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Miyawaki E, Kenmotsu H, Shintani Y, Sekine I, Shukuya T, Takayama K, Inoue A, Okamoto I, Kiura K, Takahashi K, Yamamoto N, Kawaguchi T, Miyaoka E, Yoshino I, Date H. Efficacy of platinum agents for stage III non-small-cell lung cancer following platinum-based chemoradiotherapy: a retrospective study. BMC Cancer 2022; 22:342. [PMID: 35351059 PMCID: PMC8962203 DOI: 10.1186/s12885-022-09441-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 03/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Platinum-based chemoradiotherapy is the standard treatment for unresectable stage III non-small-cell lung cancer (NSCLC). However, few studies have evaluated the efficacy of subsequent chemotherapy for relapsed NSCLC following platinum-based chemoradiotherapy. This study aimed to evaluate the efficacy of platinum-doublet chemotherapy as a second-line treatment for patients with unresectable stage III NSCLC. METHODS We retrospectively evaluated patients with unresectable stage III NSCLC treated with cytotoxic chemotherapy following platinum-based chemoradiotherapy who were registered in a nationwide registry NSCLC database. Patients were divided into the platinum-doublet chemotherapy (platinum) group and single-agent chemotherapy (non-platinum) group based on the type of second-line chemotherapy. RESULTS The platinum group (n = 119) showed significantly better overall survival (OS) than the non-platinum group (n = 201) (median OS: 21.5 vs. 10.5 months, hazard ratio [HR]: 0.54, 95% confidence interval [CI]: 0.40-0.73, p < 0.001). OS from the beginning of chemoradiotherapy was also significantly better in the platinum group than in the non-platinum group (median OS: 34.9 vs. 21.8 months, HR: 0.58, 95% CI: 0.43-0.79, p = 0.001). In the multivariate analysis, platinum-doublet chemotherapy as second-line therapy, female sex, clinical stage IIIA, and duration of ≥ 8.6 months from the beginning of first-line therapy to the beginning of second-line therapy were associated with significantly better OS. CONCLUSION Platinum-doublet chemotherapy as a second-line therapy may prolong survival in unresectable stage III NSCLC patients following platinum-based chemoradiotherapy. Thus, re-administration of platinum agents may be a promising treatment for unresectable stage III NSCLC treated with platinum-based chemoradiotherapy.
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Affiliation(s)
- Eriko Miyawaki
- Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan
| | - Hirotsugu Kenmotsu
- Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
| | - Ikuo Sekine
- Department of Medical Oncology, Faculty of Medicine, University of Tsukuba, Tsukuba, 305-8576, Japan
| | - Takehito Shukuya
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, 113-8431, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | - Akira Inoue
- Department of Palliative Medicine, Tohoku University School of Medicine, Miyagi, 980-8574, Japan
| | - Isamu Okamoto
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
| | - Katsuyuki Kiura
- Department of Allergy and Respiratory Medicine, Okayama University Hospital, Okayama, 700-8558, Japan
| | - Kazuhisa Takahashi
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, 113-8431, Japan
| | - Nobuyuki Yamamoto
- Internal Medicine III, Wakayama Medical University, Wakayama, 641-8509, Japan
| | - Tomoya Kawaguchi
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, 545-8586, Japan
| | - Etsuo Miyaoka
- Department of Mathematics, Tokyo University of Science, Tokyo, 162-8601, Japan
| | - Ichiro Yoshino
- Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, 260-8677, Japan
| | - Hiroshi Date
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
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Wang M, Chen S, Wei Y, Wei X. DNA-PK inhibition by M3814 enhances chemosensitivity in non-small cell lung cancer. Acta Pharm Sin B 2021; 11:3935-3949. [PMID: 35024317 PMCID: PMC8727896 DOI: 10.1016/j.apsb.2021.07.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/21/2021] [Accepted: 07/09/2021] [Indexed: 11/18/2022] Open
Abstract
A significant proportion of non-small cell lung cancer (NSCLC) patients experience accumulating chemotherapy-related adverse events, motivating the design of chemosensitizating strategies. The main cytotoxic damage induced by chemotherapeutic agents is DNA double-strand breaks (DSB). It is thus conceivable that DNA-dependent protein kinase (DNA-PK) inhibitors which attenuate DNA repair would enhance the anti-tumor effect of chemotherapy. The present study aims to systematically evaluate the efficacy and safety of a novel DNA-PK inhibitor M3814 in synergy with chemotherapies on NSCLC. We identified increased expression of DNA-PK in human NSCLC tissues which was associated with poor prognosis. M3814 potentiated the anti-tumor effect of paclitaxel and etoposide in A549, H460 and H1703 NSCLC cell lines. In the four combinations based on two NSCLC xenograft models and two chemotherapy, we also observed tumor regression at tolerated doses in vivo. Moreover, we identified a P53-dependent accelerated senescence response by M3814 following treatment with paclitaxel/etoposide. The present study provides a theoretical basis for the use of M3814 in combination with paclitaxel and etoposide in clinical practice, with hope to aid the optimization of NSCLC treatment.
