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Verma S, Kumar M, Kumari M, Mehrotra R, Kushwaha RAS, Goel M, Kumar A, Kant S. An Immunohistochemical Study of Anaplastic Lymphoma Kinase and Epidermal Growth Factor Receptor Mutation in Non-Small Cell Lung Carcinoma. J Clin Diagn Res 2017; 11:EC22-EC25. [PMID: 28892905 DOI: 10.7860/jcdr/2017/27941.10279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 05/03/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Lung cancer is one of the leading causes of cancer related death. Targeted treatment for specific markers may help in reducing the cancer related morbidity and mortality. AIM To study expression of Anaplastic Lymphoma Kinase (ALK)and Epidermal Growth Factor Receptor (EGFR) mutations in patients of Non-Small Cell Lung Cancer NSCLC, that are the targets for specific ALK inhibitors and EGFR tyrosine kinase inhibitors. MATERIALS AND METHODS Total 69 cases of histologically diagnosed NSCLC were examined retrospectively for immunohistochemical expression of EGFR and ALK, along with positive control of normal placental tissue and anaplastic large cell lymphoma respectively. RESULTS Of the NSCLC, Squamous Cell Carcinoma (SCC) accounted for 71.0% and adenocarcinoma was 26.1%. ALK expression was seen in single case of 60-year-old female, non-smoker with adenocarcinoma histology. EGFR expression was seen in both SCC (59.18%) and adenocarcinoma in (77.78%) accounting for 63.77% of all cases. Both ALK and EGFR mutation were mutually exclusive. CONCLUSION EGFR expression was seen in 63.77% of cases, highlighting the importance of its use in routine analysis, for targeted therapy and better treatment results. Although, ALK expression was seen in 1.45% of all cases, it is an important biomarker in targeted cancer therapy. Also, the mutually exclusive expression of these two markers need further studies to develop a diagnostic algorithm for NSCLC patients.
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Affiliation(s)
- Sonal Verma
- Senior Resident, Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Madhu Kumar
- Associate Professor, Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Malti Kumari
- Associate Professor, Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Raj Mehrotra
- Ex Professor, Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - R A S Kushwaha
- Professor, Department of Respiratory Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Madhumati Goel
- Professor, Department of Pathology, King George's, Medical University, Lucknow, Uttar Pradesh, India
| | - Ashutosh Kumar
- Professor, Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Surya Kant
- Professor, Department of Respiratory Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
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Heist RS, Guarino MJ, Masters G, Purcell WT, Starodub AN, Horn L, Scheff RJ, Bardia A, Messersmith WA, Berlin J, Ocean AJ, Govindan SV, Maliakal P, Mudenda B, Wegener WA, Sharkey RM, Goldenberg DM, Camidge DR. Therapy of Advanced Non-Small-Cell Lung Cancer With an SN-38-Anti-Trop-2 Drug Conjugate, Sacituzumab Govitecan. J Clin Oncol 2017; 35:2790-2797. [PMID: 28548889 DOI: 10.1200/jco.2016.72.1894] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Purpose Trop-2, expressed in most solid cancers, may be a target for antibody-drug conjugates (ADCs) in non-small-cell lung cancer (NSCLC). We studied sacituzumab govitecan (IMMU-132), a Trop-2 ADC, for the targeting of SN-38. Patients and Methods We evaluated IMMU-132 in a single-arm multicenter trial in patients with pretreated metastatic NSCLC who received either 8 or 10 mg/kg on days 1 and 8 of 21-day cycles. The primary end points were safety and objective response rate (ORR). Progression-free survival and overall survival were secondary end points. Results Fifty-four patients were treated. In the response-assessable study population (n = 47), which had a median of three prior therapies (range, two to seven), the ORR was 19%; median response duration, 6.0 months (95% CI, 4.8 to 8.3 months); and clinical benefit rate (complete response + partial response + stable disease ≥ 4 months), 43%. ORR in the intention-to-treat (ITT) population was 17% (nine of 54). Responses occurred with a median onset of 3.8 months, including patients who had relapsed or progressed after immune checkpoint inhibitor therapy. Median ITT progression-free survival was 5.2 months (95% CI, 3.2 to 7.1 months) and median ITT overall survival, 9.5 months (95% CI, 5.9 to 16.7 months). Grade 3 or higher adverse events included neutropenia (28%), diarrhea (7%), nausea (7%), fatigue (6%), and febrile neutropenia (4%). One patient developed a transient immune response, despite patients receiving a median of 10 doses. More than 90% of 26 assessable archival tumor specimens were highly positive (2+, 3+) for Trop-2 by immunohistochemistry, which suggests that Trop-2 is not a predictive biomarker for response. Conclusion IMMU-132 was well-tolerated and induced durable responses in heavily pretreated patients with metastatic NSCLC. This ADC should be studied further in this disease and in other patients with Trop-2-expressing tumors.
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Affiliation(s)
- Rebecca Suk Heist
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Michael J Guarino
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Gregory Masters
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - W Thomas Purcell
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Alexander N Starodub
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Leora Horn
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Ronald J Scheff
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Aditya Bardia
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Wells A Messersmith
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Jordan Berlin
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Allyson J Ocean
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Serengulam V Govindan
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Pius Maliakal
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Boyd Mudenda
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - William A Wegener
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Robert M Sharkey
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - David M Goldenberg
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - D Ross Camidge
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
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Zhao G, Xu B, Li X, Tang C, Qin H, Wang H, Yang S, Wang W, Gao H, He K, Liu X. [Detection of Serum Peptides in Patients with Lung Squamous Cell Carcinoma by MALDI-TOF-MS and Analysis of Their Correlation with Chemotherapy Efficacy]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2017; 20:318-325. [PMID: 28532539 PMCID: PMC5973065 DOI: 10.3779/j.issn.1009-3419.2017.05.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Treatment options for patients with squamous cell carcinoma of the lung (SCC) are limited in chemotherapy. However, not all patients could benefit form standard platinum regimen. Considering the dismal prognosis of patients with advanced SCC, a greater focus on selecting sensitive chemotherapy regimens remains of upmost importance to improve outcomes in this disease. In this study, we used matrix-assisted laser desorption/ionization time-of-flight mass spectrometry to detect pre-chemotherapy serum peptides in advanced lung squamous cell carcinoma patients accepting paclitaxel combined with platinum chemotherapy and to analyze the correlation between serum peptides and chemotherapy efficacy. METHODS Patients with advanced lung squamous cell carcinoma received paclitaxel combining with platinum chemotherapy and evaluated the efficacy every two cycles. Evaluation of complete response (CR) or partial response (PR) patients defined as sensitive group, progressive disease (PD) patients defined as resistant group. Serum samples were collected from patients with lung squamous cell carcinoma. Eighty-one patients were randomly divided into training group (sensitive group I and resistant group I) and validation group (sensitive group II and resistant group II) according to the ratio of 3:1. Serum samples were pretreated and Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) was used to detect serum peptide fingerprints. ClinProTools software was used to analyze the differences between the sensitive group I and the resistant group I. Three kinds of biological algorithms (SNN, GA, QC) built in CPT software were used to establish the curative effect prediction model respectively and the optimal algorithm was selected. The validation group was used for blind verification. RESULTS Thirty sensitive patients and 31 resistant patients were enrolled in the training group. Ten sensitive patients and 10 resistant patients were included in the validation group. The training group had 96 differentially expressed peptides in the sensitive and resistant patients, with 16 statistically significant peptides (P<0.001). The predictive model was established by 5 polypeptides (1,897.75 Da, 2,023.93 Da, 3,683.36 Da, 4,269.56 Da, 5,341.29 Da). The recognition rate of this model was 89.18% and the cross validation rate was 95.11%. The accuracy of the model was 85%, the sensitivity was 90.0% and the specificity was 80.0%. The median PFS in the sensitive group was better than patients in the resistant group (7.2 months 95%CI: 4.4-14.5 vs 1.8 months 95%CI: 0.7-3.5). The results showed that the differential peptides 4,232.04 Da and 4,269.56 Da were correlated with PFS in patients with lung squamous cell carcinoma (P<0.001). CONCLUSIONS MALDI-TOF-MS was used to detect the difference of serum peptides between sensitive and resistant groups. The preliminary curative effect prediction model was used to predict the efficacy of paclitaxel combined with platinum regimen. However, this model need further investigations to verify the accuracy and the sensitivity.
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Affiliation(s)
- Guanhua Zhao
- Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China
| | - Bin Xu
- National Center of Biomedical Analysis, Beijing 100850, China
| | - Xiaoyan Li
- Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China
| | - Chuanhao Tang
- Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China
| | - Haifeng Qin
- Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China
| | - Hong Wang
- Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China
| | - Shaoxing Yang
- Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China
| | - Weixia Wang
- Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China
| | - Hongjun Gao
- Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China
| | - Kun He
- Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China
| | - Xiaoqing Liu
- Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China
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Zhu W, Li GX, Chen HL, Liu XY. The role of eukaryotic translation initiation factor 6 in tumors. Oncol Lett 2017; 14:3-9. [PMID: 28693127 PMCID: PMC5494901 DOI: 10.3892/ol.2017.6161] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 10/26/2016] [Indexed: 12/28/2022] Open
Abstract
Eukaryotic translation initiation factor 6 (eIF6) affects the maturation of 60S ribosomal subunits. Found in yeast and mammalian cells, eIF6 is primarily located in the cytoplasm of mammalian cells. Emerging evidence has demonstrated that the dysregulated expression of eIF6 is important in several types of human cancer, including head and neck carcinoma, colorectal cancer, non-small cell lung cancer and ovarian serous adenocarcinoma. However, the molecular mechanisms by which eIF6 functions during tumor formation and progression remain elusive. The present review focuses on recent progress in terms of the mechanisms and functions of eIF6 in human tumorigenesis or cancer cell lines, along with the signal transduction pathways in which this novel translation initiation factor may participate. Oncogenic Ras activates Notch-1 and promotes transcription of eIF6 via a recombining binding protein suppressor of Hairless-dependent mechanism. In addition, overexpression of eIF6 results in aberrant activation of the Wnt/β-catenin signaling pathway. Similarly, overexpressed eIF6 regulates its downstream modulator, cell division control protein 42, which in turn affects oncogenesis. Finally, the potential of eIF6 as a biomarker for diagnosis of cancer is also discussed in the present review.
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Affiliation(s)
- Wei Zhu
- Department of Pathology, Guangdong Medical University, Dongguan, Guangdong 523808, P.R. China
| | - Gui Xian Li
- Department of Pathology, Guangdong Medical University, Dongguan, Guangdong 523808, P.R. China
| | - Hong Lang Chen
- Department of Pharmacology, Guangdong Medical University, Dongguan, Guangdong 523808, P.R. China
| | - Xing Yan Liu
- Sino-American Cancer Research Institute, Guangdong Medical University, Dongguan, Guangdong 523808, P.R. China
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Thorne-Nuzzo T, Williams C, Catallini A, Clements J, Singh S, Amberson J, Dickinson K, Gatalica Z, Ho SN, Loftin I, McElhinny A, Towne P. A Sensitive ALK Immunohistochemistry Companion Diagnostic Test Identifies Patients Eligible for Treatment with Crizotinib. J Thorac Oncol 2017; 12:804-813. [DOI: 10.1016/j.jtho.2017.01.020] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 12/19/2016] [Accepted: 01/06/2017] [Indexed: 01/12/2023]
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Perakis S, Auer M, Belic J, Heitzer E. Advances in Circulating Tumor DNA Analysis. Adv Clin Chem 2017; 80:73-153. [PMID: 28431643 DOI: 10.1016/bs.acc.2016.11.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The analysis of cell-free circulating tumor DNA (ctDNA) is a very promising tool and might revolutionize cancer care with respect to early detection, identification of minimal residual disease, assessment of treatment response, and monitoring tumor evolution. ctDNA analysis, often referred to as "liquid biopsy" offers what tissue biopsies cannot-a continuous monitoring of tumor-specific changes during the entire course of the disease. Owing to technological improvements, efforts for the establishment of preanalytical and analytical benchmark, and the inclusion of ctDNA analyses in clinical trial, an actual clinical implementation has come within easy reach. In this chapter, recent advances of the analysis of ctDNA are summarized starting from the discovery of cell-free DNA, to methodological approaches and the clinical applicability.
