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Propensity-matched analysis of adjuvant chemotherapy for completely resected Stage IB non-small-cell lung cancer patients. Lung Cancer 2019; 133:75-82. [PMID: 31200832 DOI: 10.1016/j.lungcan.2019.04.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 04/18/2019] [Accepted: 04/23/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND The use of adjuvant chemotherapy (ACT) in completely resected stage IB non-small cell lung cancer (NSCLC) is still controversial. The divergent outcomes of prospective trials have created uncertainty as to the utility of ACT in stage IB NSCLC. This study assesses the effect of postoperative adjuvant chemotherapy in stage IB patients in clinical practice. METHODS Patients with pT2aN0M0 stage IB NSCLC who underwent complete resection from 2004 to 2015 were identified from prospectively collected databases in two medical centers. The log-rank test was used to compare overall survival (OS) and disease free survival (DFS). Fine and Gray's competing risks regression model was built to identify predictors of cancer-specific survival. One to one propensity-score matching (PSM) was performed to reduce the selection bias and additional analyses were performed on these subgroups. RESULTS Of 1005 patients identified for the study, 202 (20.1%) received ACT and 803 (79.9%) underwent surgery alone (observation group). Compared with the observation group, patients who underwent ACT were younger (p < 0.001), had larger tumors (p = 0.004), and had higher rates of squamous cell carcinoma (p < 0.001) and lymphovascular invasion (p = 0.017). After propensity score matching, 196 pairs of patients were 1:1 matched in the two groups and all baseline characteristics were well balanced. ACT was not associated with improved survival (including OS, DFS; all log-rank p > 0.05) in both unmatched and matched (196 pairs) cohorts. In subgroup analysis of the matched population, ACT was not associated with survival benefits for patients regardless of whether their tumors measured <4 cm or ≥4 cm (both log-rank p > 0.05). CONCLUSIONS In patients with completely resected stage IB (T2aN0M0) NSCLC, ACT is not associated with improved prognosis. Further large multicenter studies are needed to confirm these findings.
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Qian J, Xu J, Wang S, Qian F, Yang W, Zhang B, Zhang Y, Nie W, Lou Y, Lu J, Zhang X, Zhang W, Chu T, Zhong H, Fang W, Zhao H, Han B. Adjuvant Chemotherapy Candidates in Stage I Lung Adenocarcinomas Following Complete Lobectomy. Ann Surg Oncol 2019; 26:2392-2400. [PMID: 31011907 DOI: 10.1245/s10434-019-07366-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND This study aimed to explore adjuvant chemotherapy (ACT) candidates based on a recurrence risk-scoring model in completely lobectomized stage I patients with lung adenocarcinoma (LAD). METHODS A retrospective study was performed on 4606 patients (non-ACT group: n = 3514; ACT group: n = 1092) who underwent complete lobectomy for LAD at Shanghai Chest Hospital from 2008 to 2014. The nomogram predicting recurrence-free survival (RFS) was developed in the non-ACT group using Cox proportional hazards regression. The nomogram-based risk score was calculated in the entire cohort. Differences of RFS between the non-ACT and ACT groups were compared as stratified by the risk score. The score cut-off points were determined using the X-tile software. RESULTS Six independent predictors, including age, sex, tumor size, pathological subtype, visceral pleural invasion (VPI), and lymphovascular invasion (LVI) were associated with RFS. The nomogram more accurately predicted RFS than the 8th TNM staging {C-index: 0.784 [95% confidence interval (CI) 0.756-0.812] vs. 0.719 (95% CI 0.689-0.749), p = 0.0017}. A significant RFS difference was observed among the low-, intermediate- and high-risk groups (p < 0.0001), as divided by the optimal cut-points of risk score (203 and 244). ACT did not improve RFS for patients at intermediate-risk, or was even detrimental for low-risk patients; however, improved RFS was observed in ACT receivers at high-risk (p = 0.0416). ACT candidates with a risk score ≥ 245 constituted 2.6% of stage I patients. CONCLUSIONS The nomogram provided an individual prediction of RFS for stage I LAD following lobectomy. High-risk patients (score ≥ 245) may benefit from postoperative ACT.
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Affiliation(s)
- Jie Qian
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jianlin Xu
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Shuyuan Wang
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Fangfei Qian
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Wenjia Yang
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Bo Zhang
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yanwei Zhang
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Nie
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yuqing Lou
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Lu
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xueyan Zhang
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Zhang
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Tianqing Chu
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hua Zhong
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Wentao Fang
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Heng Zhao
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Baohui Han
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
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Lu D, Wang Z, Liu X, Feng S, Dong X, Shi X, Wang H, Wu H, Xiong G, Wang H, Cai K. Differential effects of adjuvant EGFR tyrosine kinase inhibitors in patients with different stages of non-small-cell lung cancer after radical resection: an updated meta-analysis. Cancer Manag Res 2019; 11:2677-2690. [PMID: 31037035 PMCID: PMC6450185 DOI: 10.2147/cmar.s187940] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Purpose A survival improvement was achieved with adjuvant chemotherapy in non-small-cell lung cancer (NSCLC) patients, but its differential effects among patients with different stages remained controversial. This study aimed to compare the beneficial effects of adjuvant tyrosine kinase inhibitor (TKI) therapy with those of traditional therapy on NSCLC patients, specifically on EGFR-mutant and stage II-IIIA patients, who might benefit most from such treatment. Methods MEDLINE, Embase, and the Cochrane Library were searched, and the results were screened independently according to certain criteria by two authors. Disease-free survival (DFS) and overall survival (OS) with HRs were used as the summary statistics. Results A total of 2,915 publications were identified and screened. Six randomized control trials and three retrospective cohort studies of 2,467 patients with acceptable quality were included. The overall EGFR mutation rate was 48.62%. DFS was significantly improved in all the patients (HR, 0.77; 95% CI, 0.68-0.88) and in the subgroup of EGFR-mutant patients (HR, 0.49; 95% CI, 0.40-0.61). The difference of 5-year OS in the subgroup of EGFR-mutant patients (HR, 0.48; 95% CI, 0.31-0.72) was statistically significant, while in all the patients (HR, 1.01; 95% CI, 0.85-1.19), the difference was not significant. In the subgroups of studies in which <50% of patients were in stage I (HR, 0.46; 95% CI, 0.35-0.60) and >30% of patients were in stage IIIA (HR, 0.46; 95% CI, 0.35-0.60), DFS was significantly improved, while in the subgroups of studies in which <30% of patients were in stage IIIA (HR, 0.90; 95% CI, 0.77-1.04) and >50% of patients were in stage I (HR, 0.90; 95% CI, 0.77-1.04), DFS was not significantly improved. Conclusion Stage IIIA NSCLC patients might benefit more from adjuvant TKIs than stage I NSCLC patients after radical resection.
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Affiliation(s)
- Di Lu
- Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China,
| | - Zhizhi Wang
- Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China,
| | - Xiguang Liu
- Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China,
| | - Siyang Feng
- Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China,
| | - Xiaoying Dong
- Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China,
| | - Xiaoshun Shi
- Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China,
| | - He Wang
- Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China,
| | - Hua Wu
- Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China,
| | - Gang Xiong
- Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China,
| | - Haofei Wang
- Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China,
| | - Kaican Cai
- Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China,
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Rosell R, Karachaliou N. Gene Expression Signatures Predicting Survival and Chemotherapy Benefit in Patients with Resected Non-small-Cell Lung Cancer. EBioMedicine 2019; 33:16-17. [PMID: 29929887 PMCID: PMC6085495 DOI: 10.1016/j.ebiom.2018.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 06/07/2018] [Indexed: 12/31/2022] Open
Affiliation(s)
- Rafael Rosell
- Cancer Biology and Precision Medicine Program, Catalan Institute of Oncology, Germans Trias i Pujol Health Sciences Institute and Hospital, Badalona, Barcelona, Spain.
| | - Niki Karachaliou
- Medical Oncology Department, University Hospital Sagrat Cor, QuironSalud Group, Institute of Oncology Rosell, Barcelona, Spain
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205
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Wei W, Huo B, Shi X. miR-600 inhibits lung cancer via downregulating the expression of METTL3. Cancer Manag Res 2019; 11:1177-1187. [PMID: 30774445 PMCID: PMC6362936 DOI: 10.2147/cmar.s181058] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Methyltransferase like 3 (METTL3) is an RNA methyltransferase implicated in mRNA biogenesis, decay, and translation control through N6-methyladenosine (m6A) modification. Methods To find new treatment strategies for lung cancer and to elucidate the mechanism underlying the phenomenon, we treated the human lung cancer cell lines A549 and H1299 to investigate the effect of METTL3 on lung cancer. Results We observed that knockdown of METTL3 inhibited the survival and proliferation of A549 and H1299 cells. The migration and proliferation of both cell lines were significantly decreased, and the apoptosis was induced in comparison with control cells. These results were further confirmed by the transfection of miRNA of METTL3 increased the Bax/Bcl-2 ratio in A549 and H1299 cells, which is a sign that mitochondrial apoptotic pathway was triggered. The PI3K/Akt pathway is implicated in cell growth and survival and we also observed that knockdown of METTL3 changed the expression and phosphorylation of proteins of PI3K signaling pathway members. Further, our results demonstrated that miR-600 inhibited the expression of METTL3 and reversed the positive effect of METTL3 on NSCLC progression, indicating an miR-600/METTL3 pathway in NSCLC. Conclusion These data suggested that miR-600 inhibited lung cancer via down-regulating METTL3 expression, and knockdown of METTL3 might be used as a novel strategy for lung cancer therapy.
