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PATIENTS AND METHODS | PMC10417045 | |||
Patient eligibility | NSCLC | ONCOLOGY, DISEASE, RECURRENCE, NSCLC | Patients with histologically or cytologically confirmed non‐squamous NSCLC with measurable disease were enrolled. Other eligibility criteria included: Stage IIIB (without indications for radical chest radiation therapy), Stage IV, or postoperative recurrence; age ≥20 and <75 years; Eastern Cooperative Oncology Group (E... | PMC10417045 |
Study design and treatment | toxicities, proteinuria, hemoptysis, Cancer | ONCOLOGY, THORACIC, S; HEMOGLOBIN, CANCER | Patients received induction chemotherapy of cisplatin (75 mg/mThe criteria to start maintenance therapy included: PS 0 or 1; neutrophil count ≥1500/μL; hemoglobin ≥8.0 g/dL; platelet count ≥7.5 × 10Administration of maintenance therapies was suspended if any of the following occurred: neutrophil count <1500/μL; platele... | PMC10417045 |
Assessment of treatment | tumor, Tumor, SD, Tumors, Toxicity | ADVERSE EVENT, TUMOR, METASTASIS, TUMOR, TUMORS, ADVERSE EVENT | Before commencement of therapy, a complete medical history, physical examination, and resting 12‐lead electrocardiogram were performed. Tumor staging was determined by physical examination, routine chest radiography, computed tomography (CT) of the chest and abdomen, bone scintigraphy, or positron emission tomography (... | PMC10417045 |
Statistical analysis | NSCLC, SD | ADVERSE EVENTS, ADENOCARCINOMA, NSCLC, EVENTS, PATHOLOGY | The primary endpoint of this study was progression‐free survival (PFS) from randomization. Secondary endpoints were the objective response rate (ORR), overall survival (OS) from randomization, and adverse events. The sample size was calculated with a one‐sided significance level of 0.05 and 80% statistical power using ... | PMC10417045 |
Analysis of circulating immunocytes of peripheral blood | Circulating immunocytes, such as MDSCs, cluster of differentiation (CD) 4 T‐cells, CD8 T‐cells, and Tregs, were analyzed. To analyze circulating immunocytes, peripheral blood samples of patients were collected at four points (before and after induction chemotherapy, 4–8 weeks after the start of maintenance treatment, a... | PMC10417045 | ||
RESULTS | PMC10417045 | |||
Patients' characteristics and treatment administration | NSCLC | LUNG CANCER, DISEASE, NSCLC | A total of 108 patients were entered into this study between June 2013 and March 2019. Patients were recruited at 19 investigational sites of TORG in Japan. The patients' characteristics are listed in Table Patients' background characteristics.Abbreviations: NSCLC, non‐small cell lung cancer; NOS, not otherwise specifi... | PMC10417045 |
Antitumor activity | PD | ADVERSE EVENTS, DISEASE | Of the 108 eligible patients who received induction chemotherapy, 101 were assessable for response to chemotherapy. Seven patients could not be assessed for response because of discontinuation during induction therapy. The reasons for discontinuation during induction therapy were: patients' refusal, four patients; adve... | PMC10417045 |
Adverse events | hemorrhage, Proteinuria, hypertension | PROTEINURIA, ADVERSE EVENTS, ADVERSE EVENT, HEMORRHAGE, HYPERTENSION | Grade 3 and 4 hematological adverse events in all cycles of maintenance therapy of all 70 patients are listed in Table Adverse events (Grade 3 or 4) during maintenance therapy.Abbreviation: AST, aspartate aminotransferase; ALT, alanine aminotransferase.Proteinuria, hemorrhage from some organs, and hypertension are gene... | PMC10417045 |
Analysis of circulating immunocytes of peripheral blood | PD | Circulating immunocytes, such as MDSCs, CD 4 T‐cells, CD8 T‐cells, and Tregs, were analyzed. To analyze circulating immunocytes, peripheral blood samples were collected in ten patients. Eight of the ten patients were from the PBgroup and two of the ten patients were from the Pgroup. The eight patients in the PBgroup we... | PMC10417045 | |