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Affiliation(s)
- Samantha Perakis
- Institute of Human Genetics, Medical University of Graz, Graz, Austria
| | - Martina Auer
- Institute of Human Genetics, Medical University of Graz, Graz, Austria
| | - Jelena Belic
- Institute of Human Genetics, Medical University of Graz, Graz, Austria
| | - Ellen Heitzer
- Institute of Human Genetics, Medical University of Graz, Graz, Austria.
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Lui JK, McIntosh LJ, Escobar Valle J, Stockl T, Summers S. Facial Drooping, Aphasia, and an Incidental Lung Mass in a Nonsmoker. J Intensive Care Med 2016; 32:228-230. [PMID: 27798316 DOI: 10.1177/0885066616676044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Atrial fibrillation and atrial flutter are atrial tachycardias associated with embolic strokes. To date, there have only been a few reports highlighting the incidence of these atrial tachycardias due to mechanical compression of myocardial structures and the pulmonary vasculature in certain mediastinal masses and cysts. CASE We present a case of a 75-year-old gentleman who is a nonsmoker with a history of hypertension who presents with an acute embolic stroke due to atrial flutter likely from mechanical compression from an underlying squamous cell carcinoma of the lung. CONCLUSION This case represents, to the best of our knowledge, a rare case of squamous cell carcinoma of the lung in a nonsmoker likely leading to mechanical compression and a resultant atrial tachycardia with an embolic stroke.
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Affiliation(s)
- Justin K Lui
- 1 Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Lacey J McIntosh
- 2 Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jorge Escobar Valle
- 1 Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Thomas Stockl
- 3 Department of Pathology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Stephen Summers
- 1 Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA.,4 Division of Pulmonary Medicine, University of Massachusetts Medical School, Worcester, MA, USA
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Kim YS, Kim EY, Ahn HK, Cho EK, Jeong YM, Kim JH. Prognostic significance of CT-emphysema score in patients with advanced squamous cell lung cancer. J Thorac Dis 2016; 8:1966-73. [PMID: 27621848 DOI: 10.21037/jtd.2016.06.70] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although emphysema is a known independent risk factor of lung cancer, no study has addressed the prognostic impact of computed tomography (CT)-emphysema score in advanced stage lung cancer. METHODS For 84 consecutive patients with stage IIIB and IV squamous cell lung cancer that underwent palliative chemotherapy, severity of emphysema was semi-quantitatively scored using baseline chest CT images according to the Goddard scoring system (possible scores range, 0-24). The cutoff of high CT-emphysema score was determined using the maximum chi-squared test and the prognostic significance of the high CT-emphysema score was evaluated using Kaplan-Meier analysis and Cox proportional hazards analysis. RESULTS The median CT-emphysema score was 5 (range, 0-22). Patients with a high CT-emphysema score (≥4) tended to have poorer overall survival (OS) (median: 6.3 vs. 13.7 months) than those with a score of <4 (P=0.071). Multivariable analysis revealed that a higher CT-emphysema score was a significant independent prognostic factor for poor OS [hazard ratio (HR) =2.06; 95% confidence interval (CI), 1.24-3.41; P=0.005), along with no response to first-line therapy (P=0.009) and no second-line therapy (P<0.001). CONCLUSIONS CT-emphysema score is significantly associated with poor prognosis in patients with advanced squamous cell lung cancer.
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Affiliation(s)
- Young Saing Kim
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Eun Young Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Hee Kyung Ahn
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Eun Kyung Cho
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Yu Mi Jeong
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jeong Ho Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
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Duggan KT, Hildebrand Duffus S, D'Agostino RB, Petty WJ, Streer NP, Stephenson RC. The Impact of Hospice Services in the Care of Patients with Advanced Stage Nonsmall Cell Lung Cancer. J Palliat Med 2016; 20:29-34. [PMID: 27559623 DOI: 10.1089/jpm.2016.0064] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION Prior research has shown that advanced stage nonsmall cell lung cancer (NSCLC) patients enrolled in hospice care receive less aggressive treatment at the end of life (EOL) without compromising survival. Our purpose was to profile the continuum of care of these patients, exploring the connection between hospice enrollment and quality indicators for excellence in EOL cancer care. METHODS One hundred ninety-seven deceased stage IV NSCLC patients diagnosed between 2008 and 2010 at two separate tertiary care centers within the same county were identified. A retrospective review was conducted, collecting data from electronic medical records regarding antitumor treatment, postdiagnosis hospital visits and admissions, hospice referrals and enrollments, and circumstances surrounding the patient's death. Patients were grouped by their status of hospice enrollment, and the remainder of the measures compared accordingly. RESULTS There was no significant difference found in total number of postdiagnosis hospital admissions between the patients who were enrolled in hospice and those who were not. However, the group who received hospice services had a significantly lower number of hospitalizations (p < 0.001), emergency department visits (p < 0.01), and intensive care unit admissions in the last 30 days of life (p < 0.001). The number of lines of chemotherapy received did not differ significantly between the groups. Median survival, measured by the length of time between diagnosis and death, was significantly longer for hospice patients (p = 0.02). CONCLUSIONS This study demonstrates that, among patients with metastatic NSCLC, hospice enrollment was associated with optimized EOL oncological care and a significantly longer median survival.
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Affiliation(s)
- Kristy T Duggan
- Wake Forest Baptist Medical Center , Winston-Salem, North Carolina
| | | | | | - William J Petty
- Wake Forest Baptist Medical Center , Winston-Salem, North Carolina
| | - Nathan P Streer
- Wake Forest Baptist Medical Center , Winston-Salem, North Carolina
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Dammeijer F, Lievense LA, Veerman GDM, Hoogsteden HC, Hegmans JP, Arends LR, Aerts JG. Efficacy of Tumor Vaccines and Cellular Immunotherapies in Non-Small-Cell Lung Cancer: A Systematic Review and Meta-Analysis. J Clin Oncol 2016; 34:3204-12. [PMID: 27432922 DOI: 10.1200/jco.2015.66.3955] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
PURPOSE Programmed cell death protein-1- checkpoint blockers have recently been approved as second-line treatment for advanced non-small-cell lung cancer (NSCLC). Unfortunately, only a subgroup of patients responds and shows long-term survival to these therapies. Tumor vaccines and cellular immunotherapies could synergize with checkpoint blockade, but which of these treatments is most efficacious is unknown. In this meta-analysis, we assessed the efficacy of tumor vaccination and cellular immunotherapy in NSCLC. METHODS We searched for randomized controlled trials (RCTs) investigating cellular immunotherapy or vaccines in NSCLC. We used random effects models to analyze overall survival (OS) and progression-free survival (PFS), expressed as hazard ratios (HRs), and differences in time (months). The effect of immunotherapy type, disease stage, tumor histology, and concurrent chemotherapy was assessed using subgroup analysis and meta-regression. All procedures were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS We identified 18 RCTs that matched our selection criteria; these included a total of 6,756 patients. Immunotherapy extended NSCLC survival and PFS, expressed as HR (OS: HR, 0.81, 95% CI, 0.70 to 0.94, P = .01; PFS: HR, 0.83, 95% CI, 0.72 to 0.95, P = .006) and month difference (OS: difference, 5.43 months, 95% CI, 3.20 to 7.65, P < .005; PFS: difference, 3.24 months, 95% CI, 1.61 to 4.88, P < .005). Cellular therapies outperformed tumor vaccines (OS as HR: P = .005, month difference: P < .001; PFS as HR: P = .001, month difference: P = .004). There was a benefit of immunotherapy in low-stage compared with high-stage NSCLC and with concurrent administration of chemotherapy only in one of four outcome measures evaluated (PFS in months: P = .01 and PFS as HR: P = .031, respectively). There was no significant effect of tumor histology on survival or PFS. CONCLUSION Tumor vaccines and cellular immunotherapies enhanced OS and PFS in NSCLC. Cellular immunotherapy was found to be more effective than tumor vaccination. These findings have implications for future studies investigating combination immunotherapy in NSCLC.
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Affiliation(s)
- Floris Dammeijer
- Floris Dammeijer, Lysanne A. Lievense, G.D. Marijn Veerman, Henk C. Hoogsteden, Joost P. Hegmans, Joachim G. Aerts, and Lidia R. Arends, Erasmus Medical Center, Rotterdam, The Netherlands; and Joachim G. Aerts, Amphia Hospital, Breda, The Netherlands
| | - Lysanne A Lievense
- Floris Dammeijer, Lysanne A. Lievense, G.D. Marijn Veerman, Henk C. Hoogsteden, Joost P. Hegmans, Joachim G. Aerts, and Lidia R. Arends, Erasmus Medical Center, Rotterdam, The Netherlands; and Joachim G. Aerts, Amphia Hospital, Breda, The Netherlands
| | - G D Marijn Veerman
- Floris Dammeijer, Lysanne A. Lievense, G.D. Marijn Veerman, Henk C. Hoogsteden, Joost P. Hegmans, Joachim G. Aerts, and Lidia R. Arends, Erasmus Medical Center, Rotterdam, The Netherlands; and Joachim G. Aerts, Amphia Hospital, Breda, The Netherlands
| | - Henk C Hoogsteden
- Floris Dammeijer, Lysanne A. Lievense, G.D. Marijn Veerman, Henk C. Hoogsteden, Joost P. Hegmans, Joachim G. Aerts, and Lidia R. Arends, Erasmus Medical Center, Rotterdam, The Netherlands; and Joachim G. Aerts, Amphia Hospital, Breda, The Netherlands
| | - Joost P Hegmans
- Floris Dammeijer, Lysanne A. Lievense, G.D. Marijn Veerman, Henk C. Hoogsteden, Joost P. Hegmans, Joachim G. Aerts, and Lidia R. Arends, Erasmus Medical Center, Rotterdam, The Netherlands; and Joachim G. Aerts, Amphia Hospital, Breda, The Netherlands
| | - Lidia R Arends
- Floris Dammeijer, Lysanne A. Lievense, G.D. Marijn Veerman, Henk C. Hoogsteden, Joost P. Hegmans, Joachim G. Aerts, and Lidia R. Arends, Erasmus Medical Center, Rotterdam, The Netherlands; and Joachim G. Aerts, Amphia Hospital, Breda, The Netherlands
| | - Joachim G Aerts
- Floris Dammeijer, Lysanne A. Lievense, G.D. Marijn Veerman, Henk C. Hoogsteden, Joost P. Hegmans, Joachim G. Aerts, and Lidia R. Arends, Erasmus Medical Center, Rotterdam, The Netherlands; and Joachim G. Aerts, Amphia Hospital, Breda, The Netherlands.
