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
Since recombinant human endostatin (rh-endostatin;Endostar) has been listed 5 years,clinicians have combined it with chemotherapy for the treatment of lung cancers and other malignant tumors,and proved its effect and ...Since recombinant human endostatin (rh-endostatin;Endostar) has been listed 5 years,clinicians have combined it with chemotherapy for the treatment of lung cancers and other malignant tumors,and proved its effect and safety.A number of scholars have explored the application of Endostar alone or in combination with chemotherapy for treatment of malignant serous effusion,finding its high efficiency and low toxicity;and that hydrops controlling is stronger,and that it can significantly improve patients' quality of life.It is worthy of conducting prospective,randomized and multi-center clinical studies and basic researches to clarify the mechanism.展开更多
By one case of hemangioendothelioma of bone accompanying pulmonary metastasis was treated with rh-endostatin injection (Endostar) combined with chemotherapy. The patient got partial response (PR) for 3 years after the...By one case of hemangioendothelioma of bone accompanying pulmonary metastasis was treated with rh-endostatin injection (Endostar) combined with chemotherapy. The patient got partial response (PR) for 3 years after the application of Endostar maintenance therapy and Endostar combined with taxane-based chemotherapy. During the period of using Endostar as monotherapy, the patient got long-term disease control and good quality of life. There was no drug related adverse event during the therapy of Endostar. Suggested continued using of Endostar combined with chemotherapy could achieve an convinced therapeutic effect. Then using Endostar as maintenance treatment after patient got the optimal efficacy was feasible and profitable. This treatment strategy of long-term administration of Endostar was worthy of further observation, to explore the feasibility for long-term administration of combined with chemotherapy in the treatment of hemangioendothelioma of bone accompanying pulmonary metastasis.展开更多
Background:Hepatocellular carcinoma(HCC)persists as a dominant cause of cancer-related mortality globally,with a notably rapid escalation in mortality rates.The advent of immunotherapy,particularly immune checkpoint i...Background:Hepatocellular carcinoma(HCC)persists as a dominant cause of cancer-related mortality globally,with a notably rapid escalation in mortality rates.The advent of immunotherapy,particularly immune checkpoint inhibitors(ICIs),has ushered in a new era in the management of liver cancer,albeit with unresolved challenges in the context of treatment beyond progression(TBP)and stratified prognosis in diverse populations.This study aimed to develop and validate a novel nomogram model to identify factors that predict the benefit of continued immunotherapy for hepatocellular carcinoma patients following disease progression in clinical practice.Methods:This study retrospectively analyzed the efficacy of ICIs in TBP,focusing on the Chinese population with advanced liver cancer.A nomogram was constructed based on four independent risk factors identified through Cox multivariate analysis,aiming to predict patient prognosis post-ICI treatment.The model was validated through receiver operating characteristic(ROC)curve analysis and categorized patients into high-,intermediate-,and low-risk groups,with further validation using calibration plots and decision curve analysis(DCA).Results:The low-risk group demonstrated significantly enhanced overall survival(OS)compared to the high-risk group,with the nomogram predictions aligning closely with actual outcomes for 6-and 9-month OS.The model exhibited commendable predictive accuracy,achieving a C-index exceeding 0.7 in both training and validation datasets.The DCA underscored the clinical utility of the nomogram-based prognostic model,further substantiated by the area under the ROC curve(AUC).Conclusions:The developed nomogram presents a potentially valuable tool for predicting the prognosis of HCC patients undergoing ICI therapy beyond progression,particularly within the Chinese demographic.However,the study is constrained by its retrospective,single-center nature and necessitates further validation through large-scale,multicenter clinical studies across varied populations.展开更多
Background:The JACOB trial(NCT01774786)was a double-blinded,placebo-controlled,randomized,multicenter,international,phase III trial evaluating the efficacy and safety of adding pertuzumab to trastuzumab and chemo-ther...Background:The JACOB trial(NCT01774786)was a double-blinded,placebo-controlled,randomized,multicenter,international,phase III trial evaluating the efficacy and safety of adding pertuzumab to trastuzumab and chemo-therapy in first-line treatment of human epidermal growth factor receptor 2(HER2)-positive metastatic gastric cancer/gastroesophageal junction cancer(GEJC).The aim of this analysis was to investigate efficacy and safety outcomes in the Chinese subpopulation from the JACOB trial.Methods:This post hoc subpopulation analysis included all patients recruited in China's Mainland(n=163;20.9%)between June 2013 and January 2016.The patients were randomly assigned in a 1:1 ratio to receive