DISCUSSION | NSCLC, toxicities, human venous blood samples, tumor | TUMOR, NSCLC | A randomized, Phase II study of pemetrexed plus bevacizumab versus pemetrexed alone after treatment with cisplatin, pemetrexed, and bevacizumab in untreated advanced non‐squamous, NSCLC was conducted. To the best of our knowledge, this is the first study to demonstrate the significant progression free survival benefit ... | PMC10417045 |
AUTHOR CONTRIBUTIONS | PMC10417045 | |||
FUNDING INFORMATION | This research did not receive any specific grant from funding agencies in the public, commercial, or not‐for‐profit sectors. | PMC10417045 | ||
CONFLICT OF INTEREST STATEMENT | The authors have declared no conflicts of interest. | PMC10417045 | ||
ACKNOWLEDGMENTS | The authors would like to thank the patients and their families for consenting to participate in the study. | PMC10417045 | ||
DATA AVAILABILITY STATEMENT | Data sharing is not applicable to this article as no new data were created or analyzed in this study. | PMC10417045 | ||
REFERENCES | PMC10417045 | |||
Subject terms | psychotic symptoms, impaired delayed verbal recall | SYNDROME, POSITIVE | As countries adopt more permissive cannabis policies, it is increasingly important to identify strategies that can reduce the harmful effects of cannabis use. This study aimed to determine if increasing the CBD content of cannabis can reduce its harmful effects. Forty-six healthy, infrequent cannabis users participated... | PMC10156730 |
Introduction | psychotic symptoms | ADVERSE EFFECTS | Several countries and US states have decriminalised or legalised cannabis use, and many permit the use of cannabis preparations for medicinal purposes. Over a similar period, the potency of cannabis, as indexed by its ∆9-tetrahydrocannabinol (THC) content, has been progressively increasing [As well as THC, cannabis als... | PMC10156730 |
Methods | The study was approved by the King’s College London Research Ethics Committee (RESCMR-16/17-4163). All participants provided written informed consent and the study was conducted in compliance with the principles of Good Clinical Practice, the Declaration of Helsinki (1996). The study was registered on Open Science Fram... | PMC10156730 | ||
Design | CRF | CRF, APPENDIX | This randomised, double-blind, four-arm, within-subjects study was conducted at the NIHR Wellcome Trust Clinical Research Facility (CRF) at King’s College Hospital, London, UK (randomisation and masking described in Appendix | PMC10156730 |
Participants | DISORDER, APPENDIX | Forty-six healthy volunteers (age 21–50 years), who had used cannabis at least once in the past, but had not used cannabis >1/week over the last 12 months, had never used synthetic cannabinoids, and did not have a substance use disorder were recruited. Additional inclusion/exclusion criteria are listed in Appendix | PMC10156730 | |
Procedure (Fig. | At baseline, participants were assessed for study eligibility, and practiced the inhalation procedure. At baseline and all experimental visits, urine drug and pregnancy screen as well as alcohol and carbon monoxide breath tests (<10 ppm CO to verify 12 h tobacco abstinence) were completed. Participants were asked to av... | PMC10156730 | ||
Study drug and administration | The study drug was provided in the form of granulated cannabis inflorescence by Bedrocan BV (Netherlands) produced in accordance with Good Manufacturing Practice and confirms to the European Medicines Agency’s contaminant levels for products used in the respiratory tract. Each cannabis dose consisted of 10 mg of THC (t... | PMC10156730 | ||
Blood collection and analysis | Venous blood samples were taken before drug administration, and at 0, 5, 15, and 90 min following the final exhalation, alongside blood pressure, heart rate and temperature. The concentration of Δ9-THC, 11-OH-Δ9-THC (OH-THC), 11-COOH-Δ9-THC (COOH-THC), CBD and 7-OH-CBD were determined using high performance LC/MS at th... | PMC10156730 | ||
Cognitive tasks | PMC10156730 | |||
