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Qian B, Wang X, Mao C, Jiang Y, Shi Y, Chen L, Liu S, Wang B, Pan S, Tao Y, Shi H. Long non-coding RNA linc01433 promotes migration and invasion in non-small cell lung cancer. Thorac Cancer 2018. [PMID: 29532622 PMCID: PMC5928388 DOI: 10.1111/1759-7714.12623] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background For many years, lung cancer has been the most common and deadly cancer worldwide. Early diagnosis of non‐small cell lung cancer (NSCLC) in particular is very difficult because the symptoms are often ignored. The five‐year survival rate is very low despite great improvements to therapy. Thus, there is an urgent need to identify prognostic biomarkers and target molecules for the clinical diagnosis and individualized treatment of NSCLC. Methods We performed quantitative real‐time PCR to determine the expression levels of the long non‐coding RNA (lncRNA) linc01433 in NSCLC and normal matched lung tissue. Subsequently, we established cell lines with overexpression or knockdown of linc01433 to evaluate the effects on proliferation and metastasis in vitro. Epithelial‐to‐mesenchymal transition was examined using Western blot. Results Linc01433 was significantly overexpressed in NSCLC tissues compared to normal lung tissues. In addition, linc01433 levels were associated with smoking history. Linc01433 overexpression in lung cancer cells increased proliferation, migration, and invasion abilities, as well as epithelial‐to‐mesenchymal transition. Conclusions Linc01433 is a cancer‐related lncRNA that may have an oncogene‐like effect in NSCLC.
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Affiliation(s)
- Banglun Qian
- Department of Thoracic Surgery, Second Xiangya Hospital of Central South University, Hunan, China
| | - Xiang Wang
- Department of Thoracic Surgery, Second Xiangya Hospital of Central South University, Hunan, China
| | - Chao Mao
- Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Xiangya Hospital, Central South University, Hunan, China.,Key Laboratory of Carcinogenesis, Ministry of Health, Cancer Research Institute, Central South University, Hunan, China
| | - Yiqun Jiang
- Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Xiangya Hospital, Central South University, Hunan, China.,Key Laboratory of Carcinogenesis, Ministry of Health, Cancer Research Institute, Central South University, Hunan, China
| | - Ying Shi
- Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Xiangya Hospital, Central South University, Hunan, China.,Key Laboratory of Carcinogenesis, Ministry of Health, Cancer Research Institute, Central South University, Hunan, China
| | - Ling Chen
- Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Xiangya Hospital, Central South University, Hunan, China.,Key Laboratory of Carcinogenesis, Ministry of Health, Cancer Research Institute, Central South University, Hunan, China
| | - Shuang Liu
- Institutes of Medical Sciences, Xiangya Hospital, Central South University, Hunan, China
| | - Bin Wang
- Department of Thoracic Surgery, Second Xiangya Hospital of Central South University, Hunan, China
| | - Shu Pan
- Department of Thoracic Surgery, Second Xiangya Hospital of Central South University, Hunan, China
| | - Yongguang Tao
- Department of Thoracic Surgery, Second Xiangya Hospital of Central South University, Hunan, China.,Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Xiangya Hospital, Central South University, Hunan, China.,Key Laboratory of Carcinogenesis, Ministry of Health, Cancer Research Institute, Central South University, Hunan, China.,Institutes of Medical Sciences, Xiangya Hospital, Central South University, Hunan, China
| | - Hongcan Shi
- Department of Cardiothoracic Surgery, Clinical College of Yangzhou University, Jiangsu, China
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Plants as sources of natural and recombinant anti-cancer agents. Biotechnol Adv 2018; 36:506-520. [DOI: 10.1016/j.biotechadv.2018.02.002] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 01/23/2018] [Accepted: 02/01/2018] [Indexed: 02/07/2023]
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Chorner PM, Moorehead RA. A-674563, a putative AKT1 inhibitor that also suppresses CDK2 activity, inhibits human NSCLC cell growth more effectively than the pan-AKT inhibitor, MK-2206. PLoS One 2018; 13:e0193344. [PMID: 29470540 PMCID: PMC5823456 DOI: 10.1371/journal.pone.0193344] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 02/08/2018] [Indexed: 01/13/2023] Open
Abstract
AKT is a serine-threonine kinase implicated in tumorigenesis as a central regulator of cellular growth, proliferation, survival, and metabolism. Activated AKT is commonly overexpressed in non-small cell lung cancer (NSCLC) and accordingly AKT inhibitors are under clinical investigation for NSCLC treatment. Thus far, the AKT inhibitors being evaluated broadly target all three (1–3) AKT isoforms but recent evidence suggests opposing roles in lung tumorigenesis where loss of Akt1 inhibits while the loss of Akt2 enhances lung tumor development. Based on these findings, we hypothesized that selective inhibition of AKT-1 would be a more effective therapeutic strategy than pan-AKT inhibition for NSCLC treatment. Using six NSCLC cell lines, we found that the AKT-1 inhibitor, A-674563, was significantly more effective at reducing NSCLC cell survival relative to the pan-AKT inhibitor MK-2206. Comparison of the downstream effects of the inhibitors suggests that altered cell cycle progression and off-target CDK2 inhibition are likely vital to the improved efficacy of A-674563 over MK-2206.
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Affiliation(s)
- Paige M Chorner
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Roger A Moorehead
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
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Jeppesen SS, Hansen NCG, Schytte T, Hansen O. Survival of localized NSCLC patients without active treatment or treated with SBRT. Acta Oncol 2018; 57:219-225. [PMID: 28885080 DOI: 10.1080/0284186x.2017.1374558] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Little information on the natural history of patients with localized NSCLC is available since many of the studies covering the subject lack information on pathological confirmation, staging procedures and comorbidity. No randomized studies have compared SBRT with no treatment for patients with localized NSCLC. The purpose of this study was to evaluate whether SBRT has influence on overall survival for patients with localized NSCLC and investigate the effect of baseline ventilatory lung function on overall survival. MATERIAL AND METHODS From 2007 to 2013, 136 patients treated with SBRT at Odense University Hospital were prospectively recorded. The thoracic SBRT consisted of three fractions of 15-22 Gy delivered in 9 days. For comparison, a national group of 73 untreated patients in the same time period was extracted from the Danish Lung Cancer Registry. All patients had histologically/cytologically proven NSCLC T1-2N0M0 with a tumour diameter ≤5 cm. RESULTS The 5-year relative survival was 44% versus 7% for the SBRT and untreated groups, respectively. In a propensity score matched comparison the median overall survival was 47 months versus 11 months for the SBRT and untreated groups, respectively (p < .05). On multivariate analysis, SBRT was significantly associated with improved prognosis while ECOG performance status 2+ and tumour diameter ≥3 cm significantly predicted poorer prognosis. Severe to very severe reduction of forced expiratory volume in one second (FEV1) did not predict poorer survival for the SBRT treated patients with localized NSCLC. CONCLUSIONS SBRT offers more favourable survival than no treatment for patients with localized NSCLC. Performance status of 0-1, tumour diameter less than 3 cm and SBRT predicted improved survival. SBRT should not be withheld for patients with localized NSCLC based on poor ventilatory lung function.
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Affiliation(s)
- S. S. Jeppesen
- Department of Oncology, Odense University Hospital, Odense, Denmark
- Center for Thoracic Oncology, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - N. C. G. Hansen
- Center for Thoracic Oncology, Odense University Hospital, Odense, Denmark
- Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark
| | - T. Schytte
- Department of Oncology, Odense University Hospital, Odense, Denmark
- Center for Thoracic Oncology, Odense University Hospital, Odense, Denmark
| | - O. Hansen
- Department of Oncology, Odense University Hospital, Odense, Denmark
- Center for Thoracic Oncology, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
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Støchkel Frank M, Schou Nørøxe D, Nygård L, Fredberg Persson G. Fractionated palliative thoracic radiotherapy in non-small cell lung cancer - futile or worth-while? BMC Palliat Care 2018; 17:15. [PMID: 29304789 PMCID: PMC5756366 DOI: 10.1186/s12904-017-0270-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 12/28/2017] [Indexed: 12/25/2022] Open
Abstract
Background Palliative thoracic radiotherapy (PTR) can relieve symptoms originating from intra-thoracic disease. The optimal timing and fractionation of PTR is unknown. Time to effect is 2 months. The primary aim of this retrospective study was to investigate survival after PTR, hypothesizing that a significant number of patients received futile fractionated PTR. The secondary aim was to find prognostic factors to guide treatment decisions. Methods Patients with non-small-cell lung cancer (NSCLC) planned for PTR in the period of 2010-2011 at the University Hospital of Copenhagen were included. We noted pathology, tumor, node and metastasis (TNM) classification of malignant tumors, stage, indication, start date, schedule for PTR, completed y/n, performance status (PS) and time of death. Analyses were performed as an intention-to-treat using Cox regression, Fishers exact test and Kaplan Meier. Results A total of 159 patients were included. Median overall survival (OS) was 4.2 months. Sixteen patients (10%) did either not begin or finish PTR. Of these, eight (5%) died prior to or during PTR. Of the 151 patients receiving PTR, sixteen patients (11%) died within 14 days, thirty-three (22%) within 30 days and fifty (33%) within 2 months. PS 0-1 and squamous cell carcinoma were correlated with a better survival. Conclusions Our study show that a significant number of patients who received PTR died before they could achieve optimal effect of the treatment. PS and histology were significant prognostic factors favoring PS 0-1 and squamous cell carcinoma. Based on our study, we suggest that patients with PS 0-1 should be considered for fractionated PTR whereas patients with PS ≥ 2 should be considered for high dose single fraction only or supportive palliative care. Electronic supplementary material The online version of this article (10.1186/s12904-017-0270-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Malene Støchkel Frank
- Department of Oncology, Finsen Center, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Dorte Schou Nørøxe
- Department of Oncology, Finsen Center, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Lotte Nygård
- Department of Oncology, Finsen Center, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.,Section of Radiotherapy, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Gitte Fredberg Persson
- Department of Oncology, Finsen Center, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
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Khaksar E, Askarishahi M, Hekmatimoghaddam S, Vahedian-Ardakani H. Cox Regression and Parametric Models: Comparison of How They Determine Factors Influencing Survival of Patients with Non-Small Cell Lung Carcinoma. Asian Pac J Cancer Prev 2017; 18:3389-3393. [PMID: 29286608 PMCID: PMC5980899 DOI: 10.22034/apjcp.2017.18.12.3389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background and objectives: The present study of survival rate of patients with non-small cell carcinoma (NSCLC)
compared the efficiency of Cox semi-parametric vs. parametric models in determination of influencing factors. Methods:
In this retrospective cohort study, data were gathered from 190 patients with a confirmed diagnosis of NSCLC referred
to Shahid Sadoughi and Shohadaye Kargar Hospitals in Yazd, Iran during 2005 to 2014. To identify and compare factors
influencing the survival rate, a Cox semi-parametric model was fitted to the data. Data analysis was performed using
the R software version R3.3.1, and the significance level was set at 0.05. Results: The average age was 64.5 years.