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Affiliation(s)
- Wenwen Wei
- Department of Respiratory Medicine, The Second People's Hospital of Dongying, Guangrao City, Shandong Province 257335, People's Republic of China,
| | - Baosheng Huo
- Department of Thoracic Surgery, The Second People's Hospital of Dongying, Guangrao City, Shandong Province 257335, People's Republic of China,
| | - Xiulan Shi
- Department of Respiratory Medicine, The Second People's Hospital of Dongying, Guangrao City, Shandong Province 257335, People's Republic of China,
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206
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Shi JF, Wang L, Wu N, Li JL, Hui ZG, Liu SM, Yang BY, Gao SG, Ren JS, Huang HY, Zhu J, Liu CC, Fan JH, Zhao SJ, Xing PY, Zhang Y, Li N, Lei WD, Wang DB, Huang YC, Liao XZ, Xing XJ, Du LB, Yang L, Liu YQ, Zhang YZ, Zhang K, Qiao YL, He J, Dai M. Clinical characteristics and medical service utilization of lung cancer in China, 2005–2014: Overall design and results from a multicenter retrospective epidemiologic survey. Lung Cancer 2019; 128:91-100. [PMID: 30642458 DOI: 10.1016/j.lungcan.2018.11.031] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 11/14/2018] [Accepted: 11/23/2018] [Indexed: 01/05/2023]
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207
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Chung JH, Yoon SH, Kang YJ, Kim YS, Son BS, Kwon RJ, Han JH, Kim DH. Receptor-interacting protein kinase 3 as a predictive adjuvant chemotherapy marker after lung adenocarcinoma resection. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:42. [PMID: 30906746 DOI: 10.21037/atm.2018.12.65] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Background This study assessed the predictive value of receptor-interacting protein kinase 3 (RIPK3) expression and its correlation with clinicopathological characteristics, disease-free survival, and overall survival of patients with cisplatin-based adjuvant chemotherapy after lung adenocarcinoma resection. Methods This study included 50 patients who underwent cisplatin-based adjuvant chemotherapy after lung adenocarcinoma (stage IB-IIIA) resection. Immunohistochemical analysis was performed by probing tumor tissue microarrays with anti-RIPK3 antibody. Results High RIPK3 expression was detected in 24 (48.0%) of the 50 patients. Moreover, high RIPK3 expression was associated with a prolonged disease-free survival (P=0.015) but not with a prolonged overall survival (P=0.109) of the patients who underwent cisplatin doublet therapy after lung adenocarcinoma resection. We also examined whether RIPK3 expression was associated with prognosis based on chemotherapeutic response and found that patients with low RIPK3 expression showed a higher tendency of developing a progressive disease [14/26 (53.8%) patients] than patients with high RIPK3 expression [6/24 (25.0%) patients] (P=0.03). Results of Cox univariate proportional hazards regression model showed that age, N stage, and high RIPK3 expression (P=0.04) were associated with the prolonged disease-free survival of the patients who underwent cisplatin-based adjuvant chemotherapy after lung adenocarcinoma resection. Conclusions These results suggest that RIPK3 overexpression is a potential biomarker to identify patients with lung adenocarcinoma who can benefit the most from cisplatin-based adjuvant chemotherapy after complete adenocarcinoma resection.
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Affiliation(s)
- Jae Heun Chung
- Department of Pulmonology, Allergy and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seong Hoon Yoon
- Department of Pulmonology, Allergy and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Yong Jung Kang
- Department of Pulmonology, Allergy and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Yun Seong Kim
- Department of Pulmonology, Allergy and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Bong Soo Son
- Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ryuk Jun Kwon
- Department of Family Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jun Hee Han
- Department of Statistics, Hallym University, Chucheon, Kangwon, Korea
| | - Do Hyung Kim
- Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
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208
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Bains S, Eguchi T, Warth A, Yeh YC, Nitadori JI, Woo KM, Chou TY, Dienemann H, Muley T, Nakajima J, Shinozaki-Ushiku A, Wu YC, Lu S, Kadota K, Jones DR, Travis WD, Tan KS, Adusumilli PS. Procedure-Specific Risk Prediction for Recurrence in Patients Undergoing Lobectomy or Sublobar Resection for Small (≤2 cm) Lung Adenocarcinoma: An International Cohort Analysis. J Thorac Oncol 2019; 14:72-86. [PMID: 30253972 PMCID: PMC6309652 DOI: 10.1016/j.jtho.2018.09.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 08/23/2018] [Accepted: 09/16/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION This work was performed to develop and validate procedure-specific risk prediction for recurrence following resection for early-stage lung adenocarcinoma (ADC) and investigate risk prediction utility in identifying patients who may benefit from adjuvant chemotherapy (ACT). METHODS In patients who underwent resection for small (≤2 cm) lung ADC (lobectomy, 557; sublobar resection, 352), an association between clinicopathologic variables and risk of recurrence was assessed by a competing risks approach. Procedure-specific risk prediction was developed based on multivariable regression for recurrence. External validation was conducted using cohorts (N = 708) from Japan, Taiwan, and Germany. The accuracy of risk prediction was measured using a concordance index. We applied the lobectomy risk prediction approach to a propensity score-matched cohort of patients with stage II-III disease (n = 316, after matching) with or without ACT and compared lung cancer-specific survival between groups among low- or high-risk scores. RESULTS Micropapillary pattern, solid pattern, lymphovascular invasion, and necrosis were involved in the risk prediction following lobectomy, and micropapillary pattern, spread through air spaces, lymphovascular invasion, and necrosis following sublobar resection. Both internal and external validation showed good discrimination (concordance index in lobectomy and sublobar resection: internal, 0.77 and 0.75, respectively; and external, 0.73 and 0.79, respectively). In the stage II-III propensity score-matched cohort, among high-risk patients, ACT significantly reduced the risk of lung cancer-specific death (subhazard ratio 0.43, p = 0.001), but not among low-risk patients. CONCLUSIONS Procedure-specific risk prediction for patients with resected small lung ADC can be used to better prognosticate and stratify patients for further interventions.
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Affiliation(s)
- Sarina Bains
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Takashi Eguchi
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York; Division of Thoracic Surgery, Department of Surgery, Shinshu University, Matsumoto, Japan
| | - Arne Warth
- Institute of Pathology, Heidelberg University, Heidelberg, Germany; Translational Lung Research Center Heidelberg, German Center for Lung Research, Heidelberg, Germany
| | - Yi-Chen Yeh
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | | | - Kaitlin M Woo
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Teh-Ying Chou
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hendrik Dienemann
- Translational Lung Research Center Heidelberg, German Center for Lung Research, Heidelberg, Germany; Department of Thoracic Surgery, Thoraxklinik at Heidelberg University, Heidelberg, Germany
| | - Thomas Muley
- Translational Lung Research Center Heidelberg, German Center for Lung Research, Heidelberg, Germany; Translational Research Unit, Thoraxklinik at Heidelberg University, Heidelberg, Germany
| | - Jun Nakajima
- Department of Thoracic Surgery, University of Tokyo, Tokyo, Japan
| | | | - Yu-Chung Wu
- Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shaohua Lu
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Kyuichi Kadota
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Diagnostic Pathology, Kagawa University, Kagawa, Japan
| | - David R Jones
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - William D Travis
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kay See Tan
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Prasad S Adusumilli
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York; Center for Cell Engineering, Memorial Sloan Kettering Cancer Center, New York, New York.
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209
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Yuan C, Tao X, Zheng D, Pan Y, Ye T, Hu H, Xiang J, Zhang Y, Chen H, Sun Y. The lymph node status and histologic subtypes influenced the effect of postoperative radiotherapy on patients with N2 positive IIIA non-small cell lung cancer. J Surg Oncol 2018; 119:379-387. [PMID: 30536966 DOI: 10.1002/jso.25308] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 11/07/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND OBJECTIVE To investigate the role of postoperative radiotherapy (PORT) in IIIA-N2 non-small cell lung cancer (NSCLC) patients and subgroups which derived benefit from PORT. METHODS A total of 576 patients with pathological IIIA-N2 NSCLC, who underwent complete resection, were identified. Propensity score matching (PSM) methods were used to balance the patients' characteristics between two groups. Overall survival (OS) and relapse-free survival (RFS) were compared between PORT and non-PORT patients. RESULTS On multivariable analysis, improved OS remained correlated with younger age, single N2 station involvement, less positive lymph nodes, and chemotherapy. After PSM, 121 PROT patients and 242 non-PORT patients were matched. PORT was not associated improved patients' OS (P = 0.735) or RFS ( P = 0.483). For patients who underwent postoperative chemotherapy (POCT), PORT could improve OS in single N2 station involved patients (HR: 0.572, 95%CI: 0.312 to 1.05, P = 0.040). Patients with papillary predominant adenocarcinoma also benefited from PORT with an increase in OS (HR: 0.350, 95%CI: 0.126 to 0.972, P = 0.033). CONCLUSIONS For patients with completely resected IIIA-N2 NSCLC, mediastinal lymph node metastasis and histologic subtypes could influence the effect of PORT. Single N2 station involvement and papillary predominant subtype were predictors of benefit from PORT.
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Affiliation(s)
- Chongze Yuan
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiaoting Tao
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Difan Zheng
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan 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
| | - Ting Ye
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hong Hu
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jiaqing Xiang
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yawei Zhang
- 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
| | - Yihua Sun
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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Adjuvant Chemotherapy Improves Survival in Surgically Resected Stage IB Squamous Lung Cancer. Ann Thorac Surg 2018; 107:1683-1689. [PMID: 30468727 DOI: 10.1016/j.athoracsur.2018.10.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 09/25/2018] [Accepted: 10/01/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND At present there is a significant lack of clinical data for patients with surgically resected stage I squamous lung cancer. The purpose of this study was to investigate the impact of postoperative chemotherapy in this specific population. METHODS We retrospectively identified patients who had undergone complete squamous lung cancer resection at the Shanghai Chest Hospital between January 2008 and January 2014. RESULTS A total of 596 patients (236 stage IA, 360 stage IB) were included in this study. Results demonstrated that adjuvant chemotherapy (ACT) could provide longer overall survival for patients with p-stage IB disease (hazard ratio [HR], 0.56; 95% confidence interval [CI], 0.34-0.90; p = 0.017). Among p-stage IB patients the ACT-treated cohort trended toward a benefit (HR, 0.69; 95% CI, 0.45-1.04) in recurrence-free survival but failed to reach statistical significance (p = 0.076). After propensity score matching the HRs of recurrence-free survival and overall survival were 0.58 (95% CI, 0.35-0.96; p = 0.033) and 0.49 (95% CI, 0.27-0.88; p = 0.017), respectively. With regards to patients with p-stage IA disease, neither overall survival (HR, 0.87; 95% CI, 0.34-2.27; p = 0.783) nor recurrence-free survival (HR, 0.79; 95% CI, 0.38-1.65; p = 0.534) was significantly different when compared between patients receiving ACT and those who did not. Similar results were also achieved after propensity score matching. CONCLUSIONS The data presented herein demonstrated that ACT might provide survival benefits for squamous lung cancer patients with p-stage IB disease.
