Background:Promising efficacy and manageable toxicity of docetaxel-based concurrent chemoradiotherapy(CCRT)were reported in head and neck cancer.In addition,the effect of CCRT in combination with cisplatin and/or 5-fl...Background:Promising efficacy and manageable toxicity of docetaxel-based concurrent chemoradiotherapy(CCRT)were reported in head and neck cancer.In addition,the effect of CCRT in combination with cisplatin and/or 5-fluorouracil on both locoregionally advanced and metastatic/recurrent nasopharyngeal carcinoma(NPC)was verified.However,CCRT with docetaxel for locoregionally advanced NPC are not well studied.This study aimed to compare effectiveness and toxicities of CCRT with weekly docetaxel versus tri-weekly cisplatin for locoregionally advanced NPC.Methods:Clinical data of patients with locoregionally advanced NPC newly diagnosed between January 2010 and December 2014 receiving CCRT with either weekly docetaxel(15 mg/m2)or tri-weekly cisplatin(80-100 mg/m2)were reviewed.Propensity score matching at a 1:1 ratio was performed to balance baseline characteristics.Adverse events and survival were compared between the two groups.Results:A total of 962 patients were included as the whole cohort,and 448 patients were matched and were regarded as the matched cohort.The median follow-up duration was 48 months for the whole cohort.The 3-year nodal recurrence-free survival rate was significantly increased for patients treated with docetaxel in both the whole(hazard ratio[HR]=0.37,95%confidence interval[CI]0.19-0.72,P=0.030)and matched cohorts(HR=0.33,95%CI 0.14-0.79,P=0.023).However,no significant differences were observed in overall survival,local recurrence-free survival,and distant metastasis-free survival between the two groups in both cohorts.Significantly higher rates of grade 3 radiodermatitis(6.7%vs.1.8%,P=0.001),mucositis(74.5%vs.37.9%,P<0.001),and leucopenia(2.2%vs.11.6%,P<0.001)were observed in the docetaxel group,but any grade of renal injury(1.8%vs.15.1%,P<0.001),vomiting(18.8%vs.88.3%,P<0.001),and ALT elevation(19.2%vs.31.3%,P=0.027)were more common in the cisplatin group.Conclusions:CCRT with weekly low-dose docetaxel is an effective and tolerable therapeutic regimen for locally advanced NPC.It provides a survival benefit mainly by improving the control of regional lymph node metastases,especially for patients with low pretreatment EBV DNA levels.展开更多
Correction to:Cancer Commun(2019)39:40 https://doi.org/10.1186/s40880-019-0380-x In the original publication of this article[1],the first affiliation name in the Author details section should be updated to‘Department...Correction to:Cancer Commun(2019)39:40 https://doi.org/10.1186/s40880-019-0380-x In the original publication of this article[1],the first affiliation name in the Author details section should be updated to‘Department of Radiation Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital&Shenzhen Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Shenzhen 518116,China’because the affiliation has been renamed from Jun.15th,2019.展开更多
Background:The combination of immune checkpoint inhibitors and chemotherapy(ICI+Chemo)shows promise in treatment of recurrent or metastatic nasopharyngeal carcinoma(RM-NPC),but some patients received limited benefit a...Background:The combination of immune checkpoint inhibitors and chemotherapy(ICI+Chemo)shows promise in treatment of recurrent or metastatic nasopharyngeal carcinoma(RM-NPC),but some patients received limited benefit and the prognostic factors of the treatments remain unclear.Furthermore,ICIs efficacy in subsequent treatments needs further evaluation.Methods:A systematic search on PubMed,Embase,the Cochrane Library,and major conference proceedings was conducted to identify relevant studies for meta-analysis.The study was designed to compare ICI+Chemo with chemotherapy in first-line treatment and identify efficacy predictors,and to evaluate ICIs alone in subsequent-line treatment for RM-NPC,with a focus on progression-free survival(PFS),objective response rate(ORR),and treatment-related adverse events(AEs).Results:Fifteen trials involving 1928 patients were included.Three trials compared ICI+Chemo with chemotherapy as a first-line treatment,while 12 trials evaluated ICIs alone in subsequent-line treatment of RM-NPC patients.First-line ICI+Chemo showed superior PFS(hazard ratio[HR]=0.52,95%confidence interval[CI],0.43-0.63;P<0.001)and ORR(risk ratio[RR]=1.14,95%CI,1.05-1.24;P<0.001)compared to chemotherapy,without increased AEs(RR=1.01,95%CI,0.99-1.03;P=0.481).Neither programmed death-ligand 1(PD-L1)nor other factors predicted the efficacy of ICI+Chemo vs.chemotherapy.Subsequent-line ICIs alone had a median PFS of 4.12 months(95%CI,2.93-5.31 months),an ORR of 24%(95%CI,20-28%),with grade 1-5/grade 3-5 AEs at 79%/14%.However,ICIs alone were associated with significantly shorter PFS(HR=1.31,95%CI,1.01-1.68;P=0.040)than chemotherapy alone.Conclusions:ICI+Chemo confers superior survival benefits compared to chemotherapy in first-line RM-NPC treatment,independent of PD-L1 expression or other factors.However,ICIs alone demonstrate a manageable safety profile but do not surpass chemotherapy in efficacy for subsequent-line treatment.展开更多
