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Background: Anaplastic lymphoma kinase (ALK)?rearranged nonsmall cell lung cancer (NSCLC) represents a molecular subgroup with high sensitivity to ALK inhibitors. Tyrosine kinase inhibitor crizotinib, an anticancer drug acting as an ALK inhibitor, has shown remarkable response in ALK?positive NSCLC. The aim of our study is to explore the adverse events (AEs) of patients on crizotinib therapy and analyze the predictability of AEs for better survival or response on NSCLC patients. Methods: The medical records of our ALK?positive metastatic NSCLC patients who applied between years 2013 and 2018 had been reviewed retrospectively. ALK positivity of all patients had been detected by fluorescence in situ hybridization and no other driver mutations were present. Patient demographics, performance status, smoking history, previous treatments, metastatic sites, and AEs were recorded for further analyses. Results: Thirty?six ALK?positive metastatic NSCLC patients were included in the study. Median follow?up was 30.1 months. Median progression?free survival (PFS) for patients who developed hepatic, cardiac, or endocrine toxicities was similar when compared to patients who did not develop. Although there was a numeric median PFS difference between patients who did develop visual disorders (18.4 months) and did not develop visual disorders (15.5 month), this was not regarded as statistically significant. However, median PFS of the patients who developed neutropenia upon crizotinib treatment (31.9 months) was found to be more favorable than the patients with normal neutrophil counts (12.8 months) (P = 0.026). Conclusion: Neutropenia under crizotinib treatment was found to be associated with improved PFS suggesting that neutropenia might be an important determinant in treatment and survival strategies.
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Camrelizumab is a programmed death receptor-1 inhibitor originally developed in China for the treatment of refractory lymphoma. It has also been effective in non-small-cell lung cancer patients. However, the rechallenge of camrelizumab was not reported previously. We report the rechallenge of camrelizumab therapy in two patients previously treated with microwave ablation (MWA) and camrelizumab. Although objective responses were achieved, camrelizumab therapy was discontinued because of the development of immune-related pneumonia (IRP). Treatment with camrelizumab was reinitiated after the patients recovered from IRP. The reoccurrence of more severe IRP necessitated additional corticosteroid therapy. The rechallenge of camrelizumab in patients treated with MWA plus camrelizumab regimen and who developed IRP should be cautious
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The efficacy of treatments in patients with nonsmall cell lung cancer (NSCLC) with leptomeningeal metastases (LMs) remains unclear. Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) play an important role in the treatment of patients with NSCLC. However, few studies have investigated the efficacy of combination therapy with TKIs and whole brain radiotherapy (WBRT) in patients with NSCLC/LM. We report here the case of a male patient in his 60s with adenocarcinoma who underwent lobectomy of the right upper lobe. The cancer was classified as pT1bN1M0 Stage IIA, and a mutational analysis revealed the presence of an EGFR mutation. However, 6 months after standard chemotherapy, LM had developed and WBRT was administered. Gefitinib (250 mg/day) was administered after WBRT. The patient remained free of significant recurrent disease for 57 months after WBRT was administered. Combination therapy with TKIs and WBRT is associated with relatively long survival times in patients with LM
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Background: Ghrelin plays a role in mechanisms related to cancer progression – including cell proliferation, invasion and migration, and resistance to apoptosis in the cell lines from several cancers. We investigated the role of ghrelin levels in cancer cachexia-anorexia in patients with locally advanced nonsmall-cell lung cancer (NSCLC) treated with chemoradiotherapy (CRT). Materials and Methods: This study involved 84 NSCLC patients who had received concomitant CRT. Blood ghrelin levels were compared before and 3 months after CRT. Meanwhile, changes in body weight of the patients were also investigated with changes in ghrelin levels before and after CRT. Results: Ghrelin levels were significantly decreased in line with changes in patients' weights in patients receiving CRT (P < 0.001). Serum albumin levels and inflammatory-nutritional index were significantly decreased after radiotherapy (RT) (3.01 ± 0.40 g/dL, 0.38 ± 0.20) when compared with its baseline levels (3.40 ± 0.55 g/dL,P < 0.001; 0.86 ± 0.71,P < 0.001, respectively). Serum C-reactive protein levels were significantly increased after CRT (7.49 ± 6.53 mg/L) when compared with its baseline levels (9.54 ± 3.80 mg/L,P = 0.038). After RT, ghrelin levels in patients were positively correlated with body mass index (r = 0.830,P < 0.001) and albumin (r = 0.758,P < 0.001). Conclusion: Ghrelin may play a role in the pathogenesis of weight loss in NSCLC patients. Ghrelin seems to be implicated in cancer-related weight loss. Ghrelin, cancer, and RT all together have a role in tumor-related anorexia-cachexia in patients with NSCLC. Results of this study need further evaluation as regards to its potential role as an adjuvant diagnostic or prognostic marker