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Key Words
- Cell senescence
- Chemosensitization
- DDR, DNA damage response
- DNA repair
- DNA-PK, DNA-dependent protein kinase
- DNA-PKcs, DNA-dependent protein kinase catalytic subunit
- DNA-dependent protein kinase
- DSB, DNA double-strand breaks
- Etoposide
- HR, homologous recombination
- IHC, immunohistochemistry
- LADC, lung adenocarcinoma
- LCLC, large-cell carcinoma
- LSCC, lung squamous cell carcinoma
- M3814
- NHEJ, non homologous end joining
- NSCLC, non-small cell lung cancer
- Non-small cell lung cancer
- Paclitaxel
- dsDNA, double strand DNA
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Zhang P, Marill J, Darmon A, Mohamed Anesary N, Lu B, Paris S. NBTXR3 Radiotherapy-Activated Functionalized Hafnium Oxide Nanoparticles Show Efficient Antitumor Effects Across a Large Panel of Human Cancer Models. Int J Nanomedicine 2021; 16:2761-2773. [PMID: 33880022 PMCID: PMC8052129 DOI: 10.2147/ijn.s301182] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/09/2021] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The side effects of radiotherapy induced on healthy tissue limit its use. To overcome this issue and fully exploit the potential of radiotherapy to treat cancers, the first-in-class radioenhancer NBTXR3 (functionalized hafnium oxide nanoparticles) has been designed to amplify the effects of radiotherapy. PATIENTS AND METHODS Thanks to its physical mode of action, NBTXR3 has the potential to be used to treat any type of solid tumor. Here we demonstrate that NBTXR3 can be used to treat a wide variety of solid cancers. For this, we evaluated different parameters on a large panel of human cancer models, such as nanoparticle endocytosis, in vitro cell death induction, dispersion, and retention of NBTXR3 in the tumor tissue and tumor growth control. RESULTS Whatever the model considered, we show that NBTXR3 was internalized by cancer cells and persisted within the tumors throughout radiotherapy treatment. NBTXR3 activated by radiotherapy was also more effective in destroying cancer cells and in controlling tumor growth than radiotherapy alone. Beyond the effects of NBTXR3 as single agent, we show that the antitumor efficacy of cisplatin-based chemoradiotherapy treatment was improved when combined with NBTXR3. CONCLUSION These data support that NBTXR3 could be universally used to treat solid cancers when radiotherapy is indicated, opening promising new therapeutic perspectives of treatment for the benefit of many patients.
