The present study assessed the efficacy and safety of thoracic radiotherapy(TRT)following first-line chemotherapy or chemoimmunotherapy in patients with extensive-stage small cell lung cancer(ES-SCLC),focusing on the ...The present study assessed the efficacy and safety of thoracic radiotherapy(TRT)following first-line chemotherapy or chemoimmunotherapy in patients with extensive-stage small cell lung cancer(ES-SCLC),focusing on the influence of different TRT timing strategies(consolidative vs.salvage)on survival rates.We retrospectively analyzed a total of 54 patients with ES-SCLC treated between January 2019 and July 2022.Patients receiving consolidative TRT(cTRT)within three months after completion of first-line treatment were compared with those receiving salvage TRT(sTRT)after disease progression.The primary endpoints were overall survival(OS),progression-free survival(PFS),locoregional-free survival(LRFS),and distant metastasis-free survival(DMFS);the secondary endpoint included safety.The cTRT group(n=41)showed significantly longer median OS(26.6 vs.14.8 months,P=0.048),PFS(12.9 vs.3.5 months,P<0.0001),and DMFS(10.7 vs.3.4 months,P=0.0044)than the sTRT group(n=13).Multivariate analysis revealed that cTRT was an independent,favorable prognostic factor.No significant differences in OS or LRFS were observed between high-dose(≥50 Gy)and low-dose(<50 Gy)TRT.Hematologic and respiratory toxicities were the most frequently reported adverse events,with acceptable tolerability.In conclusion,cTRT after chemoimmunotherapy significantly improves survival outcomes for ES-SCLC patients,and low-dose TRT may be a suitable option.展开更多
Objective:Atezolizumab along with chemotherapy has prolonged the survival of patients with extensive-stage small-cell lung cancer(ES-SCLC)worldwide,although real-world(RW)data are lacking in China.This study was desig...Objective:Atezolizumab along with chemotherapy has prolonged the survival of patients with extensive-stage small-cell lung cancer(ES-SCLC)worldwide,although real-world(RW)data are lacking in China.This study was designed to evaluate the efficacy and clinical outcomes of atezolizumab plus etoposide/platinum(EP).Methods:Data obtained in this retrospective study were captured from six oncology units of five medical facilities from January 2019 to April 2022.For first-line treatments,atezolizumab combined with EP vs.EP alone,we primarily evaluated progression-free survival(PFS);other efficacy indicators,including overall survival(OS),objective response rate(ORR),and patterns of SCLC progression and adverse events(AEs)were assessed.Results:The primary analysis included data from 225 patients,of whom 133 received EP along with atezolizumab(atezolizumab group)and 92 received EP alone(EP group).The PFS duration of the atezolizumab group[7.10 months;95%confidence interval(95%CI),6.53-9.00]exceeded that of the EP group(6.50 months;95%CI,4.83-7.53).Overall,the hazard ratio(HR)was 0.69(95%CI,0.49-0.97)(P=0.029);particularly,the HR was 0.54(95%CI,0.36-0.80)among patients undergoing≥4 chemotherapy cycles and 0.33(95%CI,0.20-0.56)among individuals with atezolizumab maintenance.The ORR and disease-control rate(DCR)were similar between the two groups.Because of incomplete OS data,the median OS was not determined for either group.Bone marrow suppression was the most common AE detected(58.6%)in the atezolizumab group.Immune-related AEs occurred in 19 patients in the atezolizumab group(14.3%),with only one case of grade 3 encephalitis.Conclusions:This RW study in China demonstrated improved clinical outcomes of atezolizumab along with EP for ES-SCLC,particularly in the chemosensitive population.These results align with the results of the IMpower133 study,although the impact of this treatment modality on OS warrants additional follow-up studies.展开更多
Lung cancer, being the most common cancer type, accounts for 13% of all newly diagnosed malignant tumors globally each year. Small cell lung cancer(SCLC) accounts for approximately 15% of newly diagnosed lung cancers ...Lung cancer, being the most common cancer type, accounts for 13% of all newly diagnosed malignant tumors globally each year. Small cell lung cancer(SCLC) accounts for approximately 15% of newly diagnosed lung cancers each year, but its annual death toll accounts for 25% of that of lung cancer. We summarized relevant clinical studies to elaborate the epidemiology, pathological and clinical characteristics and the treatment status of small cell lung cancer. This paper first described the epidemiology and the pathological and clinical characteristics of SCLC and the systematic treatment of extensive-stage SCLC and then introduced the current targeted therapy and immunotherapy for SCLC to provide clinicians and patients with a more systematic, comprehensive, and beneficial treatment regimen. We expect that these studies can provide clinicians with a clear direction in molecularly targeted therapy or immunotherapy, so that a treatment approach with better antitumor effects and longer-lasting clinical benefits can be provided to the patients.展开更多
