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Reck M, Heigener D, Reinmuth N. Immunotherapy for small-cell lung cancer: emerging evidence. Future Oncol 2016; 12:931-43. [DOI: 10.2217/fon-2015-0012] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Treatment for small-cell lung cancer (SCLC) has changed little over the past few decades; available therapies have failed to extend survival in advanced disease. In recent years, immunotherapy with treatments such as interferons, TNFs, vaccines and immune checkpoint inhibitors has advanced and shown promise in the treatment of several tumor types. Immune checkpoint inhibitors such as ipilimumab, nivolumab, pembrolizumab, durvalumab, tremelimumab and ulocuplumab are at the forefront of immunotherapy and have achieved approvals for certain cancer types, including melanoma (ipilimumab, nivolumab and pembrolizumab), non-SCLC (nivolumab and pembrolizumab) and renal cell carcinoma (nivolumab). Clinical trials are investigating different immunotherapies in patients with other solid and hematologic malignancies, including SCLC. We review emerging evidence supporting the use of immunotherapy in SCLC patients.
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Affiliation(s)
- Martin Reck
- Thoracic Oncology & Clinical Trial Departments, Lung Clinic, Airway Research Center North (ARCN), Members of the German Center for Lung Research (DZL), Grosshansdorf, Germany
| | - David Heigener
- Thoracic Oncology & Clinical Trial Departments, Lung Clinic, Airway Research Center North (ARCN), Members of the German Center for Lung Research (DZL), Grosshansdorf, Germany
| | - Niels Reinmuth
- Thoracic Oncology & Clinical Trial Departments, Lung Clinic, Airway Research Center North (ARCN), Members of the German Center for Lung Research (DZL), Grosshansdorf, Germany
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Long noncoding RNA-HOTAIR affects chemoresistance by regulating HOXA1 methylation in small cell lung cancer cells. J Transl Med 2016; 96:60-8. [PMID: 26707824 DOI: 10.1038/labinvest.2015.123] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 08/14/2015] [Accepted: 09/02/2015] [Indexed: 02/07/2023] Open
Abstract
Homeobox (HOX) transcript antisense RNA (HOTAIR), a long intergenic noncoding RNA (lincRNA), has been reported to play an oncogenic role in various cancers including small cell lung cancer (SCLC). However, it is not known whether HOTAIR can modulate chemoresistance in SCLC. The aim of this study is to investigate the roles of HOTAIR in chemoresistance of SCLC and its possible molecular mechanism. Knockdown of HOTAIR was carried out in SCLC multidrug-resistant cell lines (H69AR and H446AR) and the parental cell lines (H69 and H446) to assess its influence on chemoresistance. The results showed that downregulation of HOTAIR increased cell sensitivity to anticancer drugs through increasing cell apoptosis and cell cycle arrest, and suppressed tumor growth in vivo. Moreover, HOXA1 methylation increased in the resistant cells using bisulfite sequencing PCR. Depletion of HOTAIR reduced HOXA1 methylation by decreasing DNMT1 and DNMT3b expression. The interaction between HOTAIR and HOXA1 was validated by RNA immunoprecipitation. Taken together, our study suggested that HOTAIR mediates chemoresistance of SCLC by regulating HOXA1 methylation and could be utilized as a potential target for new adjuvant therapies against chemoresistance.
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Eliyakin N, Postaci H, Baskin Y, Kozacioğlu Z. Small Cell Carcinoma of the Urinary Bladder: KIT and PDGFRA Gene Mutations. Rare Tumors 2015; 7:5982. [PMID: 26788274 PMCID: PMC4703920 DOI: 10.4081/rt.2015.5982] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 07/18/2015] [Indexed: 11/22/2022] Open
Abstract
Primary small cell carcinoma of the urinary bladder is very rare. A 72-year-old was admitted to our hospital because of hematuria and dysuria. Cystoscopy revealed a bladder full of multiple, solid and papillary tumors. Biopsies from the deep and papillary tumors were taken. Histologically, tumor was pure small cell carcinoma. Immunohistochemically, the tumor cells were positive for cytokeratin, chromo-granin, synaptophysin, neuron-specific enolase, CD56, CD117 and Ki67 (labeling 70%). The tumor cells were negative for CK7, CK20, CD3, CD20, LCA, CDX2, uroplakin, thyroid transcription factor 1, PSA and p63. Metastatic workup was performed an no primary or metastatic lung lesions were noted. Due to the clinical, radiologic and immunohistochemical findings, the patient was diagnosed as primary small cell carcinoma of bladder. A molecular genetic analysis for KIT (exons 9, 11, 13 and 17) and PDGFRA (exons 12 and 18) genes was performed, in paraffin micro dissection specimens, by the PCR-direct sequencing method. According to the sequencing analyses, two mutations were found at positions 558 (p.K558N) and 562 (p.E562D) in KIT gene exon 11 in our case. The another hand the same case presented two mutations in PDGFRA gene exon 14 at position 631 (p.P631A) and 638 (p.638Q_639AinsC). The disease process was fulminant and the patient was lost due to several complications prior to any chemotherapy.
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Affiliation(s)
- Nuket Eliyakin
- Department of Pathology, Faculty of Medicine, Adnan Menderes University, Aydin; Basic Oncology, Institute of Oncology, Dokuz Eylul University, Izmir
| | - Hakan Postaci
- Departments of Pathology and Urology, Turkish Ministry of Health, Izmir Bozyaka Research and Training Hospital , Izmir, Turkey
| | - Yasemin Baskin
- Basic Oncology, Institute of Oncology, Dokuz Eylul University , Izmir
| | - Zafer Kozacioğlu
- Urology, Turkish Ministry of Health, Izmir Bozyaka Research and Training Hospital , Izmir, Turkey
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Demir S, Aliyazicioglu Y, Turan I, Misir S, Mentese A, Yaman SO, Akbulut K, Kilinc K, Deger O. Antiproliferative and proapoptotic activity of Turkish propolis on human lung cancer cell line. Nutr Cancer 2015; 68:165-72. [PMID: 26700423 DOI: 10.1080/01635581.2016.1115096] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Cancer is a heterogeneous disease, two of whose characteristic features are uncontrollable cell proliferation and insufficient apoptosis. Various studies have investigated the antiproliferative effects of propolis, a natural bee product, from different countries, and its cytotoxic effects have been attributed to its polyphenol contents. The purpose of this study was to show the cytotoxic effects, and possible mechanisms involved, of ethanolic extract of Turkish propolis (EEP) on the human lung cancer (A549) cell line. Cytotoxic activity of EEP on A549 cells was revealed using the MTT assay. Mechanisms involved in the cytotoxic action of EEP on A549 cells were then investigated in terms of apoptosis, mitochondrial membrane potential and cell cycle using flow cytometry, endoplasmic reticulum stress using RT-PCR, and caspase activity using luminometric analysis. EEP exhibited selective toxicity against A549 cells compared to normal fibroblast cells. We determined that EEP arrested the cell cycle of A549 cells at the G1 phase, induced endoplasmic reticulum stress, caspase activity, and apoptosis and reduced mitochondrial membrane potential. These results indicate that Turkish propolis is capable of reducing cancer cell proliferation and may have a promising role to play in the development of new anticancer drugs in the future.
