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Cho BC, Ahn MJ, Kang JH, Soo RA, Reungwetwattana T, Yang JCH, Cicin I, Kim DW, Wu YL, Lu S, Lee KH, Pang YK, Zimina A, Fong CH, Poddubskaya E, Sezer A, How SH, Danchaivijitr P, Kim Y, Lim Y, An T, Lee H, Byun HM, Zaric B. Lazertinib Versus Gefitinib as First-Line Treatment in Patients With EGFR-Mutated Advanced Non-Small-Cell Lung Cancer: Results From LASER301. J Clin Oncol 2023; 41:4208-4217. [PMID: 37379502 DOI: 10.1200/jco.23.00515] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/25/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023] Open
Abstract
PURPOSE Lazertinib is a potent, CNS-penetrant, third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor. This global, phase III study (LASER301) compared lazertinib versus gefitinib in treatment-naïve patients with EGFR-mutated (exon 19 deletion [ex19del]/L858R) locally advanced or metastatic non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS Patients were 18 years and older with no previous systemic anticancer therapy. Neurologically stable patients with CNS metastases were allowed. Patients were randomly assigned 1:1 to lazertinib 240 mg once daily orally or gefitinib 250 mg once daily orally, stratified by mutation status and race. The primary end point was investigator-assessed progression-free survival (PFS) by RECIST v1.1. RESULTS Overall, 393 patients received double-blind study treatment across 96 sites in 13 countries. Median PFS was significantly longer with lazertinib than with gefitinib (20.6 v 9.7 months; hazard ratio [HR], 0.45; 95% CI, 0.34 to 0.58; P < .001). The PFS benefit of lazertinib over gefitinib was consistent across all predefined subgroups. The objective response rate was 76% in both groups (odds ratio, 0.99; 95% CI, 0.62 to 1.59). Median duration of response was 19.4 months (95% CI, 16.6 to 24.9) with lazertinib versus 8.3 months (95% CI, 6.9 to 10.9) with gefitinib. Overall survival data were immature at the interim analysis (29% maturity). The 18-month survival rate was 80% with lazertinib and 72% with gefitinib (HR, 0.74; 95% CI, 0.51 to 1.08; P = .116). Observed safety of both treatments was consistent with their previously reported safety profiles. CONCLUSION Lazertinib demonstrated significant efficacy improvement compared with gefitinib in the first-line treatment of EGFR-mutated advanced NSCLC, with a manageable safety profile.
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Affiliation(s)
- Byoung Chul Cho
- Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Myung-Ju Ahn
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jin Hyoung Kang
- Division of Medical Oncology, Department of Internal Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ross A Soo
- National University Hospital, Singapore, Singapore
| | - Thanyanan Reungwetwattana
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - James Chih-Hsin Yang
- National Taiwan University Cancer Center and National Taiwan University Hospital, Taipei, Taiwan
| | - Irfan Cicin
- Department of Medical Oncology, Trakya University Medical Center, Edirne, Turkey
| | - Dong-Wan Kim
- Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yi-Long Wu
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Shun Lu
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai JiaoTong University, Shanghai, China
| | - Ki Hyeong Lee
- Internal Medicine Department, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Yong-Kek Pang
- Department of Medicine, Faculty of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Anastasia Zimina
- Department of Oncology, Omsk Clinical Oncological Dispensary, Omsk, Russian Federation
| | - Chin Heng Fong
- Department of Radiotherapy and Oncology, Hospital Pulau Pinang, Penang, Malaysia
| | - Elena Poddubskaya
- Personalized Oncology Department, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Ahmet Sezer
- Adana Baskent Practice and Research Hospital, Adana, Turkey
| | - Soon Hin How
- Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia
| | | | | | - Yeji Lim
- Yuhan Corporation, Seoul, Republic of Korea
| | - Taewon An
- Yuhan Corporation, Seoul, Republic of Korea
| | - Hana Lee
- Yuhan Corporation, Seoul, Republic of Korea
| | | | - Bojan Zaric
- Faculty of Medicine, Institute for Pulmonary Diseases of Vojvodina, University of Novi Sad, Novi Sad, Serbia
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Djekic Malbasa J, Kovacevic T, Zaric B, Dugandzija T, Nikolin B, Radovanovic D, Paut Kusturica M. Decade of lung cancer in Serbia: tobacco abuse and gender differences. Eur Rev Med Pharmacol Sci 2023; 27:3105-3116. [PMID: 37070914 DOI: 10.26355/eurrev_202304_31945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
OBJECTIVE Lung cancer (LC) is one of the most frequently diagnosed cancers and the leading cause of cancer mortality worldwide. The aim of this study was to get a comprehensive insight into the epidemiology of LC among patients in Vojvodina, the Northern Serbian region, during the ten-year period. PATIENTS AND METHODS This retrospective study was performed using LC hospital registry data of the Institute for Pulmonary Diseases of Vojvodina (IPBV) from 2011 to 2020. All patients reported in the registry with a place of residence in Vojvodina were included in this study. The data used in this research were: date of diagnosis, gender, age at diagnosis, place of residence, smoking habits at diagnosis, the intensity of smoking (pack/years), ECOG performance (0-5), histological cancer type, TNM classification and disease stage. RESULTS A total of 12,055 LC patients were included, 69.6% of whom were male. The percentage of female LC patients significantly increased, from 26.9% in 2011 to 35.9% in 2020 (p<0.001). Non-small cell lung cancer (NSCLC) was diagnosed in 80.8% of patients, while 15.4% of patients had small cell lung cancer (SCLC). The most common histological type was adenocarcinoma (41.9%), followed by squamous cell carcinoma (30.0%) and SCLC (15.4%). CONCLUSIONS The number of diagnosed LC patients in the Northern Serbian region increased over the past decade and is significantly higher in females. There was a strong correlation between smoking habits and LC in both genders. Our results also indicate the importance of introducing and promoting LC screening programs for all risk populations, particularly current and ex-smokers of younger age.
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Affiliation(s)
- J Djekic Malbasa
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
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Oikonomidou R, Petridis D, Kosmidis C, Sapalidis K, Hohenforst-Schmidt W, Christakidis V, Petanidis S, Mathaios D, Perdikouri EI, Baka S, Tolis C, Vagionas A, Zaric B, Ioannidis A, Anemoulis M, Porpodis K, Papadopoulos V, Zarogoulidis P. Cryo-Biopsy versus 19G needle versus 22G needle with EBUS-TBNA endoscopy. J Cancer 2022; 13:3084-3090. [PMID: 36046658 PMCID: PMC9414011 DOI: 10.7150/jca.75589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 07/17/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction: We have been using cryo-biopsy for endobronchial lesions for lung cancer diagnosis and debulking. Cryo-biopsy is also known to be an excellent tool for diagnosis of lung interstitial disease. Recently cryo-biopsy with the 1.1mm probe was used for lymphnode biopsy. Patients and Methods: 311 patients participated with lymphadenopathy and at least one lung lesion. The following tools were used for diagnosis; 22G Mediglobe Sonotip, 22G Medigolbe, 21G Olympus, 19G Olympus and 1.1mm cryo probe ERBE CRYO 2 system (3 seconds froze). A PENTAX Convex-probe EBUS was used for biopsy guidance. Results: Cell-blocks slices had a higher number in the 19G needle group (19G> Cryo Probe>22G Mediglobe Sonotip >21G Olympus >22G Mediglobe). Conclusion: Cryo biopsy of the lymphnodes is safe with the 1.1mm cryo probe. Further studies are needed in order to evaluate new probes and the technique specifications.
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Affiliation(s)
| | - Dimitris Petridis
- Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece
| | | | | | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, ''Hof'' Clinics, University of Erlangen, Hof, Germany
| | | | - Savas Petanidis
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | | | | | - Sofia Baka
- Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece
| | | | | | - Bojan Zaric
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Aris Ioannidis
- Surgery Department, Genesis Private Hospital, Thessaloniki, Greece
| | - Marios Anemoulis
- General Surgery Department, General Clinic Euromedica, Thessaloniki, Greece
| | - Konstantinos Porpodis
- Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Papadopoulos
- Oncology Department, University General Hospital of Larissa, University of Thessali, Larissa, Greece
| | - Paul Zarogoulidis
- Pulmonary-Oncology Department, "General Clinic" Private Clinic, Thessaloniki, Greece
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Kovacevic T, Zaric B, Bokan D, Mikov I. EP04.02-006 Burn-Out Syndrome: Neglected Syndrome Among Health Care Professionals Managing Lung Cancer Patients. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Djekic Malbasa J, Kovacevic T, Bokan D, Zaric B. EP03.01-017 Epidemiology of Lung Cancer in Northern Serbia During the Past Ten Years. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cavic M, Kovacevic T, Zaric B, Stojiljkovic D, Korda NJ, Rancic M, Jankovic R, Radosavljevic D, Stojanovic G, Spasic J. Lung Cancer in Serbia. J Thorac Oncol 2022; 17:867-872. [PMID: 35750454 DOI: 10.1016/j.jtho.2022.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/08/2022] [Accepted: 04/08/2022] [Indexed: 12/25/2022]
Affiliation(s)
- Milena Cavic
- Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia.
| | - Tomi Kovacevic
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - Bojan Zaric
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - Dejan Stojiljkovic
- Surgical Oncology Clinic, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Natasa Jovanovic Korda
- Clinic for Radiation Oncology and Diagnostics, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Milan Rancic
- Faculty of Medicine, University of Nis, Nis, Serbia; Pulmonary Diseases Clinic, University Clinical Center Nis, Nis, Serbia
| | - Radmila Jankovic
- Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Davorin Radosavljevic
- Clinic for Medical Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Goran Stojanovic
- Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - Jelena Spasic
- Clinic for Medical Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
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Alvarez-Romero C, Martínez-García A, Sinaci AA, Gencturk M, Méndez E, Hernández-Pérez T, Liperoti R, Angioletti C, Löbe M, Ganapathy N, Deserno TM, Almada M, Costa E, Chronaki C, Cangioli G, Cornet R, Poblador-Plou B, Carmona-Pírez J, Gimeno-Miguel A, Poncel-Falcó A, Prados-Torres A, Kovacevic T, Zaric B, Bokan D, Hromis S, Djekic Malbasa J, Rapallo Fernández C, Velázquez Fernández T, Rochat J, Gaudet-Blavignac C, Lovis C, Weber P, Quintero M, Perez-Perez MM, Ashley K, Horton L, Parra Calderón CL. FAIR4Health: Findable, Accessible, Interoperable and Reusable data to foster Health Research. Open Res Eur 2022; 2:34. [PMID: 37645268 PMCID: PMC10446092 DOI: 10.12688/openreseurope.14349.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/25/2022] [Indexed: 08/31/2023]
Abstract
Due to the nature of health data, its sharing and reuse for research are limited by ethical, legal and technical barriers. The FAIR4Health project facilitated and promoted the application of FAIR principles in health research data, derived from the publicly funded health research initiatives to make them Findable, Accessible, Interoperable, and Reusable (FAIR). To confirm the feasibility of the FAIR4Health solution, we performed two pathfinder case studies to carry out federated machine learning algorithms on FAIRified datasets from five health research organizations. The case studies demonstrated the potential impact of the developed FAIR4Health solution on health outcomes and social care research. Finally, we promoted the FAIRified data to share and reuse in the European Union Health Research community, defining an effective EU-wide strategy for the use of FAIR principles in health research and preparing the ground for a roadmap for health research institutions. This scientific report presents a general overview of the FAIR4Health solution: from the FAIRification workflow design to translate raw data/metadata to FAIR data/metadata in the health research domain to the FAIR4Health demonstrators' performance.
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Affiliation(s)
- Celia Alvarez-Romero
- Computational Health Informatics Group, Institute of Biomedicine of Seville, IBiS / Virgen del Rocío University Hospital / CSIC / University of Seville, Seville, 41013, Spain
| | - Alicia Martínez-García
- Computational Health Informatics Group, Institute of Biomedicine of Seville, IBiS / Virgen del Rocío University Hospital / CSIC / University of Seville, Seville, 41013, Spain
| | - A. Anil Sinaci
- SRDC Software Research Development and Consultancy Corporation, Ankara, 06800, Turkey
| | - Mert Gencturk
- SRDC Software Research Development and Consultancy Corporation, Ankara, 06800, Turkey
| | - Eva Méndez
- Dept. of Library & Inf Sci. Universidad Carlos III de Madrid, Getafe, 28903, Spain
| | - Tony Hernández-Pérez
- Dept. of Library & Inf Sci. Universidad Carlos III de Madrid, Getafe, 28903, Spain
| | - Rosa Liperoti
- Department of Geriatric and Orthopedic Sciences, Catholic University of Sacred Heart, Roma, 00168, Italy
| | - Carmen Angioletti
- Department of Geriatric and Orthopedic Sciences, Catholic University of Sacred Heart, Roma, 00168, Italy
| | - Matthias Löbe
- Institute for Medical Informatics (IMISE), University of Leipzig, Leipzig, 04107, Germany
| | - Nagarajan Ganapathy
- PLRI Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Braunschweig, 38106, Germany
| | - Thomas M. Deserno
- PLRI Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Braunschweig, 38106, Germany
| | - Marta Almada
- Ucibio Requimte, Faculty of Pharmacy University of Porto. Porto4Ageing, Porto, 4050-313, Portugal
| | - Elisio Costa
- Ucibio Requimte, Faculty of Pharmacy University of Porto. Porto4Ageing, Porto, 4050-313, Portugal
| | | | | | - Ronald Cornet
- Amsterdam UMC, University of Amsterdam, Medical Informatics, Amsterdam Public Health, Amsterdam, 1105AZ, The Netherlands
| | - Beatriz Poblador-Plou
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, 50009, Spain
| | - Jonás Carmona-Pírez
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, 50009, Spain
| | - Antonio Gimeno-Miguel
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, 50009, Spain
| | - Antonio Poncel-Falcó
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Aragon Health Service, Zaragoza, 50009, Spain
| | - Alexandra Prados-Torres
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, 50009, Spain
| | - Tomi Kovacevic
- Medical Faculty University of Novi Sad, Novi Sad, 21000, Serbia
- Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, 21204, Serbia
| | - Bojan Zaric
- Medical Faculty University of Novi Sad, Novi Sad, 21000, Serbia
- Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, 21204, Serbia
| | - Darijo Bokan
- Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, 21204, Serbia
| | - Sanja Hromis
- Medical Faculty University of Novi Sad, Novi Sad, 21000, Serbia
- Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, 21204, Serbia
| | - Jelena Djekic Malbasa
- Medical Faculty University of Novi Sad, Novi Sad, 21000, Serbia
- Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, 21204, Serbia
| | | | | | - Jessica Rochat
- University of Geneva and University hospitals of Geneva, Geneva, 1211, Switzerland
| | | | - Christian Lovis
- University of Geneva and University hospitals of Geneva, Geneva, 1211, Switzerland
| | - Patrick Weber
- Nice Computing SA Le Mont-sur-Lausanne, Le Mont-sur-Lausanne, 1052, Switzerland
| | - Miriam Quintero
- Atos Research and Innovation - ARI. Atos IT., Madrid, 28037, Spain
- Atos Research and Innovation - ARI. Atos Spain., Madrid, 28037, Spain
| | - Manuel M. Perez-Perez
- Atos Research and Innovation - ARI. Atos IT., Madrid, 28037, Spain
- Atos Research and Innovation - ARI. Atos Spain., Madrid, 28037, Spain
| | - Kevin Ashley
- Digital Curation Centre, University of Edinburgh, Argyle House, Edinburgh, EH3 9DR, UK
| | - Laurence Horton
- Digital Curation Centre, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Carlos Luis Parra Calderón
- Computational Health Informatics Group, Institute of Biomedicine of Seville, IBiS / Virgen del Rocío University Hospital / CSIC / University of Seville, Seville, 41013, Spain
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Spasic J, Cavic M, Stanic N, Zaric B, Kovacevic T, Radosavljevic D, Nagorni-Obradovic L. Low-Cost Genetic and Clinical Predictors of Response and Toxicity of Platinum-Based Chemotherapy in Advanced Non-Small Cell Lung Cancer. Dose Response 2022; 20:15593258221111666. [PMID: 35783235 PMCID: PMC9247378 DOI: 10.1177/15593258221111666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/09/2022] [Accepted: 06/16/2022] [Indexed: 11/16/2022] Open
Abstract
Background This study aimed to evaluate for the first time whether certain genetic and
clinical factors could serve as minimally invasive predictors of survival
and toxicity to platinum-based chemotherapy in advanced lung
adenocarcinoma. Methods The study included 121 advanced lung adenocarcinoma patients treated with
platinum-based dublets until progression or unacceptable toxicity. Response
was evaluated using standard radiological methods and toxicity graded
according to the Common Terminology Criteria for Adverse Events (CTCAE)
v5.0. Genotyping was performed using PCR-RFLP. Statistical significance was
set at P < .05. Results No significant influence of the examined polymorphisms on the occurrence of
high-grade toxicity was detected. However, TP53 72Pro allele carriers were
more prone to nausea (P = .037) and thrombocytopenia (P = .051). Anemia and
neuropathy occurred more frequently in XRCC1 399Arg allele carriers (Pearson
χ2 test, P = .025 and P = .004 respectively). RAD51 135CC carriers were
significantly more prone to neutropenia (P = .027). Conclusions A set of easily determined genetic and clinical predictors of survival and
specific toxicity profiles of platinum-based chemotherapy in advanced lung
adenocarcinoma were determined in this study, which might be useful for the
construction of population-specific, time- and cost-efficient prognostic and
predictive algorithms.