Hopkins verbal learning task—Revised (HVLT-R) [ | A researcher read out a list of 12 words to the participant, who then repeated the list back. This was repeated over three trials, with the total number of words recalled indexing immediate recall. 20–25 min later participants were asked to recall the words again, indexing delayed recall. The percentage of correctly re... | PMC10156730 | ||
Forward and reverse digit span | Digit span is a measure of verbal working memory and attention, involving the recall of sequences of numbers with increasing length (WAIS-III). Beginning with three digits on forward and two digits on reverse, the task ceased when the participant failed two consecutive attempts at a number sequence. | PMC10156730 | ||
Spatial N-back [ | Participants responded to a visual stimulus appearing in one of eight locations, with task demand varied across 0-back, 1-back, and 2-back conditions. Participants were required to indicate (by pressing a Yes or No button) whether the stimulus appeared at the 12 o’clock position (0-back), the same position as the previ... | PMC10156730 | ||
Psychological measures | PMC10156730 | |||
Positive and negative syndrome scale—positive subscale (PANSS-P) [ | hyperactivity, grandiosity, hallucinations, delusions, suspiciousness, psychotic symptoms, hostility | The PANSS-P is an investigator-rated semi-structured interview, which assesses positive psychotic symptoms (delusions, conceptual disorganisation, hallucinations, hyperactivity, grandiosity, suspiciousness, and hostility). Information from this assessment was supplemented by the researcher’s observations of, and intera... | PMC10156730 | |
State social paranoia scale (SSPS) [ | The SSPS was used to assess persecutory thoughts. | PMC10156730 | ||
Community assessment of Psychic Experiences—state (CAPE-state) [ | The CAPE-state is a self-rated scale and was used to assess psychotic-like experiences. | PMC10156730 | ||
Psychotomimetic states inventory (PSI) [ | The PSI questionnaire was used to assess psychotic-like experiences following the use of cannabis use. | PMC10156730 | ||
Visual analogue scales (VAS) | VAS were used to measure subjective effects along a continuum. Participants marked on a 100 mm horizontal line to indicate the level of a given feeling at that moment (0 mm ‘Not at all’ to 100 mm ‘Extremely’). The feeling states included: | PMC10156730 | ||
Pleasurable responses | Pleasurable effects of cannabis were assessed by the participant rating their enjoyment of a piece of either milk (Marabou) or dark (Lindt 70%) chocolate, and a self-selected piece of music, on a visual analogue scale (VAS), ranging from −5 to +5 on a 100 mm line. The centre of the line (indicated by 0) indicates that ... | PMC10156730 | ||
Statistical analysis | psychotic-like reactions | According to our power calculation, at 80% power and Bonferroni adjusted alpha <0.008, a sample size of The effect of THC was determined by comparing outcome scores from the baseline visit with those following administration with THC alone (0:1) using paired t-tests. For the primary analysis, we used linear mixed model... | PMC10156730 | |
Results | PMC10156730 | |||
Participants and demographics | 80 potential participants were screened from which 64 were randomised and 46 completed the study (Fig. Study flow diagram.Demographics and cannabis use at baseline. | PMC10156730 | ||
Pharmacokinetics | There were no significant differences in either peak plasma THC, OH-THC or COOH-THC, or their respective AUCs between the CBD:THC ratios ( | PMC10156730 | ||
Blood plasma THC and CBD concentrations over time and across CBD:THC ratio. | Plasma concentrations of | PMC10156730 | ||
Cognitive effects | PMC10156730 | |||
Hopkins verbal learning task | When the 0:1 condition (THC only) was compared to baseline, there were impairments in both immediate (t(45) = 5.580, | PMC10156730 | ||
Digit span | There was significant impairment in the 0:1 condition compared to baseline in forward digit span (t(45) = 3.309, | PMC10156730 | ||