About 40% of patients had stage 4 disease. The median survival was 8 months. After comparing the models, the more
efficient was the log-normal distribution (AIC=889.3829), with which disease stage, type of therapy, and age were
significant factors. Among the different types of therapy, chemotherapy and radiotherapy yielded higher survival rates,
and increased age was associated with lower survival. Conclusion: The most efficient model was a log-normal model.
Implementation of optimal therapies at early stages can improve the survival of patients.
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Affiliation(s)
- Elahe Khaksar
- Department of Biostatistics and Epidemiology, School of Health, Shahid Sadoughi University of Medical Sciences, Safayeh, Yazd, Iran.
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Wang XF, Zhu YT, Wang JJ, Zeng DX, Mu CY, Chen YB, Lei W, Zhu YH, Huang JA. The prognostic value of interleukin-17 in lung cancer: A systematic review with meta-analysis based on Chinese patients. PLoS One 2017; 12:e0185168. [PMID: 28934305 PMCID: PMC5608354 DOI: 10.1371/journal.pone.0185168] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 09/07/2017] [Indexed: 12/13/2022] Open
Abstract
Background Interleukin-17 (IL-17) plays an important role in cancer progression. Previous studies remained controversial regarding the correlation between IL-17 expression and lung cancer (LC) prognosis. To comprehensively and quantitatively summarize the prognostic value of IL-17 expression in LC patients, a systematic review and meta-analysis were performed. Methods We identified the relevant literatures by searching the PubMed, EMBASE, Cochrane Library, SinoMed, China National Knowledge Infrastructure (CNKI) and Wanfang Data databases, up until April 1, 2017. Overall survival (OS), disease free survival (DFS) and clinicopathological characteristics were collected from relevant studies. Pooled hazard ratios (HR) and corresponding 95% confidence intervals (CI) were calculated to estimate the effective value of IL-17 expression on clinical outcomes. Results Six studies containing 479 Chinese LC patients were involved in this meta-analysis. The results indicated high IL-17 expression was independently correlated with poorer OS (HR = 1.82, 95% CI 1.44–2.29, P < 0.00001) and shorter DFS (HR = 2.41, 95% CI 1.42–4.08, P = 0.001) in LC patients. Further, when stratified by LC histological type (non-small cell lung cancer and small cell lung cancer), tumor stage (Ⅰ-Ⅲ,Ⅰ-Ⅳ and Ⅳ), detection specimen (serum, intratumoral tissue and pleural effusion), test method (immunological histological chemistry and enzyme linked immunosorbent assay), and HR estimated method (reported and estimated), all of the results were statistically significant. These data indicated that elevated IL-17 expression is correlated with poor clinical outcomes in LC. The meta-analysis did not show heterogeneity or publication bias. Conclusions The present meta-analysis revealed that high IL-17 expression was an indicator of poor prognosis for Chinese patients with LC. It could potentially help to assess patients’ prognosis and estimate treatment efficacy in therapeutic interventions.
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Affiliation(s)
- Xiao-fei Wang
- Department of Respiratory Medicine, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Yi-tong Zhu
- Department of Boxi Medical Center, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Jia-jia Wang
- Department of Respiratory Medicine, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Da-xiong Zeng
- Department of Respiratory Medicine, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Chuan-yong Mu
- Department of Respiratory Medicine, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Yan-bin Chen
- Department of Respiratory Medicine, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Wei Lei
- Department of Respiratory Medicine, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- * E-mail: (YHZ); (WL)
| | - Ye-han Zhu
- Department of Respiratory Medicine, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- * E-mail: (YHZ); (WL)
| | - Jian-an Huang
- Department of Respiratory Medicine, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
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Kwas H, Guermazi E, Khattab A, Hrizi C, Zendah I, Ghédira H. [Prognostic factors of advanced stage non-small-cell lung cancer]. REVUE DE PNEUMOLOGIE CLINIQUE 2017; 73:180-187. [PMID: 28756002 DOI: 10.1016/j.pneumo.2017.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/07/2017] [Accepted: 05/03/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Primary lung cancer is the leading cause of cancer death in men in the world. Although the introduction of new drugs, new therapeutic strategies and despite therapeutic advances, the prognosis is relatively improved during the last years. AIM To evaluate the prognosis of patients with locally advanced or metastatic non-small-cell lung cancer (NSCLC) and to identify prognostic factors at these stages. METHODS A retrospective study, including 140 cases of locally advanced or metastatic NSCLC diagnosed in our department between 2003 and 2013. RESULTS The average age was 61±10 years (35 to 90 years). Sex ratio was 18. The delays management were 80±25 days for presentation, 45±20 days for the diagnostic, while the treatment delay was 8±2.33 days. The cancer was at stage IIIA in 14%, IIIB in 27% and IV in 59%. Six months and one-year survival was between 50 and 74% and between 9 and 25%, respectively. Better survival was observed in patients with NSCLC on stage III, having better performance status, having comorbid conditions, with prolonged delays management, a short therapeutic delay and patients who received specific antitumor treatment. CONCLUSION The prognostic factors in locally advanced and metastatic NSCLC in our patients were: stage of cancer, performance status, comorbid conditions, delay of management and specific antitumoral treatment. These factors should be considered in the management of patients with advanced NSCLC.
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Affiliation(s)
- H Kwas
- Service de pneumologie I, hôpital Abderrahmane-Mami-de-l'Ariana, faculté de médecine de Tunis, université El-Manar de Tunis, 2080 Tunis, Tunisie.
| | - E Guermazi
- Service de pneumologie I, hôpital Abderrahmane-Mami-de-l'Ariana, faculté de médecine de Tunis, université El-Manar de Tunis, 2080 Tunis, Tunisie
| | - A Khattab
- Service de pneumologie I, hôpital Abderrahmane-Mami-de-l'Ariana, faculté de médecine de Tunis, université El-Manar de Tunis, 2080 Tunis, Tunisie
| | - C Hrizi
- Service d'épidémiologie, hôpital Abderrahmane-Mami-de-l'Ariana, faculté de médecine de Tunis, université E-Manar de Tunis, 2080 Tunis, Tunisie
| | - I Zendah
- Service de pneumologie I, hôpital Abderrahmane-Mami-de-l'Ariana, faculté de médecine de Tunis, université El-Manar de Tunis, 2080 Tunis, Tunisie
| | - H Ghédira
- Service de pneumologie I, hôpital Abderrahmane-Mami-de-l'Ariana, faculté de médecine de Tunis, université El-Manar de Tunis, 2080 Tunis, Tunisie
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Treatment-Related Toxicity in Patients With Early-Stage Non-Small Cell Lung Cancer and Coexisting Interstitial Lung Disease: A Systematic Review. Int J Radiat Oncol Biol Phys 2017; 98:622-631. [DOI: 10.1016/j.ijrobp.2017.03.010] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 02/20/2017] [Accepted: 03/07/2017] [Indexed: 01/20/2023]
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Khor YH, Ng Y, Goh NSL, McDonald CF, Holland AE. Prognosis of adults with idiopathic pulmonary fibrosis without treatment or without effective therapies. Hippokratia 2017. [DOI: 10.1002/14651858.cd012647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Yet H Khor
- Austin Health; Department of Respiratory and Sleep Medicine; 145 Studley Road Melbourne Victoria Australia 3084
- Austin Health; Institute for Breathing and Sleep; Melbourne Australia
- The Alfred Hospital; Department of Allergy, Immunology and Respiratory Medicine; Melbourne Australia
- University of Melbourne; Department of Medicine; Melbourne Australia
| | - Yvonne Ng
- Austin Health; Institute for Breathing and Sleep; Melbourne Australia
| | - Nicole SL Goh
- Austin Health; Department of Respiratory and Sleep Medicine; 145 Studley Road Melbourne Victoria Australia 3084
- Austin Health; Institute for Breathing and Sleep; Melbourne Australia
- The Alfred Hospital; Department of Allergy, Immunology and Respiratory Medicine; Melbourne Australia
| | - Christine F McDonald
- Austin Health; Department of Respiratory and Sleep Medicine; 145 Studley Road Melbourne Victoria Australia 3084
- Austin Health; Institute for Breathing and Sleep; Melbourne Australia
- University of Melbourne; Department of Medicine; Melbourne Australia
| | - Anne E Holland
- Austin Health; Institute for Breathing and Sleep; Melbourne Australia
- School of Allied Health, Department of Rehabilitation, Nutrition and Sport, La Trobe University; Discipline of Physiotherapy; Melbourne Victoria Australia 3086
- The Alfred Hospital; Department of Physiotherapy; Melbourne Victoria Australia 3181
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Safety and Efficacy of Radial EBUS for the Investigation of Peripheral Pulmonary Lesions in Patients With Advanced COPD. J Bronchology Interv Pulmonol 2017; 23:192-8. [PMID: 27454473 DOI: 10.1097/lbr.0000000000000288] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Peripheral pulmonary lesion (PPL) is a common scenario in patients with chronic obstructive pulmonary disease (COPD) and represents a high risk of malignancy. Severe COPD is associated with higher complication rates following percutaneous biopsy, and routine bronchoscopy. Safety and diagnostic performance of radial endobronchial ultrasound bronchoscopy (R-EBUS) in patients with advanced COPD has not been previously assessed. METHODS We examined a retrospective cohort of patients with advanced COPD undergoing R-EBUS for the evaluation of PPL. RESULTS During the study period, 92 patients underwent 94 R-EBUS procedures. In 50 cases, patients had severe obstructive deficit with mean forced expiratory volume in 1 second (FEV1) of 1.01±0.28 L, and FEV1% predicted 39.7±8.2. In 44 cases, patients had mild-moderate obstruction with severe diffusion impairment, with mean diffusion capacity for carbon monoxide% predicted of 41.2±7.9. Pneumothorax requiring intercostal catheter insertion occurred in 2 patients (2.1%). In 10 cases (10.6%; 95% confidence interval, 4.4%-16.8%) patients experienced acute respiratory failure. Diagnostic yield was 63% (59/94) and overall sensitivity for primary lung malignancy was 70% (53/76). Nine patients had a diagnosis on R-EBUS obviating lung resection. CONCLUSION R-EBUS is safe and accurate for the investigation of PPL in patients with advanced COPD.