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Affiliation(s)
- Jelena Spasic
- Clinic for Medical Oncology, Institute for Oncology and Radiology of Serbia, Serbia
| | - Milena Cavic
- Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Serbia
| | - Nemanja Stanic
- Clinic for Medical Oncology, Institute for Oncology and Radiology of Serbia, Serbia
| | - Bojan Zaric
- Faculty of Medicine, University of Novi Sad, Serbia.,Institute for Pulmonary Diseases of Vojvodina, Serbia
| | - Tomi Kovacevic
- Faculty of Medicine, University of Novi Sad, Serbia.,Institute for Pulmonary Diseases of Vojvodina, Serbia
| | | | - Ljudmila Nagorni-Obradovic
- Faculty of Medicine, University of Belgrade, Serbia.,Clinic for Pulmonology, University Clinical Centre of Serbia, Serbia
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Bokan D, Zaric B, Kovacevic T, Djekic Malbasa J, Andrijevic I. 136P Lung cancer epidemiology and survival outcomes in Vojvodina, Serbia. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Oikonomidou R, Petridis D, Alexidis P, Matthaios D, Boukovinas I, Perdikouri EI, Baka S, Hohenforst-Schmidt W, Huang H, bai C, Zaric B, Freitag L, Courcoutsakis N, Anemoulis M, Kosmidis C, Foroulis C, Petanidis S, Papadopoulos V, Ioannidis A, Zarogoulidis P. “One Shot” Sample Evaluation of 22G, 22G upgraded, 21G and 19G needle for Endobronchial Ultrasound-EBUS-TBNA. J Cancer 2022; 13:2982-2987. [PMID: 36046659 PMCID: PMC9414030 DOI: 10.7150/jca.74022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/12/2022] [Indexed: 11/05/2022] Open
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Alvarez-Romero C, Martinez-Garcia A, Ternero Vega J, Díaz-Jimènez P, Jimènez-Juan C, Nieto-Martín MD, Román Villarán E, Kovacevic T, Bokan D, Hromis S, Djekic Malbasa J, Beslać S, Zaric B, Gencturk M, Sinaci AA, Ollero Baturone M, Parra Calderón CL. Predicting 30-days Readmission Risk for COPD Patients Care through a Federated Machine Learning Architecture on FAIR Data: Development and Validation Study (Preprint). JMIR Med Inform 2021; 10:e35307. [PMID: 35653170 PMCID: PMC9204581 DOI: 10.2196/35307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/16/2022] [Accepted: 04/21/2022] [Indexed: 12/16/2022] Open
Abstract
Background Owing to the nature of health data, their sharing and reuse for research are limited by legal, technical, and ethical implications. In this sense, to address that challenge and facilitate and promote the discovery of scientific knowledge, the Findable, Accessible, Interoperable, and Reusable (FAIR) principles help organizations to share research data in a secure, appropriate, and useful way for other researchers. Objective The objective of this study was the FAIRification of existing health research data sets and applying a federated machine learning architecture on top of the FAIRified data sets of different health research performing organizations. The entire FAIR4Health solution was validated through the assessment of a federated model for real-time prediction of 30-day readmission risk in patients with chronic obstructive pulmonary disease (COPD). Methods The application of the FAIR principles on health research data sets in 3 different health care settings enabled a retrospective multicenter study for the development of specific federated machine learning models for the early prediction of 30-day readmission risk in patients with COPD. This predictive model was generated upon the FAIR4Health platform. Finally, an observational prospective study with 30 days follow-up was conducted in 2 health care centers from different countries. The same inclusion and exclusion criteria were used in both retrospective and prospective studies. Results Clinical validation was demonstrated through the implementation of federated machine learning models on top of the FAIRified data sets from different health research performing organizations. The federated model for predicting the 30-day hospital readmission risk was trained using retrospective data from 4.944 patients with COPD. The assessment of the predictive model was performed using the data of 100 recruited (22 from Spain and 78 from Serbia) out of 2070 observed (records viewed) patients during the observational prospective study, which was executed from April 2021 to September 2021. Significant accuracy (0.98) and precision (0.25) of the predictive model generated upon the FAIR4Health platform were observed. Therefore, the generated prediction of 30-day readmission risk was confirmed in 87% (87/100) of cases. Conclusions Implementing a FAIR data policy in health research performing organizations to facilitate data sharing and reuse is relevant and needed, following the discovery, access, integration, and analysis of health research data. The FAIR4Health project proposes a technological solution in the health domain to facilitate alignment with the FAIR principles.
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Affiliation(s)
- Celia Alvarez-Romero
- Computational Health Informatics Group, Institute of Biomedicine of Seville, Virgen del Rocío University Hospital, Consejo Superior de Investigaciones Científicas, University of Seville, Seville, Spain
| | - Alicia Martinez-Garcia
- Computational Health Informatics Group, Institute of Biomedicine of Seville, Virgen del Rocío University Hospital, Consejo Superior de Investigaciones Científicas, University of Seville, Seville, Spain
| | - Jara Ternero Vega
- Internal Medicine Department, Virgen del Rocío University Hospital, Seville, Spain
| | - Pablo Díaz-Jimènez
- Internal Medicine Department, Virgen del Rocío University Hospital, Seville, Spain
| | - Carlos Jimènez-Juan
- Internal Medicine Department, Virgen del Rocío University Hospital, Seville, Spain
| | | | - Esther Román Villarán
- Computational Health Informatics Group, Institute of Biomedicine of Seville, Virgen del Rocío University Hospital, Consejo Superior de Investigaciones Científicas, University of Seville, Seville, Spain
| | - Tomi Kovacevic
- Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica,
- Medical Faculty, University of Novi Sad, Novi Sad,
| | - Darijo Bokan
- Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica,
| | - Sanja Hromis
- Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica,
- Medical Faculty, University of Novi Sad, Novi Sad,
| | - Jelena Djekic Malbasa
- Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica,
- Medical Faculty, University of Novi Sad, Novi Sad,
| | - Suzana Beslać
- Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica,
| | - Bojan Zaric
- Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica,
- Medical Faculty, University of Novi Sad, Novi Sad,
| | - Mert Gencturk
- Software Research & Development and Consultancy Corporation, Ankara, Turkey
| | - A Anil Sinaci
- Software Research & Development and Consultancy Corporation, Ankara, Turkey
| | | | - Carlos Luis Parra Calderón
- Computational Health Informatics Group, Institute of Biomedicine of Seville, Virgen del Rocío University Hospital, Consejo Superior de Investigaciones Científicas, University of Seville, Seville, Spain
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12
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Zarogoulidis P, Petridis D, Huang H, Bai C, Hohenforst-Schmidt W, Freitag L, Baka S, Drougas D, Vagionas A, Tsakiridis K, Turner JF, Hatzibougias D, Boukovinas I, Zaric B, Kovacevic T, Ioannidis A, Courcoutsakis N, Matthaios D, Sardeli C. Biopsy and re-biopsy for PD-L1 expression in NSCLC. association between PD-L1 and checkpoint inhibitor efficacy through treatment in NSCLC. A pilot study. Expert Rev Respir Med 2021; 15:1483-1491. [PMID: 34591723 DOI: 10.1080/17476348.2021.1987888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Lung cancer is diagnosed at a late stage due to lack of early disease symptoms. Therefore an efficient treatment is necessary for prolonged disease free survival. PATIENTS AND METHODS In our study we recruited 124 patients NSCLC patients with adenocarcinoma and squamus cell carcinoma. All recuited patients had Programmed death-ligand 1 expression ≥50 (PD-L1)with DAKO technique. Immunotherapy was administered with as first line treatment. Re-biopsies were performed in the main lung lesion every 4 months with the restaging of the patient and also in the metastastic sites in other organs that occurred during treatment. PD-L1 expressed was evaluated in the biopsies of the metastatic sites. RESULTS It appears thereafter that the PD-L1 expression could easily be claimed as a promising bio-index with a cutoff value 65, below which a negative prognosis of the disease progress will be evident and above that value a positive continuation of the disease will be prominent. CONCLUSION The findings of this study suggest that the PD-L1-65 index works adequately either concerning the neo-metastatic sites or the patient disease responses. Re-biopsies in new metastastic sites are necessary since we probably have a new cancer and chemotherapy should be added. More studies should confirm are results and change the NSCLC treatment approach of these patients.
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Affiliation(s)
- Paul Zarogoulidis
- 3rd Department of Surgery, ``ahepa`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece.,Pulmonary Oncology Department, ``Bioclinic`` Private Hospital, Thessaloniki, Greece
| | - Dimitris Petridis
- Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece
| | - Haidong Huang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China
| | - Chong Bai
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China
| | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany
| | - Lutz Freitag
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Sofia Baka
- Oncology Department, ``Interbalkan`` European Medical Center, Thessaloniki, Greece
| | - Dimitris Drougas
- Nuclear Medicine Department, ``Bioiatriki`` Private PET-CT Laboratory, Thessaloniki, Greece
| | | | - Kosmas Tsakiridis
- Thoracic Oncology Department, ``Interbalkan`` European Medical Center, Thessaloniki, Greece
| | - J Francis Turner
- Department of Medicine, University of Tennessee Graduate School of Medicine, Knoxville, USA
| | - Dimitris Hatzibougias
- Pulmonary department, Private Pathology Laboratory, "Microdiagnostics", Thessaloniki, Greece
| | - Ioannis Boukovinas
- Oncology Department, ``Bioclinic`` Private Hospital, Thessaloniki, Greece
| | - Bojan Zaric
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Tomi Kovacevic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Aris Ioannidis
- Surgery Department, ``genesis`` Private HJospital, Thessaloniki, Greece
| | - Nikolaos Courcoutsakis
- Radiology Department, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | | | - Chrisanthi Sardeli
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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13
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Zarogoulidis P, Matthaios D, Kosmidis C, Hohenforst-Schmidt W, Tsakiridis K, Mpaka S, Boukovinas I, Drougas D, Theofilatou V, Zaric B, Courcoutsakis N, Nikolaidis G, Huang H, Bai C. Effective early diagnosis for NSCLC: an algorithm. Expert Rev Respir Med 2021; 15:1437-1445. [PMID: 34403620 DOI: 10.1080/17476348.2021.1969916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Lung cancer still remains undiagnosed for most patients until the disease is inoperable. AREAS COVERED We performed search on PubMed with the keywords: EBUS, radial-EBUS, bronchoscopy, lung cancer, electromagnetic navigation, ct-biopsy, transthoracic biopsy. We present diagnostic equipment and imaging techniques such as positron emission tomography, endoscopical navigation systems, endobronchial ultrasound, radial-endobronchial ultrasound, transthoracic ultrasound biopsy, and computed tomography guided biopsies. EXPERT OPINION However, lack of early disease symptoms remains the most important issue and therefore we should direct our efforts to screening and early disease diagnosis. An algorithm is proposed for biopsy upon initial disease diagnosis.
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Affiliation(s)
- Paul Zarogoulidis
- 3rd Department of Surgery, ``ahepa`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece.,Pulmonary Oncology Department, ``Bioclinic`` Private Hospital, Thessaloniki, Greece
| | | | | | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany
| | - Kosmas Tsakiridis
- Thoracic Oncology Department, ``Interbalkan`` European Medical Center, Thessaloniki, Greece
| | - Sofia Mpaka
- Oncology Department, ``Interbalkan`` European Medical Center, Thessaloniki, Greece
| | - Ioannis Boukovinas
- Oncology Department, ``Bioclinic`` Private Hospital, Thessaloniki, Greece
| | - Dimitris Drougas
- Nuclear Medicine Department, ``Bioiatriki`` Private PET-CT Laboratory, Thessaloniki, Greece
| | - Vasiliki Theofilatou
- Nuclear Medicine Department, ``Bioiatriki`` Private PET-CT Laboratory, Thessaloniki, Greece
| | - Bojan Zaric
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Nikolaos Courcoutsakis
- Radiology Department, Democritus University of Thrace, General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - George Nikolaidis
- Surgery Department, ``General Clinic`` Euromedica, Thessaloniki, Greece
| | - Haidong Huang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China
| | - Chong Bai
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China
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14
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Zarogoulidis P, Hatzibougias D, Tsakiridis K, Matthaios D, Hohenforst-Schmidt W, Huang H, Bai C, Tryfon S, Saroglou M, Zaric B, Boujkovinas I, Karapantzou C. Lymphadenopathy and granulomas: benignancy of malignancy and differential diagnosis with endobronchial ultrasound-transbronchial needle biopsy 19G needle fine-needle aspiration biopsy. Lung Cancer Manag 2021; 10:LMT49. [PMID: 34408790 PMCID: PMC8369527 DOI: 10.2217/lmt-2021-0002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/29/2021] [Indexed: 01/17/2023] Open
Abstract
Endobronchial ultrasound (EBUS) is a very useful tool for the diagnosis of lymphadenopathy of the mediastinum. Nowadays, EBUS can substitute video-assisted thoracic surgery when a 19G needle is used. Several studies have provided data for efficient diagnosis not only for lung cancer, but for also sarcoidosis, tuberculosis and lymphoma. We present five cases of EBUS-transbronchial needle biopsy 19G needle used for the diagnosis of mediastinum lymphadenopathy. We present not only the pathological diagnosis, but also the steps for the differential clinical and pathological differential diagnosis for sarcoidosis, tuberculosis, cancer metastasis, respiratory infection and lymphoma.
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Affiliation(s)
- Paul Zarogoulidis
- 3 University Surgery Department, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Pulmonary Department, 'Bioclinic' Private Clinic, Thessaloniki, Greece
| | | | - Kosmas Tsakiridis
- Thoracic Surgery Department, 'Interbalkan' European Medical Center, Thessaloniki, Greece
| | | | - Wolfgang Hohenforst-Schmidt
- Department of Cardiology/Pulmonology/Intensive Care/Nephrology, Sana Clinic Group Franken, 'Hof' Clinics, University of Erlangen, Hof, Germany
| | - Haidong Huang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, PR China
| | - Chong Bai
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, PR China
| | - Stavros Tryfon
- Pulmonary Department (NHS), 'G Papanikolaou' General Hospital, Thessaloniki, Greece
| | - Maria Saroglou
- Pulmonary Department (NHS), 'G Papanikolaou' General Hospital, Thessaloniki, Greece
| | - Bojan Zaric
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | | | - Chrisanthi Karapantzou
- Ear, Nose & Throat (ENT) Department, Ludwig-Maximilians University of Munich, Munich, Germany
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15
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Saif MW, Becerra CR, Fakih MG, Sun W, Popovic L, Krishnamurthi S, George TJ, Rudek MA, Shepard DR, Skopek J, Sramek V, Zaric B, Yamamiya I, Benhadji KA, Hamada K, He Y, Rosen L. A phase I, open-label study evaluating the safety and pharmacokinetics of trifluridine/tipiracil in patients with advanced solid tumors and varying degrees of renal impairment. Cancer Chemother Pharmacol 2021; 88:485-497. [PMID: 34097100 DOI: 10.1007/s00280-021-04308-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/30/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Trifluridine/tipiracil (FTD/TPI) is approved for advanced colorectal and gastric/gastroesophageal cancer; however, data in patients with renal impairment (RI) are limited. This phase I study evaluated FTD/TPI in patients with advanced solid tumors and varying degrees of RI to develop dosing guidance. METHODS Patients were enrolled into normal renal function (CrCl ≥ 90 mL/min), mild RI (CrCl 60-89 mL/min), or moderate RI (CrCl 30-59 mL/min) cohorts and administered the recommended FTD/TPI dose (35 mg/m2 twice daily, days 1-5 and 8-12; 28-day cycle). Based on interim pharmacokinetics/safety data, patients with severe RI (CrCl 15-29 mL/min) were enrolled and received FTD/TPI 20 mg/m2 twice daily. RESULTS Forty-three patients (normal renal function [n = 12]; mild RI [n = 12]; moderate RI [n = 11]; severe RI [n = 8]) were enrolled and treated. At steady state, compared to values in patients with normal renal function, FTD area under the curve (AUC) was not significantly different in patients with RI, but TPI AUC was significantly higher and increased with RI severity. FTD/TPI safety profile was consistent with prior experience, but grade ≥ 3 adverse events (AEs) were more frequent in the RI cohorts (83.3% [mild], 90.9% [moderate], 75.0% [severe], and normal [50.0%]). Hematologic AEs (anemia and neutropenia) were more frequent with RI. Overall, seven patients discontinued because of unrelated, nonhematologic AEs. CONCLUSION FTD/TPI is safe and tolerable at the recommended 35 mg/m2 dose in patients with mild/moderate RI and at the reduced 20 mg/m2 dose in patients with severe RI. TRIAL REGISTRATION NCT02301117, registration date: November 21, 2014.
