1
|
Zhu Z, Chai Y. First-Line EGFR-TKIs Treatment in Stage I Non-Small-Cell Lung Cancer Patients Harboring EGFR Gene Mutations with Postoperative Intrapulmonary Recurrence. Cancer Manag Res 2021; 13:1667-1672. [PMID: 33628055 PMCID: PMC7899306 DOI: 10.2147/cmar.s292295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 02/04/2021] [Indexed: 11/24/2022] Open
Abstract
Background The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) is an effective treatment for advanced lung cancer harboring EGFR gene mutations, and has improved progression-free survival in several clinical trials. Methods We investigated 30 stage I non-small-cell lung cancer patients harboring EGFR gene mutations with postoperative intrapulmonary recurrence. Progression-free survival and response rate were analyzed. Results Partial response was achieved in 23 patients and stable disease was found in 7 patients. The objective response rate was 76.7% and disease control rate was 100%. The median progression-free survival (PFS) time was 24.5 months. The median PFS in patients with only intrapulmonary recurrence was significantly superior to patients with both intrapulmonary recurrence and metastasis (32.0 months vs 14.0 months, P = 0.003). The median PFS observed in patients who underwent icotinib treatment was significantly longer than in patients who underwent gefitinib treatment (30.5 months vs 12.0 months, p = 0.005). There were no statistical differences in median PFS between patients with tumors harboring exon 21 mutation and exon 19 deletion, age <65 and ≥65, male and female, smoker and non-smoker. Conclusion Our result reveals that first-line EGFR-TKIs treatment for stage I non-small-cell lung cancer patients harboring EGFR gene mutations with postoperative intrapulmonary recurrence is effective and could be a useful option in practical setting.
Collapse
Affiliation(s)
- Zhouyu Zhu
- Department of Thoracic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Ying Chai
- Department of Thoracic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| |
Collapse
|
2
|
Yang X, Peng Y, Jiang X, Lu X, Duan W, Zhang S, Dai N, Shan J, Feng Y, Li X, Cheng Y, Yang Y, Baugh L, Tell G, Wang D, Li M. The regulatory role of APE1 in epithelial-to-mesenchymal transition and in determining EGFR-TKI responsiveness in non-small-cell lung cancer. Cancer Med 2018; 7:4406-4419. [PMID: 30109782 PMCID: PMC6144255 DOI: 10.1002/cam4.1717] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 06/01/2018] [Accepted: 07/15/2018] [Indexed: 01/05/2023] Open
Abstract
Background Epithelial‐to‐mesenchymal transition (EMT) plays a pivotal role in resistance to EGFR tyrosine kinase inhibitors (TKIs) in non‐small‐cell lung cancer (NSCLC). Our previous study revealed that in osteosarcoma, human apurinic/apyrimidinic endonuclease 1 (APE1) regulates transforming growth factor‐β (TGF‐β), an important player in EMT. We therefore hypothesized a link between APE1 and EGFR‐TKI responsiveness in NSCLC. Methods The protein levels of APE1 were analyzed in tumors of NSCLC patients receiving EGFR‐TKI treatment. The correlation between APE1 expression and progression‐free survival (PFS), overall survival (OS), or response rate were analyzed. The impact of APE1 on the response to EGFR‐TKIs was measured by exogenous manipulation of APE1 in EGFR‐TKI‐sensitive and EGFR‐TKI‐resistant cells. Results We indicate that low expression of APE1 in tumors is associated with a significantly longer PFS (20.8 months vs 8.4 months, P = 0.008) and a preferential OS (39.0 months vs 17.0 months, P = 0.001), with no difference in initial response rate to EGFR‐TKIs. We observed that APE1 protein level was significantly increased in EGFR‐TKI‐resistant cells and was associated with downregulated E‐cadherin and upregulated vimentin. The EMT phenotype, as well as the levels of TGF‐β, was suppressed in APE1 knockdown HCC827/IR and PC‐9/ER cells, while the EMT phenotype was promoted in APE1‐overexpressed HCC827 and PC‐9 cells. Furthermore, a specific APE1 redox inhibitor (ie, E3330) effectively reversed the EMT phenotype and further sensitized the cells to EGFR‐TKIs. Conclusion This study revealed a significant role of APE1 in EGFR‐TKI resistance via novel regulatory effects on the EMT phenotype in NSCLC.
