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Zhao D, Li Z, Hou X, Yang L, Li Z, Yan L, Li H, Liu H, Liu X, Song F, Li G, Zhang Y, Hou X. Anlotinib in Chinese patients aged ≥70 years with advanced non-squamous non-small cell lung cancer without prior chemotherapy: a multicenter, single-arm pilot trial. Front Oncol 2024; 14:1335009. [PMID: 38651156 PMCID: PMC11033435 DOI: 10.3389/fonc.2024.1335009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/25/2024] [Indexed: 04/25/2024] Open
Abstract
Background Based on pharmacoeconomics, drug availability and actual treatment, optimal treatment regimens for Chinese non-small-cell lung carcinoma (NSCLC) patients over 70 years old are needed. Methods This multicenter, single-arm pilot trial enrolled patients with advanced non-squamous NSCLC who refused systemic chemotherapy. Eligible patients received anlotinib (12 mg/day, d1-14, Q3W) until disease progression, intolerant toxicities, or withdrawal from the study. The primary endpoint was progression-free survival (PFS). Results Forty-nine patients were screened between January 2019 and September 2021, of whom 40 patients were eligible. The median age was 76 years. With a median follow-up period of 16.20 (95% CI: 8.77, 25.10) months, the median PFS was 5.45 months (95% CI: 3.52-9.23) and the median overall survival was 10.32 months (95% CI: 6.44-12.78). Three patients achieved a partial response and 34 had stable disease, with an objective response rate of 7.5% and a disease control rate of 92.5%. Thirty-three (82.5%; 33/40) patients reported treatment-related adverse events (TRAEs) of any grade, and the incidence rate of grade ≥3 TRAEs was 35% (14/40). The most common grade ≥3 TRAEs were hypertension (4/40; 10.0%), hand-foot syndrome (3/40; 7.5%), and proteinuria (2/40; 5.0%). Conclusion Anlotinib treatment was feasible and safe in Chinese elderly patients with advanced non-squamous NSCLC who did not receive any systemic chemotherapy.
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Affiliation(s)
- Da Zhao
- Department of Medical Oncology, The First Hospital of Lanzhou University, Lanzhou, China
| | - Zhengguo Li
- Department of Respiratory and Critical Care Medicine, Wuwei Cancer Hospital, Wuwei, China
| | - Xinli Hou
- Department of Medical Oncology, Hanzhong Central Hospital, Hanzhong, China
| | - Lei Yang
- Department of Respiratory Oncology, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Zeng Li
- 3201 Hospital Affiliated to Xi’an Jiaotong University School of Medicine, Hanzhong, China
| | - Li Yan
- Department of Oncology, Ankang Hospital of Traditional Chinese Medicine, Ankang, China
| | - Hongling Li
- Department of Oncology, Gansu Provincial People’s Hospital, Lanzhou, China
| | - Hua Liu
- Department of Respiratory, Gansu Provincial People’s Hospital, Lanzhou, China
| | - Xiaoping Liu
- Department of Respiratory, The Second People’s Hospital of Gansu Province, Lanzhou, China
| | - Feixue Song
- Department of Medical Oncology, The Second Hospital of Lanzhou University, Lanzhou, China
| | - Guixiang Li
- Cancer Center, The Second Hospital of Lanzhou University, Lanzhou, China
| | - Yu Zhang
- Department of Thoracic Surgery, The First Hospital of Lanzhou University, Lanzhou, China
| | - Xiaoming Hou
- Department of Medical Oncology, The First Hospital of Lanzhou University, Lanzhou, China
