Rechallenge of immune checkpoint inhibitors in advanced non-small cell lung cancer

Gen Lin¹, Zhijie Wang², Qian Chu³, Yi Hu⁴, Dingzhi Huang⁵, Jun Wang⁶, Fan Yang⁷, Wenzhao Zhong⁸, Chengzhi Zhou⁹, Bo Zhu¹⁰, Xinghao Ai¹¹, Baoshan Cao¹², Yabing Cao¹³, Mingqiu Chen¹⁴, Xiaohui Chen¹⁵, Tianqing Chu¹⁶, Jianchun Duan², Yun Fan¹⁷, Yong Fang¹⁸, Shuitu Feng¹⁹, Weineng Feng²⁰, Hui Guo²¹, Chengbo Han²², Yong He²³, Shaodong Hong²⁴, Jie Hu²⁵, Meijuan Huang²⁶, Yan Huang²⁴, Da Jiang²⁷, Kan Jiang¹, Richeng Jiang⁵, Bo Jin²⁸, Shi Jin²⁹, Jisheng Li³⁰, Min Li³¹, Ziming Li¹¹, Chao Li³², Jie Lin³³, Anwen Liu³⁴, Si-Yang Maggie Liu³⁵, Liu Yutao², Zhefeng Liu⁴, Zhe Liu³⁶, Zhenhua Liu³⁷, Zhentian Liu³⁸, Zhigang Liu³⁹, Yuping Lu⁴⁰, Tangfeng Lv⁴¹, Zhiyong Ma⁴², Qian Miao¹, Min Peng⁴³, Xingxiang Pu⁴⁴, Xiu Bao Ren⁴⁵, Jianzhen Shan⁴⁶, Jinlu Shan⁴⁷, Peng Shen⁴⁸, Bo Shen⁴⁹, Meiqi Shi⁴⁹, Yong Song⁴¹, Zhengbo Song⁵⁰, ChunXia Su⁵¹, Jianguo Sun¹⁰, Panwen Tian⁵², Jinliang Wang⁴, Feng Wang¹⁵, Huijuan Wang⁴², Jialei Wang⁵³, Qian Wang⁵⁴, Wenxian Wang¹⁷, Yan Wang², Lin Wu⁴⁴, Fang Wu⁵⁵, Yang Xia⁵⁶, Congying Xie⁵⁷, Conghua Xie⁵⁸, Tao Xin⁵⁹, Jianping Xiong⁶⁰, Haipeng Xu¹, Song Xu⁶¹, Yiquan Xu¹, Bin Xu⁴³, Chunwei Xu⁴¹, Xiaolong Yan⁶², Zhenzhou Yang⁶³, Wenxiu Yao⁶⁴, Yao Yu²¹, Ye Feng⁶⁵, Zongyang Yu⁶⁶, Yongfeng Yu¹¹, Dongsheng Yue⁶⁷, Haibo Zhang⁶⁸, HongMei Zhang⁶⁹, Li Zhang³, Longfeng Zhang¹, Qiuyu Zhang⁷⁰, Tongmei Zhang³⁶, Bicheng Zhang⁴³, Jun Zhao⁷¹, Mingfang Zhao²⁸, Xiaobin Zheng¹, Qiaofeng Zhong¹, Jin Zhou⁶⁴, Penghui Zhou²⁴, Zhengfei Zhu⁷², Juntao Zou⁷³, Zihua Zou¹