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211
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Pennell NA, Neal JW, Chaft JE, Azzoli CG, Jänne PA, Govindan R, Evans TL, Costa DB, Wakelee HA, Heist RS, Shapiro MA, Muzikansky A, Murthy S, Lanuti M, Rusch VW, Kris MG, Sequist LV. SELECT: A Phase II Trial of Adjuvant Erlotinib in Patients With Resected Epidermal Growth Factor Receptor-Mutant Non-Small-Cell Lung Cancer. J Clin Oncol 2018; 37:97-104. [PMID: 30444685 DOI: 10.1200/jco.18.00131] [Citation(s) in RCA: 145] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Given the pivotal role of epidermal growth factor receptor (EGFR) inhibitors in advanced EGFR-mutant non-small-cell lung cancer (NSCLC), we tested adjuvant erlotinib in patients with EGFR-mutant early-stage NSCLC. MATERIALS AND METHODS In this open-label phase II trial, patients with resected stage IA to IIIA (7th edition of the American Joint Committee on Cancer staging system) EGFR-mutant NSCLC were treated with erlotinib 150 mg per day for 2 years after standard adjuvant chemotherapy with or without radiotherapy. The study was designed for 100 patients and powered to demonstrate a primary end point of 2-year disease-free survival (DFS) greater than 85%, improving on historic data of 76%. RESULTS Patients (N = 100) were enrolled at seven sites from January 2008 to May 2012; 13% had stage IA disease, 32% had stage IB disease, 11% had stage IIA disease, 16% had stage IIB disease, and 28% had stage IIIA disease. Toxicities were typical of erlotinib; there were no grade 4 or 5 adverse events. Forty percent of patients required erlotinib dose reduction to 100 mg per day and 16% to 50 mg per day. The intended 2-year course was achieved in 69% of patients. The median follow-up was 5.2 years, and 2-year DFS was 88% (96% stage I, 78% stage II, 91% stage III). Median DFS and overall survival have not been reached; 5-year DFS was 56% (95% CI, 45% to 66%), 5-year overall survival was 86% (95% CI, 77% to 92%). Disease recurred in 40 patients, with only four recurrences during erlotinib treatment. The median time to recurrence was 25 months after stopping erlotinib. Of patients with recurrence who underwent rebiopsy (n = 24; 60%), only one had T790M mutation detected. The majority of patients with recurrence were retreated with erlotinib (n = 26; 65%) for a median duration of 13 months. CONCLUSION Patients with EGFR-mutant NSCLC treated with adjuvant erlotinib had an improved 2-year DFS compared with historic genotype-matched controls. Recurrences were rare for patients receiving adjuvant erlotinib, and patients rechallenged with erlotinib after recurrence experienced durable benefit.
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Affiliation(s)
| | - Joel W Neal
- 2 Stanford Cancer Institute and Stanford School of Medicine, Stanford, CA
| | - Jamie E Chaft
- 3 Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY
| | | | | | | | - Tracey L Evans
- 7 Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA
| | | | - Heather A Wakelee
- 2 Stanford Cancer Institute and Stanford School of Medicine, Stanford, CA
| | | | - Marc A Shapiro
- 1 Cleveland Clinic Taussig Cancer Institute, Cleveland, OH
| | | | - Sudish Murthy
- 1 Cleveland Clinic Taussig Cancer Institute, Cleveland, OH
| | | | - Valerie W Rusch
- 3 Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY
| | - Mark G Kris
- 3 Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY
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212
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Sakai T, Aokage K, Neri S, Nakamura H, Nomura S, Tane K, Miyoshi T, Sugano M, Kojima M, Fujii S, Kuwata T, Ochiai A, Iyoda A, Tsuboi M, Ishii G. Link between tumor-promoting fibrous microenvironment and an immunosuppressive microenvironment in stage I lung adenocarcinoma. Lung Cancer 2018; 126:64-71. [PMID: 30527194 DOI: 10.1016/j.lungcan.2018.10.021] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/10/2018] [Accepted: 10/21/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Podoplanin-positive cancer-associated fibroblasts [PDPN (+) CAFs] play an important role in cancer progression in non-small-cell lung cancer. The aim of this study was to clarify the correlation between a fibrous microenvironment containing PDPN (+) CAFs and an immune microenvironment. MATERIALS AND METHODS A total of 174 patients with pathological stage I lung adenocarcinoma were analyzed. We evaluated PDPN (+) CAFs and immune-related cells, CD 204-positive tumor-associated macrophages [CD204 (+) TAMs], CD8-positive T cells, and FOXP3-positive T cells, in cancer stroma by using immunohistochemical staining. We compared the expression levels of immune-regulatory cytokines between the PDPN high and low expression groups by analyzing the gene expression profiles of lung adenocarcinoma (n = 442). RESULTS Presence of PDPN (+) CAFs was a risk factor for recurrence (P = 0.042). The number of CD204 (+) TAMs was significantly higher (P < 0.001) and the CD8/FOXP3 T cell ratio was significantly lower in PDPN (+) CAFs cases than in PDPN (-) CAFs cases (P = 0.027). Within the same tumor, the number of CD 204 (+) TAMs was significantly higher (P < 0.001) and CD8/FOXP3 T cell ratio tended to be lower (P = 0.062) in PDPN (+) CAF areas. Microarray analysis revealed that the PDPN expression-high group had significantly higher gene expression levels of cytokines that inducing M2 macrophage polarization and suppressing immune-related lymphocytes. CONCLUSION The current results show that lung adenocarcinoma with PDPN (+) CAFs is typified by the immunosuppressive microenvironment, suggesting a close link between the tumor-promoting fibrous microenvironment and the immunosuppressive microenvironment.
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Affiliation(s)
- Takashi Sakai
- Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan; Department of Thoracic Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan; Department of Pathology and Clinical Laboratories, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan; Division of Chest Surgery, Department of Surgery, Toho University Graduate School of Medicine, 6-11-1, Omorinishi, Ota, Tokyo, 143-8541, Japan
| | - Keiju Aokage
- Department of Thoracic Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Shinya Neri
- Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, yoshidakonoe-cho, Sakyo, Kyoto, 606-8501, Japan
| | - Hiroshi Nakamura
- Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Shogo Nomura
- Biostatistics Division Center for Research Administration and Support, National Cancer Center, 6-5-1, Kashiwanoha, Kashiwa, Chiba 277-8577, Japan
| | - Kenta Tane
- Department of Thoracic Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Tomohiro Miyoshi
- Department of Thoracic Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Masato Sugano
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Motohiro Kojima
- Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Satoshi Fujii
- Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Takeshi Kuwata
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Atsushi Ochiai
- Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, 6-5-1, Kashiwanoha, Kashiwa, Chiba 277-8577, Japan
| | - Akira Iyoda
- Division of Chest Surgery, Department of Surgery, Toho University Graduate School of Medicine, 6-11-1, Omorinishi, Ota, Tokyo, 143-8541, Japan
| | - Masahiro Tsuboi
- Department of Thoracic Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Genichiro Ishii
- Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
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213
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Wang J, Wang Y, Tong M, Pan H, Li D. Research progress of the clinicopathologic features of lung adenosquamous carcinoma. Onco Targets Ther 2018; 11:7011-7017. [PMID: 30410358 PMCID: PMC6198886 DOI: 10.2147/ott.s179904] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Adenosquamous carcinoma (ASC) of the lung, a biphasic malignant tumor arising from lung tissue, is a special subtype of non-small-cell lung cancer (NSCLC) with low incidence but high tendency of invasion and poor prognosis. ASC contains components of lung adenocarcinoma (AC) and lung squamous cell carcinoma (SCC). However, there is a remarkable difference between ASC and other NSCLCs in clinical features, suggesting that ASC is not a simple mixture of AC and SCC, but is rather a more complex carcinoma with a unique molecular phenotype. At present, the research on ASC is still rare, mostly because of its complicated molecular mechanism and unclear pathological origin. The lack of cognition of ASC limits its early diagnosis and treatment, and a set of mature and effective treatment programs has not been proposed yet. In-depth study of the molecular characteristics and clinical features of ASC will not only help to better understand the scientific issues, including phenotype switching of lung cancer, the origin of tumor development, and tumor heterogeneity, but also contribute to the development of its individualized treatment. This review summarizes the recent studies concerning the clinicopathologic features and the molecular mechanisms of ASC to further facilitate the development of its individualized treatment.
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Affiliation(s)
- Jing Wang
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang, China,
| | - Yanling Wang
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang, China,
| | - Mengting Tong
- Second Department of Oncology, The Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi 830001, Xinjiang, China
| | - Hongming Pan
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang, China,
| | - Da Li
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang, China,
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214
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Maemura K, Watanabe K, Ando T, Hiyama N, Sakatani T, Amano Y, Kage H, Nakajima J, Yatomi Y, Nagase T, Takai D. Altered editing level of microRNAs is a potential biomarker in lung adenocarcinoma. Cancer Sci 2018; 109:3326-3335. [PMID: 30022565 PMCID: PMC6172074 DOI: 10.1111/cas.13742] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/10/2018] [Indexed: 01/16/2023] Open
Abstract
Adenosine‐to‐inosine (A‐to‐I) microRNA editing is associated with tumor phenotypes in various cancer types. Recent analyses of The Cancer Genome Atlas (TCGA) dataset have shown several microRNAs that undergo A‐to‐I editing in human cancers, some of which have been reported to be associated with prognosis. Herein, we examined published small RNA deep sequencing data of 74 cases of lung adenocarcinoma (AD) and the corresponding normal counterpart (NC) specimen in silico in order to identify A‐to‐I microRNA editing events. Editing levels of miR‐379‐5p, miR‐99a‐5p, and miR‐497‐5p were lower in AD than in NC and, in a large number of cases, the editing level of miR‐200b‐3p was higher in AD than in NC. Difference in the editing level between AD and NC was largest for miR‐99a‐5p. Then, we examined the editing level of miR‐99a‐5p in 50 surgically resected lung adenocarcinoma cases at our institution by a conventional sequence‐based method, and its association with clinical outcomes. The editing level of miR‐99a‐5p was significantly lower in 19 cases of AD (38%) than in corresponding NC. These cases showed a shorter overall survival as assessed using the log‐rank test (P = .047). This trend was consistent with previous analyses of TCGA dataset. The altered editing level of microRNAs in lung adenocarcinoma could serve as a potential biomarker.
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Affiliation(s)
- Keita Maemura
- Department of Respiratory Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Kousuke Watanabe
- Department of Respiratory Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Takahiro Ando
- Department of Respiratory Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Noriko Hiyama
- Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Toshio Sakatani
- Department of Respiratory Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Yosuke Amano
- Department of Respiratory Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Hidenori Kage
- Department of Respiratory Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Jun Nakajima
- Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Yutaka Yatomi
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
| | - Takahide Nagase
- Department of Respiratory Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Daiya Takai
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
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215
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Chen D, Wang H, Song X, Yue J, Yu J. Preoperative radiation may improve the outcomes of resectable IIIA/N2 non-small-cell lung cancer patients: A propensity score matching-based analysis from surveillance, epidemiology, and end results database. Cancer Med 2018; 7:4354-4360. [PMID: 30058192 PMCID: PMC6143945 DOI: 10.1002/cam4.1701] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 06/30/2018] [Accepted: 07/02/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND There are several therapeutic strategies for the management of resectable stage IIIA/N2 non-small-cell lung cancer (NSCLC) patients. However, the role of radiotherapy as a preoperative adjuvant therapy is unclear. METHODS We retrospectively analyzed the data of stage IIIA/N2 NSCLC patients who either underwent preoperative radiation (PrORT), or did not undergo preoperative radiation, collected from the Surveillance, Epidemiology and End Results (SEER) database, between 2004 and 2013. The primary endpoints were cancer-specific survival (CSS) and overall survival (OS). RESULTS Ultimately, 493 patients treated with preoperative radiation and 2675 patients treated who were not treated with preoperative radiation, were included in the analysis. Overall, preoperative radiation was associated with a better CSS (HR: 1.427 [1.297-1.572], P = 0.014) and OS (HR: 1.220 [1.131-1.493], P = 0.002) than that observed in patients who did not undergo preoperative radiation. After PSM, preoperative radiation still showed advantage in both CSS and OS. Only age, T stage, and preoperative radiation remained independent prognostic factors for both OS and CSS. In the subgroup analysis, the advantages of preoperative radiotherapy were more pronounced in patients with stage T3 tumors and highly differentiated tumors. CONCLUSIONS Preoperative radiation may improve the outcomes of resectable IIIA/N2 NSCLC patients. In IIIA/N2 NSCLC patients, particularly with T3 and highly differentiated tumors, clinicians should boldly apply preoperative radiotherapy to improve the patients' survival.
