The Chinese Society of Clinical Oncology Non-small Cell Lung Cancer(CSCO NSCLC)guidelines were first published in 2016,ranking among the earliest-released guidelines within the CSCO series.In 2020 the CSCO published s...The Chinese Society of Clinical Oncology Non-small Cell Lung Cancer(CSCO NSCLC)guidelines were first published in 2016,ranking among the earliest-released guidelines within the CSCO series.In 2020 the CSCO published separate guidelines for NSCLC and small cell lung cancer(SCLC)for the first time to improve clinical usability.展开更多
Objective: to study the efficacy and adverse reactions of carrelizumab combined with siB-IMRT and pemetrexed disodium + cisplatin in the treatment of locally advanced non-squamous non-small cell lung cancer (NSCLC). M...Objective: to study the efficacy and adverse reactions of carrelizumab combined with siB-IMRT and pemetrexed disodium + cisplatin in the treatment of locally advanced non-squamous non-small cell lung cancer (NSCLC). Methods: 120 patients with non-squamous NSCLC were selected and divided into control group and study group, with 60 patients in each group. The control group was only given SIB-IMRT combined with pemetrexed disodium + cisplatin chemotherapy, while the study group was given carrelizumab on the day before chemotherapy on the basis of the control group. Results: the total remission rate in study group was 90.00% (54/60) higher than 76.67% (46/60) in control group (Z=2.682, P<0.05). The PFS and OS of study group were longer than those of control group (t=20.900, P<0.05), and longer than those of control group (t=16.696, P<0.05). After treatment, the expression levels of CD3+, CD4+, CD8+ and CD4+/CD8+ in peripheral blood of patients in the study group were higher than those in the control group (P<0.05). The expression levels of CD3+, CD4+, CD8+ and CD4+/CD8+ in peripheral blood of 2 groups after treatment were higher than before treatment (P<0.05). After treatment, the levels of IL-2, IL-6, IL-10 and TNF-α in peripheral blood of patients in the study group were lower than those in the control group (P<0.05). The levels of IL-2, IL-6, IL-10 and TNF-α in peripheral blood of 2 groups after treatment were lower than before (P<0.05). Conclusions: carrelizumab combined with SIB-IMRT and pemetrexed disodium + cisplatin has significant efficacy in locally advanced non-squamous NSCLC patients, and there is no significant increase in adverse reactions.展开更多
Objective: To evaluate the addition of vindesine to acyclophosphamide-epirubicin-cisp (CAP) regimenfor treating the patients with locally advanced non-smallcell lung cancer (NSCLC). Methods: From May 1994to August 199...Objective: To evaluate the addition of vindesine to acyclophosphamide-epirubicin-cisp (CAP) regimenfor treating the patients with locally advanced non-smallcell lung cancer (NSCLC). Methods: From May 1994to August 1998, 59 previously untreated patients withstage IIIa and IIIb non-small cell lung cancer wereenrolled into this trial. Patients characteristics were thefollowing: the median age was 52 years; the medianperformance status was 1; there were 19 stage IIIa and40 stage IIIb; there were 47 adenocarcinoma, 10squamous cell carcinoma and 2 large cell carcinoma. AIIpatients were treated with vindesine (2 mg/m2, on day 1and day 8), cyclophosphamide (0.6/m2, on day 1),epirubicin (40 mg/m2, on day 1) and cisplatin (60 mg/m2,on day 1) every 3 or 4 weeks. Results: Four achieved acomplete response (6.8%), 29 achieved a partialresponse (49.2%), 15 had stable disease, and 10 hadprogressive disease. A clinical improvement was in 45 of59 patients (76.3%). The most frequent major toxiceffects were myelosuppression, nausea and vomiting.Conclusion: The vindesine with CAP regimen was activecombination chemotherapy in patients with locallyadvanced NSCLC accompanied by the limited sideeffects.展开更多
Background and objective Lung cancer is the most common cause of death in men in the world and in Indonesia where nonsmall cell carcinoma lung cancer(NSCLC) constitutes 85% of all lung cancer cases. The high mortality...Background and objective Lung cancer is the most common cause of death in men in the world and in Indonesia where nonsmall cell carcinoma lung cancer(NSCLC) constitutes 85% of all lung cancer cases. The high mortality rate is due to a poor prognosis and is often diagnosed as having advanced stages. If it is known at the initial stage, the prognosis of lung cancer will be better. Prognosis can be predicted with a marker of prognostic biology, one of which is micro RNA(mi RNA). This study aims to prove that serum mi RNA can be predictive biological marker and prognosis in NSCLC patients in Indonesia.Methods This study was cohort retrospective among 52 subjects in "Dharmais" Hospital National Cancer Center. Sample was obtained from patients’ serum. Mi R-34, mi R-148, mi R-155 and mi R-222 serum are measured through Real-Time PCR(q PCR). Data were analyzed and interpreted with descriptive analysis, bivariate analysis(Mann Whitney-U for two type of variables or Kruskal-Wallis for more than two type of variables. Kaplan-Meier analysis was used to know association between characteristic which are sociodemographic, performance status, clinico-pathology, and survival rate in mi RNA expression. Results From this study, mi RNA expression: mi R-34(46.15%), mi R-148(23.08%), mi R-155(40.38%) and mi R-222(32.69%). Performance status score was statistically significant correlation with mi R-148(P=0.049) and mi R-222(P=0.018). High