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Affiliation(s)
- Muhammad Wasif Saif
- Medical Oncology, Northwell Health Cancer Institute, 1111 Marcus Avenue, Suite 216, Lake Success, NY, 11042, USA.
| | - Carlos R Becerra
- Texas Oncology, Baylor University Medical Center, Dallas, TX, USA
| | - Marwan G Fakih
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Weijing Sun
- Division of Oncology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Lazar Popovic
- Oncology Institute of Vojvodina, University of Novi Sad, Novi Sad, Serbia
| | | | - Thomas J George
- University of Florida Health Cancer Center, Gainesville, FL, USA
| | - Michelle A Rudek
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
| | | | - Jiri Skopek
- Thomayer Hospital Prague and Department of Biophysics and Informatics, First Medical Faculty, Prague, Czech Republic
| | - Vladimir Sramek
- Fakultni Nemocnice u Sv. Anny v Brně, Anesteziologicko Resustitační Klinika, Brno, Czech Republic
| | - Bojan Zaric
- Institute for Pulmonary Diseases of Vojvodina, University of Novi Sad, Novi Sad, Serbia
| | | | | | | | - Yaohua He
- Taiho Oncology, Inc., Princeton, NJ, USA
| | - Lee Rosen
- Division of Hematology-Oncology, University of California, Los Angeles, CA, USA
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16
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Trukhin D, Poddubskaya E, Zoran A, Bondarenko I, Shevnia S, Zaric B, Bellala R, Charoentum C, Perez L, Bullo F, Garcia F. Bevacizumab biosimilar (MB02) and reference bevacizumab in patients with stage IIIB/IV non-squamous non-small cell lung cancer (NSCLC) (STELLA study): Multiple Imputation analysis. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e15003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15003 Background: Stella Trial is a phase III, multinational, double-blind and randomized study to confirm clinical similarity between MB02 and EU-bevacizumab in patients with stage IIIB/IV no squamous NSCLC. 627 subjects with newly diagnosed or recurrent stage IIIb/IV NSCLC were randomized 1:1 to receive either MB02 or EU-bevacizumab plus chemotherapy (paclitaxel and carboplatin) every 3-week cycle for six cycles (week 18) followed by MB02/bevacizumab in blinded monotherapy until disease progression, treatment intolerance, death, patient withdrawal or end of study (w52). An approach targeting the MI of the continuous sum of target diameters (mm), and subsequent categorization of Overall Response (OR) was performed as sensitivity analysis for the assessment of the primary endpoint. Multiple Imputation (MI) has emerged as a credible method to assess the effects of missing data (MD), an inescapable problem with a potential ability to undermine research results' strength and validity in a clinical study, providing the user with a valuable toolset to sufficiently account for the varying types of MD and appropriately adjust the assumptions. Methods: The primary endpoint of the study was Objective Response Rate (ORR) at week 18 per an Independent Radiological Committee (IRC) in the Intention to treat set (ITT). The ORR was analysed with a Cochran-Mantel-Haenszel model, including the stratification factors of sex, smoking status, disease diagnosis and disease stage, comparing the stratified estimates risk difference (RD). In addition, these results were analysed implementing a pattern-mixture MI process accounting for missing at random (MAR) and missing not at random (MNAR) data based on the sum of target diameters in subjects without tumour response data or falling into the categories NonCR/NonPD or non-evaluable (NE). Results: The clinical equivalence of MB02 with EU-bevacizumab is demonstrated by the efficacy data provided through the primary endpoint and the MI sensitive analysis applied. The MI (MAR and MNAR) represents an added value that supports the biosimilarity of MB02 and EU-bevacizumab. The results for the primary analysis of the RD in ORR at w18 in the ITT set were entirely contained within the boundaries of predefined margins (±12): -4.02 [95% CI: -11.76 to 3.71]). Under MI, the ORR RD showed similarity at 95% CIs (-1.92; 95% CI: -10.02 to 6.19) and using the multiple imputations for subjects without tumour response data (missing, NonCR/NonPD or NE), the ORR RD was -2.22 with 95% CI of (-10.54 to 6.10) at w18 in the ITT. Conclusions: The clinical equivalence of MB02 with EU-bevacizumab is demonstrated by the efficacy data provided through the primary endpoint and the MI sensitive analysis applied. The MI (MAR and MNAR) represent an added value that supports the biosimilarity of MB02 and EU-bevacizumab. Clinical trial information: NCT03296163.
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Affiliation(s)
- Dmytro Trukhin
- Communal Institution Odesa Regional Oncological Dispensary, Day Patient Facility of Dispensary and Policlinic Department, Odesa, Ukraine
| | | | - Andric Zoran
- Clinical Hospital Centre Bezanijska Kosa, Belgrade, Serbia
| | | | - Serhii Shevnia
- Vinnytsia Regional Clinical Oncology Dispensary, Chemotherapy Department, Vinnytsia, Ukraine
| | - Bojan Zaric
- University of Novi Sad Institute for Pulmonary Diseases of Vojvodina, Sremska Kamencia, Vojvodina, Serbia
| | | | - Chaiyut Charoentum
- Maharaj Nakorn Chiang Mai Hospital, Mueang Chiang Mai District, Thailand
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17
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Zarogoulidis P, Hohenforst-Schmidt W, Huang H, Zhou J, Wang Q, Wang X, Xia Y, Ding Y, Bai C, Kosmidis C, Sapalidis K, Sardeli C, Tsakiridis K, Zaric B, Kovacevic T, Stojsic V, Sarcev T, Bursac D, Kukic B, Baka S, Athanasiou E, Hatzibougias D, Michalopoulou-Manoloutsiou E, Petanidis S, Drougas D, Drevelegas K, Paliouras D, Barbetakis N, Vagionas A, Freitag L, Lallas A, Boukovinas I, Petridis D, Ioannidis A, Matthaios D, Romanidis K, Karapantzou C. Intratumoral Treatment with Chemotherapy and Immunotherapy for NSCLC with EBUS-TBNA 19G. J Cancer 2021; 12:2560-2569. [PMID: 33854617 PMCID: PMC8040712 DOI: 10.7150/jca.55322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 01/03/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction: Immunotherapy is being used for the past five years either as first line or second line treatment with great results. Chemotherapy and radiotherapy have been also used as combination to immunotherapy to further enhance this type of treatment. Intratumoral treatment has been previously proposed as a treatment option for certain non-small cell lung cancer patients. Patients and Methods: We recruited in total seventy four patients with non-small cell lung cancer in their second line treatment who received only chemotherapy in their first line treatment with programmed death-ligand-1 ≤ 50. Only adenocarcinoma or squamous cell carcinoma, and all negative for epidermal growth factor receptor, anaplastic lymphoma kinase, proto-oncogene tyrosine-protein kinase-1 and proto-oncogene B-Raf. Data were first examined with descriptive statistics choosing frequencies for categorical variables and histograms for the continuous ones. Twenty five received only intravenous immunotherapy and forty-nine intravenous cisplatin with immunotherapy. Data were first examined with descriptive statistics choosing frequencies for categorical variables and histograms for the continuous ones. Results: The relationships between changes of performance status and disease progression were examined via a single correspondence analysis. The two-dimensional scores (coordinates) derived from the correspondence analysis were then regressed against the predictors to form distinct splits and nodes obtaining quantitative results. The best fit is usually achieved by lowering exhaustively the AICc criterion and looking in parallel the change of R2 expecting improvements more than 5%. both types of therapy are capable of producing best ameliorative effects, when either the programmed death-ligand-1 expression or parenchymal site in joint with low pack years are present in the sampling data. Conclusions: Intratumoral treatment combination with cisplatin plus immunotherapy indifferent of nivolumab or pembrolizumab combination is an effective choice. In specific for those with endobronchial lesions. Moreover; patients with programmed death-ligand-1 ≥ 50 had their performance status and disease progression improved over the eight month observation.
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Affiliation(s)
- Paul Zarogoulidis
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, ''Hof'' Clinics, University of Erlangen, Hof, Germany
| | - Haidong Huang
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Naval Medical University ( Changhai Hospital, Second Military Medical University), Shanghai, China
| | - Jun Zhou
- Department of Respiratory, Changzhou maternal and child health care hospital affiliated to Nanjing Medical University, Jiangsu Changzhou, China
| | - Qin Wang
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Naval Medical University ( Changhai Hospital, Second Military Medical University), Shanghai, China
| | - Xiangqi Wang
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Naval Medical University ( Changhai Hospital, Second Military Medical University), Shanghai, China
| | - Ying Xia
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Naval Medical University ( Changhai Hospital, Second Military Medical University), Shanghai, China
| | - Yinfeng Ding
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Naval Medical University ( Changhai Hospital, Second Military Medical University), Shanghai, China
| | - Chong Bai
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Naval Medical University ( Changhai Hospital, Second Military Medical University), Shanghai, China
| | - Christoforos Kosmidis
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Konstantinos Sapalidis
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Chrysanthi Sardeli
- Department of Respiratory, Changzhou maternal and child health care hospital affiliated to Nanjing Medical University, Jiangsu Changzhou, China
| | - Kosmas Tsakiridis
- Thoracic Surgery Department, ``Interbalkan`` European Medical Center, Thessaloniki, Greece
| | - Bojan Zaric
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Tomi Kovacevic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Vladimir Stojsic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Tatjana Sarcev
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Daliborka Bursac
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Biljana Kukic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Sofia Baka
- Oncology Department, ``Interbalkan`` European Medical Center, Thessaloniki, Greece
| | | | | | | | - Savvas Petanidis
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Dimitris Drougas
- Scientigraphy Department, "Bioclinic" Private Laboratory, Thessaloniki, Greece
| | | | - Dimitris Paliouras
- Thoracic surgery Department, ``Theageneio`` Cancer Hospital, Thessaloniki, Greece
| | - Nikolaos Barbetakis
- Thoracic surgery Department, ``Theageneio`` Cancer Hospital, Thessaloniki, Greece
| | | | - Lutz Freitag
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich Switzerland
| | - Aimilios Lallas
- Dermatology Department, Aristotle University, School of Medicine, Thessaloniki, Greece
| | - Ioannis Boukovinas
- Oncology Department, ``Bioclinic`` Private Hospital, Thessaloniki, Greece
| | - Dimitris Petridis
- Department of Food Science and Technology, International Hellenic University, Thessaloniki, Greece
| | - Aris Ioannidis
- Surgery Department, ``Genesis`` Private Hospital, Thessaloniki, Greece
| | | | - Konstantinos Romanidis
- Department of Surgery, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Chrisanthi Karapantzou
- Ear, Nose and Throat (ENT) Department, Ludwig-Maximilians University of Munich, Munich, Germany
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18
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Zarogoulidis P, Huang H, Zhou J, Ning Y, Yang M, Wang J, Zhang R, Bai C, Shen X, Huang Z, Petridis D, Kosmidis C, Kosmidou M, Tsakiridis K, Hohenforst-Schmidt W, Baka S, Petanidis S, Zaric B, Kovacevic T, Stojsic V, Sarcev T, Bursac D, Kukic B, Rapti A, Pantea S, Rogoveanu O, Rogoveanu I, Romanidis K, Kesisoglou I, Ioannidis A, Vagionas A, Sapalidis K. Thyroid cancer diagnosis with transdermal probe 22G U/S versus EBUS-convex probe TBNA-B 22G and 19G: pros and cons. Expert Rev Med Devices 2021; 18:197-201. [PMID: 33482695 DOI: 10.1080/17434440.2021.1880891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Thyroid cancer is usually diagnosed both with imaging techniques and transdermal biopsy. Laboratory tests are also included in the initial work-up. PATIENTS AND METHODS One hundred and thirty patients were included in our study with pathological imaging findings in the thyroid region. Biopsies were performed with 22 G with transdermal convex probe, EBUS 22 G Mediglobe® needle and 19 G Olympus® needle. We investigated the efficiency and safety of both techniques and identified the best candidates for each method. DISCUSSION 19 G needle identified cancer types such as; Lymphoma, Medullary thyroid cancer, and Hurthle cell cancer, which we know from previous pathology studies that a larger sample is necessary for diagnosis. No safety issues were observed for both techniques and the EBUS technique produced more cell block material when 22 G needle was compared to transdermal biopsy in peritracheal lesions. CONCLUSION The method of biopsy should be made based on the size and accessibility of the lesion.
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Affiliation(s)
- Paul Zarogoulidis
- 3rdSurgery Department, Medical School of Health Sciences, ``AHEPA`` University Hospital, Thessaloniki, Greece
| | - Haidong Huang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, P. R. China
| | - Jun Zhou
- Department of Respiratory, Changzhou maternal and child health care hospital affiliated to Nanjing Medical University, Changzhou, Jiangsu Changzhou, China
| | - Yunye Ning
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, P. R. China
| | - Meng Yang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, P. R. China.,Department of Geriatrics, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Jiannan Wang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, P. R. China
| | - Rong Zhang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, P. R. China
| | - Chong Bai
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, P. R. China
| | - Xiaping Shen
- Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Zhiang Huang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Henan University, Henan Kaifeng, China
| | - Dimitris Petridis
- Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece
| | - Christoforos Kosmidis
- 3rdSurgery Department, Medical School of Health Sciences, ``AHEPA`` University Hospital, Thessaloniki, Greece
| | - Maria Kosmidou
- Internal Medicine Department, University of Ioannina, Ioannina, Greece
| | - Kosmas Tsakiridis
- Thoracic Surgery Department, ``Interbalkan`` European Medical Center, Thessaloniki, Greece
| | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany
| | - Sofia Baka
- Onc/ology Department, Interbalkan European Medical Center, Thessaloniki, Greece
| | - Savas Petanidis
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Bojan Zaric
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Tomi Kovacevic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Vladimir Stojsic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Tatjana Sarcev
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Daliborka Bursac
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Biljana Kukic
- Faculty of Medicine, University of Novi Sad, Institute for Oncology of Vojvodina, Novi Sad, Serbia
| | - Aggeliki Rapti
- Pulmonary Oncology Department, ``sotiria`` Hospital of Chest Diseases, Athens, Greece
| | - Stelian Pantea
- 3rdSurgery Department, Medical School of Health Sciences, ``AHEPA`` University Hospital, Thessaloniki, Greece.,Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Henan University, Henan Kaifeng, China
| | - Otelia Rogoveanu
- Department of Medical Rehabilitation, University of Medicine and Pharmacy, Craiova, Romania
| | - Ion Rogoveanu
- Department of Medical Rehabilitation, University of Medicine and Pharmacy, Craiova, Romania
| | - Konstantinos Romanidis
- Second Department of Surgery, General University Hospital of Alexandroupolis, Medical School Democritus University of Thrace, Alexandroupolis, Greece
| | - Issak Kesisoglou
- 3rdSurgery Department, Medical School of Health Sciences, ``AHEPA`` University Hospital, Thessaloniki, Greece
| | - Aris Ioannidis
- Surgery Department, ``Genesis`` Private Hospital, Thessaloniki, Greece
| | | | - Konstantinos Sapalidis
- 3rdSurgery Department, Medical School of Health Sciences, ``AHEPA`` University Hospital, Thessaloniki, Greece
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Hart LL, Ferrarotto R, Andric ZG, Beck JT, Subramanian J, Radosavljevic DZ, Zaric B, Hanna WT, Aljumaily R, Owonikoko TK, Verhoeven D, Xiao J, Morris SR, Antal JM, Hussein MA. Myelopreservation with Trilaciclib in Patients Receiving Topotecan for Small Cell Lung Cancer: Results from a Randomized, Double-Blind, Placebo-Controlled Phase II Study. Adv Ther 2021; 38:350-365. [PMID: 33123968 PMCID: PMC7854399 DOI: 10.1007/s12325-020-01538-0] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/14/2020] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Multilineage myelosuppression is an acute toxicity of cytotoxic chemotherapy, resulting in serious complications and dose modifications. Current therapies are lineage specific and administered after chemotherapy damage has occurred. Trilaciclib is a cyclin-dependent kinase 4/6 inhibitor that is administered prior to chemotherapy to preserve hematopoietic stem and progenitor cells and immune system function during chemotherapy (myelopreservation). METHODS In this randomized, double-blind, placebo-controlled phase II trial, patients with previously treated extensive-stage small cell lung cancer (ES-SCLC) were randomized to receive intravenous trilaciclib 240 mg/m2 or placebo before topotecan 1.5 mg/m2 on days 1-5 of each 21-day cycle. Primary endpoints were duration of severe neutropenia (DSN) in cycle 1 and occurrence of severe neutropenia (SN). Additional endpoints were prespecified to further assess the effect of trilaciclib on myelopreservation, safety, patient-reported outcomes (PROs), and antitumor efficacy. RESULTS Thirty-two patients received trilaciclib, and 29 patients received placebo. Compared with placebo, administration of trilaciclib prior to topotecan resulted in statistically significant and clinically meaningful decreases in DSN in cycle 1 (mean [standard deviation] 2 [3.9] versus 7 [6.2] days; adjusted one-sided P < 0.0001) and occurrence of SN (40.6% versus 75.9%; adjusted one-sided P = 0.016), with numerical improvements in additional neutrophil, red blood cell, and platelet measures. Patients receiving trilaciclib had fewer grade ≥ 3 hematologic adverse events than patients receiving placebo, particularly neutropenia (75.0% versus 85.7%) and anemia (28.1% versus 60.7%). Myelopreservation benefits extended to improvements in PROs, specifically in those related to fatigue. Antitumor efficacy was comparable between treatment arms. CONCLUSIONS Compared with placebo, the addition of trilaciclib prior to topotecan for the treatment of patients with previously treated ES-SCLC improves the patient experience of receiving chemotherapy, as demonstrated by a reduction in chemotherapy-induced myelosuppression, improved safety profile, improved quality of life and no detrimental effects on antitumor efficacy. TRIAL REGISTRATION ClinicalTrials.gov: NCT02514447.
