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Lamberg, Kristina
Alternative names
Publications (10 of 15) Show all publications
Löfling, L., Karimi, A., Sandin, F., Bahmanyar, S., Kieler, H., Lambe, M., . . . Wagenius, G. (2019). Clinical characteristics and survival in non-small cell lung cancer patients by smoking history: a population-based cohort study. Acta Oncologica, 58(11), 1618-1627
Open this publication in new window or tab >>Clinical characteristics and survival in non-small cell lung cancer patients by smoking history: a population-based cohort study
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2019 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 58, no 11, p. 1618-1627Article in journal (Refereed) Published
Abstract [en]

Introduction: Approximately, 10–15% of lung cancer patients have never smoked. Previous epidemiological studies on non-tobacco associated lung cancer have been hampered by selected data from a small number of hospitals or limited numbers of patients. By use of data from large population-based registers with national coverage, this study aims to compare characteristics and survival of patients with non-small cell lung cancer (NSCLC) with different smoking histories.

Methods: Swedish national population-based registers were used to retrieve data on patients diagnosed with primary NSCLC between 2002 and 2016. The Kaplan–Meier method and Cox proportional hazard models were used to estimate overall survival and lung cancer-specific survival by smoking history.

Results: In total, 41,262 patients with NSCLC were included. Of those, 4624 (11%) had never smoked. Never-smokers were more often women and older compared to ever smokers (current and former). Adenocarcinoma was proportionally more common in never-smokers (77%) compared to current (52%) and former smokers (57%). Stage IV disease was more common in never-smokers (57%) than in current (48%) and former smokers (48%). Epidermal growth factor receptor mutation was observed more in never-smokers (37%) compared to current (5%) and former smokers (9%). Both lung cancer-specific and overall survival were higher for never-smokers compared to current smokers.

Conclusions: The observed differences in characteristics between never-smokers and smokers, and the higher survival in never-smokers compared to smokers from this large population-based study provide further evidence that lung cancer in never-smokers is clinically different to tobacco-associated lung cancer. The findings from this study emphasise the need for an improved understanding of genetics, pathogenesis, mechanisms and progression of non-tobacco associated lung cancer that may help prevent lung cancer or identify individually targeted treatments.

National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-398835 (URN)10.1080/0284186X.2019.1638521 (DOI)000479930200001 ()31373239 (PubMedID)
Funder
Swedish Cancer Society, 15-0804Swedish Cancer Society, 18-0687
Available from: 2019-12-12 Created: 2019-12-12 Last updated: 2019-12-12Bibliographically approved
Salomonsson, A., Patthey, A., Reutersward, C., Jonsson, M., Botling, J., Brunnstrom, H., . . . Planck, M. (2018). A Nation-Wide Population-Based Mapping of Targetable Alterations in Smoking-Independent Lung Cancer. Paper presented at IASLC 19th World Conference on Lung Cancer. Journal of Thoracic Oncology, 13(10), S431-S432
Open this publication in new window or tab >>A Nation-Wide Population-Based Mapping of Targetable Alterations in Smoking-Independent Lung Cancer
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2018 (English)In: Journal of Thoracic Oncology, ISSN 1556-0864, E-ISSN 1556-1380, Vol. 13, no 10, p. S431-S432Article in journal, Meeting abstract (Other academic) Published
Keywords
population-based, never-smoker, gene fusion
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-373922 (URN)10.1016/j.jtho.2018.08.497 (DOI)000454014501133 ()
Conference
IASLC 19th World Conference on Lung Cancer
Available from: 2019-01-17 Created: 2019-01-17 Last updated: 2019-01-17Bibliographically approved
Gulyas, M., Mattsson, J. S., Lindgren, A., Ek, L., Lamberg Lundström, K., Behndig, A., . . . Bergman, B. (2018). COX-2 expression and effects of celecoxib in addition to standard chemotherapy in advanced non-small cell lung cancer.. Acta Oncologica, 57(2), 244-250
Open this publication in new window or tab >>COX-2 expression and effects of celecoxib in addition to standard chemotherapy in advanced non-small cell lung cancer.
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2018 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 57, no 2, p. 244-250Article in journal (Refereed) Published
Abstract [en]

Aim: Inhibition of cyclooxygenase-2 (COX-2) is proposed as a treatment option in several cancer types. However, in non-small cell lung cancer (NSCLC), phase III trials have failed to demonstrate a benefit of adding COX-2 inhibitors to standard chemotherapy. The aim of this study was to analyze COX-2 expression in tumor and stromal cells as predictive biomarker for COX-2 inhibition.