mi R-34 is associated with multiple M1 b metastatic type(P=0.020), cancer cell type(adenocarcinoma, P=0.009) and adenocarcinoma epidermal growth factor receptor(EGFR) mutation(negative, P=0.031). There was a significant correlation between the high mi R-222 as a poor prognosis in advanced stage NSCLC with M1 b metastasis(Median Survival/MS: 27 d, P=0.049) and positive EGFR mutations(MS: 74 d, P=0.049) and correlation of mi R-155 with adenocarcinoma(MS: 69 d, P=0.034) and positive EGFR gene mutations(MS: 58 d, P=0.023).Conclusion High mi R-34 expression in advanced stage NSCLC is the predictive factor for multiple metastatic, adenocarcinoma cell type and adenocarcinoma negative EGFR mutation. High expression of mi R-155 and mi R-222 are poor prognoses, especially high mi R-222 found in metastasis M1 b and positive EGFR mutation and mi R-155 found in adenocarcinoma and positive EGFR gene mutations. Further studies regarding correlation between mi RNA and survival rate are needed.展开更多
Background： The purpose of this study is to evaluate the clinical efficacy and safety of abraxane-based chemotherapy with/without nedaplatin in elderly patients with non-small-cell lung cancer （NSCLC）. Materials an...Background： The purpose of this study is to evaluate the clinical efficacy and safety of abraxane-based chemotherapy with/without nedaplatin in elderly patients with non-small-cell lung cancer （NSCLC）. Materials and methods： From October 2009 to January 2013, 48 elderly patients （≥65 years） with NSCLC were investigated in this clinical trial. The patients were randomized and equally allocated into arms A and AP- （A） abraxane （130 mg/m2, days 1, 8）; （B） abraxane ＋ nedaplatin （20 mg/m2 days 1-3, q3w）. The parameters of objective response rate （ORR）, disease control rate （DCR）, progression-free survival （PFS）, overall survival （OS） and side effects were evaluated between two arms. Results： Over 80% of the patients completed four cycles of chemotherapy. The total ORR was 21.3 %, DCR was 55.3%, PFS 4.5 months and OS 12.6 months. No significant difference was found between arms A and AP in terms of ORR （16.7% vs. 26.1%, P=0.665） or DCR （55.3% vs. 56.5%, P=0.871）. The median PFS in arm A was 3.3 months [25-75% confidence interval （CI）： 3.1-7.2] and 5.5 months （25-75% CI： 3.2-7.0） in arm AP with no statistical significance （P=0.640）. The median OS in arm A was 12.6 months （25-75% CI： 5.7-26.2） and 15.1 months （25-75% CI： 6.4-35.3） in arm AP with no statistical significance （P=0.770）. The side effects were mainly grade 1-2. The incidence of grade 3-4 toxicities was 29.1% in arm A and 62.5% in arm AP with a statistical significance （P=0.020）. Conclusions： Compared with combined therapy, abraxane alone chemotherapy was beneficial for elderly NSCLC patients with better tolerability and less adverse events, whereas did not significantly differ in terms of ORR, DCR, PFS or OS.展开更多
Objective: To compare the efficacy and toxicity between gemcitabine plus cisplatin and plus carboplatin in first-line treatment of advanced non-small cell lung cancer (NSCLC). Methods: Gemcitabine 1000 mg/m2 iv, d1, 8...Objective: To compare the efficacy and toxicity between gemcitabine plus cisplatin and plus carboplatin in first-line treatment of advanced non-small cell lung cancer (NSCLC). Methods: Gemcitabine 1000 mg/m2 iv, d1, 8; cisplatin 75 mg/m2 iv, d1, or 25 mg/m2 iv, d1-3; carboplatin AUC = 5 iv, d1; repeated every 21 days. Results: All 76 cases were available for objective response. Gemcitabine + cisplatin (GCis) group: among 33 cases, CR 1 case, PR 13 cases, MR 3 cases, SD 7 cases, PD 9 cases, response rate, disease control rate, time to progress (TTP), median survival time (MST) and 1-, 2-year survival rates were 42.42% (14/33), 72.73% (24/33), 5 months, 14 months and 66.67% (22/33), 12.12% (4/33), respectively; Gemcitabine + carboplatin (GCarb) group: among 43 cases, PR 13 cases, MR 11 cases, SD 7 cases, PD 12 cases, the results while comparing with those of GCis group were 30.23% (13/43), 72.09% (31/43), 4 months, 11 months and 48.84% (21/43), 2.33% (1/43), respectively. Among them, only MST between the two groups had significant statistic difference (χ2 = 2.45, P = 0.017). Mild to modest myelo-suppression as well as nausea and vomiting were observed. Conclusion: Both GCis and GCarb regimens had active and well-tolerated toxicity for advanced NSCLC. Cisplatin-based chemotherapy yields a substantial effective advantage over carboplatin-based regimens. Therefore, carboplatin and cisplatin are not equal-active and that cisplatin-based doublet regimens should remain the standard first-line therapy for patients with advanced NSCLC with good performance status.展开更多