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Wang Z, Li AM, Gao J, Li J, Li B, Lee P, Simone CB, Song Y, Zhu XX. Clinical outcomes of CyberKnife stereotactic radiosurgery for elderly patients with presumed primary stage I lung cancer. Transl Lung Cancer Res 2017; 6:6-13. [PMID: 28331819 DOI: 10.21037/tlcr.2017.02.04] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND In certain situations, especially in the elderly patient population, a tissue diagnosis of a suspected pulmonary neoplasm is not feasible. Often, a definitive treatment such as stereotactic body radiosurgery is recommended, rather than active surveillance. The aim of this study is to evaluate the efficacy and tolerability of stereotactic body radiotherapy (SBRT) for elderly patients with presumed primary stage I lung cancer without pathological tissue confirmation. METHODS We performed a retrospective analysis of 25 elderly patients (≥75 years) with presumed primary stage I lung cancer treated with SBRT from 2009-2015. The primary end point was local control (LC); secondary end points were survival and toxicity. RESULTS The median follow-up (FU) was 36.0 months (range, 4 to 84 months). The 1-year LC rate was 100%, 3-year LC rate was 78.8%, and 5-year LC rate was 65.7%. The median progression-free survival (PFS) time was 48.0 months (95% CI: 31.2-64.8). The 1-, 3-, and 5-year overall survival (OS) rates were 96.0%, 70.2%, and 50.7%, respectively. The 1-, 3-, and 5-year cancer-specific survival (CSS) rates were 100%, 81.3%, and 67.0%, respectively. No grade 4 or higher toxicity was encountered. CONCLUSIONS SBRT is safe and effective treatment for patients with presumed primary stage I lung cancer where obtaining pathological confirmation of malignancy is challenging.
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Affiliation(s)
- Zhen Wang
- Department of Radiation Oncology, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China
| | - Ao-Mei Li
- Department of Radiation Oncology, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China
| | - Jie Gao
- Department of Radiation Oncology, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China
| | - Jing Li
- Department of Radiation Oncology, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China
| | - Bing Li
- Department of Radiation Oncology, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China
| | - Percy Lee
- Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, MD 21201, USA
| | - Charles B Simone
- Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, MD 21201, USA
| | - Yong Song
- Division of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China
| | - Xi-Xu Zhu
- Department of Radiation Oncology, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China
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Increasing Rates of No Treatment in Advanced-Stage Non-Small Cell Lung Cancer Patients: A Propensity-Matched Analysis. J Thorac Oncol 2017; 12:437-445. [PMID: 28109804 DOI: 10.1016/j.jtho.2016.11.2221] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 11/03/2016] [Accepted: 11/08/2016] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Variation in treatment and survival outcomes for NSCLC is high among patients with stage III or IV disease, but patients with untreated NSCLC have not been critically analyzed to evaluate for improvable outcomes. We evaluated treatment trends and their association with oncologic outcomes for NSCLC, hypothesizing that there are a substantial number of untreated patients who are similar to patients who undergo treatment. METHODS Linear regression was used to calculate trends in utilization of treatment. Kaplan-Meier and Cox regression modeling were used to determine predictors of receiving treatment. Propensity matching was used to compare survival among subsets of treated versus untreated patients. RESULTS Patients with primary NSCLC were identified from the National Cancer Data base from 1998 to 2012, and 21% of patients (190,539) received no treatment. For stage IIIA and IV, the proportion of untreated patients increased over the study period by 0.21% and 0.4%, respectively (p = 0.003 and p < 0.0001). Regardless of stage, untreated patients had significantly shorter overall survival (OS) (p < 0.0001). Propensity-matched analyses of 6144 stage IIIA patient pairs treated with chemoradiation versus no treatment confirmed shorter OS for untreated patients (median 16.5 versus 6.1 months, p < 0.0001). For 19,046 stage IV patient pairs treated with chemotherapy versus no treatment, similar results were obtained (median OS 9.3 versus 2.0 months, p < 0.0001). CONCLUSIONS The proportion of untreated patients with stage IIIA and IV disease is increasing. Survival outcomes among patients with advanced-stage disease are superior with treatment, independent of selection bias. The benefits and risks of treatment should be carefully assessed before choosing to forego treatment.
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TRIM14 is a Putative Tumor Suppressor and Regulator of Innate Immune Response in Non-Small Cell Lung Cancer. Sci Rep 2017; 7:39692. [PMID: 28059079 PMCID: PMC5216374 DOI: 10.1038/srep39692] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 11/25/2016] [Indexed: 12/12/2022] Open
Abstract
Non-small-cell lung carcinoma (NSCLC) accounts for 85% of malignant lung tumors and is the leading cause of cancer deaths. Our group previously identified Tripartite Motif 14 (TRIM14) as a component of a prognostic multigene expression signature for NSCLC. Little is known about the function of TRIM14 protein in normal or disease states. We investigated the functional and prognostic role of TRIM14 in NSCLC using in vitro and in vivo perturbation model systems. Firstly, a pooled RNAi screen identified TRIM14 to effect cell proliferation/survival in NSCLC cells. Secondly, silencing of TRIM14 expression significantly enhanced tumor growth in NSCLC xenograft mouse models, while exogenous TRIM14 expression attenuated tumorigenesis. In addition, differences in apoptotic activity between TRIM14-deficient and control tumors suggests that TRIM14 tumor suppressor activity may depend on cell death signaling pathways. TRIM14-deficient cell lines showed both resistance to hypoxia-induced cell death and attenuation of interferon response via STAT1 signaling. Consistent with these phenotypes, multivariate analyses on published mRNA expression datasets of over 600 primary NSCLCs demonstrated that low TRIM14 mRNA levels are significantly associated with poorer prognosis in early stage NSCLC patients. Our functional data therefore establish a novel tumor suppressive role for TRIM14 in NSCLC progression.
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Heuvelmans MA, Groen HJM, Oudkerk M. Early lung cancer detection by low-dose CT screening: therapeutic implications. Expert Rev Respir Med 2016; 11:89-100. [DOI: 10.1080/17476348.2017.1276445] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Marjolein A Heuvelmans
- University of Groningen, University Medical Center Groningen, Center for Medical Imaging – North East Netherlands, Groningen, The Netherlands
- Medisch Spectrum Twente, Department of Pulmonology, Enschede, The Netherlands
| | - Harry J M Groen
- University of Groningen, University Medical Center Groningen, Department of Pulmonology, Groningen, The Netherlands
| | - Matthijs Oudkerk
- University of Groningen, University Medical Center Groningen, Center for Medical Imaging – North East Netherlands, Groningen, The Netherlands
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Zhou L, Yao Q, Li Y, Huang YC, Jiang H, Wang CQ, Fan L. Sulforaphane-induced apoptosis in Xuanwei lung adenocarcinoma cell line XWLC-05. Thorac Cancer 2016; 8:16-25. [PMID: 27878984 PMCID: PMC5217876 DOI: 10.1111/1759-7714.12396] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 08/20/2016] [Accepted: 08/24/2016] [Indexed: 12/02/2022] Open
Abstract
Background Xuanwei district in Yunnan Province has the highest incidence of lung cancer in China, especially among non‐smoking women. Cruciferous vegetables can reduce lung cancer risk by prompting a protective mechanism against respiratory tract inflammation caused by air pollution, and are rich in sulforaphane, which can induce changes in gene expression. We investigated the effect of sulforaphane‐induced apoptosis in Xuanwei lung adenocarcinoma cell line (XWCL‐05) to explore the value of sulforaphane in lung cancer prevention and treatment. Methods Cell growth inhibition was determined by methyl thiazolyl tetrazolium assay; cell morphology and apoptosis were observed under transmission electron microscope; cell cycle and apoptosis rates were detected using flow cytometry; B‐cell lymphoma 2 (Bcl‐2) and Bcl‐2‐like protein 4 (Bax) messenger RNA expression were determined by quantitative PCR; and p53, p73, p53 upregulated modulator of apoptosis (PUMA), Bax, Bcl‐2, and caspase‐9 protein expression were detected by Western blotting. Results Sulforaphane inhibited XWLC‐05 cell growth with inhibitory concentration (IC)50 of 4.04, 3.38, and 3.02 μg/mL at 24, 48, and 72 hours, respectively. Sulforaphane affected the XWLC‐05 cell cycle as cells accumulated in the G2/M phase. The proportion of apoptotic cells observed was 27.6%. Compared with the control, the sulforaphane group showed decreased Bcl‐2 and p53 expression, and significantly increased p73, PUMA, Bax, and caspase‐9 protein expression (P < 0.05). Conclusion Sulforaphane induces Xuanwei lung adenocarcinoma cell apoptosis. Its possible mechanism may involve the upregulation of p73 expression and its effector target genes PUMA and Bax in lung cancer cells, downregulation of the anti‐apoptotic gene Bcl‐2, and activation of caspase‐9. It may also involve downregulation of the mutant p53 protein.