Methods: In a multicenter phase III trial, 316 patients with advanced NSCLC were randomized to receive celecoxib (400 mg b.i.d.) or placebo up to one year in addition to a two-drug platinum-based chemotherapy combination. In a subset of 122 patients, archived tumor tissue was available for immunohistochemical analysis of COX-2 expression in tumor and stromal cells. For each compartment, COX-2 expression was graded as high or low, based on a product score of extension and intensity of positively stained cells.

Results: An updated analysis of all 316 patients included in the original trial, and of the 122 patients with available tumor tissue, showed no survival differences between the celecoxib and placebo arms (HR 1.01; 95% CI 0.81–1.27 and HR 1.12; 95% CI 0.78–1.61, respectively). High COX-2 scores in tumor (n = 71) or stromal cells (n = 55) was not associated with a superior survival outcome with celecoxib vs. placebo (HR =0.96, 95% CI 0.60–1.54; and HR =1.51; 95% CI 0.86–2.66), and no significant interaction effect between COX-2 score in tumor or stromal cells and celecoxib effect on survival was detected (p = .48 and .25, respectively).

Conclusions: In this subgroup analysis of patients with advanced NSCLC treated within the context of a randomized trial, we could not detect any interaction effect of COX-2 expression in tumor or stromal cells and the outcome of celecoxib treatment in addition to standard chemotherapy.

National Category
Clinical Medicine Cancer and Oncology Clinical Laboratory Medicine
Research subject
Pathology
Identifiers
urn:nbn:se:uu:diva-343645 (URN)10.1080/0284186X.2017.1400685 (DOI)000423473200011 ()29140138 (PubMedID)
Funder
Swedish Cancer Society
Available from: 2018-02-28 Created: 2018-02-28 Last updated: 2019-04-02Bibliographically approved
Isaksson, J., Willen, L., La Fleur, L., Mindus, S., Sundström, M., Branden, E., . . . Botling, J. (2017). Establishing Reflex NGS Testing in NSCLC in a Regional Network of County Hospitals in Central Sweden. Journal of Thoracic Oncology, 12(1), S499-S500
Open this publication in new window or tab >>Establishing Reflex NGS Testing in NSCLC in a Regional Network of County Hospitals in Central Sweden
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2017 (English)In: Journal of Thoracic Oncology, ISSN 1556-0864, E-ISSN 1556-1380, Vol. 12, no 1, p. S499-S500Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
FFPE, next generation sequencing, NSCLC
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-377744 (URN)10.1016/j.jtho.2016.11.605 (DOI)000413055801108 ()
Available from: 2019-02-26 Created: 2019-02-26 Last updated: 2019-02-26Bibliographically approved
La Fleur, L., Falk-Sörqvist, E., Smeds, P., Sundström, M., Mattsson, J. S., Brandén, E., . . . Botling, J. (2017). Mutation Profiling by Targeted Next Generation Sequencing of an Unselected NSCLC Cohort. Journal of Thoracic Oncology, 12(1), S526-S527
Open this publication in new window or tab >>Mutation Profiling by Targeted Next Generation Sequencing of an Unselected NSCLC Cohort
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2017 (English)In: Journal of Thoracic Oncology, ISSN 1556-0864, E-ISSN 1556-1380, Vol. 12, no 1, p. S526-S527Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
Targeted resequencing, Consecutive cohort, NSCLC
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-377745 (URN)10.1016/j.jtho.2016.11.647 (DOI)000413055801149 ()
Available from: 2019-02-26 Created: 2019-02-26 Last updated: 2019-02-26Bibliographically approved
Svensson, T., Lundström, K. L., Höglund, M. & Cherif, H. (2017). Utility of bronchoalveolar lavage in diagnosing respiratory tract infections in patients with hematological malignancies: are invasive diagnostics still needed?. Upsala Journal of Medical Sciences, 122(1), 56-60
Open this publication in new window or tab >>Utility of bronchoalveolar lavage in diagnosing respiratory tract infections in patients with hematological malignancies: are invasive diagnostics still needed?
2017 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 122, no 1, p. 56-60Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Patients treated for hematological malignancies have an increased risk of serious infections. Diagnosis and prompt initiation of therapy are essential. Bronchoalveolar lavage (BAL) is a well-established investigation for identifying the cause of pulmonary infiltrates in immunocompromised patients. The aim of the study was to determine the diagnostic yield of BAL in patients treated for hematological malignancies and how often it contributed to a modification of the anti-infectious therapy.

METHODS: We reviewed records from 151 consecutive BAL procedures in 133 adult patients with hematological malignancies, treated at a tertiary hematology unit from 2004 to 2013. Extensive microbiological work-ups on BAL samples had been performed according to a standardized protocol.