Objective The aim of the study was to evaluate the efficacy and safety of etoposide plus thalidomide as maintenance therapy for elderly patients with advanced non-small cell lung cancer（NSCLC） without disease progre...Objective The aim of the study was to evaluate the efficacy and safety of etoposide plus thalidomide as maintenance therapy for elderly patients with advanced non-small cell lung cancer（NSCLC） without disease progression after first-line chemotherapy.Methods After four to six cycles of platinum-based first-line therapy, 64 elderly patients with advanced NSCLC without disease progression who were treated in the General Hospital of Shenyang Military Region（China） from 2014 to 2016 were enrolled in this study. According to the different maintenance treatment methods, patients were divided as having received etoposide plus thalidomide therapy（treatment group, n = 32） and best supportive care（control group, n = 32）. Disease control and progression-free survival（PFS） were compared between the two groups. Results The recent curative effect objective response rates of the treatment group and the control group were 31.3% and 3.1%, respectively, and the disease control rates were 71.9% and 31.3%, respectively. The Kaplan-Meier survival curves of the two groups were significantly different（χ2 = 26.532, P = 0.001）. The median PFS for the treatment group and control group was 6.0 months [95% confidence interval（CI） = 4.3–7.9 months] and 3.2 months（95% CI = 2.6–3.8 months）, respectively. The side effects in the treatment group included hematologic abnormalities, gastrointestinal toxicity, and impaired liver function, which were relieved after symptomatic support therapy and drug withdrawal.Conclusion Etoposide plus thalidomide as maintenance therapy is associated with a significantly longer PFS with tolerable toxicity for elderly patients with advanced NSCLC.AcknowledgementThe authors would like to thank Liu Zhongzheng for his technical assistance.展开更多
Objective： The aim of this study was to evaluate the clinical efficacy and side effects of docetaxel/cisplatin regiment and gemcitabine/cisplatin regiment in the patients with advanced non-small-cell lung cancer （NS...Objective： The aim of this study was to evaluate the clinical efficacy and side effects of docetaxel/cisplatin regiment and gemcitabine/cisplatin regiment in the patients with advanced non-small-cell lung cancer （NSCLC）. Methods： Seventy-six patients with advanced NSCLC who were chemotherapy-naive were enrolled in two groups. In docetaxel group （DP group） the patients received docataxel 75 mg/m^2 and cisplatin 60 mg/m^2 on day 1. In gemcitabine group （GP group） the patients received gemcitabine 1000 mg/m^2 on day 1 and day 8. The dosage of cisplatin was the same as DP group. The two regiments were administrated intravenously every 21 days as a cycle, each patient received 2-4 cycles. All patients were followed up until disease progressed or patients died. Results： The overall response rates were 43.5% in DP group and 45.9% in GP group. The response rate was significantly different between the initial treated group and retreated group in both two groups （53.8% vs 23.0% in DP group and 56% vs 25% in GP group, P 〈 0.05, respectively）. The main side effects were bone marrow suppression and thrombocytopenia. Conclusion： Docetaxel/cisplatin regiment and gemcitabine/cisplatin regiment for the patients with advanced NSCLC were efficient and well-tolerated chemotherapeutic approachs with low toxicity levels. The efficacy and major toxicity in two groups were similar.展开更多
Objective: to study the effect of TCM treatment on advanced non-small cell lung cancer (NSCLC) with dampness-blocking type of spleen deficiency. Methods: 100 patients with advanced non-small cell lung cancer of damp h...Objective: to study the effect of TCM treatment on advanced non-small cell lung cancer (NSCLC) with dampness-blocking type of spleen deficiency. Methods: 100 patients with advanced non-small cell lung cancer of damp heat spleen deficiency type were divided into study group (50 cases of routine treatment combined with traditional Chinese Medicine) and control group (50 cases of routine treatment). Results: the total effective rate of 49 cases (98%) in the study group was significantly higher than that of 39 cases (78%) in control group. The comparison of the total effective rate of the two groups showed that the treatment effect of the study group was the most obvious and the best. At the same time, the data of the two groups showed P < 0.05, indicating that there was significant difference in the test results. The prognosis of the study group was superior to that of the control group. The data of the two groups were analyzed and compared, and the test results showed significant difference (P < 0.05). Conclusion: the application of traditional Chinese medicine in the treatment of patients with advanced non-small cell lung cancer with dampness-blocking type of spleen deficiency can improve the safety of treatment, enhance the treatment effect and increase the treatment efficiency, and improve the prognosis of patients to a large extent. Therefore, the treatment of traditional Chinese medicine has the value of promotion and application.展开更多
Objective： In recent years, the combination of cetuximab and chemoradiotherapy （CRT） has been used to treat stage III non-small cell lung cancer （NSCLC）; however, limited data are available for Chinese patients. ...Objective： In recent years, the combination of cetuximab and chemoradiotherapy （CRT） has been used to treat stage III non-small cell lung cancer （NSCLC）; however, limited data are available for Chinese patients. Herein, we report preliminary data from a phase I/II study testing the combination of cetuximab with inductive chemotherapy, followed by concurrent CRT （CCRT） in Chinese patients with stage III NSCLC. Methods： Eligibility criteria were Zubrod performance status （PS） 0-1, forced expiratory volume in 1 second （FEV1） 〉_1.2 L and adequate organ function. Enrolled patients received weekly cetuximab （initial dose of 400 mg/m2 on day 1 of week 1 and a maintenance dose of 250 mg/m2 on week 2 to the end of CCRT） with cisplatin/vinorelbine （NP） chemotherapy （every 3 weeks for 2 cycles from week 2, followed by two cycles of concomitant NP