Primary result of the efficacy and tolerance of gefitinib in advanced non-small cell lung cancer patients with brain metastasis / 中国肺癌杂志

<p><b>BACKGROUND</b>Gefitinib, an orally active epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), has shown targeted antitumor activity in patients with advanced non-small cell lung cancer (NSCLC). The aim of this study is to evaluate the efficacy and tolerance of gefitinib on brain metastasis in patients with NSCLC.</p><p><b>METHODS</b>The clinical characteristics, response to treatment and outcome of survival were retrospectively reviewed in eighteen NSCLC patients with brain metastasis. All these patients received gefitinib of 250mg/d after brain metastasis was diagnosed. They would discontinued the targeted treatment because of disease progression or other reasons. Twelve of them received intracranial irradiation (group A), while the other six patients didn't (group B).</p><p><b>RESULTS</b>The overall response rate and disease controlled rate of gefitinib for brain lesions were 27.8% and 88.9% respectively (one complete remission, 4 partial remission, 11 stable disease, 2 progressive disease). No correlation among gender, smoking status, intracranial irradiation and the response of gefitinib was observed. There was no survival difference between the two groups (P=0.192), with the median follow-up time of 6 months (range 1-24 months). Rash and diarrhea were the most common adverse events.</p><p><b>CONCLUSIONS</b>Gefitinib is active in patients with brain metastasis from NSCLC. It is feasible to conduct randomized clinical trials to demonstrate the role of targeted treatment for NSCLC patients with metastatic brain lesions.</p>

Iressa in the treatment of 24 cases of advanced non-small cell lung cancer patients who had failed to previous chemotherapy / 中国肺癌杂志

<p><b>BACKGROUND</b>Iressa is the inhibitor of epidemic growth factor receptor and mainly used to treat non-small cell lung cancer (NSCLC). The aim of this study is to evaluate the antitumor efficacy and toxicity of Iressa in the treatment of advanced NSCLC patients who had failed to previous chemotherapy.</p><p><b>METHODS</b>Twenty-four patiets with advanced NSCLC who were previously treated with chemotherapy received 250mg of Iressa orally once daily until disease progressing or intolerable toxicity developing. Tumor evaluation was performed before treatment. Then for every four weeks after administration they recevied the examination; after administration for sixteen weeks, examination was repeated once every eight weeks.</p><p><b>RESULTS</b>All twenty-four patients could be evaluated. One case got complete response, eight cases got partial response, three had no change and twelve had disease progression. So the response rate was 37.5%, the stable disease rate was 12.5%, and the clinical benifit rate was 50.0%. Median time to disease progressing was 87 days. All patients were followed up for two years and 1- and 2-year survival rate was 33.3% and 12.5% respectively. The common adverse effects were skin reaction and diarrhea and no grade III or IV toxicity was observed. Two cases were suspected of pulmonary interstitial changes and the treatment ended.</p><p><b>CONCLUSIONS</b>Iressa is effective in treatment of advanced NSCLC patients who had failed to previous chemotherapy and the adverse effects are tolerable. So Iressa is one of the best choice for NSCLC patients who need two or more line therapy.</p>

The application of traditional Chinese medicine synthetic effect criteria in the late stage lung cancer / 中国组织工程研究

Objective To inspect the correlation of synthetic effect criteria to sensitivity,reliability of late stage lung cancer curative effect verdict and median survival time. Method Using size change of tumor,symptom change related to tumor,Karnofsky score,body weight etc.as synthetic effect criteria and nstituting clinical synthetic effect criteria,to assess the curative effect of late stage lung cancer patients who received different treatment in department of tumor of Xiyuan Hospital between March 1997 and March 2000, to analysis medium survival time, and being compared with RR of tumor.Result 52 patients entered this experiment, in which 42 patients were assessable (follow up), 13 patients were effective(30.95％ ),17 were patients stable(40.48％ ),12 patients deteriorated (28.57％ ).The result of tumor objective remission rate: CR is 0,PR is 16.67％ (7 patients),NC is 64.29％ (27 patients) and PD is 19.05％ (8 patients).There was apparent difference between two effect criteria(P< 0.05).The mean survival time of this group is (9.3± 1.6)months,median survival time is 10.5 months(2～ 8months),survival rate of one year is 33.33％ (14 patients).In the patients who live longer than median survival time, most of them survive associated with tumor existence who are in NC of tumor objective remission rate, but also in the effective column of synthetic effect criteria. Compared with tumor objective remission rate,the synthetic effect criteria have more apparent correlation to survival time. Conclusion In the assessment of late stage lung cancer,synthetic effect criteria has better sensitivity and reliability,and emphasize survival quality,at same time it reflect the reaction of tumor and host to treatment,it reflect prognosis of tumor preferably and have better correlation to the survival time. It can be used as clinical effect criteria of late stage lung cancer after further consummation.

Progress of clinical application of monoclonal antibodies in the treatment of cancer / 中国癌症杂志

As biotechnology has developed so rapidly during recent years, the clinical application of monoclonal antibody in the treatment of cancer has achieved great success. This article briefly introduces the current status of several monoclonal antibodies in phase Ⅲ clinical trials and discusses in detail three monoclonal antibodies (herceptin, rituxan, panorex) in the treatment of breast cancer, malignant lymphoma and colorectal cancer, respectively. Thus, the clinicians will have updated information in monoclonal antibody development.

Docetaxel administered as three consecutive weekly infusions plus cisplatin for advanced non-small-cell lung cancer / 中国癌症杂志

Purpose:To study the efficacy and safety of docetaxel administrated weekly plus cisplatin in the treatment for patients with advanced non-small-cell lung cancer (NSCLC). Methods:Thirty-six patients with stage ⅢB,stage Ⅳ not treated previously by chemotherapy,or recurrenct after operation NSCLC received intravenous infusions of docetaxel at 35mg/m 2 three consecutive weeks,followed by a week of rest;and intravenous infusions of cisplatin at 75 mg/m 2 every four weeks. Results:There were 12 partial responses for an objective response rate of 33 %. The median survival was 11.5 months (range 4-27 months),and the 1-year survival was 50%. Hematologic toxicities,which were mild,included grade Ⅲ/Ⅳ neutropenia in 22%. The common nonhematologic toxicities included grade 2-3 nausea and vomiting (39%) and grade 2-3 asthenia (36%). Conclusions:Consecutive weekly administrations of docetaxel for 3 weeks plus cisplatin produce minimal myelosuppression and shows activity in the treatment of patients without previous chemtherapy with advanced NSCLC.