Objective： To compare the efficacy and safety of Lobaplatin plus Etoposide （EL） and Cisplatin plus Etoposide （EP） regimens in chemonaive with extensive-stage small-cell lung cancer （SCLC）. Methods： Between Jul...Objective： To compare the efficacy and safety of Lobaplatin plus Etoposide （EL） and Cisplatin plus Etoposide （EP） regimens in chemonaive with extensive-stage small-cell lung cancer （SCLC）. Methods： Between July 2010 and July 2011, a total of 62 patients with extensive-stage small-cell lung cancer who received initial treatment in our hospital and 309 hospital of PLA. 31 patients were randomly assigned to the EL Group： Lobaplatin was given intravenously at a dose of 30 mg/m2 on day 1 and Etoposide 100 mg/m2 on days 1 to 3 of 21-day cycles for a maximum of six cycles. Another 31 patients were assigned to the EP Group： Cisplatin was given intravenously at a dose of 75 mg/m2 on day 1 and Etoposide 100 mg/m2 on days 1 to 3 of 21-day cycles for a maximum of six cycles. We evaluated the efficacy, overall response rate （ORR）, disease control rate （DCR）, the progression-free survival （PFS） and toxicity between the patients of the two groups. Results： All 62 patients were eligible. In the EL group, 2 （6.5%） patients had complete response, 20 （64.5%） patients had partial response, 5 （16.1%） patients had stable disease and 4 （12.9%） patients had progress disease. In the EP group, 2 （6.5%） patients had complete response, 22 （70.9%） patients had partial response, 4 （12.9%） patients had stable disease and 3 （9.7%） patients had progress disease. The ORR of EL and EP group were 70.9% and 77.4%, respectively, showing no significant difference （P = 0.562）. The DCR of both groups were 87% and 90%, respectively, showing no significant difference （P = 0.688）. Median PFS of patients with EL and EP regimens were 5.5 months and 5 months, respectively, showing no significant difference （P = 0.637）. Adverse events were observed in all 62 patients. Grade 1 to 4 anemia was higher in the EP group than in EL group, showing significant difference （P = 0.02）. Grade 3 and 4 thrombocytopenia was seen in 4 patients （12.9%） in EL group and 1 patient （3.2%） in EP group. Although one patient had platelet transfusion owing to Grade 4 thrombocytopenia in EL group, no significant difference （P = 0.637） were shown. The incidence of nausea/vomiting was higher in the EP group than in the EL group （96.7% vs 51.6%, P = 0.00）. Conclusien： The EL regimen is an effective and low-toxicity chemotherapy and no inferior to EP regimen in treatment response, therefore, EL regimen maybe is a good choice for patients with extensive-stage SCLC.展开更多
Objective In this study, we evaluated the difference of progression-free survival （PFS） and overall survival （OS） between extensive-stage small-cell lung cancer （ES-SCLC） patients who acquired partial response ...Objective In this study, we evaluated the difference of progression-free survival （PFS） and overall survival （OS） between extensive-stage small-cell lung cancer （ES-SCLC） patients who acquired partial response （PR） or complete remission （CR） after two cycles of first-line chemotherapy with the etoposide plus cisplatin （EP） regimen and those who acquired PR or CR after four or six cycles. Methods A total of 106 eligible patients treated with the EP chemotherapy regimen for two to six cycles, at The General Hospital of Shenyang Military Region （China） between November 2004 and Way 2011, were enrolled in this study. RECIST version 1.1 was used for the evaluation of chemotherapy efficiency. We followed up all eligible patients every 4 weeks. All statistical data were analyzed by using SPSS 21.0 statistical package for Windows. Results After a median follow-up of 293 days （range, 62-1531 days）, all patients had died by the cutoff date. Fifty-one patients acquired PR or CR after two cycles of chemotherapy; the median PFS reached 6.0 months （95% CI, 5.1-6.9）, and the median OS was 10.5 months （95% CI, 8.6-12.4）. Twenty-eight patients acquired PR or CR after four or six cycles; the median PFS was 4.8 months （95% CI, 4.4-5.2）, and the median OS was 7.5 months （95% CI, 6.8-8.2）. Both PFS and OS showed a statistical difference between the two groups. Conclusion ES-SCLC patients who acquired PR or CR after two cycles of the EP regimen as first-line therapy had longer PFS and OS than those who acquired PR or CR after four or six cycles.展开更多
