Neoadjuvant nivolumab with or without relatlimab in resectable non-small-cell lung cancer: a randomized phase 2 trial.

Antibodies targeting the immune checkpoint molecules PD-1, PD-L1 and CTLA-4, administered alone or in combination with chemotherapy, are the standard of care in most patients with metastatic non-small-cell lung cancers. When given before curative surgery, tumor responses and improved event-free survival are achieved. New antibody combinations may be more efficacious and tolerable. In an ongoing, open-label phase 2 study, 60 biomarker-unselected, treatment-naive patients with resectable non-small-cell lung cancer were randomized to receive two preoperative doses of nivolumab (anti-PD-1) with or without relatlimab (anti-LAG-3) antibody therapy. The primary study endpoint was the feasibility of surgery within 43 days, which was met by all patients. Curative resection was achieved in 95% of patients. Secondary endpoints included pathological and radiographic response rates, pathologically complete resection rates, disease-free and overall survival rates, and safety. Major pathological (≤10% viable tumor cells) and objective radiographic responses were achieved in 27% and 10% (nivolumab) and in 30% and 27% (nivolumab and relatlimab) of patients, respectively. In 100% (nivolumab) and 90% (nivolumab and relatlimab) of patients, tumors and lymph nodes were pathologically completely resected. With 12 months median duration of follow-up, disease-free survival and overall survival rates at 12 months were 89% and 93% (nivolumab), and 93% and 100% (nivolumab and relatlimab). Both treatments were safe with grade ≥3 treatment-emergent adverse events reported in 10% and 13% of patients per study arm. Exploratory analyses provided insights into biological processes triggered by preoperative immunotherapy. This study establishes the feasibility and safety of dual targeting of PD-1 and LAG-3 before lung cancer surgery.ClinicalTrials.gov Indentifier: NCT04205552 .

Amyloidoma of the chest wall: a rare entity.

Amyloidoma (tumoral amyloidosis) is defined as a solitary localized tumor-like deposit of amyloid, in the absence of systemic amyloidosis. Amyloidoma is the least common presentation of tissue amyloid deposition, reported in many anatomic sites including the respiratory, genitourinary and gastrointestinal tracts, as well as the central nervous system, skin, breast and soft tissue. Amyloidoma of the chest wall is extremely rare, and to date only one case has been reported in literature. The authors present a case of a chest wall tumor that causes local destruction, being an amyloidoma on histopathologic examination. It was treated with wide local excision, with no recurrence during almost two years of follow-up. A search for occult systemic disease is recommended and was also performed.

Echocardiography remains the standard for the diagnostic evaluation of left ventricular tumors: a case report with anatomical correlation.

Primary cardiac tumors are rare. Although the majority are benign, they may cause significant morbidity and mortality. Two-dimensional transthoracic echocardiography (2D-TTE) is the primary imaging modality for the diagnosis of cardiac tumors. New and more complex non-invasive imaging modalities, such as cardiac magnetic resonance (CMR), do not always provide an added value. This is illustrated in the presented case report of a papillary fibroelastoma (PFE).