Efficacy of S-1 in Advanced Non-small Cell Lung Cancer Patients Treated with More Than Two Lines of Chemotherapy / 中国肺癌杂志

BACKGROUND@#There is no standard treatment for advanced non-small cell lung cancer (NSCLC) after the failure of two lines of chemotherapy, S-1 as the third generation of fluorouracil derivate with well safety and low toxicity, presented some efficacy in lung cancer treatment. The aim of this study is to explore the efficacy of S-1 for advanced NSCLC patients treated with two or more prior chemotherapy regimens.@*METHODS@#We performed a retrospective analysis of 105 NSCLC patients treated with S-1 monotherapy or S-1 contained chemotherapy as the third or more line of treatment in our hospital from January 2014 to April 2017. S-1 was administrated orally twice daily for 2 weeks, followed by one week of rest, the dose of drug was determined by body surface area (<1.25 m2, 80 mg/d; 1.25 m2-1.5 m2, 100 mg/d; ≥1.5 m2, 120 mg/d), platinum or the third-generation chemotherapy drugs could be combinedly used. Clinical response was assigned every cycle according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, Kaplan-Meier analysis was used to estimate progression-free survival (PFS).@*RESULTS@#42 patients received S-1 monotherapy, the other 63 patients received combined regimens, the median treatment line was 4 (3-11) and the median treatment cycle was 2 (1-14). No complete response (CR) were observed, there were 4 patients with partial response (PR), 34 patients with stable disease (SD) and 67 patients with progressive disease (PD), the objective response rate (ORR) was 3.81%, disease control rate (DCR) was 36.19%. The median PFS was 1.90 months (0.67 months-10.83 months), no difference between monotherapy and combined group (DCR: 28.56% vs 41.27%, P=0.185), the liver metastasis showed poorer PFS (1.40 months vs 1.93 months , P=0.042).@*CONCLUSIONS@#S-1 presented some activity in advanced NSCLC treated with more than two lines of treatment. The addition of other drugs cannot improve efficacy. S-1 monotherapy can be used as a choice for heavily-treated patients.

Erlotinib versus vinorelbine therapy in chemotherapy-naive elderly patients with advanced non-small-cell lung cancer and EGFR mutation: a randomized, controlled trial / 中华老年医学杂志

Objective To compare the efficacy and adverse effects of erlotinib versus vinorelbine naive patients with advanced non-small cell lung cancer (NSCLC) and epidermal growth factor receptor (EGFR) mutation.Methods Totally 46 elderly patients with histologically confirmed advanced NSCLC and EGFR mutations (exon 19 dclction or L858R point mutation) were enrolled.Patients were randomly divided into two groups:erlotinib group (43 cases,150mg per day until disease progression or unacceptable toxicities) and control group (21 cases,vinorelbine-based chemotherapy,single vinorelbine chemotherapy or vinorelbine-based double chemotherapy).Results Response rates and disease control rates were significantly improved with erlotinib compared with vinorelbine (78.6％ and 88.1％ vs.38.1％ and 61.9％,respectively,P＜ 0.05).There was a significant difference in median progression-free survival (11.6 months vs.5.6 months,P＜0.05),while no statistical difference in median overall survival with erlotinib compared with vinorelbine (19.0months vs.16.5 months,P=0.193).The most frequent adverse effects were grade Ⅰ or Ⅱ and no patients stopped treatment due to adverse effects and no drug-relatcd death.The primary adverse effects were skin rash (71.4％),diarrhea (31.0％)and liver dysfunction (23.8％) in the erlotinib group and neutropenia (66.7％),nausea or vomit (47.6％),anemia (42.9％),platelet decline (33.3％),constipation (33.3％) and peripheral neuritis (23.8％) in the vinorelbine group.Vinorelbine group versus erlotinib group have more 3-4 level adverse reactions (15/21 vs.7/42)(x2=1.69,P=0.193).Conclusions Erlotinib treatment has advances in PFS,ORR and DCR and tolerability compared with vinorelbine-based chemotherapy in elderly patients with advanced NSCLC and EGFR mutation,while overall survival is in no difference.Erlotinib may be a reasonable first-line treatment option for elderly patients with advanced NSCLC and sensitive EGFR mutation.

Gefitinib in first-fine therapy for 34 cases of advanced non-small cell lung cancer / 中国癌症杂志

Background and purpose: It has been proven that gefitinib can be safely and efficiently used to treat advanced non-small cell lung cancer (NSCLC) as a molecule targeted drug. This research was aimed to investigate the efficacy and toxicity of gefitinib as the first-line therapy for advanced NSCLC. Methods: A total of 34 pathologically-confirmed NSCLC patients who were not willing to receive or tolerate traditional cytotoxic drug chemotherapy were enrolled into the study. Gefitinib was orally administered 250 mg daily until disease progression or the occurrence of intolerable toxicity. Results: The objective response rate of gefitinib was 29.4%. The disease control rate was 61.8%. The rate of symptom relief was 47.1%. The median progression-free survival was 3.0 months. The median overall survival was 10.2 months. One-year survival rate was 35.3%. The objective response rate of nun-smoker was higher than smoker (P=0.023). The disease control rate for the patients with rash toxicity after administration of the drug were higher than those without rash (P=0.005). Logistic regression showed that rash was an independent disease control factor (P=0.003). The most common drug-related adverse events were rash and diarrhea. Conclusion: Gefitinib provided another choice to patients who are unwilling or unable to be treated by chemotherapy.

CLINICAL CHARACTERISTICS AND TREATMENT OF SUBACUTE SEVERE HEPATITIS / 第二军医大学学报

In an attempt to find out an effective treatment for severe hepatitis, clinical characteristics and treatment of fifty cases of subacute severe hepatitis (subacute necrosis of the liver), admitted to our department, were investigated. The data suggested that: (l)the fatality rate was significantly higher in the aged(40 years) group; (2) the five clinical features such as fever, exudative ascites, prolonged prothrombin time, negative CIC and increased peripheral white cell count (10?109 /L) significantly indicated a poor prognosis; (3) multiorgans system failure (MOSF)was found to be more common (71.9%) in this group- (4) branched chain amino acid (B.CAA) therapy benefited and revived most of the cases, however, did not rescue their life eventually.Fetal liver cell transplantation (iv) survived 4 out of 6 treated patients (66. 7%)without any side-effects, so it seems to be a hopeful therapeutic strategy in this field. This report also emphasizes that the mechanism of subrxute severe hepatitis and antiviral agents in its treatment remained to be studied