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Background: Checkpoint inhibitors (CPIs) have improved survival compared to chemotherapy alone in advanced nonsmall-cell lung cancer (NSCLC). This article aims to compare indirect evidence and rank the effect of different CPIs in this setting. Materials and Methods: In this network meta-analysis, we searched for trials comparing CPIs in advanced NSCLC. Figures for survival endpoints were extracted. In addition, a network meta-regression analysis was carried out. Results: A total of 9220 patients from 16 trials were included in the analysis. In the first-line setting, for the overall survival endpoint, the chemotherapy + Pembrolizumab combination had the highest effectivity rank probability as compared to chemotherapy (hazard ratio = 0.788, 95% credential interval = 0.728–0.855). For the second-line setting, and also for the efficacy in terms of progression-free survival, various CPIs and their combinations were ranked. Conclusion: Some degree of differences in terms of efficacy exists between different types, dosages, settings, and combinations of CPI. We quantify these differences to guide clinical practice
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Context: The prognostic criteria for early-stage nonsmall cell lung cancer (NSCLC) wait to be explored. Aim: In this study, our aim was to evaluate the prognostic significance of the positron emission tomography/computed tomography (PET/CT) maximum standardized uptake value (SUVmax) value of the primary tumor in patients with a diagnosis of early-stage NSCLC who received surgical treatment. Settings and Design: This was a multicenter retrospective design. Materials and Methods: Patients who had been diagnosed with early-stage NSCLC and who underwent surgery for the condition were included in this study. The preoperative fluorodeoxyglucose (18F-FDG) PET/CT results of the patients were retrospectively accessed from their medical files. The disease-free survival (DFS) rates of patients who had SUVmax values above and below the determined cutoff value were compared. Statistical Analysis Used: SPSS version 22 and Kaplan–Meier method were used for statistical analysis. Results: A total of 92 patients were included in the study. The median age of the patients was 60 years (range: 36–79). The determined cutoff SUVmax value of the primary tumor was 13.6. A comparison of the DFS rates of the patients with an SUVmax value above and below 13.6 revealed a significant difference in patients with Stage I (22.9 months vs. 50.3 months; P = 0.02) and Stage II (28 months vs. 40.4 months; P = 0.04), Stage I + II (43.5 months vs. 26.1 months; P = 0,02), and Stage IIIA (14.7 months vs. 13.6 months; P = 0.92) NSCLC. Conclusions: We found that in early-stage NSCLC patients, the SUVmax value of the primary mass in 18F FDG PET/CT was a prognostic indicator for the DFS rates
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Aims: Some studies investigated the association between nestin and the overall survival (OS) of nonsmall cell lung cancer (NSCLC). However, the results were conflicted and inconclusive. Therefore, we performed this meta-analysis to determine the association between nestin and OS of NSCLC. Materials and Methods: PubMed and EMBASE were searched to find relevant studies. The strength of the association was calculated with the hazard ratios (HRs) and respective 95% confidence intervals (CIs). Results: High expression of nestin was significantly associated with OS of NSCLC (HR = 2.09; 95% CI = 1.59–2.77). In the stratified analysis by race, we found that the expression of nestin was significantly associated with OS of NSCLC in Asians (HR = 3.02; 95% CI = 1.80–5.07) and Caucasians (HR = 1.81; 95% CI = 1.21–2.71). In addition, when we limited the meta-analysis to studies that controlled for clinical parameters, a significant association between nestin and OS of NSCLC remained (HR = 2.19; 95% CI = 1.54–3.11). A sensitivity analysis showed no substantial modification of the estimates after exclusion of individual studies. Conclusions: In conclusion, this meta-analysis suggested that high expression of nestin was significantly associated with OS of NSCLC.