Affiliations

¹ Department of Thoracic Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
² Department of Medical Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
³ Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁴ Senior Department of Oncology, Chinese PLA General Hospital, Beijing, China.
⁵ Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
⁶ Department of Oncology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Ji'nan, China.
⁷ Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China.
⁸ Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
⁹ Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
¹⁰ Institute of Cancer, Xinqiao Hospital, Army Medical University, Chongqing, China.
¹¹ Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
¹² Department of Medical Oncology and Radiation Sickness, Cancer Center, Peking University Third Hospital, Beijing, China.
¹³ Department of oncology, Kiang Wu Hospital, Macau, China.
¹⁴ Department of Thoracic Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
¹⁵ Department of Thoracic Surgery, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
¹⁶ Respiratory Department, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
¹⁷ Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
¹⁸ Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhenjiang University School of Medicine, Hangzhou, China.
¹⁹ Department of Medical Oncology, Fudan University Shanghai Cancer Center Xiamen Hospital, Xiamen, China.
²⁰ Department of Pulmonary Oncology, The First People's Hospital of Foshan, Foshan, China.
²¹ Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
²² Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China.
²³ Department of Respiratory Medicine, Xinqiao Hospital, Army Medical University, Chongqing, China.
²⁴ State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Guangzhou, China.
²⁵ Shanghai Geriatric Center, Zhongshan Hospital, Fudan University, Shanghai, China.
²⁶ Division of Thoracic Tumor Multimodality Treatment and Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
²⁷ Department of Oncology, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, China.
²⁸ Department of Medical Oncology, The First affiliated hospital of China Medical University, Shenyang, China.
²⁹ National Cancer Center/National Clinical Research Cencer for Cancer/Cancer Hospital &Shenzhen Hospital, Chinese Academy of Medical Sciences and Perking Union Medical College, Shenzhen, China.
³⁰ Department of Medical Oncology, Qilu Hospital of Shandong University, Ji'nan, China.
³¹ Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China.
³² Department of Pathology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
³³ Department of Medical Oncology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.
³⁴ Department of Medical Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
³⁵ Department of Hematology, First Affiliated Hospital, Ji'nan University, Guangzhou, China.
³⁶ Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing, China.
³⁷ Department of Oncology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China.
³⁸ Department of Thoracic Oncology, Jiangxi Cancer Hospital, Nanchang, China.
³⁹ Cancer Center, The 10th Affiliated Hospital of Southern Medical University, Dongguan, China.
⁴⁰ Department of Abdominal Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
⁴¹ Department of Respiratory Medicine, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
⁴² Department of Respiratory Medicine, Henan cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China.
⁴³ Cancer cenrter, Renmin Hospital of Wuhan University, Wuhan, China.
⁴⁴ Department of Thoracic Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
⁴⁵ Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
⁴⁶ Department of Medical Oncology, The First Affiliated Hospital of Zhejiang University, Zhejiang, China.
⁴⁷ Department of Medical Oncology, Daping Hospital, Army Medical University, Chongqing, China.
⁴⁸ Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
⁴⁹ Department of Medical Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research and Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China.
⁵⁰ Department of Clinical Trial, Zhejiang Cancer Hospital, Hangzhou, China.
⁵¹ Department of Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, China.
⁵² Precision Medicine Key Laboratory of Sichuan Province, Department of Pulmonary and Critical Care Medicine, Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
⁵³ Department of Thoracic Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
⁵⁴ Department of Respiratory Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China.
⁵⁵ Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China.
⁵⁶ Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
⁵⁷ Department of Radiation and Medical Oncology, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
⁵⁸ Department of Pulmonary Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China.
⁵⁹ Department of Oncology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
⁶⁰ Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China.
⁶¹ Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin, China.
⁶² Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, China.
⁶³ Department of Cancer Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
⁶⁴ Department of Medical Oncology, Sichuan Cancer Hospital, University of Electronic Science and Technology of China, Chengdu, China.
⁶⁵ Department of Medical Oncology, Xiamen Key Laboratory of Antitumor Drug Transformation Research, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
⁶⁶ Department of Respiratory Medicine, The 900th Hospital of the Joint Logistic Support Force, People's Liberation Army of China, Fuzhou, China.
⁶⁷ Department of Lung Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
⁶⁸ Department of Oncology, Guangdong Provicial Hospital of Chinese Medicine, Guangzhou, China.
⁶⁹ Department of Clinical Oncology, Xijing Hospital, Air Force Medical University, Xi'an, China.
⁷⁰ Institute of Immunotherapy, Fujian Medical University, Fuzhou, China.
⁷¹ Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department I of Thoracic Oncology, Peking University Cancer Hospital and Institute, Beijing, China.
⁷² Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
⁷³ Department of Respiratory Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China.

PMID: 38219795
PMCID: PMC10864121
DOI: 10.1111/1759-7714.15209

Rechallenge of immune checkpoint inhibitors in advanced non-small cell lung cancer

Gen Lin et al. Thorac Cancer. 2024 Feb.

. 2024 Feb;15(5):419-426.

doi: 10.1111/1759-7714.15209. Epub 2024 Jan 14.