Collapse
Affiliation(s)
- Xiao Yang
- Cancer Centre, Daping Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing, China
| | - Yu Peng
- Cancer Centre, Daping Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing, China
| | - Xuan Jiang
- Cancer Centre, Daping Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing, China
| | - Xianfeng Lu
- Cancer Centre, Daping Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing, China
| | - Wei Duan
- Cancer Centre, Daping Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing, China
| | - Shiheng Zhang
- Cancer Centre, Daping Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing, China
| | - Nan Dai
- Cancer Centre, Daping Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing, China
| | - Jinlu Shan
- Cancer Centre, Daping Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing, China
| | - Yan Feng
- Cancer Centre, Daping Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing, China
| | - Xuemei Li
- Cancer Centre, Daping Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing, China
| | - Yi Cheng
- Cancer Centre, Daping Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing, China
| | - Yuxin Yang
- Cancer Centre, Daping Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing, China
| | - Laura Baugh
- Department of Pathology, Baylor University Medical Center, Dallas, Texas
| | - Gianluca Tell
- Laboratory of Molecular Biology and DNA Repair, Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Dong Wang
- Cancer Centre, Daping Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing, China
| | - Mengxia Li
- Cancer Centre, Daping Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing, China
| |
Collapse
|
3
|
Xue ZX, Wen WX, Zhuang Y, Hua ZJ, Xia YN. Comparison of the efficacy of icotinib in patients with non-small-cell lung cancer according to the type of epidermal growth factor receptor mutation. Mol Clin Oncol 2016; 5:265-268. [PMID: 27588191 DOI: 10.3892/mco.2016.956] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 11/12/2015] [Indexed: 11/06/2022] Open
Abstract
Icotinib hydrochloride is a novel epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) with preclinical and clinical activity in non-small-cell lung cancer (NSCLC). Exon 19 deletion and L858R point mutation are the most commonly encountered EGFR mutations in NSCLC, and they predict improved clinical outcomes following treatment with icotinib. The objective of this study was to evaluate the differential clinical efficacy of icotinib in patients with exon 19 deletion or L858R point mutation of the EGFR gene. A total of 104 patients with advanced NSCLC, who harbored exon 19 deletion or L858R point mutation of EGFR and were treated with icotinib, were enrolled in this study. The tumor response and progression-free survival were evaluated. There were no significant differences between patients with EGFR exon 19 deletion and those with L858R point mutation who received treatment with icotinib.
Collapse
Affiliation(s)
- Zhang Xiao Xue
- Department of Oncology, Qilu Hospital, School of Medicine, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Wang Xiu Wen
- Department of Oncology, Qilu Hospital, School of Medicine, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Yu Zhuang
- Department of Oncology, The Affiliated Hospital of Qingdao University Medical College, Qingdao, Shandong 266003, P.R. China
| | - Zang Jian Hua
- Department of Oncology, Qingdao Hiser Hospital, Qingdao, Shandong 266033, P.R. China
| | - Yang Ni Xia
- Department of Oncology, Qingdao Hiser Hospital, Qingdao, Shandong 266033, P.R. China
| |
Collapse
|
4
|
Carnio S, Novello S, Bironzo P, Scagliotti GV. Moving from histological subtyping to molecular characterization: new treatment opportunities in advanced non-small-cell lung cancer. Expert Rev Anticancer Ther 2014; 14:1495-513. [PMID: 25183305 DOI: 10.1586/14737140.2014.949245] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Over the last 10 years, the systemic treatment of advanced non-small-cell lung cancer has progressively moved away from the 'one-size-fits-all' approach to histological subtyping. Currently, there is a progressive implementation of targeted therapies based on specific molecular characteristics such as the EGF receptor sensitizing mutations and the anaplastic lymphoma kinase rearrangements. Despite the availability of effective agents against these abnormalities, acquired resistance is still a major issue. A new generation of tyrosine kinase inhibitors for EGF receptor and anaplastic lymphoma kinase targeting acquired resistance mechanisms have been recently investigated. Several promising tyrosine kinase inhibitors that hit other targets are also in clinical development, including: rat sarcoma gene/MEK, BRAF1, PIK3A, c-mesenchymal-epithelial transition, c-ros oncogene 1, rearranged during transfection, human EGFR 2, FGFR, VEGFR, PDGFR and discoidin death receptor 2. Furthermore, new advances in immunology have been achieved through the discovery of vaccines and immune checkpoint pathways such as the cytotoxic T-lymphocyte-associated antigen-4, programmed cell death protein 1 and its ligands.