RESULTS: A microbiological finding causing the infectious episode could be identified in 59 (39%) cases. In 44 (29%) of the cases, results from BAL had an impact on clinical management either by contributing to a specific diagnosis (25%) or by leading to cessation of ongoing microbiological therapy. The most common diagnoses were invasive pulmonary aspergillosis (IPA) and Pneumocystis jirovecii pneumonia (PJP). Diagnoses of IPA and PJP were based on results from BAL in 65% and 93% of cases, respectively. Several microbiological tests on BAL samples rendered no positive results. Complications were few and mainly mild.

CONCLUSION: BAL is still important for either verifying or excluding some of the most important respiratory tract pathogens in patients with hematological malignancies, particularly IPA and PJP. Standardized procedures for BAL sampling should be continually revised to exclude unnecessary microbiological tests.

Keywords
Aspergillosis, bronchoalveolar lavage, hematological malignancies, immunodeficiency, invasive fungal disease, neutropenia, Pneumocystis jirovecii pneumonia, pulmonary infiltrates
National Category
General Practice Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-310816 (URN)10.1080/03009734.2016.1237595 (DOI)000396476600008 ()27739337 (PubMedID)
Available from: 2016-12-20 Created: 2016-12-20 Last updated: 2018-02-26Bibliographically approved
Holgersson, G., Bergström, S., Harmenberg, J., Ringbom, M., Klockare, M., Jerling, M., . . . Bergqvist, M. (2015). A phase I pilot study of the insulin-like growth factor 1 receptor pathway modulator AXL1717 in combination with gemcitabine HCl and carboplatin in previously untreated, locally advanced, or metastatic non-small cell lung cancer. Medical Oncology, 32(4), Article ID 129.
Open this publication in new window or tab >>A phase I pilot study of the insulin-like growth factor 1 receptor pathway modulator AXL1717 in combination with gemcitabine HCl and carboplatin in previously untreated, locally advanced, or metastatic non-small cell lung cancer
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2015 (English)In: Medical Oncology, ISSN 1357-0560, E-ISSN 1559-131X, Vol. 32, no 4, article id 129Article in journal (Refereed) Published
Abstract [en]

AXL1717 is an orally bioavailable IGF-1R pathway modulator that has been shown to have anti-tumoral effects. The objectives of the present study were to define maximum tolerated dose and the recommended phase II dose (RPTD) of AXL1717 in combination with gemcitabine HCl and carboplatin in non-small cell lung cancer (NSCLC). Patients with previously untreated, locally advanced, or metastatic NSCLC (squamous cell cancer or adenocarcinoma) in good performance status and with preserved major organ functions were enrolled in the study. The study was an open-label phase I study with planned cohorts of three patients per dose level of AXL1717 (215, 290, and 390 mg BID). In total, 12 patients were enrolled in the study, and of these, two were prematurely excluded. AXL1717 was administered at one dose level, 215 mg BID. A total number of 81 unique adverse events were reported. Bone marrow toxicity was reported in 10 out of 12 patients, and this organ class showed the largest number of related events. AXL1717 in combination with gemcitabine HCl and carboplatin is a possible treatment approach in previously untreated, locally advanced, or metastatic non-small cell lung cancer. However, due to the bone marrow toxicity profile shown in the present study, further dose increases of AXL1717 above 215 mg BID will probably not be feasible. Therefore, 215 mg BID constitutes maximum tolerated dose and RPTD.

Keywords
Phase I, IGF-1, AXL1717, Chemotherapy, NSCLC
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-258837 (URN)10.1007/s12032-015-0578-y (DOI)000351474100043 ()25794491 (PubMedID)
Available from: 2015-07-23 Created: 2015-07-20 Last updated: 2018-02-26Bibliographically approved
Gulyas, M., Mattsson, J. S. M., Lindgren, A., Sederholm, C., Ek, L., Lamberg, K., . . . Bergman, B. (2015). COX-2 Expression Does Not Predict Outcome of Celecoxib in Addition to Standard Chemotherapy in Advanced Non-Small Cell Lung Cancer. Journal of Thoracic Oncology, 10(9), S541-S542
Open this publication in new window or tab >>COX-2 Expression Does Not Predict Outcome of Celecoxib in Addition to Standard Chemotherapy in Advanced Non-Small Cell Lung Cancer
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2015 (English)In: Journal of Thoracic Oncology, ISSN 1556-0864, E-ISSN 1556-1380, Vol. 10, no 9, p. S541-S542Article in journal, Meeting abstract (Other academic) Published
Keywords
non-small cell lung cancer, COX-2 expression, chemotherapy, celecoxib
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-298971 (URN)000370365102459 ()
Available from: 2016-07-13 Created: 2016-07-12 Last updated: 2018-02-01Bibliographically approved
Sörenson, S., Fohlin, H., Lindgren, A., Lindskog, M., Bergman, B., Sederholm, C., . . . Clinchy, B. (2013). Predictive role of plasma vascular endothelial growth factor for the effect of celecoxib in advanced non-small cell lung cancer treated with chemotherapy. European Journal of Cancer, 49(1), 115-120
Open this publication in new window or tab >>Predictive role of plasma vascular endothelial growth factor for the effect of celecoxib in advanced non-small cell lung cancer treated with chemotherapy
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2013 (English)In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 49, no 1, p. 115-120Article in journal (Refereed) Published
Abstract [en]