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Affiliation(s)
- Lan Zhou
- Department of Clinical Nutrition, Yunnan Provincial Tumor Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Qian Yao
- Department of Tumor Cytobiology, Institute of Oncology, Yunnan Provincial Tumor Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yan Li
- Department of Maternal and Child Health, Public Health College, Kunming Medical University, Kunming, China
| | - Yun-Chao Huang
- Department of Thoracic Surgery, Yunnan Provincial Tumor Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Hua Jiang
- Department of Schistosomiasis Prevention and Control, Yunnan Provincial Institute of Endemic Disease Control, Dali, China
| | - Chuan-Qiong Wang
- Department of Clinical Nutrition, Yunnan Provincial Tumor Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Lei Fan
- Department of Clinical Nutrition, Yunnan Provincial Tumor Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming, China
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Salmi LR, Coureau G, Bailhache M, Mathoulin-Pélissier S. To Screen or Not to Screen: Reconciling Individual and Population Perspectives on Screening. Mayo Clin Proc 2016; 91:1594-1605. [PMID: 27814837 DOI: 10.1016/j.mayocp.2016.07.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 07/04/2016] [Accepted: 07/26/2016] [Indexed: 12/29/2022]
Abstract
Screening is the early detection of a latent disorder by a test to allow early intervention with the aim of improving prognosis. Individual and population perspectives on screening are perceived as opposing interests of patients and the population. In this article, we try to reconcile these perspectives. The individual perspective is based on the clinical experience of a better prognosis at early stages and patients with missed opportunities. In the population perspective, screening is based on a population-oriented, evidence-based model and addresses the acceptability and possible negative effects, including for people without the disorder. Known possible obstacles to a positive effect of screening include a short latent stage, lead time, overdiagnosis, lack of acceptability, poor performance of tests, and misclassification of outcome. Randomized trials of screening are challenging and need an adaptation of standards such as the Consolidated Standards of Reporting Trials (CONSORT). Simulating the effects of screening can allow the consideration of complex screening strategies and other options to help avoid biases related to treatment improvement and prevention success. Reconciling both perspectives is possible by considering that hypotheses underlying the former are prerequisites for the latter. From an evidence-based medicine and policy perspective, we suggest that recommending screening or prescribing a test is unethical if all possible obstacles are not documented by providing the best available evidence.
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Affiliation(s)
- L Rachid Salmi
- University of Bordeaux, ISPED, Centre INSERM U-1219 Bordeaux Population Health, Bordeaux, France; INSERM, ISPED, Centre INSERM U-1219 Bordeaux Population Health, Bordeaux, France; CHU de Bordeaux, Pole de Sante Publique, Service d'Information Medicale, Bordeaux, France.
| | - Gaëlle Coureau
- University of Bordeaux, ISPED, Centre INSERM U-1219 Bordeaux Population Health, Bordeaux, France; INSERM, ISPED, Centre INSERM U-1219 Bordeaux Population Health, Bordeaux, France; CHU de Bordeaux, Pole de Sante Publique, Service d'Information Medicale, Bordeaux, France
| | - Marion Bailhache
- University of Bordeaux, ISPED, Centre INSERM U-1219 Bordeaux Population Health, Bordeaux, France; INSERM, ISPED, Centre INSERM U-1219 Bordeaux Population Health, Bordeaux, France; CHU de Bordeaux, Pole de Pediatrie, Place Amélie Raba Léon, Bordeaux, France
| | - Simone Mathoulin-Pélissier
- University of Bordeaux, ISPED, Centre INSERM U-1219 Bordeaux Population Health, Bordeaux, France; INSERM, ISPED, Centre INSERM U-1219 Bordeaux Population Health, Bordeaux, France; Institut Bergonié, Unité de Recherche et d'Épidémiologie Cliniques, Inserm CIC1401, Bordeaux, France
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Abstract
Cancer is a genetic disease occurring through a multi-step process. Many important genes responsible for the genesis of various cancers have been discovered, their mutations precisely identified and the pathways through which they act characterized. One question that remains unanswered is whether the development of new, more specific therapeutic agents is the best way to minimize cancer morbidity and mortality in the long-term. Metastasis is the relentless pursuit of cancer to escape its primary site and colonize distant organs. Phenotypic changes during cancer progression reflect the sequential accumulation of genetic alterations, which endow cancer cells with the ability to undergo their own divergent evolution and create distinct metastatic species. In order to understand this process, it is crucial to identify genes whose alterations accumulate during cancer progression and correlate with metastatic phenotypes of cancer cells.
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Zhang L, Chen P, Yang S, Li G, Bao W, Wu P, Jiang S. CHKA mediates the poor prognosis of lung adenocarcinoma and acts as a prognostic indicator. Oncol Lett 2016; 12:1849-1853. [PMID: 27588131 PMCID: PMC4998128 DOI: 10.3892/ol.2016.4810] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 06/10/2016] [Indexed: 01/04/2023] Open
Abstract
Choline kinase α (CHKA), the enzyme that converts choline to phosphocholine, has been studied in human carcinogenesis widely. However, the expression and underlying clinicopathological characteristics of CHKA in lung adenocarcinoma remains elusive. In the present study, a tissue microarray of 119 pairs of lung adenocarcinoma samples and corresponding adjacent normal mucosae was used to analysis CHKA expression by immunohistochemistry, and CHKA was observed to exhibit enhanced expression in lung adenocarcinoma tissues. Elevated CHKA expression in lung adenocarcinoma tissues at the gene and protein level was observed. The levels of CHKA expression were closely associated with the poor prognosis status of lung adenocarcinoma patients. Furthermore, certain clinicopathological characteristics such as tumor diameter and differentiation were observed to be significant in those lung adenocarcinoma patients who displayed enhanced CHKA expression. The analysis of CHKA expression could provide a more precise way to predict the prognosis of lung adenocarcinoma patients. Collectively, the present study revealed a novel biomarker in lung adenocarcinoma, and indicated that CHKA may be a promising prognostic marker and therapeutic target for lung adenocarcinoma.
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Affiliation(s)
- Li Zhang
- Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China; Department of Respiratory Intensive Care Unit, Taian Central Hospital, Taian, Shandong 271000, P.R. China
| | - Ping Chen
- Department of Gastroenterology, Taian Central Hospital, Taian, Shandong 271000, P.R. China
| | - Shen Yang
- Department of Neurology, Taian Central Hospital, Taian, Shandong 271000, P.R. China
| | - Guodong Li
- Department of Respiratory Medicine, Taian Central Hospital, Taian, Shandong 271000, P.R. China
| | - Wentao Bao
- Department of Respiratory Intensive Care Unit, Taian Central Hospital, Taian, Shandong 271000, P.R. China
| | - Peng Wu
- Department of Respiratory Intensive Care Unit, Taian Central Hospital, Taian, Shandong 271000, P.R. China
| | - Shujuan Jiang
- Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
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Shafiq J, Hanna TP, Vinod SK, Delaney GP, Barton MB. A Population-based Model of Local Control and Survival Benefit of Radiotherapy for Lung Cancer. Clin Oncol (R Coll Radiol) 2016; 28:627-38. [PMID: 27260488 DOI: 10.1016/j.clon.2016.05.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 03/14/2016] [Accepted: 04/19/2016] [Indexed: 02/07/2023]
Abstract
AIMS To estimate the population-based locoregional control and overall survival benefits of radiotherapy for lung cancer if the whole population were treated according to evidence-based guidelines. These estimates were based on a published radiotherapy utilisation (RTU) model that has been used to estimate the demand and planning of radiotherapy services nationally and internationally. MATERIALS AND METHODS The lung cancer RTU model was extended to incorporate an estimate of benefits of radiotherapy alone, and of radiotherapy in conjunction with concurrent chemotherapy (CRT). Benefits were defined as the proportional gains in locoregional control and overall survival from radiotherapy over no radiotherapy for radical indications, and from postoperative radiotherapy over surgery alone for adjuvant indications. A literature review (1990-2015) was conducted to identify benefit estimates of individual radiotherapy indications and summed to estimate the population-based gains for these outcomes. Model robustness was tested through univariate and multivariate sensitivity analyses. RESULTS If evidence-based radiotherapy recommendations are followed for the whole lung cancer population, the model estimated that radiotherapy alone would result in a gain of 8.3% (95% confidence interval 7.4-9.2%) in 5 year locoregional control, 11.4% (10.8-12.0%) in 2 year overall survival and 4.0% (3.6-4.4%) in 5 year overall survival. For the use of CRT over radiotherapy alone, estimated benefits would be: locoregional control 1.7% (0.8-2.4%), 2 year overall survival 1.7% (0.5-2.8%) and 5 year overall survival 1.2% (0.7-1.9%). CONCLUSIONS The model provided estimates of radiotherapy benefit that could be achieved if treatment guidelines are followed for all cancer patients. These can be used as a benchmark so that the effects of a shortfall in the utilisation of radiotherapy can be better understood and addressed. The model can be adapted to other populations with known epidemiological parameters to ensure the planning of equitable radiotherapy services.
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Affiliation(s)
- J Shafiq
- Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Ingham Institute of Applied Medical Research, Liverpool, Australia.
| | - T P Hanna
- Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Ingham Institute of Applied Medical Research, Liverpool, Australia
| | - S K Vinod
- Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Ingham Institute of Applied Medical Research, Liverpool, Australia
| | - G P Delaney
- Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Ingham Institute of Applied Medical Research, Liverpool, Australia
| | - M B Barton
- Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Ingham Institute of Applied Medical Research, Liverpool, Australia
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Inhibiting MDM2-p53 Interaction Suppresses Tumor Growth in Patient-Derived Non-Small Cell Lung Cancer Xenograft Models. J Thorac Oncol 2016. [PMID: 26200271 DOI: 10.1097/jto.0000000000000584] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The tumor suppressor p53 is frequently inactivated in non-small cell lung cancer (NSCLC). Activation of the p53 pathway by inhibition of its negative regulator MDM2 may offer an attractive approach for NSCLC therapy. We evaluated the antitumor activity of the small-molecule MDM2 inhibitor RG7388 in patient-derived xenograft (PDX) models of NSCLC. METHODS We investigated the effect of RG7388 treatment on cell proliferation, cell cycle arrest, and apoptosis using a panel of human NSCLC cell lines (A549, H157, H1650, H1395, and H358) and PDX cell lines (human lung cell lines 12, 137, 277, and 196). PDX-bearing mice were used to test the therapeutic efficacy and pharmacodynamic effects of RG7388 treatment. RESULTS We demonstrated that RG7388 promotes low nanomolar antiproliferative activity selectively in cell lines with wild-type p53 and p53 pathway activation, resulting in cell cycle arrest and apoptosis. In PDX models, oral administration of RG7388 led to potent dose-dependent and time-dependent activation of p53 and had a significant impact on p53 downstream targets. Daily treatment of RG7388 in mice at 50 and 80 mg/kg/day inhibited tumor growth in three wild-type p53 PDX models. Activation of the p53 pathway inhibited cell proliferation as observed by reduced Ki-67-positive cells in xenograft tumors. However, induction of apoptotic caspase activity was not observed in these tumors. Notably, RG7388 treatment remains effective in tumors lacking MDM2 amplification but expressing wild-type p53. CONCLUSIONS MDM2 small-molecule inhibitor is effective in treating NSCLC tumors with wild-type p53, supporting further clinical investigation as a potential NSCLC therapy.
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Rosen JE, Keshava HB, Yao X, Kim AW, Detterbeck FC, Boffa DJ. The Natural History of Operable Non-Small Cell Lung Cancer in the National Cancer Database. Ann Thorac Surg 2016; 101:1850-5. [PMID: 27041452 DOI: 10.1016/j.athoracsur.2016.01.077] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 01/11/2016] [Accepted: 01/18/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND The survival of untreated non-small cell lung cancer (NSCLC), or the natural history, is an important perspective for patients considering resection for NSCLC. The National Cancer Database (NCDB) allows untreated NSCLC patients who were recommended to undergo surgical resection (ie, "operable") to be identified. The survival of untreated NSCLC patients in the NCDB was studied to determine the natural history of operable NSCLC. METHODS The NCDB was queried for untreated clinical stage I to IIIA NSCLC patients diagnosed between 2003 and 2009. The natural history cohort was defined as patients who were recommended to undergo resection but went untreated. RESULTS We identified 1,693 untreated patients with operable NSCLC. The median survival for clinical stage I, II, and IIIA was 16.6, 9.4, and 8.4 months, respectively. The 5-year Kaplan-Meier estimates of survival for clinical stage I, II, and IIIA NSCLC were 10.1%, 7.3%, and 4.9%, respectively. At each stage (I to IIIA), the survival of untreated operable NSCLC patients was superior to that of untreated NSCLC patients not recommended to undergo resection (nonoperable, p < 0.001). A multivariable Cox regression model identified increasing age, male gender, white (vs black) race, increasing comorbidity, squamous cell or large cell histology, and increasing stage as predictors of decreased survival. CONCLUSIONS The natural history of operable NSCLC, although poor, varies with clinical stage and is superior to that of nonoperable NSCLC.
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Affiliation(s)
- Joshua E Rosen
- Section of Thoracic Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Hari B Keshava
- Department of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Xiaopan Yao
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, Connecticut
| | - Anthony W Kim
- Section of Thoracic Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Frank C Detterbeck
- Section of Thoracic Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Daniel J Boffa
- Section of Thoracic Surgery, Yale School of Medicine, New Haven, Connecticut.
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Goss GD, Spaans JN. Epidermal Growth Factor Receptor Inhibition in the Management of Squamous Cell Carcinoma of the Lung. Oncologist 2016; 21:205-13. [PMID: 26768483 PMCID: PMC4746081 DOI: 10.1634/theoncologist.2015-0209] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 10/29/2015] [Indexed: 12/24/2022] Open
Abstract
UNLABELLED Molecular therapies targeting epidermal growth factor receptor (EGFR) have had a profound impact on the management of advanced non-small cell lung cancer (NSCLC). EGFR inhibition with EGFR tyrosine kinase inhibitors (EGFR-TKIs) and anti-EGFR monoclonal antibodies (mAbs) in squamous NSCLC (sqNSCLC) remains controversial in patients whose tumors are not known to harbor EGFR mutations. Recent meta-analyses of EGFR-inhibition randomized trials that are adequately powered for histological subgroup analysis and anti-EGFR trials limited to patients with squamous histology afford the opportunity to revisit EGFR treatment in sqNSCLC. In unselected patients with sqNSCLC who are not eligible for chemotherapy, EGFR-TKI therapy is a valid treatment option over placebo or best supportive care, with improved progression-free survival noted in randomized controlled trials in both the first- and second-line setting and improved overall survival (OS) in the second-line setting. In patients eligible for chemotherapy, first-line combination regimens with anti-EGFR mAbs have been shown to improve OS over chemotherapy alone in patients with squamous histology in meta-analysis and more recently in the SQUIRE sqNSCLC trial (chemotherapy with and without necitumumab). In sqNSCLC patients who respond to induction chemotherapy, maintenance therapy with erlotinib delays disease progression and may improve the survival of patients with stable disease. In the second-line setting, survival outcomes are comparable between chemotherapy and EGFR-TKIs in meta-analysis, with the latter being more tolerable as a second-line therapy. Newer-generation EGFR-TKI therapies may further benefit patients with sqNSCLC who have failed first-line chemotherapy, given the positive trial results from LUX-Lung 8 (afatinib vs. erlotinib). EGFR is a valid therapeutic target in unselected/EGFR wild-type patients with squamous cell carcinoma of the lung. With the recent approval of immune checkpoint inhibitors in the second-line management of advanced sqNSCLC and their adoption as a new standard of care, there exists an opportunity for novel combination therapies to increase therapeutic efficacy and durable tumor control. As more targeted agents are approved, combination regimens that include an anti-EGFR agent should be evaluated, and the optimal sequencing of targeted therapies should be defined. IMPLICATIONS FOR PRACTICE Anti-epidermal growth factor receptor (EGFR) therapies remain controversial in unselected/wild-type EGFR squamous non-small cell lung cancer (NSCLC). Recent meta-analyses and squamous-only NSCLC EGFR-inhibition trials have overcome the power limitations of early trials and can now inform the management of squamous NSCLC with anti-EGFR therapies. With the approval of immunotherapeutics in the second-line management of squamous NSCLC, there exists an opportunity for novel combination therapies to improve efficacy and durable tumor control. The optimal timing and sequencing of available second-line targeted therapies, however, have yet to be defined. This review analyzes randomized clinical trials of EGFR inhibition in NSCLC and meta-analyses of these trials, with a focus on patients with squamous histology.
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Affiliation(s)
- Glenwood D Goss
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada Ottawa Hospital Cancer Centre, Ottawa, Ontario, Canada Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Hu M, Hu Y, He J, Li B. Prognostic Value of Basic Fibroblast Growth Factor (bFGF) in Lung Cancer: A Systematic Review with Meta-Analysis. PLoS One 2016; 11:e0147374. [PMID: 26824699 PMCID: PMC4732945 DOI: 10.1371/journal.pone.0147374] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 01/04/2016] [Indexed: 12/20/2022] Open
Abstract
Background Basic fibroblast growth factor (bFGF) is known to stimulate angiogenesis and thus to influence the proliferation, migration and survival of tumor cells. Many studies examined the relationship between human bFGF overexpression and survival in lung cancer patients, but the results have been mixed. To systematically summarize the clinical prognostic function of bFGF in lung cancer, we performed this systematic review with meta-analysis. Method Studies were identified by an electronic search of PubMed, EMBASE, China National Knowledge Infrastructure and Wanfang databases, including publications prior toAugust 2014. Pooled hazard ratios (HR) for overall survival (OS) were aggregated and quantitatively analyzed by meta-analysis. Results Twenty-two studies (n = 2154) were evaluated in the meta-analysis. Combined HR suggested that bFGF overexpression had an adverse impact on survival of patients with lung cancer(HR = 1.202,95%CI, 1.022–1.382). Our subgroup analysis revealed that the combined HR evaluating bFGF expression on OS in operable non-small cell lung cancer (NSCLC) was 1.553 (95%CI, 1.120–1.986); the combined HR in small cell lung cancer (SCLC) was 1.667 (95%CI, 1.035–2.299). There was no significant impact of bFGF expression on survival in advanced NSCLC. Conclusion This meta-analysis showed that bFGF overexpression is a potential indicator of worse prognosis for patients with operable NSCLC and SCLC, but is not associated with outcome in advanced NSCLC. The data suggests that high bFGF expression is highly related to poor prognosis. Nevertheless,more high-quality studies should be performed in order to provide additional evidence for the prognostic value of bFGF in lung cancer.
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Affiliation(s)
- Mingming Hu
- Department of General Medicine, Beijing Tuberculosis and Thoracic tumor research Institute/ Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China
| | - Ying Hu
- Department of General Medicine, Beijing Tuberculosis and Thoracic tumor research Institute/ Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China
| | - Jiabei He
- Department of General Medicine, Beijing Tuberculosis and Thoracic tumor research Institute/ Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China
| | - Baolan Li
- Department of General Medicine, Beijing Tuberculosis and Thoracic tumor research Institute/ Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China
- * E-mail:
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Khalil EM, Anwar MM, M.Abdelfattah S. Pattern of treatment and clinico-epidemiological analysis of 804 lung and pleura cancer patients treated in radiation oncology department, NCI-Egypt. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2016. [DOI: 10.1016/j.ejcdt.2015.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Korner EJ, Morris A, Allen IE, Hurvitz S, Beattie MS, Kalesan B. NatHER: protocol for systematic evaluation of trends in survival among patients with HER2-positive advanced breast cancer. Syst Rev 2015; 4:133. [PMID: 26428301 PMCID: PMC4591587 DOI: 10.1186/s13643-015-0118-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 09/16/2015] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) is an aggressive form of breast cancer and is historically associated with poor outcomes compared with HER2-negative MBC. Since 1998, four drugs have been globally approved for the targeted treatment of HER2-positive MBC. Additional advances in patient care-such as improved breast cancer screening, HER2 testing, and supportive care-have also occurred. The objective of this systematic review and meta-analysis is to determine whether there has been a cumulative change in survival over time in patients with HER2-positive advanced breast cancer based on results from interventional clinical trials (ICTs) and observational studies and to compare outcomes across these types of studies. METHODS/DESIGN A systematic search of Medline, EMBASE, and the Cochrane Central Register of Controlled Trials will be performed. Two investigators will independently assess each abstract for inclusion. English language reports of ICTs and observational studies that include patients with HER2-positive advanced breast cancer from 1987 onwards will be considered. The primary outcome of interest is overall survival; secondary outcomes include progression-free survival and safety. Data on clinical outcomes, as well as on study design, study population, treatment/intervention, methodological quality, and outcomes, will be extracted using a structured codebook developed by the authors for this study. Standard and cumulative random effects meta-analysis will be performed to derive pooled risk estimates, both overall and by study design, controlling for covariates such as aggregate demographic and clinical characteristics of patients, treatment/intervention, and study characteristics. Heterogeneity of studies will be evaluated using the I(2) statistic. Differences in risk estimates by quality characteristics will be performed using meta-regression. DISCUSSION This study will evaluate current and evolving trends in survival associated with HER2-positive advanced breast cancer over nearly 30 years and will build upon prior, less comprehensive, systematic analyses. This information is important to patients, healthcare providers, and researchers, particularly in the advanced disease setting, in which new therapies have been recently approved. Including observational studies allows us to evaluate real-world effectiveness; useful information will be gained by comparing findings from observational studies with those from ICTs. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42014014345.