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Affiliation(s)
- Selim Demir
- a Department of Medical Biochemistry , Institute of Health Sciences, Karadeniz Technical University , Trabzon , Turkey
| | - Yuksel Aliyazicioglu
- b Department of Medical Biochemistry , Faculty of Medicine, Karadeniz Technical University , Trabzon , Turkey
| | - Ibrahim Turan
- c Department of Genetic and Bioengineering , Faculty of Engineering and Natural Sciences, Gumushane University, Gumushane, Turkey, and Medicinal Plants, Traditional Medicine Practice and Research Center, Gumushane University , Gumushane , Turkey
| | - Sema Misir
- d Department of Medical Biochemistry , Institute of Health Sciences, Karadeniz Technical University, Trabzon, Turkey and Department of Biochemistry, Faculty of Pharmacy, Cumhuriyet University , Sivas , Turkey
| | - Ahmet Mentese
- b Department of Medical Biochemistry , Faculty of Medicine, Karadeniz Technical University , Trabzon , Turkey
| | - Serap Ozer Yaman
- a Department of Medical Biochemistry , Institute of Health Sciences, Karadeniz Technical University , Trabzon , Turkey
| | - Kubra Akbulut
- a Department of Medical Biochemistry , Institute of Health Sciences, Karadeniz Technical University , Trabzon , Turkey
| | - Kagan Kilinc
- e Department of Genetic and Bioengineering , Faculty of Engineering and Natural Sciences, Gumushane University , Gumushane , Turkey
| | - Orhan Deger
- b Department of Medical Biochemistry , Faculty of Medicine, Karadeniz Technical University , Trabzon , Turkey
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Abdelraouf F, Sharp A, Maurya M, Mair D, Wotherspoon A, Leary A, Gonzalez de Castro D, Bhosle J, Nassef A, Gaafar T, Popat S, Yap TA, O'Brien M. Focused molecular analysis of small cell lung cancer: feasibility in routine clinical practice. BMC Res Notes 2015; 8:688. [PMID: 26581482 PMCID: PMC4652351 DOI: 10.1186/s13104-015-1675-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 11/05/2015] [Indexed: 02/02/2023] Open
Abstract
Background There is an urgent need to identify molecular signatures in small cell lung cancer (SCLC) that may select patients who are likely to respond to molecularly targeted therapies. In this study, we investigate the feasibility of undertaking focused molecular analyses on routine diagnostic biopsies in patients with SCLC. Methods A series of histopathologically confirmed formalin-fixed, paraffin-embedded SCLC specimens were analysed for epidermal growth factor receptors (EGFR), KRAS, NRAS and BRAF mutations, ALK gene rearrangements and MET amplification. EGFR and KRAS mutation testing was evaluated using real time polymerase chain reaction (RT-PCR cobas®), BRAF and NRAS mutations using multiplex PCR and capillary electrophoresis-single strand conformation analysis, and ALK and MET aberrations with fluorescent in situ hybridization. All genetic aberrations detected were validated independently. Results A total of 105 patients diagnosed with SCLC between July 1990 and September 2006 were included. 60 (57 %) patients had suitable tumour tissue for molecular testing. 25 patients were successfully evaluated for all six pre-defined molecular aberrations. Eleven patients failed all molecular analysis. No mutations in EGFR, KRAS and NRAS were detected, and no ALK gene rearrangements or MET gene amplifications were identified. A V600E substitution in BRAF was detected in a Caucasian male smoker diagnosed with SCLC with squamoid and glandular features. Conclusion The paucity of patients with sufficient tumour tissue, quality of DNA extracted and low frequency of aberrations detected indicate that alternative molecular characterisation approaches are necessary, such as the use of circulating plasma DNA in patients with SCLC.
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Affiliation(s)
- Fatma Abdelraouf
- Lung Cancer Unit, Department of Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, London, SM2 5PT, UK. .,Clinical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Adam Sharp
- Lung Cancer Unit, Department of Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, London, SM2 5PT, UK. .,The Institute of Cancer Research, London, UK.
| | - Manisha Maurya
- Lung Cancer Unit, Department of Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, London, SM2 5PT, UK.
| | - Debbie Mair
- Lung Cancer Unit, Department of Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, London, SM2 5PT, UK.
| | - Andrew Wotherspoon
- Lung Cancer Unit, Department of Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, London, SM2 5PT, UK.
| | - Alex Leary
- Lung Cancer Unit, Department of Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, London, SM2 5PT, UK.
| | - David Gonzalez de Castro
- Lung Cancer Unit, Department of Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, London, SM2 5PT, UK.
| | - Jaishree Bhosle
- Lung Cancer Unit, Department of Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, London, SM2 5PT, UK.
| | - Ayatallah Nassef
- Lung Cancer Unit, Department of Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, London, SM2 5PT, UK. .,Clinical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Taghrid Gaafar
- Lung Cancer Unit, Department of Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, London, SM2 5PT, UK. .,Clinical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Sanjay Popat
- Lung Cancer Unit, Department of Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, London, SM2 5PT, UK. .,National Heart and Lung institute, London, UK.
| | - Timothy A Yap
- Lung Cancer Unit, Department of Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, London, SM2 5PT, UK. .,The Institute of Cancer Research, London, UK.
| | - Mary O'Brien
- Lung Cancer Unit, Department of Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, London, SM2 5PT, UK.
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Takeuchi S, Fukuda K, Arai S, Nanjo S, Kita K, Yamada T, Hara E, Nishihara H, Uehara H, Yano S. Organ-specific efficacy of HSP90 inhibitor in multiple-organ metastasis model of chemorefractory small cell lung cancer. Int J Cancer 2015; 138:1281-9. [DOI: 10.1002/ijc.29858] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 09/04/2015] [Indexed: 02/02/2023]
Affiliation(s)
- Shinji Takeuchi
- Division of Medical Oncology; Cancer Research Institute, Kanazawa University; Kanazawa Japan
| | - Koji Fukuda
- Division of Medical Oncology; Cancer Research Institute, Kanazawa University; Kanazawa Japan
| | - Sachiko Arai
- Division of Medical Oncology; Cancer Research Institute, Kanazawa University; Kanazawa Japan
| | - Shigeki Nanjo
- Division of Medical Oncology; Cancer Research Institute, Kanazawa University; Kanazawa Japan
| | - Kenji Kita
- Division of Medical Oncology; Cancer Research Institute, Kanazawa University; Kanazawa Japan
| | - Tadaaki Yamada
- Division of Medical Oncology; Cancer Research Institute, Kanazawa University; Kanazawa Japan
| | - Eiji Hara
- Division of Cancer Biology; the Cancer Institute, Japanese Foundation for Cancer Research; Koto-Ku Tokyo Japan
| | - Hiroshi Nishihara
- Department of Pathology; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - Hisanori Uehara
- Department of Molecular and Environmental Pathology; Institute of Health Biosciences, the University of Tokushima Graduate School; Tokushima Japan
| | - Seiji Yano
- Division of Medical Oncology; Cancer Research Institute, Kanazawa University; Kanazawa Japan
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Sang H, Liu H, Xiong P, Zhu M. Long non-coding RNA functions in lung cancer. Tumour Biol 2015; 36:4027-37. [PMID: 25895460 DOI: 10.1007/s13277-015-3449-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 04/08/2015] [Indexed: 02/06/2023] Open
Abstract
Numerous long non-coding RNAs (lncRNAs) have been discovered as a result of advances in sequencing methods in genomic research. Recent evidence indicates that lncRNAs may serve as gene regulators via various mechanisms, such as translational control. Dysregulation of lncRNAs contributes to the development and progression of several human diseases, notably lung cancer, which is one of the leading causes of cancer-associated death. Recent studies have identified key roles for molecules such as p53 and polycomb repressive complex 2 (PRC2) in carcinogenesis and the anti-carcinogenic action of lncRNAs. These findings point to the potential of lncRNAs as prospective diagnostic and prognostic biomarkers in lung cancer. In this review, we consider the functions of lncRNAs in translational control and discuss their involvement in lung cancer via p53, PRC2, and other pathways. We also consider the effects of modulating the levels and functions of lncRNAs. Further characterization of these lung cancer-associated lncRNAs will provide a better understanding of their potential roles as therapeutic targets.