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The triptolide derivative MRx102 inhibits Wnt pathway activation and has potent anti-tumor effects in lung cancer. BMC Cancer 2016; 16:439. [PMID: 27400883 PMCID: PMC4939706 DOI: 10.1186/s12885-016-2487-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 07/04/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The natural compound triptolide has been shown to decrease cell proliferation and induce apoptosis and cellular senescence. We previously demonstrated that triptolide decreases tumor formation and metastasis of human non-small cell lung cancer cells (NSCLC). Due to the toxicity of triptolide, derivatives of the natural compound have been developed that show more favorable toxicity profiles and pharmacokinetics in animal models. The purpose of this study was to evaluate MRx102 as a novel therapeutic for lung cancer. METHODS Mice injected subcutaneously with H460 lung cancer cells were treated with MRx102 or carboplatin to determine the effect of MRx102 on tumor formation in comparison to standard treatment. Patient-derived xenografts (PDX) with different WIF1 expression levels were treated with MRx102 or cisplatin. We tested the effects of MRx102 treatment on migration and invasion of lung cancer cells using Transwell filters coated with fibronectin and Matrigel, respectively. Tail vein injections using H460 and A549 cells were performed. RESULTS Here we report that the triptolide derivative MRx102 significantly decreases NSCLC proliferation and stimulates apoptosis. Further, MRx102 potently inhibits NSCLC haptotactic migration and invasion through Matrigel. In vivo, NSCLC tumor formation and metastasis were greatly decreased by MRx102 treatment. The decrease in tumor formation by MRx102 in the patient-derived xenograft model was WIF1-dependent, demonstrating that MRx102 is a potent inhibitor of the Wnt pathway in low WIF1 expressing NSCLC patient tumors. CONCLUSIONS These results indicate that MRx102 has potent antitumor effects both in vitro and in vivo, and is a potential novel therapy for the treatment of NSCLC.
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Lin JJ, Ezer N, Sigel K, Mhango G, Wisnivesky JP. The effect of statins on survival in patients with stage IV lung cancer. Lung Cancer 2016; 99:137-42. [PMID: 27565929 DOI: 10.1016/j.lungcan.2016.07.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 06/14/2016] [Accepted: 07/05/2016] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Prior studies have shown an anticancer effect of statins in patients with certain malignancies. However, it is unclear whether statins have a mortality benefit in lung cancer. We compared survival of patients with stage IV non-small cell lung cancer (NSCLC) receiving vs. not receiving statins prior to diagnosis. METHODS Using data from the Surveillance, Epidemiology and End Results registry linked to Medicare claims, we identified 5118 patients >65 years of age diagnosed with stage IV NSCLC between 2007 and 2009. We used propensity score methods to assess the association of statin use with overall and lung cancer-specific survival while controlling for measured confounders. RESULTS Overall, 27% of patients were on statins at time of lung cancer diagnosis. Median survival in the statin group was 7 months, compared to 4 months in patients not treated with statins (p<0.001). Propensity score analyses found that statin use was associated with improvement in overall (hazard ratio [HR]: 0.76, 95% confidence interval [CI]: 0.73-0.79) and lung cancer-specific survival (HR: 0.77, 95% CI: 0.73-0.81), after controlling for baseline patient characteristics, cancer characteristics, staging work-up and chemotherapy use. CONCLUSIONS Statin use is associated with improved survival among patients with stage IV NSCLC suggesting a potential anticancer effect. Further research should evaluate plausible biological mechanisms as well as test the effect of statins in prospective clinical trials.
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Affiliation(s)
- Jenny J Lin
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY 10029, USA.
| | - Nicole Ezer
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY 10029, USA
| | - Keith Sigel
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY 10029, USA
| | - Grace Mhango
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY 10029, USA
| | - Juan P Wisnivesky
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY 10029, USA; Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
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Withrow DR, Racey CS, Jamal S. A critical review of methods for assessing cancer survival disparities in indigenous population. Ann Epidemiol 2016; 26:579-591. [PMID: 27431064 DOI: 10.1016/j.annepidem.2016.06.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 05/27/2016] [Accepted: 06/06/2016] [Indexed: 12/24/2022]
Abstract
PURPOSE An increasing cancer burden among indigenous populations has led to a growing literature about survival disparities between indigenous and nonindigenous persons. We aim to describe and appraise methods used to measure cancer survival in indigenous persons in the United States, Canada, Australia, and New Zealand. METHODS We searched Medline, Web of Science, and EMBASE for articles published between 1990 and 2015 that estimated survival in populations indigenous to one of these four countries. We gathered information about data sources, analytical methods, and the extent to which threats to validity were discussed. RESULTS The search retrieved 83 articles. The most common approach to survival analysis was cause-specific survival (n = 49). Thirty-eight articles measured all-cause survival and 11 measured excess mortality attributable to cancer (relative survival). Three sources of information bias common to all studies (ethnic misclassification, incomplete case ascertainment, and incomplete death ascertainment) were acknowledged in a minority of articles. CONCLUSIONS The methodological considerations we present here are shared with studies of cancer survival across other subpopulations. We urge future researchers on this and related topics to clearly describe their data sources, to justify analytic choices, and to fully discuss the potential impact of those choices on the results and interpretation.
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Affiliation(s)
- Diana R Withrow
- Aboriginal Cancer Control Unit, Prevention and Cancer Control, Cancer Care Ontario, Toronto, Canada; Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
| | - C Sarai Racey
- Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sehar Jamal
- Aboriginal Cancer Control Unit, Prevention and Cancer Control, Cancer Care Ontario, Toronto, Canada
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Association between nuclear expression of retinoic acid receptor alpha and beta and clinicopathological features and prognosis of advanced non-small cell lung cancer. Int J Clin Oncol 2016; 21:1051-1061. [PMID: 27306217 DOI: 10.1007/s10147-016-1002-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 06/02/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Transcription factors such as retinoic acid receptor alpha (RARα) and beta (RARβ) and Yin Yang 1 (YY1) are associated with the progression of non-small cell lung cancer (NSCLC). In particular, a lack of RARβ expression is associated with NSCLC development. The aim of this study was to analyze the expression of RARα, RARβ and YY1 and their relationship with prognosis in patients with advanced NSCLC. METHODS The expression of RARα, RARβ and YY1 was assessed by immunohistochemistry and quantitative computerized image software. RESULTS Eighty-five patients treated with platinum-based chemotherapy were included in the analysis. The mean and standard deviation of the nuclear expression of RARα, RARβ and YY1 were 184.5 ± 124.4, 18 ± 27 and 16.6 ± 20.5, respectively. The nuclear expression of RARβ was associated with the nuclear expression of YY1 (R 2 = 0.28; p value < 0.0001). Patients with high nuclear expression of YY1 were likely to be non-smokers (61.9 vs 40.5 %). Median progression-free survival (PFS) was 5.9 months (3.48-8.28). Low expression of RARα was independently associated with worse PFS following chemotherapy (10.3 vs 5.46 months p = 0.040). Median overall survival (OS) was 15.6 months (4.5-26.7), and lower nuclear expression of RARβ was independently associated with shorter OS (27.5 vs 8.7 months; p = 0.037). CONCLUSION Our study suggests that the loss of RARs is associated with a worse prognosis and these receptors could be a potential molecular target for NSCLC.
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Clinicopathologic Features of Advanced Squamous NSCLC. J Thorac Oncol 2016; 11:1411-22. [PMID: 27296106 DOI: 10.1016/j.jtho.2016.05.024] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 05/19/2016] [Accepted: 05/19/2016] [Indexed: 12/31/2022]
Abstract
Lung cancer remains the leading cause of cancer-related death worldwide. NSCLC accounts for more than 85% of all lung cancers, and the prognosis for advanced-stage disease is typically poor. In recent years, the importance of histologic subtypes of NSCLC has been recognized, and the distinction between squamous and other NSCLC histologic subtypes is now critical to patient management. Squamous cell lung cancer (sqCLC) represents approximately 25% to 30% of NSCLC. The prognosis for patients with advanced NSCLC is poorer for those with sqCLC than for those with adenocarcinoma. This is partly due to a number of clinical characteristics that distinguish sqCLC from other NSCLC histologic subtypes, such as smoking history, comorbid diseases, age, and molecular profile. Together, these factors make sqCLC an especially challenging disease to manage. Herein, we review some of the key clinicopathologic features of sqCLC. Understanding these features to optimally address many of the unique therapeutic challenges of this disease is likely to be central to ultimately improving outcomes for patients with squamous NSCLC.
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Li D, Du XL, Ren Y, Liu P, Li S, Yang J, Lv M, Chen L, Wang X, Li E, Yang J, Yi M. Comparative Analysis of Clinicopathologic Features of, Treatment in, and Survival of Americans with Lung or Bronchial Cancer. PLoS One 2016; 11:e0156617. [PMID: 27244238 PMCID: PMC4886968 DOI: 10.1371/journal.pone.0156617] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 05/17/2016] [Indexed: 01/12/2023] Open
Abstract
Ethnic disparities in lung and bronchial cancer diagnoses and disease-specific survival (DSS) rates in the United States are well known. However, few studies have specifically assessed these differences in Asian subgroups. The primary objectives of the retrospective analysis described herein were to identify any significant differences in clinicopathologic features, treatment, and survival rate between Asian lung cancer patients and lung cancer patients in other broad ethnic groups in the United States and to determine the reasons for these differences among subgroups of Asian patients with lung or bronchial cancer. We searched the Surveillance, Epidemiology, and End Results Program database to identify patients diagnosed with lung or bronchial cancer from 1990 to 2012. Differences in clinicopathologic features, treatment, and DSS rate in four broad ethnic groups and eight Asian subgroups were compared. The study population consisted of 849,088 patients, 5.2% of whom were of Asian descent. Female Asian patients had the lowest lung and bronchial cancer incidence rates, whereas male black patients had the highest rates. Asian patients had the best 5-year DSS rate. In our Asian subgroup analysis, Indian/Pakistani patients had the best 5-year DSS rate, whereas Hawaiian/Pacific Islander patients had the worst 5-year DSS rates. We found the differences in DSS rate among the four broad ethnic groups and eight Asian subgroups when we grouped patients by age and disease stage, as well. Asian patients had better DSS rates than those in the other three broad ethnic groups in almost every age and disease-stage group, especially in older patients and those with advanced-stage disease. In conclusion, we found that clinicopathologic features and treatment of lung and bronchial cancer differ by ethnicity in the United States, and the differences impact survival in each ethnic group.
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Affiliation(s)
- Dan Li
- Department of Medical Oncology The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Xianglin L. Du
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas School of Public Health, Houston, Texas, United States of America
| | - Yinghong Ren
- Department of Internal Medicine, Shangluo Central Hospital, Shangluo, Shaanxi, China
| | - Peijun Liu
- Department of Translational Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Shuting Li
- Department of Medical Oncology The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Jiao Yang
- Department of Medical Oncology The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Meng Lv
- Department of Medical Oncology The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Ling Chen
- Department of Medical Oncology The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Xin Wang
- Department of Medical Oncology The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Enxiao Li
- Department of Medical Oncology The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Jin Yang
- Department of Medical Oncology The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
- * E-mail: (MY); (Jin Yang)
| | - Min Yi
- Department of Medical Oncology The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
- * E-mail: (MY); (Jin Yang)
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Abstract
INTRODUCTION Lung cancer is associated with poor prognosis and limited benefit from chemotherapy. The treatment of non-small cell lung cancer (NSCLC) has been revolutionized by the discovery of targetable genetic alterations, including the ALK fusion oncogene. AREAS COVERED Three drugs have been approved for clinical use in ALK-positive patients - crizotinib, ceritinib and alectinib. Unfortunately, treatment resistance inevitably develops. Several mechanisms of acquired resistance are reported. In this review, we will discuss emerging treatment options in ALK-positive advanced NSCLC and strategies to overcome resistance mechanisms, including newer generation of ALK inhibitors, Hsp90 inhibitors and immunotherapy. EXPERT OPINION Tremendous advances have been made in the treatment of ALK-positive lung cancers, but management hurdles still exist, including universal development of resistance to ALK inhibitors and limited CNS activity. Given that specific treatment strategies target distinct patterns of resistance, re-biopsy at the time of progression appears necessary to optimize management. However, there remain many issues in routine clinical application including the burden placed on the patients by serial biopsies and the risks of repeat invasive procedures. Future studies are needed to validate the usage of non- or minimally invasive tests and to determine the optimal orders of utilizing different ALK inhibitors.