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Affiliation(s)
| | | | | | | | - Bo Lu
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA, 19107, USA
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4
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Gkika E, Lenz S, Schimek-Jasch T, Waller CF, Kremp S, Schaefer-Schuler A, Mix M, Küsters A, Tosch M, Hehr T, Eschmann SM, Bultel YP, Hass P, Fleckenstein J, Thieme AH, Stockinger M, Dieckmann K, Miederer M, Holl G, Rischke HC, Adebahr S, König J, Binder H, Grosu AL, Nestle U. Efficacy and Toxicity of Different Chemotherapy Protocols for Concurrent Chemoradiation in Non-Small Cell Lung Cancer-A Secondary Analysis of the PET Plan Trial. Cancers (Basel) 2020; 12:cancers12113359. [PMID: 33202825 PMCID: PMC7697287 DOI: 10.3390/cancers12113359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 11/01/2020] [Accepted: 11/05/2020] [Indexed: 12/14/2022] Open
Abstract
Simple Summary Concurrent chemoradiation (cCRT) with a platinum-based doublet, followed by immunotherapy, is the treatment of choice in locally advanced non-small cell lung cancer. A remaining open question is the difference between cisplatin and carboplatin in combination with second and third generation agents for concurrent chemoradiation, as they have a substantially different toxicity profile and data are scarce and inconclusive concerning cCRT. We here present a secondary analysis of the international PET Plan trial in order to assess the efficacy and toxicity of different chemotherapy regimens as well as the difference between the commonly used platinum based agents, cisplatin and carboplatin. All regimens were well tolerated and cisplatin in combination with vinorelbin either as a single dose or daily doses per cycle showed comparable efficacy. Patients treated with carboplatin doublets had a worse survival, but after adjusting for possibly relevant factors, this difference became non-significant, probably due to existing selection bias. Abstract (1) Background: The optimal chemotherapy (CHT) regimen for concurrent chemoradiation (cCRT) is not well defined. In this secondary analysis of the international randomized PET-Plan trial, we evaluate the efficacy of different CHT. (2) Methods: Patients with inoperable NSCLC were randomized at a 1:1 ratio regarding the target volume definition and received isotoxically dose-escalated cCRT using cisplatin 80 mg/m2 (day 1, 22) and vinorelbin 15 mg/m2 (day 1, 8, 22, 29) (P1) or cisplatin 20 mg/m2 (day 1–5, 29–33) and vinorelbin 12.5 mg/m2 (day 1, 8, 15, 29, 36, 43) (P2) or carboplatin AUC1 (day 1–5, 29–33) and vinorelbin 12.5 mg/m2 (day 1, 8, 15, 29, 36, 43) (P3) or other CHT at the treating physician’s discretion. (3) Results: Between 05/2009 and 11/2016, 205 patients were randomized and 172 included in the per-protocol analysis. Patients treated in P1 or P2 had a better overall survival (OS) compared to P3 (p = 0.015, p = 0.01, respectively). Patients treated with carboplatin had a worse OS compared to cisplatin (HR 1.78, p = 0.03), but the difference did not remain significant after adjusting for age, ECOG, cardiac function creatinine and completeness of CHT. (4) Conclusions: Carboplatin doublets show no significant difference compared to cisplatin, after adjusting for possibly relevant factors, probably due to existing selection bias.
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Affiliation(s)
- Eleni Gkika
- Department of Radiation Oncology, Medical Center—University of Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (T.S.-J.); (H.C.R.); (S.A.); (A.-L.G.); (U.N.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (DKFZ), Neuenheimer Feld 280, 69120 Heidelberg, Germany
- Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (C.F.W.); (M.M.)
- Correspondence: ; Tel.: +49-(0)-761-95371
| | - Stefan Lenz
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, 79106 Freiburg, Germany; (S.L.); (H.B.)
| | - Tanja Schimek-Jasch
- Department of Radiation Oncology, Medical Center—University of Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (T.S.-J.); (H.C.R.); (S.A.); (A.-L.G.); (U.N.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (DKFZ), Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Cornelius F. Waller
- Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (C.F.W.); (M.M.)
- Department of Medicine I, Hematology, Oncology and Stem Cell Transplantation, Medical Center-University of Freiburg, 79106 Freiburg, Germany
| | - Stephanie Kremp
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Center and Faculty of Medicine, 66421 Homburg/Saar, Germany; (S.K.); (J.F.)
| | - Andrea Schaefer-Schuler
- Department of Nuclear Medicine, Saarland University Medical Center and Faculty of Medicine, 66421 Homburg/Saar, Germany;
| | - Michael Mix
- Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (C.F.W.); (M.M.)
- Department of Nuclear Medicine, Medical Center—University of Freiburg, 79106 Freiburg, Germany
| | - Andreas Küsters
- Department of Radiation Oncology, Kliniken Maria Hilf, 41063 Mönchengladbach, Germany;
| | - Marco Tosch
- Department of Nuclear Medicine, Helios University Hospital Wuppertal, 42283 Wuppertal, Germany;
- Department of Medicine, Faculty of Health, University of Witten/Herdecke, 58448 Witten, Germany
| | - Thomas Hehr
- Department of Radiation Oncology, Marienhospital, 70199 Stuttgart, Germany;
| | | | - Yves-Pierre Bultel
- Department of Radiation Oncology, Klinikum Mutterhaus der Boromäerinnen, 54290 Trier, Germany;
| | - Peter Hass
- Department of Radiation Oncology, University Hospital Magdeburg, 39120 Magdeburg, Germany;
| | - Jochen Fleckenstein
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Center and Faculty of Medicine, 66421 Homburg/Saar, Germany; (S.K.); (J.F.)