Objective:To explore the efficacy of integrated traditional Chinese and Western medicine in the treatment of extensive-stage small cell lung cancer(ES-SCLC).Methods:Patients who were hospitalized and outpatients in th...Objective:To explore the efficacy of integrated traditional Chinese and Western medicine in the treatment of extensive-stage small cell lung cancer(ES-SCLC).Methods:Patients who were hospitalized and outpatients in the Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine from April 1,2018,to April 1,2023,were selected and screened according to the inclusion and exclusion criteria.A total of 161 patients were included,of which the control group was chemotherapy combined with traditional Chinese medicine(TCM),and the experimental group was chemotherapy+immunotherapy combined with TCM.The primary endpoint of this study was overall survival(OS),and secondary endpoints included progression-free survival(PFS),objective remission rate(ORR),and disease control rate(DCR).SPSS 25.0 statistical software and R software(version 4.2.1)were used for processing and data analysis.Results:The prognosis of patients treated with chemotherapy+immunotherapy combined with TCM was significantly better than that of the chemotherapy combined with TCM group,with median OS(15.07 months vs.13.3 months,P=0.02)and median PFS(6.87 months vs.5.97 months,P=0.04).Conclusion:Based on adjuvant therapy with TCM,chemotherapy combined with immunotherapy has more advantages than chemotherapy alone in prolonging the median OS and PFS.It can improve the general condition of patients after treatment,enhance their tolerance,and provide basic guarantees for subsequent treatment.展开更多
Small cell lung cancer(SCLC)has a high degree of malignancy and rapid progression,and most of the patients are in the extensive stage when they are diagnosed.The traditional treatment of SCLC is mainly systematic chem...Small cell lung cancer(SCLC)has a high degree of malignancy and rapid progression,and most of the patients are in the extensive stage when they are diagnosed.The traditional treatment of SCLC is mainly systematic chemotherapy combined with radiotherapy,but there has been no significant progress for many years.The emergence of immunotherapy represented by immune checkpoint inhibitors(ICIs)has changed the treatment pattern of SCLC.Some studies have confirmed the effect of ICIs monotherapy.However,the disadvantages of ICIs monotherapy such as low responsiveness,drug resistance,and adverse reactions limited the clinical application.The combined treatment of immune checkpoint inhibitors was newly developing treatment models.Clinical studies have found that ICIs combined with standard chemotherapy can significantly improve the survival of patients with extensive small cell lung cancer without increasing adverse reactions.Based on the synergistic effect of immunotherapy combined with chemotherapy,this paper reviews the current progress,deficiency and future exploration direction of first-line immunotherapy for extensive small cell lung cancer.展开更多
Background:The disease burden,treatment patterns,and financial costs associated with chemotherapy-induced myelosuppression(CIM)in Chinese patients with extensive-stage small cell lung cancer(ES-SCLC)remain poorly char...Background:The disease burden,treatment patterns,and financial costs associated with chemotherapy-induced myelosuppression(CIM)in Chinese patients with extensive-stage small cell lung cancer(ES-SCLC)remain poorly characterized,particularly in terms of real-world evidence derived from large populations.This study aimed to describe the incidence,treatment patterns,costs,and healthcare resource utilization(HCRU)in Chinese patients with ES-SCLC who develop CIM.Methods:Adults diagnosed with ES-SCLC who started etoposide—platinum(EP)chemotherapy for the first time between January 1,2018 and December 31,2022 were retrospectively identifiedin the Chinese National Cancer Information Database.Baseline