Authors

Affiliations

¹ Department of Thoracic Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
² Department of Medical Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
³ Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁴ Senior Department of Oncology, Chinese PLA General Hospital, Beijing, China.
⁵ Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
⁶ Department of Oncology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Ji'nan, China.
⁷ Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China.
⁸ Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
⁹ Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
¹⁰ Institute of Cancer, Xinqiao Hospital, Army Medical University, Chongqing, China.
¹¹ Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
¹² Department of Medical Oncology and Radiation Sickness, Cancer Center, Peking University Third Hospital, Beijing, China.
¹³ Department of oncology, Kiang Wu Hospital, Macau, China.
¹⁴ Department of Thoracic Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
¹⁵ Department of Thoracic Surgery, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
¹⁶ Respiratory Department, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
¹⁷ Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
¹⁸ Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhenjiang University School of Medicine, Hangzhou, China.
¹⁹ Department of Medical Oncology, Fudan University Shanghai Cancer Center Xiamen Hospital, Xiamen, China.
²⁰ Department of Pulmonary Oncology, The First People's Hospital of Foshan, Foshan, China.
²¹ Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
²² Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China.
²³ Department of Respiratory Medicine, Xinqiao Hospital, Army Medical University, Chongqing, China.
²⁴ State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Guangzhou, China.
²⁵ Shanghai Geriatric Center, Zhongshan Hospital, Fudan University, Shanghai, China.
²⁶ Division of Thoracic Tumor Multimodality Treatment and Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
²⁷ Department of Oncology, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, China.
²⁸ Department of Medical Oncology, The First affiliated hospital of China Medical University, Shenyang, China.
²⁹ National Cancer Center/National Clinical Research Cencer for Cancer/Cancer Hospital &Shenzhen Hospital, Chinese Academy of Medical Sciences and Perking Union Medical College, Shenzhen, China.
³⁰ Department of Medical Oncology, Qilu Hospital of Shandong University, Ji'nan, China.
³¹ Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China.
³² Department of Pathology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
³³ Department of Medical Oncology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.
³⁴ Department of Medical Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
³⁵ Department of Hematology, First Affiliated Hospital, Ji'nan University, Guangzhou, China.
³⁶ Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing, China.
³⁷ Department of Oncology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China.
³⁸ Department of Thoracic Oncology, Jiangxi Cancer Hospital, Nanchang, China.
³⁹ Cancer Center, The 10th Affiliated Hospital of Southern Medical University, Dongguan, China.
⁴⁰ Department of Abdominal Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
⁴¹ Department of Respiratory Medicine, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
⁴² Department of Respiratory Medicine, Henan cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China.
⁴³ Cancer cenrter, Renmin Hospital of Wuhan University, Wuhan, China.
⁴⁴ Department of Thoracic Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
⁴⁵ Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
⁴⁶ Department of Medical Oncology, The First Affiliated Hospital of Zhejiang University, Zhejiang, China.
⁴⁷ Department of Medical Oncology, Daping Hospital, Army Medical University, Chongqing, China.
⁴⁸ Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
⁴⁹ Department of Medical Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research and Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China.
⁵⁰ Department of Clinical Trial, Zhejiang Cancer Hospital, Hangzhou, China.
⁵¹ Department of Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, China.
⁵² Precision Medicine Key Laboratory of Sichuan Province, Department of Pulmonary and Critical Care Medicine, Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
⁵³ Department of Thoracic Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
⁵⁴ Department of Respiratory Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China.
⁵⁵ Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China.
⁵⁶ Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
⁵⁷ Department of Radiation and Medical Oncology, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
⁵⁸ Department of Pulmonary Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China.
⁵⁹ Department of Oncology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
⁶⁰ Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China.
⁶¹ Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin, China.
⁶² Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, China.
⁶³ Department of Cancer Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
⁶⁴ Department of Medical Oncology, Sichuan Cancer Hospital, University of Electronic Science and Technology of China, Chengdu, China.
⁶⁵ Department of Medical Oncology, Xiamen Key Laboratory of Antitumor Drug Transformation Research, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
⁶⁶ Department of Respiratory Medicine, The 900th Hospital of the Joint Logistic Support Force, People's Liberation Army of China, Fuzhou, China.
⁶⁷ Department of Lung Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
⁶⁸ Department of Oncology, Guangdong Provicial Hospital of Chinese Medicine, Guangzhou, China.
⁶⁹ Department of Clinical Oncology, Xijing Hospital, Air Force Medical University, Xi'an, China.
⁷⁰ Institute of Immunotherapy, Fujian Medical University, Fuzhou, China.
⁷¹ Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department I of Thoracic Oncology, Peking University Cancer Hospital and Institute, Beijing, China.
⁷² Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
⁷³ Department of Respiratory Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China.

PMID: 38219795
PMCID: PMC10864121
DOI: 10.1111/1759-7714.15209

Abstract

Immune checkpoint inhibitor (ICI) rechallenge in non-small cell lung cancer (NSCLC) is a promising therapeutic strategy. The situation for ICI rechallenge can be divided into three categories: adverse events (AEs); resistance to ICIs, and rechallenge becomes compulsive because of tumor relapse while the patients had completed a 2 year course of immunotherapy. However, these categories are still controversial and should be explored further. Through voting at the 6th Straits Summit Forum on Lung Cancer, in this study we summarize the consensus of 147 experts in ICI rechallenges. A total of 97.74% experts agreed to rechallenge; 48.87% experts rechallenge with the original drug, and the others rechallenge with a different drug; 40.3% agreed to rechallenge directly after progression; 88.06% experts agreed to ICI rechallenge with a combination regimen; and factors such as previous performance status score, PD-1 expression, and age should also be considered. Understanding the the clinical studies in ICI rechallenge could bring us one step closer to understanding the consensus. In patients with advanced NSCLC who have suffered recurrent or distant metastasis after immunotherapy, the option of rechallenge with ICIs is a promising treatment option.

Keywords: ICI; NSCLC; re-challenge.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

**FIGURE 1**
Optimal response to initial treatment with immune checkpoint inhibitors (ICIs).

**FIGURE 2**
Optimal response to rechallenge with immune checkpoint inhibitors (ICIs).

**FIGURE 3**
Progression‐free survival (PFS) of patients in the primary treatment and immune checkpoint inhibitor (ICI) rechallenge settings.

**FIGURE 4**
Effects of other antitumor regimens on immune checkpoint inhibitor (ICI) rechallenge efficacy between ICI treatments.

See this image and copyright information in PMC

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Rechallenge of immune checkpoint inhibitors in advanced non-small cell lung cancer

Affiliations

Rechallenge of immune checkpoint inhibitors in advanced non-small cell lung cancer

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical