Pharmacoeconomic Systematic Review of Osimertinib for Advanced Non-small Cell Lung Cancer / 中国药房

OBJECTIVE：To s ystematically review the economics of osimertinib for advanced non-small cell lung cancer （NSCLC），and to provide the reference for clinical application and healthcare decision makers. METHODS ：Retrieved from PubMed，Embase，the Cochrane L ibrary，Health Technology Assessment ，CNKI，Wanfang database ，VIP，CBM，etc.， pharmacoeconomic studies on osimertinib in the treatment of advanced NSCLC were collected from the inception to Apr. 2020. After screening and extracting relevant data ，the quality of the included studies was evaluated by using the Quality of Health Economics Studies （QHES），and the economic research results of the included literatures were systematically evaluated by using descriptive analysis method. RESULTS & CONCLUSIONS ：A total of 10 studies from 7 different countries were included ；QHES scores of the included literatures were 73-93，with an average of 86.8，and the quality of the researches was generally high. All the 10 studies were cost-effectiveness analysis ，including 6 first-line treatment ，4 second-line treatment. Six studies reported the cost discount rate ；only one study used the cost of osimertinib after price reduction for evaluation and analysis. Compared with other epidermal growth factor receptor-tyrosine kinase inhibitors （EGFR-TKI），six studies from different countries showed that osimertinib as the first-line treatment drug had no cost-effectiveness advantage ；cost-effectiveness of second-line treatment of osimertinib was controversial ，compared to chemotherapy. For advanced NSCLC patients ，the second-line treatment of osimertinib after the national centralized negotiation of price reduction has a more cost-effectiveness advantage in China ’s medical service system，while the first-line treatment of osimertinib before price reduction does not have this advantage compared with other EGFR-TKI drugs.

Clinical research on the expression of X chromosome coupled ZFX expression in the serum and pathology of NSCLC patients / 中国综合临床

Objective To discuss the expression of X chromosome coupled zinc finger protein(ZFX) in the serum and pathology of patients with advanced non-small cell lung cancer before and after treatment and its evaluation in the chemotherapy efficacy.Methods Forty cases(NSCLC group)with non-small cell lung cancer treated in Baotou Central Hospital from January 2013 to October 2014 were retrospectively analyzed.The control group included 40 normal people who may have tumor by normal physical examination.Based on the blood tests of research subjects before and after treatment,the peripheral blood ZFX content was detected by the quantitative detection, ZFX expression was detected by tissue morphological identification and immunohistochemical methods.Results The level of adenocarcinoma ZFX serum was(15.32± 2.01)μg/L, squamous cell carcinomas ZFX serum level was(11.65±4.12)μg/L,the difference between the two groups was statistically significant(t=3.216,P<0.05); the ZFX serum level of non-small cell lung cancer group was (17.55±0.37)μg/L before treatment,and was(6.35± 0.06)μg/L after treatment which was significantly lower,the difference was statistically significant(t=188.97,P<0.05); the serum level of non-small cell lung cancer group before treatment was(17.55±0.37)μg/L,after treatment was(6.35±0.06)μg/L,compared with (2.29± 0.01)μg/L,(2.29 ± 0.01)μg/L in the control group,the differences were statistically significant (before treatment:t=260.75,after treatment t=422.14,P<0.05); the expression of ZFX in adenocarcinoma was(15.32±2.01)ug / L,higher than that of squamous cell carcinoma((11.65±4.12)μg/L),the difference was statistically significant(t=3.216,P<0.05);the expression of ZFX in CR+PR group before treatment was (17.35±0.46)μg/L,higher than that after treatment((6.24±0.11)μg/L),the difference was statistically significant(t=142.88,P<0.05).Conclusion The expression of ZFX in peripheral blood serum and pathology may be a marker for the diagnosis of non-small cell lung cancer,and it has guiding significance for the diagnosis and curative effect evaluation of lung cancer.