| | - Alexander Henry Thieme
- Department of Radiation Oncology, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany;
| | - Marcus Stockinger
- Department of Radiation Oncology, University Hospital Mainz, 55131 Mainz, Germany;
| | - Karin Dieckmann
- Department of Radiotherapy, Vienna General Hospital, Medical University of Vienna, 1090 Vienna, Austria;
| | - Matthias Miederer
- Department of Nuclear Medicine, University Hospital Mainz, 55131 Mainz, Germany;
| | - Gabriele Holl
- Department of Nuclear Medicine, Kliniken Schwerin, 19055 Schwerin, Germany;
| | - Hans Christian Rischke
- Department of Radiation Oncology, Medical Center—University of Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (T.S.-J.); (H.C.R.); (S.A.); (A.-L.G.); (U.N.)
- Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (C.F.W.); (M.M.)
- Department of Nuclear Medicine, Medical Center—University of Freiburg, 79106 Freiburg, Germany
| | - Sonja Adebahr
- Department of Radiation Oncology, Medical Center—University of Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (T.S.-J.); (H.C.R.); (S.A.); (A.-L.G.); (U.N.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (DKFZ), Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Jochem König
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Hospital of Mainz, 55131 Mainz, Germany;
| | - Harald Binder
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, 79106 Freiburg, Germany; (S.L.); (H.B.)
| | - Anca-Ligia Grosu
- Department of Radiation Oncology, Medical Center—University of Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (T.S.-J.); (H.C.R.); (S.A.); (A.-L.G.); (U.N.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (DKFZ), Neuenheimer Feld 280, 69120 Heidelberg, Germany
- Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (C.F.W.); (M.M.)
| | - Ursula Nestle
- Department of Radiation Oncology, Medical Center—University of Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (T.S.-J.); (H.C.R.); (S.A.); (A.-L.G.); (U.N.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (DKFZ), Neuenheimer Feld 280, 69120 Heidelberg, Germany
- Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (C.F.W.); (M.M.)
- Department of Radiation Oncology, Kliniken Maria Hilf, 41063 Mönchengladbach, Germany;
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Bobbili P, Ryan K, DerSarkissian M, Dua A, Yee C, Duh MS, Gomez JE. Predictors of chemoradiotherapy versus single modality therapy and overall survival among patients with unresectable, stage III non-small cell lung cancer. PLoS One 2020; 15:e0230444. [PMID: 32187231 PMCID: PMC7080248 DOI: 10.1371/journal.pone.0230444] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 02/29/2020] [Indexed: 12/25/2022] Open
Abstract
Introduction Concurrent chemoradiotherapy (cCRT) was the standard of care for patients with unresectable stage III non-small cell lung cancer (NSCLC) prior to the PACIFIC trial, however, patients also received single modality therapy. This study identified predictors of therapy and differences in overall survival (OS). Methods This retrospective study included stage III NSCLC patients aged ≥65 years, with ≥1 claim for systemic therapy (ST) or radiotherapy (RT) within 90 days of diagnosis, identified in SEER-Medicare data (2009–2014). Patients who had overlapping claims for chemotherapy and RT ≤90 days from start of therapy were classified as having received cCRT. Patients who received sequential CRT or surgical resection of tumor were excluded. Predictors of cCRT were analyzed using logistic regression. OS was compared between therapies using adjusted Cox proportional hazards models. Results Of 3,799 patients identified, 21.7% received ST; 26.3% received RT; and 52.0% received cCRT. cCRT patients tended to be younger (p <0.001), White (p = 0.002), and have a good predicted performance status (p<0.001). Patients who saw all three specialist types (medical oncologist, radiation oncologist, and surgeon) had increased odds of receiving cCRT (p<0.001). ST and RT patients had higher mortality risk versus cCRT patients (hazard ratio [95% CI]: ST: 1.38 [1.26–1.51]; RT: 1.75 [1.61, 1.91]); p<0.001). Conclusions Several factors contributed to treatment selection, including patient age and health status, and whether the patient received multidisciplinary care. Given the survival benefit of receiving cCRT over single-modality therapy, physicians should discuss treatment within a multidisciplinary team, and be encouraged to pursue cCRT for patients with unresectable stage III NSCLC.