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Affiliation(s)
- Haiwei Sang
- Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Wuhan, 430030, Hubei, China
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Luo Y, Hui Z, Yang L, Li J. [Clinical analysis of 80 patients with combined small-cell lung cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2015; 18:161-6. [PMID: 25800573 PMCID: PMC6000002 DOI: 10.3779/j.issn.1009-3419.2015.03.06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
背景与目的 复合型小细胞肺癌(combined small cell lung cancer, C-SCLC)的检出率逐年增高,但其相关报道仍较少,本研究探讨C-SCLC的临床病理特征与预后的关系,分析其治疗现状。 方法 回顾性分析2006年1月-2011年12月间80例病理证实的C-SCLC患者的资料,采用Kaplan-Meier法计算生存率,Log-rank法进行单因素预后分析,Cox风险回归模型分析影响总生存(overall survival, OS)的因素。 结果 全组的OS为0.3个月-81.4个月,中位OS为26.2个月。单因素分析显示:性别、治疗前卡氏评分、肿瘤直径、分期是影响OS的预后因素(P<0.05)。多因素分析显示,只有TNM分期是独立的影响OS的因素(P=0.015)。全组多数患者(75.0%)采取综合模式治疗,以铂类药物为基础的联合化疗是主要的治疗方法,采用SCLC的化疗方案或非小细胞肺癌的方案对患者生存的影响无统计学意义(P>0.05)。 结论 C-SCLC是一种特殊类型的肺混合性癌,治疗应采用以铂类为基础的化疗为主的综合治疗模式,TNM分期是独立的预后影响因素。
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Affiliation(s)
- Yang Luo
- Department of Medical Oncology, Cancer Hospital (Institute),
Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Zhouguang Hui
- Department of Radiation Oncology, Cancer Hospital (Institute),
Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Lin Yang
- Department of Pathology, Cancer Hospital (Institute),
Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Junling Li
- Department of Medical Oncology, Cancer Hospital (Institute),
Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
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Tiseo M, Buti S, Boni L, Mattioni R, Ardizzoni A. Prognostic role of hyponatremia in 564 small cell lung cancer patients treated with topotecan. Lung Cancer 2014; 86:91-5. [PMID: 25130081 DOI: 10.1016/j.lungcan.2014.07.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 07/19/2014] [Accepted: 07/25/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Hyponatremia is reported in about 15% of small cell lung cancer (SCLC). Variable results of the prognostic significance of low plasmatic sodium (Napl) have been reported. Our study was performed to investigate the prognostic role of hyponatremia in SCLC patients treated in second-line with topotecan chemotherapy. MATERIALS AND METHODS Data were retrospectively collected from a database including clinical data from 631 patients enrolled in 6 prospective topotecan iv studies. Final data were obtained from 564 patients in which data on baseline Napl were available. Univariate and multivariate analysis were carried out to study the possible correlation between Napl and second-line clinical outcomes. RESULTS Hyponatremia (Napl<135mequiv./l) was present in 101 cases (17.9%). Napl was <125mequiv./l in 16 patients (2.8%), 126-130mequiv./l in 11 (2%), 130-134mequiv./l in 74 (13.1%), while 463 patients (82.1%) showed normal values. The median survival was 28.7 weeks in patients with normal Napl, and 21.1 weeks in patients with hyponatremia (p<0.0001, HR=1.67, 95%CI=1.32-2.10). By Cox multivariate analysis, hyponatremia was associated with poorer prognosis (p=0.0024, HR=1.44, 95%CI=1.13-1.82). A not statistically significant trend of correlation between hyponatremia and progression-free survival (p=0.085, HR=1.23, 95%CI 0.97-1.55) and response rate (p=0.5037, OR=0.81, 95%CI 0.44-1.49) was observed. CONCLUSION Hyponatremia is an independent prognostic factor for patients with SCLC treated with topotecan in second-line setting. Further studies are needed to prospectically confirm these results and to develop an optimal therapy for hyponatremic patients.
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Affiliation(s)
- Marcello Tiseo
- Oncology Unit, University Hospital of Parma, Viale Antonio Gramsci, 14, 43126 Parma, Italy
| | - Sebastiano Buti
- Oncology Unit, University Hospital of Parma, Viale Antonio Gramsci, 14, 43126 Parma, Italy.
| | - Luca Boni
- Clinical Trials Coordinating Center, Istituto Toscano Tumori Core Research Laboratory, Department of Oncology, University Hospital of Careggi, via Taddeo Alderotti 26/N, 50139 Firenze, Italy
| | - Roberto Mattioni
- Oncology Unit, University Hospital of Parma, Viale Antonio Gramsci, 14, 43126 Parma, Italy
| | - Andrea Ardizzoni
- Oncology Unit, University Hospital of Parma, Viale Antonio Gramsci, 14, 43126 Parma, Italy
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Ozasa H, Oguri T, Maeno K, Takakuwa O, Kunii E, Yagi Y, Uemura T, Kasai D, Miyazaki M, Niimi A. Significance of c-MET overexpression in cytotoxic anticancer drug-resistant small-cell lung cancer cells. Cancer Sci 2014; 105:1032-9. [PMID: 24827412 PMCID: PMC4317853 DOI: 10.1111/cas.12447] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 05/01/2014] [Accepted: 05/12/2014] [Indexed: 12/11/2022] Open
Abstract
The c-MET receptor tyrosine kinase is the receptor for hepatocyte growth factor. Recently, activation of the c-MET/hepatocyte growth factor signaling pathway was associated with poor prognosis in various solid tumors and was one of the mechanisms of acquired resistance to epidermal growth factor receptor tyrosine kinase inhibitor, gefitinib. But the link between c-MET activation and the cytotoxic anticancer drug has not been fully examined. Here, we found that the enhanced expression and activation of c-MET in cytotoxic anticancer agent-resistant small-cell lung cancer cells. Downregulation of c-MET expression by siRNA against the c-MET gene or inhibition of c-MET activation by SU11274, a c-MET inhibitor, in the resistant cells altered resistance to the cytotoxic anticancer agent. These results indicated that c-MET overexpression might play an important role in acquired resistance to cytotoxic anticancer drugs. Furthermore, the number of c-MET gene loci was increased in the resistant cells compared to the parental cells. In conclusion, increased c-Met expression through an increase in the number of c-MET gene loci is one of the mechanisms of acquired resistance to cytotoxic anticancer drugs. Our results add a new strategy, the targeting of c-MET, for overcoming resistance to cytotoxic agents in small-cell lung cancer.
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Affiliation(s)
- Hiroaki Ozasa
- Department of Medical Oncology and Immunology, Nagoya City University, Nagoya, Japan; Department of Multidisciplinary Cancer Treatment, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Liu YZ, Jiang YY, Wang BS, Hao JJ, Shang L, Zhang TT, Cao J, Xu X, Zhan QM, Wang MR. A panel of protein markers for the early detection of lung cancer with bronchial brushing specimens. Cancer Cytopathol 2014; 122:833-41. [PMID: 25045014 DOI: 10.1002/cncy.21461] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 05/29/2014] [Accepted: 06/10/2014] [Indexed: 12/15/2022]
Abstract
BACKGROUND To date, no robust biomarkers have been available in clinical practice that can provide an early diagnostic evaluation of lung cancer. The objective of this study was to identify potential biomarkers for the early detection of lung cancer using bronchial brushing specimens. METHODS Immunocytochemistry was used to investigate the expression of 35 proteins in 880 bronchial brushing specimens from both outpatients and inpatients who had either lung cancer or benign lung lesions. An optimal panel was identified that had high sensitivity and considerable specificity for detecting lung cancer. Associations between protein expression and clinicopathologic parameters were assessed. RESULTS Tumor protein 53 (TP53), TP63, Ki67, epidermal growth factor receptor (EGFR), minichromosome maintenance complex component 6 (MCM6), MCM7, uncharacterized proteins KIAA1522 and KIAA0317, and ubiquitin-protein ligase UHR1 (ICBP90) frequently presented high expression in bronchial brushing specimens from patients who had lung cancer compared with patients who had benign lung lesions. A 6-protein panel consisting of TP53, Ki67, MCM6, MCM7, KIAA1522, and KIAA0317 was identified as the best combination, with sensitivity of 81.1% (309 of 381 specimens) for detecting nonsmall cell lung cancer (NSCLC) and 86.8% (145 of 167 specimens) for detecting small cell lung cancer (SCLC) (specificity, 83.3%; 65 of 78 specimens). The combination of cytology and the protein panel significantly improved the sensitivity of bronchial brushing examination for detecting lung cancer (P<.00001), which increased from 49.1% to 81% in early stage NSCLC (stage I and II). In combined analyses, the protein panel was positively associated with patient sex (P=.00033), tumor type (P<.00001), tumor location (P<.00001), and lymph node metastasis (P=.028). CONCLUSIONS The 6-protein panel is a potential biomarker for the early detection of lung cancer in bronchial brushings.
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Affiliation(s)
- Yi-Zhen Liu
- State Key Laboratory of Molecular Oncology, Cancer Institute/Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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de Souza MC, Vasconcelos AGG, Rebelo MS, Rebelo PADP, Cruz OG. Profile of patients with lung cancer assisted at the National Cancer Institute, according to their smoking status, from 2000 to 2007. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2014; 17:175-88. [PMID: 24896791 DOI: 10.1590/1415-790x201400010014eng] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2012] [Accepted: 02/13/2013] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Tobacco use is directly related to the future incidence of lung cancer. In Brazil, a growing tendency in age-adjusted lung cancer mortality rates was observed in recent years. OBJECTIVE To describe the profile of patients with lung cancer diagnosed and treated at the National Cancer Institute (INCA) in Rio de Janeiro, Brazil, between 2000 and 2007 according to their smoking status. METHODS An observational study was conducted using INCA's database of cancer cases. To assess whether the observed differences among the categories of sociodemographic variables, characterization of the tumor, and assistance - pertaining to smokers and non-smokers - were statistically significant, a chi-square test was applied. A multiple correspondence analysis was carried out to identify the main characteristics of smokers and non-smokers. RESULTS There was a prevalence of smokers (90.5% of 1131 patients included in the study). The first two dimensions of the multivariate analysis explained 72.8% of data variability. Four groups of patients were identified, namely smokers, non-smokers, small-cell tumors, and tumors in early stages. CONCLUSION Smoking cessation must be stimulated in a disseminated manner in the population in order to avoid new cases of lung cancer. The Tumors in Initial Stages Group stood out with greater chances of cure.
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Affiliation(s)
- Mirian Carvalho de Souza
- Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Ana Glória Godoi Vasconcelos
- Departamento de Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Marise Souto Rebelo
- Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, RJ, Brasil
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Molecular profiling of small cell lung cancer in a Japanese cohort. Lung Cancer 2014; 84:139-44. [DOI: 10.1016/j.lungcan.2014.02.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 02/05/2014] [Accepted: 02/23/2014] [Indexed: 11/18/2022]
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Ono H, Motoi N, Nagano H, Miyauchi E, Ushijima M, Matsuura M, Okumura S, Nishio M, Hirose T, Inase N, Ishikawa Y. Long noncoding RNA HOTAIR is relevant to cellular proliferation, invasiveness, and clinical relapse in small-cell lung cancer. Cancer Med 2014; 3:632-42. [PMID: 24591352 PMCID: PMC4101754 DOI: 10.1002/cam4.220] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 01/05/2014] [Accepted: 01/23/2014] [Indexed: 01/09/2023] Open
Abstract
Small-cell lung cancer (SCLC) is a subtype of lung cancer with poor prognosis. To identify accurate predictive biomarkers and effective therapeutic modalities, we focus on a long noncoding RNA, Hox transcript antisense intergenic RNA (HOTAIR), and investigated its expression, cellular functions, and clinical relevance in SCLC. In this study, HOTAIR expression was assessed in 35 surgical SCLC samples and 10 SCLC cell lines. The efficacy of knockdown of HOTAIR by siRNA transfection was evaluated in SBC-3 cells in vitro, and the gene expression was analyzed using microarray. HOTAIR was expressed highly in pure, rather than combined, SCLC (P = 0.012), that the subgroup with high expression had significantly more pure SCLC (P = 0.04), more lymphatic invasion (P = 0.03) and more relapse (P = 0.04) than the low-expression subgroup. The knockdown of HOTAIR in SBC-3 cells led to decreased proliferation activity and decreased invasiveness in vitro. Gene expression analysis indicated that depletion of HOTAIR resulted in upregulation of cell adhesion-related genes such as ASTN1, PCDHA1, and mucin production-related genes such as MUC5AC, and downregulation of genes involved in neuronal growth and signal transduction including NTM and PTK2B. Our results suggest that HOTAIR has an oncogenic role in SCLC and could be a prognostic biomarker and therapeutic target.
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Affiliation(s)
- Hiroshi Ono
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer ResearchTokyo, Japan
- Department of Integrated Pulmonology, Tokyo Medical and Dental UniversityTokyo, Japan
| | - Noriko Motoi
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer ResearchTokyo, Japan
| | - Hiroko Nagano
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer ResearchTokyo, Japan
| | - Eisaku Miyauchi
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer ResearchTokyo, Japan
| | - Masaru Ushijima
- Bioinformatics Group, Genome Center, Japanese Foundation for Cancer ResearchTokyo, Japan
| | - Masaaki Matsuura
- Bioinformatics Group, Genome Center, Japanese Foundation for Cancer ResearchTokyo, Japan
- Division of Cancer Genomics, The Cancer Institute, Japanese Foundation for Cancer ResearchTokyo, Japan
| | - Sakae Okumura
- Thoracic Oncology Center, The Cancer Institute Hospital, Japanese Foundation for Cancer ResearchTokyo, Japan
| | - Makoto Nishio
- Thoracic Oncology Center, The Cancer Institute Hospital, Japanese Foundation for Cancer ResearchTokyo, Japan
| | - Tetsuro Hirose
- Institute for Genetic Medicine, Hokkaido UniversitySapporo, Japan
| | - Naohiko Inase
- Department of Integrated Pulmonology, Tokyo Medical and Dental UniversityTokyo, Japan
| | - Yuichi Ishikawa
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer ResearchTokyo, Japan
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Tartarone A, Lerose R, Ardito R, Troiani L, Tedesco B, Bozza G, Cangiano R, Aieta M. Long-term survival in small cell lung cancer: a case report and review of the literature. Future Oncol 2014; 10:523-8. [DOI: 10.2217/fon.13.213] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
ABSTRACT: Small cell lung cancer (SCLC) represents approximately 13% of all newly diagnosed lung cancers. SCLC is a very aggressive disease characterized by early locoregional and distant metastases. The median survival is 14–16 months for patients with limited disease and 8–11 months for those with extensive disease, with 20–40% of patients with limited disease and 5% of patients with extensive disease alive at 2 years. This report discusses the case of a long-term SCLC survivor treated with radiotherapy, several lines of chemotherapy and long-acting somatostatin analogs who is alive 7 years after diagnosis, with no evidence of further relapse. In the near future, better identification of prognostic and predictive factors based on models that integrate clinical data and multiple gene expression profiles and the use of novel treatments could increase the number of long-term SCLC survivors.