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Affiliation(s)
- Eli J Korner
- Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA.
| | - Anne Morris
- PRO Unlimited, Inc., 1350 Old Bayshore Hwy Suite 350, Burlingame, CA, 94010, USA.
- College of Social and Behavioral Sciences, School of Psychology, Walden University, 155 5th Avenue South, Minneapolis, MN, 55401, USA.
| | - Isabel Elaine Allen
- Department of Epidemiology and Biostatistics, University of California, San Francisco School of Medicine, 550 16th Street, 2nd Floor, San Francisco, CA, 94158, USA.
| | - Sara Hurvitz
- UCLA Jonsson Comprehensive Cancer Center, 2020 Santa Monica Blvd., Suite 580, Santa Monica, CA, 90404, USA.
| | - Mary S Beattie
- Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA.
| | - Bindu Kalesan
- Department of Epidemiology, Columbia University, 722 W 168th Street, New York, NY, 10032, USA.
- Pharmaceutical Product Development, 980 Harvest Drive #130, Blue Bell, PA, 19422, USA.
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Nanda RH, Liu Y, Gillespie TW, Mikell JL, Ramalingam SS, Fernandez FG, Curran WJ, Lipscomb J, Higgins KA. Stereotactic body radiation therapy versus no treatment for early stage non-small cell lung cancer in medically inoperable elderly patients: A National Cancer Data Base analysis. Cancer 2015; 121:4222-30. [DOI: 10.1002/cncr.29640] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 07/07/2015] [Accepted: 07/20/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Ronica H. Nanda
- Department of Radiation Oncology; Emory University; Atlanta Georgia
- Winship Cancer Institute; Emory University; Atlanta Georgia
| | - Yuan Liu
- Winship Cancer Institute; Emory University; Atlanta Georgia
- Department of Biostatistics and Bioinformatics Shared Resource; Emory University; Atlanta Georgia
- Rollins School of Public Health; Emory University; Atlanta Georgia
| | - Theresa W. Gillespie
- Winship Cancer Institute; Emory University; Atlanta Georgia
- Department of Biostatistics and Bioinformatics Shared Resource; Emory University; Atlanta Georgia
| | - John L. Mikell
- Department of Radiation Oncology; Emory University; Atlanta Georgia
- Winship Cancer Institute; Emory University; Atlanta Georgia
| | - Suresh S. Ramalingam
- Winship Cancer Institute; Emory University; Atlanta Georgia
- Department of Hematology and Oncology; Emory University; Atlanta Georgia
| | - Felix G. Fernandez
- Winship Cancer Institute; Emory University; Atlanta Georgia
- Department of Surgery; Emory University; Atlanta Georgia
| | - Walter J. Curran
- Department of Radiation Oncology; Emory University; Atlanta Georgia
- Winship Cancer Institute; Emory University; Atlanta Georgia
| | - Joseph Lipscomb
- Winship Cancer Institute; Emory University; Atlanta Georgia
- Rollins School of Public Health; Emory University; Atlanta Georgia
| | - Kristin A. Higgins
- Department of Radiation Oncology; Emory University; Atlanta Georgia
- Winship Cancer Institute; Emory University; Atlanta Georgia
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79
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Kocher F, Lunger F, Pircher A, Hilbe W, Fiegl M. NSCLC without Antineoplastic Treatment: Incidence, Characteristics, and Outcome as Outlined in the TYROL Study. Oncology 2015; 89:255-61. [PMID: 26303584 DOI: 10.1159/000433544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 05/11/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND The treatment of non-small cell lung cancer (NSCLC) has become more and more individualized with the availability of potent and less toxic therapies. However, there are still patients who do not receive antineoplastic treatment. The aim of this study was to investigate the incidence of 'no treatment', its reasons, and the outcome of untreated NSCLC patients in recent years. PATIENTS AND METHODS Medical files of 1,256 consecutive NSCLC patients diagnosed between 2001 and 2009 at the Medical University of Innsbruck and affiliated hospitals were retrospectively analyzed. RESULTS In 66 of the 1,256 patients (5.3%), the absence of antineoplastic treatment could be ascertained. The median age was 72.1 years, and 42 patients (63.3%) were males. The majority of patients presented with stage IV (n=45; 68.2%). Treatment was omitted due to physical deterioration in 41 patients (62.1%), and 25 patients (37.9%) refused any treatment. The median overall survival of the untreated patients was 3.1 months (refusal: 9.7 months; physical deterioration: 2.1 months). CONCLUSION This study provides information on the incidence of NSCLC patients without antineoplastic treatment and gives a detailed description of the characteristics and comorbidities. These data might help clinicians in the survival estimations of their NSCLC patients in scenarios like therapy refusal or poor physical condition.
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Affiliation(s)
- Florian Kocher
- Department of Internal Medicine V, Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
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80
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Restoration of CBX7 expression increases the susceptibility of human lung carcinoma cells to irinotecan treatment. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2015. [PMID: 26216446 DOI: 10.1007/s00210-015-1153-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Lung cancer is one of the most common causes of cancer-related death worldwide in men and women, and, despite the recent remarkable scientific advances, drug treatment is still unsatisfactory. Polycomb protein chromobox homolog 7 (CBX7) is involved in several biological processes, including development and cancer progression, indeed the lack of CBX7 protein correlates with a highly malignant phenotype and a poor prognosis. However, its role in lung cancer still remains unknown. Since CBX7 is drastically downregulated in human lung carcinomas, we investigated whether restoration of CBX7 expression could affect growth property of lung cancer cells and modulate their sensitivity to treatment with irinotecan and etoposide, two chemoterapy drugs most commonly used in lung cancer therapy. Here, we demonstrate that restoration of CBX7 in two human lung carcinoma cell lines (A549 and H1299), in which this protein is not detectable, leads to a decreased proliferation (at least in part through a downregulation of phosphorylated ERK and phosphorylated p38) and an increased apoptotic cell death after drug exposure (at least in part through the downregulation of Bcl-2, phosphorylated Akt, and phosphorylated JNK). Taken together, these results suggest that the retention of CBX7 expression may play a role in the modulation of chemosensitivity of lung cancer patients to the treatment with irinotecan and etoposide.
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81
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Crizotinib-loaded polymeric nanoparticles in lung cancer chemotherapy. Med Oncol 2015; 32:193. [PMID: 26025486 DOI: 10.1007/s12032-015-0636-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 05/12/2015] [Indexed: 12/23/2022]
Abstract
The study describes the development of polylactide-tocopheryl polyethylene glycol 1000 succinate (PLA-TPGS)-based nanosystem as a carrier of crizotinib (CZT) to achieve superior anticancer efficacy in lung cancer therapy. We have demonstrated that block copolymer and hydrophobic drug is capable of self-assembling into a very stable nanocarrier, with suitable properties that allow their application for cancer drug delivery. Drug release study showed a sustained release pattern as a result of entrapment in the hydrophobic core of micelles. CZT/PT NP showed a noticeable cytotoxic effect in NCIH3122 lung cancer cells in a dose-dependent manner. Furthermore, morphological imaging and Live/Dead assay revealed a superior anticancer efficacy for nanoformulations. The polymeric nanoparticle showed a predominant presence in the cytoplasmic region of cell, indicating a typical endocytosis-mediated cellular uptake. The annexin V/PI staining-based apoptosis assay showed a remarkable ~40 % apoptosis (early and late apoptosis cells) comparing to only ~25 % apoptosis by free CZT. Taken together, Vitamin E TPGS-modified PLA nanoparticles would be a potential drug delivery system to increase the chemotherapeutic efficacy of CZT in lung cancer chemotherapy.