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Affiliation(s)
- Dawei Chen
- Department of RadiotherapyShandong Cancer Hospital affiliated to Shandong UniversityJinanShandongChina
| | - Haiyong Wang
- Shandong Cancer Hospital and InstituteShandong Academy of Medical SciencesShandong Cancer Hospital affiliated to Shandong UniversityJinanShandongChina
| | - Xinyu Song
- Shandong Cancer Hospital and InstituteShandong Academy of Medical SciencesShandong Cancer Hospital affiliated to Shandong UniversityJinanShandongChina
- School of Medicine and Life SciencesUniversity of Jinan‐Shandong Academy of Medical SciencesJinanShandongChina
| | - Jinbo Yue
- Shandong Cancer Hospital and InstituteShandong Academy of Medical SciencesShandong Cancer Hospital affiliated to Shandong UniversityJinanShandongChina
| | - Jinming Yu
- Shandong Cancer Hospital and InstituteShandong Academy of Medical SciencesShandong Cancer Hospital affiliated to Shandong UniversityJinanShandongChina
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216
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Jiang G, Chen C, Zhu Y, Xie D, Dai J, Jin K, Shen Y, Wang H, Li H, Zhang L, Gao S, Chen K, Zhang L, Zhou X, Shi J, Wang H, Xie B, Jiang L, Fan J, Zhao D, Chen Q, Duan L, He W, Zhou Y, Liu H, Zhao X, Zhang P, Qin X. [Shanghai Pulmonary Hospital Experts Consensus on the Management of Ground-Glass Nodules Suspected as Lung Adenocarcinoma (Version 1)]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2018; 21:147-159. [PMID: 29587930 PMCID: PMC5973030 DOI: 10.3779/j.issn.1009-3419.2018.03.05] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
随着胸部计算机断层扫描(computed tomography, CT)检查,尤其是低剂量薄层CT筛查项目在中国的广泛开展,越来越多的无症状肺部磨玻璃结节(ground-glass nodules, GGNs)被发现。虽然国内及国际上已发布了一系列针对肺部GGNs的指南,但是这些指南的撰写者多来自呼吸、肿瘤及影像专业,可能缺乏对现代微创胸外科的充分认识,造成外科手术在肺部GGNs诊治中的作用不明确,甚至被低估;而且,肺部肿瘤相关的各学科对于早期肺癌,尤其是浸润前病变的处理也缺乏统一规范。因此,基于国内外现有文献及上海市肺科医院多年积累的经验,上海市肺科医院撰写了此诊疗共识。本共识推荐对于疑似肺腺癌的GGNs进行多学科评估,依据诊断,选择合理的处置方式。对于疑似原位腺癌,推荐进行胸部薄层CT随访,或在特定情况下进行不超过肺段切除的限制性肺切除;对于疑似微浸润腺癌,推荐进行限制性肺切除或肺叶切除;对于疑似浸润性腺癌,建议依据病灶是否含有磨玻璃成分、位置、大小、个数及患者躯体情况选择合理的手术方式;而肺多发结节的处理原则推荐为主病灶优先,兼顾次要病灶,综合选择治疗方案。
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Affiliation(s)
- Gening Jiang
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Chang Chen
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Yuming Zhu
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Dong Xie
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Jie Dai
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Kaiqi Jin
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Yingran Shen
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Haifeng Wang
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Hui Li
- Capital Medical University Affiliated Beijing Chao-Yang Hospital, Beijing 100020 , China
| | - Lanjun Zhang
- Sun Yat-sen University Cancer Center, Guangzhou 510060 , China
| | - Shugeng Gao
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - Keneng Chen
- Peking University Cancer Hospital and Institute, Beijing 100142 , China
| | - Lei Zhang
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Xiao Zhou
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Jingyun Shi
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Hao Wang
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Boxiong Xie
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Lei Jiang
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Jiang Fan
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Deping Zhao
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Qiankun Chen
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Liang Duan
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Wenxin He
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Yiming Zhou
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Hongcheng Liu
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Xiaogang Zhao
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Peng Zhang
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
| | - Xiong Qin
- Tongji University affiliated Shanghai Pulmonary Hospital, Shanghai 200043 , China
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217
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Battiloro C, Della Gravara L, Rocco D, Gridelli C. What pharmacotherapeutics should one use for early stage non-small cell lung cancer? Expert Opin Pharmacother 2018; 19:1403-1406. [DOI: 10.1080/14656566.2018.1510915] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Ciro Battiloro
- UOC Pneumologia Oncologica, AORN Azienda Ospedaliera Dei Colli Monaldi, Napoli, Italy
| | | | - Danilo Rocco
- UOC Pneumologia Oncologica, AORN Azienda Ospedaliera Dei Colli Monaldi, Napoli, Italy
| | - Cesare Gridelli
- Hematology and Oncology Department, AORN Giuseppe Moscati, Avellino, Italy
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218
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Abstract
Adenosquamous carcinoma of the lung (ASC), a relatively rare subtype of non-small-cell lung cancer, is defined as a malignancy containing components of lung adenocarcinoma (ADC) and lung squamous cell carcinoma (SCC). Although ASC has biological characteristics of ADC and SCC, it is not by any means a simple hybrid of two components above. It is extremely difficult to diagnose preoperatively; pathology of surgically resected gross specimen is the most effective means for adequate diagnosis of ASC. Platinum-based postoperative adjuvant chemotherapy for at least four cycles can significantly improve the survival in stage III patients with ASC. Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) such as erlotinib and gefitinib can be the effective therapeutic strategies for advanced EGFR-mutant ASC. The studies of crizotinib in the treatment of patients with ASC are very limited. Immune checkpoint blockade therapy may be a potential treatment choice for ASC patients.
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Affiliation(s)
- Chenghui Li
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang province, People's Republic of China.,Department of Thoracic Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China,
| | - Hongyang Lu
- Department of Thoracic Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China, .,Zhejiang Key Laboratory of Diagnosis & Treatment Technology on Thoracic Oncology (Lung and Esophagus), Zhejiang Cancer Hospital, Hangzhou, People's Republic of China,
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219
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Tessari A, Parbhoo K, Pawlikowski M, Fassan M, Rulli E, Foray C, Fabbri A, Embrione V, Ganzinelli M, Capece M, Campbell MJ, Broggini M, La Perle K, Farina G, Cole S, Marabese M, Hernandez M, Amann JM, Pruneri G, Carbone DP, Garassino MC, Croce CM, Palmieri D, Coppola V. RANBP9 affects cancer cells response to genotoxic stress and its overexpression is associated with worse response to platinum in NSCLC patients. Oncogene 2018; 37:6463-6476. [PMID: 30076413 DOI: 10.1038/s41388-018-0424-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 06/28/2018] [Accepted: 07/05/2018] [Indexed: 01/11/2023]
Abstract
Although limited by severe side effects and development of resistance, platinum-based therapies still represent the most common first-line treatment for non-small cell lung cancer (NSCLC). However, a crucial need in the clinical management of NSCLC is represented by the identification of cases sensitive to DNA damage response (DDR)-targeting drugs, such as cisplatin or PARP inhibitors. Here, we provide a molecular rationale for the stratification of NSCLC patients potentially benefitting from platinum compounds based on the expression levels of RANBP9, a recently identified player of the cellular DDR. RANBP9 was found overexpressed by immunohistochemistry (IHC) in NSCLC compared to normal adjacent tissues (NATs) (n = 147). Moreover, a retrospective analysis of 132 platinum-treated patients from the multi-centric TAILOR trial showed that RANBP9 overexpression levels are associated with clinical response to platinum compounds [Progression Free Survival Hazard Ratio (RANBP9 high vs low) 1.73, 95% CI 1.15-2.59, p = 0.0084; Overall Survival HR (RANBP9 high vs low) 1.99, 95% CI 1.27-3.11, p = 0.003]. Accordingly, RANBP9 KO cells showed higher sensitivity to cisplatin in comparison with WT controls both in vitro and in vivo models. NSCLC RANBP9 KO cells were also more sensitive than control cells to the PARP inhibitor olaparib alone and in combination with cisplatin, due to defective ATM-dependent and hyper-activated PARP-dependent DDR. The current investigation paves the way to prospective studies to assess the clinical value of RANBP9 protein levels as prognostic and predictive biomarker of response to DDR-targeting drugs, leading to the development of new tools for the management of NSCLC patients.