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Affiliation(s)
- Janaki Sharma
- a Division of Medical Oncology , Montefiore Medical Center, Albert Einstein College of Medicine , Bronx , NY , USA
| | - Vipul Pareek
- a Division of Medical Oncology , Montefiore Medical Center, Albert Einstein College of Medicine , Bronx , NY , USA
| | - Huijie Liu
- a Division of Medical Oncology , Montefiore Medical Center, Albert Einstein College of Medicine , Bronx , NY , USA
| | - Haiying Cheng
- a Division of Medical Oncology , Montefiore Medical Center, Albert Einstein College of Medicine , Bronx , NY , USA
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CPEB4 and IRF4 expression in peripheral mononuclear cells are potential prognostic factors for advanced lung cancer. J Formos Med Assoc 2016; 116:114-122. [PMID: 27113098 DOI: 10.1016/j.jfma.2016.01.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 08/25/2015] [Accepted: 01/20/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND/PURPOSE Lung cancer is a heterogeneous disease with varied outcomes. Molecular markers are eagerly investigated to predict a patient's treatment response or outcome. Previous studies used frozen biopsy tissues to identify crucial genes as prognostic markers. We explored the prognostic value of peripheral blood (PB) molecular signatures in patients with advanced non-small cell lung cancer (NSCLC). METHODS Peripheral blood mononuclear cell (PBMC) fractions from patients with advanced NSCLC were applied for RNA extraction, cDNA synthesis, and real-time polymerase chain reaction (PCR) for the expression profiling of eight genes: DUSP6, MMD, CPEB4, RNF4, STAT2, NF1, IRF4, and ZNF264. Proportional hazard (PH) models were constructed to evaluate the association of the eight expressing genes and multiple clinical factors [e.g., sex, smoking status, and Charlson comorbidity index (CCI)] with overall survival. RESULTS One hundred and forty-one patients with advanced NSCLC were enrolled. They included 109 (77.30%) patients with adenocarcinoma, 12 (8.51%) patients with squamous cell carcinoma, and 20 (14.18%) patients with other pathological lung cancer types. A PH model containing two significant survival-associated genes, CPEB4 and IRF4, could help in predicting the overall survival of patients with advanced stage NSCLC [hazard ratio (HR) = 0.48, p < 0.0001). Adding multiple clinical factors further improved the prediction power of prognosis (HR = 0.33; p < 0.0001). CONCLUSION Molecular signatures in PB can stratify the prognosis in patients with advanced NSCLC. Further prospective, interventional clinical trials should be performed to test if gene profiling also predicts resistance to chemotherapy.
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Patel AN, Simone CB, Jabbour SK. Risk factors and management of oligometastatic non-small cell lung cancer. Ther Adv Respir Dis 2016; 10:338-48. [PMID: 27060187 DOI: 10.1177/1753465816642636] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Non-small cell lung cancer (NSCLC) is an aggressive malignancy with close to half of all patients presenting with metastatic disease. A proportion of these patients with limited metastatic disease, termed oligometastatic disease, have been shown to benefit from a definitive treatment approach. Synchronous and metachronous presentation of oligometastatic disease have prognostic significance, with current belief that metachronous disease is more favorable. Surgical excision of intracranial and extracranial oligometastatic disease has been shown to improve survival, especially in patients with lymph node-negative disease, adenocarcinoma histology and smaller thoracic tumors. Definitive radiation to sites of oligometastatic disease and initial thoracic disease has also been shown to have a similar impact on survival for both intracranial and extracranial disease. Recent studies have reported on the use of targeted agents combined with ablative doses of radiation in the oligometastatic setting with promising outcomes. In this review, we present the historical and current literature describing surgical and radiation treatment options for patients with oligometastatic NSCLC.
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Affiliation(s)
- Akshar N Patel
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Charles B Simone
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - Salma K Jabbour
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, Room 2038, New Brunswick, NJ 08901 USA
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Bu S, Wang R, Pan Y, Yu S, Shen X, Li Y, Sun Y, Chen H. Clinicopathologic Characteristics of Patients with HER2 Insertions in Non-small Cell Lung Cancer. Ann Surg Oncol 2016; 24:291-297. [PMID: 27008586 DOI: 10.1245/s10434-015-5044-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND The human epidermal growth factor receptor-2 (HER2) genes have been described in a subset of non-small cell lung cancer (NSCLC). To help identify and treat these patients, we investigated the frequency, clinicopathologic characteristics, and clinical outcomes of patients who had NSCLC with or without HER2 insertions. METHODS The mutational status of the HER2 (exons 19-20) gene was assessed in a cohort of 1875 patients with NSCLC. All patients were also analyzed for mutations in EGFR, KRAS, BRAF, ALK, RET, and ROS1. Clinical characteristics, including age, sex, smoking status, stage, histology, tumor size, differentiation, overall survival, and relapse-free survival, were collected. RESULTS Among 1875 NSCLCs examined, 35 (1.9 %) were HER2 insertion. Compared with the HER2 insertion-negative group, patients with HER2 insertions were more likely to be never smokers (97.1 %, 34/35 patients, P < 0.001), significantly associated with female (91.4 %, 32/35 patients, P < 0.001), adenocarcinoma (91.4 %, 32/35 patients, P = 0.01), and with a tendency to be no more than 60 years of age (71.4 %, 25/35 patients, P = 0.051). CONCLUSIONS HER2 insertion could define a distinct subset of NSCLC, which had a higher prevalence among females, nonsmokers, and adenocarcinoma. HER2 should be in the clinical genotyping of lung cancer, so patients may benefit from HER2-targeted therapy.
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Affiliation(s)
- Shi Bu
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Rui Wang
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yunjian Pan
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Su Yu
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Cancer Research Laboratory, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Xuxia Shen
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Yuan Li
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Yihua Sun
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Haiquan Chen
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China. .,Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China. .,Institutes of Biomedical Sciences, Fudan University, Shanghai, China.
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Reck M, Socinski MA, Luft A, Szczęsna A, Dediu M, Ramlau R, Losonczy G, Molinier O, Schumann C, Gralla RJ, Bonomi P, Brown J, Soldatenkova V, Chouaki N, Obasaju C, Peterson P, Thatcher N. The Effect of Necitumumab in Combination with Gemcitabine plus Cisplatin on Tolerability and on Quality of Life: Results from the Phase 3 SQUIRE Trial. J Thorac Oncol 2016; 11:808-18. [PMID: 26980471 DOI: 10.1016/j.jtho.2016.03.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 02/26/2016] [Accepted: 03/02/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Necitumumab, a second-generation, recombinant human immunoglobulin G1 epidermal growth factor receptor antibody in the phase 3 SQUIRE trial (NCT00981058), increased survival benefit for patients randomized to receive necitumumab plus gemcitabine-cisplatin compared with those who received gemcitabine-cisplatin. Here we characterize health-related quality of life (HRQoL) and tolerability results. METHODS A total of 1093 patients with stage IV squamous non-small cell lung cancer were randomized 1:1 to receive necitumumab (800 mg absolute dose intravenously [IV]) plus gemcitabine-cisplatin (gemcitabine = 1250 mg/m(2) IV on days 1 and 8; cisplatin = 75 mg/m(2) IV on day 1) or gemcitabine-cisplatin alone (every 21 days) for up to six cycles. Patients receiving necitumumab plus gemcitabine-cisplatin without disease progression continued necitumumab until progression. HRQoL was measured by Eastern Cooperative Oncology Group performance status, the Lung Cancer Symptom Scale (LCSS), and the European Quality of Life Five-Dimensions questionnaire. Efficacy and LCSS outcomes were analyzed using the baseline maximum severity score of the LCSS. Tolerability was measured in terms of exposure to the study treatment and adverse events. Hospitalization rates were collected. RESULTS Most patients in both study arms similarly maintained Eastern Cooperative Oncology Group performance status and comparable LCSS and European Quality of Life Five-Dimensions questionnaire assessments. Patients with a higher baseline LCSS had a greater survival benefit on the necitumumab arm. Chemotherapy exposure was similar in both treatment arms; 51% of patients on the necitumumab plus gemcitabine-cisplatin arm continued on single-agent necitumumab. The most frequent grade 4 adverse events were neutropenia (6.1% versus 7.9%) and thrombocytopenia (3.2% versus 4.3%) in the necitumumab plus gemcitabine-cisplatin versus gemcitabine-cisplatin arms, respectively. Hospitalizations were slightly higher with necitumumab plus gemcitabine-cisplatin (36.4%) than with gemcitabine-cisplatin (34.0%). CONCLUSIONS The addition of necitumumab to gemcitabine-cisplatin was well tolerated, did not negatively affect HRQoL or toxicity, and particularly benefited patients with more severe baseline symptoms or lower HRQoL.
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Affiliation(s)
- Martin Reck
- Department of Thoracic Oncology, LungenClinic Grosshansdorf, Airway Research Center North, Grosshansdorf, Germany.
| | - Mark A Socinski
- Lung Cancer Section, Division of Hematology/Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Alexander Luft
- Leningrad Regional Clinical Hospital, St. Petersburg, Russia
| | | | - Mircea Dediu
- Institute of Oncology "Alexandru Trestioreanu," Bucharest, Romania
| | - Rodryg Ramlau
- Poznan University of Medical Sciences, Poznań, Poland
| | - György Losonczy
- Semmelweis University Department of Pulmonology, Budapest, Hungary
| | | | - Christian Schumann
- Department of Internal Medicine II, University Hospital of Ulm, Ulm, Germany; Clinic for Pneumology, Thoracic Oncology, Sleep- and Respiratory Critical Care, Kempten-Oberallgaeu Hospitals, Kempten, Germany
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Bozinovski S, Vlahos R, Anthony D, McQualter J, Anderson G, Irving L, Steinfort D. COPD and squamous cell lung cancer: aberrant inflammation and immunity is the common link. Br J Pharmacol 2016; 173:635-48. [PMID: 26013585 PMCID: PMC4742298 DOI: 10.1111/bph.13198] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Revised: 04/30/2015] [Accepted: 05/14/2015] [Indexed: 12/25/2022] Open
Abstract
Cigarette smoking has reached epidemic proportions within many regions of the world and remains the highest risk factor for chronic obstructive pulmonary disease (COPD) and lung cancer. Squamous cell lung cancer is commonly detected in heavy smokers, where the risk of developing lung cancer is not solely defined by tobacco consumption. Although therapies that target common driver mutations in adenocarcinomas are showing some promise, they are proving ineffective in smoking-related squamous cell lung cancer. Since COPD is characterized by an excessive inflammatory and oxidative stress response, this review details how aberrant innate, adaptive and systemic inflammatory processes can contribute to lung cancer susceptibility in COPD. Activated leukocytes release increasing levels of proteases and free radicals as COPD progresses and tertiary lymphoid aggregates accumulate with increasing severity. Reactive oxygen species promote formation of reactive carbonyls that are not only tumourigenic through initiating DNA damage, but can directly alter the function of regulatory proteins involved in host immunity and tumour suppressor functions. Systemic inflammation is also markedly increased during infective exacerbations in COPD and the interplay between tumour-promoting serum amyloid A (SAA) and IL-17A is discussed. SAA is also an endogenous allosteric modifier of FPR2 expressed on immune and epithelial cells, and the therapeutic potential of targeting this receptor is proposed as a novel strategy for COPD-lung cancer overlap.