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82
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Juchum M, Günther M, Laufer SA. Fighting cancer drug resistance: Opportunities and challenges for mutation-specific EGFR inhibitors. Drug Resist Updat 2015; 20:12-28. [PMID: 26021435 DOI: 10.1016/j.drup.2015.05.002] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 04/29/2015] [Accepted: 05/04/2015] [Indexed: 12/21/2022]
Abstract
Multiple mutations in the EGFR gene are a major cause for the failure of Erlotinib and Gefitinib in the treatment of patients harboring non-small-cell lung cancer (NSCLC) who initially responded to this therapy. The development of these tyrosine kinase inhibitors (TKIs) is going back to the early 90s, where cancer was widely considered and fully treated as a disease of an organ. Fundamental gain of knowledge in cell biology in general and cancer genetics in particular led us to where we currently stand: cancer is a disease that originates in the genome. Fast and affordable gene sequencing paved the way and opened our eyes for the genetic instability of many cancers, particularly EGFR driven NSCLC. This might allow highly rational and personal therapies by aiming at a very particular wild type and mutant kinase pattern. However, the paradigm "one disease - one target - one drug" is currently challenged. Both activating and deactivating EGFR mutations are known to render the development of novel targeted drugs difficult. Among all lung adenocarcinomas, only 20% are driven by EGFR and only a subpopulation has an activating mutation (e.g. L858R), making them sensitive to first generation EGFR inhibitors. Unfortunately, most of them acquire second deactivating mutations (e.g. T790M) during treatment, leading to a complete loss of response. Are specific inhibitors of the double EGFR mutant L858R/T790M the magic bullet? Much scientific evidence but also high expectations justify this approach. Structural biology of EGFR mutants constitutes the basis for highly rational approaches. Second generation pan EGFR inhibitors inhibiting wild type (WT) and mutant EGFR like Afatinib suffer from dose-limiting adverse effects. Inhibition of WT EGFR is considered to be the culprit. Third generation EGFR inhibitors follow two strategies. Mutant selectivity and improved target residential time. These inhibitors display high mutant selectivity and irreversible binding patterns while sparing WT EGFR activity, hence enhancing tumor selectivity while minimizing adverse effects. Third generation EGFR inhibitors are still undergoing preclinical and clinical evaluation. The most advanced are Rociletinib and AZD9291 which displayed encouraging preliminary clinical phase II data regarding response and adverse effects. In the current review we show both a medicinal chemists' approach toward the design of third generation EGFR inhibitors as well as a detailed overview of the development of EGFR inhibitors over the last decade. High interdisciplinary approaches, such as structural biology and time-resolved tumor genetics pave the way toward the development of drugs that target EGFR mutants. This might lead to highly effective targeted and personalized therapies with enhanced response rates for a minor cohort of patients which have to undergo continuous gene sequencing, hence enabling therapies with tailor-made TKIs.
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Affiliation(s)
- Michael Juchum
- Department of Pharmaceutical and Medicinal Chemistry, Institute of Pharmaceutical Sciences, Eberhard Karls University Tuebingen, Auf der Morgenstelle 8, 72076 Tuebingen, Germany
| | - Marcel Günther
- Department of Pharmaceutical and Medicinal Chemistry, Institute of Pharmaceutical Sciences, Eberhard Karls University Tuebingen, Auf der Morgenstelle 8, 72076 Tuebingen, Germany
| | - Stefan A Laufer
- Department of Pharmaceutical and Medicinal Chemistry, Institute of Pharmaceutical Sciences, Eberhard Karls University Tuebingen, Auf der Morgenstelle 8, 72076 Tuebingen, Germany.
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83
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Park C, Hong SH, Kim GY, Choi YH. So-Cheong-Ryong-Tang induces apoptosis through activation of the intrinsic and extrinsic apoptosis pathways, and inhibition of the PI3K/Akt signaling pathway in non-small-cell lung cancer A549 cells. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 15:113. [PMID: 25889185 PMCID: PMC4397677 DOI: 10.1186/s12906-015-0639-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 03/30/2015] [Indexed: 01/09/2023]
Abstract
Background So-Cheong-Ryong-Tang (SCRT), a traditional Korean medicine containing eight species of medicinal plant, has been used to treat patients with bronchial asthma and allergic rhinitis for hundreds of years; however, its anti-cancer potential is poorly understood. The present study was designed to evaluate the apoptotic effect of SCRT against human non-small-cell lung cancer (NSCLC) A549 cells. Methods The effects of SCRT on cell growth and viability were evaluated by trypan blue dye exclusion and 3-(4, 5-dimethyl-thiazol-2-yl)-2, 5-diphenyl tetrazoliumbromide (MTT) assays, respectively. Apoptosis was detected using 4,6-diamidino-2-phenyllindile (DAPI) staining, agarose gel electrophoresis and flow cytometry. The protein levels were determined by Western blot analysis. Caspase activity was measured using a colorimetric assay. Results SCRT treatment resulted in significantly decreased A549 cell growth and viability by induction of apoptosis. SCRT induced the translocation of pro-apoptotic Bax to the mitochondria, mitochondrial membrane permeabilization, cytochrome c release from mitochondria to cytosol, and activated caspase-9 and caspase-3. SCRT also increased death receptor-associated ligands and enhanced the activation of caspase-8 and cleavage of its substrate Bid. However, the pan-caspases inhibitor significantly blocked the SCRT-induced apoptosis, suggesting that it is a caspase-dependent pathway. In addition, SCRT suppressed the phosphorylation of phosphoinositide 3-kinase (PI3K) and Akt, and treatment with a potent inhibitor of PI3K further increased the apoptotic activity of SCRT. Conclusions These findings suggest that SCRT may play its anti-cancer actions partly through a suppression of the PI3K/Akt signal pathway in A549 cells, and further in vivo studies on the potential of SCRT for prevention and therapy of NSCLCs are warranted.
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84
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Zhang XY, Zhang YD. Enhanced antiproliferative and apoptosis effect of paclitaxel-loaded polymeric micelles against non-small cell lung cancers. Tumour Biol 2015; 36:4949-59. [DOI: 10.1007/s13277-015-3142-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Accepted: 01/19/2015] [Indexed: 12/28/2022] Open
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85
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Liam CK, Andarini S, Lee P, Ho JCM, Chau NQ, Tscheikuna J. Lung cancer staging now and in the future. Respirology 2015; 20:526-34. [PMID: 25682805 DOI: 10.1111/resp.12489] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 11/24/2014] [Accepted: 12/29/2014] [Indexed: 12/24/2022]
Abstract
For a long time lung cancer was associated with a fatalistic approach by healthcare professionals. In recent years, advances in imaging, improved diagnostic techniques and more effective treatment modalities are reasons for optimism. Accurate lung cancer staging is vitally important because treatment options and prognosis differ significantly by stage. The staging algorithm should include a contrast computed tomography (CT) of the chest and the upper abdomen including adrenals, positron emission tomography/CT for staging the mediastinum and to rule out extrathoracic metastasis in patients considered for surgical resection, endosonography-guided needle sampling procedure replacing mediastinoscopy for near complete mediastinal staging, and brain imaging as clinically indicated. Applicability of evidence-based guidelines for staging of lung cancer depends on the available expertise and level of resources and is directly impacted by financial issues. Considering the diversity of healthcare infrastructure and economic performance of Asian countries, optimal and cost-effective use of staging methods appropriate to the available resources is prudent. The pulmonologist plays a central role in the multidisciplinary approach to lung cancer diagnosis, staging and management. Regional respiratory societies such as the Asian Pacific Society of Respirology should work with national respiratory societies to strive for uniform standards of care. For developing countries, a minimum set of care standards should be formulated. Cost-effective delivery of optimal care for lung cancer patients, including staging within the various healthcare systems, should be encouraged and most importantly, tobacco control implementation should receive an absolute priority status in all countries in Asia.
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Affiliation(s)
- Chong-Kin Liam
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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86
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Wang SJ, Huo ZJ, Liu K, Yu N, Ma Y, Qin YH, Li XC, Yu JM, Wang ZQ. Ligand-conjugated pH-sensitive polymeric micelles for the targeted delivery of gefitinib in lung cancers. RSC Adv 2015. [DOI: 10.1039/c5ra09931e] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The aim of the present study was to investigate the tumor targeting potential of a mannose-conjugated pH-sensitive nanosystem for the effective delivery of gefitinib (Gnb) to lung cancers.
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Affiliation(s)
- Shi-Jiang Wang
- Department of Radiation Oncology
- Shandong Cancer Hospital and Institute
- Ji'nan
- China
| | - Zhi-Jun Huo
- Department of Breast Disease Center
- Shandong Cancer Hospital and Institute
- Ji'nan
- China
| | - Kai Liu
- Department of Gastrointestinal Surgery
- Shandong Cancer Hospital and Institute
- Ji'nan
- China
| | - Ning Yu
- Department of Pathology
- Affiliated Hospital of Binzhou Medical College
- Binzhou
- China
| | - Yan Ma
- Department of Radiation Oncology
- Shandong Cancer Hospital and Institute
- Ji'nan
- China
| | - Yue-Hong Qin
- Department of Neurosurgery
- Shandong Provincial Hospital
- Ji'nan
- China
| | - Xiao-Chen Li
- Department of Internal Medicine
- Affiliated Hospital of Shandong Academy of Medical Sciences
- Ji'nan
- China
| | - Jin-Ming Yu
- Department of Radiation Oncology
- Shandong Cancer Hospital and Institute
- Ji'nan
- China
| | - Zhi-Qi Wang
- Department of Head and Neck Surgery
- Shandong Cancer Hospital and Institute
- Jinan
- China
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87
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Tsai MF, Wang CC, Chen JJW. Tumour suppressor HLJ1: A potential diagnostic, preventive and therapeutic target in non-small cell lung cancer. World J Clin Oncol 2014; 5:865-873. [PMID: 25493224 PMCID: PMC4259948 DOI: 10.5306/wjco.v5.i5.865] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 02/10/2014] [Accepted: 04/16/2014] [Indexed: 02/06/2023] Open
Abstract
Lung cancer is the leading cause of cancer-related mortality throughout the world. Non-small cell lung cancer (NSCLC) accounts for 85% of all diagnosed lung cancers. Despite considerable progress in the diagnosis and treatment of the disease, the overall 5-year survival rate of NSCLC patients remains lower than 15%. The most common causes of death in lung cancer patients are treatment failure and metastasis. Therefore, developing novel strategies that target both tumour growth and metastasis is an important and urgent mission for the next generation of anticancer therapy research. Heat shock proteins (HSPs), which are involved in the fundamental defence mechanism for maintaining cellular viability, are markedly activated during environmental or pathogenic stress. HSPs facilitate rapid cell division, metastasis, and the evasion of apoptosis in cancer development. These proteins are essential players in the development of cancer and are prime therapeutic targets. In this review, we focus on the current understanding of the molecular mechanisms responsible for HLJ1’s role in lung cancer carcinogenesis and progression. HLJ1, a member of the human HSP 40 family, has been characterised as a tumour suppressor. Research studies have also reported that HLJ1 shows promising dual anticancer effects, inhibiting both tumour growth and metastasis in NSCLC. The accumulated evidence suggests that HLJ1 is a potential biomarker and treatment target for NSCLC.