chemotherapy and intensity-modulated thoracic radiotherapy （TRT） （60-66 Gy/2 Gy）. The primary endpoints were toxicity and feasibility. All patients received positron emission tomography- computerized tomography （PET-CT） scans within the 2 weeks prior to enrollment. Univariate analyses were used to assess the correlation between SUV-T, SUV-N, SUV-TOTAL, gender, age, histology, tumor-node- metastasis （TNM） stage, PS and smoking status and survival. Survival curves were generated for different populations using the Kaplan-Meier method and compared using a log-rank test. Results： Seventeen patients were enrolled and 16 completed the full regime. The overall response rate （ORR） was 58.8% and 82.3% after the induction and CCRT phases, respectively. With a median follow-up duration of 27.6 months, the median survival was 27.6 months [95% confidence interval （CI）： 11.3-43.9 months] with 1- and 2-year survival rates of 88.2% （95% CI, 60.6-96.9%） and 58.8% （95% CI, 60.6-77.8%）, respectively. Three patients remain progression-free to date, and the median progression-free survival （PFS） was 13.5 months （95% CI, 6.8-20.2 months）. No treatment-related death occurred; however, 76% of the patients experienced grade 3＋ adverse events （AEs）, including nansea/vomiting, intestinal obstruction, and esophagitis （〈6%）, while other AEs were mostly of hematological nature （71%）. The cut-off values for SUV-T and SUV-TOTAL were 11 and 20, respectively. Univariate analyses revealed SUV-TOTAL （P=0.027）, SUV-T （P=0.025）, and PS （P=0.006） as potential survival predictors, with a hazard ratio （HR） of 3.4, 3.7, and 9.9, respectively. Conclusions： The combination of cetuximab with induction chemotherapy followed by CCRT appears feasible and promising. Local and locoregional maximal SUVs, defined by 18F-FDG PET-CT scanning, may represent a prognostic indicator for long-term survival for these patients, which warrants further study.展开更多
Objective:This study was aimed to research the feasibility of ATP-bioluminescence assay(ATP-TCA) guiding the treatment on recurrent non-small cell lung cancer(NSCLC) combined with malignant pleural effusion.Methods:We...Objective:This study was aimed to research the feasibility of ATP-bioluminescence assay(ATP-TCA) guiding the treatment on recurrent non-small cell lung cancer(NSCLC) combined with malignant pleural effusion.Methods:We collected 30 pleural fluid samples which were approved to be positive by cytology from recurrent NSCLC patients.These cells were cocultured with chemotherapy medicines,single agent or drugs combination.Five drug concentrations,two parallel holes were examined in vitro for 4 days,the results were measured by adding luciferase-fluorescein working system and luminescence analyzer.We applied chemotherapy medicines according to the results in vitro of ATP-TCA.Results:There were differences among drug sensitivities of individuals.All the samples could be evaluated.Effective single drugs included cisplatinum,mitomycin C,doxorubicin,and pemetrexed disodium;sensitive drugs in the combination therapy were gemcitabine plus cisplatin,vinorelbine plus cisplatin,paclitaxel plus cisplatin,docetaxel plus cisplatin,and mitomycin C,vindesine plus cisplatin,in which gemcitabine + cisplatin(GEM + DDP) in vitro was the most efficient program.Conclusion:ATP-TCA in vitro sensitivity assay is rapid,reliable,and simple to guide the treatment of recurrent NSCLC with malignant pleural effusion,and can help clinicians to make the individual chemotherapy program.展开更多
Limited benefit population of immune checkpoint inhibitors makes it urgent to screen predictive biomarkers for stratifying the patients.Herein,we have investigated peripheral CD4^(+) T cell signatures in advanced non-...Limited benefit population of immune checkpoint inhibitors makes it urgent to screen predictive biomarkers for stratifying the patients.Herein,we have investigated peripheral CD4^(+) T cell signatures in advanced non-small cell lung cancer(NSCLC)patients receiving anti-PD-1/PD-L1 treatments.It was found that the percentages of IFN-γand IL-17A secreting naïve CD4^(+) T cells(Tn),and memory CD4^(+) T cells(Tm)expressing PD-1,PD-L1 and CTLA-4 were significantly higher in responder(R)than non-responder(NonR)NSCLC patients associated with a longer progression free survival(PFS).Logistic regression analysis revealed that the baseline IFN-γ-producing CD4^(+) Tn cells and PD-1^(+)CD4^(+) Tm cells were the most significant signatures with the area under curve(AUC)value reaching 0.849.This was further validated in another anti-PD-1 monotherapy cohort.Conversely,high percentage of CTLA-4^(+)CD4^(+) Tm cells was associated with a shorter PFS in patients receiving anti-PD-L1 monotherapy.Our study therefore elucidates the significance of functional CD4^(+) Tn and Tm subpopulations before the treatment in predicting the responses to anti-PD-1 treatment in Chinese NSCLC patients.The fact that there display distinct CD4^(+) T cell signatures in the prediction to anti-PD-1 and anti-PD-L1 monotherapy from our study provides preliminary evidence on the feasibility of anti-PD-1 and anti-PD-L1 combination therapy for advanced NSCLC patients.展开更多
文摘The Chinese Society of Clinical Oncology Non-small Cell Lung Cancer(CSCO NSCLC)guidelines were first published in 2016,ranking among the earliest-released guidelines within the CSCO series.In 2020 the CSCO published separate guidelines for NSCLC and small cell lung cancer(SCLC)for the first time to improve clinical usability.