Collapse
Affiliation(s)
- Simona Carnio
- Department of Oncology, S. Luigi Hospital, University of Torino, Regione Gonzole 10, 10043 Orbassano, Torino, Italy
| | | | | | | |
Collapse
|
5
|
Paz-Ares L, Soulières D, Moecks J, Bara I, Mok T, Klughammer B. Pooled analysis of clinical outcome for EGFR TKI-treated patients with EGFR mutation-positive NSCLC. J Cell Mol Med 2014; 18:1519-39. [PMID: 25100284 PMCID: PMC4190899 DOI: 10.1111/jcmm.12278] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 12/06/2013] [Indexed: 01/16/2023] Open
Abstract
Patients with non-small-cell lung cancer (NSCLC) appear to gain particular benefit from treatment with epidermal growth factor receptor (EGFR) tyrosine-kinase inhibitors (TKI) if their disease tests positive for EGFR activating mutations. Recently, several large, controlled, phase III studies have been published in NSCLC patients with EGFR mutation-positive tumours. Given the increased patient dataset now available, a comprehensive literature search for EGFR TKIs or chemotherapy in EGFR mutation-positive NSCLC was undertaken to update the results of a previously published pooled analysis. Pooling eligible progression-free survival (PFS) data from 27 erlotinib studies (n = 731), 54 gefitinib studies (n = 1802) and 20 chemotherapy studies (n = 984) provided median PFS values for each treatment. The pooled median PFS was: 12.4 months (95% accuracy intervals [AI] 11.6-13.4) for erlotinib-treated patients; 9.4 months (95% AI 9.0-9.8) for gefitinib-treated patients; and 5.6 months (95% AI 5.3-6.0) for chemotherapy. Both erlotinib and gefitinib resulted in significantly longer PFS than chemotherapy (permutation testing; P = 0.000 and P = 0.000, respectively). Data on more recent TKIs (afatinib, dacomitinib and icotinib) were insufficient at this time-point to carry out a pooled PFS analysis on these compounds. The results of this updated pooled analysis suggest a substantial clear PFS benefit of treating patients with EGFR mutation-positive NSCLC with erlotinib or gefitinib compared with chemotherapy.
Collapse
Affiliation(s)
- Luis Paz-Ares
- Department of Medical Oncology, Instituto de Biomedicina de Sevilla (HUVR, US and CSIC) and Hospital Universitario Virgen del RocioSeville, Spain
| | - Denis Soulières
- Département de Médecine, Service d'hémato-oncologie, Centre Hospitalier de l'Université de MontréalMontréal, QC, Canada
| | - Joachim Moecks
- Department Bio-Mathematics, BIOMCON GmbHMannheim, Germany
| | - Ilze Bara
- Global Medical Affairs Oncology, F. Hoffmann-La Roche LtdBasel, Switzerland
| | - Tony Mok
- Department of Clinical Oncology, The Chinese University of Hong Kong, Prince of Wales HospitalHong Kong, China
| | | |
Collapse
|
6
|
Chen X, Zhu Q, Liu Y, Liu P, Yin Y, Guo R, Lu K, Gu Y, Liu L, Wang J, Wang Z, Røe OD, Shu Y, Zhu L. Icotinib is an active treatment of non-small-cell lung cancer: a retrospective study. PLoS One 2014; 9:e95897. [PMID: 24836053 PMCID: PMC4023939 DOI: 10.1371/journal.pone.0095897] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 04/01/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Icotinib hydrochloride is a novel epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) with preclinical and clinical activity in non-small cell lung cancer (NSCLC). This retrospective analysis was performed to assess the efficacy of icotinib on patients with non-small-cell lung cancer (NSCLC). METHODS 82 consecutive patients treated with icotinib as first (n = 24) or second/third line (n = 58) treatment at three hospitals in Nanjing were enrolled into our retrospective research. The Response Evaluation Criteria in Solid Tumors (RECIST) was used to evaluate the tumor responses and the progression-free survival (PFS) and overall survival (OS) was evaluated by the Kaplan-Meier method. RESULTS Median PFS was 4.0 months (95% CI 2.311-5.689). Median OS was 11.0 months (95% CI 8.537-13.463) in this cohort. Median PFS for first and second/third line were 7.0 months (95% CI 2.151-11.8) and 3.0 months (95% CI 1.042-4.958), respectively. Median OS for first and second/third line were 13.0 months (95% CI 10.305-15.695) and 10.0 months (95% CI 7.295-12.70), respectively. In patients with EGFR mutation (n = 19), icotinib significantly reduced the risk of progression (HR 0.36, 95% CI 0.18-0.70, p = 0.003) and death (HR 0.10, 95% CI 0.02-0.42, p = 0.002) compared with those EGFR status unknown (n = 63). The most common adverse events were acne-like rash (39.0%) and diarrhea (20.7%). CONCLUSIONS Icotinib is active in the treatment of patients with NSCLC both in first or second/third line, especially in those patients harbouring EGFR mutations, with an acceptable adverse event profile.