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Affiliation(s)
- Lowell L Hart
- Medical Oncology, Florida Cancer Specialists, Fort Myers, FL, USA.
- Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
| | - Renata Ferrarotto
- Department of Thoracic and Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Zoran G Andric
- Medical Oncology Department, Clinical Hospital Center Bezanijska Kosa, Belgrade, Serbia
| | - J Thaddeus Beck
- Department of Medical Oncology and Hematology, Highlands Oncology Group, Rogers, MI, USA
| | | | | | - Bojan Zaric
- Faculty of Medicine, Institute for Pulmonary Diseases of Vojvodina, University of Novi Sad, Sremska Kamenica, Serbia
| | - Wahid T Hanna
- Hematology/Oncology, University of Tennessee Graduate School of Medicine, Knoxville, TN, USA
| | - Raid Aljumaily
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA
- Sarah Cannon Research Institute, Nashville, TN, USA
| | - Taofeek K Owonikoko
- Department of Hematology and Medical Oncology, Emory University, Atlanta, GA, USA
| | - Didier Verhoeven
- Department of Medical Oncology, AZ Klina Brasschaat, University of Antwerp, Antwerp, Belgium
| | - Jie Xiao
- G1 Therapeutics, Inc., Research Triangle Park, NC, USA
| | | | - Joyce M Antal
- G1 Therapeutics, Inc., Research Triangle Park, NC, USA
| | - Maen A Hussein
- Department of Oncology, Florida Cancer Specialists, Leesburg, FL, USA
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20
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Zarogoulidis P, Christakidis V, Petridis D, Sapalidis K, Kosmidis C, Vagionas A, Perdikouri EI, Hohenforst-Schmidt W, Huang H, Petanidis S, Tsakiridis K, Baka S, Romanidis K, Zaric B, Kovacevic T, Stojsic V, Sarcev T, Bursac D, Kukic B, Boukovinas I, Tolis C, Sardeli C. Connection between PD-L1 expression and standardized uptake value in NSCLC: an early prognostic treatment combination. Expert Rev Respir Med 2020; 15:675-679. [PMID: 33275458 DOI: 10.1080/17476348.2021.1859373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objectives: Lung cancer is still diagnosed at advanced stage and early treatment initiation is needed. Therefore, we need biomarkers or clusters of information that can provide early treatment prognosis.Methods: Biopsies were acquired from 471 patients-lung masses with CT-guided biopsy, convex probe transthorasic biopsy, and EBUS-TBNA convex probe with 18 G needles and 19 G needles.Results: Standardized uptake value (SUV) measurement is associated with female, smoking status, hepatic metastasis, adenocarcinoma and programmed death-ligand 1 (PD-L1). In specific we expect that SUV ≥ 7 is associated with PD-L1 ≥ 50.Conclusions: Lung masses indifferent of size that have SUV ≥ 7 will also have PD-L1 expression ≥ 50. Also, it is likely that these patients will be female with intense smoking habit and hepar or multiple metastasis.
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Affiliation(s)
- Paul Zarogoulidis
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | | | - Dimitris Petridis
- Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece
| | - Konstantinos Sapalidis
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Chriforos Kosmidis
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | | | | | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany
| | - Haidong Huang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, P. R. China
| | - Savvas Petanidis
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Kosmas Tsakiridis
- Thoracic Surgery Department, ``Interbalkan`` European Medical Center, Thessaloniki, Greece
| | - Sofia Baka
- Oncology Department, Interbalkan European Medical Center, Thessaloniki, Greece
| | - Konstantinos Romanidis
- Second Department of Surgery, General University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Bojan Zaric
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Tomi Kovacevic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Vladimir Stojsic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Tatjana Sarcev
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Daliborka Bursac
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Biljana Kukic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Ioannis Boukovinas
- Oncology Department, ``Bioclinic`` Private Hospital, Thessaloniki, Greece
| | - Christos Tolis
- Oncology Department, ``Bioclinic`` Private Hospital, Thessaloniki, Greece
| | - Chrysanthi Sardeli
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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21
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Zarogoulidis P, Tsakiridis K, Vagionas A, Hohenforst-Schmidt W, Zaric B, Tryfon S, Saroglou M, Drevelegas K, Hatzibougias D, Michalopoulou-Manoloutsiou E, Paliouras D, Barbetakis N, Huang H, Bai C. Bronchogenic cyst or lung cancer. Only biopsy can tell. Respir Med Case Rep 2020; 32:101328. [PMID: 33457198 PMCID: PMC7797910 DOI: 10.1016/j.rmcr.2020.101328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/27/2020] [Indexed: 11/29/2022] Open
Abstract
Bronchogenic cysts are rare congenital malformations which derive from primitive ventral foregut. They are usually observed in intrathoracically. A fifty year old male was admitted for the investigation of a three month chest pain. Computed tomography scan of the thorax revealed a lesion around the esophagus and left stem bronchus. Endobronchial ultrasound with convex probe and a 19G needle biopsy revealed a bronchogenic cystic which was removed with video assisted thoracic surgery. Initial radiologic assessment although was thought to be lung cancer because of the smoking habit it turned out to be benignancy. EBUS-TBNAB with 10G needle is safe and absolutely necessary for these lesions, as they take large samples.
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Affiliation(s)
- Paul Zarogoulidis
- 3rd University General Hospital, ''AHEPA'' University Hospital, Thessaloniki, Greece
| | - Kosmas Tsakiridis
- Thoracic Surgery Department, ''Interbalkan'' European Medical Center, Thessaloniki, Greece
| | | | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany
| | - Bojan Zaric
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Stavros Tryfon
- Pulmonary Department (NHS), ''G. Papanikolaou'' General Hospital, Thessaloniki, Greece
| | - Maria Saroglou
- Pulmonary Department (NHS), ''G. Papanikolaou'' General Hospital, Thessaloniki, Greece
| | | | | | | | - Dimitris Paliouras
- Thoracic Surgery Department, ''Theageneio'' Cancer Hospital, Thessaloniki, Greece
| | - Nikolaos Barbetakis
- Thoracic Surgery Department, ''Theageneio'' Cancer Hospital, Thessaloniki, Greece
| | - Haidong Huang
- Department of Respiratory Medicine, Changhai Hospital of Second Military Medical University, Shanghai, China
| | - Chong Bai
- Department of Respiratory Medicine, Changhai Hospital of Second Military Medical University, Shanghai, China
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22
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Sardeli C, Zarogoulidis P, Romanidis K, Oikonomou P, Sapalidis K, Huang H, Bai C, Hohenforst-Schmidt W, Tsakiridis K, Zaric B, Perin B, Ioannidis A, Baka S, Drevelegas K, Kosmidou M, Kosmidis C. Acute pneumothorax due to immunotherapy administration in non-small cell lung cancer. Respir Med Case Rep 2020; 31:101258. [PMID: 33145157 PMCID: PMC7596337 DOI: 10.1016/j.rmcr.2020.101258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 10/08/2020] [Accepted: 10/11/2020] [Indexed: 11/10/2022] Open
Abstract
Nowadays we have novel therapies for advanced stage non-small cell lung cancer. Immunotherapy has been introduced in the market for several years and until now its administration is mostly based on the programmed death-ligand 1. First line treatment with immunotherapy can be administered alone if programmed death-ligand 1 expression is ≥ 50%. All therapies for advanced stage disease have advantages and disadvantages, immunotherapy until now has presented mild adverse effects when compared to chemotherapy. However; it is known to induce inflammatory response to different tissues within the body. In our case acute pneumothorax was induced after immunotherapy administration.
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Affiliation(s)
- Chrysanthi Sardeli
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Paul Zarogoulidis
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.,3rd Department of Surgery, ''AHEPA'' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Konstantinos Romanidis
- Second Department of Surgery, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Panagoula Oikonomou
- Second Department of Surgery, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Konstantinos Sapalidis
- 3rd Department of Surgery, ''AHEPA'' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Haidong Huang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Chong Bai
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, ''Hof'' Clinics, University of Erlangen, Hof, Germany
| | - Kosmas Tsakiridis
- Thoracic Surgery Department, ''Interbalkan'' European Medical Center, Thessaloniki, Greece
| | - Bojan Zaric
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Branislav Perin
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Aris Ioannidis
- Surgery Department, ''Genesis'' Private Hospital, Thessaloniki, Greece
| | - Sofia Baka
- Oncology Department, ''Intebalkan'' European Medical Center, Thessaloniki, Greece
| | | | - Maria Kosmidou
- Internal Medicine, University Hospital of Ioannina, Ioannina, Greece
| | - Christoforos Kosmidis
- 3rd Department of Surgery, ''AHEPA'' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
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23
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Andric Z, Ceric T, Stanetic M, Rancic M, Jakopovic M, Aix SP, Ramlau R, Smit E, Ulanska M, Caldwell C, Ferrari D, Annis A, Vukovic V, Zaric B. Prevention of Chemotherapy-induced Myelosuppression in SCLC patients treated with the Dual MDMX/MDM2 Inhibitor ALRN-6924. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)31081-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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24
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Zarogoulidis P, Petridis D, Sapalidis K, Tsakiridis K, Baka S, Vagionas A, Hohenforst-Schmidt W, Freitag L, Huang H, Bai C, Drougas D, Theofilatou V, Romanidis K, Perdikouri EI, Petanidis S, Zaric B, Kovacevic T, Stojsic V, Sarcev T, Bursac D, Kukic B, Perin B, Courcoutsakis N, Athanasiou E, Hatzibougias D, Drevelegas K, Boukovinas I, Kosmidou M, Kosmidis C. Lung cancer biopsies: Comparison between simple 22G, 22G upgraded and 21G needle for EBUS-TBNA. J Cancer 2020; 11:6454-6459. [PMID: 33033529 PMCID: PMC7532516 DOI: 10.7150/jca.48691] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/25/2020] [Indexed: 02/07/2023] Open
Abstract
Introduction: Novel technologies are currently used for lung cancer diagnosis. EBUS-TBNA 22G is considered one of the most important tools. However; there are still issues with the sample size.Patients and Methods: 223 patients underwent EBUS-TBNA with a 21G Olympus needle, 22GUS Mediglobe and 22GUB Mediglobe. In order to evaluate the efficiency of 22GUB novel needle design. In order to evaluate the sample size of each needle, we constructed cell blocks and measured the different number of slices from each biopsy site. Results: The 22GUB novel needle had similar and larger number of slices from each biopsy site compared to 21G needle. Discussion: Firstly as a novel methodology we used the number of slices from the constructed cell blocks in order to evaluate the sample size. Secondly, we should seek novel needle designs and not only concentrate on the volume of the sample size.
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Affiliation(s)
- Paul Zarogoulidis
- 3rd University General Hospital, "AHEPA" University Hospital, Thessaloniki, Greece
| | - Dimitris Petridis
- Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece
| | | | - Kosmas Tsakiridis
- Thoracic Surgery Department, "Interbalkan" European Medical Center, Thessaloniki, Greece
| | - Sofia Baka
- Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece
| | | | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany
| | - Lutz Freitag
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich Switzerland
| | - Haidong Huang
- Department of Respiratory Medicine, Changhai Hospital of Second Military Medical University, Shanghai, China
| | - Chong Bai
- Department of Respiratory Medicine, Changhai Hospital of Second Military Medical University, Shanghai, China
| | - Dimitris Drougas
- Scientigraphy Department, "Bioclinic" Private Laboratory, Thessaloniki, Greece
| | | | - Konstantinos Romanidis
- Second Department of Surgery, General University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Savas Petanidis
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Bojan Zaric
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Tomi Kovacevic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Vladimir Stojsic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Tatjana Sarcev
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Daliborka Bursac
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Biljana Kukic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Branislav Perin
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | | | | | | | | | | | - Maria Kosmidou
- Internal Medicine Department, University of Ioannina, Ioannina, Greece
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25
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Shi D, Li F, Wang K, Kong C, Huang H, Li Q, Jin F, Hu C, Wang C, Shi H, Hu Z, Dong Y, Ning Y, Tsakiridis K, Sapalidis K, Kosmidis C, Vagionas A, Hohenforst-Schmidt W, Freitag L, Turner JF, Drevelegas K, Perdikouri EI, Kovacevic T, Sarcev T, Zaric B, Petanidis S, Baka S, Boukovinas I, Kakolyris S, Zarogoulidis P, Bai C. The development of bronchoscopy in China: a national cross-sectional study. J Cancer 2020; 11:5547-5555. [PMID: 32913450 PMCID: PMC7477436 DOI: 10.7150/jca.47183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 07/09/2020] [Indexed: 11/05/2022] Open
Abstract
Objective: To investigate the development of bronchoscopy in China and compare it with its application in the early 21st century. Methods: The data collection was based on questionnaires. Three hundred and nineteen hospitals, which distributed across 30 provinces and 130 cities, were included in the study. Data about the application of bronchoscopy in Shanghai and Hunan province in the early 21st century are also involved for comparison. Results: The median period of performing diagnostic and therapeutic bronchoscopy was 19.7±11.0 and 7.4±7.0 years, respectively. On average, about 155.2 cases and 28.4 cases received diagnostic and therapeutic bronchoscopy in each hospital per month. The average area and number of the examination room was 122.7m2 and 2.2m2, respectively. More examination items were performed in specialty hospitals than those in general hospitals (P<0.05) and specialty hospitals owned more rooms exclusively for bronchoscopy (P<0.05), while no difference of the number of allocated doctors was found (P>0.05). On the other side, the whole amount of diagnosis and therapeutic items in teaching hospitals was slightly higher than that in non-teaching hospitals (P<0.01). Comparison of diagnosis and therapeutic endoscopy in Shanghai and Hunan province shows that the number of flexible bronchoscopy increased by 5.8 times in Shanghai from 2002 to 2017, while that increased by 3.4 times in Hunan province from 2005 to 2017. Furthermore, the average number of allocated doctors increased by 0.85 times in Shanghai, which was more rapidly compared with that of Hunan province (0.66 times) (P<0.05). Besides, the development rate of the diagnosis and therapeutic projects in Shanghai was significantly higher than that in Hunan province (P<0.05). Conclusion: All different classes of hospitals in China are capable of carrying out conventional bronchoscopy diagnosis and therapeutic projects, and newly developed bronchoscopy technology has gradually spread in high-level hospitals since 21st century. The higher class the hospital was, the earlier bronchoscopy was performed. Respiratory endoscopy in China has developed rapidly since the early 21st century and the construction of respiratory endoscopy center and the personnel training are on the right track, but it is also faced with inadequate equipment, unbalanced regional development and insufficient personnel allocation.