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88
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Wu Z, Zou X, Yang L, Lin S, Fan J, Yang B, Sun X, Wan Q, Chen Y, Fu S. Thermosensitive hydrogel used in dual drug delivery system with paclitaxel-loaded micelles for in situ treatment of lung cancer. Colloids Surf B Biointerfaces 2014; 122:90-98. [DOI: 10.1016/j.colsurfb.2014.06.052] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Revised: 06/21/2014] [Accepted: 06/24/2014] [Indexed: 10/25/2022]
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89
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Olsen JB, Sim F, Chandu A. Non-small cell lung cancer metastasis to the oral cavity: a case report. Aust Dent J 2014; 59:520-4. [PMID: 25131571 DOI: 10.1111/adj.12215] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2014] [Indexed: 12/20/2022]
Abstract
Lung cancer, including non-small cell lung cancer, remains prevalent in Australia and has a very poor survival rate. Metastases to the oral cavity are a rare occurrence that can arise from lung cancers. This case report describes the presentation of a metastatic lesion from a poorly differentiated lung adenocarcinoma on the mandibular buccal alveolar attached gingivae. The inpatient had terminal disease with known pleural, brain and liver metastases and was receiving palliative care at the time of diagnosis of the oral lesion.
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Affiliation(s)
- J B Olsen
- Department of Oral and Maxillofacial Surgery, Western Hospital Footscray, Victoria
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90
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Tchaicha JH, Akbay EA, Altabef A, Mikse OR, Kikuchi E, Rhee K, Liao RG, Bronson RT, Sholl LM, Meyerson M, Hammerman PS, Wong KK. Kinase domain activation of FGFR2 yields high-grade lung adenocarcinoma sensitive to a Pan-FGFR inhibitor in a mouse model of NSCLC. Cancer Res 2014; 74:4676-84. [PMID: 25035393 DOI: 10.1158/0008-5472.can-13-3218] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Somatic mutations in FGFR2 are present in 4% to 5% of patients diagnosed with non-small cell lung cancer (NSCLC). Amplification and mutations in FGFR genes have been identified in patients with NSCLCs, and clinical trials are testing the efficacy of anti-FGFR therapies. FGFR2 and other FGFR kinase family gene alterations have been found in both lung squamous cell carcinoma and lung adenocarcinoma, although mouse models of FGFR-driven lung cancers have not been reported. Here, we generated a genetically engineered mouse model (GEMM) of NSCLC driven by a kinase domain mutation in FGFR2. Combined with p53 ablation, primary grade 3/4 adenocarcinoma was induced in the lung epithelial compartment exhibiting locally invasive and pleiotropic tendencies largely made up of multinucleated cells. Tumors were acutely sensitive to pan-FGFR inhibition. This is the first FGFR2-driven lung cancer GEMM, which can be applied across different cancer indications in a preclinical setting.
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MESH Headings
- Adenocarcinoma/drug therapy
- Adenocarcinoma/genetics
- Adenocarcinoma/metabolism
- Adenocarcinoma of Lung
- Animals
- Animals, Genetically Modified/genetics
- Animals, Genetically Modified/metabolism
- Antineoplastic Agents/pharmacology
- Carcinoma, Non-Small-Cell Lung/drug therapy
- Carcinoma, Non-Small-Cell Lung/genetics
- Carcinoma, Non-Small-Cell Lung/metabolism
- Disease Models, Animal
- Female
- Humans
- Lung Neoplasms/drug therapy
- Lung Neoplasms/genetics
- Lung Neoplasms/metabolism
- Male
- Mice
- Mice, Inbred BALB C
- Mice, Inbred C57BL
- Mutation/drug effects
- Mutation/genetics
- Protein Kinase Inhibitors/pharmacology
- Receptor, Fibroblast Growth Factor, Type 2/antagonists & inhibitors
- Receptor, Fibroblast Growth Factor, Type 2/genetics
- Receptor, Fibroblast Growth Factor, Type 2/metabolism
- Tumor Suppressor Protein p53/genetics
- Tumor Suppressor Protein p53/metabolism
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Affiliation(s)
- Jeremy H Tchaicha
- Department of Medicine, Dana Farber Cancer Institute, Boston, Massachusetts. Harvard Medical School, Boston, Massachusetts. Ludwig Institute for Cancer, Cambridge, Massachusetts
| | - Esra A Akbay
- Department of Medicine, Dana Farber Cancer Institute, Boston, Massachusetts. Harvard Medical School, Boston, Massachusetts. Ludwig Institute for Cancer, Cambridge, Massachusetts
| | - Abigail Altabef
- Department of Medicine, Dana Farber Cancer Institute, Boston, Massachusetts. Ludwig Institute for Cancer, Cambridge, Massachusetts
| | - Oliver R Mikse
- Department of Medicine, Dana Farber Cancer Institute, Boston, Massachusetts. Harvard Medical School, Boston, Massachusetts. Ludwig Institute for Cancer, Cambridge, Massachusetts
| | - Eiki Kikuchi
- Department of Medicine, Dana Farber Cancer Institute, Boston, Massachusetts. Harvard Medical School, Boston, Massachusetts. Ludwig Institute for Cancer, Cambridge, Massachusetts
| | - Kevin Rhee
- Department of Medicine, Dana Farber Cancer Institute, Boston, Massachusetts. Ludwig Institute for Cancer, Cambridge, Massachusetts
| | - Rachel G Liao
- Department of Medicine, Dana Farber Cancer Institute, Boston, Massachusetts. The Broad Institute, Cambridge, Massachusetts
| | - Roderick T Bronson
- Department of Microbiology and Immunobiology, Division of Immunology, Harvard Medical School, Boston, Massachusetts
| | - Lynette M Sholl
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Matthew Meyerson
- Department of Medicine, Dana Farber Cancer Institute, Boston, Massachusetts. Harvard Medical School, Boston, Massachusetts. The Broad Institute, Cambridge, Massachusetts
| | - Peter S Hammerman
- Department of Medicine, Dana Farber Cancer Institute, Boston, Massachusetts. Harvard Medical School, Boston, Massachusetts. The Broad Institute, Cambridge, Massachusetts.
| | - Kwok-Kin Wong
- Department of Medicine, Dana Farber Cancer Institute, Boston, Massachusetts. Harvard Medical School, Boston, Massachusetts. Ludwig Institute for Cancer, Cambridge, Massachusetts. Belfer Institute for Applied Cancer Science, Boston, Massachusetts.
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91
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What about Alice? Peripheral neuropathy from taxane-containing treatment for advanced nonsmall cell lung cancer. Support Care Cancer 2014; 22:2581-92. [DOI: 10.1007/s00520-014-2317-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 06/08/2014] [Indexed: 01/05/2023]
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92
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Gao L, Li Q, Jiang M, Liu C, Song Z, Bao X, Shen Y, Liu G, Hu K. Combined therapy of percutaneous cryoablation and traditional Chinese medicine can be a promising strategy for elderly or advanced lung cancer patients based on a retrospective clinical study. Cryobiology 2014; 69:174-7. [PMID: 24859157 DOI: 10.1016/j.cryobiol.2014.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 04/23/2014] [Accepted: 05/14/2014] [Indexed: 12/17/2022]
Abstract
Presently, elderly and advanced lung cancer patients have very limited treatment options. With no promising therapy, treatment of these patients is challenging. We have reviewed 119 primary lung cancer patients who received a combined percutaneous cryoablation and traditional Chinese medicine therapy (Cryo-TCM therapy) between 2005 and 2013. Out of 119 patients, 84.1% patients were elderly or advanced lung cancer when receiving cryoablation. Overall Survival time from the time of Diagnosis (DOS) and Cryoablation (COS) was 19 and 10 months respectively, which were longer than data previously published. Patients who accepted only Cryo-TCM therapy got similar DOS as those who were treated with Cryo-TCM and other classic anticancer therapies. Thus, Cryo-TCM therapy can prolong the survival time and can be used as the main therapy for the elderly or advanced lung cancer patients in China both in quality of life and cost effectiveness.
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Affiliation(s)
- Lei Gao
- Oncology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
| | - Quanwang Li
- Oncology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
| | - Min Jiang
- Oncology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
| | - Chuanbo Liu
- Oncology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
| | - Zilin Song
- Oncology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
| | - Xiaoling Bao
- Oncology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
| | - Yang Shen
- Oncology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
| | - Guijian Liu
- Laboratory Department, Guanganmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Kaiwen Hu
- Oncology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China.
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93
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Inhibition of protein kinase C α/βII and activation of c-Jun NH2-terminal kinase mediate glycyrrhetinic acid induced apoptosis in non-small cell lung cancer NCI-H460 cells. Bioorg Med Chem Lett 2014; 24:1188-91. [DOI: 10.1016/j.bmcl.2013.12.111] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 12/24/2013] [Accepted: 12/24/2013] [Indexed: 12/20/2022]
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94
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Talebian Yazdi M, Keene KR, Hiemstra PS, van der Burg SH. Recent progress in peptide vaccination in cancer with a focus on non-small-cell lung cancer. Expert Rev Vaccines 2013; 13:87-116. [PMID: 24308580 DOI: 10.1586/14760584.2014.862499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Active immunotherapy aimed at the stimulation of tumor-specific T cells has established itself within the clinic as a therapeutic option to treat cancer. One strategy is the use of so-called peptides that mimic genuine T-cell epitopes as vaccines to activate tumor-specific T cells. In various clinical trials, different types of vaccines, adjuvants and other immunomodulatory compounds were evaluated in patients with different types of tumors. Here, we review the trials published in the last 3 years focusing on the T-cell response, the effect of immunomodulation and potential relationships with clinical outcomes. Furthermore, we would like to make a case for the development of peptide vaccines aiming to treat non-small-cell lung cancer, the most common cause of cancer mortality.
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Affiliation(s)
- Mehrdad Talebian Yazdi
- Department of Pulmonology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
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Molfino NA. Recent therapeutic breakthroughs in respiratory medicine. Expert Rev Respir Med 2013; 7:331-3. [PMID: 23964623 DOI: 10.1586/17476348.2013.814388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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