Spatial N-Back | There were no significant differences between baseline and 0:1, or between CBD:THC ratios ( | PMC10156730 | ||
Psychological effects | PMC10156730 | |||
PANSS positive subscale | There was a significant increase in PANSS positive score between baseline and 0:1 (t(45) = −4.709, | PMC10156730 | ||
SSPS | There were no significant differences in SSPS scores between baseline and 0:1, between CBD:THC ratios (t(45) = −1.096, | PMC10156730 | ||
CAPE | There was a significant increase in total CAPE score between baseline and 0:1 (t(45) = −4.088, | PMC10156730 | ||
PSI | There was a significant increase in total PSI score between baseline and 0:1 (t(39) = −7.461, | PMC10156730 | ||
VAS | There were no significant differences in subjective effects between CBD:THC ratios in terms of either VAS AUC or peak VAS ratings ( | PMC10156730 | ||
Pleasurable responses | All CBD:THC ratios increased scores for both chocolate and music compared to baseline, but there were no significant differences between the CBD:THC ratios ( | PMC10156730 | ||
Physiological effects | PMC10156730 | |||
Blood pressure | There were no significant differences in systolic (t(44) = −1.19, | PMC10156730 | ||
Heart rate | There was a significant increase in heart rate in the 0:1 condition compared to baseline (t(44) = −9.35, | PMC10156730 | ||
Body temperature | APPENDIX | There were no significant differences in body temperature between any of the conditions (Appendix | PMC10156730 | |
Inhalation and coughing | APPENDIX | There was evidence of greater CBD:THC ratios increasing inhalation time and coughing in a dose responsive manner (Appendix | PMC10156730 | |
Order and sex effects | fatigue | APPENDIX | Adding order to the models did not have any impact on the significance or direction of pharmacokinetic, cognitive, psychological, subjective, pleasurable, or physiological effects. Restricting the analysis of the primary outcome to visit 1 found no differences across conditions, suggesting no evidence for significant p... | PMC10156730 |
Discussion | psychotic symptoms, cognitive impairments | Our main finding is that the co-administration of CBD with THC had no effect on the induction of either cognitive impairments or psychotic symptoms following cannabis use. Similarly, CBD did not influence the subjective (as measured by VAS) or the pleasurable effects (music and chocolate) of THC. This was true across t... | PMC10156730 | |
Conclusions | ADVERSE EFFECTS | At the doses typically present in recreational and medicinal cannabis, we found no evidence of CBD reducing the acute adverse effects of THC on cognition and mental health. Similarly, there was no evidence that it altered the subjective or pleasurable effects of THC. These results suggest that the CBD content in cannab... | PMC10156730 | |
Supplementary information | The online version contains supplementary material available at 10.1038/s41386-022-01478-z. | PMC10156730 | ||
Acknowledgements | BROWN | We would like to wholeheartedly thank all the participants who took part in this study, both the ones who completed as well as the ones who withdrew. We thank George Brown, John Villajin, Louisa Green, Asha Mathews, Chifundo Stubbs, Olabisi Awogbemila, Noah Yogo, Elka Giemza, Stephanie David, Adebukola Shopade, and Her... | PMC10156730 | |
Author contributions | AE, TF, RM and PMG conceptualised and designed the study, as well as provided continuous review and oversight of the running of the study along with PFP and JS. AE, DO, EC, LC, JW, SS and ADM recruited participants, collected, and interpreted data. JH set up the randomisation algorithm and contributed to the power anal... | PMC10156730 | ||
Funding | Maudsley | This study was fully funded by a Research Grant from the Medical Research Council UK (MR/P006841/1). The funder had no involvement in the design, data collection, analysis, interpretation, write up or the decision of where to publish. AE, LC, JH, RMM, and JS are part-funded or supported by the National Institute for He... | PMC10156730 | |