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Affiliation(s)
- Steven Bozinovski
- School of Health Sciences and Health Innovations Research Institute, RMIT University, Melbourne, Vic., Australia
- Lung Health Research Centre, Department of Pharmacology & Therapeutics, The University of Melbourne, Parkville, Vic., Australia
| | - Ross Vlahos
- School of Health Sciences and Health Innovations Research Institute, RMIT University, Melbourne, Vic., Australia
- Lung Health Research Centre, Department of Pharmacology & Therapeutics, The University of Melbourne, Parkville, Vic., Australia
| | - Desiree Anthony
- Lung Health Research Centre, Department of Pharmacology & Therapeutics, The University of Melbourne, Parkville, Vic., Australia
| | - Jonathan McQualter
- Lung Health Research Centre, Department of Pharmacology & Therapeutics, The University of Melbourne, Parkville, Vic., Australia
| | - Gary Anderson
- Lung Health Research Centre, Department of Pharmacology & Therapeutics, The University of Melbourne, Parkville, Vic., Australia
| | - Louis Irving
- Department of Respiratory Medicine, The Royal Melbourne Hospital, Parkville, Vic., Australia
| | - Daniel Steinfort
- Department of Respiratory Medicine, The Royal Melbourne Hospital, Parkville, Vic., Australia
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Loong HH, Chan AC, Wong AC. Evolving Evidence of the Efficacy and Safety of nab-Paclitaxel in the Treatment of Cancers with Squamous Histologies. J Cancer 2016; 7:268-75. [PMID: 26918039 PMCID: PMC4747880 DOI: 10.7150/jca.12986] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 10/18/2015] [Indexed: 01/05/2023] Open
Abstract
Taxanes, such as paclitaxel and docetaxel, are well-established cytotoxic chemotherapeutics used in the treatment of a variety of cancers, including those of squamous histology. In their formulation, both agents require solvents, which have been associated with hypersensitivity reactions, peripheral neuropathy, hepatic toxicities, and impaired drug delivery. nab-Paclitaxel is a novel, albumin-bound form of paclitaxel with improved tolerability, bioavailability, and efficacy compared with solvent-based paclitaxel. Currently, nab-paclitaxel is approved for the treatment of metastatic breast cancer, locally advanced/metastatic non-small cell lung cancer (NSCLC), and metastatic pancreatic cancer. Clinical studies suggest that nab-paclitaxel may be particularly effective in cancers with squamous histology, including NSCLC. This article reviews the emerging evidence supporting nab-paclitaxel as an effective agent in the treatment of malignancies of squamous histology.
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Affiliation(s)
- Herbert H. Loong
- 1. Department of Clinical Oncology, State Key Laboratory in Oncology in South China, Hong Kong Cancer Institute, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, NT, Hong Kong SAR
- 2. Department of Clinical Oncology, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, NT, Hong Kong SAR
| | - Alvita C.Y. Chan
- 2. Department of Clinical Oncology, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, NT, Hong Kong SAR
| | - Ashley C.Y. Wong
- 2. Department of Clinical Oncology, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, NT, Hong Kong SAR
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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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125
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Bui N, Wong-Sefidan I. Reactivation of hepatitis B virus after withdrawal of erlotinib. ACTA ACUST UNITED AC 2015; 22:430-2. [PMID: 26715877 DOI: 10.3747/co.22.2665] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Reactivation of hepatitis B virus (hbv) is a reported complication for patients undergoing chemotherapy, particularly immunochemotherapy with anti-CD20 agents such as rituximab. However, as the use of molecularly targeted agents increases, the risk of viral reactivation is less clearly defined. Here, we present the case of a 62-year-old woman with newly diagnosed EGFR mutation-positive metastatic non-small-cell lung cancer (nsclc). Per interview, our patient had a remote history of hbv infection. She was started on erlotinib and developed profound diarrhea leading to renal failure that required hospital admission and temporary discontinuation of erlotinib. At 8 days after erlotinib cessation, she had a marked spike in her liver function tests, with viral serologies that were consistent with hbv reactivation. Although erlotinib and other tyrosine kinase inhibitors (tkis) are not classically associated with hbv reactivation, hbv reactivation can occur even in the setting of tki withdrawal. Before tki initiation, careful patient screening in those at risk for hbv should be performed to attenuate preventable hepatotoxicity and to differentiate between other causes of hepatotoxicity (for example, drug-induced toxicity).
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Affiliation(s)
- N Bui
- Department of Medicine, University of California San Diego, Moores Cancer Center, La Jolla, CA, U.S.A
| | - I Wong-Sefidan
- Department of Medicine, University of California San Diego, Moores Cancer Center, La Jolla, CA, U.S.A
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126
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Fan H, Shao ZY, Xiao YY, Xie ZH, Chen W, Xie H, Qin GY, Zhao NQ. Incidence and survival of non-small cell lung cancer in Shanghai: a population-based cohort study. BMJ Open 2015; 5:e009419. [PMID: 26700282 PMCID: PMC4691760 DOI: 10.1136/bmjopen-2015-009419] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 09/02/2015] [Accepted: 10/26/2015] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES Large population-based studies on the incidence and outcome of non-small cell lung cancer (NSCLC) are lacking in mainland China. This study aimed to investigate the NSCLC incidence, demographic features and survival as well as factors affecting survival of patients with NSCLC in Shanghai. DESIGN Prospective observational cohort study. SETTING Baseline information was collected from Shanghai Health Information Network, which is based on the Health Information Systems from all the comprehensive hospitals and specialist hospitals qualified for cancer diagnosis in the Shanghai metropolitan area. PARTICIPANTS All NSCLC cases identified from the database between 2011 and 2013 were recruited (15,020 patients). MAIN RESULTS The crude and age-adjusted incidences of NSCLC were 54.20 per 100,000 people (55.90 per 100,000 for men, 52.39 per 100,000 for women) and 39.05 per 100,000 people (41.43 per 100,000 for men and 37.13 per 100,000 for women), respectively. The median survival time was 22.7 months (95% CI 21.8 to 24.2 months) with an overall 1-year survival rate of 71.8% (95% CI 69.8% to 73.8%). The 1-year survival rate was 96.5% (95% CI 94.0% to 98.6%) in patients with stage I NSCLC, 89.1% (95% CI 83.3% to 94.9%) in patients with stage II NSCLC, 78.8% (95% CI 74.1% to 83.5%) in patients with stage IIIa NSCLC and 58.9% (95% CI 56.1% to 61.7%) in patients with stage IIIb/IV NSCLC. Multivariate analysis showed surgical resection (HR=0.607, 95% CI 0.511 to 0.722) and chemotherapy (HR=0.838, 95% CI 0.709 to 0.991) significantly improved survival. Factors associated with poor survival included older age, male sex, larger tumour size, lymph node metastasis, distant metastasis and squamous cell carcinoma. CONCLUSIONS A higher incidence and better survival rates for patients with NSCLC were identified when compared with previously published studies, which may provide evidence on the incidence and survival of NSCLC in China.
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Affiliation(s)
- Heng Fan
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Zhen-Yi Shao
- Information Centre, Shanghai Municipal Commission of Health and Family Planning, Shanghai, China
| | - Yuan-Yuan Xiao
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Zhi-Hui Xie
- Information Centre, Shanghai Municipal Commission of Health and Family Planning, Shanghai, China
| | - Wen Chen
- Information Centre, Shanghai Municipal Commission of Health and Family Planning, Shanghai, China
| | - Hua Xie
- Information Centre, Shanghai Municipal Commission of Health and Family Planning, Shanghai, China
| | - Guo-You Qin
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Nai-Qing Zhao
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
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5-Nitro-5′-hydroxy-indirubin-3′-oxime (AGM130), an indirubin-3′-oxime derivative, inhibits tumor growth by inducing apoptosis against non-small cell lung cancer in vitro and in vivo. Eur J Pharm Sci 2015; 79:122-31. [PMID: 26342773 DOI: 10.1016/j.ejps.2015.08.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 08/11/2015] [Accepted: 08/26/2015] [Indexed: 12/17/2022]
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Zeng J, Yin J, Yuan D, Yang W, Liang W, Wu G, Song Y. Assessing the clinical outcome of nab-paclitaxel in Chinese patients with advanced non-small-cell lung cancer. CLINICAL RESPIRATORY JOURNAL 2015; 11:632-639. [PMID: 26404101 DOI: 10.1111/crj.12394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 07/01/2015] [Accepted: 09/24/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE Nab-paclitaxel [nab-P, 130-nm albumin-bound paclitaxel particles] is a new solvent-free paclitaxel that allows for high intratumoral concentration and has been approved for use in various solid tumours. The aim of our study was to evaluate the efficacy and safety of nab-paclitaxel in the treatment of advanced non-small-cell lung cancer [NSCLC]. PATIENTS AND METHODS We assessed 101 Chinese patients who were diagnosed with Stage IIIB or IV NSCLC from August 2009 to November 2014.The patients were injected with nab-paclitaxel [260 mg/m2 , day1] with or without platinum. Patients who completed more than two treatment cycles were assessed for response and survival. All patients were assessed for adverse events. RESULTS The efficacy was evaluated in 79 patients; the overall response rate was 32.9%, and the disease control rate was 89.9%. Subgroup analysis found patients with squamous cell carcinoma, and combination therapies showed better outcomes. The median progression-free survival was 5.3 months [95%CI: 4.6-5.9], and the median overall survival was 8.9 months [95%CI: 6.1-11.6]. The main grades 3/4 adverse events were peripheral neuropathy [5.9%], leukopenia [5.0%], and anaemia [3.0%]. Additionally, severe abnormal hepatic function [2.0%], alopecia [2.0%], thrombocytopenia [1.0%] and fatigue [1.0%] could also be identified in some patients. CONCLUSION The nab-paclitaxel chemotherapy could achieve significant tumour responses and encourage survival in advanced NSCLC patients with tolerable toxicities. Further clinical studies are needed to explore the optimal therapy regimen and target users.
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Affiliation(s)
- Junli Zeng
- Department of Respiratory Medicine, Jinling Hospital, Southern Medical University [Guangzhou], Nanjing, 210002, China
| | - Jie Yin
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002, China
| | - Dongmei Yuan
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002, China
| | - Wen Yang
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002, China
| | - Wenjun Liang
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002, China
| | - Guannan Wu
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002, China
| | - Yong Song
- Department of Respiratory Medicine, Jinling Hospital, Southern Medical University [Guangzhou], Nanjing, 210002, China.,Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002, China
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Bibby AC, Clive AO, Slade GC, Morley AJ, Fallon J, Psallidas I, Pepperell JCT, Slade MG, Stanton AE, Rahman NM, Maskell NA. Survival in Patients With Malignant Pleural Effusions Who Developed Pleural Infection: A Retrospective Case Review From Six UK Centers. Chest 2015; 148:235-241. [PMID: 25429399 DOI: 10.1378/chest.14-2199] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVE Malignant pleural effusion (MPE) incidence is increasing, and prognosis remains poor. Indwelling pleural catheters (IPCs) relieve symptoms but increase the risk of pleural infection. We reviewed cases of pleural infection in patients with IPCs for MPE from six UK centers between January 1, 2005, and January 31, 2014. METHODS Survival in patients with pleural infection was compared with 788 patients with MPE (known as the LENT [pleural fluid lactate dehydrogenase, Eastern Cooperative Oncology Group performance status, serum neutrophil to lymphocyte ratio, and tumor type] cohort) and with national statistics. RESULTS Of 672 IPCs inserted, 25 (3.7%) became infected. Most patients (20 of 25) had mesothelioma or lung cancer. Median survival in the pleural infection cohort appeared longer than in the LENT cohort, although this result did not achieve significance (386 days vs 132 days; hazard ratio, 0.67; P = .07). Median survival with mesothelioma and pleural infection was twice as long as national estimates for mesothelioma survival (753 days vs < 365 days) and double the median survival of patients with mesothelioma in the LENT cohort (339 days; 95% CI, nonoverlapping). Survival with lung and breast cancer did not differ significantly between the groups. Sixty-one percent of patients experienced early infection. There was no survival difference between patients with early and late infection (P = .6). CONCLUSIONS This small series of patients with IPCs for MPE suggests pleural infection may be associated with longer survival, particularly in patients with mesothelioma. Results did not achieve significance, and a larger study is needed to explore this relationship further and investigate whether the local immune response, triggered by infection, is able to modulate mesothelioma progression.
