Lung Cancer Management最新文献

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Afatinib in locally advanced/metastatic NSCLC harboring common EGFR mutations, after chemotherapy: a Phase IV study 阿法替尼治疗化疗后携带常见EGFR突变的局部晚期/转移性NSCLC：一项IV期研究

IF 2.8 Q4 RESPIRATORY SYSTEM

Lung Cancer Management

Pub Date : 2019-09-02 DOI: 10.2217/lmt-2019-0004

S. Thongprasert, Sarayut Lucien Geater, D. Clement, A. Abdelaziz, J. Reyes-Igama, D. Jovanovic, A. Alexandru, M. Schenker, V. Sriuranpong, P. Serwatowski, S. Suresh, A. Cseh, R. Gaafar

Aim: The current study evaluated the efficacy and tolerability of second-line afatinib in patients with EGFR mutation-positive (EGFRm+) non-small-cell lung cancer (NSCLC) following chemotherapy. Patients & methods: In this open-label, single-arm Phase IV study, patients with EGFRm+ (Del19/L858R) NSCLC who had progressed following platinum-based chemotherapy received afatinib (starting dose 40 mg/day). The primary end point was confirmed objective response. Results: 60 patients received afatinib for a median duration of 11.5 months. 50% of patients had a confirmed objective response, of median duration 13.8 months. Median progression-free survival was 10.9 months. The most common treatment-related adverse events were diarrhea (72%), rash (28%) and paronychia (23%). Conclusion: Our data support the use of afatinib (40 mg/day) as an effective and well-tolerated second-line treatment in EGFRm+ NSCLC.

目的：评价二线阿法替尼治疗化疗后EGFR突变阳性（EGFRm+）非小细胞肺癌（NSCLC）患者的疗效和耐受性。患者和方法：在这项开放标签的单臂IV期研究中，在铂类化疗后进展的EGFRm+（Del19/L858R）NSCLC患者接受了阿法替尼（起始剂量40 mg/天）治疗。主要终点是确认的客观反应。结果：60名患者接受阿法替尼治疗，中位持续时间11.5个月。50%的患者有明确的客观反应，中位持续时间为13.8个月。中位无进展生存期为10.9个月。最常见的治疗相关不良事件是腹泻（72%）、皮疹（28%）和甲沟炎（23%）。结论：我们的数据支持阿法替尼（40mg/天）作为EGFRm+NSCLC的一种有效且耐受性良好的二线治疗方法。

引用次数: 3

Are neuroendocrine negative small cell lung cancer and large cell neuroendocrine carcinoma with WT RB1 two faces of the same entity? 神经内分泌阴性的小细胞肺癌和WT RB1型的大细胞神经内分泌癌是同一实体的两面吗?

IF 2.8 Q4 RESPIRATORY SYSTEM

Lung Cancer Management

Pub Date : 2019-08-21 DOI: 10.2217/lmt-2019-0005

D. Sonkin, Anish Thomas, B. Teicher

Until recently, small cell lung cancer (SCLC) was described as SCLC and SCLC variant, based upon cellular morphology and loss of neuroendocrine markers in the SCLC variant. However, based on recent research advances, driven in part by the increase in comprehensive genomic data, it has become clear that there are multiple SCLC subtypes including an ASCL1 and NEUROD1 low, YAP1 high (SCLC-Y) subtype enriched for WT RB1. Comparing morphological and other features of this SCLC subtype to neuroendocrine negative RB1, KEAP1, STK11 WT LCNEC raises a number of important questions with diagnostic and therapeutic implications.

直到最近，小细胞肺癌癌症（SCLC）被描述为SCLC和SCLC变体，基于SCLC变体中的细胞形态和神经内分泌标志物的缺失。然而，根据最近的研究进展，部分受综合基因组数据增加的驱动，很明显存在多种SCLC亚型，包括富含WT RB1的ASCL1和NEUROD1低、YAP1高（SCLC-Y）亚型。将这种SCLC亚型的形态学和其他特征与神经内分泌阴性RB1、KEAP1、STK11 WT LCNEC进行比较，提出了许多具有诊断和治疗意义的重要问题。

引用次数: 20

Stereotactic body radiation therapy versus fractionated radiation therapy for early-stage bronchopulmonary carcinoid 立体定向放射治疗与分级放射治疗早期支气管肺类癌的比较

IF 2.8 Q4 RESPIRATORY SYSTEM

Lung Cancer Management

Pub Date : 2019-08-21 DOI: 10.2217/lmt-2019-0003

R. Wegner, S. Abel, Z. Horne, S. Hasan, A. Colonias, V. Verma

Aim: To compare trends and outcomes in early stage bronchopulmonary carcinoid (BPC) tumors treated nonoperatively with conventionally fractionated radiotherapy (CFRT) and stereotactic body radiotherapy (SBRT). Methods/materials: We queried the National Cancer Database for primary (typical) BPC staged cT1-2N0M0 and treated nonsurgically with lung-directed radiation and ≥1 month of follow-up. Odds ratios were used to predict likelihood of SBRT treatment and multivariable Cox regression determined predictors of survival. Results: Out of 154 patients, 84 (55%) were treated with SBRT and the remainder were treated with CFRT. Although SBRT use was 0% from 2004 to 2007, it varied from 50 to 70% per year thereafter. Propensity-matched Kaplan–Meier analysis revealed improved survival with lung SBRT (median: 66 vs 58 months; p = 0.034). Conclusion: SBRT for early stage, primary BPC has increased over time and was associated with higher survival than CFRT.