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Purpose: To assess the survival outcomes and prognostic factors of young (≤45 years) Stage IIIB nonsmall cell lung cancer (NSCLC) patients treated with definitive concurrent chemoradiotherapy (C-CRT). Materials and Methods: Medical records of 145 Stage IIIB NSCLC patients (≤45 years) who received 60–66 Gy thoracic radiotherapy and concurrent 1–3 cycles of cisplatin-based doublet chemotherapy were retrospectively evaluated. The primary endpoint was overall survival (OS), while locoregional progression-free survival (LRPFS), progression-free survival (PFS), and evaluation of potential prognostic factors constituted the secondary endpoints. Results: At median 21.6 months (range: 7.3–62.5) of follow-up, the median and 4-year survival estimates were 24.8 months and 24.2% for OS, 15.7 months and 18.9%, for LRPFS and 12.0 months and 11.2% for PFS, respectively. On univariate analyses, among all factors, the smaller tumor size (≤7.0 cm; P = 0.03), lower T-stage (T1–T2; P = 0.02), lower N-stage (N2; P = 0.01), absence of anemia before C-CRT (hemoglobin [Hb] ≥12 g/dL; P < 0.001), and lower/no pretreatment weight loss (WL ≤5%; P < 0.001) were found to be associated significantly with longer median OS durations, which also retained their independent significance on multivariate analyses, except for tumor size category. Conclusions: The encouraging median 24.8 months OS duration observed here in young NSCLC patients accords well with the results of recent landmark locally advanced NSCLC series without age stratification. Other than the well-established T and N stages, extra exhibit of superior OS in patients with initial Hb ≥12 g/dL and ≤5% WL levels suggests a noteworthy prognostic role for these two latter variables in the stratification of such patients
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Objective: The objective of the study was to evaluate the clinical efficacy of kanglaite (KLT) injection combined with gefitinib versus gefitinib alone in the treatment of nonsmall cell lung cancer (NSCLC). Methods: The randomized controlled trials involving NSCLC treatment with KLT injection combined with gefitinib versus gefitinib alone were searched on seven medical databases up to October 2016. Two reviewers independently assessed the methodological quality of the included studies. The RevMan 5.3 software was employed for data analysis. Results: Seven randomized trials involving 554 patients met our criteria. Compared with gefitinib alone, KLT injection combined with gefitinib showed significant effects in increasing objective response rate (relative risk [RR] =1.38; 95% confidence interval [CI], 1.09–1.75), improving the performance status (RR = 1.80; 95% CI: 1.34–2.42), raising the percentages of CD4+ cells (weighted mean difference [WMD] = 4.45; 95% CI: 2.61–6.28), natural killer cells (WMD = 4.43; 95% CI: 3.85–5.01), and ratio of CD4+/CD8+ (WMD = 0.08; 95% CI: 0.02–0.14), whereas the difference was not significant in gefitinib toxicity including rash (RR 0.90; 95% CI: 0.58–1.40, P = 0.65), diarrhea (RR 1.04; 95% CI: 0.66–1.64, P = 0.88), and liver injury (RR 1.00; 95% CI: 0.58–1.73, P = 1.00), CD3+ cells (WMD = 1.16; 95% CI: -2.64–4.97) and CD8+ cells (WMD = 6.78; 95% CI: -1.68–15.23). Conclusion: Co-use of KLT injection and gefitinib may benefit the patients with NSCLC through enhancing the therapeutic effectiveness compared with gefitinib alone. To confirm these results, further rigorously designed trials are warranted
