-old patient with ALK-positive NSCLC showing carcinomatous meningitis due to CNS metastases, poor PS, and dysphagia to lorlatinib. Lorlatinib administration through a nasogastric tube alleviated complications related to consciousness within three days, and the patient survived for 16 months after CNS relapse. Lorlatinib could be a treatment option for patients with ALK-positive NSCLC showing carcinomatous meningitis, poor PS, and dysphagia upon failure of other ALK inhibitor-based treatments.

THE DISPERSION OF HERBACEOUS PLANT POLLEN IN ITO CITY, SHIZUOKA.

BACKGROUND: Airborne pollen was examined in Ito City, Shizuoka for the purpose of treatment and prophylaxis pollen allergies because the patients with pollen allergy to herbaceous plants have recently increased. METHODS: Setting up a Durham's sampler, we measured airborne pollen identified and classified: Poaceae, Polygonaceae, Amaranthaceae, Urticaceae, Cannabaceae, Ambrosia and Artemisia indica.We studied whether each airborne pollen count has something to do with weather condition (2004-2015). RESULTS: Average total airborne Poaceae pollen count and standard deviation from January to June was 19.4±5.5 cells/cm(2), average total airborne Polygonaceae pollen count and standard deviation from April to September was 11.6±13.4 cells/cm(2). Airborne Poaceae, Amaranthaceae, Cannabaceae, Uriticaceae. Ambrosia and Artamisia indica pollen count from July to Deccember in order: 34.0±15.5 cells/cm(2), 1.3±1.1 cells/cm(2), 8.7±6.4cells/cm(2), 4.9±6.4 cells/cm(2), 10.5±7.8 cells/cm(2), and 13.6±16.3 cells/cm(2).Cannabaceae admitted that its airborne pollen count has negative correlation to the rainfall.Artemisia indica admitted that its airborne pollen count has negative correlation to the average temperature. CONCLUSION: Herbaceous plants pollen doesn't cause allergies because it is much less than tree pollen in ItoCity.It is thought that the diversity of the plants keep the people from having a serious allergy to pollen with awarm weather in this area.

The usefulness of KL-6 and SP-D for the diagnosis and management of chronic hypersensitivity pneumonitis.

BACKGROUND: It is believed that Krebs von den Lungen-6 (KL-6) and surfactant protein D (SP-D) are useful biomarkers for the diagnosis of various types of interstitial lung diseases, including hypersensitivity pneumonitis (HP). The clinical features of chronic HP are similar to those of idiopathic interstitial pneumonias, especially idiopathic pulmonary fibrosis (IPF). OBJECTIVE: We sought to clarify the usefulness of serum KL-6 and SP-D for the diagnosis and management of chronic HP. METHODS: We examined serum KL-6 and SP-D levels and retrospectively evaluated the clinical parameters of acute HP (n = 35), chronic HP (n = 57), IPF (n = 54), collagen vascular disease-associated interstitial pneumonia (CVD-IP) (n = 67), and sarcoidosis (n = 47). We analyzed the relations between the two biomarkers and clinical data in chronic HP. RESULTS: Serum KL-6 and SP-D levels in acute HP (2710 U/ml and 338 ng/ml, median) and chronic HP (1500 U/ml and 264 ng/ml, median) were significantly higher than in IPF, CVD-IP, and sarcoidosis. The area under the curve (AUC) values for serum KL-6 and SP-D between chronic HP and IPF were 0.771 and 0.729, respectively. Serum KL-6 levels in chronic HP were significantly higher during episodes of acute exacerbation than 1 month before acute exacerbation. The serum KL-6 levels had correlations with serum SP-D and the percentage of lymphocytes in bronchoalveolar lavage fluid. CONCLUSIONS: Serum KL-6 and SP-D levels are useful for the diagnosis and management of chronic HP.

[Tree pollen dispersion in Ito City, Shizuoka Prefecture].

BACKGROUND: The authors investigated the atmospheric tree pollen dispersion in Ito City, Shizuoka Prefecture for 12 years for the purpose of the prophylaxis and treatment of pollinosis. METHODS: We set up a Durham sampler on the rooftop of the three-story building in Ito City, and counted atmospheric pollen grouping first, Taxodiaceae and Cupressaceae; second, Pinaceae and Podocarpaceae; third, Betulaceae and Ulmaceae; last, Fagaceae. The counts of atmospheric tree pollen on season and the weather from January to June were treated statistically and analyzed on the computer program Microsoft Excel. RESULTS: Each average and SD of total pollen count was, in order, 7079±6503 count/cm(2), 502±146 count/cm(2), 891±480 count/cm(2), 906±481 count/cm(2). The last summer weather correlates to the atmospheric pollen count of Taxodiaceae, Cupressaceae, Betulaceace and Ulmaceae. The atmospheric pollen count of Taxodiaceae and Cupressaceae in spring is influenced by the weather; their atmospheric pollen count is reduced by a heavy rain or a heavy snow out of season. The atmospheric pollen count of Pinaceae, Podocarpaceae and Fagaceae does not relate to the weather. CONCLUSION: As a result of having examined the relations between the count of the atmospheric pollen and the weather in Ito City, I recognized relations in Taxodiaceae, Cupressaceae, Pinaceae and Podocarpaceae, but there were not the relations of intentionality in Betulaceae, Ulmaceae and Fagaceae.

[Pollen dispersion of Cryptomeria japonica and Cupressaceae in Ito city during 10 years].

BACKGROUND: For a period of 10 years, ending in 2010, the authors investigated atmospheric pollen dispersion of Cryptomeria japonica and Cupressaceae in Ito City. We expect this investigation useful in treating patients with pollen allergy. METHODS: We set up a Durham sampler on a rooftop of the three-story building in Ito City and counted atmospheric pollen day by day. The results and the local weather conditions were treated statistically on the computer program Microsoft Excel. RESULTS: During the 10 years, in average, initial pollen was observed at January 3; pollen began to release was observed at February 6; final pollen was observed at May 12. The spring seasonal total pollen counts was 5683 grain/cm2. This pollen counts and the previous early winter seasonal pollen counts were correlated statistically. The pollen counts were related with the local weather conditions significantly. CONCLUSION: The investigations of the atmospheric pollen dispersion of Cryptomeria japonica and Cupressaceae and the weather conditions in the local area are useful to treat patients with the pollen allergy.