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Uchiyama M, Miyazaki M, Hayashi T, Shimokawa M, Nakano T, Kakimoto H, Takaki S, Fukue H, Inoue T, Inoue R, Mashima K, Kawata S, Sumi Y, Igarashi Y, Kamimura H, Imakyure O, Matsuo K. Assessing the ability of the Cancer and Aging Research Group tool to predict chemotherapy toxicity in older Japanese patients: A prospective observational study. J Geriatr Oncol 2024; 15:101814. [PMID: 38851083 DOI: 10.1016/j.jgo.2024.101814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/22/2024] [Accepted: 05/30/2024] [Indexed: 06/10/2024]
Abstract
INTRODUCTION The Cancer and Aging Research Group (CARG) prediction tool was designed in the United States to predict grade ≥ 3 chemotherapy-related adverse events (CRAE) in older patients. However, its usefulness among Japanese people, who have different sensitivities to anticancer drugs and life expectancy, remains unknown. We aimed to prospectively evaluate the utility of the CARG tool for predicting severe CRAE in older Japanese patients with cancer. MATERIAL AND METHODS Patients with solid tumors aged 65 years and older who commenced anticancer drug regimens from April 2018 to October 2020 were divided into three groups (low, medium, and high-risk) based on their CARG risk scores. Toxicity was prospectively observed by a pharmacist. The primary objective was to evaluate the correlation between the incidence of grade ≥ 3 CRAE and the CARG risk score. The secondary objective was to evaluate hematological and non-hematological toxicities. CRAE incidence was compared among the three groups using a closed testing procedure: (1) Cochran-Armitage test for trend and (2) chi-square test for paired comparison. RESULTS The patients (N = 165) had a median age of 71 years (range: 65-89 years). CRAE in patients divided into low-, medium-, and high-risk groups, based on CARG risk scores, were 39%, 55%, and 82%, respectively (low vs high; p < 0.001, medium vs high; p < 0.01). The incidence of severe hematologic toxicity was 37%, 35%, and 50% in the low-, medium-, and high-risk groups, respectively; the incidence of severe non-hematologic toxicity was 15%, 36%, and 65%, respectively (low vs medium; p < 0.01, low vs high; p < 0.001, and medium vs high; p < 0.01). DISCUSSION To our knowledge, this is the first prospective observational study to validate the CARG prediction tool in older Japanese patients with cancer. The CARG risk score may be effective in predicting the development of non-hematologic toxicities. These results should be considered when administering chemotherapy to older Japanese patients with advanced solid tumors.
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Affiliation(s)
- Masanobu Uchiyama
- Department of Oncology and Infectious Disease Pharmacy, Faculty of Pharmaceutical Sciences, Fukuoka University, 8-19-1 Nanakuma Jonan-ku, Fukuoka 814-0180, Japan; Department of Pharmacy, Fukuoka University Hospital; 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
| | - Motoyasu Miyazaki
- Department of Pharmaceutical and Health Care Management, Faculty of Pharmaceutical Sciences, Fukuoka University, 8-19-1 Nanakuma Jonan-ku, Fukuoka 814-0180, Japan; Department of Pharmacy, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino-shi, Fukuoka 818-8502, Japan
| | - Toshinobu Hayashi
- Department of Emergency and Disaster Medical Pharmacy, Faculty of Pharmaceutical Sciences, Fukuoka University, Japan
| | - Mototsugu Shimokawa
- Department of Biostatistics, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamiogushi, Ube, Yamaguchi 755-8505, Japan
| | - Takafumi Nakano
- Department of Oncology and Infectious Disease Pharmacy, Faculty of Pharmaceutical Sciences, Fukuoka University, 8-19-1 Nanakuma Jonan-ku, Fukuoka 814-0180, Japan; Department of Pharmacy, Fukuoka University Hospital; 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
| | - Hideki Kakimoto
- Department of Pharmacy, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino-shi, Fukuoka 818-8502, Japan
| | - Satoko Takaki
- Department of Pharmacy, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino-shi, Fukuoka 818-8502, Japan
| | - Haruka Fukue
- Department of Pharmacy, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino-shi, Fukuoka 818-8502, Japan
| | - Takafumi Inoue
- Department of Pharmacy, Fukuoka University Hospital; 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
| | - Ryuichi Inoue
- Department of Pharmacy, Fukuoka University Hospital; 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
| | - Kouta Mashima
- Department of Pharmacy, Fukuoka University Hospital; 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
| | - Satoshi Kawata
- Department of Pharmacy, Fukuoka University Hospital; 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
| | - Yasutaka Sumi
- Department of Pharmacy, Fukuoka University Hospital; 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
| | - Yasuaki Igarashi