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Affiliation(s)
- Anna Tessari
- Department of Cancer Biology and Genetics, College of Medicine, The Ohio State University and Arthur G. James Comprehensive Cancer Center, Columbus, OH, 43210, USA
| | - Kareesma Parbhoo
- Department of Cancer Biology and Genetics, College of Medicine, The Ohio State University and Arthur G. James Comprehensive Cancer Center, Columbus, OH, 43210, USA
| | - Meghan Pawlikowski
- Department of Cancer Biology and Genetics, College of Medicine, The Ohio State University and Arthur G. James Comprehensive Cancer Center, Columbus, OH, 43210, USA
| | - Matteo Fassan
- Department of Medicine (DIMED), Surgical Pathology Unit, University of Padua, Padua, Italy
| | - Eliana Rulli
- Department of Oncology, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Claudia Foray
- Department of Cancer Biology and Genetics, College of Medicine, The Ohio State University and Arthur G. James Comprehensive Cancer Center, Columbus, OH, 43210, USA
| | - Alessandra Fabbri
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Valerio Embrione
- Department of Cancer Biology and Genetics, College of Medicine, The Ohio State University and Arthur G. James Comprehensive Cancer Center, Columbus, OH, 43210, USA
| | - Monica Ganzinelli
- Thoracic Oncology Unit, Department of Medical Oncology, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Marina Capece
- Department of Cancer Biology and Genetics, College of Medicine, The Ohio State University and Arthur G. James Comprehensive Cancer Center, Columbus, OH, 43210, USA
| | - Moray J Campbell
- Division of Pharmaceutics and Pharmaceutical Chemistry, College of Pharmacy, The Ohio State University, 536 Parks Hall, Columbus, OH, 43210, USA
| | - Massimo Broggini
- Department of Oncology, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Krista La Perle
- Department of Veterinary Biosciences and Comparative Pathology and Mouse Phenotyping Shared Resource, College of Veterinary Medicine, The Ohio State University and Arthur G. James Comprehensive Cancer Center, Columbus, OH, USA
| | - Gabriella Farina
- Department of Oncology, Ospedale Fatebenefratelli and Oftalmico, Milan, Italy
| | - Sara Cole
- Campus Microscopy and Imaging Facility, The Ohio State University, Columbus, OH, 43210, USA
| | - Mirko Marabese
- Department of Oncology, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Marianna Hernandez
- Department of Cancer Biology and Genetics, College of Medicine, The Ohio State University and Arthur G. James Comprehensive Cancer Center, Columbus, OH, 43210, USA
| | - Joseph M Amann
- Department of Internal Medicine, College of Medicine, James Thoracic Center, Ohio State University and Arthur G. James Comprehensive Cancer Center, Columbus, OH, 43210, USA
| | - Giancarlo Pruneri
- Division of Pathology, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - David P Carbone
- Department of Internal Medicine, College of Medicine, James Thoracic Center, Ohio State University and Arthur G. James Comprehensive Cancer Center, Columbus, OH, 43210, USA
| | - Marina C Garassino
- Thoracic Oncology Unit, Department of Medical Oncology, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Carlo M Croce
- Department of Cancer Biology and Genetics, College of Medicine, The Ohio State University and Arthur G. James Comprehensive Cancer Center, Columbus, OH, 43210, USA
| | - Dario Palmieri
- Department of Cancer Biology and Genetics, College of Medicine, The Ohio State University and Arthur G. James Comprehensive Cancer Center, Columbus, OH, 43210, USA
| | - Vincenzo Coppola
- Department of Cancer Biology and Genetics, College of Medicine, The Ohio State University and Arthur G. James Comprehensive Cancer Center, Columbus, OH, 43210, USA.
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Herbst RS, Morgensztern D, Boshoff C. The biology and management of non-small cell lung cancer. Nature 2018; 553:446-454. [PMID: 29364287 DOI: 10.1038/nature25183] [Citation(s) in RCA: 2546] [Impact Index Per Article: 424.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 11/29/2017] [Indexed: 12/17/2022]
Abstract
Important advancements in the treatment of non-small cell lung cancer (NSCLC) have been achieved over the past two decades, increasing our understanding of the disease biology and mechanisms of tumour progression, and advancing early detection and multimodal care. The use of small molecule tyrosine kinase inhibitors and immunotherapy has led to unprecedented survival benefits in selected patients. However, the overall cure and survival rates for NSCLC remain low, particularly in metastatic disease. Therefore, continued research into new drugs and combination therapies is required to expand the clinical benefit to a broader patient population and to improve outcomes in NSCLC.
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Affiliation(s)
- Roy S Herbst
- Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Chris Boshoff
- Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut, USA.,Pfizer, Inc. New York City, New York, USA
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221
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Isbell JM, Jones DR, Li BT. Circulating tumor DNA: A promising biomarker to guide postoperative treatment and surveillance of non–small cell lung cancer. J Thorac Cardiovasc Surg 2018; 155:2628-2631. [DOI: 10.1016/j.jtcvs.2017.12.157] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 11/30/2017] [Accepted: 12/14/2017] [Indexed: 01/11/2023]
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222
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Heineman DJ, Daniels JM, Schreurs WH. Invited letter to the editor on the editorial on " Clinical staging of NSCLC: current evidence and implications for adjuvant chemotherapy". J Thorac Dis 2018; 10:S2083-S2085. [PMID: 30023125 DOI: 10.21037/jtd.2018.04.121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- David Jonathan Heineman
- Department of Surgery and Cardiothoracic Surgery, VU University Medical Center, Amsterdam, The Netherlands
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223
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Waddle MR, Ko S, Johnson MM, Lou Y, Miller RC, Harrell AC, Trifiletti DM. Post-operative radiation therapy in locally advanced non-small cell lung cancer and the impact of sequential versus concurrent chemotherapy. Transl Lung Cancer Res 2018; 7:S171-S175. [PMID: 29782566 DOI: 10.21037/tlcr.2018.03.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Mark R Waddle
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida, USA
| | - Stephen Ko
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida, USA
| | | | - Yanyan Lou
- Department of Hematology and Oncology, Mayo Clinic, Jacksonville, Florida, USA
| | - Robert C Miller
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida, USA
| | - Anna C Harrell
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida, USA
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224
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Okuda K, Tatematsu T, Yano M, Nakamae K, Yamada T, Kasugai T, Nishida T, Sano M, Moriyama S, Haneda H, Kawano O, Sakane T, Oda R, Watanabe T, Nakanishi R. The relationship between the expression of thymidylate synthase, dihydropyrimidine dehydrogenase, orotate phosphoribosyltransferase, excision repair cross-complementation group 1 and class III β-tubulin, and the therapeutic effect of S-1 or carboplatin plus paclitaxel in non-small-cell lung cancer. Mol Clin Oncol 2018; 9:21-29. [PMID: 29977535 PMCID: PMC6031014 DOI: 10.3892/mco.2018.1619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/02/2018] [Indexed: 11/26/2022] Open
Abstract
Previous studies have reported that the expressions of specific proteins may predict the efficacy of chemotherapy agents for non-small cell lung cancer (NSCLC) patients. The present study evaluated the expression of proteins hypothesized to be associated with the effect of chemotherapeutic agents in 38 NSCLC patients with pathological stage II and IIIA. The subjects received carboplatin plus paclitaxel (CP) or S-1 as adjuvant chemotherapy following complete resection. The protein expressions evaluated were those of thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD) and orotate phsphoribosyltransferase (OPRT), which were suspected to be associated with the effect of S-1 agents, excision repair cross-complementation group 1 (ERCC1), which was suspected to be associated with the effect of platinum-based agents, and class III β-tubulin (TUBB3), which was suspected to be associated with the effect of taxane-based agents. The positive rate of TS was 55.3% (n=21/38), DPD was 57.9% (n=22/38), OPRT was 42.1% (n=16/38), ERCC1 was 47.4% (n=18/38) and TUBB3 was 44.7% (n=17/38). Among the patients who received S-1 adjuvant chemotherapy, TS-negative cases demonstrated a significantly better disease-free survival than positive cases. Thus, TS protein expression may have been a factor that predicted the effect of S-1 agent as adjuvant chemotherapy.
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Affiliation(s)
- Katsuhiro Okuda
- Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467-8601, Japan
| | - Tsutomu Tatematsu
- Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467-8601, Japan
| | - Motoki Yano
- Department of Surgery, Aichi Medical University, Nagakute, Aichi 480-1195, Japan
| | - Katsumi Nakamae
- Department of Surgery, Nagoya City West Medical Center, Nagoya, Aichi 462-8508, Japan
| | - Takeshi Yamada
- Department of Surgery, Kariya Toyota General Hospital, Kariya, Aichi 448-8505, Japan
| | - Toshio Kasugai
- Department of Surgery, Matsunami General Hospital, Hashima, Gifu 501-6062, Japan
| | - Tsutomu Nishida
- Department of Surgery, Toyokawa City Hospital, Toyokawa, Aichi 442-8561, Japan
| | - Masaaki Sano
- Department of Surgery, Nagoya Memorial Hospital, Nagoya, Aichi 468-8520, Japan
| | - Satoru Moriyama
- Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467-8601, Japan
| | - Hiroshi Haneda
- Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467-8601, Japan
| | - Osamu Kawano
- Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467-8601, Japan
| | - Tadashi Sakane
- Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467-8601, Japan
| | - Risa Oda
- Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467-8601, Japan
| | - Takuya Watanabe
- Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467-8601, Japan
| | - Ryoichi Nakanishi
- Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467-8601, Japan
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225
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Shen P, Zhong W. Adjuvant EGFR TKI therapy for resectable non-small cell lung cancer: new era for personalized medicine. J Thorac Dis 2018; 10:1364-1369. [PMID: 29708118 DOI: 10.21037/jtd.2018.03.97] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Peng Shen
- Department of Oncology, Nanfang Hospital, Southern Medical University/The First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
| | - Wenzhao Zhong
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou 510080, China
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226
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Kruser TJ, Mohindra N, DeCamp MM. One size does not fit all: Nuances in postoperative N2 non-small cell lung cancer management. J Thorac Cardiovasc Surg 2018; 156:370-373. [PMID: 29681397 DOI: 10.1016/j.jtcvs.2018.02.100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 02/03/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Tim J Kruser
- Department of Radiation Oncology, Feinberg School of Medicine, Northwestern University, Chicago, Ill; Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Ill
| | - Nisha Mohindra
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Ill; Division of Hematology and Oncology, Department of Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Malcolm M DeCamp
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Ill; Division of Thoracic Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
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227
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Santarpia M, Liguori A, D'Aveni A, Karachaliou N, Gonzalez-Cao M, Daffinà MG, Lazzari C, Altavilla G, Rosell R. Liquid biopsy for lung cancer early detection. J Thorac Dis 2018; 10:S882-S897. [PMID: 29780635 DOI: 10.21037/jtd.2018.03.81] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Molecularly targeted therapies and immune checkpoint inhibitors have markedly improved the therapeutic management of advanced lung cancer. However, it still remains the leading cause of cancer-related mortality worldwide, with disease stage at diagnosis representing the main prognostic factor. Detection of lung cancer at an earlier stage of disease, potentially susceptible of curative resection, can be critical to improve patients survival. Low-dose computed tomography (LDCT) screening of high-risk patients has been demonstrated to reduce mortality from lung cancer, but can be also associated with high false-positive rate, thus often resulting in unnecessary interventions for patients. Novel sensitive and specific biomarkers for identification of high-risk subjects and early detection that can be used alternatively and/or complement current routine diagnostic procedures are needed. Liquid biopsy has recently demonstrated its clinical usefulness in advanced NSCLC as a surrogate of tissue biopsy for noninvasive assessment of specific genomic alterations, thereby providing prognostic and predictive information. Different biosources from liquid biopsy, including cell free circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), exosomes and tumor-educated platelets (TEPs), have also been widely investigated for their potential role in lung cancer diagnosis. This review will provide an overview on the circulating biomarkers being evaluated for lung cancer detection, mainly focusing on results from most recent studies, the techniques developed to perform their assessment in blood and other biologic fluids and challenges in their clinical applications.