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Affiliation(s)
- Priyanka Bobbili
- Analysis Group, Inc., Boston, Massachusetts, United States of America
- * E-mail:
| | - Kellie Ryan
- AstraZeneca, Gaithersburg, Maryland, United States of America
| | | | - Akanksha Dua
- Analysis Group, Inc., Boston, Massachusetts, United States of America
| | - Christopher Yee
- Analysis Group, Inc., Boston, Massachusetts, United States of America
| | - Mei Sheng Duh
- Analysis Group, Inc., Boston, Massachusetts, United States of America
| | - Jorge E. Gomez
- Icahn School of Medicine at Mt. Sinai, New York, New York, United States of America
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Zhang P, He D, Song E, Jiang M, Song Y. Celecoxib enhances the sensitivity of non-small-cell lung cancer cells to radiation-induced apoptosis through downregulation of the Akt/mTOR signaling pathway and COX-2 expression. PLoS One 2019; 14:e0223760. [PMID: 31613929 PMCID: PMC6793859 DOI: 10.1371/journal.pone.0223760] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 09/27/2019] [Indexed: 12/21/2022] Open
Abstract
The current study aimed to identify the radiosensitizing effect of celecoxib, a selective cyclooxygenase-2 (COX-2) inhibitor, in combination with radiotherapy in non-small-cell lung cancer (NSCLC) cells. The combination of celecoxib potentiated radiation-induced apoptosis; however, no changes in cell cycle distribution and number of phosphorylated histone H2AX foci were detected, indicating a DNA damage-independent mechanism. In an in vivo mouse model, the tumor size was significantly decreased in the group combining celecoxib with radiation compared with the radiation only group. Phosphorylation of protein kinase B (Akt) and mammalian target of rapamycin (mTOR), as well as expression of COX-2 were significantly downregulated in cells treated with the combination of celecoxib and radiation compared with the radiation only group. The result indicated that celecoxib exhibits radiosensitizing effects through COX-2 and Akt/mTOR-dependent mechanisms. Induction the Akt/mTOR signaling pathway promotes radioresistance in various cancers, including NSCLC. Therefore, the current study suggested the therapeutic potential of combination therapy of celecoxib and radiation in the prevention of radioresistance.
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Affiliation(s)
- Pan Zhang
- Key Laboratory of Luminescence and Real-Time Analytical Chemistry, Ministry of Education, College of Pharmaceutical Sciences, Southwest University, Chongqing, P. R. China
| | - Dan He
- Department of Oncology, Nuclear Industry Hospital, Chengdu, Sichuan, P. R. China
| | - Erqun Song
- Key Laboratory of Luminescence and Real-Time Analytical Chemistry, Ministry of Education, College of Pharmaceutical Sciences, Southwest University, Chongqing, P. R. China
| | - Mingdong Jiang
- Department of Radiation Oncology, The Ninth People's Hospital of Chongqing, Chongqing, P. R. China
- * E-mail: (YS); (MJ)
| | - Yang Song
- Key Laboratory of Luminescence and Real-Time Analytical Chemistry, Ministry of Education, College of Pharmaceutical Sciences, Southwest University, Chongqing, P. R. China
- * E-mail: (YS); (MJ)
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Bobbili P, Ryan K, Duh MS, Dua A, Fernandes AW, Pavilack M, Gomez JE. Treatment patterns and overall survival among patients with unresectable, stage III non-small-cell lung cancer. Future Oncol 2019; 15:3381-3393. [PMID: 31544510 DOI: 10.2217/fon-2019-0282] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Aim: To analyze treatment patterns and overall survival (OS) across time (2009-2014) among patients with unresected, stage III non-small-cell lung cancer (NSCLC). Patients & methods: Stage III NSCLC patients aged ≥65 years who initiated therapy were identified using SEER-Medicare data. Results: Among 4564 patients, 84% received chemotherapy (with or without radiotherapy), and 59% received chemoradiotherapy (CRT). Carboplatin + paclitaxel was the most frequent regimen. Median (interquartile range) OS among chemotherapy patients was 13.2 (6.0-28.9) months, and 14.8 (6.7-33.4) months among CRT patients. Among CRT patients, there was no difference in OS across years of CRT initiation. Conclusion: OS remained static across 2009-2014, indicating stagnancy in clinical outcomes for stage III NSCLC patients and a need for more effective therapeutic options.
