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Objective The aim of the study is to investigate the therapeutic efficacy of next-generation anaplastic lynphoma kinase-tyrosine kinase inhibitor (ALK-TKI) in advanced non-small cell lung cancer (NSCLC).Methods The clinical data and outcomes of 22 patients with advanced non-small cell lung cancer who received the next generation of ALK-TKI from 2014 to 2017 in our hospital were retrospectively analyzed.Results 22 patients were included for survival analysis with 15 males and 7 females.The median age was 48 and all of them were adenocarcinoma patients.There were 12,2,7 and 1 patients received ceritinib,alectinib,brigatinib and lorlatinib,respectively.A total of 14 patients could be evaluated,including complete response (CR) in 2 cases,partial response (PR) in 3 cases,stable disease (SD) in 6 cases,progressive disease (PD) in 3 cases.The ORR and DCR were 35.7％ and 78.6％,respectively.The median progression free survival (PFS) of the 22 NSCLC patients was 8.7 months.Progression pattern can be analyzed in 17 patients.Among them,10 patients underwent primary progression (lung),occurring at the leading frequency (accounting for 58.8％) and followed by central nerve system (CNS) progression (accounting for 29.4％).Conclusions Next-generation ALK-TKI provide a reasonable choice for crizotinib-resistant patients.Primary progression (lung) is the leading cause for treatment failure.Multi-disciplinary integration may provide a potential choice for prolonging administration of next-generation ALK-TKI.
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Objective To investigate the clinical significance and difference in the expression of endostatin and vascular endothelial growth factor (VEGF) in non-small cell lung cancer (NSCLC) patients with different response to recombinant human endostatin (rh-endostatin) combined with chemotherapy.Methods Serum levels of endostatin and VEGF in peripheral blood of 30 patients with stage Ⅳ NSCLC (NSCLC group) and 30 healthy controls (control group) were determined by enzyme-linked immunosorbent assay.Two cycles of chemotherapy combined with rh-endostatin were provided to NSCLC patients to evaluate the efficacy of the regimen.Simultaneously,serum levels of endostatin and VEGF were measured before and after treatment.Results The level of serum endostatin was (37.96 ± 9.01) ng/ml and (40.12 ± 12.11)ng/ml in NSCLC patients and healthy controls,respectively,which was lower in the former than that of the latter,without statistical difference (P ＞ 0.05).Furthermore,the level of serum VEGF was (127.98 ± 33.88) pg/ml and (36.33 ± 15.43) pg/ml in NSCLC patients and healthy controls,respectively,which was higher in the former than that of the latter,with statistical difference (t =13.48,P ＜ 0.05).Besides,levels of endostatin and VEGF in serum were not correlated with the sex,age,tumor pathological type and differentiation of NSCLC patients (P ＞ 0.05).After two cycles of chemotherapy combined with rh-endostatin treatment,the level of serum endostatin in partial response (PR) or stable disease (SD) patients was (76.22 ± 20.41) ng/ml,higher than that of progressive disease (PD) patients,which was (31.24 ± 13.09) ng/ml (t =7.143,P ＜ 0.05).In addition,the level of serum VEGF in PR or SD patients was (93.28 ± 21.33) pg/ml,which was lower than (155.81 ± 48.38) pg/ml of the PD patients (t =3.503,P ＜ 0.05).Conclusions The levels of endostatin and VEGF are associated with the efficacy of anti-angiogenesis combined with chemotherapy in NSCLC patients.
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Objective To investigate the changes and clinical significance of serum tumor markers in patients with non-small cell lung cancer before and after gefitinib targeted therapy.Methods 80 cases of non-small cell lung cancer patients in our hospital from June 2015 to May 2017 were divided into control group and observation group randomly,40 cases in each group.The control group were treated with docetaxel conventional chemotherapy,and the observation group were treated with gefitinib targeted therapy.The clinical treatment effect,changes of serum tumor markers cancer antigen125 (CA125),carcinoembryonic antigen (CEA),neuron specific enolase (NSE) and adverse reactions were observed and compared between the two groups before and after treatment.Results The effective rate and disease control rate of the observation group were higher than that in the control group,with statistically significant difference (P ＜ 0.05).The levels of serum tumor markers CA125,CEA and NSE in the control group and the observation group before treatment were not significantly different (P ＞ 0.05).After 1 months of treatment,the levels of serum tumor markers CA125,CEA and NSE in the two groups were all decreased,and the level of serum tumor markers,CA125,CEA and NSE in the observation group were lower than those in the control group,with statistically significant difference.The incidence of adverse reactions in the observation group was lower than that in the control group (P ＜ 0.05),with statistically significant difference.Conclusions Gefitinib is effective in the treatment of non-small cell lung cancer.It reduces the level of serum tumor markers CA125,CEA,NSE,and reduces postoperative adverse reactions.It is worthy of clinical application.