The clinical observation of advanced non small cell lung cancer treated with Shenqifuzheng injections combined with PTX and DDP / 肿瘤研究与临床

Objective To observe the clinical effects of Shenqifuzheng injections combined with PTX and DDP on advanced non small cell lung cancers. Methods Fifty cases of advanced non small cell lung cancers were randomly divided into pure chemotherapy and chemotherapy combined with traditional Chinese medicine groups. The former was treated with 30 mg/m2 DDP from day 1 to day 3, 135 mg/m2 PTX only at the first day. The latter was treated with 250 ml Shenqifuzheng injections every day until the twentieth-first one, three days before the beginning of chemotherapy. After two periods of treatments, the therapeutic effects were evaluated, respectively. Results The recent effective ratios of chemotherapy combined with traditional Chinese medicine and pure chemotherapy groups were 48 % and 40 %, respectively. The former could ameliorate the physical status, the numbers of peripheral leucocytes, the decreases of blood platelet, the gastrointestinal reactions of subjects. Conclusion The Shenqifuzheng injections could increase the recent treatment effect of PTX combined with DDP on advanced non small cell lung cancers, effectively meliorate the clinical symptoms and alleviate the side effects of chemotherapy leading to improve the life qualities of subjects.

The Radiotherapeutic Significance of Serum NSE Level in Non-Small Cell Lung Cancers (NSCLC) / 대한치료방사선과학회지

From December 1989 to February 1993, 108 patients with Non-Small Cell Lung Cancers(NSCLC) were studied retrospectively to evaluate radiotherapeutic significance of serum levels of NSE. We considered elevated serum neuron specific pathologic evaluation revealed 86 squamous cell carcinomas, 11 adenocarcinomas, 3 large cell carcinomas, 3 mucoepidermoid carcinomas, and 5 unknown pathology. Eight patients had stageI, 40 stage III A, and 60 stageIII B. S-NSE level greater than 15 ng/ml was considered as elevated, and below this considered as normal. All patients received radiotherapy as primary treatment modality. The responders to radiotherapy had significantly higher mean S-NSE level than on-responders (28.5 ng/ml vs 20 ng/ml, p=0.01). Overall 2-year survival rate (YSR) was 23.6%. According to radiotherapy response, 2 YSR for patients with CR, PR, and NR were 39.2%, 28.6%, and 6.2% respectively (p=0.001). 2 YSR for patients with elevated and normal S-NSE were 14.6% and 31.7%(p=0.02). The patients with NR showed no difference in survival according to S-NSE level. When we considered all patients, S-NSE level showed no significant impact on response. But for squamous cell cardinomas alone, patients with elevated S-NSE had more patients with higher nodal stage. Based on our and other data, NSCLSC with neuroendocrine features have different response to treatment and clinical behavior compared to other NSCLSC. Thus, this subgroup may need different treatment modality, and S-NSE level may have prognostic significance.

Relationship of STAT3 and VEGF in non-small cell lung cancer / 重庆医科大学学报

Objective:To explore the expression of STAT3 and vascular endothelial growth factor (VEGF) in non-small cell lung cancer (NSCLC) and their relationship.Methods:SABC immunohistochemistry was used to detect the expression of STAT3 and VEGF in non-small tissues of 40 cases.Results:(1)The expression of STAT3 in NSCLCs had a obvious relation with the tumor cell differentiation and lymph node metastasis.No obvious difference in STAT3 expression was found among different tumor sizes of tumor types.(2)The expression of VEGF in NSCLCs had a significant relation with tumor size and lymph node metastasis.There was no significant difference between VEGF expression and tumor types and tumor cell differentiation.(3)There was significant positive correlation between the expression of VEGF and STAT3 in NSCLCs.Conclusion:STAT3 and VEGF may play an important role in the development of NSCLC.We identify that VEGF gene is regulated directly by STAT3 protein.