pertuzumab plus trastuzumab and chemotherapy(pertuzumab group;n=82)or placebo plus trastuzumab and chemotherapy(con-trol group;n=81).Intravenous pertuzumab(840 mg)and trastuzumab(8 mg/kg loading and 6 mg/kg maintenance doses)were given every 3 weeks until disease progression or unacceptable toxicity.Chemotherapy was given as per standard regimens/doses of capecitabine or 5-fluorouracil plus cisplatin.The primary endpoint was overall survival(OS);secondary efficacy endpoints included progression-free survival(PFS),and overall objective response rate(ORR).Results:The median OS was 18.7 months in the pertuzumab group and 16.1 months in the control group(hazard ratio[HR]0.75;95%confidence interval[CI]0.49 to 1.14).The median PFS was 10.5 and 8.6 months in the pertuzumab and control groups,respectively(HR 0.85;95%CI 0.60 to 1.21),and the median ORRs were 68.9%and 55.7%,respectively.The treatment effect in this Chinese subpopulation showed consistency with that in the global ITT population with numerically lower HR for OS and PFS compared with the control group.The safety profiles of the pertuzumab and control groups in this Chinese subpopulation analysis were generally comparable.The most common grade 3-5adverse events were neutropenia,anemia,and leukopenia.However,due to the nature of being a post hoc subgroup analysis,the results presented here are descriptive only and need to be interpreted with caution.Conclusions:OS and PFS were numerically improved by adding pertuzumab to trastuzumab and chemotherapy as first-line treatment in Chinese HER2-positive gastric cancer/GEJC patients,and this regimen demonstrated an acceptable safety profile.展开更多
Hepatocellular carcinoma(HCC)is a common malignancy worldwide and is especially prevalent in the Chinese population.Treatment of advanced HCC has posed a considerable challenge to clinicians and highly effective thera...Hepatocellular carcinoma(HCC)is a common malignancy worldwide and is especially prevalent in the Chinese population.Treatment of advanced HCC has posed a considerable challenge to clinicians and highly effective therapies remain elusive.Angiogenesis contributes greatly to the pathogenesis,invasion and metastasis of HCC.Therefore,anti-angiogenesis therapy could be instrumental to the treatment of HCC.In recent years,several anti-angiogenesis drugs have generated significant outcomes in a few key clinical studies,and in this light,anti-angiogenesis therapy has become a critical aspect of comprehensive treatment of HCC.In this article,to provide a reference for clinicians,we review these advances and discuss the future direction of development.展开更多
Recent advances in systemic and locoregional treatments for patients with unresectable or advanced hepatocellular carcinoma(HCC)have resulted in improved response rates.This has provided an opportunity for selected pa...Recent advances in systemic and locoregional treatments for patients with unresectable or advanced hepatocellular carcinoma(HCC)have resulted in improved response rates.This has provided an opportunity for selected patients with initially unresectable HCC to achieve adequate tumor downstaging to undergo surgical resection,a‘conversion therapy’strategy.However,conversion therapy is a new approach to the treatment of HCC and its practice and treatment protocols are still being developed.Review the evidence for conversion therapy in HCC and develop consensus statements to guide clinical practice.Evidence review:Many research centers in China have accumulated significant experience implementing HCC conversion therapy.Preliminary findings and data have shown that conversion therapy represents an important strategy to maximize the survival of selected patients with intermediate stage to advanced HCC;however,there are still many urgent clinical and scientific challenges for this therapeutic strategy and its related fields.In order to summarize and learn from past experience and review current challenges,the Chinese Expert Consensus on Conversion Therapy for Hepatocellular Carcinoma(2021 Edition)was developed based on a review of preliminary experience and clinical data from Chinese and non-Chinese studies in this field and combined with recommendations for clinical practice.Sixteen consensus statements on the implementation of conversion therapy for HCC were developed.The statements generated in this review are based on a review of clinical evidence and real clinical experience and will help guide future progress in conversion therapy for patients with HCC.展开更多
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Supported by a grant of Key Medical Issue of Nanjing Military Region (No.2007-012007-06)
文摘Since recombinant human endostatin (rh-endostatin;Endostar) has been listed 5 years,clinicians have combined it with chemotherapy for the treatment of lung cancers and other malignant tumors,and proved its effect and safety.A number of scholars have explored the application of Endostar alone or in combination with chemotherapy for treatment of malignant serous effusion,finding its high efficiency and low toxicity;and that hydrops controlling is stronger,and that it can significantly improve patients' quality of life.It is worthy of conducting prospective,randomized and multi-center clinical studies and basic researches to clarify the mechanism.