文摘Objective: to study the efficacy and adverse reactions of carrelizumab combined with siB-IMRT and pemetrexed disodium + cisplatin in the treatment of locally advanced non-squamous non-small cell lung cancer (NSCLC). Methods: 120 patients with non-squamous NSCLC were selected and divided into control group and study group, with 60 patients in each group. The control group was only given SIB-IMRT combined with pemetrexed disodium + cisplatin chemotherapy, while the study group was given carrelizumab on the day before chemotherapy on the basis of the control group. Results: the total remission rate in study group was 90.00% (54/60) higher than 76.67% (46/60) in control group (Z=2.682, P<0.05). The PFS and OS of study group were longer than those of control group (t=20.900, P<0.05), and longer than those of control group (t=16.696, P<0.05). After treatment, the expression levels of CD3+, CD4+, CD8+ and CD4+/CD8+ in peripheral blood of patients in the study group were higher than those in the control group (P<0.05). The expression levels of CD3+, CD4+, CD8+ and CD4+/CD8+ in peripheral blood of 2 groups after treatment were higher than before treatment (P<0.05). After treatment, the levels of IL-2, IL-6, IL-10 and TNF-α in peripheral blood of patients in the study group were lower than those in the control group (P<0.05). The levels of IL-2, IL-6, IL-10 and TNF-α in peripheral blood of 2 groups after treatment were lower than before (P<0.05). Conclusions: carrelizumab combined with SIB-IMRT and pemetrexed disodium + cisplatin has significant efficacy in locally advanced non-squamous NSCLC patients, and there is no significant increase in adverse reactions.
文摘Objective: To evaluate the addition of vindesine to acyclophosphamide-epirubicin-cisp (CAP) regimenfor treating the patients with locally advanced non-smallcell lung cancer (NSCLC). Methods: From May 1994to August 1998, 59 previously untreated patients withstage IIIa and IIIb non-small cell lung cancer wereenrolled into this trial. Patients characteristics were thefollowing: the median age was 52 years; the medianperformance status was 1; there were 19 stage IIIa and40 stage IIIb; there were 47 adenocarcinoma, 10squamous cell carcinoma and 2 large cell carcinoma. AIIpatients were treated with vindesine (2 mg/m2, on day 1and day 8), cyclophosphamide (0.6/m2, on day 1),epirubicin (40 mg/m2, on day 1) and cisplatin (60 mg/m2,on day 1) every 3 or 4 weeks. Results: Four achieved acomplete response (6.8%), 29 achieved a partialresponse (49.2%), 15 had stable disease, and 10 hadprogressive disease. A clinical improvement was in 45 of59 patients (76.3%). The most frequent major toxiceffects were myelosuppression, nausea and vomiting.Conclusion: The vindesine with CAP regimen was activecombination chemotherapy in patients with locallyadvanced NSCLC accompanied by the limited sideeffects.