demographic and clinical data were collected.Information on CIM-related events,treatment,costs,and HCRU during EP chemotherapy and during follow-up was assessed.Costs and HCRU were compared among patients with grade 3-4 CIM,grade 12 CIM,and no CIM using the KruskalWallis test.Results:In total,7505 patients with ES-SCLC(mean age 61.2 years;17.7%[1332/7505]female;body mass index 23.2±3.3 kg/m^(2))were enrolled.After initiation of EP-based chemotherapy,6901 patients(92.0%)experienced at least one CIM-related event.At least one grade 34 CIM event occurred in 1883 patients(25.1%)and consisted of single-lineage(neutropenia[n=609,8.1%],thrombocytopenia[n=85,1.1%],anemia[n=797,10.6%]),twolineage(n=318,4.2%),and three-lineage(n=74,1.0%)events.Patients receiving immune checkpoint inhibitors(ICIs)plus EP(n=1674)had a significantly higher incidence of at least one CIM during the ICI combination therapy(87.8%[1469/1674]vs.82.8%[4827/5831];χ^(2)=23.43,P<0.0001)and grade 34 CIM(25.7%[430/1674]vs.20.6%[1201/5831];χ^(2)=19.51,P<0.0001)compared to those receiving other EP-basedtherapies duringEP chemotherapy(n=5831).Rates of use of granulocyte colony-stimulating factor,thrombopoietin,interleukin-11,erythropoiesis-stimulating agents,and blood transfusion were 81.1%(n=6087),9.2%(n=691),12.4%(n=927),9.0%(n=678),and 12.1%(n=907),respectively.HCRU and total costs per patient were higher for those with grade 3-4 CIM than for those without CIM or grade 1-2 CIM,and significant differences in the total cost were observed across groups(H=195.54,P<0.0001).Conclusion:Despite the availability of supportive care for CIM in patients with ES-SCLC in China,a considerable clinical and financial burden persists.Strategies that protect bone marrow from progressing to high-grade myelosuppression could reduce the burden on patients and healthcare organizations.展开更多
As survival rates improve and detection technologies advance,the occurrence of multiple primary cancers(MPCs)has been increasing.Approximately 16%of cancer survivors develop a subsequent malignancy,with lung cancer of...As survival rates improve and detection technologies advance,the occurrence of multiple primary cancers(MPCs)has been increasing.Approximately 16%of cancer survivors develop a subsequent malignancy,with lung cancer often developing after esophageal cancer due to potential“field cancerization”effects.Despite this observation,the genetic heterogeneity underlying MPCs remains understudied.However,the recent emergence of genetic testing has expanded the scope of investigations into MPCs to investigate signatures underlying cancer predisposition.This report reveals 3 unprecedented TP53 fusion mutations in a Chinese patient afflicted by MPCs,namely,AP1M2–TP53(A1;T11)fusion,TP53–ILF3(T10;I13)fusion,and SLC44A2–TP53(S5;T11)fusion.This patient exhibited an extended period of survival after diagnosis of extensive-stage small cell lung cancer,which occurred 6 years after the diagnosis of esophageal squamous cell cancer.This unique reportmay provide supplementary data that enhance our understanding of the genetic landscape ofMPCs.展开更多
Background:Small cell lung cancer(SCLC)is an aggressive malignant tumor with strong immunosuppressive effects,characterized by rapid doubling time and poor prognosis.Currently,effective therapeutic options are urgentl...Background:Small cell lung cancer(SCLC)is an aggressive malignant tumor with strong immunosuppressive effects,characterized by rapid doubling time and poor prognosis.Currently,effective therapeutic options are urgently needed for Extensive-stage small-cell lung Cancer.Case description:In the present case,a combination therapy of anlotinib,envolizumab,and etoposide was administered to treat an 80-year-old female patient with extensive-stage SCLC accompanied by mediastinal lymph node and bone metastasis.After two cycles of treatment,the tumor lesions in the right lungs decreased from 5.04*3.44 cm to 1.65*1.42 cm.As of now,no significant mass is seen there and no serious adverse reactions in this patient.Until September 2023,she has survived for 18 months with no disease progression.Conclusions:Research shows that Alectinib,in combination with evolocumab plus etoposide,could be an original,viable therapeutic option for the treatment option of patients with extensive-stage SCLC.展开更多
基金supported by the Young Talents Program of Jiangsu Cancer Hospital(Grant No.QL201802)the Science and Technology Development Fund of Jiangsu Cancer Hospital(Grant No.ZL202105).