Background Prognosis varies among patients within the same colon adenocarcinoma(COAD)stage,indicating the need for reliable molecular markers to enable individualized treatment.This study aimed to investigate gene sig...Background Prognosis varies among patients within the same colon adenocarcinoma(COAD)stage,indicating the need for reliable molecular markers to enable individualized treatment.This study aimed to investigate gene signatures that can be used for better prognostic prediction of COAD.Methods Gene-expression profiles of COAD patients were obtained from the Gene Expression Omnibus database(n=332)and The Cancer Genome Atlas database(n=431).The relationship between gene signature and relapse-free survival was analysed in the training set(n=93)and validated in the internal validation set(n=94)and external validation sets(n=145 and 431).Results Overall,11 genes(N-myc downstream regulated gene 1[NDRG1],fms-like tyrosine kinase 1[FLT1],lipopolysaccharide binding protein[LBP],fatty acid binding protein 4[FABP4],adiponectin gene[ADIPOQ],angiotensinogen gene[AGT],activin A receptor,type II-like kinase 1[ACVRL1],CC chemokine ligand 11[CCL11],cell division cycle 42[CDC42],T-cell receptor alpha variable 9_2[TRAV9_2],and proopiomelanocortin[POMC])were identified by univariable and least absolute shrinkage and selection operator(LASSO)Cox regression analyses.Based on the risk-score model,the patients were grouped into the high-risk or low-risk groups using the median risk score as the cut-off.The area under the curve(AUC)values for 1-,3-,and 5-year recurrence were 0.970,0.849,and 0.859,respectively.Patients in the high-risk group had significantly poorer relapsefree survival than did those in the low-risk group.The predictive accuracy of the 11-gene signature was proven in the validation sets.Our gene signature showed better predictive performance for 1-,3-,and 5-year recurrence than did the other four models.Conclusions The 11-gene signature showed good performance in predicting recurrence in COAD.The accuracy of the signature for prognostic classification requires further confirmation.展开更多
CA209-7AL is a randomized,multicenter,phase 2 trial evaluating the efficacy and safety of consolidative nivolumab(NIVO)versus observation following neoadjuvant NIVO plus chemotherapy and concurrent chemoradiotherapy(C...CA209-7AL is a randomized,multicenter,phase 2 trial evaluating the efficacy and safety of consolidative nivolumab(NIVO)versus observation following neoadjuvant NIVO plus chemotherapy and concurrent chemoradiotherapy(CCRT)for unresectable stage Ⅲ NSCLC.Patients received 2 cycles of neoadjuvant chemo-NIVO therapy(docetaxel+cisplatin+NIVO)and CCRT(total dose 54–64 Gy).Post-CCRT,eligible patients were randomized 1:1 to receive consolidative NIVO(360 mg every 3 weeks for up to 12 months)or observation.The primary endpoint was progression-free survival(PFS)from randomization.Between December 3rd,2019,and August 18th,2023,264 patients were enrolled,and 172 were randomized to NIVO consolidation(n=86)or observation(n=86).With a median follow-up of 22·8 months,NIVO consolidation resulted in significantly longer PFS than did observation(median not reached vs.12.2 months[95%CI 10.2–20.8];stratified hazard ratio 0·49[95%CI 0.30–0.79],p=0.003).NIVO consolidation also demonstrated superior PFS compared with a parallel real-world study,where patients received CCRT followed by consolidative immunotherapy(median PFS:15.7 months[95%CI 11.9-NA]).Grade 3 or 4 toxicities occurred in 9.3%of patients in the consolidation group versus 4·6%in the observation group,with similar rates of pneumonitis(2.3%each)and proximal bronchial tree toxicity(3.5%vs.2.3%).Treatment-related death occurred in 1(1.2%)patient in the consolidation group because of pneumonitis.Patients with a high TMB had a longer PFS with consolidation(NR vs.15.2 months,p=0.042).Consolidative NIVO following neoadjuvant NIVO plus chemotherapy and CCRT demonstrated effectiveness and tolerability for patients with unresectable stage Ⅲ NSCLC(ClinicalTrials.gov NCT04085250).展开更多