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Introduction: More than 70% of lung cancer comprises nonsmall-cell lung carcinoma and is associated with poor survival outcome owing to late diagnosis. Identification of lung cancer in early stages when no clinical signs or symptoms are evident, can drastically improve the prognosis. To this end, we aimed to evaluate the changes occurring at tissue level by assessing the expression of six microRNAs (miRNAs) in lung adenocarcinoma (AC) and squamous cell carcinoma (SCC). Materials and Methods: Peripheral blood of histopathologically proven cases of lung AC and SCC was collected and processed for the isolation of miRNAs using commercially available kit. Primers against mir-2114, mir-2115, mir-2116, mir-2117, mir-449c, and mir-548q with loading control Caenorhabditis elegans were used. Screening was carried out in thirty cases of both AC and SCC, whereas twenty healthy controls were included. Results:Real-time polymerase chain reaction data revealed that the expression of mir-2114 and mir-449c in AC and mir-2115 in SCC was significantly upregulated. The expression of these miRNAs was also confirmed in lung AC cell line. The differential pattern of expression of these miRNAs can be used for precise diagnosis of lung carcinoma Conclusions: We have used a noninvasive technique to identify the subtype of lung cancer based on molecular genetic signatures. The results suggest that through molecular profiling of miRNA, we can screen high-risk cases for cancer interception
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Several studies including genomewide association studies (GWASs) in diverse ethnic populations have reported a significant association of genetic variant rs10937405 of TP63 with nonsmall cell lung cancer (NSCLC). However, no data are available from any Indian population on the association of this variant with NSCLC. Using TaqMan genotyping chemistry, we conducted a case–control study involving 190 NSCLC cases and 400 ethnic, age-matched controls to explore the association of rs10937405 genetic variant with NSCLC in patients from north India. Our data support that the rs10937405 variant is also significantly associated with the NSCLC and is a risk factor in the north Indian populations to develop NSCLC. However, unlike most other studies, the wild-type allele T appears to be the risk allele, as its frequency was significantly higher in the cases than controls (0.439 in cases versus 0.383 in controls. OR=1.95 (1.23–3.09 at 95% CI); P value (adjusted)= 0.004). Genetic association was also observed by applying different genetic models. The present study provides important information of the genetic aetiology of NSCLC and strengthens GWAS findings, highlighting the role of TP63 in lung cancer risk.
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BACKGROUND: Lung cancer most commonly presents in advanced stages in developing countries, where combined modality treatment using chemo‑radiotherapy (CTRT) is the standard of care. MATERIALS AND METHODS: A retrospective audit of patients of nonsmall cell lung cancer (NSCLC) treated at a single Institute from January 2008 to December 2012 was conducted. Various prognostic factors affecting disease‑free survival (DFS) and overall survival (OS) were studied by univariate and multivariate analysis. All patients were meticulously followed‑up clinically and telephonic contacts. RESULTS: Overall 171 patients of NSCLC were treated with definitive CTRT using concurrent chemotherapy in 66% patients and sequential therapy in 28% patients. The actuarial 2 years DFS was 17.5% and 2 years OS was 61.5%. Complete response to treatment resulted in significantly better DFS and OS. Definitive CTRT was very well‑tolerated in these patients with good compliance. CONCLUSION: Definitive CTRT, sequence being individualized depending on performance status and disease stage at presentation, is a feasible and effective treatment modality for locally advanced NSCLC patients in the developing world. Response to treatment is an important prognostic factor for treatment outcomes.