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Affiliation(s)
- Mariacarmela Santarpia
- Medical Oncology Unit, Department of Human Pathology of Adult and Evolutive Age "G. Barresi", University of Messina, Messina, Italy
| | - Alessia Liguori
- Medical Oncology Unit, Department of Human Pathology of Adult and Evolutive Age "G. Barresi", University of Messina, Messina, Italy
| | - Alessandro D'Aveni
- Medical Oncology Unit, Department of Human Pathology of Adult and Evolutive Age "G. Barresi", University of Messina, Messina, Italy
| | - Niki Karachaliou
- Institute of Oncology Rosell (IOR), University Hospital Sagrat Cor, Barcelona, Spain
| | - Maria Gonzalez-Cao
- Department of Oncology, Institute of Oncology Rosell (IOR), Quirón-Dexeus University Institute, Barcelona, Spain
| | - Maria Grazia Daffinà
- Medical Oncology Unit, Department of Human Pathology of Adult and Evolutive Age "G. Barresi", University of Messina, Messina, Italy
| | - Chiara Lazzari
- Department of Oncology, Division of Experimental Medicine, IRCCS San Raffaele, Milan, Italy
| | - Giuseppe Altavilla
- Medical Oncology Unit, Department of Human Pathology of Adult and Evolutive Age "G. Barresi", University of Messina, Messina, Italy
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Germans Trias i Pujol University Hospital, Badalona, Spain.,Catalan Institute of Oncology, Germans Trias i Pujol University Hospital, Badalona, Spain
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228
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Qian B, Wang X, Mao C, Jiang Y, Shi Y, Chen L, Liu S, Wang B, Pan S, Tao Y, Shi H. Long non-coding RNA linc01433 promotes migration and invasion in non-small cell lung cancer. Thorac Cancer 2018. [PMID: 29532622 PMCID: PMC5928388 DOI: 10.1111/1759-7714.12623] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background For many years, lung cancer has been the most common and deadly cancer worldwide. Early diagnosis of non‐small cell lung cancer (NSCLC) in particular is very difficult because the symptoms are often ignored. The five‐year survival rate is very low despite great improvements to therapy. Thus, there is an urgent need to identify prognostic biomarkers and target molecules for the clinical diagnosis and individualized treatment of NSCLC. Methods We performed quantitative real‐time PCR to determine the expression levels of the long non‐coding RNA (lncRNA) linc01433 in NSCLC and normal matched lung tissue. Subsequently, we established cell lines with overexpression or knockdown of linc01433 to evaluate the effects on proliferation and metastasis in vitro. Epithelial‐to‐mesenchymal transition was examined using Western blot. Results Linc01433 was significantly overexpressed in NSCLC tissues compared to normal lung tissues. In addition, linc01433 levels were associated with smoking history. Linc01433 overexpression in lung cancer cells increased proliferation, migration, and invasion abilities, as well as epithelial‐to‐mesenchymal transition. Conclusions Linc01433 is a cancer‐related lncRNA that may have an oncogene‐like effect in NSCLC.
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Affiliation(s)
- Banglun Qian
- Department of Thoracic Surgery, Second Xiangya Hospital of Central South University, Hunan, China
| | - Xiang Wang
- Department of Thoracic Surgery, Second Xiangya Hospital of Central South University, Hunan, China
| | - Chao Mao
- Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Xiangya Hospital, Central South University, Hunan, China.,Key Laboratory of Carcinogenesis, Ministry of Health, Cancer Research Institute, Central South University, Hunan, China
| | - Yiqun Jiang
- Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Xiangya Hospital, Central South University, Hunan, China.,Key Laboratory of Carcinogenesis, Ministry of Health, Cancer Research Institute, Central South University, Hunan, China
| | - Ying Shi
- Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Xiangya Hospital, Central South University, Hunan, China.,Key Laboratory of Carcinogenesis, Ministry of Health, Cancer Research Institute, Central South University, Hunan, China
| | - Ling Chen
- Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Xiangya Hospital, Central South University, Hunan, China.,Key Laboratory of Carcinogenesis, Ministry of Health, Cancer Research Institute, Central South University, Hunan, China
| | - Shuang Liu
- Institutes of Medical Sciences, Xiangya Hospital, Central South University, Hunan, China
| | - Bin Wang
- Department of Thoracic Surgery, Second Xiangya Hospital of Central South University, Hunan, China
| | - Shu Pan
- Department of Thoracic Surgery, Second Xiangya Hospital of Central South University, Hunan, China
| | - Yongguang Tao
- Department of Thoracic Surgery, Second Xiangya Hospital of Central South University, Hunan, China.,Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Xiangya Hospital, Central South University, Hunan, China.,Key Laboratory of Carcinogenesis, Ministry of Health, Cancer Research Institute, Central South University, Hunan, China.,Institutes of Medical Sciences, Xiangya Hospital, Central South University, Hunan, China
| | - Hongcan Shi
- Department of Cardiothoracic Surgery, Clinical College of Yangzhou University, Jiangsu, China
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229
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Schneider BJ, Daly ME, Kennedy EB, Antonoff MB, Broderick S, Feldman J, Jolly S, Meyers B, Rocco G, Rusthoven C, Slotman BJ, Sterman DH, Stiles BM. Stereotactic Body Radiotherapy for Early-Stage Non-Small-Cell Lung Cancer: American Society of Clinical Oncology Endorsement of the American Society for Radiation Oncology Evidence-Based Guideline. J Clin Oncol 2018; 36:710-719. [PMID: 29106810 DOI: 10.1200/jco.2017.74.9671] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Purpose The American Society for Radiation Oncology (ASTRO) produced an evidence-based guideline on treatment with stereotactic body radiotherapy (SBRT) for patients with early-stage non-small-cell lung cancer. ASCO has a policy and set of procedures for endorsing and/or adapting clinical practice guidelines that have been developed by other professional organizations. Methods The ASTRO Evidence-Based Guideline for Stereotactic Body Radiotherapy for Early-Stage Non-Small-Cell Lung Cancer was reviewed for developmental rigor by methodologists. An ASCO Expert Panel updated the literature search and reviewed the guideline content and recommendations. Results The ASCO Expert Panel determined that the recommendations from the ASTRO guideline, published in 2017, are clear, thorough, and based on the most relevant scientific evidence. ASCO statements and minor modifications were added to enhance the applicability of the ASTRO guideline for the broader ASCO audience. Recommendations For standard operative risk patients with stage I NSCLC, SBRT is not recommended outside of a clinical trial. Lobectomy with systematic lymph node evaluation remains the recommended treatment, although a sublobar resection may be considered in select clinical scenarios. Recommendations are provided regarding the use of SBRT in high operative risk patients and for inoperative patients, including in challenging scenarios where tumors are: centrally located, > 5 cm in diameter, lacking tissue diagnosis, synchronous primary or multifocal, second primary after pneumonectomy, proximal to or involved with mediastinal structures, abutting the chest wall, or recurring after previous treatment. Qualifying statements are included to provide further guidance for implementation, and the importance of a discussion of treatment options among members of the multidisciplinary cancer care team is emphasized. Additional information is available at: www.asco.org/thoracic-cancer-guidelines and www.asco.org/guidelineswiki .
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Affiliation(s)
- Bryan J Schneider
- Bryan J. Schneider and Shruti Jolly, University of Michigan, Ann Arbor, MI; Megan E. Daly, University of California, Davis, CA; Erin B. Kennedy, American Society of Clinical Oncology, Alexandria, VA; Mara B. Antonoff, MD Anderson Cancer Center, Houston TX; Stephen Broderick, Johns Hopkins Medicine, Baltimore, MD; Jill Feldman, Lungevity Foundation, Chicago, IL; Bryan Meyers, Washington University, St Louis, MO; Gaetano Rocco, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy; Chad Rusthoven, University of Colorado Hospital, Aurora, CO; Ben J. Slotman, Vrije Universiteit Medical Center, Amsterdam, Netherlands; Daniel H. Sterman, New York University Langone Medical Center; and Brendon M. Stiles, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY
| | - Megan E Daly
- Bryan J. Schneider and Shruti Jolly, University of Michigan, Ann Arbor, MI; Megan E. Daly, University of California, Davis, CA; Erin B. Kennedy, American Society of Clinical Oncology, Alexandria, VA; Mara B. Antonoff, MD Anderson Cancer Center, Houston TX; Stephen Broderick, Johns Hopkins Medicine, Baltimore, MD; Jill Feldman, Lungevity Foundation, Chicago, IL; Bryan Meyers, Washington University, St Louis, MO; Gaetano Rocco, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy; Chad Rusthoven, University of Colorado Hospital, Aurora, CO; Ben J. Slotman, Vrije Universiteit Medical Center, Amsterdam, Netherlands; Daniel H. Sterman, New York University Langone Medical Center; and Brendon M. Stiles, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY
| | - Erin B Kennedy
- Bryan J. Schneider and Shruti Jolly, University of Michigan, Ann Arbor, MI; Megan E. Daly, University of California, Davis, CA; Erin B. Kennedy, American Society of Clinical Oncology, Alexandria, VA; Mara B. Antonoff, MD Anderson Cancer Center, Houston TX; Stephen Broderick, Johns Hopkins Medicine, Baltimore, MD; Jill Feldman, Lungevity Foundation, Chicago, IL; Bryan Meyers, Washington University, St Louis, MO; Gaetano Rocco, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy; Chad Rusthoven, University of Colorado Hospital, Aurora, CO; Ben J. Slotman, Vrije Universiteit Medical Center, Amsterdam, Netherlands; Daniel H. Sterman, New York University Langone Medical Center; and Brendon M. Stiles, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY
| | - Mara B Antonoff
- Bryan J. Schneider and Shruti Jolly, University of Michigan, Ann Arbor, MI; Megan E. Daly, University of California, Davis, CA; Erin B. Kennedy, American Society of Clinical Oncology, Alexandria, VA; Mara B. Antonoff, MD Anderson Cancer Center, Houston TX; Stephen Broderick, Johns Hopkins Medicine, Baltimore, MD; Jill Feldman, Lungevity Foundation, Chicago, IL; Bryan Meyers, Washington University, St Louis, MO; Gaetano Rocco, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy; Chad Rusthoven, University of Colorado Hospital, Aurora, CO; Ben J. Slotman, Vrije Universiteit Medical Center, Amsterdam, Netherlands; Daniel H. Sterman, New York University Langone Medical Center; and Brendon M. Stiles, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY
| | - Stephen Broderick
- Bryan J. Schneider and Shruti Jolly, University of Michigan, Ann Arbor, MI; Megan E. Daly, University of California, Davis, CA; Erin B. Kennedy, American Society of Clinical Oncology, Alexandria, VA; Mara B. Antonoff, MD Anderson Cancer Center, Houston TX; Stephen Broderick, Johns Hopkins Medicine, Baltimore, MD; Jill Feldman, Lungevity Foundation, Chicago, IL; Bryan Meyers, Washington University, St Louis, MO; Gaetano Rocco, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy; Chad Rusthoven, University of Colorado Hospital, Aurora, CO; Ben J. Slotman, Vrije Universiteit Medical Center, Amsterdam, Netherlands; Daniel H. Sterman, New York University Langone Medical Center; and Brendon M. Stiles, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY
| | - Jill Feldman