- Department of Pharmacy, Fukuoka University Hospital; 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
| | - Hidetoshi Kamimura
- Department of Pharmacy, Fukuoka University Hospital; 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; Department of Pharmaceutical and Health Care Management, Faculty of Pharmaceutical Sciences, Fukuoka University, 8-19-1 Nanakuma Jonan-ku, Fukuoka 814-0180, Japan
| | - Osamu Imakyure
- Department of Pharmaceutical and Health Care Management, Faculty of Pharmaceutical Sciences, Fukuoka University, 8-19-1 Nanakuma Jonan-ku, Fukuoka 814-0180, Japan; Department of Pharmacy, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino-shi, Fukuoka 818-8502, Japan
| | - Koichi Matsuo
- Department of Oncology and Infectious Disease Pharmacy, Faculty of Pharmaceutical Sciences, Fukuoka University, 8-19-1 Nanakuma Jonan-ku, Fukuoka 814-0180, Japan; Department of Pharmacy, Fukuoka University Hospital; 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
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Li LJ, Chong Q, Wang L, Cher GB, Soo RA. Different treatment efficacies and side effects of cytotoxic chemotherapy. J Thorac Dis 2020; 12:3785-3795. [PMID: 32802458 PMCID: PMC7399437 DOI: 10.21037/jtd.2019.08.63] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Differences in efficacy and toxicity between Asian and Caucasian patients with lung cancer treated with systemic chemotherapy is increasingly recognised. This is a major concern in the clinical setting as it influences outcomes and affect international harmonization of drug development. Interindividual variability of pharmacokinetics, where different genetic polymorphisms affect drug metabolism, transport, and receptor binding may account for the ethnic differences. Treatment efficacy and outcomes may also be explained by differences in diet and lifestyle, access to healthcare, cultural barriers and environmental exposure. Efforts made to design prospective studies investigating ethnic specific determinants to systemic therapy and individualise lung cancer treatment based on genetic makeup of patient are important.
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Affiliation(s)
- Low-Jia Li
- Department of Haematology-Oncology, National University Hospital, Singapore, Singapore
| | - Qingyun Chong
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - Lingzhi Wang
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore.,Department of Pharmacology, National University of Singapore, Singapore, Singapore
| | - Goh Boon Cher
- Department of Haematology-Oncology, National University Hospital, Singapore, Singapore.,Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore.,Department of Pharmacology, National University of Singapore, Singapore, Singapore
| | - Ross A Soo
- Department of Haematology-Oncology, National University Hospital, Singapore, Singapore
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Towards precision medicine: interrogating the human genome to identify drug pathways associated with potentially functional, population-differentiated polymorphisms. THE PHARMACOGENOMICS JOURNAL 2019; 19:516-527. [PMID: 31578463 PMCID: PMC6867962 DOI: 10.1038/s41397-019-0096-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 09/10/2019] [Accepted: 09/18/2019] [Indexed: 12/24/2022]
Abstract
Drug response variations amongst different individuals/populations are influenced by several factors including allele frequency differences of single nucleotide polymorphisms (SNPs) that functionally affect drug-response genes. Here, we aim to identify drugs that potentially exhibit population differences in response using SNP data mining and analytics. Ninety-one pairwise-comparisons of >22,000,000 SNPs from the 1000 Genomes Project, across 14 different populations, were performed to identify ‘population-differentiated’ SNPs (pdSNPs). Potentially-functional pdSNPs (pf-pdSNPs) were then selected, mapped into genes, and integrated with drug–gene databases to identify ‘population-differentiated’ drugs enriched with genes carrying pf-pdSNPs. 1191 clinically-approved drugs were found to be significantly enriched (Z > 2.58) with genes carrying SNPs that were differentiated in one or more population-pair comparisons. Thirteen drugs were found to be enriched with such differentiated genes across all 91 population-pairs. Notably, 82% of drugs, which were previously reported in the literature to exhibit population differences in response were also found by this method to contain a significant enrichment of population specific differentiated SNPs. Furthermore, drugs with genetic testing labels, or those suspected to cause adverse reactions, contained a significantly larger number (P < 0.01) of population-pairs with enriched pf-pdSNPs compared with those without these labels. This pioneering effort at harnessing big-data pharmacogenomics to identify ‘population differentiated’ drugs could help to facilitate data-driven decision-making for a more personalized medicine.