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Ozmen HK, Sezen O, Aktan M, Erdemci B, Alan BS, Ertekin MV, Ezirmik S. Comparision of Radiochemotherapy Applications that Committing with Two Different Chemotherapies Route in Locally Advanced Lung Cancer. Eurasian J Med 2020; 52:73-76. [PMID: 32158319 DOI: 10.5152/eurasianjmed.2019.19136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective This study investigated pre- and post-treatment tumor and lymph node dimension response rates and differences between side-effect profiles in patients with locally advanced inoperable nonsmall-cell lung cancer (NSCLC) receiving radiotherapy (RT) and concurrent chemotherapy (CT). Materials and Methods A total of 30 inoperable patients who had not previously received RT and having a mean age of 58.73±8.65 years with sufficient hematological reserves and normal hepatic and renal functions were included in the study. Those with pleural effusion, supraventricular lymph node metastasis, and N3 lymph node involvement were excluded. Group I (n=15) received a 21-day 75 mg/m2 cisplatin (D1) and 15 mg/m2 vinorelbine (D1, D8), whereas Group II (n=15) received 45 mg/m2 paclitaxel and AUC2 carboplatin weekly. RT was administered using a linear accelerator device with the 3D conformal RT technique at 6-18 MV energy with a 1.8-2 Gy fraction for 6-7 weeks. Results Patients were randomized into Group I receiving RT and concurrent cisplatin-vinorelbine and Group II receiving weekly paclitaxel-carboplatin CT. Pre- and post-treatment tumor and lymph node dimensions significantly differed in both groups (p<0.001 and p<0.01, respectively). No significant change was observed in post-RT tumor and lymph node dimensions in terms of applied CT regimens (p>0.05). Conclusion The significant response achieved with concurrent RT and CT in groups I and II in the local advanced stage of NSCLC is important for local tumor control. Responses to treatment in the group of two arms did not differ.
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Affiliation(s)
- Hilal Kiziltunc Ozmen
- Department of Radiation Oncology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Orhan Sezen
- Department of Radiation Oncology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Meryem Aktan
- Department of Radiation Oncology, Necmettin Erbakan University School of Medicine, Konya, Turkey
| | - Burak Erdemci
- Department of Radiation Oncology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Burcu Sağlam Alan
- Department of Radiation Oncology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Mustafa Vecdi Ertekin
- Department of Radiation Oncology, Nisantasi University School of Medicine, Istanbul, Turkey
| | - Sinan Ezirmik
- Department of Radiation Oncology, Nisantasi University School of Medicine, Istanbul, Turkey
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Iyikesici MS. Feasibility study of metabolically supported chemotherapy with weekly carboplatin/paclitaxel combined with ketogenic diet, hyperthermia and hyperbaric oxygen therapy in metastatic non-small cell lung cancer. Int J Hyperthermia 2019; 36:446-455. [DOI: 10.1080/02656736.2019.1589584] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Mehmet Salih Iyikesici
- Department of Medical Oncology, School of Medicine, Altinbas University, Istanbul, Turkey
- ChemoThermia Oncology Center, Istanbul, Turkey
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Pérez-Ramírez C, Cañadas-Garre M, Alnatsha A, Villar E, Valdivia-Bautista J, Faus-Dáder MJ, Calleja-Hernández MÁ. Pharmacogenetics of platinum-based chemotherapy: impact of DNA repair and folate metabolism gene polymorphisms on prognosis of non-small cell lung cancer patients. THE PHARMACOGENOMICS JOURNAL 2018; 19:164-177. [PMID: 29662106 DOI: 10.1038/s41397-018-0014-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 07/03/2017] [Accepted: 11/06/2017] [Indexed: 02/08/2023]
Abstract