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Affiliation(s)
- Dongchen Shi
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Fuqi Li
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Kaicheng Wang
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Chen Kong
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Haidong Huang
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Qiang Li
- Department of Respiratory, Oriental Hospital, Tongji University, Shanghai, China
| | - Faguang Jin
- Department of Respiratory, Tangdu Hospital, The Fourth Military Medical University, Xian, China
| | - Chengping Hu
- Department of Respiratory, Xiangya Hospital, Central South University, Changsha, China
| | - Changhui Wang
- Department of Respiratory, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Hui Shi
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Zhenli Hu
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Yuchao Dong
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Yunye Ning
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Kosmas Tsakiridis
- Thoracic Surgery Department, ``Interbalkan`` European Medical Center, Thessaloniki, Greece
| | - Konstantinos Sapalidis
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Christoforos Kosmidis
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | | | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany
| | - Lutz Freitag
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - J Francis Turner
- University of Tennessee Graduate School of Medicine, Department of Medicine, Knoxville, TN, USA
| | - Konstantinos Drevelegas
- Radiology Department, ``G. Papageorgiou`` University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Tomi Kovacevic
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Tatjana Sarcev
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Bojan Zaric
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Savas Petanidis
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Sofia Baka
- Oncology Department, ``Interbalkan`` European Medical Center, Thessaloniki, Greece
| | - Ioannis Boukovinas
- Oncology Department, ``Bioclinic`` Private Hospital, Thessaloniki, Greece
| | - Stylianos Kakolyris
- Oncology Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Paul Zarogoulidis
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Chong Bai
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
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Tsiouda T, Sardeli C, Porpodis K, Pilikidou M, Apostolidis G, Kyrka K, Miziou A, Kyrka K, Tsingerlioti Z, Papadopoulou S, Heva A, Koulouris C, Giannakidis D, Boniou K, Kesisoglou I, Vagionas A, Kosmidis C, Sevva C, Papazisis G, Goganau AM, Sapalidis K, Tsakiridis K, Tryfon S, Platanas M, Baka S, Zaric B, Perin B, Petanidis S, Zarogoulidis P. Sex Differences and Adverse Effects between Chemotherapy and Immunotherapy for Non-Small Cell Lung Cancer. J Cancer 2020; 11:3407-3415. [PMID: 32231747 PMCID: PMC7097940 DOI: 10.7150/jca.40196] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 01/20/2020] [Indexed: 12/16/2022] Open
Abstract
Introduction: Lung cancer remains the leading cause of cancer mortality in men and women and around the world. Approximately 90% of cases of lung cancer are caused by smoking and the use of tobacco products. However, other factors such as asbestos, air pollution and chronic infections can contribute to pulmonary carcinogenesis. Lung cancer is divided into two broad histological categories, which develop and spread different small cell lung carcinomas and non-small cell lung carcinomas. The treatment options for lung cancer include surgery, radiotherapy, chemotherapy and targeted treatments. Tumor induced immune suppression is vital for malignant progression. Immunotherapies act by strengthening the patient's innate tendency for an immune response and give positive promise to patients with non-small cell lung cancer and small cell lung cancer. Immune checkpoint inhibitors are a new approach to cancer therapies. Just as immune therapies include a new approach to cancer biology, the toxicities associated with these factors have created new challenges in clinical practice. Materials & Methods: Patients (218) aged 40-80 years were treated with either chemotherapy or immunotherapy. Their response to treatment and any subsequent adverse drug reactions were studied. Results: 69% of patients were treated with chemotherapy and 31% were treated with immunotherapy. The type of treatment had a statistically significant effect on the undesirable effects of the treatment. Conclusions: The type of treatment was statistically significant in responding to the treatment and treatment side effects but not in the rate of death.
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Affiliation(s)
- Theodora Tsiouda
- Pulmonary Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece
| | - Chrisanthi Sardeli
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Porpodis
- Pulmonary Department, G. "Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Pilikidou
- Pulmonary Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece
| | | | - Krystallia Kyrka
- Pulmonary Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece
| | - Angeliki Miziou
- Pulmonary Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece
| | - Konstantina Kyrka
- Pulmonary Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece
| | - Zoi Tsingerlioti
- Pulmonary Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece
| | | | - Anta Heva
- Pulmonary Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece
| | - Charilaos Koulouris
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Dimitrios Giannakidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Konstantina Boniou
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Isaak Kesisoglou
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Anastasios Vagionas
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Christoforos Kosmidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Christina Sevva
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - George Papazisis
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandru Marian Goganau
- General Surgery Clinic 1, University of Medicine and Pharmacy of Craiova, Craiova County Emergency Hospital, Craiova, Romania
| | - Konstantinos Sapalidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Kosmas Tsakiridis
- Thoracic Surgery Department, "Interbalkan" European Medical Center, Thessaloniki, Greece
| | - Stavros Tryfon
- Pulmonary Department (NHS), G.H. "G. Papanikolaou" Thessaloniki, Thessaloniki, Greece
| | - Michalis Platanas
- Urology Department (NHS), General Hospital of Giannitsa, Giannitsa, Greece
| | - Sofia Baka
- Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece
| | - Bojan Zaric
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Branislav Perin
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Savvas Petanidis
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Paul Zarogoulidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
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Kovacevic T, Zaric B, Bokan D. EP1.16-40 Communicating with Lung Cancer Patients in Eastern European Country: Topics of Interest. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Todorovic V, Aapro M, Pavlidis N, Arsovski O, Belkacemi Y, Babovic N, Bidard FC, Bourhafour M, Beslija S, Boussen H, Cetnikovic B, Ceric T, Cicmil N, Crnogorac N, Cuedari E, De Laurentis M, Dragovich T, Durutovic I, Dzamic Z, Dzodic R, Eri Z, Geara F, Khalil A, Kerrou K, Knezevic Usaj S, Kovcin V, Koroveshi D, Kristo Pema A, Kuten A, Lakicevic J, Lukovac N, Markovic I, Markovic M, Mijalkovic N, Miladinova D, Milasevic N, Mustachi G, Ognjenovic D, Pantelic A, Popovic L, Radosavljevic D, Radosevic N, Radulovic S, Ristevski M, Rosic I, Secen N, Sorat M, Stamatovic L, Stefanovski P, Stojkovski I, Tesanovic D, Tomasevic Z, Tomasevic Z, Tsoutsou P, Turkan S, Vasev N, Vasovic S, Vicko F, Vrbanec D, Vukmirovic F, Vrdoljak E, Zaric B, Zambrovski JJ, Cavalli F, Gligorov J. AROME-ESO Oncology Consensus Conference: access to cancer care innovations in countries with limited resources. Association of Radiotherapy and Oncology of the Mediterranean Area (AROME-Paris) and European School of Oncology (ESO - Milan). J BUON 2019; 24:2180-2197. [PMID: 31786893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE Cancer is a leading cause of mortality worldwide. Its incidence is still increasing, particularly in developing countries. Recent progresses further strengthen the differences between low/middle and high-income countries. This situation calls for joint action to reduce inequities in cancer outcomes among the patients. The Association of Radiotherapy and Oncology of the Mediterranean Area (AROME) and the European School of Oncology (ESO), have initiated joint conferences devoted to access to innovations in oncology in the Mediterranean area. The heterogeneity of the economic, political and cultural situations of the different participating countries, offers the opportunity to develop consensus conference. METHODS Cancer prevention and treatment strategies were discussed according to existing international guidelines. The Scientific committee prepared 111 questions with an objective to prioritize the access to treatments and innovations in low/middle-income Mediterranean countries. The results from the votes of 65 oncology experts, coming from 16 countries and 33 institutions have been analysed and access priorities classified accordingly. RESULTS Ninety six percent of the proposed general recommendations concerning national health care strategies, oncology education, and treatment organization were considered to be high priorities. Regarding access to systemic treatments, 41% of the drugs without validated predictive markers and 53% of those with validated predictive markers were considered to be 1st level priority. Only 4 biological tests were considered to be 1st level priority to access to innovation. CONCLUSIONS AROME-ESO consensus offers to cancer specialists from developing countries a basis for discussion with health authorities and payers on the prioritization of access to innovations in cancer care.
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Affiliation(s)
- Vladimir Todorovic
- Clinical Center of Montenegro, University of Montenegro, Podgorica, Montenegro
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Hart LL, Andric ZG, Hussein MA, Ferrarotto R, Beck JT, Subramanian J, Radosavljevic DZ, Jovanovic D, Pachipala KK, Samarzija M, Zaric B, Hanna WT, Aljumaily R, Owonikoko TK, Malik RK, Morris SR, Johnson ML, Yang Z, Adler S, Spigel DR. Effect of trilaciclib, a CDK 4/6 inhibitor, on myelosuppression in patients with previously treated extensive-stage small cell lung cancer receiving topotecan. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.8505] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8505 Background: Multi-lineage myelosuppression is an acute toxicity of cytotoxic chemotherapy leading to hematologic adverse events and dose reductions and delays. Current therapies are lineage specific and administered after chemotherapy damage.Trilaciclib (T), a highly selective, reversible CDK4/6 inhibitor, is designed to preserve hematopoietic stem and progenitor cells and immune system function during chemotherapy (myelopreservation). We have shown that T mitigates myelosuppression in patients with newly diagnosed extensive-stage small cell lung cancer (ES-SCLC) receiving 1st-line chemotherapy. Methods: In this blinded, placebo-controlled, multicenter Phase 2 study, patients with previously treated ES-SCLC were randomized to T (240 mg/m2) + 0.75 mg/m2 topotecan, T (240 mg/m2) + 1.5 mg/m2 topotecan, or placebo (P) + 1.5 mg/m2 topotecan IV on days 1-5 of 21-day cycles. Patients had access to standard supportive care, except in cycle 1 where prophylactic growth factors were not allowed. Eligible patients had adequate organ function, measurable disease, ECOG PS 0-2, and disease progression during or after prior 1st/2nd-line chemotherapy. Objectives included safety, tolerability, measures of myelosuppression and tumor efficacy. Results: 91 patients were randomized: 30 patients received T + 0.75 mg/m2 topotecan, 32 patients received T + 1.5 mg/m2 topotecan and 28 patients received P + 1.5 mg/m2 topotecan. In patients receiving 1.5 mg/m2 topotecan, T treatment reduced occurrence [40.6% (T) vs 75.6% (P), p = 0.016], and duration in cycle 1 [2 days (T) vs 8 days (P), p = < 0.0001] of severe neutropenia. T-treated patients had fewer RBC transfusions on/after 5 weeks on study, GCSF administrations, and all-cause dose reductions. Chemotherapy efficacy was comparable in both arms (P and T) treated with 1.5 mg/m2 topotecan (median PFS (T) 4.2 months vs (P) 4.2 months, HR = 0.83). OS data is immature. Conclusions: T combined with topotecan mitigated chemotherapy-induced myelosuppression and improved tolerability of topotecan vs P. Results suggest the addition of T to cytotoxic chemotherapy for the treatment of ES-SCLC is clinically beneficial. Clinical trial information: NCT02514447.
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Affiliation(s)
- Lowell L. Hart
- Florida Cancer Specialists and Research Institute, Fort Myers, FL
| | | | | | | | | | | | | | - Dragana Jovanovic
- Clinic for Pulmonary Diseases, Clinical Center of Serbia, Belgrade, Serbia
| | | | | | - Bojan Zaric
- University of Novi Sad Institute for Pulmonary Diseases of Vojvodina, Sremska Kamencia, Vojvodina, Serbia
| | | | - Raid Aljumaily
- Stephenson Cancer Center, University of Oklahoma HSC; Sarah Cannon Research Institute, Nashville, TN
| | | | | | | | | | - Zhao Yang
- G1 Therapeutics, Inc., Research Triangle Park, NC
| | | | - David R. Spigel
- Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN
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Kovacevic T, Zaric B, Bokan D. P2.15-14 Survivorship of Advanced Lung Cancer Patients with Psychiatric Disorders and Malnutrition Risk. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Zaric B, Brcic L, Buder A, Brandstetter A, Buresch JO, Traint S, Kovacevic T, Stojsic V, Perin B, Pirker R, Filipits M. PD-1 and PD-L1 Protein Expression Predict Survival in Completely Resected Lung Adenocarcinoma. Clin Lung Cancer 2018; 19:e957-e963. [PMID: 30197262 DOI: 10.1016/j.cllc.2018.08.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 07/19/2018] [Accepted: 08/12/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND We assessed the prognostic value of programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) in patients with completely resected lung adenocarcinoma. PATIENTS AND METHODS PD-1 and PD-L1 expression was determined using immunohistochemistry in formalin-fixed paraffin-embedded surgical specimens and correlated with the clinicopathologic features and survival of 161 patients with lung adenocarcinoma. RESULTS PD-1 expression on immune cells was observed in 71 of 159 evaluable tumor samples (45%) and was not significantly associated with the clinicopathologic features. Multivariate analyses identified PD-1 expression as an independent prognostic factor for recurrence (adjusted hazard ratio [HR], 0.59; 95% confidence interval [CI], 0.36-0.95; P = .03) and death (adjusted HR, 0.48; 95% CI, 0.27-0.86; P = 0.01). PD-L1 expression on tumor cells was seen in 59 of 161 cases (37%) and correlated with KRAS mutation status (P = .02) and type of surgery (P = .01). PD-L1 expression was not associated with recurrence-free survival in the patients (adjusted HR, 0.90; 95% CI, 0.55-1.48; P = .68) but correlated with longer overall survival (adjusted HR, 0.54; 95% CI, 0.30-0.97; P = .04). CONCLUSION PD-1 and PD-L1 expression was associated with favorable overall survival in patients with completely resected adenocarcinoma of the lung.
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Affiliation(s)
- Bojan Zaric
- Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, University of Novi Sad, Faculty of Medicine, Sremska Kamenica, Serbia
| | - Luka Brcic
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Anna Buder
- Institute of Cancer Research, Medical University of Vienna, Vienna, Austria
| | - Anita Brandstetter
- Institute of Cancer Research, Medical University of Vienna, Vienna, Austria
| | - Jorun O Buresch
- Institute of Cancer Research, Medical University of Vienna, Vienna, Austria
| | - Stefan Traint
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Tomi Kovacevic
- Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, University of Novi Sad, Faculty of Medicine, Sremska Kamenica, Serbia
| | - Vladimir Stojsic
- Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, University of Novi Sad, Faculty of Medicine, Sremska Kamenica, Serbia
| | - Branislav Perin
- Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, University of Novi Sad, Faculty of Medicine, Sremska Kamenica, Serbia
| | - Robert Pirker
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Martin Filipits
- Institute of Cancer Research, Medical University of Vienna, Vienna, Austria; Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
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Kovacevic T, Zaric B, Bokan D. P2.10-005 Overall Survival of Lung Cancer Patients with Brain Metastases in a Developing Country. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Spasic J, Krivokuca A, Zaric B, Radosavljevic D, Perin B, Radulovic S, Jankovic R, Cavic M. P1.02-007 TP53 and DNA-Repair Gene Polymorphisms as Risk Factors for the Development of Advanced Lung Adenocarcinoma in Serbia. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Dutau H, Breen D, Bugalho A, Dalar L, Daniels J, Dooms C, Eberhardt R, Ek L, Encheva M, Febvre M, Hackl M, Marran S, Papai-Szekely Z, Perch M, Roglic M, Rosell A, Rozman A, Shah PL, Simon M, Szlubowski A, Stratakos G, Sundset A, Uibu T, Von Garnier C, Zaric B, Zdraveska M, Zuccatosta L, Bokan D, Arshad Husain S, Bilaceroglu S, Gasche-Soccal P, Gasparini S, Herth FJ, Munavvar M. Current Practice of Airway Stenting in the Adult Population in Europe: A Survey of the European Association of Bronchology and Interventional Pulmonology (EABIP). Respiration 2017; 95:44-54. [DOI: 10.1159/000480152] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 08/08/2017] [Indexed: 11/19/2022] Open
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Hirsch FR, Zaric B, Rabea A, Thongprasert S, Lertprasertsuke N, Dalurzo ML, Varella-Garcia M. Biomarker Testing for Personalized Therapy in Lung Cancer in Low- and Middle-Income Countries. Am Soc Clin Oncol Educ Book 2017. [PMID: 28561679 DOI: 10.14694/edbk_175243] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
There have been many important advances in personalized therapy for patients with lung cancer, particularly for those with advanced disease. Molecular testing is crucial for implementation of personalized therapy. Although the United States and many Western countries have come far in the implementation of personalized therapy for lung cancer, there are substantial challenges for low- and middle-income countries (LMICs). Globally, the LMICs display great heterogeneity in the pattern of implementation of molecular testing and targeted therapy. The current review presents an attempt to identify the challenges and obstacles for the implementation of molecular testing and the use of targeted therapies in these areas. Lack of infrastructure, lack of technical expertise, economic factors, and lack of access to new drugs are among the substantial barriers.