文摘Background and objective Lung cancer is the most common cause of death in men in the world and in Indonesia where nonsmall cell carcinoma lung cancer(NSCLC) constitutes 85% of all lung cancer cases. The high mortality rate is due to a poor prognosis and is often diagnosed as having advanced stages. If it is known at the initial stage, the prognosis of lung cancer will be better. Prognosis can be predicted with a marker of prognostic biology, one of which is micro RNA(mi RNA). This study aims to prove that serum mi RNA can be predictive biological marker and prognosis in NSCLC patients in Indonesia.Methods This study was cohort retrospective among 52 subjects in "Dharmais" Hospital National Cancer Center. Sample was obtained from patients’ serum. Mi R-34, mi R-148, mi R-155 and mi R-222 serum are measured through Real-Time PCR(q PCR). Data were analyzed and interpreted with descriptive analysis, bivariate analysis(Mann Whitney-U for two type of variables or Kruskal-Wallis for more than two type of variables. Kaplan-Meier analysis was used to know association between characteristic which are sociodemographic, performance status, clinico-pathology, and survival rate in mi RNA expression. Results From this study, mi RNA expression: mi R-34(46.15%), mi R-148(23.08%), mi R-155(40.38%) and mi R-222(32.69%). Performance status score was statistically significant correlation with mi R-148(P=0.049) and mi R-222(P=0.018). High mi R-34 is associated with multiple M1 b metastatic type(P=0.020), cancer cell type(adenocarcinoma, P=0.009) and adenocarcinoma epidermal growth factor receptor(EGFR) mutation(negative, P=0.031). There was a significant correlation between the high mi R-222 as a poor prognosis in advanced stage NSCLC with M1 b metastasis(Median Survival/MS: 27 d, P=0.049) and positive EGFR mutations(MS: 74 d, P=0.049) and correlation of mi R-155 with adenocarcinoma(MS: 69 d, P=0.034) and positive EGFR gene mutations(MS: 58 d, P=0.023).Conclusion High mi R-34 expression in advanced stage NSCLC is the predictive factor for multiple metastatic, adenocarcinoma cell type and adenocarcinoma negative EGFR mutation. High expression of mi R-155 and mi R-222 are poor prognoses, especially high mi R-222 found in metastasis M1 b and positive EGFR mutation and mi R-155 found in adenocarcinoma and positive EGFR gene mutations. Further studies regarding correlation between mi RNA and survival rate are needed.
文摘Background： The purpose of this study is to evaluate the clinical efficacy and safety of abraxane-based chemotherapy with/without nedaplatin in elderly patients with non-small-cell lung cancer （NSCLC）. Materials and methods： From October 2009 to January 2013, 48 elderly patients （≥65 years） with NSCLC were investigated in this clinical trial. The patients were randomized and equally allocated into arms A and AP- （A） abraxane （130 mg/m2, days 1, 8）; （B） abraxane ＋ nedaplatin （20 mg/m2 days 1-3, q3w）. The parameters of objective response rate （ORR）, disease control rate （DCR）, progression-free survival （PFS）, overall survival （OS） and side effects were evaluated between two arms. Results： Over 80% of the patients completed four cycles of chemotherapy. The total ORR was 21.3 %, DCR was 55.3%, PFS 4.5 months and OS 12.6 months. No significant difference was found between arms A and AP in terms of ORR （16.7% vs. 26.1%, P=0.665） or DCR （55.3% vs. 56.5%, P=0.871）. The median PFS in arm A was 3.3 months [25-75% confidence interval （CI）： 3.1-7.2] and 5.5 months （25-75% CI： 3.2-7.0） in arm AP with no statistical significance （P=0.640）. The median OS in arm A was 12.6 months （25-75% CI： 5.7-26.2） and 15.1 months （25-75% CI： 6.4-35.3） in arm AP with no statistical significance （P=0.770）. The side effects were mainly grade 1-2. The incidence of grade 3-4 toxicities was 29.1% in arm A and 62.5% in arm AP with a statistical significance （P=0.020）. Conclusions： Compared with combined therapy, abraxane alone chemotherapy was beneficial for elderly NSCLC patients with better tolerability and less adverse events, whereas did not significantly differ in terms of ORR, DCR, PFS or OS.
基金Scientific and Technical Development Project of Jiangsu Province (No. BS2006005)
文摘Objective: To compare the efficacy and toxicity between gemcitabine plus cisplatin and plus carboplatin in first-line treatment of advanced non-small cell lung cancer (NSCLC). Methods: Gemcitabine 1000 mg/m2 iv, d1, 8; cisplatin 75 mg/m2 iv, d1, or 25 mg/m2 iv, d1-3; carboplatin AUC = 5 iv, d1; repeated every 21 days. Results: All 76 cases were available for objective response. Gemcitabine + cisplatin (GCis) group: among 33 cases, CR 1 case, PR 13 cases, MR 3 cases, SD 7 cases, PD 9 cases, response rate, disease control rate, time to progress (TTP), median survival time (MST) and 1-, 2-year survival rates were 42.42% (14/33), 72.73% (24/33), 5 months, 14 months and 66.67% (22/33), 12.12% (4/33), respectively; Gemcitabine + carboplatin (GCarb) group: among 43 cases, PR 13 cases, MR 11 cases, SD 7 cases, PD 12 cases, the results while comparing with those of GCis group were 30.23% (13/43), 72.09% (31/43), 4 months, 11 months and 48.84% (21/43), 2.33% (1/43), respectively. Among them, only MST between the two groups had significant statistic difference (χ2 = 2.45, P = 0.017). Mild to modest myelo-suppression as well as nausea and vomiting were observed. Conclusion: Both GCis and GCarb regimens had active and well-tolerated toxicity for advanced NSCLC. Cisplatin-based chemotherapy yields a substantial effective advantage over carboplatin-based regimens. Therefore, carboplatin and cisplatin are not equal-active and that cisplatin-based doublet regimens should remain the standard first-line therapy for patients with advanced NSCLC with good performance status.