Aim of the study:

The primary purpose of this study is to investigate if pretreatment plasma levels of vascular endothelial growth factor (VEGF) are predictive of the effect of celecoxib on survival in advanced non-small cell lung cancer (NSCLC) treated with palliative chemotherapy. A secondary objective is to describe the course of plasma VEGF levels during and after treatment with cytotoxic chemotherapy combined with celecoxib or placebo.

Methods:

In a previously published double-blind multicenter phase III trial, 316 patients with NSCLC stage IIIB or IV and World Health Organisation (WHO) performance status 0-2 were randomised to receive celecoxib 400 mg b.i.d. or placebo in combination with two-drug platinum-based chemotherapy. Chemotherapy cycle length was three weeks and planned duration of chemotherapy was four cycles. Celecoxib was given for a maximum of one year but was stopped earlier in case of disease progression or prohibitive toxicity. In a subset of patients, plasma VEGF levels were examined at onset of treatment and at 6, 12 and 20 weeks.

Results:

VEGF levels at start of treatment were obtained in 107 patients at four study sites. The median value was 70 pg/ml. Mean values declined during the first 12 weeks and then increased at 20 weeks. A subpopulation treatment effect pattern plot (STEPP) analysis showed an inverse relationship between initial plasma VEGF and the impact of celecoxib on survival with zero effect at 200 pg/ml. The effect on survival by celecoxib in the whole subset of patients was positive (hazard ratio (HR) = 0.64 [confidence interval (CI) 0.43-0.95], p = 0.028).

Conclusion:

Low pretreatment plasma levels of VEGF appear to be predictive of a positive effect of celecoxib on survival.

Keywords
Celecoxib, Chemotherapy, Non-small cell lung cancer, Plasma VEGF, Survival
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-191988 (URN)10.1016/j.ejca.2012.07.032 (DOI)000312896700015 ()
Available from: 2013-01-24 Created: 2013-01-15 Last updated: 2017-12-06Bibliographically approved
Edlund, K., Lindskog, C., Saito, A., Berglund, A., Pontén, F., Göransson-Kultima, H., . . . Micke, P. (2012). CD99 is a novel prognostic stromal marker in non-small cell lung cancer. International Journal of Cancer, 131(10), 2264-2273
Open this publication in new window or tab >>CD99 is a novel prognostic stromal marker in non-small cell lung cancer
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2012 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 131, no 10, p. 2264-2273Article in journal (Refereed) Published
Abstract [en]

The complex interaction between cancer cells and the microenvironment plays an essential role in all stages of tumourigenesis. Despite the significance of this interplay, alterations in protein composition underlying tumour-stroma interactions are largely unknown. The aim of this study was to identify stromal proteins with clinical relevance in non-small cell lung cancer (NSCLC). A list encompassing 203 stromal candidate genes was compiled based on gene expression array data and available literature. The protein expression of these genes in human NSCLC was screened using the Human Protein Atlas. Twelve proteins were selected that showed a differential stromal staining pattern (BGN, CD99, DCN, EMILIN1, FBN1, PDGFRB, PDLIM5, POSTN, SPARC, TAGLN, TNC, VCAN). The corresponding antibodies were applied on tissue microarrays, including 190 NSCLC samples, and stromal staining was correlated with clinical parameters. Higher stromal expression of CD99 was associated with better prognosis in the univariate (p=0.037) and multivariate (p=0.039) analysis. The association was independent from the proportion of tumour stroma, the fraction of inflammatory cells, and clinical and pathological parameters like stage, performance status and tumour histology. The prognostic impact of stromal CD99 protein expression was confirmed in an independent cohort of 240 NSCLC patients (p=0.008). Furthermore, double-staining confocal fluorescence microscopy showed that CD99 was expressed in stromal lymphocytes as well as in cancer associated fibroblasts. Based on a comprehensive screening strategy the membrane protein CD99 was identified as a novel stromal factor with clinical relevance. The results support the concept that stromal properties have an important impact on tumour progression.

National Category
Clinical Laboratory Medicine
Research subject
Pathology
Identifiers
urn:nbn:se:uu:diva-170991 (URN)10.1002/ijc.27518 (DOI)000309185300007 ()22392539 (PubMedID)
Note

Karolina Edlund and Cecilia Lindskog are shared first authors.

Available from: 2012-03-14 Created: 2012-03-14 Last updated: 2018-02-01
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