OBJECTIVES: To evaluate the molecular testing and treatment patterns in a retrospective cohort of newly diagnosed treatment-naïve patients with locally advanced or metastatic non-small-cell lung cancer (NSCLC). METHODS: This is an observational retrospective cohort study conducted across 10 cancer centers in Brazil. Treatment-naïve patients with locally advanced or metastatic NSCLC were enrolled from January to December 2014. The following data were collected from the medical records of patients from diagnosis until the last record (death, loss to follow-up, or the end of the maximum follow-up period): demographics; medical history; smoking status; disease characteristics; previous treatments; and molecular testing patterns and results. The overall survival (OS) was also estimated. Results: A total of 391 patients from 8 different Brazilian states were included, with a median age of 64.1 years (23.7-98.7), with most patients being males (60.1%). The smoking status of 74.2% of patients was a ‘former’ or ‘current smoker’. Stage IV NSCLC at diagnosis was observed in 82.4% of patients, with 269 of them (68.8%) presenting adenocarcinoma (ADC). Among the stage IV ADC patients, 54.0% were referred for molecular testing. Among the patients with an available epidermal growth factor receptor (EGFR) mutation status, 31 (24.0%) were EGFR-positive. The first-line treatment was a platinum-based chemotherapy for 98 patients (25.1%), while non-platinum-based regimens were used in 54 patients (13.8%). OS data were available for 370 patients, with a median OS of 10.8 months. Never smokers had a significantly higher median OS versus current or former smokers (14.6 versus 9.1 months; log-rank p=0.003). Among the patients for whom molecular testing data were available, those with EGFR-positive results had a longer median OS (34.6 versus 12.8 months; log-rank p=0.003). Conclusion: Our findings provide relevant information for prescribers and policy decision-makers by highlighting the unmet needs of patients and the importance of molecular testing in newly diagnosed locally advanced or metastatic lung adenocarcinoma. We also highlight the respective EGFR-tyrosine kinase inhibitor treatment when the result is positive and the areas in which further efforts are required to grant access to effective treatment.

"Adaptações neurais e morfológicas dos músculos vasto lateral e vasto medial para treinamento isocinético excêntrico." Vasto lateral (VL) e vasto medial (VM) são comumente visados em programas de condicionamento/reabilitação devido ao seu papel na estabilização patelar durante a extensão do joelho. Este estudo avaliou as adaptações neurais e musculares nesses dois músculos após um programa de treinamento excêntrico em dinamômetro isocinético. Vinte homens saudáveis foram submetidos a um período controle de quatro semanas seguido de um período de 12 semanas de treinamento excêntrico isocinético. Avaliações de ultrassom da espessura muscular do VL e VM em repouso e avaliações eletromiográficas durante testes isométricos máximos foram utilizadas para acessar as propriedades morfológicas e neurais, respectivamente. Não foram encontradas diferenças significativas no período controle para adaptações morfológicas e neurais, enquanto ambos os músculos mostraram incrementos significativos (VL = 6,9%; p < 0,001 e VM = 15,8%; p < 0,001) no pós-treino. Incrementos significativos na atividade muscular foram observados no VM (47,8%; p = 0,003), mas não no VL (19,8%; p > 0,05) no pós-treino. O treinamento excêntrico isocinético produziu adaptações neurais e maiores adaptações morfológicas no VM comparado ao VL, o que mostra que músculos sinergistas respondem de foram distinta a um programa de treinamento de força isocinético excêntrico.

Vastus lateralis (VL) and vastus medialis (VM) are frequently targeted in conditioning/rehabilitation programs due to their role in patellar stabilization during knee extension. This study assessed neural and muscular adaptations in these two muscles after an isokinetic eccentric training program. Twenty healthy men underwent a four-week control period followed by a 12-week period of isokinetic eccentric training. Ultrasound evaluations of VL and VM muscle thickness at rest and electromyographic evaluations during maximal isometric tests were used to assess the morphological and neural properties, respectively. No morphological and neural changes were found throughout the control period, whereas both muscles showed significant increases in thickness (VL = 6.9%; p < .001 and VM = 15.8%; p < .001) post-training. Significant increases in muscle activity were observed in VM (47.8%; p = .003), but not in VL (19.8%; p > .05) post-training. Isokinetic eccentric training produces neural and greater morphological adaptations in VM compared to VL, which shows that synergistic muscles respond differently to an eccentric isokinetic strength training program

"Adaptaciones neurales y morfológicas de los músculos vasto externo y vasto medial a entrenamiento isocinético excéntrico." Vasto lateral (VL) y vasto medial (VM) son señalados en los programas de acondicionamiento/rehabilitación debido a su papel en la estabilización de la rótula durante la extensión de la rodilla. Este estudio evaluó adaptaciones neurales y musculares en estos dos músculos después de un programa de entrenamiento excéntrico isocinético. Veinte hombres saludables fueron sometidos a un período de control de cuatro semanas, seguido de un período de 12 semanas de entrenamiento excéntrico isocinético. Se han usado las evaluaciones de ultrasonido de la espesor del músculo VL y VM en reposo y las evaluaciones electromiográficas durante las pruebas isométricas máximas para evaluar las propiedades morfológicas y neurales, respectivamente. No se observaron diferencias morfológicos y neurales significativas a lo del período de control, mientras que los dos músculos mostraron incrementos significativos en la espesor del músculo (VL = 6,9%, p < 0,001 y VM = 15,8%, p < 0,001) después de lo entrenamiento. Aumentos significativos en la actividad muscular se observaron en VM (47,8%, p = 0,003), pero no en VL (19,8 %, p > 0,05) después de lo entrenamiento. Entrenamiento excéntrico isocinético produce adaptaciones neurales y mayores adaptaciones morfológicas en VM en comparación con VL, lo que demuestra que los músculos sinérgicos responden de manera diferente a un programa de entrenamiento de fuerza isocinético excéntrico.