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BACKGROUND@#Immune checkpoint inhibitors (ICIs) are increasingly used as first-line therapy for patients with advanced non-small cell lung cancer (NSCLC) harboring no actionable mutations; however, data on their efficacy among patients presenting with intracranial lesions are limited. This study aimed to explore the efficacy and safety of ICIs combined with chemotherapy in advanced NSCLC patients with measurable brain metastasis at initial diagnosis.@*METHODS@#Our study retrospectively analyzed clinical data of a total of 211 patients diagnosed with driver gene mutation-negative advanced NSCLC with measurable, asymptomatic brain metastasis at baseline from Hunan Cancer Hospital between January 1, 2019 and September 30, 2021. The patients were stratified into two groups according to the first-line treatment regimen received: ICI combined with chemotherapy ( n = 102) or chemotherapy ( n = 109). Systemic and intracranial objective response rates (ORRs) and progression-free survival (PFS) were analyzed. Adverse events were also compared between the groups.@*RESULTS@#Compared with the chemotherapy-based regimen, the ICI-containing regimen was associated with a significantly higher intracranial (44.1% [45/102] vs . 28.4% [31/109], χ2 = 5.620, P = 0.013) and systemic (49.0% [50/102] vs . 33.9% [37/109], χ2 = 4.942, P = 0.019) ORRs and longer intracranial (11.0 months vs . 7.0 months, P <0.001) and systemic (9.0 months vs . 5.0 months, P <0.001) PFS. Multivariable analysis consistently revealed an independent association between receiving ICI plus platinum-based chemotherapy as a first-line regimen and prolonged intracranial PFS (hazard ratio [HR] = 0.52, 95% confidence interval [CI]: 0.37-0.73, P <0.001) and systemic PFS (HR = 0.48, 95% CI: 0.35-0.66, P <0.001). No unexpected serious adverse effects were observed.@*CONCLUSION@#Our study provides real-world clinical evidence that ICI combined with chemotherapy is a promising first-line treatment option for driver gene mutation-negative advanced NSCLC patients who present with brain metastasis at initial diagnosis.@*CLINICAL TRIAL REGISTRATION@#https://www.clinicaltrials.gov/ , OMESIA, NCT05129202.
Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung/genetics , Lung Neoplasms/genetics , Immune Checkpoint Inhibitors/therapeutic use , Retrospective Studies , Brain Neoplasms/geneticsABSTRACT
Objective To analyze the epidemiological and temporal-spatial distribution characteristics of hemorrhagic fever with renal syndrome (HFRS) in Shandong province during 2010-2016 and provide references for developing prevention and control measures.Methods Based on the data of Infectious Disease Reporting Information System in China,the incidence and temporal-spatial distribution of HFRS in Shandong from 2010 to 2016 were analyzed by spatial autocorrelation and space-time scan statistics.Results A total of 9 114 HFRS cases were reported in Shandong during this period.The cases were mainly distributed in age group 30-70 years,and the male to female ratio of the cases was 2.63 ∶ 1.Most cases were farmers.The higher incidence rate was reported in southeastern Shandong,while the lower incidence rate was reported in northwestern Shandong.Among the epidemic periods,the highest incidence rate was 1.87/100 000 in 2013.The results of spatial autocorrelation and space-time scanning indicated that the high-high clusters of HFRS were concentrated in southeastern Shandong and then spread to central Shandong.The cluster mainly occurred from the end of 2011 to the first half of 2015.Both the incidence rate and the cluster decreased in 2016.Conclusions The epidemic and cluster of HFRS still existed in Shandong from 2010 to 2016.The key areas for the prevention and control of HFRS were in southeastern and central Shandong.
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Objective To analyze the epidemiological and temporal-spatial distribution characteristics of hemorrhagic fever with renal syndrome (HFRS) in Shandong province during 2010-2016 and provide references for developing prevention and control measures.Methods Based on the data of Infectious Disease Reporting Information System in China,the incidence and temporal-spatial distribution of HFRS in Shandong from 2010 to 2016 were analyzed by spatial autocorrelation and space-time scan statistics.Results A total of 9 114 HFRS cases were reported in Shandong during this period.The cases were mainly distributed in age group 30-70 years,and the male to female ratio of the cases was 2.63 ∶ 1.Most cases were farmers.The higher incidence rate was reported in southeastern Shandong,while the lower incidence rate was reported in northwestern Shandong.Among the epidemic periods,the highest incidence rate was 1.87/100 000 in 2013.The results of spatial autocorrelation and space-time scanning indicated that the high-high clusters of HFRS were concentrated in southeastern Shandong and then spread to central Shandong.The cluster mainly occurred from the end of 2011 to the first half of 2015.Both the incidence rate and the cluster decreased in 2016.Conclusions The epidemic and cluster of HFRS still existed in Shandong from 2010 to 2016.The key areas for the prevention and control of HFRS were in southeastern and central Shandong.
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Objective To analyze the epidemiological characteristics of mumps in 2012 and 2014,and to explore the preventive effect of the second dose of mumps-containing vaccine (MuCV) in mumps in Shandong province.Methods On the basis of certain model assumptions,a Space State model was formulated.Iterated Filter was applied to the epidemic model to estimate the parameters.Results The basic reproduction number (R0) for children in schools was 4.49 (95％ CI:4.30-4.67)and 2.50 (95％CI:2.38-2.61) respectively for the year of 2012 and 2014.Conclusions Space State model seems suitable for mumps prevalence description.The policy of 2-dose MuCV can effectively reduce the number of total patients.Children in schools are the key to reduce the mumps.
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Objective To investigate the roles of SENP1 in regulation of biological characteristics of NK cells.Methods Lentivirus-mediated-Senp1-small-hairpinRNA (shRNA) transduction was applied to NK92 cells.The expression of SENP1 in NK92 cells was determined by real-time PCR and Western blot.The proliferation of NK92 cells was detected by CCK-8 assay.The apoptosis of NK92 cells was determined by Annexin Ⅴ and PI labeling.The cytotoxicity of NK92 cells against K562 cells was evaluated by luciferase reporter assay.Results Treatment of NK92 cells with IL-21 resulted in SENP1 upregulation.Lentivirus mediated SENP1 knockdown reduced proliferation and increased apoptosis in NK-92 cells,but SENP1 inhibition had slight impact on the cytotoxic ability of NK92 cells to kill K562 cells.Conclusion SENP1 mediates the regulatory effect of IL-21 on the proliferation and survival of NK92 cells.
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Objective To analyze the epidemiological characteristics of mumps in 2012 and 2014,and to explore the preventive effect of the second dose of mumps-containing vaccine (MuCV) in mumps in Shandong province.Methods On the basis of certain model assumptions,a Space State model was formulated.Iterated Filter was applied to the epidemic model to estimate the parameters.Results The basic reproduction number (R0) for children in schools was 4.49 (95％ CI:4.30-4.67)and 2.50 (95％CI:2.38-2.61) respectively for the year of 2012 and 2014.Conclusions Space State model seems suitable for mumps prevalence description.The policy of 2-dose MuCV can effectively reduce the number of total patients.Children in schools are the key to reduce the mumps.