Competing interests | AE has received speakers’ honoraria from GW Pharmaceuticals. RMM has received speakers’ honoraria from Lundbeck, Sunovian, Otsuka, and Janssen. JS has undertaken research supported financially by various pharmaceutical companies, but this has not involved studies of cannabis or cannabis-related products. All remaining ... | PMC10156730 | ||
References | PMC10156730 | |||
Key Points | PMC10369925 | |||
Question | lung cancer, tumor | LUNG CANCER, TUMOR | Can we improve time to treatment using circulating tumor DNA (ctDNA) genotyping before tissue diagnosis among patients with suspected advanced lung cancer? | PMC10369925 |
Findings | lung cancer, nonsquamous | LUNG CANCER, SMALL CELL LUNG CANCER | In this nonrandomized clinical trial, 150 patients with suspected advanced lung cancer underwent ctDNA testing during initial diagnostic workup; 90 patients had tissue confirmation of advanced nonsquamous non–small cell lung cancer. Median time to treatment was 39 days vs 62 days for a reference cohort, with faster tur... | PMC10369925 |
Meaning | lung cancer | LUNG CANCER | The use of plasma ctDNA testing before tissue diagnosis among patients with suspected advanced lung cancer may expedite biomarker testing and accelerate time to treatment. | PMC10369925 |
Importance | NSCLC, tumor | SMALL CELL LUNG CANCER, TUMOR, NSCLC | Liquid biopsy has emerged as a complement to tumor tissue profiling for advanced non–small cell lung cancer (NSCLC). The optimal way to integrate liquid biopsy into the diagnostic algorithm for patients with newly diagnosed advanced NSCLC remains unclear. | PMC10369925 |
Objective | NSCLC, tumor | TUMOR, NSCLC | To evaluate the use of circulating tumor DNA (ctDNA) genotyping before tissue diagnosis among patients with suspected advanced NSCLC and its association with time to treatment. | PMC10369925 |
Design, Setting, and Participants | lung cancer, Cancer | LUNG CANCER, CANCER | This single-group nonrandomized clinical trial was conducted among 150 patients at the Princess Margaret Cancer Centre–University Health Network (Toronto, Ontario, Canada) between July 1, 2021, and November 30, 2022. Patients referred for investigation and diagnosis of lung cancer were eligible if they had radiologic e... | PMC10369925 |
Interventions | lung cancer | LUNG CANCER | Patients underwent plasma ctDNA testing with a next-generation sequencing (NGS) assay before lung cancer diagnosis. Diagnostic biopsy and tissue NGS were performed per standard of care. | PMC10369925 |
Main Outcome and Measures | Accelerating Lung Cancer, nonsquamous NSCLC | The primary end point was time from referral to treatment initiation among patients with advanced nonsquamous NSCLC using ctDNA testing before diagnosis (ACCELERATE [Accelerating Lung Cancer Diagnosis Through Liquid Biopsy] cohort). This cohort was compared with a reference cohort using standard tissue genotyping after... | PMC10369925 | |
Results | nonsquamous NSCLC | Of the 150 patients (median age at diagnosis, 68 years [range, 33-91 years]; 80 men [53%]) enrolled, 90 (60%) had advanced nonsquamous NSCLC. The median time to treatment was 39 days (IQR, 27-52 days) for the ACCELERATE cohort vs 62 days (IQR, 44-82 days) for the reference cohort ( | PMC10369925 | |
Conclusions and Relevance | NSCLC | NSCLC | This nonrandomized clinical trial found that the use of plasma ctDNA genotyping before tissue diagnosis among patients with suspected advanced NSCLC was associated with accelerated time to treatment compared with a reference cohort undergoing standard tissue testing. | PMC10369925 |
Trial Registration | tumor | SMALL CELL LUNG CANCER, TUMOR | ClinicalTrials.gov Identifier: This nonrandomized clinical trial evaluates the use of circulating tumor DNA genotyping before tissue diagnosis among patients with suspected advanced non–small cell lung cancer and its association with time to treatment. | PMC10369925 |
