Prediction of efficacy of early-stage tumor markers combined with NLR and PLR for immunotherapy in gastric cancer / 国际肿瘤学杂志

Objective:To explore the predictive value of early serum tumor markers (STM) , neutrophil to lymphocyte ratio (NLR) , platelet to lymphocyte ratio (PLR) combination score on the efficacy of gastric cancer immunotherapy.Methods:A total of 76 patients with gastric cancer who received immunotherapy at Second Affiliated Hospital of Shandong First Medical University from January 1, 2020 to June 30, 2022 were selected. Patients' leading STM, NLR, PLR were collected. Optimal cut-off value of NLR and PLR were determined by the receiver operating characteristic (ROC) curve. The clinical efficacy and prognosis of different leading STM, NLR, PLR and combined scores in gastric cancer patients received immunotherapy were analyzed. ROC curve was used to evaluate the predictive efficiency of each index and the combined score. Cox regression model was used to analyze the factors affecting patients' survival.Results:The best truncation value for NLR was 2.75, and the best truncation value for PLR was 175.9. All patients completed at least 2 cycles of immunotherapy, the objective response rate (ORR) was 23.7% (18/76) , and the disease control rate (DCR) was 88.2% (67/76) . There were no significant differences in ORR [ (20.9% (9/43) vs. 27.3% (9/33) ], DCR [83.7% (36/43) vs. 93.9% (31/33) ] between the high NLR group ( n=43) and low NLR group ( n=33) ( χ2=0.42, P=0.519; χ2=1.02, P=0.313) . There were no significant differences in ORR [27.3% (12/44) vs. 18.8% (6/32) ], DCR [81.8% (36/44) vs. 96.9% (31/32) ] between the high PLR group ( n=44) and low PLR group ( n=32) ( χ2=0.75, P=0.388; χ2=2.71, P=0.555) . The ORR for the high combined score group ( n=39) and low combined score group ( n=37) was 17.9% (7/39) and 29.7% (11/37) , respectively, with no statistically significant difference ( χ2=1.46, P=0.230) ; the DCR was 79.5% (31/39) and 97.3% (36/37) , respectively, with a statistically significant difference ( χ2=4.19, P=0.041) . The median progression free survival (PFS) and overall survival (OS) of 76 patients were 8.0 and 12.0 months. The median PFS in the high NLR group and low NLR group was 7.0 and 10.0 months, respectively, with a statistically significant difference ( χ2=7.95, P=0.005) ; the median OS was 12.0 and 14.0 months, respectively, with no statistically significant difference ( χ2=1.04, P=0.307) . The median PFS in the high PLR group and low PLR group was 8.0 and 10.0 months, respectively, with a statistically significant difference ( χ2=3.90, P=0.048) ; the median OS was 13.0 and 13.0 months, respectively, with no significant difference ( χ2=0.02, P=0.896) . The median PFS in the high combined score group and low combined score group was 7.0 and 10.0 months, respectively, with a statistically significant difference ( χ2=13.52, P<0.001) ; the median OS was 12.0 and 14.0 months, respectively, with a statistically significant difference ( χ2=5.02, P=0.025) . ROC curve analysis showed that the area under curve (AUC) of leading STM, NLR, PLR and combined score to predict the efficacy of gastric cancer immunotherapy was 0.662, 0.697, 0.601 and 0.773. Univariate analysis showed that, surgery ( HR=0.59, 95% CI: 0.36-0.95, P=0.031) , leading STM ( HR=0.57, 95% CI: 0.34-0.93, P=0.026) , NLR ( HR=0.54, 95% CI: 0.34-0.87, P=0.011) , combined score ( HR=0.42, 95% CI: 0.26-0.68, P<0.001) were all influencing factors for PFS in gastric cancer patients received immunotherapy; tumor stage ( HR=0.30, 95% CI: 0.12-0.75, P=0.011) , leading STM ( HR=0.28, 95% CI: 0.15-0.50, P<0.001) , combined score ( HR=0.55, 95% CI: 0.31-0.96, P=0.036) were all influencing factors for OS in gastric cancer patients received immunotherapy. Multivariate analysis showed that, leading STM ( HR=0.56, 95% CI: 0.33-0.98, P=0.041) was an independent influencing factor for PFS in gastric cancer patients received immunotherapy; tumor stage ( HR=0.29, 95% CI: 0.11-0.76, P=0.012) , leading STM ( HR=0.32, 95% CI: 0.17-0.58, P<0.001) , combined score ( HR=0.46, 95% CI: 0.25-0.82, P=0.009) were all independent influencing factors for OS in gastric cancer patients received immunotherapy. Conclusion:The combined score of leading STM, NLR and PLR is an independent factor influencing OS in patients receiving immunotherapy for gastric cancer, and can predict the efficacy of immunotherapy for gastric cancer.

A new predictor of the efficacy of immunotherapy for non-small cell lung cancer—lung immune prognostic index (LIPI) / 国际肿瘤学杂志

Immune checkpoint inhibitors have demonstrated the ability to significantly improve survival across a range of cancers. So predictive markers are required to guide treatment decisions. The lung immune prognostic index (LIPI) is recently developed to predict immune checkpoint inhibitors (ICIs) treatment outcomes for non-small cell lung cancer. The pre-treatment LIPI is a convenient prognostic marker able to identify ICIs-treated patient groups with significantly different survival and response outcomes.