文摘The present study assessed the efficacy and safety of thoracic radiotherapy(TRT)following first-line chemotherapy or chemoimmunotherapy in patients with extensive-stage small cell lung cancer(ES-SCLC),focusing on the influence of different TRT timing strategies(consolidative vs.salvage)on survival rates.We retrospectively analyzed a total of 54 patients with ES-SCLC treated between January 2019 and July 2022.Patients receiving consolidative TRT(cTRT)within three months after completion of first-line treatment were compared with those receiving salvage TRT(sTRT)after disease progression.The primary endpoints were overall survival(OS),progression-free survival(PFS),locoregional-free survival(LRFS),and distant metastasis-free survival(DMFS);the secondary endpoint included safety.The cTRT group(n=41)showed significantly longer median OS(26.6 vs.14.8 months,P=0.048),PFS(12.9 vs.3.5 months,P<0.0001),and DMFS(10.7 vs.3.4 months,P=0.0044)than the sTRT group(n=13).Multivariate analysis revealed that cTRT was an independent,favorable prognostic factor.No significant differences in OS or LRFS were observed between high-dose(≥50 Gy)and low-dose(<50 Gy)TRT.Hematologic and respiratory toxicities were the most frequently reported adverse events,with acceptable tolerability.In conclusion,cTRT after chemoimmunotherapy significantly improves survival outcomes for ES-SCLC patients,and low-dose TRT may be a suitable option.
基金supported by National Natural Science Foundation of China(No.82141117)the Capital Health Research and Development of Special Fund(No.2022-21023)+2 种基金Beijing Municipal Administration of Hospitals Incubating Program(No.PX2020045)Science Foundation of Peking University Cancer Hospital(No.2020-4)Wu Jieping Medical Foundation(No.320.6750.2021-16-19)。
文摘Objective:Atezolizumab along with chemotherapy has prolonged the survival of patients with extensive-stage small-cell lung cancer(ES-SCLC)worldwide,although real-world(RW)data are lacking in China.This study was designed to evaluate the efficacy and clinical outcomes of atezolizumab plus etoposide/platinum(EP).Methods:Data obtained in this retrospective study were captured from six oncology units of five medical facilities from January 2019 to April 2022.For first-line treatments,atezolizumab combined with EP vs.EP alone,we primarily evaluated progression-free survival(PFS);other efficacy indicators,including overall survival(OS),objective response rate(ORR),and patterns of SCLC progression and adverse events(AEs)were assessed.Results:The primary analysis included data from 225 patients,of whom 133 received EP along with atezolizumab(atezolizumab group)and 92 received EP alone(EP group).The PFS duration of the atezolizumab group[7.10 months;95%confidence interval(95%CI),6.53-9.00]exceeded that of the EP group(6.50 months;95%CI,4.83-7.53).Overall,the hazard ratio(HR)was 0.69(95%CI,0.49-0.97)(P=0.029);particularly,the HR was 0.54(95%CI,0.36-0.80)among patients undergoing≥4 chemotherapy cycles and 0.33(95%CI,0.20-0.56)among individuals with atezolizumab maintenance.The ORR and disease-control rate(DCR)were similar between the two groups.Because of incomplete OS data,the median OS was not determined for either group.Bone marrow suppression was the most common AE detected(58.6%)in the atezolizumab group.Immune-related AEs occurred in 19 patients in the atezolizumab group(14.3%),with only one case of grade 3 encephalitis.Conclusions:This RW study in China demonstrated improved clinical outcomes of atezolizumab along with EP for ES-SCLC,particularly in the chemosensitive population.These results align with the results of the IMpower133 study,although the impact of this treatment modality on OS warrants additional follow-up studies.
文摘Lung cancer, being the most common cancer type, accounts for 13% of all newly diagnosed malignant tumors globally each year. Small cell lung cancer(SCLC) accounts for approximately 15% of newly diagnosed lung cancers each year, but its annual death toll accounts for 25% of that of lung cancer. We summarized relevant clinical studies to elaborate the epidemiology, pathological and clinical characteristics and the treatment status of small cell lung cancer. This paper first described the epidemiology and the pathological and clinical characteristics of SCLC and the systematic treatment of extensive-stage SCLC and then introduced the current targeted therapy and immunotherapy for SCLC to provide clinicians and patients with a more systematic, comprehensive, and beneficial treatment regimen. We expect that these studies can provide clinicians with a clear direction in molecularly targeted therapy or immunotherapy, so that a treatment approach with better antitumor effects and longer-lasting clinical benefits can be provided to the patients.