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Objective To compare the efficacy and safety between mono-chemotherapy and targeted therapy as first-line regimen for patients over 80 years old with advanced non-small cell lung cancer (NSCLC).Methods 108 NSCLC patients aged ≥80 years in our hospital were divided into two groups according to the therapeutic program,of which group A was mono-chemotherapy group (n =60) and group B was targeted therapy group (n =48).The primary endpoint was overall survival (OS) and progression free survival (PFS),while secondary endpoint was objective response rate (RR),disease control rate (DCR) and safety.Results The median PFS,and median OS in group B were significantly longer than those in group A (P =0.013,0.025).The 1-year survival rate of group B was significantly higher than that of group A (P =0.001),and there was no significant difference between the two groups (P =0.605).There was also no statistically significant difference in RR between the two groups (P =O.408).DCR in Group B was significantly higher than that in group A (P =0.043).The incidence of skin rash in group B was significantly higher than that in group A,and the incidence of adverse reactions and hematological toxicity in group A was significantly higher than that in group B.Conclusions Compared with single-agent chemotherapy,epithelial growth factor receptor-tyrosinekinase (EGFR-TKI) targeted therapy has longer PFS and OS benefits for patients ≥ 80 years with advanced NSCLC,and was well tolerated by patients.
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Objective To investigate the prognostic value of prognostic nutritional index (PNI) in patients with non-small cell lung cancer.Methods A total of 179 patients with non small cell lung cancer was enrolled in our hospital from November 2010 to January 2014.All patients were pathologically confirmed to be non small cell lung cancer.The clinical data of patients were collected,and the PNI values of each patient were calculated.The patients were divided into 4 groups according to the patients in the PNI of the patients in the treatment group (PNIQ0-25 group,PNIQ25-50 group,PNIQ50-75 group and PNIQ75-100 group).The survival curve was drawn by Kaplan-Meier method,and the difference of progression free survival (DFS) and overall survival (OS) of each group was compared by Log-rank method.Results (1) compared with PNIQ0-25 group,PNIQ25-50 group,PNIQ50-75 group and PNIQ75-100 group,there was signifi cant difference in age,smoking and KPS score (P ＜ 0.05).(2) the PNIQ0-25 group had a median overall survival of 11.5 months (95％ CI:6.6 ～ 15.4),the 3 year survival rate was 6.7％;PNIQ25-50 group had a median overall survival of 12.2 months (95％ CI:9.1 ～ 18),the 3 year survival rate was 6.4％ in PNIQ50-75 group;the median overall survival was 14.1 the month of (95％ CI:8.7 ～ 13.3),the 3 year survival rate was 11.4％,the PNIQ75-100 group had a median overall survival of 15 months (95％ CI:12.3 ～ 17.8),the 3 year survival rate was 11.6％.The Log-rank test,the four groups of patients with a significant difference in overall survival (x2 =15.6,P =0.001).(3) the PNIQ0-25 group had a median progres sion free survival was 5 months for (95％ CI:4.3 ～5.6),the 3 year progression free survival rate was 4.4％;PNIQ25-50 group had a median progression free survival was 6.4 months for (95％ CI:4.7 ～8.1),the 3 year progression free survival rate was 4.3％ in the PNIQ50-75 group;the median progression free survival was 7.4 months (95％ CI:6 ～ 8.7),the 3 year progression free survival rate was 9.1％ in PNIQ75-100 group,the median progression free survival was 8.9 months for (95％ CI:6.4 ～ 10.8),the 3 year progression free survival rate was 9.3％ by Log-rank test,survival was statistically significant was no difference between the four groups (x2 =26.7,P =0.000).Conclusions PNI has a good application value in the prognosis of patients with non-small cell lung cancer.
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Angiogenesis is vital in the process of primary tumor growth,proliferation and metastasis.In many cancers,including non-small cell lung cancer (NSCLC),inhibition of tumor angiogenesis has been identified as an important therapy.The most common drugs include bevacizumab,ramucirumab,tyrosine kinase inhibitor such as sorafenib tosylate,and nintedanib.We will summarize the research about some inhibition of tumor angiogenesis.
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Objective To study the effect of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) gefitinib on cancer cell apoptosisand survival time of patients with advanced non-small cell lung cancer (NSCLC).Methods A total of 126 cases of patients diagnosised as NSCLC stage Ⅲ B-ⅣV in our hospital during June 2013-October 2015 were randomly divided into group A received AC chemotherapy,group B received gefitinib,and group C received AC chemotherapy combined with gefitinib therapy.The progression free survival (PFS) rate and objective response rate (ORR) were measured during 12 months follow-up,tumor markers contents in serum and the mRNA expression of apoptosis molecules in tumor lesions were measured.Results The 12-month ORR and PFS of group C were significantly higher than those in groups A and B.The 12-month ORR and PFS of group B were significantly higher than those in group A.For 1 cycle after treatment,serum carcinoembryonic antigen (CEA),cytokeratin 19 (CY-FRA21-1),and thymidine kinase-1 (TK-1) contents among three groups were significantly lower than those before treatment.Caspase-3,Caspase-8,and Caspase-9 mRNA expressions in tumor were significantly higher than those before treatment.For 1 cycle after treatment,serum CEA,CYFRA21-1,and TK-1 contents of group C were significantly lower than groups A and B.Caspase-3,Caspase-8,and Caspase-9 mRNA expressions in tumor were significantly higher than those groups A and B,and serum CEA,CYFRA211,and TK-1 contents of group B were significantly lower than group A.Caspase-3,Caspase-8,and Caspase-9 mRNA expressions in tumor were significantly higher than thsoe of group A.Conclusions Gefitinib combined with intravenous chemotherapy can prolong the survival time of patients with advanced NSCLC and kill tumor cells,induce apoptosis.