文摘Objective The aim of the study was to evaluate the efficacy and safety of etoposide plus thalidomide as maintenance therapy for elderly patients with advanced non-small cell lung cancer（NSCLC） without disease progression after first-line chemotherapy.Methods After four to six cycles of platinum-based first-line therapy, 64 elderly patients with advanced NSCLC without disease progression who were treated in the General Hospital of Shenyang Military Region（China） from 2014 to 2016 were enrolled in this study. According to the different maintenance treatment methods, patients were divided as having received etoposide plus thalidomide therapy（treatment group, n = 32） and best supportive care（control group, n = 32）. Disease control and progression-free survival（PFS） were compared between the two groups. Results The recent curative effect objective response rates of the treatment group and the control group were 31.3% and 3.1%, respectively, and the disease control rates were 71.9% and 31.3%, respectively. The Kaplan-Meier survival curves of the two groups were significantly different（χ2 = 26.532, P = 0.001）. The median PFS for the treatment group and control group was 6.0 months [95% confidence interval（CI） = 4.3–7.9 months] and 3.2 months（95% CI = 2.6–3.8 months）, respectively. The side effects in the treatment group included hematologic abnormalities, gastrointestinal toxicity, and impaired liver function, which were relieved after symptomatic support therapy and drug withdrawal.Conclusion Etoposide plus thalidomide as maintenance therapy is associated with a significantly longer PFS with tolerable toxicity for elderly patients with advanced NSCLC.AcknowledgementThe authors would like to thank Liu Zhongzheng for his technical assistance.
文摘Objective： The aim of this study was to evaluate the clinical efficacy and side effects of docetaxel/cisplatin regiment and gemcitabine/cisplatin regiment in the patients with advanced non-small-cell lung cancer （NSCLC）. Methods： Seventy-six patients with advanced NSCLC who were chemotherapy-naive were enrolled in two groups. In docetaxel group （DP group） the patients received docataxel 75 mg/m^2 and cisplatin 60 mg/m^2 on day 1. In gemcitabine group （GP group） the patients received gemcitabine 1000 mg/m^2 on day 1 and day 8. The dosage of cisplatin was the same as DP group. The two regiments were administrated intravenously every 21 days as a cycle, each patient received 2-4 cycles. All patients were followed up until disease progressed or patients died. Results： The overall response rates were 43.5% in DP group and 45.9% in GP group. The response rate was significantly different between the initial treated group and retreated group in both two groups （53.8% vs 23.0% in DP group and 56% vs 25% in GP group, P 〈 0.05, respectively）. The main side effects were bone marrow suppression and thrombocytopenia. Conclusion： Docetaxel/cisplatin regiment and gemcitabine/cisplatin regiment for the patients with advanced NSCLC were efficient and well-tolerated chemotherapeutic approachs with low toxicity levels. The efficacy and major toxicity in two groups were similar.
文摘Objective: to study the effect of TCM treatment on advanced non-small cell lung cancer (NSCLC) with dampness-blocking type of spleen deficiency. Methods: 100 patients with advanced non-small cell lung cancer of damp heat spleen deficiency type were divided into study group (50 cases of routine treatment combined with traditional Chinese Medicine) and control group (50 cases of routine treatment). Results: the total effective rate of 49 cases (98%) in the study group was significantly higher than that of 39 cases (78%) in control group. The comparison of the total effective rate of the two groups showed that the treatment effect of the study group was the most obvious and the best. At the same time, the data of the two groups showed P < 0.05, indicating that there was significant difference in the test results. The prognosis of the study group was superior to that of the control group. The data of the two groups were analyzed and compared, and the test results showed significant difference (P < 0.05). Conclusion: the application of traditional Chinese medicine in the treatment of patients with advanced non-small cell lung cancer with dampness-blocking type of spleen deficiency can improve the safety of treatment, enhance the treatment effect and increase the treatment efficiency, and improve the prognosis of patients to a large extent. Therefore, the treatment of traditional Chinese medicine has the value of promotion and application.
