Neoadjuvant Immunotherapy in Oncogene-Positive Non-Small Cell Lung Cancer: A Multicenter Study.

BACKGROUND: Preoperative immunotherapy has shed light on the management of resectable non-small cell lung cancer (NSCLC). However, whether neoadjuvant immunotherapy benefits patients with oncogene-positive NSCLC remains unknown. METHODS: Data were retrieved from 4 institutions in the period from August 2018 to May 2021. Eligible patients were aged ≥18 years with histologically confirmed stage IIA to stage IIIB (T1-2 N1-2 or T3-4 N0-2) NSCLC that was deemed to be surgically resectable. The neoadjuvant regimen included immune checkpoint inhibitors alone or in combination with platinum-based doublets. Surgical resection was performed 4 to 6 weeks after the first day of the last cycle of treatment. The primary end point was major pathologic response (MPR; ≤10% viable tumor cells). Analyses were categorized according to the patients' oncogene (EGFR, ALK, KRAS, MET, BRAF, ROS1, RET) status. RESULTS: Overall, 137 patients were identified; 46 (33%) patients had nonsquamous cell cancer, and 114 (83%) had stage IIIA/B disease. Oncogene alterations were identified in 22 (16%) patients, of whom only 2 patients (2/22 [9%]) had an MPR compared with 65 (65/115 [56.5%]) in the oncogene-negative population (P < .001). Similar results were retained after propensity score matching for age, sex, smoking status, histologic type, stage, and cycles of neoadjuvant treatment. Squamous cell carcinoma (odds ratio, 2.54; 95% CI, 1.08-5.99) and positive oncogene status (odds ratio, 0.13; 95% CI, 0.03-0.64) were found to be indicators for MPR by logistic regression. The 1-year event-free survival rate was 75.4% in the oncogene-positive group, which was not significantly different from 85.5% in the oncogene-negative population (P = .23). CONCLUSIONS: Patients with stage II-III oncogene-positive NSCLCs respond less than patients with oncogene-negative NSCLCs after neoadjuvant immunotherapy.

[Changes of electrical property of the twelve source-points in encephaloma patients before and after surgery].

OBJECTIVE: To observe the changes of electrical property of the 12 Source-points in encephaloma patients undergoing surgery. METHODS: A total of 116 encephaloma patients and 60 healthy people who signed the informed consent were enlisted in the present study. The regional cutaneous electric resistance (CER) of the bilateral 12 Yuan (Source)-points was measured in the afternoon (14:00-16:00) before and one week after surgery under room temperature [(22 +/- 3) degrees C, (55 +/- 10)% in humidity] by using "Meridian Energy Analysis Device". RESULTS: In comparison with normal subjects, CER values of the 12 Source-points on both sides of the body in encephaloma patients were significantly lower (P < 0.01). Before surgery, CER values of Wangu (SI 4), Taibai (SP 3), Taichong (LR 3) and Chongyang (ST 42) on the left side were significantly higher than those of the isonym points on the right side (P < 0.01, P < 0.05), suggesting an imbalance of the bilateral Small Intestine, Spleen, Liver and Stomach Meridians. After surgery, CER values of Shenmen (HT 7), Wangu (SI 4), Yangchi (SJ 4) and Taibai (SP 3) on the left side were markedly higher than those of the isonym points on the right side (P < 0.05, P < 0.01), suggesting an imbalance of the bilateral Heart, Small Intestine, Trienergizer and Spleen Meridians. Comparison between pre- and post-surgery showed that CER values of Taiyuan (LU 9), Daling (PC 7), Taibai (SP 3), Taichong (LR 3), Taixi (KI 3), Jinggu (BL 64), Qiuxu (GB 40) and Chongyang (ST 42) on both sides, and Wangu (SI 4) on the right side lessened obviously post-surgery (P < 0.01, P < 0.05), suggesting an imbalance of the bilateral meridians found in more meridians, including yang meridians entering the brain as the Bladder, Gallbladder, Stomach Meridians. CONCLUSION: In encephaloma patients, the CER values of some Source-points on the left side are significantly higher than those on the right side, suggesting an imbalance of the bilateral meridians in functional activities.