Introduction | NSCLC, tumor | SMALL CELL LUNG CANCER, TUMOR, NSCLC | Clinical management of newly diagnosed non–small cell lung cancer (NSCLC) requires knowledge of tumor molecular alterations to guide treatment decisions.Liquid biopsies are minimally invasive blood tests that identify circulating tumor DNA (ctDNA) in patients’ plasma. | PMC10369925 |
Methods | Cancer, Lung Cancer | CANCER, LUNG CANCER | The ACCELERATE (Accelerating Lung Cancer Diagnosis Through Liquid Biopsy) study is a prospective, single-group, minimally invasive nonrandomized clinical trial conducted at the Princess Margaret Cancer Centre–University Health Network (UHN), Toronto, Ontario, Canada. Conduct of this study was approved by the institutio... | PMC10369925 |
Patients | NSCLC, cancer, lung cancer, unresectable stage III or IV lung cancer, pleural effusions, MCC, malignant disease | LUNG, CANCER, DISEASE, MCC, LUNG CANCER, PLEURAL EFFUSIONS, NSCLC, MALIGNANT DISEASE | Between July 1, 2021, and November 30, 2022, 150 patients were enrolled in the ACCELERATE cohort. Patients referred to the UHN Lung Rapid Assessment and Management Program (LungRAMP) were eligible to participate if they had (1) radiologic evidence of unresectable stage III or IV lung cancer; (2) measurable disease with... | PMC10369925 |
Study Procedures | After eligibility confirmation, patients were invited to participate in the study ( | PMC10369925 | ||
Plasma ctDNA Testing | Plasma ctDNA testing was performed using InVisionFirst-Lung, a highly sensitive and specific NGS assay targeting 37 genes that has been prospectively validated and demonstrates high concordance with tissue results and high sensitivity and specificity for variants, single-nucleotide variants, fusions, and copy number al... | PMC10369925 | ||
Tumor Tissue Molecular Testing | tumor, Trusight Tumor | TUMOR | Reflex molecular testing of tumor tissue was performed per institutional standard of care, including comprehensive NGS (Oncomine Comprehensive Assay, version 3; Thermo Fisher Scientific) (eFigure 1 in For patients in the reference cohort, reflex testing using an NGS assay targeting 15 genes (Trusight Tumor 15 Panel, Il... | PMC10369925 |
Study End Points | nonsquamous NSCLC, tumor | ONCOLOGY, TUMOR | The primary end point was time to treatment, defined as the time from diagnostic program referral to systemic treatment initiation for patients with advanced nonsquamous NSCLC enrolled in the ACCELERATE cohort using ctDNA genotyping prior to pathologic diagnosis compared with a reference cohort of consecutive patients ... | PMC10369925 |
Reference Cohort | lung cancer, NSCLC, Cancer | LUNG CANCER, NSCLC, CANCER | The LungRAMP program maintains a prospective database of all patients referred for investigation of suspected lung cancer. A reference cohort of 89 patients with advanced NSCLC diagnosed through LungRAMP and treated at the Princess Margaret Cancer Centre prior to the COVID-19 pandemic (2018-2019) was identified. Demogr... | PMC10369925 |
Statistical Analysis | nonsquamous NSCLC | Patient characteristics and molecular data are summarized using median, IQR, frequency, and percentage. The nonparametric Wilcoxon-Mann-Whitney test was used to compare time to treatment for patients with advanced nonsquamous NSCLC enrolled in the ACCELERATE cohort and the reference cohort. The Wilcoxon signed rank tes... | PMC10369925 | |
Results | Between July 1, 2021, and November 30, 2022, 150 patients (median age at diagnosis, 68 years [range, 33-91 years]; 80 men [53%] and 70 women [47%]; and 61 patients [41%] were never smokers) were enrolled in the ACCELERATE cohort ( | PMC10369925 | ||