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Affiliation(s)
- Fred R Hirsch
- From the University of Colorado School of Medicine, University of Colorado Cancer Center, International Association for the Study of Lung Cancer, Aurora, CO; Institute for Pulmonary Diseases of Vojvodina, University of Novi Sad, Sremska Kamenica, Serbia; National Cancer Institute, Cairo University, Giza, Egypt; Chiang Mai University, Chiang Mai, Thailand; Pathology Department, Chiang Mai University, Chiang Mai, Thailand; Hospital Italiano Buenos Aires, Perón, Argentina; University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Bojan Zaric
- From the University of Colorado School of Medicine, University of Colorado Cancer Center, International Association for the Study of Lung Cancer, Aurora, CO; Institute for Pulmonary Diseases of Vojvodina, University of Novi Sad, Sremska Kamenica, Serbia; National Cancer Institute, Cairo University, Giza, Egypt; Chiang Mai University, Chiang Mai, Thailand; Pathology Department, Chiang Mai University, Chiang Mai, Thailand; Hospital Italiano Buenos Aires, Perón, Argentina; University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Ahmed Rabea
- From the University of Colorado School of Medicine, University of Colorado Cancer Center, International Association for the Study of Lung Cancer, Aurora, CO; Institute for Pulmonary Diseases of Vojvodina, University of Novi Sad, Sremska Kamenica, Serbia; National Cancer Institute, Cairo University, Giza, Egypt; Chiang Mai University, Chiang Mai, Thailand; Pathology Department, Chiang Mai University, Chiang Mai, Thailand; Hospital Italiano Buenos Aires, Perón, Argentina; University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Sumitra Thongprasert
- From the University of Colorado School of Medicine, University of Colorado Cancer Center, International Association for the Study of Lung Cancer, Aurora, CO; Institute for Pulmonary Diseases of Vojvodina, University of Novi Sad, Sremska Kamenica, Serbia; National Cancer Institute, Cairo University, Giza, Egypt; Chiang Mai University, Chiang Mai, Thailand; Pathology Department, Chiang Mai University, Chiang Mai, Thailand; Hospital Italiano Buenos Aires, Perón, Argentina; University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Nirush Lertprasertsuke
- From the University of Colorado School of Medicine, University of Colorado Cancer Center, International Association for the Study of Lung Cancer, Aurora, CO; Institute for Pulmonary Diseases of Vojvodina, University of Novi Sad, Sremska Kamenica, Serbia; National Cancer Institute, Cairo University, Giza, Egypt; Chiang Mai University, Chiang Mai, Thailand; Pathology Department, Chiang Mai University, Chiang Mai, Thailand; Hospital Italiano Buenos Aires, Perón, Argentina; University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Mercedes Liliana Dalurzo
- From the University of Colorado School of Medicine, University of Colorado Cancer Center, International Association for the Study of Lung Cancer, Aurora, CO; Institute for Pulmonary Diseases of Vojvodina, University of Novi Sad, Sremska Kamenica, Serbia; National Cancer Institute, Cairo University, Giza, Egypt; Chiang Mai University, Chiang Mai, Thailand; Pathology Department, Chiang Mai University, Chiang Mai, Thailand; Hospital Italiano Buenos Aires, Perón, Argentina; University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Marileila Varella-Garcia
- From the University of Colorado School of Medicine, University of Colorado Cancer Center, International Association for the Study of Lung Cancer, Aurora, CO; Institute for Pulmonary Diseases of Vojvodina, University of Novi Sad, Sremska Kamenica, Serbia; National Cancer Institute, Cairo University, Giza, Egypt; Chiang Mai University, Chiang Mai, Thailand; Pathology Department, Chiang Mai University, Chiang Mai, Thailand; Hospital Italiano Buenos Aires, Perón, Argentina; University of Colorado Anschutz Medical Campus, Aurora, CO
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Spasic J, Stanic N, Radosavljevic D, Krivokuca A, Kuburovic M, Zaric B, Perin B, Radulovic S, Jankovic R, Cavic M. P2.03b-052 XRCC1 Arg399Gln and Rad51 G135C Gene Polymorphisms in Advanced Lung Adenocarcinoma in Serbia. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.1333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zaric B, Brcic L, Buder A, Tomuta C, Brandstetter A, Buresch J, Traint S, Stojsic V, Kovacevic T, Perin B, Pirker R, Filipits M. P2.03b-075 PD-1 Protein Expression Predicts Survival in Resected Adenocarcinomas of the Lung. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.1357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hirsch FR, Zaric B, Rabea A, Thongprasert S, Lertprasertsuke N, Dalurzo ML, Varella-Garcia M. Biomarker Testing for Personalized Therapy in Lung Cancer in Low- and Middle-Income Countries. Am Soc Clin Oncol Educ Book 2017; 37:403-408. [PMID: 28561679 DOI: 10.1200/edbk_175243] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
There have been many important advances in personalized therapy for patients with lung cancer, particularly for those with advanced disease. Molecular testing is crucial for implementation of personalized therapy. Although the United States and many Western countries have come far in the implementation of personalized therapy for lung cancer, there are substantial challenges for low- and middle-income countries (LMICs). Globally, the LMICs display great heterogeneity in the pattern of implementation of molecular testing and targeted therapy. The current review presents an attempt to identify the challenges and obstacles for the implementation of molecular testing and the use of targeted therapies in these areas. Lack of infrastructure, lack of technical expertise, economic factors, and lack of access to new drugs are among the substantial barriers.
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Affiliation(s)
- Fred R Hirsch
- From the University of Colorado School of Medicine, University of Colorado Cancer Center, International Association for the Study of Lung Cancer, Aurora, CO; Institute for Pulmonary Diseases of Vojvodina, University of Novi Sad, Sremska Kamenica, Serbia; National Cancer Institute, Cairo University, Giza, Egypt; Chiang Mai University, Chiang Mai, Thailand; Pathology Department, Chiang Mai University, Chiang Mai, Thailand; Hospital Italiano Buenos Aires, Perón, Argentina; University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Bojan Zaric
- From the University of Colorado School of Medicine, University of Colorado Cancer Center, International Association for the Study of Lung Cancer, Aurora, CO; Institute for Pulmonary Diseases of Vojvodina, University of Novi Sad, Sremska Kamenica, Serbia; National Cancer Institute, Cairo University, Giza, Egypt; Chiang Mai University, Chiang Mai, Thailand; Pathology Department, Chiang Mai University, Chiang Mai, Thailand; Hospital Italiano Buenos Aires, Perón, Argentina; University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Ahmed Rabea
- From the University of Colorado School of Medicine, University of Colorado Cancer Center, International Association for the Study of Lung Cancer, Aurora, CO; Institute for Pulmonary Diseases of Vojvodina, University of Novi Sad, Sremska Kamenica, Serbia; National Cancer Institute, Cairo University, Giza, Egypt; Chiang Mai University, Chiang Mai, Thailand; Pathology Department, Chiang Mai University, Chiang Mai, Thailand; Hospital Italiano Buenos Aires, Perón, Argentina; University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Sumitra Thongprasert
- From the University of Colorado School of Medicine, University of Colorado Cancer Center, International Association for the Study of Lung Cancer, Aurora, CO; Institute for Pulmonary Diseases of Vojvodina, University of Novi Sad, Sremska Kamenica, Serbia; National Cancer Institute, Cairo University, Giza, Egypt; Chiang Mai University, Chiang Mai, Thailand; Pathology Department, Chiang Mai University, Chiang Mai, Thailand; Hospital Italiano Buenos Aires, Perón, Argentina; University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Nirush Lertprasertsuke
- From the University of Colorado School of Medicine, University of Colorado Cancer Center, International Association for the Study of Lung Cancer, Aurora, CO; Institute for Pulmonary Diseases of Vojvodina, University of Novi Sad, Sremska Kamenica, Serbia; National Cancer Institute, Cairo University, Giza, Egypt; Chiang Mai University, Chiang Mai, Thailand; Pathology Department, Chiang Mai University, Chiang Mai, Thailand; Hospital Italiano Buenos Aires, Perón, Argentina; University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Mercedes Liliana Dalurzo
- From the University of Colorado School of Medicine, University of Colorado Cancer Center, International Association for the Study of Lung Cancer, Aurora, CO; Institute for Pulmonary Diseases of Vojvodina, University of Novi Sad, Sremska Kamenica, Serbia; National Cancer Institute, Cairo University, Giza, Egypt; Chiang Mai University, Chiang Mai, Thailand; Pathology Department, Chiang Mai University, Chiang Mai, Thailand; Hospital Italiano Buenos Aires, Perón, Argentina; University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Marileila Varella-Garcia
- From the University of Colorado School of Medicine, University of Colorado Cancer Center, International Association for the Study of Lung Cancer, Aurora, CO; Institute for Pulmonary Diseases of Vojvodina, University of Novi Sad, Sremska Kamenica, Serbia; National Cancer Institute, Cairo University, Giza, Egypt; Chiang Mai University, Chiang Mai, Thailand; Pathology Department, Chiang Mai University, Chiang Mai, Thailand; Hospital Italiano Buenos Aires, Perón, Argentina; University of Colorado Anschutz Medical Campus, Aurora, CO
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Zaric B, Stojsic V, Panjkovic M, Tegeltija D, Stepanov V, Kovacevic T, Sarcev T, Radosavljevic D, Milovancev A, Adamidis V, Zarogoulidis P, Hohenforst-Schmidt W, Trakada G, Rapti A, Perin B. Clinicopathological features and relation between anaplastic lymphoma kinase (ALK) mutation and histological subtype of lung adenocarcinoma in Eastern European Caucasian population. J Cancer 2016; 7:2207-2212. [PMID: 27994656 PMCID: PMC5166529 DOI: 10.7150/jca.16768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 09/04/2016] [Indexed: 12/24/2022] Open
Abstract
Introduction: The incidence of echinoderm microtubule-associated protein-like4-anaplastic lymphoma kinase (EML4-ALK) mutation among surgically treated patients with adenocarcinoma of the lung of the Eastern European ethnicity is underreported. The aim of this trial was the determination of EML4-ALK mutation frequency in investigated population, and the evaluation of correlations between lung adenocarcinoma subtype and clinical characteristics with mutation status. Patients and methods: This was a prospective trial which included 195 patients with adenocarcinoma of the lung who underwent surgical treatment. ALK mutation screening was performed by immunohistochemistry (IHC). IHC scores of 2+ and 3+ were regarded as positive. Confirmatory FISH was performed in all IHC positive and in 2:1 ratio in negative patients. Results: Overall ALK mutation rate established by IHC was 6.2%, while FISH confirmed rate of 5.1%. The FISH confirmed ALK positivity in 7.6% Hungarians, 5.5% Serbians, and 6.6% Slovakians. Acinar subtype of adenocarcinoma of the lung was significantly (p=0.02) related to EML4-ALK positive mutation status. Most of the patients were males (56.9%), smokers (50.8%), or former smokers (28.7%) with acinar (55.4%) or solid (35.9%) adenocarcinoma of the lung. Sensitivity and specificity of IHC were 100% and 98.9% respectively. Conclusions: ALK mutation rate in surgically treated patients with adenocarcinoma of the lung was found to be 6.2% by IHC and 5.1% by FISH. Acinar subtype of the adenocarcinoma of the lung was significantly related to ALK positive mutation.
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Affiliation(s)
- Bojan Zaric
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Vladimir Stojsic
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Milana Panjkovic
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Dragana Tegeltija
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Vanesa Stepanov
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Tomi Kovacevic
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Tatjana Sarcev
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | | | - Aleksandar Milovancev
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Vasilis Adamidis
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Paul Zarogoulidis
- Pulmonary Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Georgia Trakada
- Division of Pulmonology, Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Alexandra Hospital, Athens, Greece
| | - Aggeliki Rapti
- Pulmonary Department, ''Sotiria '' Hospital of Chest Diseases, Athens, Greece
| | - Branislav Perin
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
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Affiliation(s)
- Bojan Zaric
- a Institute for Pulmonary Diseases of Vojvodina , University of Novi Sad , Sremska Kamenica , Serbia
| | - Tomi Kovacevic
- a Institute for Pulmonary Diseases of Vojvodina , University of Novi Sad , Sremska Kamenica , Serbia
| | - Vladimir Stojsic
- a Institute for Pulmonary Diseases of Vojvodina , University of Novi Sad , Sremska Kamenica , Serbia
| | - Aleksandar Milovancev
- a Institute for Pulmonary Diseases of Vojvodina , University of Novi Sad , Sremska Kamenica , Serbia
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Sreter KB, Jakopovic M, Janevski Z, Samarzija M, Zarogoulidis P, Kioumis I, Mparmpetakis N, Pataka A, Zarogoulidis K, Tsiouda T, Kosmidis C, Mpaka S, Huang H, Hohenforst-Schmidt W, Charalampidis C, Machairiotis N, Zaric B, Milovancev A. A pilot study-is there a role for mitoxantrone pleurodesis in the management of pleural effusion due to lung cancer? Ann Transl Med 2016; 4:162. [PMID: 27275475 DOI: 10.21037/atm.2016.04.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Lung cancer is the leading cause of malignant pleural effusion (MPE). Management of MPEs remains a clinical challenge due to recurrence and poor quality of life. An ideal sclerosing agent has yet to be found. The aim of this cohort pilot study was to evaluate the role of mitoxantrone pleurodesis (MP) as an alternative to talc sclerotherapy for managing MPEs in lung cancer patients. METHODS A retrospective chart review was conducted on consecutively admitted patients with MPE to the Department of Post-Intensive Care at the Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, in Croatia. RESULTS Of 34 patients with MPE, twenty-one (64.8±9.46 years; 47-84 years) with primary lung carcinoma who received MP (30 mg of mitoxantrone) between December 2003 and February 2009 were included in this study. Chest radiographs taken prior to sclerotherapy and at 1-, 2-, and 3-month follow-up were compared. At the post-sclerotherapy evaluation periods, overall success (OS) rates of MP were 88.2% [17.6%, complete response (CR); 70.6%, partial response (PR)], 53.9% (7.7% CR; 46.2% PR), and 45.5% (PR), respectively. Kaplan-Meier median survival from MP until death was 5.2 months, while that from diagnosis of primary lung cancer was 12.3 months. CONCLUSIONS MP may be a safe and effective method of managing MPE due to lung cancer. Future randomized controlled studies comparing mitoxantrone and talc pleurodesis in lung cancer patients are warranted to elucidate whether a significant difference exists between these agents. Factors affecting success, survival probability, and quality of life also require further investigation.