- Bryan J. Schneider and Shruti Jolly, University of Michigan, Ann Arbor, MI; Megan E. Daly, University of California, Davis, CA; Erin B. Kennedy, American Society of Clinical Oncology, Alexandria, VA; Mara B. Antonoff, MD Anderson Cancer Center, Houston TX; Stephen Broderick, Johns Hopkins Medicine, Baltimore, MD; Jill Feldman, Lungevity Foundation, Chicago, IL; Bryan Meyers, Washington University, St Louis, MO; Gaetano Rocco, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy; Chad Rusthoven, University of Colorado Hospital, Aurora, CO; Ben J. Slotman, Vrije Universiteit Medical Center, Amsterdam, Netherlands; Daniel H. Sterman, New York University Langone Medical Center; and Brendon M. Stiles, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY
| | - Shruti Jolly
- Bryan J. Schneider and Shruti Jolly, University of Michigan, Ann Arbor, MI; Megan E. Daly, University of California, Davis, CA; Erin B. Kennedy, American Society of Clinical Oncology, Alexandria, VA; Mara B. Antonoff, MD Anderson Cancer Center, Houston TX; Stephen Broderick, Johns Hopkins Medicine, Baltimore, MD; Jill Feldman, Lungevity Foundation, Chicago, IL; Bryan Meyers, Washington University, St Louis, MO; Gaetano Rocco, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy; Chad Rusthoven, University of Colorado Hospital, Aurora, CO; Ben J. Slotman, Vrije Universiteit Medical Center, Amsterdam, Netherlands; Daniel H. Sterman, New York University Langone Medical Center; and Brendon M. Stiles, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY
| | - Bryan Meyers
- Bryan J. Schneider and Shruti Jolly, University of Michigan, Ann Arbor, MI; Megan E. Daly, University of California, Davis, CA; Erin B. Kennedy, American Society of Clinical Oncology, Alexandria, VA; Mara B. Antonoff, MD Anderson Cancer Center, Houston TX; Stephen Broderick, Johns Hopkins Medicine, Baltimore, MD; Jill Feldman, Lungevity Foundation, Chicago, IL; Bryan Meyers, Washington University, St Louis, MO; Gaetano Rocco, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy; Chad Rusthoven, University of Colorado Hospital, Aurora, CO; Ben J. Slotman, Vrije Universiteit Medical Center, Amsterdam, Netherlands; Daniel H. Sterman, New York University Langone Medical Center; and Brendon M. Stiles, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY
| | - Gaetano Rocco
- Bryan J. Schneider and Shruti Jolly, University of Michigan, Ann Arbor, MI; Megan E. Daly, University of California, Davis, CA; Erin B. Kennedy, American Society of Clinical Oncology, Alexandria, VA; Mara B. Antonoff, MD Anderson Cancer Center, Houston TX; Stephen Broderick, Johns Hopkins Medicine, Baltimore, MD; Jill Feldman, Lungevity Foundation, Chicago, IL; Bryan Meyers, Washington University, St Louis, MO; Gaetano Rocco, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy; Chad Rusthoven, University of Colorado Hospital, Aurora, CO; Ben J. Slotman, Vrije Universiteit Medical Center, Amsterdam, Netherlands; Daniel H. Sterman, New York University Langone Medical Center; and Brendon M. Stiles, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY
| | - Chad Rusthoven
- Bryan J. Schneider and Shruti Jolly, University of Michigan, Ann Arbor, MI; Megan E. Daly, University of California, Davis, CA; Erin B. Kennedy, American Society of Clinical Oncology, Alexandria, VA; Mara B. Antonoff, MD Anderson Cancer Center, Houston TX; Stephen Broderick, Johns Hopkins Medicine, Baltimore, MD; Jill Feldman, Lungevity Foundation, Chicago, IL; Bryan Meyers, Washington University, St Louis, MO; Gaetano Rocco, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy; Chad Rusthoven, University of Colorado Hospital, Aurora, CO; Ben J. Slotman, Vrije Universiteit Medical Center, Amsterdam, Netherlands; Daniel H. Sterman, New York University Langone Medical Center; and Brendon M. Stiles, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY
| | - Ben J Slotman
- Bryan J. Schneider and Shruti Jolly, University of Michigan, Ann Arbor, MI; Megan E. Daly, University of California, Davis, CA; Erin B. Kennedy, American Society of Clinical Oncology, Alexandria, VA; Mara B. Antonoff, MD Anderson Cancer Center, Houston TX; Stephen Broderick, Johns Hopkins Medicine, Baltimore, MD; Jill Feldman, Lungevity Foundation, Chicago, IL; Bryan Meyers, Washington University, St Louis, MO; Gaetano Rocco, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy; Chad Rusthoven, University of Colorado Hospital, Aurora, CO; Ben J. Slotman, Vrije Universiteit Medical Center, Amsterdam, Netherlands; Daniel H. Sterman, New York University Langone Medical Center; and Brendon M. Stiles, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY
| | - Daniel H Sterman
- Bryan J. Schneider and Shruti Jolly, University of Michigan, Ann Arbor, MI; Megan E. Daly, University of California, Davis, CA; Erin B. Kennedy, American Society of Clinical Oncology, Alexandria, VA; Mara B. Antonoff, MD Anderson Cancer Center, Houston TX; Stephen Broderick, Johns Hopkins Medicine, Baltimore, MD; Jill Feldman, Lungevity Foundation, Chicago, IL; Bryan Meyers, Washington University, St Louis, MO; Gaetano Rocco, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy; Chad Rusthoven, University of Colorado Hospital, Aurora, CO; Ben J. Slotman, Vrije Universiteit Medical Center, Amsterdam, Netherlands; Daniel H. Sterman, New York University Langone Medical Center; and Brendon M. Stiles, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY
| | - Brendon M Stiles
- Bryan J. Schneider and Shruti Jolly, University of Michigan, Ann Arbor, MI; Megan E. Daly, University of California, Davis, CA; Erin B. Kennedy, American Society of Clinical Oncology, Alexandria, VA; Mara B. Antonoff, MD Anderson Cancer Center, Houston TX; Stephen Broderick, Johns Hopkins Medicine, Baltimore, MD; Jill Feldman, Lungevity Foundation, Chicago, IL; Bryan Meyers, Washington University, St Louis, MO; Gaetano Rocco, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy; Chad Rusthoven, University of Colorado Hospital, Aurora, CO; Ben J. Slotman, Vrije Universiteit Medical Center, Amsterdam, Netherlands; Daniel H. Sterman, New York University Langone Medical Center; and Brendon M. Stiles, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY
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Affiliation(s)
- Abbie Begnaud
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Oncology, and Transplant, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Robert A Kratzke
- Division of Hematology, Oncology, and Transplant, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
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231
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Morgensztern D, Samson PS, Waqar SN, Devarakonda S, Robinson CG, Govindan R, Puri V. Early Mortality in Patients Undergoing Adjuvant Chemotherapy for Non-Small Cell Lung Cancer. J Thorac Oncol 2018; 13:543-549. [PMID: 29410127 DOI: 10.1016/j.jtho.2018.01.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 12/01/2017] [Accepted: 01/05/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Although adjuvant chemotherapy improves survival in patients with completely resected NSCLC, it is also associated with potentially disabling or lethal adverse events. Because there is limited information on the early mortality among patients undergoing adjuvant chemotherapy, we used the National Cancer Database to calculate the percentage of deaths within the first 6 months of starting chemotherapy. METHODS The National Cancer Database was queried for patients age 18 or older in whom stage IB to IIIA NSCLC had been diagnosed between 2004 and 2012 and who had received multiagent adjuvant chemotherapy starting within 120 days from the surgical resection with negative surgical margins. Age groups were divided as follows: younger than 50, 51 to 60, 61 to 70, 71 to 80, and older than 80 years. RESULTS A total of 19,691 patients met the eligibility criteria, 19,398 of whom had a known 6-month mortality status. The median age was 65 years (range 19-89). The 1-, 2-, 3-, 4-, 5-, and 6-month cumulative mortality rates from initiation of chemotherapy were 0.7%, 1.3%, 1.9%, 2.6%, 3.2%, and 4.1% respectively. The 6-month mortality rates for each age group (≤ 50 years, 51-60, 61-70, 71-80, and >80) were 2.6%, 3.1%, 4.1%, 5.3%, and 7.6%, respectively (p < 0.001). Independent factors associated with increased 6-month mortality included age 71 to 80 versus younger than 50 (OR = 1.72, 95% confidence interval [CI]: 1.16-2.55, p = 0.007), age older than 80 versus younger than 50 (OR = 2.43, 95% CI: 1.40-4.20, p = 0.002), male sex (OR = 1.42; 95% CI: 1.21-1.67, p < 0.001), Charlson-Deyo comorbidity score of 2 versus 0 (OR = 1.52, 95% CI 1.22-1.89, p < 0.001), pneumonectomy (OR = 1.38, 95% CI: 1.11-1.73, p = 0.004), length of postopertive stay longer than 6 days after surgery (OR = 1.21, 95% CI: 1.03-1.41, p = 0.02), and readmission within 30 days from surgery (OR = 1.48, 95% CI: 1.15-1.90, p = 0.02). CONCLUSIONS Early mortality with the use of adjuvant chemotherapy after complete resection of NSCLC is a clinical concern. The risk is higher in patients older than 70 years, with higher comorbidity scores and a prolonged length of stay postoperatively.
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Affiliation(s)
- Daniel Morgensztern
- Division of Medical Oncology, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri.
| | - Pamela S Samson
- Department of Radiation Oncology, Washington University in St. Louis, St. Louis, Missouri
| | - Saiama N Waqar
- Division of Medical Oncology, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - Siddhartha Devarakonda
- Division of Medical Oncology, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - Clifford G Robinson
- Department of Radiation Oncology, Washington University in St. Louis, St. Louis, Missouri
| | - Ramaswamy Govindan
- Division of Medical Oncology, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - Varun Puri
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University in St. Louis, St. Louis, Missouri
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232
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Suzuki M, Mori T, Shiraishi K, Ikeda K, Masuda Y, Matsubara E, Shirakami C, Hinokuma H. What is the optimal adjuvant therapy for T3N0 lung cancer invading the chest wall? J Thorac Dis 2017; 9:4233-4235. [PMID: 29268480 DOI: 10.21037/jtd.2017.10.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Makoto Suzuki
- Department of Thoracic Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Takeshi Mori
- Department of Thoracic Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Kenji Shiraishi
- Department of Thoracic Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Koei Ikeda
- Department of Thoracic Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Yoshiko Masuda
- Department of Thoracic Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Eri Matsubara
- Department of Thoracic Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Chika Shirakami
- Department of Thoracic Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Hironori Hinokuma
- Department of Thoracic Surgery, Kumamoto University Hospital, Kumamoto, Japan
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233
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Li BT, Stephens D, Chaft JE, Rudin CM, Jones DR, Rusch VW, Rimner A, Isbell JM. Liquid biopsy for ctDNA to revolutionize the care of patients with early stage lung cancers. ANNALS OF TRANSLATIONAL MEDICINE 2017; 5:479. [PMID: 29285512 DOI: 10.21037/atm.2017.09.02] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The current standard of adjuvant therapies for patients with early stage non-small-cell lung cancers largely depends on the stage of disease. Liquid biopsy for circulating tumor DNA (ctDNA) has the potential to detect minimal residual disease, depict genomic evolution, guide precision medicine to individual patients and revolutionize the management of early stage lung cancers. In light of the seminal work published by Abbosh and colleagues, we discuss the potential paradigm changing clinical implications of ctDNA, the biological and technological challenges to consider, and the future of ctDNA driven therapeutic studies.