Baseline Characteristics and Histologic Diagnoses and Stage in the ACCELERATE and Reference Groups | NSCLC, pleural effusion, death, melanoma, liver lesion, plasmacytoma, lung cancer, Hodgkin lymphoma, Lung Cancer | PLEURAL EFFUSION, MELANOMA, UTERINE LEIOMYOSARCOMA, PROSTATE, MESOTHELIOMA, ONCOLOGY, ENDOMETRIAL ADENOCARCINOMA, PLASMACYTOMA, SMALL CELL LUNG CANCER, HODGKIN LYMPHOMA, BONE LESION, LUNG, CARCINOMA OF UNKNOWN PRIMARY, LUNG CANCER, BONE ISLAND, METASTASES, LUNG CANCER, GASTROINTESTINAL NEUROENDOCRINE CARCINOMA, NSCLC, ... | ACCELERATE, Accelerating Lung Cancer Diagnosis Through Liquid Biopsy; ECOG, Eastern Cooperative Oncology Group; NA, not applicable; NOS, not otherwise specified; NSCLC, non–small cell lung cancer.Not documented in the ACCELERATE cohort: ethnicity (n = 24). ECOG performance status and ethnicity were not systematically c... | PMC10369925 |
Tissue Diagnosis | NSCLC, pleural effusion, nonsquamous, squamous carcinoma | PLEURAL EFFUSION, ATYPICAL CARCINOID TUMOR, DISEASE, NSCLC, SQUAMOUS CARCINOMA | Biopsy-proven NSCLC was demonstrated in 107 patients (71%), although 3 patients were later found to have early-stage disease and underwent surgical resection (benign pleural effusion and bone and liver lesions). Of 104 patients with advanced NSCLC, 90 patients had nonsquamous histologic characteristics, 2 had atypical ... | PMC10369925 |
NGS Testing in Plasma and Tissue | cancer | CANCER | All participants underwent plasma testing; 115 (77%) had tumor-associated variants detected (Among the 18 patients with other cancer diagnoses, 7 did not have detectable cfDNA in plasma, but 3 had potentially informative results based on cancer type (eTable 3 in Combining plasma and tissue results, 53 of 90 patients (5... | PMC10369925 |
Time to Treatment | nonsquamous NSCLC | Most patients (72 of 90 [80%]) started systemic therapy for advanced nonsquamous NSCLC. Median time to treatment was 39 days (IQR, 27-52 days) for the ACCELERATE cohort compared with 62 days (IQR, 44-82 days) for the reference cohort ( | PMC10369925 | |
NGS Turnaround Time and Wait Times | In the ACCELERATE cohort, the median turnaround time for plasma testing from blood draw to result reporting was 7 days (IQR, 6-9 days) vs 23 days (IQR, 18-28 days) for tissue NGS, measured from tissue biopsy to reporting (In the reference cohort, referred before the COVID-19 pandemic ( | PMC10369925 | ||
Discussion | NSCLC, cancer, nonsquamous NSCLC, lung cancer | LUNG CANCER, CANCER, NSCLC | In our study, plasma ctDNA testing before diagnosis in the initial diagnostic workup of patients with suspected advanced NSCLC was associated with shorter time to molecular results than tissue testing and shorter median time to treatment compared with a reference cohort using tissue molecular testing only (39 vs 62 day... | PMC10369925 |
Limitations | lung cancer, cancers, NSCLC | LUNG CANCER, CANCERS, MALIGNANT NEOPLASMS, NSCLC | Our study has limitations, including its single-group prospective design and the fact that it was conducted at a single institution. Despite expert selection of patients with radiologic evidence of advanced lung cancer by a multidisciplinary team, only 70% of patients had biopsy-proven advanced NSCLC, while 30% had oth... | PMC10369925 |
Conclusions | lung cancer, NSCLC | LUNG CANCER, NSCLC | In this nonrandomized clinical trial, the use of liquid biopsy before lung cancer diagnosis in the initial diagnostic workup of patients with suspected advanced NSCLC was associated with shortened time to treatment and molecular results and yielded a higher rate of detection of actionable alterations. Complementing sta... | PMC10369925 |
Subject terms | proarrhythmia | ADVERSE EFFECTS, ATRIAL FIBRILLATION (AF) | Existing antiarrhythmic drugs to treat atrial fibrillation (AF) have incomplete efficacy, contraindications and adverse effects, including proarrhythmia. AP30663, an inhibitor of the KIn a phase 2 clinical trial, an inhibitor of the K | PMC10803288 |
Main | stroke, heart failure, cardiac arrhythmia | STROKE, HEART FAILURE, ATRIAL FIBRILLATION (AF), CARDIAC ARRHYTHMIA | Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with reduced quality of life and increased risk of stroke, heart failure and deathThe KThe AF efficacy of K | PMC10803288 |
Results | PMC10803288 |
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