Chemotherapy based on platinum compounds is the standard treatment for NSCLC patients with EGFR wild type, and is also used as second line in mutated EGFR patients. Nevertheless, this therapy presents poor clinical outcomes. ERCC1, ERCC2, XRCC1, MDM2, MTHFR, MTR, and SLC19A1 gene polymorphisms may contribute to individual variation in response and survival to platinum-based chemotherapy. The aim of this study was to investigate the influence of these polymorphisms on response and survival of NSCLC patients treated with platinum-based chemotherapy. A retrospective-prospective cohorts study was conducted, including 141 NSCLC patients. Polymorphisms were analyzed by PCR real-time with Taqman® probes. Patients with ERCC1 rs3212986-GG (p = 0.0268; OR = 2.50; CI95% = 1.12-5.69) and XRCC1 rs25487-GG (p = 0.0161; OR = 2.99; CI95% = 1.26-7.62) genotype showed significantly better ORR. Cox survival analysis revealed that patients carrying the MDM2 rs1690924-GG genotype (p = 0.0345; HR = 1.99; CI95% = 1.05-3.80) presented higher risk of death. Furthermore, carriers of MTR rs1805087-A alleles (p = 0.0060; HR = 8.91; CI95% = 1.87-42.42) and SLC19A1 rs1051266-AA genotype (p = 0.0130; HR = 1.74; CI95% = 1.12-2.68) showed greater risk of progression. No influence of ERCC1 rs11615, ERCC2 rs13181, ERCC2 rs1799793, XRCC1 rs1799782, MDM2 rs1470383, MTHFR rs1801131, and MTHFR rs1801133 on platinum-based chemotherapy clinical outcomes was found. In conclusion, our results suggest that ERCC1 rs3212986, XRCC1 rs25487, MDM2 rs1690924, MTR rs1805087, and SLC19A1 rs1051266 gene polymorphisms may significantly act as predictive factors in NSCLC patients treated with platinum-based chemotherapy.
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Affiliation(s)
- Cristina Pérez-Ramírez
- Pharmacogenetics Unit, UGC Provincial de Farmacia de Granada, Instituto de Investigación Biosanitaria de Granada, Complejo Hospitalario Universitario de Granada, Avda. Fuerzas Armadas, 2, Granada, Spain.,Department of Biochemistry, Faculty of Pharmacy, University of Granada, Campus Universitario de Cartuja, s/n, 18071, Granada, Spain
| | - Marisa Cañadas-Garre
- Centre for Public Health, Nephrology Research Group, Queen's University Belfast, c/o Regional Genetics Centre, Level A Tower Block Belfast City Hospital Lisburn Road, Belfast, BT9 7AB, UK.
| | - Ahmed Alnatsha
- Department of Molecular Medicine, Faculty of Medicine, University of Tübingen, Geissweg 5, 72076, Tübingen, Germany
| | - Eduardo Villar
- Pathology Service, UGC Anatomía Patológica, Instituto de Investigación Biosanitaria de Granada Complejo Hospitalario Universitario de Granada, Avda. Fuerzas Armadas, 2, 18014, Granada, Spain
| | - Javier Valdivia-Bautista
- Medical Oncology Service, UGC Oncología Médica Instituto de Investigación Biosanitaria de Granada, Complejo Hospitalario Universitario de Granada, Avda. Fuerzas Armadas, 2, 18014, Granada, Spain
| | - María José Faus-Dáder
- Department of Biochemistry, Faculty of Pharmacy, University of Granada, Campus Universitario de Cartuja, s/n, 18071, Granada, Spain
| | - Miguel Ángel Calleja-Hernández
- Pharmacogenetics Unit, UGC Provincial de Farmacia de Granada, Instituto de Investigación Biosanitaria de Granada, Complejo Hospitalario Universitario de Granada, Avda. Fuerzas Armadas, 2, Granada, Spain.,Department of Pharmacology, Faculty of Pharmacy, University of Granada, Campus Universitario de Cartuja, s/n, 18071, Granada, Spain
