Progress advance in the application of immune checkpoint inhibitors in the treatment of non-small cell lung cancer / 国际生物医学工程杂志

Lung cancer is the most common malignant tumor in the world. In order to improve the survival rate of patients with advanced lung cancer, more effective treatment methods are needed,in which immunotherapy has a broad therapeutic prospect. In recent years, immune-checkpoint inhibitors have received extensive attention in the treatment of lung cancer. Significant progress has been made in the development of a variety of first-line and second-line treatments, and significant advances have been made in the treatment of advanced lung cancer. With the successful application of immune-checkpoint inhibitors, neoadjuvant therapy has attracted extensive attention. In addition, the successful application of combined therapies such as immune combined immunization, immune combined tyrosine kinase inhibitor (TKI) and immune combined chemotherapy improved the survival rate of patients to some extent. However, pseudo progression and drug resistance has become a non-negligible problem in the immunotherapy of non-small cell lung cancer, which is worthy of further study. Although immune-checkpoint inhibitors have once again brought attention to tumor immunotherapy, their side effects are also worthy of attention. The recent advances in the application of immune-checkpoint inhibitors in lung cancer were summarized in order to provide a theoretical basis for its clinical application.

Advances in adjuvant targeted therapy for non-small cell lung cancer / 中国肿瘤临床

Currently, postoperative adjuvant chemotherapy is recommended for patients with stageⅡ-ⅢA non-small cell lung cancer (NSCLC). However, the toxicity of chemotherapy should not be neglected, despite the survival benefits achieved. There is an urgent need for new, effective, individualized treatment regimens with low toxicity. EGFR-TKI is widely used for the treatment of advanced NSCLC because of its high efficiency and low toxicity. To explore more effective treatment methodologies, researchers at home and abroad have made many attempts to extend targeted therapy to the field of postoperative adjuvant therapy. This article reviews the retrospective and prospective clinical studies that have been conducted, analyzes the preponderant population of postoperative adju-vant targeted therapy, and seeks evidence-based medical evidence to guide clinical practice, so that patients with NSCLC can benefit from targeted therapies and improved postoperative survival rates.

Prediction of prognosis in patients with advanced stage of NSCLC by combined plasma fibrinogen and D-dimer levels before treatment / 天津医药

Objective To retrospectively analyze the relationship between progression free survival (PFS) and overall survival (OS) in patients with non small cell lung cancer (NSCLC), and to detect the influence of plasma fibrinogen and D-dimer levels before treatment in the prognosis of advanced stage (stageⅢB-Ⅳ) of NSCLC. Methods The study comprised 134 NSCLC patients with clear pathological diagnosis. All patients were grouped by plasma fibrinogen and D-dimer levels before treatment. We set the normal values of fibrinogen as≤4 g/L and D-dimer as≤500μg/L(FEU). Patients with normal levels of fibrinogen and D-dimer were grouped into low risk group, patients with elevated fibrinogen or D-dimer were grouped into median risk group, and patients with both elevated values were grouped into high risk group. Chi-square test and one way ANOVA analysis were used to analyze the clinicopathologic features of different groups. The OS and PFS in different groups were analyzed by Kaplan-Meier analysis. Univariate analysis of PFS and OS were conducted. Then multivariate analysis was conducted with the Cox regression model in three groups. Results The clinicopathologic features showed no differences between different groups. There were significant differences in OS and PFS between high risk group and other groups. In the survival curves, the high risk group showed poor prognosis. The result of multivariate analysis showed that clinical stage (OS:RR=1.846, 95%CI 1.150-2.964,P=0.011; PFS:RR=1.762, 95%CI 1.190-2.609, P=0.005) and grouped by fibrinogen and D-dimer (OS:RR=1.415,95%CI 1.050-1.908,P=0.023;PFS:RR=1.373,95%CI 1.070-1.761,P=0.013) were prognostic factors for patients with NSCLC. Conclusion The plasma fibrinogen and D-dimer levels before treatment are closely related with the prognosis of NSCLC patients. And a high plasma fibrinogen and D-dimer levels before treatment are associated with poor prognosis in advanced stage of NSCLC patients.

Surgical resection standard and prognostic analysis of non-small cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the effect of complete resection standards on the prognosis of non-small cell lung cancer.</p><p><b>METHODS</b>Clinical data of 2 711 inpatient cases treated from January 2000 to December 2008 at our hospital were retrospectively reviewed. The relationship between surgical resection standard and the overall survival and other factors affecting the overall survival was analyzed.</p><p><b>RESULTS</b>The overall 5-year survival rate was 44.6%. The overall 5-year survival rate of stage IA, IB, IIA, IIB, IIIA cases was 60.5%, 55.4%, 43.1%, 37.0% and 28.1%, respectively. The 5-year survival rate of patients who underwent complete resection was 50.3%, and that of patients who underwent incomplete resection was only 40.1% (P < 0.01). The main prognostic factors were operation type, resection margin, pathological type, T stage, N stage, TNM stage, the number of dissected lymph node (LN) stations (<6 and ≥ 6), the number of resected lymph nodes (1-10, 11-20, and >20), postoperative radiotherapy and complete resection (P < 0.05 for all). Cox regression suggested that TNM stage and complete resection were independent factors affecting the prognosis. Adjuvant chemotherapy affected the prognosis of stage II-IIIA patients.</p><p><b>CONCLUSIONS</b>TNM stage and complete resection are independent factors affecting the prognosis of NSCLC patients. The 5-year survival rate of NSCLC has significantly increased through promoting the standard of operation, especially increasing the standard of lymph node dissection. The standard of complete resection should be recommended to be used in clinical practice. Adjuvant chemotherapy is beneficial for stage II-IIIA NSCLC patients.</p>

The Expression of TSLP and Its Relationship with the Number of Infiltrating Regulatory T Cells in Lung Cancer / 中国肿瘤临床

Objective: To investigate the expression of TSLP in human lung cancer tissue and the correla-tion between TSLP expression and number of regulatory T cells (Tregs). Methods: The expression of TSLP mRNA and protein was detected in different pathological lesions of the lung by Q-RT-PCR and immunohisto-chemistry. Immunohistochemistry was used to detect Foxp3+ Tregs. The correlation of TSLP with the number of Tregs was analyzed. Results: TSLP gene was expressed in tumor tissues (n=37), latero-tumor tissues (n=29) and non-tumor lung tissues (n=24), without statistical difference (P=0.148). TSLP protein was expressed in the cytoplasm and was observeed in 69.57% of tumor tissues, 13.33% of benign lesions and 30.00% of non-tumor lung tissues, with a significant difference (P<0.05). The expression of TSLP protein was correlated with tumor size (P=0.000) and lymph node metastasis (P=0.018). The number of Tregs in TSLP positive group was more than that in TSLP negative group (P<0.05). Conclusion: The expression of TSLP in lung tu-mor tissues is increased and is correlated with the number of Tregs, indicating that TSLP could induce Treg to play an important role in tumor immunotolerance.