基金Supported by a grant from the Nanjing Military Region "11th Five-year Plan" Medical Research General Program
文摘By one case of hemangioendothelioma of bone accompanying pulmonary metastasis was treated with rh-endostatin injection (Endostar) combined with chemotherapy. The patient got partial response (PR) for 3 years after the application of Endostar maintenance therapy and Endostar combined with taxane-based chemotherapy. During the period of using Endostar as monotherapy, the patient got long-term disease control and good quality of life. There was no drug related adverse event during the therapy of Endostar. Suggested continued using of Endostar combined with chemotherapy could achieve an convinced therapeutic effect. Then using Endostar as maintenance treatment after patient got the optimal efficacy was feasible and profitable. This treatment strategy of long-term administration of Endostar was worthy of further observation, to explore the feasibility for long-term administration of combined with chemotherapy in the treatment of hemangioendothelioma of bone accompanying pulmonary metastasis.
基金supported by the Jiangsu Provincial Graduate Student Practice Innovation Project(No.JX22013930)the Internal Research Fund Project of Jinling Hospital Affiliated to Nanjing Medical University(No.22LCZLXJS21)the Internal Research Fund Project of Jinling Hospital Affiliated to Nanjing Medical University(No.22LCYY-LH5).
文摘Background:Hepatocellular carcinoma(HCC)persists as a dominant cause of cancer-related mortality globally,with a notably rapid escalation in mortality rates.The advent of immunotherapy,particularly immune checkpoint inhibitors(ICIs),has ushered in a new era in the management of liver cancer,albeit with unresolved challenges in the context of treatment beyond progression(TBP)and stratified prognosis in diverse populations.This study aimed to develop and validate a novel nomogram model to identify factors that predict the benefit of continued immunotherapy for hepatocellular carcinoma patients following disease progression in clinical practice.Methods:This study retrospectively analyzed the efficacy of ICIs in TBP,focusing on the Chinese population with advanced liver cancer.A nomogram was constructed based on four independent risk factors identified through Cox multivariate analysis,aiming to predict patient prognosis post-ICI treatment.The model was validated through receiver operating characteristic(ROC)curve analysis and categorized patients into high-,intermediate-,and low-risk groups,with further validation using calibration plots and decision curve analysis(DCA).Results:The low-risk group demonstrated significantly enhanced overall survival(OS)compared to the high-risk group,with the nomogram predictions aligning closely with actual outcomes for 6-and 9-month OS.The model exhibited commendable predictive accuracy,achieving a C-index exceeding 0.7 in both training and validation datasets.The DCA underscored the clinical utility of the nomogram-based prognostic model,further substantiated by the area under the ROC curve(AUC).Conclusions:The developed nomogram presents a potentially valuable tool for predicting the prognosis of HCC patients undergoing ICI therapy beyond progression,particularly within the Chinese demographic.However,the study is constrained by its retrospective,single-center nature and necessitates further validation through large-scale,multicenter clinical studies across varied populations.