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Affiliation(s)
- Katherina-Bernadette Sreter
- 1 Department of Clinical Immunology, Pulmonology, and Rheumatology, University Hospital Centre "Sestre Milosrdnice", Zagreb, Croatia ; 2 Department of Post-Intensive Care, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, University of Zagreb, Faculty of Medicine, Zagreb, Croatia ; 3 Department of Thoracic Surgery, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, Zagreb, Croatia ; 4 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 6 University Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Department of Respiratory Diseases, Changhai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai 200003, China ; 9 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 10 Department of Anatomy, Democritus University of Thrace, Alexandroupolis, Greece ; 11 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, Athens, Greece ; 12 Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Marko Jakopovic
- 1 Department of Clinical Immunology, Pulmonology, and Rheumatology, University Hospital Centre "Sestre Milosrdnice", Zagreb, Croatia ; 2 Department of Post-Intensive Care, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, University of Zagreb, Faculty of Medicine, Zagreb, Croatia ; 3 Department of Thoracic Surgery, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, Zagreb, Croatia ; 4 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 6 University Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Department of Respiratory Diseases, Changhai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai 200003, China ; 9 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 10 Department of Anatomy, Democritus University of Thrace, Alexandroupolis, Greece ; 11 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, Athens, Greece ; 12 Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Zoran Janevski
- 1 Department of Clinical Immunology, Pulmonology, and Rheumatology, University Hospital Centre "Sestre Milosrdnice", Zagreb, Croatia ; 2 Department of Post-Intensive Care, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, University of Zagreb, Faculty of Medicine, Zagreb, Croatia ; 3 Department of Thoracic Surgery, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, Zagreb, Croatia ; 4 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 6 University Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Department of Respiratory Diseases, Changhai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai 200003, China ; 9 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 10 Department of Anatomy, Democritus University of Thrace, Alexandroupolis, Greece ; 11 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, Athens, Greece ; 12 Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Miroslav Samarzija
- 1 Department of Clinical Immunology, Pulmonology, and Rheumatology, University Hospital Centre "Sestre Milosrdnice", Zagreb, Croatia ; 2 Department of Post-Intensive Care, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, University of Zagreb, Faculty of Medicine, Zagreb, Croatia ; 3 Department of Thoracic Surgery, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, Zagreb, Croatia ; 4 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 6 University Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Department of Respiratory Diseases, Changhai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai 200003, China ; 9 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 10 Department of Anatomy, Democritus University of Thrace, Alexandroupolis, Greece ; 11 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, Athens, Greece ; 12 Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Paul Zarogoulidis
- 1 Department of Clinical Immunology, Pulmonology, and Rheumatology, University Hospital Centre "Sestre Milosrdnice", Zagreb, Croatia ; 2 Department of Post-Intensive Care, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, University of Zagreb, Faculty of Medicine, Zagreb, Croatia ; 3 Department of Thoracic Surgery, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, Zagreb, Croatia ; 4 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 6 University Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Department of Respiratory Diseases, Changhai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai 200003, China ; 9 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 10 Department of Anatomy, Democritus University of Thrace, Alexandroupolis, Greece ; 11 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, Athens, Greece ; 12 Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Ioannis Kioumis
- 1 Department of Clinical Immunology, Pulmonology, and Rheumatology, University Hospital Centre "Sestre Milosrdnice", Zagreb, Croatia ; 2 Department of Post-Intensive Care, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, University of Zagreb, Faculty of Medicine, Zagreb, Croatia ; 3 Department of Thoracic Surgery, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, Zagreb, Croatia ; 4 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 6 University Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Department of Respiratory Diseases, Changhai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai 200003, China ; 9 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 10 Department of Anatomy, Democritus University of Thrace, Alexandroupolis, Greece ; 11 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, Athens, Greece ; 12 Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Nikolaos Mparmpetakis
- 1 Department of Clinical Immunology, Pulmonology, and Rheumatology, University Hospital Centre "Sestre Milosrdnice", Zagreb, Croatia ; 2 Department of Post-Intensive Care, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, University of Zagreb, Faculty of Medicine, Zagreb, Croatia ; 3 Department of Thoracic Surgery, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, Zagreb, Croatia ; 4 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 6 University Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Department of Respiratory Diseases, Changhai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai 200003, China ; 9 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 10 Department of Anatomy, Democritus University of Thrace, Alexandroupolis, Greece ; 11 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, Athens, Greece ; 12 Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Athanasia Pataka
- 1 Department of Clinical Immunology, Pulmonology, and Rheumatology, University Hospital Centre "Sestre Milosrdnice", Zagreb, Croatia ; 2 Department of Post-Intensive Care, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, University of Zagreb, Faculty of Medicine, Zagreb, Croatia ; 3 Department of Thoracic Surgery, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, Zagreb, Croatia ; 4 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 6 University Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Department of Respiratory Diseases, Changhai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai 200003, China ; 9 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 10 Department of Anatomy, Democritus University of Thrace, Alexandroupolis, Greece ; 11 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, Athens, Greece ; 12 Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Konstantinos Zarogoulidis
- 1 Department of Clinical Immunology, Pulmonology, and Rheumatology, University Hospital Centre "Sestre Milosrdnice", Zagreb, Croatia ; 2 Department of Post-Intensive Care, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, University of Zagreb, Faculty of Medicine, Zagreb, Croatia ; 3 Department of Thoracic Surgery, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, Zagreb, Croatia ; 4 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 6 University Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Department of Respiratory Diseases, Changhai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai 200003, China ; 9 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 10 Department of Anatomy, Democritus University of Thrace, Alexandroupolis, Greece ; 11 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, Athens, Greece ; 12 Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Theodora Tsiouda
- 1 Department of Clinical Immunology, Pulmonology, and Rheumatology, University Hospital Centre "Sestre Milosrdnice", Zagreb, Croatia ; 2 Department of Post-Intensive Care, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, University of Zagreb, Faculty of Medicine, Zagreb, Croatia ; 3 Department of Thoracic Surgery, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, Zagreb, Croatia ; 4 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 6 University Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Department of Respiratory Diseases, Changhai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai 200003, China ; 9 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 10 Department of Anatomy, Democritus University of Thrace, Alexandroupolis, Greece ; 11 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, Athens, Greece ; 12 Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Christoforos Kosmidis
- 1 Department of Clinical Immunology, Pulmonology, and Rheumatology, University Hospital Centre "Sestre Milosrdnice", Zagreb, Croatia ; 2 Department of Post-Intensive Care, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, University of Zagreb, Faculty of Medicine, Zagreb, Croatia ; 3 Department of Thoracic Surgery, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, Zagreb, Croatia ; 4 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 6 University Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Department of Respiratory Diseases, Changhai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai 200003, China ; 9 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 10 Department of Anatomy, Democritus University of Thrace, Alexandroupolis, Greece ; 11 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, Athens, Greece ; 12 Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Sofia Mpaka
- 1 Department of Clinical Immunology, Pulmonology, and Rheumatology, University Hospital Centre "Sestre Milosrdnice", Zagreb, Croatia ; 2 Department of Post-Intensive Care, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, University of Zagreb, Faculty of Medicine, Zagreb, Croatia ; 3 Department of Thoracic Surgery, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, Zagreb, Croatia ; 4 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 6 University Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Department of Respiratory Diseases, Changhai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai 200003, China ; 9 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 10 Department of Anatomy, Democritus University of Thrace, Alexandroupolis, Greece ; 11 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, Athens, Greece ; 12 Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Haidong Huang
- 1 Department of Clinical Immunology, Pulmonology, and Rheumatology, University Hospital Centre "Sestre Milosrdnice", Zagreb, Croatia ; 2 Department of Post-Intensive Care, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, University of Zagreb, Faculty of Medicine, Zagreb, Croatia ; 3 Department of Thoracic Surgery, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, Zagreb, Croatia ; 4 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 6 University Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Department of Respiratory Diseases, Changhai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai 200003, China ; 9 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 10 Department of Anatomy, Democritus University of Thrace, Alexandroupolis, Greece ; 11 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, Athens, Greece ; 12 Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Wolfgang Hohenforst-Schmidt
- 1 Department of Clinical Immunology, Pulmonology, and Rheumatology, University Hospital Centre "Sestre Milosrdnice", Zagreb, Croatia ; 2 Department of Post-Intensive Care, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, University of Zagreb, Faculty of Medicine, Zagreb, Croatia ; 3 Department of Thoracic Surgery, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, Zagreb, Croatia ; 4 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 6 University Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Department of Respiratory Diseases, Changhai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai 200003, China ; 9 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 10 Department of Anatomy, Democritus University of Thrace, Alexandroupolis, Greece ; 11 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, Athens, Greece ; 12 Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Charalampos Charalampidis
- 1 Department of Clinical Immunology, Pulmonology, and Rheumatology, University Hospital Centre "Sestre Milosrdnice", Zagreb, Croatia ; 2 Department of Post-Intensive Care, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, University of Zagreb, Faculty of Medicine, Zagreb, Croatia ; 3 Department of Thoracic Surgery, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, Zagreb, Croatia ; 4 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 6 University Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Department of Respiratory Diseases, Changhai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai 200003, China ; 9 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 10 Department of Anatomy, Democritus University of Thrace, Alexandroupolis, Greece ; 11 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, Athens, Greece ; 12 Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Nikolaos Machairiotis
- 1 Department of Clinical Immunology, Pulmonology, and Rheumatology, University Hospital Centre "Sestre Milosrdnice", Zagreb, Croatia ; 2 Department of Post-Intensive Care, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, University of Zagreb, Faculty of Medicine, Zagreb, Croatia ; 3 Department of Thoracic Surgery, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, Zagreb, Croatia ; 4 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 6 University Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Department of Respiratory Diseases, Changhai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai 200003, China ; 9 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 10 Department of Anatomy, Democritus University of Thrace, Alexandroupolis, Greece ; 11 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, Athens, Greece ; 12 Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Bojan Zaric
- 1 Department of Clinical Immunology, Pulmonology, and Rheumatology, University Hospital Centre "Sestre Milosrdnice", Zagreb, Croatia ; 2 Department of Post-Intensive Care, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, University of Zagreb, Faculty of Medicine, Zagreb, Croatia ; 3 Department of Thoracic Surgery, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, Zagreb, Croatia ; 4 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 6 University Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Department of Respiratory Diseases, Changhai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai 200003, China ; 9 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 10 Department of Anatomy, Democritus University of Thrace, Alexandroupolis, Greece ; 11 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, Athens, Greece ; 12 Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Aleksandar Milovancev
- 1 Department of Clinical Immunology, Pulmonology, and Rheumatology, University Hospital Centre "Sestre Milosrdnice", Zagreb, Croatia ; 2 Department of Post-Intensive Care, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, University of Zagreb, Faculty of Medicine, Zagreb, Croatia ; 3 Department of Thoracic Surgery, Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, Zagreb, Croatia ; 4 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 6 University Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Department of Respiratory Diseases, Changhai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai 200003, China ; 9 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 10 Department of Anatomy, Democritus University of Thrace, Alexandroupolis, Greece ; 11 Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, Athens, Greece ; 12 Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
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Hohenforst-Schmidt W, Zarogoulidis P, Pitsiou G, Linsmeier B, Tsavlis D, Kioumis I, Papadaki E, Freitag L, Tsiouda T, Turner JF, Browning R, Simoff M, Sachpekidis N, Tsakiridis K, Zaric B, Yarmus L, Baka S, Stratakos G, Rittger H. Drug Eluting Stents for Malignant Airway Obstruction: A Critical Review of the Literature. J Cancer 2016; 7:377-90. [PMID: 26918052 PMCID: PMC4749359 DOI: 10.7150/jca.13611] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 11/01/2015] [Indexed: 02/07/2023] Open
Abstract
Lung cancer being the most prevalent malignancy in men and the 3(rd) most frequent in women is still associated with dismal prognosis due to advanced disease at the time of diagnosis. Novel targeted therapies are already on the market and several others are under investigation. However non-specific cytotoxic agents still remain the cornerstone of treatment for many patients. Central airways stenosis or obstruction may often complicate and decrease quality of life and survival of these patients. Interventional pulmonology modalities (mainly debulking and stent placement) can alleviate symptoms related to airways stenosis and improve the quality of life of patients. Mitomycin C and sirolimus have been observed to assist a successful stent placement by reducing granuloma tissue formation. Additionally, these drugs enhance the normal tissue ability against cancer cell infiltration. In this mini review we will concentrate on mitomycin C and sirolimus and their use in stent placement.
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Affiliation(s)
| | - Paul Zarogoulidis
- 2. Pulmonary Department-Oncology Unit, ``G. Papanikolaou`` General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgia Pitsiou
- 2. Pulmonary Department-Oncology Unit, ``G. Papanikolaou`` General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Bernd Linsmeier
- 3. Department of General Surgery, Coburg Clinic, Coburg, Germany
| | - Drosos Tsavlis
- 2. Pulmonary Department-Oncology Unit, ``G. Papanikolaou`` General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Kioumis
- 2. Pulmonary Department-Oncology Unit, ``G. Papanikolaou`` General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Papadaki
- 2. Pulmonary Department-Oncology Unit, ``G. Papanikolaou`` General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Lutz Freitag
- 4. Department of Interventional Pneumology, Ruhrlandklinik, University Hospital Essen, University of Essen-Duisburg, Tueschener Weg 40, 45239 Essen, Germany
| | - Theodora Tsiouda
- 2. Pulmonary Department-Oncology Unit, ``G. Papanikolaou`` General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - J Francis Turner
- 5. Division of Interventional Pulmonology & Medical Oncology, Cancer Treatment Centers of America, Western Regional Medical Center, Goodyear, AZ
| | - Robert Browning
- 6. Pulmonary & Critical Care Medicine, Interventional Pulmonology, National Naval Medical Center, Walter Reed Army Medical Center, Bethesda, U.S.A
| | - Michael Simoff
- 7. Bronchoscopy and Interventional Pulmonology, Pulmonary and Critical Care Medicine, Henry Ford Hospital, Wayne State University, School of Medicine, MI, USA
| | - Nikolaos Sachpekidis
- 8. Cardiothoracic Surgery Department, ``Saint Luke`` Private Hospital, Thessaloniki, Panorama, Greece
| | - Kosmas Tsakiridis
- 8. Cardiothoracic Surgery Department, ``Saint Luke`` Private Hospital, Thessaloniki, Panorama, Greece
| | - Bojan Zaric
- 9. Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Lonny Yarmus
- 10. Division of Pulmonary and Critical Care Medicine, Sheikh Zayed Cardiovascular & Critical Care Tower, Baltimore, U.S.A
| | - Sofia Baka
- 11. Oncology Department, ``Interbalkan`` European Medical Center, Thessaloniki, Greece
| | - Grigoris Stratakos
- 12. 1st Respiratory Medicine Department of National University of Athens, "Sotiria" General Hospital Athens, Greece
| | - Harald Rittger
- 1. Medical Clinic I, ''Fuerth'' Hospital, University of Erlangen, Fuerth, Germany
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43
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Zaric B, Stojsic V, Carapic V, Kovacevic T, Stojanovic G, Panjkovic M, Kioumis I, Darwiche K, Zarogoulidis K, Stratakos G, Tsavlis D, Hohenforst-Schmidt W, Pitsiou G, Zissimopoulos A, Sachpekidis N, Karapantzos I, Karapantzou C, Zarogoulidis P, Perin B. Radial Endobronchial Ultrasound (EBUS) Guided Suction Catheter-Biopsy in Histological Diagnosis of Peripheral Pulmonary Lesions. J Cancer 2016; 7:7-13. [PMID: 26722354 PMCID: PMC4679375 DOI: 10.7150/jca.13081] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 08/31/2015] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND EBUS guided trans-bronchial biopsy became routine in diagnosis of peripheral pulmonary lesions (PPL). Suction catheter-biopsy is a technique for obtaining a tissue sample from peripheral lung parenchyma. Aim of this study was to evaluate diagnostic efficiency, feasibility and safety of EBUS guided suction catheter-biopsy (SCB) in comparison to trans-bronchial biopsy (TBB) in diagnosis of PPL. The main intention was to demonstrate non-inferiority of the technique over trans-bronchial biopsy, especially when used under navigation of the EBUS. METHODS Radial EBUS probe (UM-3R, Olympus Co, Japan.) without guiding sheath was used to navigate suction catheter and TBB forceps to the PPL. The catheter was connected to the collection canister via vacuum pump. The SCB specimens were fixed with 10% buffered formalin. RESULTS There were 168 patients enrolled in this study; 69.9% males and 30.1% females. Main lesion diameter was 4.1±1.9 cm. Majority of patients, 131(77.9%) were diagnosed with lung cancer. Per-biopsy calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for EBUS-SCB were 92.4%, 100%, 100% and 67.7%, respectively. Corresponding values for EBUS-TBB were 92.3%, 100%, 100% and 69.7%. Only the size of the lesion significantly influenced (p=0.005) diagnostic performance. Complications occurred in 2 patients; one pneumothorax and one excessive bleeding. CONCLUSION EBUS guided SCB is efficient, feasible and safe in diagnosis of peripheral lung cancer. The technique is complementary to trans-bronchial biopsy.
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Affiliation(s)
- Bojan Zaric
- 1. Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Vladimir Stojsic
- 1. Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Vladimir Carapic
- 1. Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Tomi Kovacevic
- 1. Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Goran Stojanovic
- 1. Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Milana Panjkovic
- 1. Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Ioannis Kioumis
- 3. Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kaid Darwiche
- 2. Department of Interventional Pneumology, Ruhrlandklinik, University Hospital Essen, University of Duisburg-Essen, 45239 Essen, Germany
| | - Konstantinos Zarogoulidis
- 3. Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Grigoris Stratakos
- 4. Department of Interventional Pneumology, "Sotiria" Hospital of Chest Diseases, Athens, Greece
| | - Drosos Tsavlis
- 3. Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Georgia Pitsiou
- 3. Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanasios Zissimopoulos
- 6. Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Nikos Sachpekidis
- 7. Thoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece
| | - Ilias Karapantzos
- 8. Ear, Nose and Throat Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece
| | - Chrysanthi Karapantzou
- 8. Ear, Nose and Throat Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece
| | - Paul Zarogoulidis
- 3. Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Branislav Perin
- 1. Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
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Milovancev A, Stojsic V, Zaric B, Kovacevic T, Sarcev T, Perin B, Zarogoulidis K, Tsirgogianni K, Freitag L, Darwiche K, Tsavlis D, Zissimopoulos A, Stratakos G, Zarogoulidis P. EGFR-TKIs in adjuvant treatment of lung cancer: to give or not to give? Onco Targets Ther 2015; 8:2915-21. [PMID: 26508876 PMCID: PMC4610780 DOI: 10.2147/ott.s91627] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Epidermal growth factor receptor-tyrosine-kinase inhibitors (EGFR-TKIs) brought a significant revolution in the treatment of non-small-cell lung cancer (NSCLC). In a short period of time, EGFR-TKIs became the standard of treatment for mutation-positive, advanced stage non-squamous NSCLC. In recent years, second- and third-generation EGFR-TKIs are emerging, further widening the clinical use. However, the question of EGFR-TKIs efficiency in the treatment of early stage NSCLC still remains open. Early clinical trials failed to approve the use of EGFR-TKIs in adjuvant setting. The majority of these early trials were performed in unselected NSCLC populations and without standardized biomarker identification. One should certainly not rely solely on these results and dismiss the use of EGFR-TKIs as adjuvant therapy. Many important questions are still unanswered. Most important issues such as stage heterogeneity (IA–IIIA), timing (after or concomitantly with chemotherapy), and type of administration (monotherapy or combination) need to be answered in near future. Adjuvant TKIs in the treatment of lung cancer might offer significant number of advancements. Having in mind the significant duration of response observed in advance disease setting, there could be place for prolongation of response in adjuvant setting potentially, leading to improvement in survival. TKIs could offer less-toxic adjuvant treatment with better efficiency than chemotherapy. However, there is a chronic lack of randomized controlled trials in this field, leading to inability to draw any scientifically sound conclusion with regard to the adjuvant treatment. For now, the use of EGFR-TKIs outside clinical trial setting is not recommended. The purpose of this review is to evaluate current and available data.