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Affiliation(s)
- Anna C Bibby
- Royal United Hospital NHS Trust, Combe Park, Bath
| | - Amelia O Clive
- North Bristol Lung Centre, Southmead Hospital, North Bristol NHS Trust, Bristol
| | - Gerry C Slade
- Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge; Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge
| | - Anna J Morley
- North Bristol Lung Centre, Southmead Hospital, North Bristol NHS Trust, Bristol
| | | | - Ioannis Psallidas
- Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxfordshire
| | | | - Mark G Slade
- Royal United Hospital NHS Trust, Combe Park, Bath
| | | | - Najib M Rahman
- Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxfordshire
| | - Nick A Maskell
- North Bristol Lung Centre, Southmead Hospital, North Bristol NHS Trust, Bristol; Academic Respiratory Unit, University of Bristol School of Clinical Sciences, Bristol, England.
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130
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Kundranda MN, Niu J. Albumin-bound paclitaxel in solid tumors: clinical development and future directions. Drug Des Devel Ther 2015; 9:3767-77. [PMID: 26244011 PMCID: PMC4521678 DOI: 10.2147/dddt.s88023] [Citation(s) in RCA: 158] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Albumin-bound paclitaxel (nab-paclitaxel) is a solvent-free formulation of paclitaxel that was initially developed more than a decade ago to overcome toxicities associated with the solvents used in the formulation of standard paclitaxel and to potentially improve efficacy. Nab-paclitaxel has demonstrated an advantage over solvent-based paclitaxel by being able to deliver a higher dose of paclitaxel to tumors and decrease the incidence of serious toxicities, including severe allergic reactions. To date, nab-paclitaxel has been indicated for the treatment of three solid tumors in the USA. It was first approved for the treatment of metastatic breast cancer in 2005, followed by locally advanced or metastatic non-small-cell lung cancer in 2012, and most recently for metastatic pancreatic cancer in 2013. Nab-paclitaxel is also under investigation for the treatment of a number of other solid tumors. This review highlights key clinical efficacy and safety outcomes of nab-paclitaxel in the solid tumors for which it is currently indicated, discusses ongoing trials that may provide new data for the expansion of nab-paclitaxel's indications into other solid tumors, and provides a clinical perspective on the use of nab-paclitaxel in practice.
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Affiliation(s)
| | - Jiaxin Niu
- Department of Medical Oncology, Cancer Treatment Centers of America, Goodyear, AZ, USA
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131
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Philip J, Hudson P, Bostanci A, Street A, Horey DE, Aranda S, Zordan R, Rumbold BD, Moore G, Sundararajan V. Metastatic non-small cell lung cancer: a benchmark for quality end-of-life cancer care? Med J Aust 2015; 202:139-43. [PMID: 25669476 DOI: 10.5694/mja14.00579] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 09/18/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To investigate the quality of end-of-life care for patients with metastatic non-small cell lung cancer (NSCLC). DESIGN AND PARTICIPANTS Retrospective cohort study of patients from first hospitalisation for metastatic disease until death, using hospital, emergency department and death registration data from Victoria, Australia, between 1 July 2003 and 30 June 2010. MAIN OUTCOME MEASURES Emergency department and hospital use; aggressiveness of care including intensive care and chemotherapy in last 30 days; palliative and supportive care provision; and place of death. RESULTS Metastatic NSCLC patients underwent limited aggressive treatment such as intensive care (5%) and chemotherapy (< 1%) at the end of life; however, high numbers died in acute hospitals (42%) and 61% had a length of stay of greater than 14 days in the last month of life. Although 62% were referred to palliative care services, this occurred late in the illness. In a logistic regression model adjusted for year of metastasis, age, sex, metastatic site and survival, the odds ratio (OR) of dying in an acute hospital bed compared with death at home or in a hospice unit decreased with receipt of palliative care (OR, 0.25; 95% CI, 0.21-0.30) and multimodality supportive care (OR, 0.65; 95% CI, 0.56-0.75). CONCLUSION Because early palliative care for patients with metastatic NSCLC is recommended, we propose that this group be considered a benchmark of quality end-of-life care. Future work is required to determine appropriate quality-of-care targets in this and other cancer patient cohorts, with particular focus on the timeliness of palliative care engagement.
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Affiliation(s)
| | - Peter Hudson
- St Vincent's Hospital, Melbourne, VIC, Australia
| | | | | | | | | | | | | | - Gaye Moore
- St Vincent's Hospital, Melbourne, VIC, Australia
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Immune-Signatures for Lung Cancer Diagnostics: Evaluation of Protein Microarray Data Normalization Strategies. MICROARRAYS 2015; 4:162-87. [PMID: 27600218 PMCID: PMC4996396 DOI: 10.3390/microarrays4020162] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 03/23/2015] [Accepted: 03/25/2015] [Indexed: 01/27/2023]
Abstract
New minimal invasive diagnostic methods for early detection of lung cancer are urgently needed. It is known that the immune system responds to tumors with production of tumor-autoantibodies. Protein microarrays are a suitable highly multiplexed platform for identification of autoantibody signatures against tumor-associated antigens (TAA). These microarrays can be probed using 0.1 mg immunoglobulin G (IgG), purified from 10 µL of plasma. We used a microarray comprising recombinant proteins derived from 15,417 cDNA clones for the screening of 100 lung cancer samples, including 25 samples of each main histological entity of lung cancer, and 100 controls. Since this number of samples cannot be processed at once, the resulting data showed non-biological variances due to “batch effects”. Our aim was to evaluate quantile normalization, “distance-weighted discrimination” (DWD), and “ComBat” for their effectiveness in data pre-processing for elucidating diagnostic immune-signatures. “ComBat” data adjustment outperformed the other methods and allowed us to identify classifiers for all lung cancer cases versus controls and small-cell, squamous cell, large-cell, and adenocarcinoma of the lung with an accuracy of 85%, 94%, 96%, 92%, and 83% (sensitivity of 0.85, 0.92, 0.96, 0.88, 0.83; specificity of 0.85, 0.96, 0.96, 0.96, 0.83), respectively. These promising data would be the basis for further validation using targeted autoantibody tests.
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Garrido-Castro AC, Felip E. HER2 driven non-small cell lung cancer (NSCLC): potential therapeutic approaches. Transl Lung Cancer Res 2015; 2:122-7. [PMID: 25806223 DOI: 10.3978/j.issn.2218-6751.2013.02.02] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 02/19/2013] [Indexed: 12/24/2022]
Abstract
Oncogenic driver mutations identified in non-small cell lung cancer (NSCLC) have triggered the development of drugs capable of interfering in intracellular signaling pathways involved in tumorigenesis. Tyrosine kinase inhibitors, such as erlotinib or gefitinib, have demonstrated promising results in patients with advanced NSCLC that harbor EGFR mutations. Human epidermal growth factor 2 (HER2/ERBB2/neu) is a member of the ERBB family of tyrosine kinase receptors, and is activated by homodimerization or heterodimerization with other ERBB receptors. Deregulation of HER2 gene, by overexpression and/or gene amplification has been proved important in breast and gastric cancer, in which overexpression of HER2 confers greater response to specific anti-HER2 treatment, including trastuzumab. In lung carcinogenesis, HER2 mutations are thought to be more clinically relevant than overexpression or gene amplification. HER2 mutations in NSCLC, described exclusively in adenocarcinoma histology, are present in approximately 4% of this subset of lung cancer patients, suggesting that thousands of patients per year may possibly benefit from targeted therapy. Therefore, we conclude that systematic genotypic testing in this subgroup of NSCLC patients should include detection of HER2 mutations. In addition, clinical trials with standard antiHER2 agents and new investigational therapies are ongoing, with promising preliminary results, as illustrated in this review, although further research is warranted in this field.
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Affiliation(s)
| | - Enriqueta Felip
- Medical Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
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134
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Thomas M, Fischer J, Andreas S, Kortsik C, Grah C, Serke M, von Eiff M, Witt C, Kollmeier J, Müller E, Schenk M, Schröder M, Villalobos M, Reinmuth N, Penzel R, Schnabel P, Acker T, Reuss A, Wolf M. Erlotinib and bevacizumab versus cisplatin, gemcitabine and bevacizumab in unselected nonsquamous nonsmall cell lung cancer. Eur Respir J 2015; 46:219-29. [PMID: 25792638 DOI: 10.1183/09031936.00229014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Accepted: 01/27/2015] [Indexed: 11/05/2022]
Abstract
Erlotinib with bevacizumab showed promising activity in recurrent nonsquamous (NS) nonsmall cell lung cancer (NSCLC). The INNOVATIONS study was designed to assess in first-line treatment of unselected cisplatin-eligible patients this combination compared to cisplatin, gemcitabine and bevacizumab. Stage IIIB/IV patients with NS-NSCLC were randomised on erlotinib (150 mg daily) and bevacizumab (15 mg·kg(-1) on day 1, every 3 weeks) (EB) until progression, or cisplatin (80 mg·m(-2) on day 1, every 3 weeks) and gemcitabine (1250 mg·m(-2) on days 1 and 8, every 3 weeks) up to six cycles and bevacizumab (15 mg·kg(-1) on day 1, every 3 weeks) (PGB) until progression. 224 patients were randomised (EB n=111, PGB n=113). The response rate (12% versus 36%; p<0.0001), progression-free survival (median 3.5 versus 6.9 months; hazard ratio (HR) 1.85, 95% CI 1.39-2.45; p<0.0001) and overall survival (median 12.6 versus 17.8 months; HR 1.41, 95% CI 1.01-1.97; p=0.04) clearly favoured PGB. In patients with epidermal growth factor receptor mutations (n=32), response rate, progression-free survival and overall survival were not superior with EB. Platinum-based combination chemotherapy remains the standard of care in first-line treatment of unselected NS-NSCLC. Molecular targeted approaches strongly mandate appropriate testing and patient selection.