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Duan ZY, Liu JQ, Yin P, Li JJ, Cai GY, Chen XM. Impact of aging on the risk of platinum-related renal toxicity: A systematic review and meta-analysis. Cancer Treat Rev 2018; 69:243-253. [PMID: 30121504 DOI: 10.1016/j.ctrv.2018.07.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 07/04/2018] [Accepted: 07/06/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Renal toxicity limits the clinical use of platinum-based therapy in the elderly. In order to clarify the impact of aging on the risk of platinum-related nephrotoxicity, the following meta-analysis was performed. METHODS We searched multiple databases for studies published before January 2017. The inclusion criteria were case-control, cohort studies published in any language. RESULTS The risk of platinum-induced nephrotoxicity in the older group was 1.43 times (risk rate) higher than in the non-older group. Platinum-induced nephrotoxicity in older patients was mainly I/II. There was no significant difference in the incidence of grade III/IV renal toxicity between groups. The risk for elderly patients in Asia was significantly higher than in Europe and North America. Carboplatin had a lower risk of renal toxicity and only half of the amount of moderate and severe nephrotoxicity than cisplatin. In the age stratification analysis, the RR values were 1.43, 1.51 and 1.35 respectively for the elderly group (55, 60, 70 years old), and all had significant differences. The risk of platinum-related nephrotoxicity in elderly patients was significantly increased in the high comorbidity rate group. Moreover, the RR values of the normal renal function group were significantly higher than that of the 'no mention or renal insufficiency' subgroup. CONCLUSIONS Aging increased the risk of platinum-induced nephrotoxicity by 43%, partly due to more comorbidities in elderly patients, and mild renal toxicity was dominant. The risk of renal toxicity of the elderly patients in Asian countries was much higher than that of in European countries and North America.
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Affiliation(s)
- Zhi-Yu Duan
- Department of Nephrology, First Affiliated Hospital of Chinese PLA General Hospital, Beijing 100048, China
| | - Jie-Qiong Liu
- Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing 100853, China
| | - Pei Yin
- Department of Nephrology, First Affiliated Hospital of Chinese PLA General Hospital, Beijing 100048, China
| | - Ji-Jun Li
- Department of Nephrology, First Affiliated Hospital of Chinese PLA General Hospital, Beijing 100048, China.
| | - Guang-Yan Cai
- Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing 100853, China.
| | - Xiang-Mei Chen
- Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing 100853, China
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Wang S, Zhang Q, Yang P, Yu X, Huang LY, Shen S, Cai S. Manganese Oxide-Coated Carbon Nanotubes As Dual-Modality Lymph Mapping Agents for Photothermal Therapy of Tumor Metastasis. ACS APPLIED MATERIALS & INTERFACES 2016; 8:3736-43. [PMID: 26653008 DOI: 10.1021/acsami.5b08087] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Lymph node (LN) status is a major indicator of stage and survival of lung cancer patients. LN dissection is a primary option for lung cancer LN metastasis; however, this strategy elicits adverse effects and great trauma. Therefore, developing a minimally invasive technique to cure LN metastasis of lung cancer is desired. In this study, multiwalled carbon nanotubes (MWNTs) coated with manganese oxide (MnO) and polyethylene glycol (PEG) (namely MWNTs-MnO-PEG) was employed as a lymphatic theranostic agent to diagnose and treat metastatic LNs. After single local injection and lymph drainage were performed, regional LNs were clearly mapped by T1-weighted magnetic resonance (MR) of MnO and dark dye imaging of MWNTs. Meanwhile, metastatic LNs could be simultaneously ablated by near-infrared (NIR) irradiation under the guidance of dual-modality mapping. The excellent result was obtained in mice bearing LNs metastasis models, showing that MWNTs-MnO-PEG as a multifunctional theranostic agent was competent for dual-modality mapping guided photothermal therapy of metastatic LNs.