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Tyrosine kinase inhibitors (TKIs) are a pharmaceutical class of small molecules, orally available with manageable safety profile, approved worldwide for the treatment of several neoplasms, including lung, breast, kidney and pancreatic cancer as well as gastro‑intestinal stromal tumours and chronic myeloid leukaemia. In recent years, management of lung cancer has been moving towards molecular‑guided treatment, and the best example of this new approach is the use of the tyrosine kinase inhibitors (TKIs) in patients with mutations in the epidermal growth factor receptor (EGFR). The identification of molecular predictors of response can allow the selection of patients who will be the most likely to respond to these tyrosine kinase inhibitors (TKIs). Gastrointestinal (GI) adverse events (AEs) are frequently observed in patients receiving EGFR tyrosine kinase inhibitor therapy and are most impactful on the patient’s quality of life. Dermatologic side effects are also relatively common among patients treated with EGFR inhibitors. Evidence has emerged in recent years to suggest that the incidence and severity of rash, positively correlated with response to treatment. These skin disorders are generally mild or moderate in severity and can be managed by appropriate interventions or by reducing or interrupting the dose. Appropriate and timely management make it possible to continue a patient’s quality of life and maintain compliance; however if these adverse events (AEs) are not managed appropriately, and become more severe, treatment cessation may be warranted compromising clinical outcome. Strategies to improve the assessment and management of TKI related skin AEs are therefore essential to ensure compliance with TKI therapy, thereby enabling patients to achieve optimal benefits. This article provides a consensus on practical recommendation for the prevention and management of diarrhoea and rash in Non‑Small Cell Lung Cancer (NSCLC) patients receiving TKIs.
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OBJECTIVES: Although more and more video‑assisted thoracoscopic surgery (VATS) lobectomies via two‑port have been performed to treat early‑stage nonsmall‑cell lung cancer (NSCLC) in recent years, concern remains whether it can achieve satisfactory adequacy of lymphadenectomy. This retrospective study was aimed to evaluate the adequacy of lymphadenectomy by VATS via two‑port, compared with three‑port. MATERIALS AND METHODS: The clinical and pathological data of patients who underwent VATS lobectomy via two‑port or three‑port with systematic lymphadenectomy for clinical early‑stage NSCLC were reviewed. As the main evaluation criterion, the number of mediastinal nodes and node stations, and the total number of nodes and node stations was compared by approach. RESULTS: 1872 patients with NSCLC underwent VATS lobectomy, 1086 via a two‑port approach and 786 through a three‑port approach. In the two‑port and three‑port groups, the baseline patient characteristics were similar, and there was no significant difference in the mean number of dissected mediastinal lymph nodes (MLNs) (12.3 ± 2.2 and 13.1 ± 1.7, P > 0.05) and the mean number of dissected MLN stations (3.5 ± 0.7 and 3.4 ± 0.8, P > 0.05). Meanwhile, the mean total number of dissected lymph nodes (24.1 ± 4.2 and 25.7 ± 4.3, P > 0.05) and the mean total number of dissected lymph node stations (6.8 ± 1.3 and 6.9 ± 1.1, P > 0.05) were also similar. Otherwise, in terms of postoperative complications, there was no obvious difference in the two groups. CONCLUSIONS: The adequacy of lymphadenectomy including MLN dissection by VATS via two‑port is similar to that via three‑port for patients undergoing lobectomy for clinical early‑stage NSCLC.
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BACKGROUND: We aimed to assess the clinical outcome of computed tomography (CT)‑guided percutaneous microwave ablation (MWA) in patients 75 years of age and older with early stage peripheral nonsmall cell lung cancer (NSCLC). MATERIALS AND METHODS: Twenty‑eight patients, aged ≥75 years, with Stage I and lymph node‑negative IIa peripheral NSCLC underwent CT‑guided percutaneous MWA in our hospital between July 2007 and March 2015. The overall 1‑, 2‑, 3‑, and 4‑year survival rates were estimated using Kaplan–Meier analysis. Adverse events were recorded. RESULTS: The median follow‑up time was 22.5 months. The overall median survival time (MST) was 35 months (95% confidence interval [CI] 22.3–47.7 months), and the cancer‑specific MST was 41.9 months (95% CI 38.8–49.9 months). The 1‑, 2‑, 3‑, and 4‑year overall survival rates were 91.7%, 76.5%, 47.9%, and 47.9%, while the cancer‑specific survival rates were 94.7%, 73.9%, 64.7%, and 64.7%, respectively. Median time to local progression was 28.0 months (95% CI 17.7–38.3 months). Major complications were included pneumothorax (21.4%, requiring drainage), pleural effusions (3.6%, requiring drainage), and pulmonary infection (3.6%). CONCLUSIONS: CT‑guided percutaneous MWA is safe and effective for the treatment of patients 75 years of age and older with medically inoperable early stage peripheral NSCLC.