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Affiliation(s)
- Alfredo Tartarone
- Division of Medical Oncology, Centro di Riferimento Oncologico di Basilicata, I.R.C.C.S., via Padre Pio 1, 85028 Rionero in Vulture (PZ), Italy
| | - Rosa Lerose
- Hospital Pharmacy, Centro di Riferimento Oncologico di Basilicata, I.R.C.C.S., Rionero in Vulture (PZ), Italy
| | - Raffaele Ardito
- Division of Medical Oncology, Centro di Riferimento Oncologico di Basilicata, I.R.C.C.S., via Padre Pio 1, 85028 Rionero in Vulture (PZ), Italy
| | - Laura Troiani
- Division of Medical Oncology, Centro di Riferimento Oncologico di Basilicata, I.R.C.C.S., via Padre Pio 1, 85028 Rionero in Vulture (PZ), Italy
| | - Beatrice Tedesco
- Division of Medical Oncology, Centro di Riferimento Oncologico di Basilicata, I.R.C.C.S., via Padre Pio 1, 85028 Rionero in Vulture (PZ), Italy
| | - Giovanni Bozza
- Division of Medical Oncology, Centro di Riferimento Oncologico di Basilicata, I.R.C.C.S., via Padre Pio 1, 85028 Rionero in Vulture (PZ), Italy
| | - Rodolfo Cangiano
- Division of Medical Oncology, Centro di Riferimento Oncologico di Basilicata, I.R.C.C.S., via Padre Pio 1, 85028 Rionero in Vulture (PZ), Italy
| | - Michele Aieta
- Division of Medical Oncology, Centro di Riferimento Oncologico di Basilicata, I.R.C.C.S., via Padre Pio 1, 85028 Rionero in Vulture (PZ), Italy
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Chen X, Fang J, Nie J, Dai L, Zhang J, Hu W, Han J, Ma X, Tian G, Han S, Wu D, Long J, Wang Y. [Multivariate analysis of prognostic factors in the eldly patients with small cell lung cancer: a study of 160 patients]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2014; 17:15-23. [PMID: 24398309 PMCID: PMC6000207 DOI: 10.3779/j.issn.1009-3419.2014.01.03] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
背景与目的 肺癌是目前恶性肿瘤死亡的首要原因,2/3的患者年龄超过65岁,小细胞肺癌约占全部肺癌15%-20%。本研究旨在分析65岁以上老年小细胞肺癌患者的生存状况及预后因素。 方法 回顾性研究160例65岁以上老年小细胞肺癌患者临床资料,采用Kaplan-Meier法及Cox多因素回归分析预后因素。 结果 ① 中位随访12个月(2个月-109个月)。全组1年、3年、5年生存率分别为47.1%、13.0%、9.6%,局限期为74.4%、25.0%、19.7%,广泛期为36.8%、8.7%、5.8%。全组中位生存期(median survival time, MST)12个月,局限期24个月、广泛期11个月。全组的中位无进展生存期(progression-free survival, PFS)6个月,局限期10个月、广泛期5个月。②全组分析提示治疗前体能状态(performance status, PS)评分、治疗后PS改变、分期、有无肝转移、胸部放疗是独立预后因素。③局限期中,治疗前PS评分、胸部放疗是独立预后因素。胸部放疗方式(同步放化疗vs序贯放疗、早期同步放化疗vs晚期同步放化疗)及是否行预防性全脑放疗,MST均未见统计学差异。④广泛期中性别、治疗后PS改变、化疗方案、有无肝转移、胸部放疗、预防性全脑放疗是独立预后因素。 结论 老年小细胞肺癌患者生存期与PS评分和胸部放疗相关,而广泛期患者还与性别、化疗方案、有无肝转移及是否行预防性全脑放疗相关。
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Affiliation(s)
- Xiaoling Chen
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Chest Cancer, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Jian Fang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Chest Cancer, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Jun Nie
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Chest Cancer, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Ling Dai
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Chest Cancer, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Jie Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Chest Cancer, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Weiheng Hu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Chest Cancer, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Jindi Han
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Chest Cancer, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Xiangjuan Ma
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Chest Cancer, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Guangming Tian
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Chest Cancer, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Sen Han
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Chest Cancer, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Di Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Chest Cancer, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Jieran Long
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Chest Cancer, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Yang Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Chest Cancer, Peking University Cancer Hospital and Institute, Beijing 100142, China
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Whiteman KR, Johnson HA, Mayo MF, Audette CA, Carrigan CN, LaBelle A, Zukerberg L, Lambert JM, Lutz RJ. Lorvotuzumab mertansine, a CD56-targeting antibody-drug conjugate with potent antitumor activity against small cell lung cancer in human xenograft models. MAbs 2014; 6:556-66. [PMID: 24492307 DOI: 10.4161/mabs.27756] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Lorvotuzumab mertansine (LM) is an antibody-drug conjugate composed of a humanized anti-CD56 antibody, lorvotuzumab, linked via a cleavable disulfide linker to the tubulin-binding maytansinoid DM1. CD56 is expressed on most small cell lung cancers (SCLC), providing a promising therapeutic target for treatment of this aggressive cancer, which has a poor five-year survival rate of only 5-10%. We performed immunohistochemical staining on SCLC tumor microarrays, which confirmed that CD56 is expressed at high levels on most (~74%) SCLC tumors. Conjugation of lorvotuzumab with DM1 did not alter its specific binding to cells and LM demonstrated potent target-dependent cytotoxicity against CD56-positive SCLC cells in vitro. The anti-tumor activity of LM was evaluated against SCLC xenograft models in mice, both as monotherapy and in combination with platinum/etoposide and paclitaxel/carboplatin. Dose-dependent and antigen-specific anti-tumor activity of LM monotherapy was demonstrated at doses as low as 3 mg/kg. LM was highly active in combination with standard-of-care platinum/etoposide therapies, even in relatively resistant xenograft models. LM demonstrated outstanding anti-tumor activity in combination with carboplatin/etoposide, with superior activity over chemotherapy alone when LM was used in combinations at significantly reduced doses (6-fold below the minimally efficacious dose for LM monotherapy). The combination of LM with carboplatin/paclitaxel was also highly active. This study provides the rationale for clinical evaluation of LM as a promising novel targeted therapy for SCLC, both as monotherapy and in combination with chemotherapy.
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Affiliation(s)
| | | | | | | | | | | | - Lawrence Zukerberg
- Harvard Medical School and Massachusetts General Hospital; Boston, MA USA
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Simos D, Sajjady G, Sergi M, Liew MS, Califano R, Ho C, Leighl N, White S, Summers Y, Petrcich W, Wheatley-Price P. Third-line chemotherapy in small-cell lung cancer: an international analysis. Clin Lung Cancer 2013; 15:110-8. [PMID: 24365050 DOI: 10.1016/j.cllc.2013.11.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 10/23/2013] [Accepted: 11/08/2013] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Small-cell lung cancer is an aggressive disease for which the mainstay of treatment is chemotherapy. Despite good initial responses most patients will relapse. Some will receive second-line therapy with clinical benefit, but for third-line chemotherapy there is little evidence to guide treatment decisions and the benefits of treatment are unknown. This study investigated the treatment of SCLC in the third-line setting. PATIENTS AND METHODS An international, multicenter retrospective analysis of patients who received at least 3 lines of chemotherapy for their SCLC was performed. RESULTS From 2000 to 2010, 120 patients were identified from 5 centers: median age 61, 40% (n = 72) limited stage, and 79% (n = 95) Eastern Cooperative Oncology Group performance status of 0 to 1. Only 22% of these patients received 3 distinct lines of chemotherapy. The remainder were rechallenged with a chemotherapy regimen used at least once previously. Six percent received platinum-based chemotherapy in all 3 lines. In third-line, response rate was 18% and median overall survival was 4.7 months. Factors associated with longer survival included normal baseline LDH levels and response to second-line chemotherapy. On multivariate analysis only normal baseline LDH retained statistical significance. Thirty-five patients went on to receive chemotherapy beyond the third line. CONCLUSION Few SCLC patients receive 3 chemotherapy lines. Most patients were rechallenged with a similar regimen at least once. Response and survival in the third-line setting are modest. Lack of response to second-line chemotherapy and elevated baseline LDH level might predict lack of benefit from third-line treatment. This data set does not include patients receiving fewer lines for comparison.