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Pérez-Ramírez C, Cañadas-Garre M, Alnatsha A, Molina MÁ, Robles AI, Villar E, Delgado JR, Faus-Dáder MJ, Calleja-Hernández MÁ. Interleukins as new prognostic genetic biomarkers in non-small cell lung cancer. Surg Oncol 2017; 26:278-285. [PMID: 28807247 DOI: 10.1016/j.suronc.2017.05.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 05/12/2017] [Accepted: 05/19/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Surgery is the standard treatment for early-stage NSCLC, and platinum-based chemotherapy remains as the treatment of choice for advanced-stage NSCLC patients with naïve EGFR status. However, overall 5-years relative survival rates are low. Interleukins (ILs) are crucial for processes associated with tumor development. In NSCLC, IL1B, IL6, IL12A, IL13 and IL16 gene polymorphisms may contribute to individual variation in terms of patient survival. The purpose of this study was to evaluate the association between IL gene polymorphisms and survival in NSCLC patients. METHODS A prospective cohorts study was performed, including 170 NSCLC patients (114 Stage IIIB-IV, 56 Stage I-IIIA). IL1B (C > T; rs1143634), IL1B (C > T; rs12621220), IL1B (C > G; rs1143623), IL1B (A > G; rs16944), IL1B (C > T; rs1143627), IL6 (C > G; rs1800795), IL12A (C > T; rs662959), IL13 (A > C; rs1881457) and IL16 (G > T; rs7170924) gene polymorphisms were analyzed by PCR Real-Time. RESULTS Patients with IL16 rs7170924-GG genotype were in higher risk of death (p = 0.0139; HR = 1.82; CI95% = 1.13-2.94) Furthermore, carriers of the TT genotype for IL12A rs662959 presented higher risk of progression in the non-resected NSCLC patient subgroup (p = 0.0412; HR = 4.49; CI95% = 1.06-18.99). The rest of polymorphisms showed no effect of on outcomes. CONCLUSIONS Our results suggest that IL16 rs7170924-GG and IL12A rs662959-TT genotypes predict higher risk of death and progression, respectively, in NSCLC patients. No influence of IL1B rs12621220, IL1B rs1143623, IL1B rs16944, IL1B rs1143627, IL6 rs1800795, IL13 rs1881457 on NSCLC clinical outcomes was found in our patients.
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Affiliation(s)
- Cristina Pérez-Ramírez
- Pharmacogenetics Unit, UGC Provincial de Farmacia de Granada, Instituto de Investigación Biosanitaria de Granada, Complejo Hospitalario Universitario de Granada, Avda. Fuerzas Armadas, 2, Spain; Department of Biochemistry, Faculty of Pharmacy, University of Granada, Campus Universitario de Cartuja, s/n, 18071 Granada, Spain.
| | - Marisa Cañadas-Garre
- Centre for Public Health, Queen's University of Belfast c/o Regional Genetics Centre, Level A, Tower Block, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AB, United Kingdom.
| | - Ahmed Alnatsha
- Pharmacogenetics Unit, UGC Provincial de Farmacia de Granada, Instituto de Investigación Biosanitaria de Granada, Complejo Hospitalario Universitario de Granada, Avda. Fuerzas Armadas, 2, Spain; Department of Molecular Medicine, Faculty of Medicine, University of Tübingen, Geissweg 5, 72076 Tübingen, Germany.
| | - Miguel Ángel Molina
- Pangaea Biotech, S.L., Hospital Universitario Quirón Dexeus, C/ Sabino Arana, 5-19, 08028 Barcelona, Spain.
| | - Ana I Robles
- National Cancer Institute, 37 Convent Dr, 37/3060D, Bethesda, MD, United States.
| | - Eduardo Villar
- Pathology Service, UGC Anatomía Patológica, Instituto de Investigación Biosanitaria de Granada, Complejo Hospitalario Universitario de Granada, Avda. Fuerzas Armadas, 2, 18014 Granada, Spain.
| | - Juan Ramón Delgado
- Medical Oncology Service, UGC Oncología Médica, Instituto de Investigación Biosanitaria de Granada, Complejo Hospitalario Universitario de Granada, Avda. Fuerzas Armadas, 2, 18014 Granada, Spain.
| | - María José Faus-Dáder
- Department of Biochemistry, Faculty of Pharmacy, University of Granada, Campus Universitario de Cartuja, s/n, 18071 Granada, Spain.
| | - Miguel Ángel Calleja-Hernández
- Department of Pharmacology, Faculty of Pharmacy, University of Granada, Campus Universitario de Cartuja, s/n, 18071 Granada, Spain.