基金a grant of the Hainan Chang'an International Pharmaceutical Company Limited
文摘Objective： To compare the efficacy and safety of Lobaplatin plus Etoposide （EL） and Cisplatin plus Etoposide （EP） regimens in chemonaive with extensive-stage small-cell lung cancer （SCLC）. Methods： Between July 2010 and July 2011, a total of 62 patients with extensive-stage small-cell lung cancer who received initial treatment in our hospital and 309 hospital of PLA. 31 patients were randomly assigned to the EL Group： Lobaplatin was given intravenously at a dose of 30 mg/m2 on day 1 and Etoposide 100 mg/m2 on days 1 to 3 of 21-day cycles for a maximum of six cycles. Another 31 patients were assigned to the EP Group： Cisplatin was given intravenously at a dose of 75 mg/m2 on day 1 and Etoposide 100 mg/m2 on days 1 to 3 of 21-day cycles for a maximum of six cycles. We evaluated the efficacy, overall response rate （ORR）, disease control rate （DCR）, the progression-free survival （PFS） and toxicity between the patients of the two groups. Results： All 62 patients were eligible. In the EL group, 2 （6.5%） patients had complete response, 20 （64.5%） patients had partial response, 5 （16.1%） patients had stable disease and 4 （12.9%） patients had progress disease. In the EP group, 2 （6.5%） patients had complete response, 22 （70.9%） patients had partial response, 4 （12.9%） patients had stable disease and 3 （9.7%） patients had progress disease. The ORR of EL and EP group were 70.9% and 77.4%, respectively, showing no significant difference （P = 0.562）. The DCR of both groups were 87% and 90%, respectively, showing no significant difference （P = 0.688）. Median PFS of patients with EL and EP regimens were 5.5 months and 5 months, respectively, showing no significant difference （P = 0.637）. Adverse events were observed in all 62 patients. Grade 1 to 4 anemia was higher in the EP group than in EL group, showing significant difference （P = 0.02）. Grade 3 and 4 thrombocytopenia was seen in 4 patients （12.9%） in EL group and 1 patient （3.2%） in EP group. Although one patient had platelet transfusion owing to Grade 4 thrombocytopenia in EL group, no significant difference （P = 0.637） were shown. The incidence of nausea/vomiting was higher in the EP group than in the EL group （96.7% vs 51.6%, P = 0.00）. Conclusien： The EL regimen is an effective and low-toxicity chemotherapy and no inferior to EP regimen in treatment response, therefore, EL regimen maybe is a good choice for patients with extensive-stage SCLC.
基金Supported by grants from the National Research Key Project of the Twelfth Five-year Plan of the Republic of China(No.2012ZX09303016-002)the Science and Technology Key Programs of Liaoning Province(No.2012225019)
文摘Objective In this study, we evaluated the difference of progression-free survival （PFS） and overall survival （OS） between extensive-stage small-cell lung cancer （ES-SCLC） patients who acquired partial response （PR） or complete remission （CR） after two cycles of first-line chemotherapy with the etoposide plus cisplatin （EP） regimen and those who acquired PR or CR after four or six cycles. Methods A total of 106 eligible patients treated with the EP chemotherapy regimen for two to six cycles, at The General Hospital of Shenyang Military Region （China） between November 2004 and Way 2011, were enrolled in this study. RECIST version 1.1 was used for the evaluation of chemotherapy efficiency. We followed up all eligible patients every 4 weeks. All statistical data were analyzed by using SPSS 21.0 statistical package for Windows. Results After a median follow-up of 293 days （range, 62-1531 days）, all patients had died by the cutoff date. Fifty-one patients acquired PR or CR after two cycles of chemotherapy; the median PFS reached 6.0 months （95% CI, 5.1-6.9）, and the median OS was 10.5 months （95% CI, 8.6-12.4）. Twenty-eight patients acquired PR or CR after four or six cycles; the median PFS was 4.8 months （95% CI, 4.4-5.2）, and the median OS was 7.5 months （95% CI, 6.8-8.2）. Both PFS and OS showed a statistical difference between the two groups. Conclusion ES-SCLC patients who acquired PR or CR after two cycles of the EP regimen as first-line therapy had longer PFS and OS than those who acquired PR or CR after four or six cycles.
