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Immune checkpoint inhibitors(ICIs)treatment significantly prolonged the survival period of patients with lung cancer, liver cancer, and malignant melanoma and other solid malignant tumors and improved the quality of life.But at the same time a variety of immune-related adverse reactions(irAEs)appeared.The incidence of immune-mediated liver injury(IMH)caused by ICIs is increasing but the severity is different.To diagnose IMH earlier and perform individualized diagnosis and treatment, it is necessary to have a reasonable application of drug treatment.
ABSTRACT
Venous thromboembolism(VTE)is one of the common and serious complications of malignant tumors.In elderly lung cancer patients, problems such as decreased autonomic activity, bed rest, poor performance status(PS), combined underlying diseases and the use of chemoradiotherapy are often considered as risk factors for high incidence of VTE.This article is aimed to review the clinical features and pathogenesis of lung cancer in the elderly combined with VTE, to investigate the risk factors and explore feasible evaluation and prevention strategies.
ABSTRACT
Venous thromboembolism(VTE)is one of the common and serious complications of malignant tumors.In elderly lung cancer patients,problems such as decreased autonomic activity,bed rest,poor performance status(PS),combined underlying diseases and the use of chemoradiotherapy are often considered as risk factors for high incidence of VTE.This article is aimed to review the clinical features and pathogenesis of lung cancer in the elderly combined with VTE,to investigate the risk factors and explore feasible evaluation and prevention strategies.
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Objective To analyse the clinical effect and safety of Alimta (Pemetrexed) combined with cisplatin treatment (PP) on elderly patients with non small cell lung cancer (NSCLC).Methods We retrospectively analyzed the clinical data of 40 cases of NSCLC patients treated with Pemetrexed combined with cisplatin for first-line chemotherapy,and 24 cases of them continually received single Pemetrexed for maintenance treatment (PP + C).Then we compared the results with 35 patients in the non-Pemetrexed regimen (control group) and 26 patients with best supportive care (BSC) in the same period.The adverse reactions and short-term efficacy [response rate (RR),disease control rate (DCR)] were evaluated.Time to progression (TTP),median survival time (MST),one-year and three-year survival rates and follow-up overall survival (OS) were calculated.Results Among 40 patients with Pemetrexed regimen,2 patients had complete remission (CR),and the RR was 47.8％,which was better than 42.8％ (P =0.026) in the control group.The main adverse reactions of pemetrexed regimen were myelosuppression,fatigue,nausea and vomiting,but all were tolerated and no treatment-related death occurred.24 patients received single Pemetrexed maintenance therapy.The MST of the PP + C group was superior to the other groups (P =0.03,P ≤0.05);the median OS of the PP + C group,the control group,and the BSC group reached 13.2,10.4 months and 8.6 months,respectively (P ≤ 0.001).Conclusions For elderly patients with advanced NSCLC,especially adenocarcinoma,the combination of Pemetrexed and cisplatin is a better treatment option.It is convenient to administer and has less toxicity and adverse reactions related to chemotherapy.Patients with better PS score after first-line treatment can obtain longer survival period after maintenance treatment.
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Lung cancer is one of the malignant tumors with serious health consequences for people all over the world.Non small-cell lung cancer(NSCLC)is the most common type of lung cancer,making up 80％ to 85％ of all cases.As a result of low rates of early detection,more than 70％ of patients,many of them elderly patients,are in late stages(Ⅲ-Ⅳ)at the time of diagnosis,and cannot be effectively treated with surgery.First line chemotherapy is the most common and critical treatment for patients with advanced or recurrent lung cancer.Elderly patients show decreased tolerance for side effects and toxicities of chemotherapy agents because of low basic metabolic rates and functional decline of major organs.Therefore,first-line chemotherapy strategies for elderly patients with NSCLC need further investigation.
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Objective Microheterogeneity is an important problem in molecularly biological and proteomic research on malignancies.The goal of this study was to investigate the method to purify targeted cells in lung cancer and its paired normal tissues for proteomic study on lung cancer applying laser capture microdissection(LCM).Methods LCM technique was emploged to obtain the cells of lung cancer tissues and their paired normal tissues from frozen sections.Results LCM can be applied to quickly and precisely obtain pure targeted cells subgroup or single cell without interstitium under the microscope.Conclusion LCM can tackle the problem of tissue heterogeneity in molecular analysis successfully.These results indicate that LCM has a potential as a tool in lung cancer proteomic research.