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Affiliation(s)
- Sheng Wang
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center , Shanghai 200032, China
| | - Qin Zhang
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University , Shanghai 200030, China
| | | | | | - Li-Yong Huang
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center , Shanghai 200032, China
| | | | - Sanjun Cai
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center , Shanghai 200032, China
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Lee JL, Park SH, Koh SJ, Lee SH, Kim YJ, Choi YJ, Lee J, Lim HY. Effectiveness and safety of cabazitaxel plus prednisolone chemotherapy for metastatic castration-resistant prostatic carcinoma: data on Korean patients obtained by the cabazitaxel compassionate-use program. Cancer Chemother Pharmacol 2014; 74:1005-13. [DOI: 10.1007/s00280-014-2579-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 08/30/2014] [Indexed: 10/24/2022]
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Race and ethnicity in cancer therapy: what have we learned? Clin Pharmacol Ther 2014; 95:403-12. [PMID: 24419564 DOI: 10.1038/clpt.2014.5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 01/06/2014] [Indexed: 12/13/2022]
Abstract
Racial and ethnic disparities in the pathogenesis of common malignancies and outcomes from treatment remain a major health concern. Factors attributed to these disparities include differences in lifestyle, environment, genetics, and tumor biology. As we strive to personalize cancer therapy, it will be imperative that we understand the relative contributions of each factor so that we may apply this knowledge in choosing the best treatment for each individual, regardless of his or her racial or ethnic heritage.
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Mack PC, Gandara DR, Lara PN. Efficacy and toxicity differences in lung cancer populations in the era of clinical trials globalization: the ‘common arm’ approach. Expert Rev Anticancer Ther 2014; 12:1591-6. [DOI: 10.1586/era.12.135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Soo RA, Kawaguchi T, Loh M, Ou SHI, Shieh MP, Cho BC, Mok TS, Soong R. Differences in outcome and toxicity between Asian and caucasian patients with lung cancer treated with systemic therapy. Future Oncol 2012; 8:451-62. [PMID: 22515448 DOI: 10.2217/fon.12.25] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
It is increasingly recognized that differences in overall survival and toxicity exist between Asian and caucasian patients with small-cell and non-small-cell lung cancer, with a longer survival, higher response rates and greater toxicity to chemotherapy and targeted therapy reported in Asian patients. Two global studies are used to illustrate how the proportions of Asian patients can influence survival outcome. Ethnicity is an important and complex characteristic that should considered in the design and conduct of a global clinical study, as the safety, tolerability and response may vary between Asian and caucasian patients. Whether ethnic differences in lung cancer survival are attributed to genetic differences among races or are simply a surrogate marker of differences in access to healthcare because of socioeconomic differences is unclear. Carefully designed prospective studies investigating ethnic-specific determinants of sensitivity and toxicity to systemic therapy are warranted.
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Affiliation(s)
- Ross A Soo
- Cancer Science Institute of Singapore, National University of Singapore, Singapore.