文摘Background:Promising efficacy and manageable toxicity of docetaxel-based concurrent chemoradiotherapy(CCRT)were reported in head and neck cancer.In addition,the effect of CCRT in combination with cisplatin and/or 5-fluorouracil on both locoregionally advanced and metastatic/recurrent nasopharyngeal carcinoma(NPC)was verified.However,CCRT with docetaxel for locoregionally advanced NPC are not well studied.This study aimed to compare effectiveness and toxicities of CCRT with weekly docetaxel versus tri-weekly cisplatin for locoregionally advanced NPC.Methods:Clinical data of patients with locoregionally advanced NPC newly diagnosed between January 2010 and December 2014 receiving CCRT with either weekly docetaxel(15 mg/m2)or tri-weekly cisplatin(80-100 mg/m2)were reviewed.Propensity score matching at a 1:1 ratio was performed to balance baseline characteristics.Adverse events and survival were compared between the two groups.Results:A total of 962 patients were included as the whole cohort,and 448 patients were matched and were regarded as the matched cohort.The median follow-up duration was 48 months for the whole cohort.The 3-year nodal recurrence-free survival rate was significantly increased for patients treated with docetaxel in both the whole(hazard ratio[HR]=0.37,95%confidence interval[CI]0.19-0.72,P=0.030)and matched cohorts(HR=0.33,95%CI 0.14-0.79,P=0.023).However,no significant differences were observed in overall survival,local recurrence-free survival,and distant metastasis-free survival between the two groups in both cohorts.Significantly higher rates of grade 3 radiodermatitis(6.7%vs.1.8%,P=0.001),mucositis(74.5%vs.37.9%,P<0.001),and leucopenia(2.2%vs.11.6%,P<0.001)were observed in the docetaxel group,but any grade of renal injury(1.8%vs.15.1%,P<0.001),vomiting(18.8%vs.88.3%,P<0.001),and ALT elevation(19.2%vs.31.3%,P=0.027)were more common in the cisplatin group.Conclusions:CCRT with weekly low-dose docetaxel is an effective and tolerable therapeutic regimen for locally advanced NPC.It provides a survival benefit mainly by improving the control of regional lymph node metastases,especially for patients with low pretreatment EBV DNA levels.
文摘Correction to:Cancer Commun(2019)39:40 https://doi.org/10.1186/s40880-019-0380-x In the original publication of this article[1],the first affiliation name in the Author details section should be updated to‘Department of Radiation Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital&Shenzhen Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Shenzhen 518116,China’because the affiliation has been renamed from Jun.15th,2019.
文摘Background:The combination of immune checkpoint inhibitors and chemotherapy(ICI+Chemo)shows promise in treatment of recurrent or metastatic nasopharyngeal carcinoma(RM-NPC),but some patients received limited benefit and the prognostic factors of the treatments remain unclear.Furthermore,ICIs efficacy in subsequent treatments needs further evaluation.Methods:A systematic search on PubMed,Embase,the Cochrane Library,and major conference proceedings was conducted to identify relevant studies for meta-analysis.The study was designed to compare ICI+Chemo with chemotherapy in first-line treatment and identify efficacy predictors,and to evaluate ICIs alone in subsequent-line treatment for RM-NPC,with a focus on progression-free survival(PFS),objective response rate(ORR),and treatment-related adverse events(AEs).Results:Fifteen trials involving 1928 patients were included.Three trials compared ICI+Chemo with chemotherapy as a first-line treatment,while 12 trials evaluated ICIs alone in subsequent-line treatment of RM-NPC patients.First-line ICI+Chemo showed superior PFS(hazard ratio[HR]=0.52,95%confidence interval[CI],0.43-0.63;P<0.001)and ORR(risk ratio[RR]=1.14,95%CI,1.05-1.24;P<0.001)compared to chemotherapy,without increased AEs(RR=1.01,95%CI,0.99-1.03;P=0.481).Neither programmed death-ligand 1(PD-L1)nor other factors predicted the efficacy of ICI+Chemo vs.chemotherapy.Subsequent-line ICIs alone had a median PFS of 4.12 months(95%CI,2.93-5.31 months),an ORR of 24%(95%CI,20-28%),with grade 1-5/grade 3-5 AEs at 79%/14%.However,ICIs alone were associated with significantly shorter PFS(HR=1.31,95%CI,1.01-1.68;P=0.040)than chemotherapy alone.Conclusions:ICI+Chemo confers superior survival benefits compared to chemotherapy in first-line RM-NPC treatment,independent of PD-L1 expression or other factors.However,ICIs alone demonstrate a manageable safety profile but do not surpass chemotherapy in efficacy for subsequent-line treatment.
