1
|
Brodowicz T, Ciuleanu T, Crawford J, Filipits M, Fischer JR, Georgoulias V, Gridelli C, Hirsch FR, Jassem J, Kosmidis P, Krzakowski M, Manegold C, Pujol JL, Stahel R, Thatcher N, Vansteenkiste J, Minichsdorfer C, Zöchbauer-Müller S, Pirker R, Zielinski CC. Third CECOG consensus on the systemic treatment of non-small-cell lung cancer. Ann Oncol 2012; 23:1223-1229. [PMID: 21940784 DOI: 10.1093/annonc/mdr381] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The current third consensus on the systemic treatment of non-small-cell lung cancer (NSCLC) builds upon and updates similar publications on the subject by the Central European Cooperative Oncology Group (CECOG), which has published such consensus statements in the years 2002 and 2005 (Zielinski CC, Beinert T, Crawford J et al. Consensus on medical treatment of non-small-cell lung cancer--update 2004. Lung Cancer 2005; 50: 129-137). The principle of all CECOG consensus is such that evidence-based recommendations for state-of-the-art treatment are given upon which all participants and authors of the manuscript have to agree (Beslija S, Bonneterre J, Burstein HJ et al. Third consensus on medical treatment of metastatic breast cancer. Ann Oncol 2009; 20 (11): 1771-1785). This is of particular importance in diseases in which treatment options depend on very particular clinical and biologic variables (Zielinski CC, Beinert T, Crawford J et al. Consensus on medical treatment of non-small-cell lung cancer--update 2004. Lung Cancer 2005; 50: 129-137; Beslija S, Bonneterre J, Burstein HJ et al. Third consensus on medical treatment of metastatic breast cancer. Ann Oncol 2009; 20 (11): 1771-1785). Since the publication of the last CECOG consensus on the medical treatment of NSCLC, a series of diagnostic tools for the characterization of biomarkers for personalized therapy for NSCLC as well as therapeutic options including adjuvant treatment, targeted therapy, and maintenance treatment have emerged and strongly influenced the field. Thus, the present third consensus was generated that not only readdresses previous disease-related issues but also expands toward recent developments in the management of NSCLC. It is the aim of the present consensus to summarize minimal quality-oriented requirements for individual patients with NSCLC in its various stages based upon levels of evidence in the light of a rapidly expanding array of individual therapeutic options.
Collapse
Affiliation(s)
- T Brodowicz
- Clinical Division of Oncology, Comprehensive Cancer Center, Medical University Vienna-General Hospital, Vienna, Austria; Central European Cooperative Oncology Group
| | - T Ciuleanu
- Medical Oncology Department, Institute of Oncology, Cluj-Napoca, Romania
| | - J Crawford
- Department of Medicine, Duke Medical Center, Durham, USA
| | - M Filipits
- Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna-General Hospital, Vienna, Austria
| | - J R Fischer
- Department of Medicine II, Onkology, Klinik Löwenstein, Löwenstein, Germany
| | - V Georgoulias
- Department of Medical Oncology, University General Hospital of Heraklion, Heraklion, Crete, Greece
| | - C Gridelli
- Division of Medical Oncology, S.G. Moscati Hospital, Contrada Amoretta, Italy
| | - F R Hirsch
- Department of Pathology, University of Colorado, Aurora, USA
| | - J Jassem
- Central European Cooperative Oncology Group; Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
| | - P Kosmidis
- Department of Medical Oncology, Hygeia Hospital, Athens, Greece
| | - M Krzakowski
- Central European Cooperative Oncology Group; Department of Lung and Thoracic Tumours, Maria Sklodowska Curie Memorial Cancer Center, Warsaw, Poland
| | - Ch Manegold
- Department of Surgery, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - J L Pujol
- Department of Oncology Lung, Hopital Arnaud de Villeneuve, Montpellier, France
| | - R Stahel
- Laboratory for Molecular Oncology, Department of Thoracic Oncology, Clinic and Policlinic for Oncology, University Hospital Zurich, Zurich, Switzerland
| | - N Thatcher
- Department of Medical Oncology, Christie Hospital NHS Trust, Manchester, UK
| | - J Vansteenkiste
- Respiratory Oncology Unit (Pulmonology), University Hospital Gasthuisberg, Leuven, Belgium
| | - C Minichsdorfer
- Clinical Division of Oncology, Comprehensive Cancer Center, Medical University Vienna-General Hospital, Vienna, Austria
| | - S Zöchbauer-Müller
- Clinical Division of Oncology, Comprehensive Cancer Center, Medical University Vienna-General Hospital, Vienna, Austria
| | - R Pirker
- Clinical Division of Oncology, Comprehensive Cancer Center, Medical University Vienna-General Hospital, Vienna, Austria
| | - C C Zielinski
- Clinical Division of Oncology, Comprehensive Cancer Center, Medical University Vienna-General Hospital, Vienna, Austria; Central European Cooperative Oncology Group.
| |
Collapse
|
2
|
Kowalski DM, Krzakowski M, Jaśkiewicz P, Olszewski W, Janowicz-Żebrowska A, Wojas-Krawczyk K, Krawczyk P. Prognostic value of synaptophysin and chromogranin a expression in patients receiving palliative chemotherapy for advanced non-small-cell lung cancer. ACTA ACUST UNITED AC 2012; 85:289-96. [PMID: 22472871 DOI: 10.1159/000337090] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Accepted: 01/31/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Chemotherapy is the principal treatment method for patients with advanced non-small-cell lung cancer (NSCLC). Treatment with platinum-based and novel chemotherapeutic regimens, compared to monotherapy, slightly increases the response rates to 20-40%. The predictive and prognostic values of molecular factors are highly variable; however, data on clinical-demographic factors are still burdened by significant limitations. OBJECTIVES The aim of this study was to assess the prognostic value of synaptophysin and chromogranin A protein expression in patients receiving palliative chemotherapy for advanced NSCLC. METHODS The study population consisted of 23 women and 116 men. The median age was 57.3 years. Expression of synaptophysin and chromogranin was assessed using a two-step model of immunohistochemical staining. Level 0 represented lack of activity, while level 1 represented its expression. RESULTS Expression of synaptophysin and chromogranin A was observed in 12 (8.6%) and 5 (3.6%) patients, respectively. The risk of death was significantly lower in patients with expression of synaptophysin (p = 0.008) and chromogranin A (p = 0.014). The 12- and 24-month survival rate of patients with synaptophysin expression was 64% (95% CI 0.35-0.93), while for patients without expression it was 46% (95% CI 0.36-0.56) and 16% (95% CI 0.07-0.25), respectively. The 12- and 24-month survival rate of patients with chromogranin expression was 80% (95% CI 0.44-1.00), while for chromogranin A-negative patients it was 47% (95% CI 0.37-0.57) and 19% (95% CI 0.10-0.28), respectively. We did not observe associations between expression of synaptophysin and chromogranin A and the other typical prognostic factors. CONCLUSIONS Expression of synaptophysin and chromogranin A was associated with a longer median overall survival and might have prognostic value. These results should be confirmed in a prospective study.
Collapse
Affiliation(s)
- Dariusz M Kowalski
- Department of Lung Cancer and Chest Tumors, Maria Skłodowska-Curie Memorial Cancer Center and Institute, Warsaw, Poland
| | | | | | | | | | | | | |
Collapse
|