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OBJECTIVES: MicroRNAs are important modulators of the cellular epithelial‑mesenchymal transition (EMT) process and are associated with metastasis in human nonsmall cell lung cancer (NSCLC). In this study, we tried to investigate the role of miR‑338‑3p in NSCLC cells. MATERIALS AND METHODS: Real‑time polymerase chain reaction was applied to quantify the expression levels of miR‑338‑3p, as well as EMT‑associated molecules in NSCLC cells. Wound healing and transwell assays were performed to evaluate the migration and invasion capacities, respectively. Dual‑luciferase reporter assay was finally performed to determine the targeting of zinc finger E‑box‑binding protein 2 (ZEB2) by miR‑338‑3p. RESULTS: We found that miR‑338‑3p was significantly reduced in NSCLC cell lines. Forced expression of miR‑338‑3p in A549 cells led to the suppression of migration/invasion capacity and inhibition of epithelial markers. In addition, we proved that miR‑338‑3p could directly target ZEB2. CONCLUSIONS: In general, we summarized that miR‑338‑3p could inhibit EMT and metastasis of human NSCLC cells, which probably via directly targeting ZEB2 expression.
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BACKGROUND: Serum carcinoembryonic antigen (CEA) and the soluble fragment of cytokeratin 19 (CYFRA 21‑1) are supposed to have a prognostic role in patients with nonsmall cell lung cancer (NSCLC) after surgery, but it has not been used as an adjunct to the tumor‑node‑metastasis (TNM) staging system to provide therapy options for patients with pathological Stage I NSCLC. This study was designed to investigate the effect of serum levels of CEA and CYFRA 21‑1 before and after surgery on the prognosis of patients with Stage I NSCLC. MATERIALS AND METHODS: A retrospective review was performed regarding the medical records and follow‑ups of 169 patients with Stage I NSCLC before and after surgery. The patients were divided into three groups based on levels of serum CEA and CYFRA 21‑1 before and after surgery: (1) continuously normal‑level groups (CEA [NN] and CYFRA 21‑1 [NN] groups); (2) declined to normal‑level groups (CEA [HN] and CYFRA 21‑1 [HN] groups); and (3) continuously high‑level groups (CEA [HH] and CYFRA 21‑1 [HH] groups). Survival analysis was conducted using the Kaplan–Meier method for each group. The Chi‑square or Fisher exact test was employed to compare clinical and pathologic factors at the level of P < 0.05. The prognostic factor was evaluated by the Cox proportional hazards model. RESULTS: Compared with the continuously normal‑level groups, the CEA [HN] group was significantly correlated to tumor size (P = 0.011), and the CYFRA 21‑1 [HN] group was significantly correlated to tumor type and pathological TNM in addition to tumor size. Five‑year survivals were significantly lower (P = 0.004) in the CEA [HH] group (67.3%) and the CEA [HN] group (86.5%) than in the CEA [NN] group (85.7%) and were significantly lower (P < 0.001) in the CYFRA 21‑1 [HH] group (47.2%) and the CYFRA 21‑1 [HN] group (70.1%) than in the CYFRA 21‑1 [NN] group (90.1%). Multivariate analysis demonstrated that tumor size (21–50 mm), CEA [HH], and CYFRA 21‑1 [HH] were independent unfavorable prognostic factors for overall survival (OS), whereas tumor size (21–50 mm), CEA [HH], CYFRA 21‑1 [HN], and CYFRA 21‑1 [HH] were independent significant prognostic factors for progression‑free survival (PFS). CONCLUSION: Patients with a persistently high serum CEA or CYFRA 21‑1 before and after surgery had shortest OS and PFS. These patients had worst prognosis. Adjuvant chemotherapy was likely to improve survival for these patients.