文摘Objective： In recent years, the combination of cetuximab and chemoradiotherapy （CRT） has been used to treat stage III non-small cell lung cancer （NSCLC）; however, limited data are available for Chinese patients. Herein, we report preliminary data from a phase I/II study testing the combination of cetuximab with inductive chemotherapy, followed by concurrent CRT （CCRT） in Chinese patients with stage III NSCLC. Methods： Eligibility criteria were Zubrod performance status （PS） 0-1, forced expiratory volume in 1 second （FEV1） 〉_1.2 L and adequate organ function. Enrolled patients received weekly cetuximab （initial dose of 400 mg/m2 on day 1 of week 1 and a maintenance dose of 250 mg/m2 on week 2 to the end of CCRT） with cisplatin/vinorelbine （NP） chemotherapy （every 3 weeks for 2 cycles from week 2, followed by two cycles of concomitant NP chemotherapy and intensity-modulated thoracic radiotherapy （TRT） （60-66 Gy/2 Gy）. The primary endpoints were toxicity and feasibility. All patients received positron emission tomography- computerized tomography （PET-CT） scans within the 2 weeks prior to enrollment. Univariate analyses were used to assess the correlation between SUV-T, SUV-N, SUV-TOTAL, gender, age, histology, tumor-node- metastasis （TNM） stage, PS and smoking status and survival. Survival curves were generated for different populations using the Kaplan-Meier method and compared using a log-rank test. Results： Seventeen patients were enrolled and 16 completed the full regime. The overall response rate （ORR） was 58.8% and 82.3% after the induction and CCRT phases, respectively. With a median follow-up duration of 27.6 months, the median survival was 27.6 months [95% confidence interval （CI）： 11.3-43.9 months] with 1- and 2-year survival rates of 88.2% （95% CI, 60.6-96.9%） and 58.8% （95% CI, 60.6-77.8%）, respectively. Three patients remain progression-free to date, and the median progression-free survival （PFS） was 13.5 months （95% CI, 6.8-20.2 months）. No treatment-related death occurred; however, 76% of the patients experienced grade 3＋ adverse events （AEs）, including nansea/vomiting, intestinal obstruction, and esophagitis （〈6%）, while other AEs were mostly of hematological nature （71%）. The cut-off values for SUV-T and SUV-TOTAL were 11 and 20, respectively. Univariate analyses revealed SUV-TOTAL （P=0.027）, SUV-T （P=0.025）, and PS （P=0.006） as potential survival predictors, with a hazard ratio （HR） of 3.4, 3.7, and 9.9, respectively. Conclusions： The combination of cetuximab with induction chemotherapy followed by CCRT appears feasible and promising. Local and locoregional maximal SUVs, defined by 18F-FDG PET-CT scanning, may represent a prognostic indicator for long-term survival for these patients, which warrants further study.
文摘Objective:This study was aimed to research the feasibility of ATP-bioluminescence assay(ATP-TCA) guiding the treatment on recurrent non-small cell lung cancer(NSCLC) combined with malignant pleural effusion.Methods:We collected 30 pleural fluid samples which were approved to be positive by cytology from recurrent NSCLC patients.These cells were cocultured with chemotherapy medicines,single agent or drugs combination.Five drug concentrations,two parallel holes were examined in vitro for 4 days,the results were measured by adding luciferase-fluorescein working system and luminescence analyzer.We applied chemotherapy medicines according to the results in vitro of ATP-TCA.Results:There were differences among drug sensitivities of individuals.All the samples could be evaluated.Effective single drugs included cisplatinum,mitomycin C,doxorubicin,and pemetrexed disodium;sensitive drugs in the combination therapy were gemcitabine plus cisplatin,vinorelbine plus cisplatin,paclitaxel plus cisplatin,docetaxel plus cisplatin,and mitomycin C,vindesine plus cisplatin,in which gemcitabine + cisplatin(GEM + DDP) in vitro was the most efficient program.Conclusion:ATP-TCA in vitro sensitivity assay is rapid,reliable,and simple to guide the treatment of recurrent NSCLC with malignant pleural effusion,and can help clinicians to make the individual chemotherapy program.
基金supported by the National Key Research and Development Program of China(2016YFC1303303)the National Natural Science Foundation of China(82073152,81802264)+1 种基金Technology Innovation Program of Shanghai(19411950500)Talent Training Program of Shanghai Chest Hospital in 2019,and Incubation Project Plan for Research in Shanghai Chest Hospital(2019YNJCM07)。
文摘Limited benefit population of immune checkpoint inhibitors makes it urgent to screen predictive biomarkers for stratifying the patients.Herein,we have investigated peripheral CD4^(+) T cell signatures in advanced non-small cell lung cancer(NSCLC)patients receiving anti-PD-1/PD-L1 treatments.It was found that the percentages of IFN-γand IL-17A secreting naïve CD4^(+) T cells(Tn),and memory CD4^(+) T cells(Tm)expressing PD-1,PD-L1 and CTLA-4 were significantly higher in responder(R)than non-responder(NonR)NSCLC patients associated with a longer progression free survival(PFS).Logistic regression analysis revealed that the baseline IFN-γ-producing CD4^(+) Tn cells and PD-1^(+)CD4^(+) Tm cells were the most significant signatures with the area under curve(AUC)value reaching 0.849.This was further validated in another anti-PD-1 monotherapy cohort.Conversely,high percentage of CTLA-4^(+)CD4^(+) Tm cells was associated with a shorter PFS in patients receiving anti-PD-L1 monotherapy.Our study therefore elucidates the significance of functional CD4^(+) Tn and Tm subpopulations before the treatment in predicting the responses to anti-PD-1 treatment in Chinese NSCLC patients.The fact that there display distinct CD4^(+) T cell signatures in the prediction to anti-PD-1 and anti-PD-L1 monotherapy from our study provides preliminary evidence on the feasibility of anti-PD-1 and anti-PD-L1 combination therapy for advanced NSCLC patients.