Collapse
Affiliation(s)
- Xiaofeng Chen
- Department of Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Quan Zhu
- Department of Cardiothoracic Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yiqian Liu
- Department of Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ping Liu
- Department of Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yongmei Yin
- Department of Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Renhua Guo
- Department of Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Kaihua Lu
- Department of Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yanhong Gu
- Department of Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lianke Liu
- Department of Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jinghua Wang
- Department of Oncology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Zhaoxia Wang
- Department of Oncology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Oluf Dimitri Røe
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Norwegian University of Science and Technology, Trondheim, Norway, Cancer Clinic, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway
| | - Yongqian Shu
- Department of Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- * E-mail: (YS); (LZ)
| | - Lingjun Zhu
- Department of Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- * E-mail: (YS); (LZ)
| |
Collapse
|
7
|
Qin N, Yang X, Zhang Q, Li X, Zhang H, Lv J, Wu Y, Wang J, Zhang S. Efficacy of Icotinib treatment in patients with stage IIIb/IV non-small cell lung cancer. Thorac Cancer 2014; 5:243-9. [PMID: 26767007 DOI: 10.1111/1759-7714.12085] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Accepted: 12/26/2013] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND To evaluate the efficacy and safety of Icotinib - an orally administered, highly potent selective inhibitor of epidermal growth factor receptor (EGFR) and its active mutations, in the treatment of patients with advanced non-small cell lung cancer (NSCLC). METHODS A total of 101 patients with stage IIIb/IV NSCLC were treated with 125 mg Icotinib three times a day until disease progression or intolerable toxicity. Response rate was evaluated using response evaluation criteria in solid tumors and progression-free survival (PFS) was collected. RESULTS The overall response rate (ORR) and disease control rate (DCR) were 37.6% (38/101) and 79.2% (80/101), respectively. The median PFS was 6.5 months. Multivariate analysis showed that female gender (P= 0.048, 95% confidence interval [CI] 1.010-6.016) and occurrence of rash (P= 0.002, 95% CI 1.667-9.809) were the independent predictive factors for ORR, while a performance status (PS) score of 0-1 (P= 0.001, 95% CI 0.024-0.402) and rash (P= 0.042, 95% CI 1.089-76.557) were the independent predictive factors for DCR. In addition, PS scores of 0-1 (P <0.001, 95% CI 0.135-0.509), and non-smoking (P= 0.017, 95% CI 0.342-0.900) were found to be independent influencing factors for PFS. Moreover, patients with EGFR mutations had better PFS than patients with wild type EGFR, while patients with EGFR exon 19 deletion had better survival than those with EGFR exon 21 mutation. The most common adverse effects of Icotinib were rash (35.6%) and diarrhea (17.8%), which was tolerable. CONCLUSION Treatment of stage IIIb/IV NSCLC patients with Icotinib was effective and tolerable, specifically in patients with EGFR mutation.