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Affiliation(s)
- Demetrios Simos
- Division of Medical Oncology, The Ottawa Hospital Cancer Centre, University of Ottawa and The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Golmehr Sajjady
- Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Melissa Sergi
- Department of Internal Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mun Sem Liew
- Joint Austin-Ludwig Oncology Unit, Olivia Newton-John Cancer and Wellness Centre, Austin Health, Melbourne, Australia
| | - Raffaele Califano
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Cheryl Ho
- Division of Medical Oncology, The British Columbia Cancer Agency and University of British Columbia, Vancouver, British Columbia, Canada
| | - Natasha Leighl
- Division of Medical Oncology, Princess Margaret Hospital Cancer Centre/University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Shane White
- Joint Austin-Ludwig Oncology Unit, Olivia Newton-John Cancer and Wellness Centre, Austin Health, Melbourne, Australia
| | - Yvonne Summers
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - William Petrcich
- The Ottawa Hospital Research Institute, Clinical Epidemiology Program, Methods Centre, Ottawa, Ontario, Canada
| | - Paul Wheatley-Price
- Division of Medical Oncology, The Ottawa Hospital Cancer Centre, University of Ottawa and The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
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Li YN, Zhang L, Li XL, Cui DJ, Zheng HD, Yang SY, Yang WL. Glycoprotein nonmetastatic B as a prognostic indicator in small cell lung cancer. APMIS 2013; 122:140-6. [PMID: 23656629 DOI: 10.1111/apm.12107] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 03/17/2013] [Indexed: 02/02/2023]
Affiliation(s)
- Ying-Na Li
- Department of Geriatrics; The Second Affiliated Hospital; Medical School of Xi'an Jiaotong University Xi'an; Xi'an China
| | - Lin Zhang
- Department of Geriatrics; The Second Affiliated Hospital; Medical School of Xi'an Jiaotong University Xi'an; Xi'an China
| | - Xiu-Li Li
- Department of Geriatrics; The Second Affiliated Hospital; Medical School of Xi'an Jiaotong University Xi'an; Xi'an China
| | - Da-Jiang Cui
- Department of Geriatrics; The Second Affiliated Hospital; Medical School of Xi'an Jiaotong University Xi'an; Xi'an China
| | - Hua-Dong Zheng
- Department of Geriatrics; The Second Affiliated Hospital; Medical School of Xi'an Jiaotong University Xi'an; Xi'an China
| | - Shuan-Ying Yang
- Department of Respiratory Medicine; The Second Affiliated Hospital; Medical School of Xi'an Jiaotong University; Xi'an China
| | - Wei-Lin Yang
- Department of Geriatrics; The Second Affiliated Hospital; Medical School of Xi'an Jiaotong University Xi'an; Xi'an China
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Rationale for Chemotherapy, Immunotherapy, and Checkpoint Blockade in SCLC: Beyond Traditional Treatment Approaches. J Thorac Oncol 2013; 8:587-98. [DOI: 10.1097/jto.0b013e318286cf88] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Babakoohi S, Fu P, Yang M, Linden PA, Dowlati A. Combined SCLC clinical and pathologic characteristics. Clin Lung Cancer 2012; 14:113-9. [PMID: 23010092 DOI: 10.1016/j.cllc.2012.07.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 06/28/2012] [Accepted: 07/30/2012] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Despite the well characterized clinical course of 'pure' SCLC, there have not been many data on combined SCLC, ie, tumors, which contain both small-cell and non-small-cell components. MATERIALS AND METHODS We analyzed 1628 consecutive cases of lung cancer (1200 NSCLC, 428 SCLC) at our institution over the past decade. We identified 22 patients with C-SCLC. The pathologic and clinical characteristics of these patients were reviewed. Survival analysis was performed and prognostic factors were assessed. These data were compared with the results obtained from our 406 pure SCLC patients who presented during the same time period. RESULTS The most common pathology was combined small-cell and large-cell with 16 cases followed by combined small- and squamous-cell carcinoma (3 cases), 2 cases of small-cell and nonspecified NSCLC, and 1 case of small cell and adenocarcinoma. Overall survival was significantly higher in C-SCLC patients compared with pure SCLC (median 15 vs. 10.8 months; P = .035). Surgery was significantly more common in this group of patients (45% vs. 3% in the pure small cell group; P < .0001). No difference in overall survival was observed in patients with C-SCLC and patients with pure SCLC, that did not receive surgery (P = .64). CONCLUSION Patients with combined SCLC carry a better prognosis than those with pure small-cell variety and are more likely to undergo surgery.
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Affiliation(s)
- Shahab Babakoohi
- Division of Hematology and Oncology, Case Western Reserve University, University Hospital Case Medical Center, Cleveland, OH, USA
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Reck M, Bondarenko I, Luft A, Serwatowski P, Barlesi F, Chacko R, Sebastian M, Lu H, Cuillerot JM, Lynch TJ. Ipilimumab in combination with paclitaxel and carboplatin as first-line therapy in extensive-disease-small-cell lung cancer: results from a randomized, double-blind, multicenter phase 2 trial. Ann Oncol 2012; 24:75-83. [PMID: 22858559 DOI: 10.1093/annonc/mds213] [Citation(s) in RCA: 481] [Impact Index Per Article: 40.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Ipilimumab, an anti-CTLA4 monoclonal antibody, demonstrated survival benefit in melanoma with immune-related (ir) adverse events (irAEs) managed by the protocol-defined guidelines. This phase 2 study evaluated ipilimumab+paclitaxel (Taxol)/carboplatin in extensive-disease-small-cell lung cancer (ED-SCLC). DESIGN Patients (n=130) with chemotherapy-naïve ED-SCLC were randomized 1: 1: 1 to receive paclitaxel (175 mg/m2)/carboplatin (area under the curve=6) with either placebo (control) or ipilimumab 10 mg/kg in two alternative regimens, concurrent ipilimumab (ipilimumab+paclitaxel/carboplatin followed by placebo+paclitaxel/carboplatin) or phased ipilimumab (placebo+paclitaxel/carboplatin followed by ipilimumab+paclitaxel/carboplatin). Treatment was administered every 3 weeks for a maximum of 18 weeks (induction), followed by maintenance ipilimumab or placebo every 12 weeks. End points included progression-free survival (PFS), irPFS, best overall response rate (BORR); irBORR, overall survival (OS), and safety. RESULTS Phased ipilimumab, but not concurrent ipilimumab, improved irPFS versus control [HR (hazard ratio)=0.64; P=0.03]. No improvement in PFS (HR=0.93; P=0.37) or OS (HR=0.75; P=0.13) occurred. Phased ipilimumab, concurrent ipilimumab and control, respectively, were associated with median irPFS of 6.4, 5.7 and 5.3 months; median PFS of 5.2, 3.9 and 5.2 months; median OS of 12.9, 9.1 and 9.9 months. Overall rates of grade 3/4 irAEs were 17, 21 and 9% for phased ipilimumab, concurrent ipilimumab and control, respectively. CONCLUSION These results suggest further investigation of ipilimumab in ED-SCLC.
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Affiliation(s)
- M Reck
- Department of Thoracic Oncology, Hospital Grosshansdorf, Grosshansdorf, Germany.
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Togashi Y, Masago K, Handa T, Tanizawa K, Okuda C, Sakamori Y, Nagai H, Kim YH, Mishima M. Prognostic Significance of Preexisting Interstitial Lung Disease in Japanese Patients With Small-Cell Lung Cancer. Clin Lung Cancer 2012; 13:304-11. [PMID: 22169479 DOI: 10.1016/j.cllc.2011.11.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2011] [Revised: 10/08/2011] [Accepted: 11/09/2011] [Indexed: 11/25/2022]
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Terazaki Y, Yoshiyama K, Matsueda S, Watanabe N, Kawahara A, Naito Y, Suekane S, Komatsu N, Ioji T, Yamada A, Mine T, Terasaki M, Itoh K, Takamori S, Sasada T. Immunological evaluation of personalized peptide vaccination in refractory small cell lung cancer. Cancer Sci 2012; 103:638-44. [PMID: 22321067 DOI: 10.1111/j.1349-7006.2012.02202.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Revised: 12/16/2011] [Accepted: 12/25/2011] [Indexed: 12/27/2022] Open
Abstract
Since the prognosis of small cell lung cancer (SCLC) remains poor, development of new therapeutic approaches, including immunotherapies, would be desirable. In the current study, to evaluate immunological responses in refractory SCLC patients, we conducted a small scale phase II clinical trial of personalized peptide vaccination (PPV), in which vaccine antigens are selected based on pre-existing host immunity. Ten refractory SCLC patients, who had failed to respond to chemo- and/or chemoradiotherapies (median number of regimens, 2.5; median duration, 20.5 months), were enrolled. A maximum of four human leukocyte antigen (HLA)-matched peptides showing higher antigen-specific humoral responses were subcutaneously administered (weekly for six consecutive weeks and then bi-weekly thereafter). PPV was terminated before the 3rd administration in four patients because of rapid disease progression, whereas the remaining six patients completed at least one cycle (six times) of vaccinations. Peptide-specific immunological boosting was observed in all of the six patients at the end of the first cycle of vaccinations, with their survival time of 25, 24.5 (alive), 10 (alive), 9.5, 6.5, and 6 months. Number of previous chemotherapy regimens and frequency of CD3(+) CD26(+) cells in peripheral blood were potentially prognostic in the vaccinated patients (hazard ratio [HR] = 2.540, 95% confidence interval [CI] = 1.188-5.431, P = 0.016; HR = 0.941, 95% CI = 0.878-1.008, P = 0.084; respectively). Based on the feasible immune responses in refractory SCLC patients who received at least one cycle (six times) of vaccinations, PPV could be recommended for a next stage of larger-scale, prospective clinical trials.