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Ethnic difference in hematological toxicity in patients with non-small cell lung cancer treated with chemotherapy: a pooled analysis on Asian versus non-Asian in phase II and III clinical trials. J Thorac Oncol 2012; 6:1881-8. [PMID: 21841503 DOI: 10.1097/jto.0b013e31822722b6] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION There are a large number of global clinical trials ongoing for patients with non-small cell lung cancer (NSCLC). Ethnic difference in toxicity has not been adequately studied. METHODS We performed a systematic search in PubMed for randomized phase II and III trials of NSCLC from January 2000 to December 2009, examining ethnic difference in hematological toxicity due to cytotoxic chemotherapy. Ethnicity was classified into Asian and non-Asian. We chose three treatment regimens used for NSCLC globally: cisplatin plus gemcitabine (CG), cisplatin plus vinorelbine (CV), and carboplatin plus paclitaxel (CP). We applied sensitivity analysis to examine unreported ethnic differences in hematological toxicities by changing the percentage of Asian patients from 0 to 18% in trials reported from the United States and Europe. RESULTS We identified 12 phase II trials and 38 phase III trials of NSCLC with a total of 11,271 patients. Among these, 14 trials had reported ethnic origins. Grade 3/4 toxicities were more frequently observed in the Asian studies. On the basis of sensitivity analysis, odds ratio of grade 3/4 neutropenia was significantly higher in Asian patients than non-Asian, when treated with CG (OR = 1.55-3.45, p < 0.001), CV (OR = 2.99-4.43, p < 0.001), and CP (OR = 4.79-6.22, p < 0.001). Grade 3/4 anemia was also significantly higher in Asians with CG (OR = 3.10-3.27, p < 0.001), CV (OR = 1.99-2.43, p < 0.001), and CP (OR = 1.34-1.52, p < 0.001-0.004). However, no significant difference was observed in thrombocytopenia with CG (OR = 0.66-2.04, p < 0.001-1.000), CV (OR = 0.42-0.57, p = 0.097-0.323), or CP (OR = 1.21-1.39, p = 0.114-0.152). CONCLUSIONS Severe hematological toxicity was frequently observed in Asian patients compared with non-Asian (mostly whites) in the treatment of chemotherapy for NSCLC.
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Horinouchi H, Sekine I. [The cutting-edge of medicine; Ethnic and gender differences in lung cancer]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 2011; 100:3064-3071. [PMID: 22175154 DOI: 10.2169/naika.100.3064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Hidehito Horinouchi
- Division of Internal Medicine and Thoracic Oncology, National Cancer Center Hospital, Japan
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Qian J, Shen J, Bai H, Han B. [The clinical analysis of paclitaxel at two dose levels plus carboplatin as the first-line treatment in advanced non-small cell lung cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2011; 14:323-8. [PMID: 21496430 PMCID: PMC5999718 DOI: 10.3779/j.issn.1009-3419.2011.04.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
背景与目的 紫杉醇联合卡铂一线治疗晚期非小细胞肺癌(non-small cell lung cancer, NSCLC)临床应用较为广泛。本研究旨在比较不同剂量紫杉醇联合卡铂一线治疗晚期NSCLC患者的毒副反应及疗效。 方法 2006年12月-2008年6月,共63例晚期NSCLC患者接受紫杉醇175 mg/m2或200 mg/m2联合卡铂(AUC 5)化疗,前者42例,后者21例,ECOG评分0-1分,3周-4周重复,比较两组近期和远期疗效及毒副反应。 结果 紫杉醇175 mg/m2与200 mg/m2化疗组客观有效率分别为28.57%与33.33%(P=0.698),中位TP为6.7个月与7个月(P=0.561),MST为18.7个月与19个月(P=0.255),1年生存率为61.9%与66.7%(P=0.711),2年生存率为31%与33.3%(P=0.852)。紫杉醇200 mg/m2组3/4级中性粒细胞下降发生率明显高于175 mg/m2组,分别为61.9%与33.3%(P=0.031)。 结论 与200 mg/m2化疗组相比,紫杉醇175 mg/m2联合卡铂一线治疗晚期NSCLC患者可明显减少3/4级中性粒细胞下降发生率,且疗效及生存期并不劣于较高剂量化疗组。
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Affiliation(s)
- Jialin Qian
- Department of Pulmonary Medicine, Shanghai Chest hospital, Shanghai Jiaotong University, Shanghai, China
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Chang PMH, Tzeng CH, Chen MH, Tsao CJ, Su WC, Hwang WS, Chang YF, Chang SY, Yang MH. Triweekly reduced-dose docetaxel combined with cisplatin in recurrent/metastatic head and neck squamous cell carcinoma: a multicenter phase II study. Cancer Chemother Pharmacol 2011; 68:1477-84. [DOI: 10.1007/s00280-011-1645-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2011] [Accepted: 03/28/2011] [Indexed: 10/18/2022]