基金National Natural Science Foundation of China(Project No.:82074425)Young Qihuang Scholars Talent Project of National Administration of Traditional Chinese Medicine+4 种基金Top Technology Leading Talents Project of Hunan ProvinceKey R&D projects in Hunan Province(Project No.:2021SK2006)Natural Science Foundation of Hunan Province(Project No.:2021JJ30417)Hunan Provincial Engineering Research Center of Anti-tumor Chinese Medicine Creation Technology ProjectHunan Provincial Health Commission Traditional Chinese Medicine Shennong Leading Talent Project。
文摘Objective:To explore the efficacy of integrated traditional Chinese and Western medicine in the treatment of extensive-stage small cell lung cancer(ES-SCLC).Methods:Patients who were hospitalized and outpatients in the Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine from April 1,2018,to April 1,2023,were selected and screened according to the inclusion and exclusion criteria.A total of 161 patients were included,of which the control group was chemotherapy combined with traditional Chinese medicine(TCM),and the experimental group was chemotherapy+immunotherapy combined with TCM.The primary endpoint of this study was overall survival(OS),and secondary endpoints included progression-free survival(PFS),objective remission rate(ORR),and disease control rate(DCR).SPSS 25.0 statistical software and R software(version 4.2.1)were used for processing and data analysis.Results:The prognosis of patients treated with chemotherapy+immunotherapy combined with TCM was significantly better than that of the chemotherapy combined with TCM group,with median OS(15.07 months vs.13.3 months,P=0.02)and median PFS(6.87 months vs.5.97 months,P=0.04).Conclusion:Based on adjuvant therapy with TCM,chemotherapy combined with immunotherapy has more advantages than chemotherapy alone in prolonging the median OS and PFS.It can improve the general condition of patients after treatment,enhance their tolerance,and provide basic guarantees for subsequent treatment.
基金supported by the National Natural Science Foundation of China(No.81403220)Tianjin Health and family planning-high level talent selection and training project+1 种基金Tianjin Science and Technology Plan Projects(No.17ZXMFSY00190)Tianjin Traditional Chinese Medicine Research Project,Tianjin health and family planning commission(No.2017003).
文摘Small cell lung cancer(SCLC)has a high degree of malignancy and rapid progression,and most of the patients are in the extensive stage when they are diagnosed.The traditional treatment of SCLC is mainly systematic chemotherapy combined with radiotherapy,but there has been no significant progress for many years.The emergence of immunotherapy represented by immune checkpoint inhibitors(ICIs)has changed the treatment pattern of SCLC.Some studies have confirmed the effect of ICIs monotherapy.However,the disadvantages of ICIs monotherapy such as low responsiveness,drug resistance,and adverse reactions limited the clinical application.The combined treatment of immune checkpoint inhibitors was newly developing treatment models.Clinical studies have found that ICIs combined with standard chemotherapy can significantly improve the survival of patients with extensive small cell lung cancer without increasing adverse reactions.Based on the synergistic effect of immunotherapy combined with chemotherapy,this paper reviews the current progress,deficiency and future exploration direction of first-line immunotherapy for extensive small cell lung cancer.
基金funded by the National Key Reseach&Development Program of China(No.2022YFC2505000)the Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(No.CIFMS 2022-I2M-1-O09)+2 种基金the National Natural Science Foundation of China(NSFC)Special Program(No.82241229)the Y&M Cultivation Project of Cancer Hospital Chinese Academy of Medical Sciences(No.CICAMS-MOY&M-202402)Simcere Zaiming Pharmaceutical Co.,Ltd.