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Affiliation(s)
| | - Kellie Ryan
- US Medical Affairs, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Mei S Duh
- Analysis Group, Inc., Boston, MA 02199, USA
| | | | | | | | - Jorge E Gomez
- Icahn School of Medicine at Mt Sinai, New York, NY 10029, USA
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Radiation Therapy in Non-small-Cell Lung Cancer. Radiat Oncol 2019. [DOI: 10.1007/978-3-319-52619-5_34-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Abstract
INTRODUCTION Epidermal Growth Factor Receptor (EGFR)-dependent signaling plays a crucial role in epithelial cancer biology, and dictated the development of several targeting agents. The mouse-human chimeric antibody Cetuximab was among the first to be developed. After about two decades of clinical research it has gained a significant place in the management of advanced colorectal and head and neck cancers, whereas its development in non small cell lung cancer (NSCLC) has not led to a place in routine clinical practice, because of marginal clinical benefit despite statistically significant Phase III trials. Recent data from ongoing trials suggest that more careful selection based on molecular markers may identify good responders. Areas covered: In this article, the authors review the literature concerning basic science studies identifying EGFR as a therapeutic target, pharmacological development of Cetuximab, its pharmacodynamics and pharmacokinetics, and clinical trials on Cetuximab in NSCLC, focusing on recent findings on putative predictive biomarkers. Expert opinion: Cetuximab currently has no role in NSCLC treatment outside of research settings. We argue that failure to identify a predictive biomarker early on has hampered its chances to enter routine practice. Although recent research suggests benefit in highly selected patient subsets, its potential impact is severely dampened by lack of regulatory body approval and the emergence of competitors for the same niches.
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Affiliation(s)
- Luca Mazzarella
- a University of Milano, Department of Oncology and Hemato-Oncology, Division of Early Drug Development for Innovative Therapies , European Institute of Oncology , Milano , Italia
| | - Alessandro Guida
- a University of Milano, Department of Oncology and Hemato-Oncology, Division of Early Drug Development for Innovative Therapies , European Institute of Oncology , Milano , Italia
| | - Giuseppe Curigliano
- a University of Milano, Department of Oncology and Hemato-Oncology, Division of Early Drug Development for Innovative Therapies , European Institute of Oncology , Milano , Italia
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Jo SD, Lee J, Joo MK, Pizzuti VJ, Sherck NJ, Choi S, Lee BS, Yeom SH, Kim SY, Kim SH, Kwon IC, Won YY. PEG–PLA-Coated and Uncoated Radio-Luminescent CaWO4 Micro- and Nanoparticles for Concomitant Radiation and UV-A/Radio-Enhancement Cancer Treatments. ACS Biomater Sci Eng 2018; 4:1445-1462. [DOI: 10.1021/acsbiomaterials.8b00119] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Sung Duk Jo
- Center for Theragnosis, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), 5 Hwarang-ro 14-gil, Seongbuk-gu, Seoul 02792, South Korea
| | - Jaewon Lee
- School of Chemical Engineering, Purdue University, 480 Stadium Mall Drive, West Lafayette, Indiana 47907, United States
| | - Min Kyung Joo
- Center for Theragnosis, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), 5 Hwarang-ro 14-gil, Seongbuk-gu, Seoul 02792, South Korea
| | - Vincenzo J. Pizzuti
- School of Chemical Engineering, Purdue University, 480 Stadium Mall Drive, West Lafayette, Indiana 47907, United States
| | - Nicholas J. Sherck
- School of Chemical Engineering, Purdue University, 480 Stadium Mall Drive, West Lafayette, Indiana 47907, United States
| | - Slgi Choi
- School of Chemical Engineering, Purdue University, 480 Stadium Mall Drive, West Lafayette, Indiana 47907, United States
| | - Beom Suk Lee
- Center for Theragnosis, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), 5 Hwarang-ro 14-gil, Seongbuk-gu, Seoul 02792, South Korea
| | - Sung Ho Yeom
- Department of Biochemical Engineering, Gangneung-Wonju National University, 7 Jukheon-gil, Gangneung-si, Gangwon-do 25457, South Korea
| | - Sang Yoon Kim
- Center for Theragnosis, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), 5 Hwarang-ro 14-gil, Seongbuk-gu, Seoul 02792, South Korea
| | - Sun Hwa Kim
- Center for Theragnosis, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), 5 Hwarang-ro 14-gil, Seongbuk-gu, Seoul 02792, South Korea