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OBJECTIVE: To systematic review and analysis the clinical efficacy and toxicity of lentinan injection combined with chemotherapy in the treatment of nonsmall cell lung cancer (NSCLC). MATERIALS AND METHODS: The databases of PubMed and CNKI were electronic searched with the free text word of lung cancer/NSCLC and lentinan. The prospective clinical study reporting the clinical efficacy and safety of lentinan injection combined with chemotherapy in the treatment of NSCLC were reviewed and included in this meta‑analysis. The combined treatment efficacy and toxicity of lentinan injection combined with chemotherapy were pooled by Stata 11.0 software. RESULTS: Twelve clinical studies of lentinan injection combined with chemotherapy in the treatment of NSCLC with 458 controls and 492 NSCLCs patients were finally included in this meta‑analysis. The pooled results indicated that the objective response rate was significant improved in the lentinan injection combined chemotherapy group compared with chemotherapy group only (relative risk [RR] = 1.31, 95% confidence interval [CI]: 1.14–1.52). The chemotherapy‑related toxicity of III/IV gastrointestinal reaction (RR = 0.54, 95% CI: 0.43–0.68) and III/IV granulocytopenia (RR = 0.65, 95% CI: 0.51–0.70) were significant decreased in the combined group. CONCLUSION: Lentinan injection combined chemotherapy significant increase the objective response rate and decreased the chemotherapy‑related toxicity.
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BACKGROUND: The extent of the benefit of erlotinib in the treatment of advanced nonsmall‑cell lung cancer (NSCLC) is still controversial when compared with docetaxel. This meta‑analysis was performed to compare the efficacy of erlotinib with docetaxel for different patients with advanced NSCLC. MATERIALS AND METHODS: We searched Cochrane Library, PubMed, CNKI, and identified 23 randomized controlled clinical trials from 2008 to 2015. According to our further full‑text screening, 6 clinical trials were included in the final meta‑analysis. RESULTS: Six papers were included in this study. The progression‑free survival (PFS), overall survival (OS), objective response rate (ORR), and toxicity were included in our outcomes. The pooled hazard ratio (HR) of PFS was 1.57 (95% confidential index [CI] = 1.47–1.69). The pooled HR of OS was 1.66 (95% CI = 1.43–1.92). The pooled risk ratio of ORR was 0.56 (95% CI = 0.35–0.91). The toxicity analysis showed odds ratio = 1.79 (95% CI = 1.20–2.69). CONCLUSIONS: In terms of PFS, OS, and toxicity the effect of erlotinib in the treatment of advanced NSCLC patients is superior to docetaxel.
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OBJECTIVE:To investigate the inhibitory effect of astragalosides on proliferation of lung adenocarcinoma SPCA-1 cells. METHODS:After the cells were cultured in 0 (blank control),7.8,15.6,31.2,62.5,125.0 and 250.0 μg/ml for 48 h, MTT method was used to determine cell viability and median inhibitory concentration(IC50)was calculated,and terminal deoxynu-cleotidyl transferase-mediated dUTP-biotin nick end labeling assay(TUNEL)and flow cytometry were employed to detect apopto-sis. RESULTS:Compared to the blank control,after the cells were cultured in 7.8,15.6,31.2,62.5,125.0 and 250.0 μg/ml as-tragalosides for 48 h,the cell viability was poorer(P<0.01),and IC50 was 61.75 μg/ml;after the cells were cultured in 15.6,31.2, 62.5,125.0 and 250.0 μg/ml astragalosides for 48 h,the apoptosis rate was higher. CONCLUSIONS:Astragalosides have an anti-tumor effect to some degree by a mechanism which may be related to inhibiting cancer cell proliferation and accelerating apoptosis.