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Affiliation(s)
- Aleksandar Milovancev
- Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Vladimir Stojsic
- Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Bojan Zaric
- Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Tomi Kovacevic
- Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Tatjana Sarcev
- Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Branislav Perin
- Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Konstantinos Zarogoulidis
- Pulmonary Department-Oncology Unit, "G Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Katerina Tsirgogianni
- Pulmonary Department-Oncology Unit, "G Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Lutz Freitag
- Department of Interventional Pneumology, Ruhrlandklinik, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Kaid Darwiche
- Department of Interventional Pneumology, Ruhrlandklinik, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Drosos Tsavlis
- Pulmonary Department-Oncology Unit, "G Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Grigoris Stratakos
- Department of Interventional Pneumology, "Sotiria" Hospital of Chest Diseases, Athens, Greece
| | - Paul Zarogoulidis
- Pulmonary Department-Oncology Unit, "G Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Ramalingam S, Goss G, Rosell R, Schmid-Bindert G, Zaric B, Andric Z, Bondarenko I, Komov D, Ceric T, Khuri F, Samarzija M, Felip E, Ciuleanu T, Hirsh V, Wehler T, Spicer J, Salgia R, Shapiro G, Sheldon E, Teofilovici F, Vukovic V, Fennell D. A randomized phase II study of ganetespib, a heat shock protein 90 inhibitor, in combination with docetaxel in second-line therapy of advanced non-small cell lung cancer (GALAXY-1). Ann Oncol 2015; 26:1741-8. [PMID: 25997818 DOI: 10.1093/annonc/mdv220] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/28/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This trial was designed to evaluate the activity and safety of ganetespib in combination with docetaxel in advanced non-small cell lung cancer (NSCLC) and to identify patient populations most likely to benefit from the combination. PATIENTS AND METHODS Patients with one prior systemic therapy for advanced disease were eligible. Docetaxel (75 mg/m(2) on day 1) was administered alone or with ganetespib (150 mg/m(2) on days 1 and 15) every 3 weeks. The primary end points were progression-free survival (PFS) in two subgroups of the adenocarcinoma population: patients with elevated lactate dehydrogenase (eLDH) and mutated KRAS (mKRAS). RESULTS Of 385 patients enrolled, 381 were treated. Early in the trial, increased hemoptysis and lack of efficacy were observed in nonadenocarcinoma patients (n = 71); therefore, only patients with adenocarcinoma histology were subsequently enrolled. Neutropenia was the most common grade ≥3 adverse event: 41% in the combination arm versus 42% in docetaxel alone. There was no improvement in PFS for the combination arm in the eLDH (N = 114, adjusted hazard ratio (HR) = 0.77, P = 0.1134) or mKRAS (N = 89, adjusted HR = 1.11, P = 0.3384) subgroups. In the intent-to-treat adenocarcinoma population, there was a trend in favor of the combination, with PFS (N = 253, adjusted HR = 0.82, P = 0.0784) and overall survival (OS) (adjusted HR = 0.84, P = 0.1139). Exploratory analyses showed significant benefit of the ganetespib combination in the prespecified subgroup of adenocarcinoma patients diagnosed with advanced disease >6 months before study entry (N = 177): PFS (adjusted HR = 0.74, P = 0.0417); OS (adjusted HR = 0.69, P = 0.0191). CONCLUSION Advanced lung adenocarcinoma patients treated with ganetespib in combination with docetaxel had an acceptable safety profile. While the study's primary end points were not met, significant prolongation of PFS and OS was observed in patients >6 months from diagnosis of advanced disease, a subgroup chosen as the target population for the phase III study.
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Affiliation(s)
- S Ramalingam
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, USA
| | - G Goss
- Division of Medical Oncology, University of Ottawa, Ottawa, Canada
| | - R Rosell
- Medical Oncology Service, Catalan Institute of Oncology, Badalona, Spain
| | - G Schmid-Bindert
- Department of Surgery, University Medical Center Mannheim, Mannheim, Germany
| | - B Zaric
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad
| | - Z Andric
- Clinic for Oncology, Medical Center Bezanijska Kosa, Belgrade, Serbia
| | - I Bondarenko
- Department of Oncology, Multiple-Discipline Clinical Hospital #4, Dnipropetrovsk, Ukraine
| | - D Komov
- Surgical Department of Tumor Diagnostics, Russian Academy of Medical Science, Moscow, Russia
| | - T Ceric
- Oncology Clinic, University of Sarajevo Clinics Center, Sarajevo, Bosnia
| | - F Khuri
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, USA
| | - M Samarzija
- Department for Respiratory Diseases Jordanovac, University of Zagreb, Zagreb, Croatia
| | - E Felip
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - T Ciuleanu
- Department of Medical Oncology, Oncological Institute Ion Chiricuta, Cluj-Napoca, Romania
| | - V Hirsh
- Department of Medical Oncology, McGill University Health Centre, Montreal, Canada
| | - T Wehler
- Third Department of Internal Medicine, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - J Spicer
- Department of Research Oncology, King's College London, London, UK
| | - R Salgia
- Department of Medicine, University of Chicago, Chicago
| | - G Shapiro
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston
| | - E Sheldon
- Department of Clinical Research, Synta Pharmaceuticals Corp., Lexington, USA
| | - F Teofilovici
- Department of Clinical Research, Synta Pharmaceuticals Corp., Lexington, USA
| | - V Vukovic
- Department of Clinical Research, Synta Pharmaceuticals Corp., Lexington, USA
| | - D Fennell
- Department of Cancer Studies, University of Leicester, Leicester, UK
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46
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Jankovic R, Cavic M, Spasic J, Krivokuca A, Brotto K, Jovanovic K, Boljevic I, Tanic M, Malisic E, Zaric B, Perin B, Radosavljevic DZ, Radulovic S. EGFR mutations in advanced non-small cell lung cancer patients in Serbia: 3 year-experience of central testing and gefitinib therapy response. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e19111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Radmila Jankovic
- Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Milena Cavic
- Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Jelena Spasic
- Department of Medical Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Ana Krivokuca
- Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Ksenija Brotto
- Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Katarina Jovanovic
- Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Ivana Boljevic
- Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Miljana Tanic
- Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Emina Malisic
- Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Bojan Zaric
- University of Novi Sad Institute for Pulmonary Diseases of Vojvodina, Sremska Kamencia, Vojvodina, Serbia
| | - Branislav Perin
- Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia
| | | | - Sinisa Radulovic
- Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
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47
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Zaric B, Perin B, Cekic M, Rancic M, Kovcin V, Andric Z, Murtezani Z, Jovanovic D, Velinovic M, Markovic M. Erlotinib as First-Line Treatment for Patients with Advanced EGFR Mutation-Positive Non-Small-Cell Lung Cancer: Phase Iiib Study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv050.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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48
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Zaric B, Kovacevic T, Stojsic V, Sarcev T, Kocic M, Urosevic M, Kalem D, Perin B. Neodymium yttrium-aluminium-garnet laser resection significantly improves quality of life in patients with malignant central airway obstruction due to lung cancer. Eur J Cancer Care (Engl) 2014; 24:560-6. [PMID: 25348599 DOI: 10.1111/ecc.12256] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2014] [Indexed: 01/20/2023]
Abstract
Neodymium yttrium-aluminium-garnet (Nd : YAG) laser resection is one of the mostly used interventional pulmonology techniques for urgent desobstruction of malignant central airway obstruction (CAO). The major aim of this trial was to evaluate potential influence of Nd : YAG laser resection on overall quality of life (QoL) in patients with central lung cancer. Patients with malignant CAO scheduled for Nd : YAG laser resection were prospectively recruited in the trial. All patients were given European Organization for Research and Treatment, Quality of Life questionnaire (EORTC QLQ-30 v.3) before the procedure and approximately 2 weeks after the treatment. There were 37 male and 10 female patients, average age 54 ± 10 years. Most common tumour type was adenocarcinoma diagnosed in 51% of patients. Majority of patients were diagnosed in stage IIIB (53.2%) and stage IV (25.5%). Most common Eastern Cooperative Oncology Group performance status was 1 (72.3%). Nd : YAG laser resection significantly improved (P<0.0001) QoL and overall health according to EORTC QLQ-30. However, in some of the questions dealing with nausea, vomiting, diarrhoea, constipation, family life, social activities and financial situation, we did not observe statistically significant improvement. Nd : YAG laser resection of malignant CAO significantly improves QoL and overall health in patients with lung cancer.
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Affiliation(s)
- B Zaric
- Clinic for Thoracic Oncology, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - T Kovacevic
- Clinic for Thoracic Oncology, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - V Stojsic
- Clinic for Thoracic Oncology, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - T Sarcev
- Clinic for Thoracic Oncology, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - M Kocic
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - M Urosevic
- Scientific Institute of Reproduction and Artificial Insemination of Domestic Animals 'Temerin', University of Novi Sad, Novi Sad, Serbia
| | - D Kalem
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - B Perin
- Clinic for Thoracic Oncology, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
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49
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Manika K, Kioumis I, Zarogoulidis K, Kougioumtzi I, Dryllis G, Pitsiou G, Machairiotis N, Katsikogiannis N, Lampaki S, Papaiwannou A, Zaric B, Branislav P, Huang H, Li Q, Steiropoulos P, Zarogoulidis P. Pneumothorax in sarcoidosis. J Thorac Dis 2014; 6:S466-9. [PMID: 25337404 DOI: 10.3978/j.issn.2072-1439.2014.09.11] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 08/26/2014] [Indexed: 11/14/2022]
Abstract
While sarcoidosis is a relatively common but often underdiagnosed disease, pneumothorax appears to be a rare clinical event observed mostly at the late stages of the disease course. The precise underlying mechanism of such complication is unclear and probably involves the formation of bullae due to bronchial obstruction and retraction-collapse of distracted lung tissue. Thoracoscopic bullectomy represent the preferred treatment option for recurrent pneumothoraces. The administration of corticosteroids for the treatment of pulmonary sarcoidosis may have a protecting effect for such recurrences, but remains a controversial issue.
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Affiliation(s)
- Katerina Manika
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 6 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 7 Pulmonary Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Ioannis Kioumis
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 6 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 7 Pulmonary Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Konstantinos Zarogoulidis
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 6 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 7 Pulmonary Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Ioanna Kougioumtzi
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 6 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 7 Pulmonary Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Georgios Dryllis
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 6 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 7 Pulmonary Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Georgia Pitsiou
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 6 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 7 Pulmonary Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Nikolaos Machairiotis
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 6 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 7 Pulmonary Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Nikolaos Katsikogiannis
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 6 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 7 Pulmonary Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Sofia Lampaki
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 6 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 7 Pulmonary Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Antonis Papaiwannou
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 6 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 7 Pulmonary Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Bojan Zaric
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 6 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 7 Pulmonary Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Perin Branislav
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 6 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 7 Pulmonary Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Haidong Huang
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 6 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 7 Pulmonary Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Qiang Li
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 6 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 7 Pulmonary Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Paschalis Steiropoulos
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 6 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 7 Pulmonary Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Paul Zarogoulidis
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 6 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 7 Pulmonary Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
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50
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Terzi E, Zarogoulidis K, Kougioumtzi I, Dryllis G, Kioumis I, Pitsiou G, Machairiotis N, Katsikogiannis N, Lampaki S, Papaiwannou A, Tsiouda T, Madesis A, Karaiskos T, Zaric B, Branislav P, Zarogoulidis P. Acute respiratory distress syndrome and pneumothorax. J Thorac Dis 2014; 6:S435-42. [PMID: 25337400 DOI: 10.3978/j.issn.2072-1439.2014.08.34] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 08/19/2014] [Indexed: 12/16/2022]
Abstract
Acute respiratory distress syndrome (ARDS) can occur during the treatment of several diseases and in several interventional procedures as a complication. It is a difficult situation to handle and special care should be applied to the patients. Mechanical ventilation is used for these patients and several parameters are changed constantly until compliance is achieved. However, a complication that is observed during the application of positive airway pressure is pneumothorax. In our current work we will present definition and causes of pneumothorax in the setting of intensive care unit (ICU). We will identify differences and similarities of this situation and present treatment options.
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Affiliation(s)
- Eirini Terzi
- 1 Internal Medicine Department-Unit of Infectious Diseases, "AHEPA" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 5 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 6 Internal Medicine Department, "Theiageneio" Anticancer Hospital, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 8 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Konstantinos Zarogoulidis
- 1 Internal Medicine Department-Unit of Infectious Diseases, "AHEPA" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 5 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 6 Internal Medicine Department, "Theiageneio" Anticancer Hospital, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 8 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Ioanna Kougioumtzi
- 1 Internal Medicine Department-Unit of Infectious Diseases, "AHEPA" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 5 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 6 Internal Medicine Department, "Theiageneio" Anticancer Hospital, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 8 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Georgios Dryllis
- 1 Internal Medicine Department-Unit of Infectious Diseases, "AHEPA" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 5 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 6 Internal Medicine Department, "Theiageneio" Anticancer Hospital, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 8 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Ioannis Kioumis
- 1 Internal Medicine Department-Unit of Infectious Diseases, "AHEPA" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 5 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 6 Internal Medicine Department, "Theiageneio" Anticancer Hospital, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 8 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Georgia Pitsiou
- 1 Internal Medicine Department-Unit of Infectious Diseases, "AHEPA" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 5 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 6 Internal Medicine Department, "Theiageneio" Anticancer Hospital, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 8 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Nikolaos Machairiotis
- 1 Internal Medicine Department-Unit of Infectious Diseases, "AHEPA" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 5 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 6 Internal Medicine Department, "Theiageneio" Anticancer Hospital, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 8 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Nikolaos Katsikogiannis
- 1 Internal Medicine Department-Unit of Infectious Diseases, "AHEPA" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 5 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 6 Internal Medicine Department, "Theiageneio" Anticancer Hospital, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 8 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Sofia Lampaki
- 1 Internal Medicine Department-Unit of Infectious Diseases, "AHEPA" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 5 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 6 Internal Medicine Department, "Theiageneio" Anticancer Hospital, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 8 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Antonis Papaiwannou
- 1 Internal Medicine Department-Unit of Infectious Diseases, "AHEPA" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 5 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 6 Internal Medicine Department, "Theiageneio" Anticancer Hospital, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 8 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Theodora Tsiouda
- 1 Internal Medicine Department-Unit of Infectious Diseases, "AHEPA" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 5 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 6 Internal Medicine Department, "Theiageneio" Anticancer Hospital, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 8 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Athanasios Madesis
- 1 Internal Medicine Department-Unit of Infectious Diseases, "AHEPA" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 5 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 6 Internal Medicine Department, "Theiageneio" Anticancer Hospital, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 8 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Theodoros Karaiskos
- 1 Internal Medicine Department-Unit of Infectious Diseases, "AHEPA" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 5 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 6 Internal Medicine Department, "Theiageneio" Anticancer Hospital, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 8 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Bojan Zaric
- 1 Internal Medicine Department-Unit of Infectious Diseases, "AHEPA" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 5 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 6 Internal Medicine Department, "Theiageneio" Anticancer Hospital, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 8 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Perin Branislav
- 1 Internal Medicine Department-Unit of Infectious Diseases, "AHEPA" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 5 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 6 Internal Medicine Department, "Theiageneio" Anticancer Hospital, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 8 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Paul Zarogoulidis
- 1 Internal Medicine Department-Unit of Infectious Diseases, "AHEPA" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 5 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 6 Internal Medicine Department, "Theiageneio" Anticancer Hospital, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 8 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
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