Clinical research of microwave ablation plus sorafenib in the treatment of advanced-stage hepatocellular carcinoma / 国际肿瘤学杂志

Objective To compare the clinical effects and adverse effects of microwave ablation (MWA) with sorafenib and sorafenib monotherapy in the treatment of advanced-stage hepatocellular carcinoma (HCC).Methods Medical records and follow-up information of 57 patients with advanced-stage HCC were retrospectively reviewed.25 patients were treated with MWA combined with sorafenib (combined group),and 32 patients were treated with sorafenib monotherapy (monotherapy group).The end points were therapeutic effect,progression-free survival (PFS),overall survival (OS) and adverse reactions.Results The objective response rate in the combined group was similar to the monotherapy group (16.0％ vs.3.1％,x2 =1.521,P =0.217).The disease control rate in the combined group was significantly higher than that in the monotherapy group (80.0％ vs.50.0％,χ2 =5.429,P =0.020).The median PFS in the combined group was longer than that in the monotherapy group (6.0 months vs.3.2 months,x2 =7.675,P =0.006),but the median OS was similar (11.5 months vs.8.5 months,x2 =2.480,P =0.115).The serious adverse reactions were similar between the two treatment groups (44.0％ vs.34.4％,x2 =0.549,P =0.459).Conclusion MWA plus sorafenib is superior to sorafenib alone with respect to PFS in patients with advanced-stage HCC,although it may not improve OS,with no increased risk of serious adverse reactions.

Clinical observation of nimotuzumab with chemotherapy in metastatic gastrointestinal tumor patients / 肿瘤研究与临床

ObjectiveTo explore the efficacy and toxicity of nimotuzumab plus chemotherapy in the treatment of metastatic gastrointestinal tumor.MethodsObservationgroup 22 patients with metastatic gastrointestinal tumor with confirmed diagnosis,were treated with nimotuzumab in combination chemotherapy.Nimotuzumab was given 200 mg weekly for at least six weeks. Control group 21 patients with metastatic gastrointestinal tumor with confirmed diagnosis were treated with only chemotherapy.ResultsThe effects of observation group could be observed in 22 patients, the rate of response(RR)was 31.8％ (7/22), and the disease control rate (DCR) was 72.7 ％ (16/22).QOL was improved.The effects of observation group could be observed in 21 patients,RR was 14.3 ％ (3/21),and the disease control rate was 42.8 ％ (19/21).DCR and QOL improvements were statistically significant different between the two groups.(x2=3.939,x2=4.250,P＜0.05).The two groups had no significant difference in RR and toxicity.ConclusionNimotuzumab in combination with chemotherapy is effective and can improve the disease control rate, toxicity, tolerance,quality of life.

Topotecan in combination with cisplatin in the treatment of recurrent small cell lung cancer / 中国肺癌杂志

<p><b>BACKGROUND</b>There is no effective regimen for recurrent small cell lung cancer patients now. The aim of this study is to assess the activity and toxicity of topotecan combined with cisplatin in the treatment of recurrent small cell lung cancer patients.</p><p><b>METHODS</b>Twenty-eight patients with progressive disease after one first-line regimen enrolled in the study from May 2002 to October 2004. Topotecan was given at the dose of 1.2mg/m² from 1st to 4th days and cisplatin was administered at the dose of 25mg/m² from 5th to 7th days in a cycle of 3 weeks. The patients could be evaluated at least after 2 cycles.</p><p><b>RESULTS</b>One patient got complete response and ten patients got partial response in this group. The overall response rate was 39.3% , and the response rate of refractory group and sensitive group was 37.5% (3/8) and 40.0% (8/20) respectively. The median time to progression was 4.2 months. The main toxicity was hematological toxicity. Grade III+IV neutropenia occurred in 42.9% (12/28) of the patients.</p><p><b>CONCLUSIONS</b>The regimen of topotecan and cisplatin shows better activity in retreated small cell lung cancer patients. The main toxicity is hematological toxicity and can be tolerated.</p>

Capecitabine in the treatment of relapsed breast cancer / 中国癌症杂志

Purpose:To observe the efficacy of capecitabi ne in the treatment of relapsed breast cancer. Methods:21 patients with relapsed breast cancer were treated. C apecitabine was administered twice a day at the dose of 2 500 mg/(m 2?d) f or two weeks. 21 days was one cycle. Patients could be evaluated after at least 2 cycles treatment. Results:20 patients could be evaluated. There were no complete response but 6 partial response, 8 stable disease and 6 progressive disease in t he group. The response rate was 30.0%. The common toxic effects were hand-foot syndrome (61.1%), nausea and vomiting(66.7%), leucopenia (42.9%) and skin pigm entation (23.8%). Conclusions:Capecitabine is effective for the relapsed breast c ancer patients who have been treated with anthracycline and taxanes. The toxic e ffects are mild and the tolerance is well. Capecitabine can be used as the secon d line regimen for relapsed breast cancer.

Study on the specific autoantibody in nonimmune thrombocytopenia in malignant tumor / 肿瘤研究与临床

Objective To study the possibility of the exist of specific antibody against platelet in tumor patients and to evaluate the value of MAIPA in measure of specific antibody against platelet in malignant tumor patients with nonimmune thrombocytopenic purpura. Methods Anti- GPⅡb/Ⅲa and anti- GPⅠb/Ⅸ autoantibodies were detected by a modified monoclonal antibody immobilization of platelet antigens assay(modified MAIPA). Results The positive rate of the platelet antibody in nonimmune thrombocytopenic purpura is very low with MAIPA. Conclusions The platelet GP- specific autoantibody detection is considerably important in discriminating immune from nonimmune thrombocytopenia.