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Affiliation(s)
- Michael Thomas
- Dept of Thoracic Oncology, Thoraxklinik, Thoraxklinik im Universitätsklinikum Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - Jürgen Fischer
- Med. Clinic II, Oncology, Klinik Löwenstein, Löwenstein, Germany
| | - Stefan Andreas
- Lungenfachklinik Immenhausen, Immenhausen, Germany Dept of Pneumology, Universitätsmedizin Göttingen, Göttingen, Germany
| | | | - Christian Grah
- Pneumology and Lung Cancer Center, Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany
| | - Monika Serke
- Pneumology/Oncology, Lungenklinik Hemer, Hemer, Germany
| | - Michael von Eiff
- Malteser Krankenhaus St Hildegardis, Internal Medicine, Cologne, Germany
| | - Christian Witt
- Dept of Pneumological Oncology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Jens Kollmeier
- Lungenklinik Heckershorn, HELIOS Klinikum Emil von Behring, Berlin, Germany
| | - Ernst Müller
- Forschungszentrum Borstel, Medizinische Klinik, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Borstel, Germany
| | - Michael Schenk
- Krankenhaus Barmherzige Brüder Regensburg, Clinic for Oncology and Hematology, Regensburg, Germany
| | - Michael Schröder
- Hematology/Oncology, HELIOS St Johannes Klinik, Duisburg, Germany
| | - Matthias Villalobos
- Dept of Thoracic Oncology, Thoraxklinik, Thoraxklinik im Universitätsklinikum Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - Niels Reinmuth
- Dept of Thoracic Oncology, Thoraxklinik, Thoraxklinik im Universitätsklinikum Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Heidelberg, Germany Lungenclinic Großhansdorf, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Großhansdorf, Germany
| | - Roland Penzel
- Dept of Pathology, University of Heidelberg, Heidelberg, Germany
| | - Philipp Schnabel
- Dept of Pathology, University of Heidelberg, Heidelberg, Germany
| | - Thomas Acker
- Coordinating Center for Clinical Trials, University of Marburg, Marburg, Germany
| | - Alexander Reuss
- Coordinating Center for Clinical Trials, University of Marburg, Marburg, Germany
| | - Martin Wolf
- Med. Clinic IV, Hematology/Oncology, Klinikum Kassel, Kassel, Germany
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Non-Small-Cell Lung Cancer Clinicopathologic Features and Survival Outcomes in Asian Pacific Islanders Residing in the United States: A SEER Analysis. J Cancer Epidemiol 2015; 2015:269304. [PMID: 25685148 PMCID: PMC4312650 DOI: 10.1155/2015/269304] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 11/27/2014] [Accepted: 11/27/2014] [Indexed: 12/13/2022] Open
Abstract
Background. The objective of our study was to ascertain racial/ethnic disparities in Asian/Pacific Islanders (API) for non-small-cell lung cancer (NSCLC) clinicopathologic features and survival outcomes based on various tumor characteristics and treatment modalities. Method. SEER database identified invasive NSCLC cases from 2004 to 2010. Variables included American Joint Committee on Cancer (AJCC) stage 7, tumor grade, tumor size, histology, age, marital status, radiation, surgery, and reason for no surgery. The Kruskall-Wallis test and the Z test were used to examine differences between races/ethnicities and the referent, non-Hispanic white (NHW). Multivariate Cox proportional analyses were used to establish the weight of the prognostic significance contributing to disease-specific survival (DSS) in each AJCC stage. Result. Improved DSS was seen in API across stage I (HR: 0.78), stage II (HR: 0.79), and stage IV (HR: 0.86), respectively, compared to the referent NHW (P < 0.01). Prognosis was improved by being married, being female gender, AIS histology, and birth outside the US (P < 0.01). Conclusion. We have demonstrated improved survival among API in early stage and stage IV NSCLC. Further research is necessary to clarify the role of lifestyle and tumor biology for these differences.
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Real-world treatment patterns and costs in a US Medicare population with metastatic squamous non-small cell lung cancer. Lung Cancer 2014; 87:176-85. [PMID: 25532680 DOI: 10.1016/j.lungcan.2014.11.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 11/02/2014] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Despite advances in the treatment of nonsquamous non-small cell lung cancer (NSCLC), therapeutic choices and overall disease course for squamous NSCLC have remained relatively unchanged over the past several years. We provide a detailed account of current treatment patterns, healthcare use, and survival in real-world clinical settings for metastatic squamous NSCLC. MATERIALS AND METHODS Patients aged ≥65 years with metastatic squamous NSCLC diagnosed 2001-2009 were identified and followed through 2010 using the Surveillance, Epidemiology and End Results-Medicare database. Treatment patterns were descriptively analyzed. Multivariate logistic regressions were estimated to identify predictors of treatment pattern events; generalized linear models were estimated for total all-cause and NSCLC-related costs to assess cost drivers. RESULTS Of 17,133 patients, 72% received cancer-directed therapy (surgery, radiation, chemotherapy, or biologic therapy), whereas 28% received only supportive care. Median survival was significantly longer in patients receiving cancer-directed therapy (8 months) than in patients receiving supportive care only (2 months) (P<0.0001). An agent-specific first-line chemotherapy regimen was identified for 91% of the 7700 patients who received chemotherapy. Among these, the most common first-line regimen was carboplatin-paclitaxel combination therapy (46%). Common second-line regimens were gemcitabine monotherapy (16%) and pemetrexed monotherapy (11%). Factors associated with decreased odds of receiving cancer-directed treatment were black versus white race (OR, 0.72; 95% CI, 0.64-0.82), residence in the West versus South (OR, 0.73; 95% CI, 0.66-0.81), and metastatic disease at initial diagnosis versus progression to metastatic disease (OR, 0.77; 95% CI, 0.70-0.84). CONCLUSIONS Our study shows that prognosis remains poor for patients with metastatic squamous NSCLC, even among those receiving treatment, but particularly for patients limited to supportive care only, highlighting the continuing unmet medical need in this population. Additionally, our analysis indicates that selections for second-line and third-line chemotherapies are not necessarily consistent with National Comprehensive Cancer Network guidelines.
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137
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Platinum(IV) cisplatin derivative trans, cis, cis-bis(heptanoato)amine(cyclohexylamine)dichloridoplatinum(IV) has an enhanced therapeutic index compared to cisplatin for the treatment of non-small cell lung cancer. Inorganica Chim Acta 2014. [DOI: 10.1016/j.ica.2014.07.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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138
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Tanriverdi O, Cokmert S, Oktay E, Pilanci KN, Menekse S, Kocar M, Sen CA, Avci N, Akman T, Ordu C, Goksel G, Meydan N. Prognostic significance of the baseline serum uric acid level in non-small cell lung cancer patients treated with first-line chemotherapy: a study of the Turkish Descriptive Oncological Researches Group. Med Oncol 2014; 31:217. [DOI: 10.1007/s12032-014-0217-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 09/02/2014] [Indexed: 12/16/2022]
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139
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Lee DS, Kim SJ, Kang JH, Hong SH, Jeon EK, Kim YK, Yoo IR, Park JG, Jang HS, Lee HC, Kim YS. Serum Carcinoembryonic Antigen Levels and the Risk of Whole-body Metastatic Potential in Advanced Non-small Cell Lung Cancer. J Cancer 2014; 5:663-9. [PMID: 25258647 PMCID: PMC4174510 DOI: 10.7150/jca.9871] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 07/18/2014] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND This study aimed to clarify the clinical associations between serum carcinoembryonic antigen (CEA) levels and whole-body metastatic distribution in stage IV NSCLC patients. METHODS This study analyzed 377 eligible patients between June 2007 and December 2012. All patients enrolled in the study were newly diagnosed with stage IV NSCLC and had records of pre-treatment serum CEA levels. The serum CEA levels were categorized as normal (< 5 ng/ml) or abnormal (≥ 5 ng/ml) to reveal clinically correlated factors with abnormal serum CEA levels. RESULTS The median age of the study cohort was 65 years old (range, 30-94), and 236 (62.6%) patients were male. Two hundred seventy-seven (73.5%) patients had tumors with a histology that is consistent with adenocarcinoma. The median serum CEA value was 8.2 ng/ml (range, 0.1-2872.7), and 218 (57.8%) patients had abnormal serum CEA levels. In multivariate analysis, abnormal serum CEA levels had statistically strong associations with non-squamous cell histology (P=0.002), bone (P=0.001), and brain metastases (P=0.005); and were also closely correlated with positive metastatic LN status (P=0.083) and pulmonary metastasis (P=0.065). Very high serum CEA levels (≥ 100 ng/ml) were additionally correlated with abdominal/pelvic metastasis (P < 0.001). CONCLUSIONS Our findings suggested that abnormal serum CEA levels were strongly correlated with increased whole-body metastatic potential in advanced NSCLC. The results provided evidence for future exploratory anti-CEA targeting and intensive systemic assessment in advanced NSCLC patients with abnormal serum CEA levels.
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Affiliation(s)
- Dong Soo Lee
- 1. Department of Radiation Oncology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Gyeonggi-do, South Korea; ; 6. Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Seung Joon Kim
- 2. Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jin Hyoung Kang
- 3. Department of Medical Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Sook Hee Hong
- 3. Department of Medical Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Eun Kyoung Jeon
- 3. Department of Medical Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Young Kyoon Kim
- 2. Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Ie Ryoung Yoo
- 4. Department of Nuclear Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jae Gil Park
- 5. Department of Thoracic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hong Seok Jang
- 6. Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hyo Chun Lee
- 6. Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Yeon Sil Kim
- 6. Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Dopamine D2 receptor agonists inhibit lung cancer progression by reducing angiogenesis and tumor infiltrating myeloid derived suppressor cells. Mol Oncol 2014; 9:270-81. [PMID: 25226814 DOI: 10.1016/j.molonc.2014.08.008] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 08/18/2014] [Accepted: 08/20/2014] [Indexed: 01/11/2023] Open
Abstract
We sought to determine whether Dopamine D2 Receptor (D2R) agonists inhibit lung tumor progression and identify subpopulations of lung cancer patients that benefit most from D2R agonist therapy. We demonstrate D2R agonists abrogate lung tumor progression in syngeneic (LLC1) and human xenograft (A549) orthotopic murine models through inhibition of tumor angiogenesis and reduction of tumor infiltrating myeloid derived suppressor cells. Pathological examination of human lung cancer tissue revealed a positive correlation between endothelial D2R expression and tumor stage. Lung cancer patients with a smoking history exhibited greater levels of D2R in lung endothelium. Our results suggest D2R agonists may represent a promising individualized therapy for lung cancer patients with high levels of endothelial D2R expression and a smoking history.
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141
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Simon GR. nab-Paclitaxel for the treatment of advanced squamous non-small-cell lung cancer: a comprehensive update. Clin Lung Cancer 2014; 15:391-7. [PMID: 25246384 DOI: 10.1016/j.cllc.2014.07.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 07/21/2014] [Accepted: 07/29/2014] [Indexed: 01/28/2023]
Abstract
Despite advances in the treatment of patients with nonsquamous non-small-cell lung cancer (NSCLC), lung cancer remains a leading cause of death globally. Studies have demonstrated that survival varies according to histological subtype, and, in many cases, patients with squamous NSCLC have a poorer survival rate than those with nonsquamous NSCLC. For patients with squamous NSCLC, platinum-based doublets remain the standard first-line therapy option. This is in part because of the efficacy and safety concerns with some of the approved therapies and is secondary to the observation that many of the mutations targetable with currently approved therapies are rare in patients with squamous NSCLC. Recently, a subset analysis of a completed phase III trial demonstrated that use of nab-paclitaxel with carboplatin led to improved responses in patients with squamous NSCLC compared with solvent-based paclitaxel with carboplatin. In this review, the current experience and evolving role of nab-paclitaxel with carboplatin in the treatment of squamous NSCLC is discussed.
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Affiliation(s)
- George R Simon
- The University of Texas M.D. Anderson Cancer Center, Houston, TX.
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142
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Cribriform adenocarcinoma of the lung: clinicopathologic, immunohistochemical, and molecular analysis of 15 cases of a distinctive morphologic subtype of lung adenocarcinoma. Mod Pathol 2014; 27:1063-72. [PMID: 24390215 DOI: 10.1038/modpathol.2013.227] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 10/29/2013] [Accepted: 10/30/2013] [Indexed: 11/08/2022]
Abstract
Lung adenocarcinoma is characterized by marked heterogeneity and may be composed of an admixture of histologic growth patterns, including acinar, papillary, solid, and lepidic (bronchioloalveolar). Tumors displaying a prominent or predominant cribriform architecture are rare and most often confused for metastases from other organs. We report the clinical, histologic, immunohistochemical, and molecular features in 15 primary lung adenocarcinomas with a predominant cribriform histology. All patients were adults between 30 and 80 years of age (median: 64), and all but one reported a history of heavy cigarette smoking. All cases showed a predominant (>70%) cribriform architecture that resembled a variety of tumors arising in other organs, including breast, prostate, ovary, pancreas, uterus, colon, and thyroid. Immunohistochemical stains showed a phenotype consistent with a primary lung tumor (ie, TTF1+/CK7+), with negative results for other markers. Molecular analysis in six cases showed that none harbored an EGFR-activating mutation. KRAS mutation was detected in one case, and an ALK1 and ROS1 gene rearrangement were each detected in an additional two cases. Cribriform adenocarcinomas of the lung represent a distinctive histologic subtype of lung cancer that may be morphologically difficult to differentiate from metastases with a predominant cribriform architecture.