文摘Background:The disease burden,treatment patterns,and financial costs associated with chemotherapy-induced myelosuppression(CIM)in Chinese patients with extensive-stage small cell lung cancer(ES-SCLC)remain poorly characterized,particularly in terms of real-world evidence derived from large populations.This study aimed to describe the incidence,treatment patterns,costs,and healthcare resource utilization(HCRU)in Chinese patients with ES-SCLC who develop CIM.Methods:Adults diagnosed with ES-SCLC who started etoposide—platinum(EP)chemotherapy for the first time between January 1,2018 and December 31,2022 were retrospectively identifiedin the Chinese National Cancer Information Database.Baseline demographic and clinical data were collected.Information on CIM-related events,treatment,costs,and HCRU during EP chemotherapy and during follow-up was assessed.Costs and HCRU were compared among patients with grade 3-4 CIM,grade 12 CIM,and no CIM using the KruskalWallis test.Results:In total,7505 patients with ES-SCLC(mean age 61.2 years;17.7%[1332/7505]female;body mass index 23.2±3.3 kg/m^(2))were enrolled.After initiation of EP-based chemotherapy,6901 patients(92.0%)experienced at least one CIM-related event.At least one grade 34 CIM event occurred in 1883 patients(25.1%)and consisted of single-lineage(neutropenia[n=609,8.1%],thrombocytopenia[n=85,1.1%],anemia[n=797,10.6%]),twolineage(n=318,4.2%),and three-lineage(n=74,1.0%)events.Patients receiving immune checkpoint inhibitors(ICIs)plus EP(n=1674)had a significantly higher incidence of at least one CIM during the ICI combination therapy(87.8%[1469/1674]vs.82.8%[4827/5831];χ^(2)=23.43,P<0.0001)and grade 34 CIM(25.7%[430/1674]vs.20.6%[1201/5831];χ^(2)=19.51,P<0.0001)compared to those receiving other EP-basedtherapies duringEP chemotherapy(n=5831).Rates of use of granulocyte colony-stimulating factor,thrombopoietin,interleukin-11,erythropoiesis-stimulating agents,and blood transfusion were 81.1%(n=6087),9.2%(n=691),12.4%(n=927),9.0%(n=678),and 12.1%(n=907),respectively.HCRU and total costs per patient were higher for those with grade 3-4 CIM than for those without CIM or grade 1-2 CIM,and significant differences in the total cost were observed across groups(H=195.54,P<0.0001).Conclusion:Despite the availability of supportive care for CIM in patients with ES-SCLC in China,a considerable clinical and financial burden persists.Strategies that protect bone marrow from progressing to high-grade myelosuppression could reduce the burden on patients and healthcare organizations.
基金supported by the National Natural Science Foun-dation of China(grant numbers 81974483 and 82072589)the ChineseSocietyofClinicalOncology-HengruiCancerResearch Fund(Y-HR2020QN-0946).
文摘As survival rates improve and detection technologies advance,the occurrence of multiple primary cancers(MPCs)has been increasing.Approximately 16%of cancer survivors develop a subsequent malignancy,with lung cancer often developing after esophageal cancer due to potential“field cancerization”effects.Despite this observation,the genetic heterogeneity underlying MPCs remains understudied.However,the recent emergence of genetic testing has expanded the scope of investigations into MPCs to investigate signatures underlying cancer predisposition.This report reveals 3 unprecedented TP53 fusion mutations in a Chinese patient afflicted by MPCs,namely,AP1M2–TP53(A1;T11)fusion,TP53–ILF3(T10;I13)fusion,and SLC44A2–TP53(S5;T11)fusion.This patient exhibited an extended period of survival after diagnosis of extensive-stage small cell lung cancer,which occurred 6 years after the diagnosis of esophageal squamous cell cancer.This unique reportmay provide supplementary data that enhance our understanding of the genetic landscape ofMPCs.
文摘Background:Small cell lung cancer(SCLC)is an aggressive malignant tumor with strong immunosuppressive effects,characterized by rapid doubling time and poor prognosis.Currently,effective therapeutic options are urgently needed for Extensive-stage small-cell lung Cancer.Case description:In the present case,a combination therapy of anlotinib,envolizumab,and etoposide was administered to treat an 80-year-old female patient with extensive-stage SCLC accompanied by mediastinal lymph node and bone metastasis.After two cycles of treatment,the tumor lesions in the right lungs decreased from 5.04*3.44 cm to 1.65*1.42 cm.As of now,no significant mass is seen there and no serious adverse reactions in this patient.Until September 2023,she has survived for 18 months with no disease progression.Conclusions:Research shows that Alectinib,in combination with evolocumab plus etoposide,could be an original,viable therapeutic option for the treatment option of patients with extensive-stage SCLC.