基金This post hoc analysis was sponsored by Shanghai Roche Pharmaceuticals Ltd.,China.Shanghai Roche Pharmaceuticals Ltd.,China was involved in the data interpretation and writing of the report.F.Hoffmann-La Roche Ltd.was involved in the study design,data collection,and data analysis
文摘Background:The JACOB trial(NCT01774786)was a double-blinded,placebo-controlled,randomized,multicenter,international,phase III trial evaluating the efficacy and safety of adding pertuzumab to trastuzumab and chemo-therapy in first-line treatment of human epidermal growth factor receptor 2(HER2)-positive metastatic gastric cancer/gastroesophageal junction cancer(GEJC).The aim of this analysis was to investigate efficacy and safety outcomes in the Chinese subpopulation from the JACOB trial.Methods:This post hoc subpopulation analysis included all patients recruited in China's Mainland(n=163;20.9%)between June 2013 and January 2016.The patients were randomly assigned in a 1:1 ratio to receive pertuzumab plus trastuzumab and chemotherapy(pertuzumab group;n=82)or placebo plus trastuzumab and chemotherapy(con-trol group;n=81).Intravenous pertuzumab(840 mg)and trastuzumab(8 mg/kg loading and 6 mg/kg maintenance doses)were given every 3 weeks until disease progression or unacceptable toxicity.Chemotherapy was given as per standard regimens/doses of capecitabine or 5-fluorouracil plus cisplatin.The primary endpoint was overall survival(OS);secondary efficacy endpoints included progression-free survival(PFS),and overall objective response rate(ORR).Results:The median OS was 18.7 months in the pertuzumab group and 16.1 months in the control group(hazard ratio[HR]0.75;95%confidence interval[CI]0.49 to 1.14).The median PFS was 10.5 and 8.6 months in the pertuzumab and control groups,respectively(HR 0.85;95%CI 0.60 to 1.21),and the median ORRs were 68.9%and 55.7%,respectively.The treatment effect in this Chinese subpopulation showed consistency with that in the global ITT population with numerically lower HR for OS and PFS compared with the control group.The safety profiles of the pertuzumab and control groups in this Chinese subpopulation analysis were generally comparable.The most common grade 3-5adverse events were neutropenia,anemia,and leukopenia.However,due to the nature of being a post hoc subgroup analysis,the results presented here are descriptive only and need to be interpreted with caution.Conclusions:OS and PFS were numerically improved by adding pertuzumab to trastuzumab and chemotherapy as first-line treatment in Chinese HER2-positive gastric cancer/GEJC patients,and this regimen demonstrated an acceptable safety profile.
文摘Hepatocellular carcinoma(HCC)is a common malignancy worldwide and is especially prevalent in the Chinese population.Treatment of advanced HCC has posed a considerable challenge to clinicians and highly effective therapies remain elusive.Angiogenesis contributes greatly to the pathogenesis,invasion and metastasis of HCC.Therefore,anti-angiogenesis therapy could be instrumental to the treatment of HCC.In recent years,several anti-angiogenesis drugs have generated significant outcomes in a few key clinical studies,and in this light,anti-angiogenesis therapy has become a critical aspect of comprehensive treatment of HCC.In this article,to provide a reference for clinicians,we review these advances and discuss the future direction of development.
文摘Recent advances in systemic and locoregional treatments for patients with unresectable or advanced hepatocellular carcinoma(HCC)have resulted in improved response rates.This has provided an opportunity for selected patients with initially unresectable HCC to achieve adequate tumor downstaging to undergo surgical resection,a‘conversion therapy’strategy.However,conversion therapy is a new approach to the treatment of HCC and its practice and treatment protocols are still being developed.Review the evidence for conversion therapy in HCC and develop consensus statements to guide clinical practice.Evidence review:Many research centers in China have accumulated significant experience implementing HCC conversion therapy.Preliminary findings and data have shown that conversion therapy represents an important strategy to maximize the survival of selected patients with intermediate stage to advanced HCC;however,there are still many urgent clinical and scientific challenges for this therapeutic strategy and its related fields.In order to summarize and learn from past experience and review current challenges,the Chinese Expert Consensus on Conversion Therapy for Hepatocellular Carcinoma(2021 Edition)was developed based on a review of preliminary experience and clinical data from Chinese and non-Chinese studies in this field and combined with recommendations for clinical practice.Sixteen consensus statements on the implementation of conversion therapy for HCC were developed.The statements generated in this review are based on a review of clinical evidence and real clinical experience and will help guide future progress in conversion therapy for patients with HCC.