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Affiliation(s)
- Yasuhiro Terazaki
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
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Kepka L, Baumann M. Radiotherapy in small cell lung cancer: Limited volumes in limited disease and adding thoracic radiotherapy in extended disease? Radiother Oncol 2012; 102:165-7. [DOI: 10.1016/j.radonc.2012.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 01/11/2012] [Indexed: 12/25/2022]
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77
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Ismaili N. A rare bladder cancer--small cell carcinoma: review and update. Orphanet J Rare Dis 2011; 6:75. [PMID: 22078012 PMCID: PMC3253713 DOI: 10.1186/1750-1172-6-75] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Accepted: 11/13/2011] [Indexed: 01/04/2023] Open
Abstract
Small cell carcinoma of the bladder (SCCB) is rare, highly aggressive and diagnosed mainly at advanced stages. Hematuria is the main symptom of this malignancy. The origin of the disease is unknown; however the multipotent stem cell theory applies best to this case. Histology and immunohistochemistry shows a tumour which is indistinguishable from small cell lung carcinoma (SCLC). Coexistence of SCCB with other types of carcinoma is common. The staging system used is the TNM-staging of bladder transitional cell carcinoma. The treatment is extrapolated from that of SCLC. However, many patients with SCCB undergo radical resection which is rarely performed in SCLC. Patients with surgically resectable disease (< or = cT1-4aN0M0) should be managed with multimodal therapy associating chemotherapy, surgery and/or radiotherapy. Neoadjuvant chemotherapy using four chemotherapy cycles followed by radical cystectomy is the most effective therapeutic sequence. Patients with unresectable disease (> or = cT4bN+M+) should be managed with palliative chemotherapy based on neuroendocrine type regimens comprising a platinum drug (cisplatin in fit patients). The prognosis of the disease is poor mainly in the case of pure small cell carcinoma. Other research programs are needed to improve the outcome of SCCB.
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Affiliation(s)
- Nabil Ismaili
- Medical oncology, centre régional d'oncologie, Agadir, Morocco.
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78
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Abstract
The incidence and mortality of small-cell lung cancer worldwide make this disease a notable health-care issue. Diagnosis relies on histology, with the use of immunohistochemical studies to confirm difficult cases. Typical patients are men older than 70 years who are current or past heavy smokers and who have pulmonary and cardiovascular comorbidities. Patients often present with rapid-onset symptoms due to local intrathoracic tumour growth, extrapulmonary distant spread, paraneoplastic syndromes, or a combination of these features. Staging aims ultimately to define disease as metastatic or non-metastatic. Combination chemotherapy, generally platinum-based plus etoposide or irinotecan, is the mainstay first-line treatment for metastatic small-cell lung cancer. For non-metastatic disease, evidence supports early concurrent thoracic radiotherapy. Prophylactic cranial irradiation should be considered for patients with or without metastases whose disease does not progress after induction chemotherapy and radiotherapy. Despite high initial response rates, most patients eventually relapse. Except for topotecan, few treatment options then remain. Signalling pathways have been identified that might yield new drug targets.
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Affiliation(s)
- Jan P van Meerbeeck
- Department of Respiratory Medicine and Lung Oncological Network, Ghent University Hospital, Ghent, Belgium.
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79
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Zhou S, Huang Y, Zhao Z, Wang L. [Advances about treatment of small cell lung cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2011; 14:819-24. [PMID: 22008113 PMCID: PMC5999943 DOI: 10.3779/j.issn.1009-3419.2011.10.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Shaohua Zhou
- Department of Thoracic Surgery, Zhongshan Hospital, Affiliated to Dalian University, China
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80
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Luchenko VL, Salcido CD, Zhang Y, Agama K, Komlodi-Pasztor E, Murphy RF, Giaccone G, Pommier Y, Bates SE, Varticovski L. Schedule-dependent synergy of histone deacetylase inhibitors with DNA damaging agents in small cell lung cancer. Cell Cycle 2011; 10:3119-28. [PMID: 21900747 DOI: 10.4161/cc.10.18.17190] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Small cell lung cancer (SCLC) is an aggressive lung cancer subtype in need of better therapies. Histone deacetylase inhibitors (HDIs) promote increased lysine acetylation in nucleosomal histones and are thought to relax chromatin, thereby allowing increased access of transcription factors and DNA damaging agents alike to DNA. We studied whether two HDIs, belinostat and romidepsin, could be effectively combined with cisplatin or etoposide (VP-16) for SCLC cells. Analysis of cell survival and synergy was performed using CalcuSyn mathematical modeling to calculate a combination index. Immunostaining of γH2AX was performed to evaluate persistence of DNA damage following simultaneous or sequential exposure. Based on CalcuSyn modeling, HDIs synergized with DNA damaging agents only when added simultaneously. An additive-to-antagonistic effect was seen with HDI pretreatment for 24 h or with addition after cisplatin or etoposide. Furthermore, pretreatment with HDIs resulted in normalization of cell cycle and reduced PARP degradation as compared with simultaneous treatment. The increase in γH2AX phosphorylation confirmed that simultaneous but not sequential treatment enhanced double-stranded DNA breaks. These results suggest that DNA relaxation is not required for synergy of HDIs with DNA damaging agents, and that scheduling of drug administration will be critical for rational development of clinical protocols.
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81
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Chemotherapy with concurrent brain and thoracic radiotherapy in brain-only metastases of treatment naive small-cell lung cancer: a phase II study. Med Oncol 2011; 29:1687-92. [DOI: 10.1007/s12032-011-0040-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Accepted: 07/29/2011] [Indexed: 11/26/2022]
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82
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Janssen-Heijnen MLG, Maas HAAM, Siesling S, Koning CCE, Coebergh JWW, Groen HJM. Treatment and survival of patients with small-cell lung cancer: small steps forward, but not for patients >80. Ann Oncol 2011; 23:954-60. [PMID: 21690233 DOI: 10.1093/annonc/mdr303] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Seventy-five percent of newly diagnosed patients with small-cell lung cancer (SCLC) are aged 60+ and quite a few are treated less aggressively because of fear of toxic effects. We described trends in treatment and survival of unselected SCLC patients. PATIENTS AND METHODS For the present study, all 13,007 SCLC patients aged 60+ diagnosed in The Netherlands from 1997 to 2007 were included. RESULTS Among patients with limited disease, the proportion receiving chemoradiation increased from 35% to almost 60% for those aged 60-69, from 28% to 48% in age group 70-74, from 17% to 33% in age group 75-79, but remained <10% for those aged 80+. Among patients with extensive disease, the proportion receiving chemotherapy (CT) decreased from 81% of patients aged 60-64 to 23% of those aged 85+, without substantial changes over time. Survival has only improved for patients <80 years. CONCLUSIONS CT (+radiotherapy) has improved survival for unselected SCLC patients <80. A better understanding of the impact of frailty on completion of treatment and toxic effects among patients aged 80+ would enable the treating physician to anticipate toxic effects better and to discuss risks and benefits of treatment with the patient.
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Affiliation(s)
- M L G Janssen-Heijnen
- Department of Research, Eindhoven Cancer Registry, Comprehensive Cancer Centre South, Eindhoven, The Netherlands.