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Tong S, Fan K, Jiang K, Zhai W, Fang B, Wang SH, Wang JJ. Increased risk of severe infections in non-small-cell lung cancer patients treated with pemetrexed: a meta-analysis of randomized controlled trials. Curr Med Res Opin 2017; 33:31-37. [PMID: 27590399 DOI: 10.1080/03007995.2016.1232705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS Infections related to pemetrexed have been reported in clinical trials. It is not yet clear whether this drug increases infection risk or not. This meta-analysis assessed the overall incidence and risk of severe infections (≥ grade 3) associated with the use of pemetrexed in non-small-cell lung cancer patients. METHODS The databases of PubMed, Embase, and the Cochrane Library were searched for relevant studies published up to December 2015. Eligible studies included randomized controlled trials (RCTs) of pemetrexed for non-small-cell lung cancer patients that reported grade 3-5 infection and febrile neutropenia. Summary incidence rates, relative risks (RRs) and 95% confidence intervals (CIs) were calculated by using either random-effects or fixed-effects models, according to the heterogeneity of the included studies. RESULTS Seven randomized controlled trials were included, comprising 1848 patients. The incidence of severe infection and febrile neutropenia due to pemetrexed was 5.7% (95% CI: 3.2-8.3%) and 1.3% (95% CI: 0.7-2.0%), respectively. The use of pemetrexed was associated with an increased risk of severe infection (RR 1.61, 95% CI: 1.07-2.44, P = .02) and febrile neutropenia (RR 4.28, 95% CI: 1.08-17.01, P = .04). CONCLUSION The use of pemetrexed was associated with an increased risk of developing severe infections and febrile neutropenia in non-small-cell lung cancer patients. Frequent clinical monitoring and management of infections should be emphasized during pemetrexed treatment. More studies are needed to reveal the mechanism of the increased risk of severe infections.
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Affiliation(s)
- Song Tong
- a Department of Thoracic Surgery , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Kai Fan
- a Department of Thoracic Surgery , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Ke Jiang
- a Department of Thoracic Surgery , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Wei Zhai
- a Department of Thoracic Surgery , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Bin Fang
- b Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Si-Hua Wang
- a Department of Thoracic Surgery , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Jian-Jun Wang
- a Department of Thoracic Surgery , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
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MiR-200b regulates autophagy associated with chemoresistance in human lung adenocarcinoma. Oncotarget 2016; 6:32805-20. [PMID: 26416454 PMCID: PMC4741731 DOI: 10.18632/oncotarget.5352] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Accepted: 09/10/2015] [Indexed: 01/07/2023] Open
Abstract
Chemoresistance remains a major clinical problem in combating human lung adenocarcinoma (LAD), and abnormal autophagy is closely associated with this phenomenon. In the present study, an inverse correlation between miR-200b and autophagy-associated gene 12 (ATG12) expressions was observed in docetaxel-resistant (SPC-A1/DTX and H1299/DTX) and sensitive (SPC-A1 and H1299) LAD cells as well as in tissue samples. Further study showed that miR-200b directly targeted ATG12 in LAD. Moreover, miR-200b-dependent ATG12 downregulation inhibited autophagy and enhanced the chemosensitivity of SPC-A1/DTX and H1299/DTX cells both in vivo and in vitro. LAD chemoresistance is therefore closely related to downregulation of miR-200b and the corresponding upregulation of ATG12. These results provide new evidence for the mechanisms governing the microRNA (miRNA)-ATG12 network and their possible contribution to autophagy modulation and LAD chemoresistance.
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