Collapse
Affiliation(s)
- Na Qin
- Department of Medical Oncology, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University Beijing, China
| | - Xinjie Yang
- Department of Medical Oncology, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University Beijing, China
| | - Quan Zhang
- Department of Medical Oncology, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University Beijing, China
| | - Xi Li
- Department of Medical Oncology, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University Beijing, China
| | - Hui Zhang
- Department of Medical Oncology, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University Beijing, China
| | - Jialin Lv
- Department of Medical Oncology, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University Beijing, China
| | - Yuhua Wu
- Department of Medical Oncology, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University Beijing, China
| | - Jinghui Wang
- Department of Medical Oncology, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University Beijing, China
| | - Shucai Zhang
- Department of Medical Oncology, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University Beijing, China
| |
Collapse
|
8
|
Guan Y, Zhao H, Meng J, Yan X, Jiao S. Dramatic response to high-dose icotinib in a lung adenocarcinoma patient after erlotinib failure. Lung Cancer 2014; 83:305-7. [DOI: 10.1016/j.lungcan.2013.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Revised: 11/08/2013] [Accepted: 12/04/2013] [Indexed: 10/25/2022]
|
9
|
Song Z, Zhang Y. Efficacy of chemotherapy plus gefitinib treatment in advanced non-small-cell lung cancer patients following acquired resistance to gefitinib. Mol Clin Oncol 2013; 1:875-878. [PMID: 24649264 PMCID: PMC3915312 DOI: 10.3892/mco.2013.156] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 07/09/2013] [Indexed: 11/19/2022] Open
Abstract
Non-small-cell lung cancer (NSCLC) may exhibit oncogene addiction in patients who benefited from prior treatment with epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs). Preclinical data suggested that EGFR addiction persists after the development of TKI resistance, leading many clinicians to continue TKI treatment along with chemotherapy. However, this strategy has not been adequately evaluated in clinical practice. Patients who benefited from gefitinib followed by acquired resistance to this drug were reviewed in the Zhejiang Cancer Hospital. Patients were included if they received chemotherapy and gefitinib following failure of prior gefitinib treatment. A total of 26 patients were included in the present study. Six patients (23.1%) exhibited a partial response (PR), 13 (50%) achieved stable disease (SD) and 7 (26.9%) had progressive disease (PD) during the chemotherapy and gefitinib treatment. The disease control rate (DCR) was 73.1% and the median progression-free survival (PFS) was 4.6 months [95% confidence interval (CI): 3.8–5.4]. The toxicities associated with gefitinib and chemotherapy were generally acceptable. In conclusion, continued concurrent gefitinib and chemotherapy may be a valuable strategy, with acceptable and well-tolerated toxicity. However, this treatment requires further investigation.
Collapse
Affiliation(s)
- Zhengbo Song
- Department of Chemotherapy, Zhejiang Cancer Hospital, Zhejiang 310022, P.R. China ; Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Hangzhou, Zhejiang 310022, P.R. China
| | - Yiping Zhang
- Department of Chemotherapy, Zhejiang Cancer Hospital, Zhejiang 310022, P.R. China ; Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Hangzhou, Zhejiang 310022, P.R. China
| |
Collapse
|
10
|
Ding HX, Liu KKC, Sakya SM, Flick AC, O’Donnell CJ. Synthetic approaches to the 2011 new drugs. Bioorg Med Chem 2013; 21:2795-825. [DOI: 10.1016/j.bmc.2013.02.061] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Revised: 02/12/2013] [Accepted: 02/19/2013] [Indexed: 12/15/2022]
|
11
|
|
12
|
Wu YL, Zhou Q. Clinical trials and biomarker research on lung cancer in China. Expert Opin Ther Targets 2012; 16 Suppl 1:S45-50. [PMID: 22313283 DOI: 10.1517/14728222.2011.630663] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Over the past 10 years, there have been significant advances in clinical trials and translation research on lung cancer in China. These advances have changed the clinical practice of lung cancer treatment. Translation research has clarified many molecular mechanisms of lung cancer development, growth and metastasis. Based on these results, a few cancer-driving molecular targets were identified. Many new compounds that directly or indirectly target these driver genes have been developed and tested. AREAS COVERED Studies from the literature and ongoing work from the author's group were reviewed. This was with the aim of outlining the current state of a clinical trial cooperative group for lung cancer and highlighting some important clinical trials and biomarker research that have changed lung cancer clinical practice in China. EXPERT OPINION For biomarker-driven clinical research, it is important to identify subgroups of patients who are most likely to benefit from given targeted therapies. In this setting, the rapid identification and translation of validated biomarkers will be integral to the treatment of lung cancer. It is also important to utilize results from high-quality clinical research groups to enrich patients lives and to perform these challenging clinical trials.
Collapse
Affiliation(s)
- Yi-long Wu
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
| | | |
Collapse
|