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Japanese ethnicity compared with Caucasian ethnicity and never-smoking status are independent favorable prognostic factors for overall survival in non-small cell lung cancer: a collaborative epidemiologic study of the National Hospital Organization Study Group for Lung Cancer (NHSGLC) in Japan and a Southern California Regional Cancer Registry databases. J Thorac Oncol 2010; 5:1001-10. [PMID: 20526205 DOI: 10.1097/jto.0b013e3181e2f607] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND We previously reported that Asian ethnicity was a favorable prognostic factor for overall survival (OS) in non-small cell lung cancer (NSCLC). In this study, we performed a combined data analysis from a Japanese Cancer Registry and a regional California Cancer Registry to further validate this observation. METHODS Retrospective population-based analysis of Japanese and Caucasian patients with NSCLC with known smoking status from the Japanese National Hospital Organization Study Group for Lung Cancer and a Southern California Regional Cancer Registry between 1991 and 2001. RESULTS A total of 15,185 Japanese and 13,332 US Caucasian patients were analyzed. Median age of Japanese patients was 68 years compared with 69 years for Caucasian patients (p < 0.0001). A total of 29.3% of Japanese compared with 7.3% Caucasian patients were never-smokers. Never-smoking status conferred significant improved OS for Japanese (p < 0.0001) and a trend for improved OS for Caucasian patients (p = 0.1282). Univariate analysis revealed Japanese patients with stage III (versus Caucasian; hazard ratio [HR] = 0.830, 95% confidence interval [CI]: 0.789-0.873, p < 0.0001) and IV disease (versus Caucasian; HR = 0.955, 95% CI: 0.915-0.997, p = 0.0369) had improved OS compared with Caucasian patients. Multivariate analysis revealed Japanese ethnicity (versus Caucasian; HR = 0.937, 95% CI: 0.898-0.978, p = 0.0028) and never-smoker status (versus ever-smoker; HR = 0.947, 95% CI: 0.909-0.987, p = 0.0104) to be independent favorable factors for OS in addition to younger age, female gender, early stage, and treatment received (surgery, radiation, and chemotherapy). CONCLUSIONS Japanese ethnicity when compared with Caucasian ethnicity and never-smoker status are independent favorable prognostic factors for OS in NSCLC.
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Efficacy and Safety of Cisplatin/Pemetrexed Versus Cisplatin/Gemcitabine as First-Line Treatment in East Asian Patients with Advanced Non-small Cell Lung Cancer: Results of an Exploratory Subgroup Analysis of a Phase III Trial. J Thorac Oncol 2010; 5:688-95. [DOI: 10.1097/jto.0b013e3181d1273d] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chang ET, Shema SJ, Wakelee HA, Clarke CA, Gomez SL. Uncovering disparities in survival after non-small-cell lung cancer among Asian/Pacific Islander ethnic populations in California. Cancer Epidemiol Biomarkers Prev 2009; 18:2248-55. [PMID: 19622719 DOI: 10.1158/1055-9965.epi-09-0332] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Asians may have better survival after non-small-cell lung cancer (NSCLC) than non-Asians. However, it is unknown whether survival varies among the heterogeneous U.S. Asian/Pacific Islander (API) populations. Therefore, this study aimed to quantify survival differences among APIs with NSCLC. Differences in overall and disease-specific survival were analyzed in the California Cancer Registry among 16,577 API patients diagnosed with incident NSCLC between 1988 and 2007. Adjusted hazard ratios (HR) with 95% confidence intervals (95% CI) were estimated using Cox proportional hazards regression models with separate baseline hazards by disease stage. Despite better overall and disease-specific survival among APIs compared with non-Hispanic Whites, differences were evident across API populations. Among women, Japanese (overall survival HR, 1.16; 95% CI, 1.06-1.27) and APIs other than those in the six largest ethnic groups (other APIs; HR, 1.19; 95% CI, 1.07-1.33) had significantly poorer overall and disease-specific survival than Chinese. By contrast, South Asian women had significantly better survival than Chinese (HR, 0.79; 95% CI, 0.63-0.97). Among men, Japanese (HR, 1.15; 95% CI, 1.07-1.24), Vietnamese (HR, 1.07; 95% CI, 1.00-1.16), and other APIs (HR, 1.18; 95% CI, 1.08-1.28) had significantly poorer overall and disease-specific survival than Chinese. Other factors independently associated with poorer survival were lower neighborhood socioeconomic status, involvement with a non-university hospital, unmarried status, older age, and earlier year of diagnosis. APIs have significant ethnic differences in NSCLC survival that may be related to disparate lifestyles, biology, and especially health care access or use. To reduce the nationwide burden of lung cancer mortality, it is critical to identify and ameliorate hidden survival disparities such as those among APIs.