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Affiliation(s)
- Bob T Li
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY, USA
| | - Dennis Stephens
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY, USA
| | - Jamie E Chaft
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY, USA
| | - Charles M Rudin
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY, USA
| | - David R Jones
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY, USA
| | - Valerie W Rusch
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY, USA
| | - Andreas Rimner
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - James M Isbell
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY, USA
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234
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Zhong WZ, Wang Q, Mao WM, Xu ST, Wu L, Shen Y, Liu YY, Chen C, Cheng Y, Xu L, Wang J, Fei K, Li XF, Li J, Huang C, Liu ZD, Xu S, Chen KN, Xu SD, Liu LX, Yu P, Wang BH, Ma HT, Yan HH, Yang XN, Zhou Q, Wu YL. Gefitinib versus vinorelbine plus cisplatin as adjuvant treatment for stage II-IIIA (N1-N2) EGFR-mutant NSCLC (ADJUVANT/CTONG1104): a randomised, open-label, phase 3 study. Lancet Oncol 2017; 19:139-148. [PMID: 29174310 DOI: 10.1016/s1470-2045(17)30729-5] [Citation(s) in RCA: 371] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/03/2017] [Accepted: 09/12/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Cisplatin-based adjuvant chemotherapy is the standard of care for patients with resected stage II-IIIA non-small-cell lung cancer (NSCLC). RADIANT and SELECT trial data suggest patients with EGFR-mutant stage IB-IIIA resected NSCLC could benefit from adjuvant EGFR tyrosine kinase inhibitor treatment. We aimed to compare the efficacy of adjuvant gefitinib versus vinorelbine plus cisplatin in patients with completely resected EGFR-mutant stage II-IIIA (N1-N2) NSCLC. METHODS We did a randomised, open-label, phase 3 trial at 27 centres in China. We enrolled patients aged 18-75 years with completely resected (R0), stage II-IIIA (N1-N2), EGFR-mutant (exon 19 deletion or exon 21 Leu858Arg) NSCLC. Patients were stratified by N stage and EGFR mutation status and randomised (1:1) by Pocock and Simon minimisation with a random element to either gefitinib (250 mg once daily) for 24 months or intravenous vinorelbine (25 mg/m2 on days 1 and 8) plus intravenous cisplatin (75 mg/m2 on day 1) every 3 weeks for four cycles. The primary endpoint was disease-free survival in the intention-to-treat population, which comprised all randomised patients; the safety population included all randomised patients who received at least one dose of study medication. Enrolment to the study is closed but survival follow-up is ongoing. The study is registered with ClinicalTrials.gov, number NCT01405079. FINDINGS Between Sept 19, 2011, and April 24, 2014, 483 patients were screened and 222 patients were randomised, 111 to gefitinib and 111 to vinorelbine plus cisplatin. Median follow-up was 36·5 months (IQR 23·8-44·8). Median disease-free survival was significantly longer with gefitinib (28·7 months [95% CI 24·9-32·5]) than with vinorelbine plus cisplatin (18·0 months [13·6-22·3]; hazard ratio [HR] 0·60, 95% CI 0·42-0·87; p=0·0054). In the safety population, the most commonly reported grade 3 or worse adverse events in the gefitinib group (n=106) were raised alanine aminotransferase and asparate aminotransferase (two [2%] patients with each event vs none with vinorelbine plus cisplatin). In the vinorelbine plus cisplatin group (n=87), the most frequently reported grade 3 or worse adverse events were neutropenia (30 [34%] patients vs none with gefitinib), leucopenia (14 [16%] vs none), and vomiting (eight [9%] vs none). Serious adverse events were reported for seven (7%) patients who received gefitinib and 20 (23%) patients who received vinorelbine plus cisplatin. No interstitial lung disease was noted with gefitinib. No deaths were treatment related. INTERPRETATION Adjuvant gefitinib led to significantly longer disease-free survival compared with that for vinorelbine plus cisplatin in patients with completely resected stage II-IIIA (N1-N2) EGFR-mutant NSCLC. Based on the superior disease-free survival, reduced toxicity, and improved quality of life, adjuvant gefitinib could be a potential treatment option compared with adjuvant chemotherapy in these patients. However, the duration of benefit with gefitinib after 24 months might be limited and overall survival data are not yet mature. FUNDING Guangdong Provincial Key Laboratory of Lung Cancer Translational Medicine; National Health and Family Planning Commission of People's Republic of China; Guangzhou Science and Technology Bureau; AstraZeneca China.
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Affiliation(s)
- Wen-Zhao Zhong
- Guangdong Lung Cancer Institute, Guangdong General Hospital, and Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Qun Wang
- Fudan University Affiliated Zhongshan Hospital, Shanghai, China
| | | | - Song-Tao Xu
- Fudan University Affiliated Zhongshan Hospital, Shanghai, China
| | - Lin Wu
- Hunan Cancer Hospital, Changsha, China
| | - Yi Shen
- The Affiliated Hospital of Medical College Qingdao University, Qingdao, China
| | | | - Chun Chen
- Fujian Medical University Union Hospital, Fuzhou, China
| | - Ying Cheng
- Jilin Provincial Tumor Hospital, Changchun, China
| | - Lin Xu
- Jiangsu Cancer Hospital, Nanjing, China
| | - Jun Wang
- The People's Hospital of Peking University, Beijing, China
| | - Ke Fei
- Shanghai Pulmonary Hospital, Tongji University, Shanghai, China
| | | | - Jian Li
- Peking University First Hospital, Beijing, China
| | | | | | - Shun Xu
- The First Hospital of China Medical University, Shenyang, China
| | | | - Shi-Dong Xu
- Harbin Medical University Cancer Hospital, Harbin, China
| | - Lun-Xu Liu
- West China Hospital of Sichuan University, Chengdu, China
| | - Ping Yu
- Sichuan Cancer Hospital, Chengdu, China
| | - Bu-Hai Wang
- The Northern Jiangsu People's Hospital, Yangzhou, China
| | - Hai-Tao Ma
- The First Affiliated Hospital of Suzhou University, Suzhou, China
| | - Hong-Hong Yan
- Guangdong Lung Cancer Institute, Guangdong General Hospital, and Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xue-Ning Yang
- Guangdong Lung Cancer Institute, Guangdong General Hospital, and Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Qing Zhou
- Guangdong Lung Cancer Institute, Guangdong General Hospital, and Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yi-Long Wu
- Guangdong Lung Cancer Institute, Guangdong General Hospital, and Guangdong Academy of Medical Sciences, Guangzhou, China.
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Jazieh AR, Al Kattan K, Bamousa A, Al Olayan A, Abdelwarith A, Ansari J, Al Twairqi A, Al Fayea T, Al Saleh K, Al Husaini H, Abdelhafiez N, Mahrous M, Faris M, Al Omair A, Hebshi A, Al Shehri S, Al Dayel F, Bamefleh H, Khalbuss W, Al Ghanem S, Loutfi S, Khankan A, Al Rujaib M, Al Ghamdi M, Ibrahim N, Swied A, Al Kayait M, Datario M. Saudi lung cancer management guidelines 2017. Ann Thorac Med 2017; 12:221-246. [PMID: 29118855 PMCID: PMC5656941 DOI: 10.4103/atm.atm_92_17] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 06/09/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Lung cancer management is getting more complex due to the rapid advances in all aspects of diagnostic and therapeutic options. Developing guidelines is critical to help practitioners provide standard of care. METHODS The Saudi Lung Cancer Guidelines Committee (SLCGC) multidisciplinary members from different specialties and from various regions and healthcare sectors of the country reviewed and updated all lung cancer guidelines with appropriate labeling of level of evidence. Supporting documents to help healthcare professionals were developed. RESULTS Detailed lung cancer management guidelines were finalized with appropriate resources for systemic therapy and short reviews highlighting important issues. Stage based disease management recommendation were included. A summary explanation for complex topics were included in addition to tables of approved systemic therapy. CONCLUSION A multidisciplinary lung cancer guidelines was developed and will be disseminated across the country.
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Affiliation(s)
| | - Abdul Rahman Jazieh
- Department of Medical Oncology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Khaled Al Kattan
- Department of Surgery, Al Faisal University, Riyadh, Saudi Arabia
| | - Ahmed Bamousa
- Department of Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ashwaq Al Olayan
- Department of Medical Oncology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Ahmed Abdelwarith
- Department of Medical Oncology, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Jawaher Ansari
- Department of Medical Oncology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abdullah Al Twairqi
- Department of Medical Oncology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Turki Al Fayea
- Department of Medical Oncology, Princess Noorah Oncology Center, Riyadh, Saudi Arabia
| | - Khalid Al Saleh
- Department of Medical Oncology, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Hamed Al Husaini
- Department of Medical Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Nafisa Abdelhafiez
- Department of Medical Oncology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Mervat Mahrous
- Department of Medical Oncology, King Fahad Hospital, Madinah, Saudi Arabia
| | - Medhat Faris
- Department of Medical Oncology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Ameen Al Omair
- Department of Radiation Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Adnan Hebshi
- Department of Radiation Oncology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Salem Al Shehri
- Department of Radiation Oncology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Foad Al Dayel
- Department of Pathology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Hanaa Bamefleh
- Department of Pathology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Walid Khalbuss
- Department of Pathology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Sarah Al Ghanem
- Department of Radiology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Shukri Loutfi
- Department of Radiology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Azzam Khankan
- Department of Interventional Radiology, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Meshael Al Rujaib
- Department of Radiology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Majed Al Ghamdi
- Department of Pulmonary, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Nagwa Ibrahim
- Department of Pharmacy, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abdulmonem Swied
- Department of Gastroenterology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Mohammad Al Kayait
- Department of Oncology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Marie Datario
- Department of Oncology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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