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83
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O'Brien MER, Konopa K, Lorigan P, Bosquee L, Marshall E, Bustin F, Margerit S, Fink C, Stigt JA, Dingemans AMC, Hasan B, Van Meerbeeck J, Baas P. Randomised phase II study of amrubicin as single agent or in combination with cisplatin versus cisplatin etoposide as first-line treatment in patients with extensive stage small cell lung cancer - EORTC 08062. Eur J Cancer 2011; 47:2322-30. [PMID: 21684151 DOI: 10.1016/j.ejca.2011.05.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Accepted: 05/13/2011] [Indexed: 11/16/2022]
Abstract
PURPOSE The EORTC 08062 phase II randomised trial investigated the activity and safety of single agent amrubicin, cisplatin combined with amrubicin, and cisplatin combined with etoposide as first line treatment in extensive disease (ED) small cell lung cancer (SCLC). PATIENTS AND METHODS Eligible patients with previously untreated ED-SCLC, WHO performance status (PS) 0-2 and measurable disease were randomised to 3 weekly cycles of either amrubicin alone 45mg/m(2) i.v. day(d) 1-3 (A), cisplatin 60mg/m(2) i.v. d1 and amrubicin 40mg/m(2) i.v. d1-3 (PA), or cisplatin 75mg/m(2) i.v. d1 and etoposide 100mg/m(2) d1, d2-3 i.v./po (PE). The primary end-point was overall response rate (ORR) as assessed by local investigators (RECIST1.0 criteria). Secondary end-points were treatment toxicity, progression-free survival and overall survival. RESULTS The number of randomised/eligible patients who started treatment was 33/28 in A, 33/30 in PA and 33/30 in PE, respectively. Grade (G) ⩾3 haematological toxicity in A, PA and PE was neutropenia (73%, 73%, 69%); thrombocytopenia (17%, 15%, 9.4%), anaemia (10%, 15%, 3.1%) and febrile neutropenia (13%, 18%, 6%). Early deaths, including treatment related, occurred in 1, 3 and 3 patients in A, PA and PE arms, respectively. Cardiac toxicity did not differ among the 3 arms. Out of 88 eligible patients who started treatment, ORR was 61%, (90% 1-sided confidence intervals [CI] 47-100%), 77% (CI 64-100%) and 63%, (CI 50-100%) for A, PA and PE respectively. CONCLUSION All regimens were active and PA met the criteria for further investigation, despite slightly higher haematological toxicity.
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84
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Neumann H, Vieth M, Neurath MF, Fuchs FS. In Vivo Diagnosis of Small-Cell Lung Cancer by Endocytoscopy. J Clin Oncol 2011; 29:e131-2. [DOI: 10.1200/jco.2010.31.8097] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
| | - Michael Vieth
- Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany
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85
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Togashi Y, Kim YH, Masago K, Sakamori Y, Okuda C, Mio T, Mishima M. Long-term Survival in a Patient with Small-cell Lung Cancer Undergoing Hemodialysis Who Received Multiple Courses of Chemotherapy. Jpn J Clin Oncol 2011; 41:582-5. [DOI: 10.1093/jjco/hyq244] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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86
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Prophylactic cranial irradiation in patients with small-cell lung cancer: the experience at the Institute of Oncology Ljubljana. Radiol Oncol 2010; 44:180-6. [PMID: 22933913 PMCID: PMC3423698 DOI: 10.2478/v10019-010-0038-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Accepted: 06/14/2010] [Indexed: 11/24/2022] Open
Abstract
Background Prophylactic cranial irradiation (PCI) has been used in patients with small-cell lung cancer (SCLC) to reduce the incidence of brain metastases (BM) and thus increase overall survival. The aim of this retrospective study was to analyze the characteristics of patients with SCLC referred to the Institute of Oncology Ljubljana, their eligibility for PCI, patterns of dissemination, and survival. Patients and methods Medical charts of 357 patients with SCLC, referred to the Institute of Oncology Ljubljana between January 2004 and December 2006, were reviewed to determine characteristics of patients chosen for PCI. The following data were collected: age, gender, performance status (PS), extent of the disease, smoking status, type of primary treatment with outcome, haematological and biochemical parameters, PCI use, and finally brain metastases (BM) status at diagnoses and after treatment. Results PCI was performed in 24 (6.7%) of all patients. Six (25%) patients developed brain metastases after they were treated with PCI. Brain was the only site of metastases in 4 patients, two progressed to multiple organs. Median overall survival of patients with PCI was 21.9 months, without PCI 12.13 months (p = 0.004). From the collected data there were good prognostic factors: age under 65 years, limited disease (LD), performance status, normal levels of lactate dehydrogenase (LDH) and normal levels of C-reactive protein levels (CRP). Other prognostic factors did not show statistical significant values. Conclusions Survival of patients with LD, who have had PCI, was significantly better than those who had not. We decided to perform PCI in patients with LD, in those with complete or near complete response, and those with good performance status (≥ 80). We did not use PCI in extended disease (ED). The reason for that shall be addressed in the future. Doses for PCI were not uniform, therefore more standard approach should be considered.
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87
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Schmid K, Bago-Horvath Z, Berger W, Haitel A, Cejka D, Werzowa J, Filipits M, Herberger B, Hayden H, Sieghart W. Dual inhibition of EGFR and mTOR pathways in small cell lung cancer. Br J Cancer 2010; 103:622-8. [PMID: 20683448 PMCID: PMC2938245 DOI: 10.1038/sj.bjc.6605761] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background: In this report we investigated the combination of epidermal growth factor receptor (EGFR) and mammalian target of rapamycin (mTOR) pathway inhibition as a possible new therapeutic strategy for small cell lung cancer (SCLC). Methods: EGFR, p-AKT, p-ERK, p-mTOR and p-p70s6K protein expressions were studied by immunohistochemistry in 107 small cell lung carcinomas and correlated with clinicopathological parameters. Cells of SCLC were treated with erlotinib±RAD001 and analysed for cell viability, proliferation, autophagy, and pathway regulation. Results: Epidermal growth factor receptor, p-AKT, p-ERK, p-mTOR, and p-p70s6K were expressed in 37, 24, 13, 55 and 91% of the tumour specimens of all SCLC patients, respectively, and were not associated with disease-free or overall survival. The expression of EGFR was lower in neoadjuvant-treated patients (P=0.038); mTOR pathway activation was higher in the early stages of disease (P=0.048). Coexpression of EGFR/p-mTOR/p-p70s6K was observed in 28% of all patients . EGFR immunoreactivity was associated with p-ERK and p-mTOR expression (P=0.02 and P=0.0001); p-mTOR immunoreactivity was associated with p-p70s6K expression (P=0.001). Tumour cells comprised a functional EGFR, no activating mutations in exons 18–21, and resistance to RAD001 monotherapy. We found synergistic effects of erlotinib and RAD001 combination therapy on the molecular level, cell viability, proliferation and autophagy. Conclusions: The combined inhibition of EGFR/mTOR pathways could be a promising approach to treat SCLC.
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Affiliation(s)
- K Schmid
- Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria
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88
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Du L, Schageman JJ, Irnov, Girard L, Hammond SM, Minna JD, Gazdar AF, Pertsemlidis A. MicroRNA expression distinguishes SCLC from NSCLC lung tumor cells and suggests a possible pathological relationship between SCLCs and NSCLCs. J Exp Clin Cancer Res 2010; 29:75. [PMID: 20624269 PMCID: PMC2907339 DOI: 10.1186/1756-9966-29-75] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2010] [Accepted: 06/17/2010] [Indexed: 12/03/2022] Open
Abstract
Background Recent studies have shown that microRNAs (miRNAs) play roles in tumorigenesis and are reliable classifiers of certain cancer types and subtypes. However, the role of miRNAs in the pathogenesis and diagnosis of small cell carcinoma (SCLC), the majority of which represent the most aggressive lung tumors, has not been investigated. Methods In order to explore miRNA involvement in the pathogenesis of small cell lung carcinoma (SCLC) and the potential role of miRNAs in SCLC diagnosis, we compared the miRNA expression profile of a set of SCLC cell lines to that of a set of non-small cell lung cancer (NSCLC) cell lines and normal immortalized human bronchial epithelial cells (HBECs) using microarray analysis. Results Our results show that miRNA profiles reliably distinguish SCLC cell lines from NSCLC and HBEC cell lines. Further analysis of the miRNA expression profile of the two subtypes of lung cancer cell lines indicates that the expression levels of the majority of the miRNAs that are differentially expressed in SCLC cells relative to NSCLC cells and HBECs show a progressive trend from HBECs to NSCLC cells to SCLC cells. Conclusions The distinctive miRNA expression signature of SCLCs relative to NSCLCs and HBECs suggests that miRNA profiles have the potential to serve as a diagnostic marker of SCLC lung tumors. The progressive trend of miRNA profile changes from HBECs to NSCLCs to SCLCs suggests a possible pathological relationship between SCLCs and NSCLCs, and suggests that the increasing dysregulation of miRNA expression may play a role in lung tumor progression. The specific role of these miRNAs in lung tumor pathogenesis and differentiation need to be investigated further in future studies.
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Affiliation(s)
- Liqin Du
- Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, Texas, USA.
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