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Affiliation(s)
- Ellen T Chang
- Northern California Cancer Center, Fremont, CA 94538, USA.
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Phan VH, Moore MM, McLachlan AJ, Piquette-Miller M, Xu H, Clarke SJ. Ethnic differences in drug metabolism and toxicity from chemotherapy. Expert Opin Drug Metab Toxicol 2009; 5:243-57. [PMID: 19331590 DOI: 10.1517/17425250902800153] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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19
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Sekine I. Is there a need to take ethnicity into account when considering lung cancer treatment? Expert Rev Respir Med 2009; 3:1-4. [DOI: 10.1586/17476348.3.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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20
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Kubota K, Kawahara M, Ogawara M, Nishiwaki Y, Komuta K, Minato K, Fujita Y, Teramukai S, Fukushima M, Furuse K. Vinorelbine plus gemcitabine followed by docetaxel versus carboplatin plus paclitaxel in patients with advanced non-small-cell lung cancer: a randomised, open-label, phase III study. Lancet Oncol 2008; 9:1135-42. [DOI: 10.1016/s1470-2045(08)70261-4] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Sekine I, Yamamoto N, Nishio K, Saijo N. Emerging ethnic differences in lung cancer therapy. Br J Cancer 2008; 99:1757-62. [PMID: 18985035 PMCID: PMC2600690 DOI: 10.1038/sj.bjc.6604721] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Although global clinical trials for lung cancer can enable the development of new agents efficiently, whether the results of clinical trials performed in one population can be fully extrapolated to another population remains questionable. A comparison of phase III trials for the same drug combinations against lung cancer in different countries shows a great diversity in haematological toxicity. One possible reason for this diversity may be that different ethnic populations may have different physiological capacities for white blood cell production and maturation. In addition, polymorphisms in the promoter and coding regions of drug-metabolising enzymes (e.g., CYP3A4 and UGT1A1) or in transporters (e.g., ABCB1) may vary among different ethnic populations. For example, epidermal growth factor receptor (EGFR) inhibitors are more effective in Asian patients than in patients of other ethnicities, a characteristic that parallels the incidence of EGFR-activating mutations. Interstitial lung disease associated with the administration of gefitinib is also more common among Japanese patients than among patients of other ethnicities. Although research into these differences has just begun, these studies suggest that possible pharmacogenomic and tumour genetic differences associated with individual responses to anticancer agents should be carefully considered when conducting global clinical trials.
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Affiliation(s)
- I Sekine
- Division of Internal Medicine and Thoracic Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo 104-0045, Japan.
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Gautschi O, Mack PC, Davies AM, Jablons DM, Rosell R, Gandara DR. Pharmacogenomic Approaches to Individualizing Chemotherapy for Non–Small-Cell Lung Cancer: Current Status and New Directions. Clin Lung Cancer 2008; 9 Suppl 3:S129-38. [DOI: 10.3816/clc.2008.s.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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