| | - Ick Chan Kwon
- Center for Theragnosis, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), 5 Hwarang-ro 14-gil, Seongbuk-gu, Seoul 02792, South Korea
| | - You-Yeon Won
- Center for Theragnosis, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), 5 Hwarang-ro 14-gil, Seongbuk-gu, Seoul 02792, South Korea
- School of Chemical Engineering, Purdue University, 480 Stadium Mall Drive, West Lafayette, Indiana 47907, United States
- Purdue University Center for Cancer Research, 201 South University Street, West Lafayette, Indiana 47907, Unites States
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Bettega D, Calzolari P, Ciocca M, Facoetti A, Lafiandra M, Marchesini R, Molinelli S, Pignoli E, Vischioni B. Combining proton or photon irradiation with epothilone B. An
in vitro
study of cytotoxicity in human cancer cells. Biomed Phys Eng Express 2017. [DOI: 10.1088/2057-1976/aa818f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Yoon SM, Shaikh T, Hallman M. Therapeutic management options for stage III non-small cell lung cancer. World J Clin Oncol 2017; 8:1-20. [PMID: 28246582 PMCID: PMC5309711 DOI: 10.5306/wjco.v8.i1.1] [Citation(s) in RCA: 176] [Impact Index Per Article: 25.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 09/20/2016] [Accepted: 12/28/2016] [Indexed: 02/06/2023] Open
Abstract
Lung cancer is the leading cause of cancer death worldwide. Majority of newly diagnosed lung cancers are non-small cell lung cancer (NSCLC), of which up to half are considered locally advanced at the time of diagnosis. Patients with locally advanced stage III NSCLC consists of a heterogeneous population, making management for these patients complex. Surgery has long been the preferred local treatment for patients with resectable disease. For select patients, multi-modality therapy involving systemic and radiation therapies in addition to surgery improves treatment outcomes compared to surgery alone. For patients with unresectable disease, concurrent chemoradiation is the preferred treatment. More recently, research into different chemotherapy agents, targeted therapies, radiation fractionation schedules, intensity-modulated radiotherapy, and proton therapy have shown promise to improve treatment outcomes and quality of life. The array of treatment approaches for locally advanced NSCLC is large and constantly evolving. An updated review of past and current literature for the roles of surgery, chemotherapeutic agents, radiation therapy, and targeted therapy for stage III NSCLC patients are presented.
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Definitive chemoradiation for non-small-cell lung cancer: could a consensus be reached? TUMORI JOURNAL 2016; 102:496-500. [PMID: 26166225 DOI: 10.5301/tj.5000384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2015] [Indexed: 11/20/2022]
Abstract
AIMS AND BACKGROUND There is currently no consensus as to which chemotherapy to combine with thoracic radiotherapy (TRT) in the setting of definitive chemoradiation for non-small-cell lung cancer (NSCLC). We aimed to retrospectively evaluate the efficacy and report outcome measures of cisplatin/etoposide with conventionally fractionated TRT over a 9-year period. METHODS Cisplatin 50 mg/m² on days 1, 8, 29, and 36 and etoposide 50 mg/m² on days 1-5 and 29-33 with conventionally fractionated conformal radiation therapy starting on day 1 was given to 201 eligible patients. Patient records were reviewed for overall survival (OS) and progression-free survival (PFS). RESULTS The 2-year OS and PFS were 53% and 47%, respectively, while the 3-year OS and PFS were 18% and 17%, respectively. No grade 4 or treatment-related deaths were recorded, and grade 3 hematologic toxicity occurred in only 22 patients (11%) in the form of granulocytopenia and thrombocytopenia. Multivariable analysis showed clinical stage and Eastern Cooperative Oncology Group performance status to statistically significantly affect PFS and OS. CONCLUSIONS Cisplatin and etoposide in these doses with conventionally fractionated TRT is a well-tolerated, effective treatment schedule in the definitive treatment of unresectable or inoperable NSCLC.
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Scientific Advances in Lung Cancer 2015. J Thorac Oncol 2016; 11:613-638. [DOI: 10.1016/j.jtho.2016.03.012] [Citation(s) in RCA: 185] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 03/16/2016] [Accepted: 03/16/2016] [Indexed: 02/07/2023]
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