基金supported by National Key Clinical Discipline,the Fundamental Research Funds for the young teacher training program of Sun Yat-sen University[grant number 18ykpy02]the“5010 Clinical Research Program”of Sun Yat-sen University[grant number 2010012]+1 种基金the Natural Science Foundation of Guangdong Province,China[grant number 2020A1515010428]the Medical Science Research Grant from the Health Department of Guangdong Province[grant number A2018007].
文摘Background Prognosis varies among patients within the same colon adenocarcinoma(COAD)stage,indicating the need for reliable molecular markers to enable individualized treatment.This study aimed to investigate gene signatures that can be used for better prognostic prediction of COAD.Methods Gene-expression profiles of COAD patients were obtained from the Gene Expression Omnibus database(n=332)and The Cancer Genome Atlas database(n=431).The relationship between gene signature and relapse-free survival was analysed in the training set(n=93)and validated in the internal validation set(n=94)and external validation sets(n=145 and 431).Results Overall,11 genes(N-myc downstream regulated gene 1[NDRG1],fms-like tyrosine kinase 1[FLT1],lipopolysaccharide binding protein[LBP],fatty acid binding protein 4[FABP4],adiponectin gene[ADIPOQ],angiotensinogen gene[AGT],activin A receptor,type II-like kinase 1[ACVRL1],CC chemokine ligand 11[CCL11],cell division cycle 42[CDC42],T-cell receptor alpha variable 9_2[TRAV9_2],and proopiomelanocortin[POMC])were identified by univariable and least absolute shrinkage and selection operator(LASSO)Cox regression analyses.Based on the risk-score model,the patients were grouped into the high-risk or low-risk groups using the median risk score as the cut-off.The area under the curve(AUC)values for 1-,3-,and 5-year recurrence were 0.970,0.849,and 0.859,respectively.Patients in the high-risk group had significantly poorer relapsefree survival than did those in the low-risk group.The predictive accuracy of the 11-gene signature was proven in the validation sets.Our gene signature showed better predictive performance for 1-,3-,and 5-year recurrence than did the other four models.Conclusions The 11-gene signature showed good performance in predicting recurrence in COAD.The accuracy of the signature for prognostic classification requires further confirmation.
基金funded by Bristol Myers Squibb(CA209-7AL)funding from Varian Medical Systems,Elekta Medical Systemsthe Guangdong Association Study of Thoracic Oncology(GASTO-1091).
文摘CA209-7AL is a randomized,multicenter,phase 2 trial evaluating the efficacy and safety of consolidative nivolumab(NIVO)versus observation following neoadjuvant NIVO plus chemotherapy and concurrent chemoradiotherapy(CCRT)for unresectable stage Ⅲ NSCLC.Patients received 2 cycles of neoadjuvant chemo-NIVO therapy(docetaxel+cisplatin+NIVO)and CCRT(total dose 54–64 Gy).Post-CCRT,eligible patients were randomized 1:1 to receive consolidative NIVO(360 mg every 3 weeks for up to 12 months)or observation.The primary endpoint was progression-free survival(PFS)from randomization.Between December 3rd,2019,and August 18th,2023,264 patients were enrolled,and 172 were randomized to NIVO consolidation(n=86)or observation(n=86).With a median follow-up of 22·8 months,NIVO consolidation resulted in significantly longer PFS than did observation(median not reached vs.12.2 months[95%CI 10.2–20.8];stratified hazard ratio 0·49[95%CI 0.30–0.79],p=0.003).NIVO consolidation also demonstrated superior PFS compared with a parallel real-world study,where patients received CCRT followed by consolidative immunotherapy(median PFS:15.7 months[95%CI 11.9-NA]).Grade 3 or 4 toxicities occurred in 9.3%of patients in the consolidation group versus 4·6%in the observation group,with similar rates of pneumonitis(2.3%each)and proximal bronchial tree toxicity(3.5%vs.2.3%).Treatment-related death occurred in 1(1.2%)patient in the consolidation group because of pneumonitis.Patients with a high TMB had a longer PFS with consolidation(NR vs.15.2 months,p=0.042).Consolidative NIVO following neoadjuvant NIVO plus chemotherapy and CCRT demonstrated effectiveness and tolerability for patients with unresectable stage Ⅲ NSCLC(ClinicalTrials.gov NCT04085250).