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143
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Kumar AMS, Woody NM, Djemil T, Videtic GMM, Stephans KL. Synchronous non small cell lung cancer nodules treated with stereotactic body radiation therapy (SBRT). JOURNAL OF RADIOSURGERY AND SBRT 2014; 3:81-88. [PMID: 29296388 PMCID: PMC5725333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 02/20/2013] [Indexed: 06/07/2023]
Abstract
BACKGROUND AND PURPOSE We compare our institutional outcomes of synchronous primary (SP) lung lesion patients with non-SP patients.Materials and Methods: From an IRB approved prospective registry of 445 NSCLC patients treated with SBRT (8/2005 8/2012), 26 (5.8%) had SPs by biopsy or PET/CT. SBRT was delivered on a Novalis/BrainLAB platform with daily Exactrac set-up. RESULTS There were no significant differences comparing SP vs non-SP groups for age, Charlson score, smoking pack years, and PET SUV (p=ns). 18 (69%) SP patients had at least one lesion biopsied. Ipsilateral and bilateral SPs were seen in 10 (38.4%) and 16 (61.6%) respectively. 77% received 50 Gy / 5 fx. SP vs non-SP median follow up was 12 (range 1.5-49.8) vs 15.2 months. Median survival for SP vs non-SP groups was 20.7 vs 28.4 months (p=0.3). In SP vs non-SP groups, local failure was 4% vs 7.6% (p=ns) and nodal/distant failure was 23% vs 24.6% (p=ns). Patients with ipsilateral and bilateral SPs had a 50% vs 14% distant failure respectively (p=0.037). CONCLUSIONS After SBRT, there were no differences in survival and patterns of failure for SP vs non-SP patients. Ipsilateral SPs had significantly worse distant failure compared to bilateral SPs.
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Affiliation(s)
| | - Neil M Woody
- Cleveland Clinic, Department of Radiation Oncology, Cleveland OH 44195, USA
| | - Toufik Djemil
- Cleveland Clinic, Department of Radiation Oncology, Cleveland OH 44195, USA
| | | | - Kevin L Stephans
- Cleveland Clinic, Department of Radiation Oncology, Cleveland OH 44195, USA
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Socinski MA, Okamoto I, Hon JK, Hirsh V, Dakhil SR, Page RD, Orsini J, Yamamoto N, Zhang H, Renschler MF. Safety and efficacy analysis by histology of weekly nab-paclitaxel in combination with carboplatin as first-line therapy in patients with advanced non-small-cell lung cancer. Ann Oncol 2013; 24:2390-6. [PMID: 23842283 DOI: 10.1093/annonc/mdt235] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This analysis compared the efficacy and safety outcomes by histology of nab-paclitaxel (nab-P) plus carboplatin (C) versus solvent-based paclitaxel (sb-P) plus C in patients with advanced non-small-cell lung cancer (NSCLC) based on preplanned stratification factors specified in the phase III trial protocol. PATIENTS AND METHODS Patients with untreated stage III/IV NSCLC received 100 mg/m(2) nab-P weekly and C (area under the curve, AUC = 6) every 3 weeks (q3w) or 200 mg/m(2) sb-P plus C (AUC = 6) q3w. Primary end point was objective overall response rate (ORR). RESULTS nab-P/C versus sb-P/C produced a significantly higher ORR (41% versus 24%; response rate ratio [RRR] 1.680; P < 0.001) in patients with squamous cell (SCC) NSCLC. For nab-P/C versus sb-P/C, ORRs were 26% versus 27% (RRR 0.966; P = 0.814) in patients with adenocarcinoma, 33% versus 15% (RRR 2.167; P = 0.323) in patients with large cell carcinoma (LC), and 24% versus 15% (RRR 1.593; P = 0.372) in patients with not otherwise specified histology. Median overall survival for nab-P/C versus sb-P/C in patients with SCC was 10.7 versus 9.5 months (HR 0.890; P = 0.310), and 12.4 versus 10.6 months (HR 1.208; P = 0.721) for patients with LC. nab-P/C produced significantly (P < 0.05) less grade 3/4 neuropathy and arthralgia, whereas sb-P/C produced less thrombocytopenia and anemia. CONCLUSION(S) First-line nab-P/C demonstrated a favorable risk-benefit profile in patients with NSCLC regardless of histology.
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Affiliation(s)
- M A Socinski
- Division of Hematology/Oncology, University of Pittsburgh Cancer Institute, PA 15232, USA.
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Satouchi M, Okamoto I, Sakai H, Yamamoto N, Ichinose Y, Ohmatsu H, Nogami N, Takeda K, Mitsudomi T, Kasahara K, Negoro S. Efficacy and safety of weekly nab-paclitaxel plus carboplatin in patients with advanced non-small cell lung cancer. Lung Cancer 2013; 81:97-101. [DOI: 10.1016/j.lungcan.2013.02.020] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 02/24/2013] [Indexed: 10/27/2022]
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146
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Abstract
Lung cancer is the most commonly diagnosed cancer in the world. “Driver” and “passenger” mutations identified in lung cancer indicate that genetics play a major role in the development of the disease, progression, metastasis and response to therapy. Survival rates for lung cancer treatment have remained stagnant at ~15% over the past 40 years in patients with disseminated disease despite advances in surgical techniques, radiotherapy and chemotherapy. Resistance to therapy; either intrinsic or acquired has been a major hindrance to treatment leading to great interest in studies seeking to understand and overcome resistance. Genetic information gained from molecular analyses has been critical in identifying druggable targets and tumor profiles that may be predictors of therapeutic response and mediators of resistance. Mutated or overexpressed epidermal growth factor receptor (EGFR) and translocations in the echinoderm microtubule-associated protein-like 4 (EML4)-anaplastic lymphoma kinase (ALK) genes (EML4-ALK) are examples of genetic aberrations resulting in targeted therapies for both localized and metastatic disease. Positive clinical responses have been noted in patients harboring these genetic mutations when treated with targeted therapies compared to patients lacking these mutations. Resistance is nonetheless a major factor contributing to the failure of targeted agents and standard cytotoxic agents. In this review, we examine molecular mechanisms that are potential drivers of resistance in non-small cell lung carcinoma, the most frequently diagnosed form of lung cancer. The mechanisms addressed include resistance to molecular targeted therapies as well as conventional chemotherapeutics through the activity of multidrug resistance proteins.
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Affiliation(s)
- Janet Wangari-Talbot
- Fox Chase Cancer Center, Developmental Therapeutics Program, 333 Cottman Ave, Philadelphia, PA, USA
| | - Elizabeth Hopper-Borge
- Fox Chase Cancer Center, Developmental Therapeutics Program, 333 Cottman Ave, Philadelphia, PA, USA
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147
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Sereno M, Esteban IR, Zambrana F, Merino M, Gómez-Raposo C, López-Gómez M, Sáenz EC. Squamous-cell carcinoma of the lungs: Is it really so different? Crit Rev Oncol Hematol 2012; 84:327-39. [DOI: 10.1016/j.critrevonc.2012.06.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Revised: 06/22/2012] [Accepted: 06/27/2012] [Indexed: 12/24/2022] Open
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148
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Soo RA, Kawaguchi T, Loh M, Ou SHI, Shieh MP, Cho BC, Mok TS, Soong R. Differences in outcome and toxicity between Asian and caucasian patients with lung cancer treated with systemic therapy. Future Oncol 2012; 8:451-62. [PMID: 22515448 DOI: 10.2217/fon.12.25] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
It is increasingly recognized that differences in overall survival and toxicity exist between Asian and caucasian patients with small-cell and non-small-cell lung cancer, with a longer survival, higher response rates and greater toxicity to chemotherapy and targeted therapy reported in Asian patients. Two global studies are used to illustrate how the proportions of Asian patients can influence survival outcome. Ethnicity is an important and complex characteristic that should considered in the design and conduct of a global clinical study, as the safety, tolerability and response may vary between Asian and caucasian patients. Whether ethnic differences in lung cancer survival are attributed to genetic differences among races or are simply a surrogate marker of differences in access to healthcare because of socioeconomic differences is unclear. Carefully designed prospective studies investigating ethnic-specific determinants of sensitivity and toxicity to systemic therapy are warranted.
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Affiliation(s)
- Ross A Soo
- Cancer Science Institute of Singapore, National University of Singapore, Singapore.
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149
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Chemotherapeutic sensitization of leptomycin B resistant lung cancer cells by pretreatment with doxorubicin. PLoS One 2012; 7:e32895. [PMID: 22412944 PMCID: PMC3296751 DOI: 10.1371/journal.pone.0032895] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 02/07/2012] [Indexed: 12/26/2022] Open
Abstract
The development of novel targeted therapies has become an important research focus for lung cancer treatment. Our previous study has shown leptomycin B (LMB) significantly inhibited proliferation of lung cancer cells; however, p53 wild type lung cancer cells were resistant to LMB. Therefore, the objective of this study was to develop and evaluate a novel therapeutic strategy to sensitize LMB-resistant lung cancer cells by combining LMB and doxorubicin (DOX). Among the different treatment regimens, pretreatment with DOX (pre-DOX) and subsequent treatment with LMB to A549 cells significantly decreased the 50% inhibitory concentration (IC50) as compared to that of LMB alone (4.4 nM vs. 10.6 nM, P<0.05). Analysis of cell cycle and apoptosis by flow cytometry further confirmed the cytotoxic data. To investigate molecular mechanisms for this drug combination effects, p53 pathways were analyzed by Western blot, and nuclear proteome was evaluated by two dimensional-difference gel electrophoresis (2D-DIGE) and mass spectrometry. In comparison with control groups, the levels of p53, phospho-p53 (ser15), and p21 proteins were significantly increased while phospho-p53 (Thr55) and survivin were significantly decreased after treatments of pre-DOX and LMB (P<0.05). The 2D-DIGE/MS analysis identified that sequestosome 1 (SQSTM1/p62) had a significant increase in pre-DOX and LMB-treated cells (P<0.05). In conclusion, our results suggest that drug-resistant lung cancer cells with p53 wild type could be sensitized to cell death by scheduled combination treatment of DOX and LMB through activating and restoring p53 as well as potentially other signaling pathway(s) involving sequestosome 1.
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150
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Akgün KM, Crothers K, Pisani M. Epidemiology and management of common pulmonary diseases in older persons. J Gerontol A Biol Sci Med Sci 2012; 67:276-91. [PMID: 22337938 DOI: 10.1093/gerona/glr251] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Pulmonary disease prevalence increases with age and contributes to morbidity and mortality in older patients. Dyspnea in older patients is often ascribed to multiple etiologies such as medical comorbidities and deconditioning. Common pulmonary disorders are frequently overlooked as contributors to dyspnea in older patients. In addition to negative impacts on morbidity and mortality, quality of life is reduced in older patients with uncontrolled, undertreated pulmonary symptoms. The purpose of this review is to discuss the epidemiology of common pulmonary diseases, namely pneumonia, chronic obstructive pulmonary disease, asthma, lung cancer, and idiopathic pulmonary fibrosis in older patients. We will review common clinical presentations for these diseases and highlight differences between younger and older patients. We will also briefly discuss risk factors, treatment, and mortality associated with these diseases. Finally, we will address the relationship between comorbidities, pulmonary symptoms, and quality of life in older patients with pulmonary diseases.
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Affiliation(s)
- Kathleen M Akgün
- Pulmonary and Critical Care Section, Department of Internal Medicine, VA Connecticut Healthcare System, West Haven, USA.
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