目的:比较常规分割放疗(CFRT)和立体定向放射治疗(SBRT)非手术治疗早期支气管肺类癌(BPC)肿瘤的趋势和结果。方法/材料:我们查询了国家癌症数据库中原发性(典型)BPC分期cT1-2N0M0，并通过肺定向放疗和≥1个月的随访进行非手术治疗。比值比用于预测SBRT治疗的可能性，多变量Cox回归确定生存预测因子。结果:154例患者中，84例(55%)接受SBRT治疗，其余患者接受CFRT治疗。尽管SBRT的使用率从2004年到2007年为0%，但此后每年的使用率从50%到70%不等。倾向匹配的Kaplan-Meier分析显示，肺SBRT改善了生存率(中位数:66个月vs 58个月;P = 0.034)。结论:SBRT对早期原发性BPC的治疗随着时间的推移而增加，并且与CFRT相比具有更高的生存率。

引用次数: 5

Treatment effect and safety profile of salvage chemotherapy following immune checkpoint inhibitors in lung cancer 免疫检查点抑制剂治疗癌症挽救性化疗的疗效和安全性

IF 2.8 Q4 RESPIRATORY SYSTEM

Lung Cancer Management

Pub Date : 2019-05-09 DOI: 10.2217/lmt-2019-0001

M. Tone, T. Izumo, Nobuyasu Awano, N. Kuse, M. Inomata, Tatsunori Jo, Hanako Yoshimura, S. Miyamoto, H. Kunitoh

Aim: To assess the relationship of treatment effects between immune checkpoint inhibitor (ICI) and salvage chemotherapy, with the safety profile of salvage chemotherapy. Patients & methods: 18 patients with advanced NSCLC treated using salvage chemotherapy following ICI treatment were retrospectively included. We assessed the overall response rate to and adverse events of salvage chemotherapy. Results: The overall response rate to salvage chemotherapy was 33.3% and that of ICI responders was significantly higher than that of ICI nonresponders (66.7 vs 16.7%, respectively, p = 0.03). The incidence rate of adverse events to salvage chemotherapy was 55.6%. Conclusion: The efficacy of salvage chemotherapy was similar to that preceding ICI. Moreover, the safety of salvage chemotherapy was good.

目的：评估免疫检查点抑制剂（ICI）与挽救性化疗疗效的关系，以及挽救性化疗的安全性。患者和方法：对18例晚期NSCLC患者进行回顾性分析。我们评估了挽救性化疗的总有效率和不良事件。结果：对挽救性化疗的总有效率为33.3%，ICI应答者明显高于无应答者（分别为66.7%和16.7%，p=0.03）。挽救性化疗不良事件发生率为55.6%。结论：挽救性化疗疗效与ICI前相似。此外，挽救性化疗的安全性良好。

引用次数: 14

Pembrolizumab-induced necrotizing myositis in a patient with metastatic non-small-cell lung cancer: a case report 一例转移性非小细胞肺癌癌症患者Pembrolizumab诱导的坏死性肌炎：病例报告

IF 2.8 Q4 RESPIRATORY SYSTEM

Lung Cancer Management

Pub Date : 2019-05-08 DOI: 10.2217/lmt-2018-0017

Jonas Claus, Annelies Van Den Bergh, Sanne Verbeek, E. Wauters, K. Nackaerts

A 57-year-old man presented with swelling and pain in the lower limbs, inability to walk and increasing dyspnea for 2 days. Because of refractory stage IV non-small-cell lung cancer, pembrolizumab was started 21 days before presentation. Since then, he experienced general discomfort, fatigue and bilateral weakness in the legs with exercise limitation. A diagnosis of pembrolizumab-induced grade III myositis was made based on muscle biopsy. Pembrolizumab is a humanized monoclonal antibody against PD-1. It has been approved for the treatment of metastatic melanoma and refractory non-small-cell lung cancer with increased expression of PD-L1 on the cell surface of tumor cells. With such a humanized monoclonal antibody, fewer adverse events are expected than with systemic chemotherapy. However, 13% of patients develop autoimmune side effects which can be severe (grade III, IV or V) in 5–10%. We discuss a case of pembrolizumab-induced myositis, with a brief overview of the literature. Only three cases of pembrolizumab-induced myositis have been reported in literature.

一名57岁的男子出现下肢肿胀和疼痛，无法行走，呼吸困难加剧，持续2天。由于难治性IV期非小细胞肺癌癌症，pembrolizumab在出现前21天开始。从那以后，他经历了全身不适、疲劳和双侧腿部无力，运动受限。根据肌肉活检诊断为pembrolizumab诱导的III级肌炎。Pembrolizumab是一种抗PD-1的人源化单克隆抗体。它已被批准用于治疗转移性黑色素瘤和难治性非小细胞肺癌癌症，肿瘤细胞表面PD-L1表达增加。与全身化疗相比，使用这种人源化单克隆抗体预计会发生更少的不良事件。然而，13%的患者出现自身免疫性副作用，5-10%的患者出现严重副作用（III、IV或V级）。我们讨论了一例pembrolizumab诱导的肌炎，并简要综述了文献。文献中仅报道了三例pembrolizumab诱导的肌炎。

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引用次数: 6

Clinical outcomes in non-small-cell lung cancer patients receiving concurrent metformin and immune checkpoint inhibitors 同时接受二甲双胍和免疫检查点抑制剂治疗的非小细胞肺癌患者的临床结果

IF 2.8 Q4 RESPIRATORY SYSTEM

Lung Cancer Management

Pub Date : 2019-05-07 DOI: 10.2217/lmt-2018-0016

M. Afzal, K. Dragnev, Tayyaba Sarwar, K. Shirai

Aim: To study the clinical benefits of concurrent metformin and immune checkpoint inhibitors (ICIs) in non-small-cell lung cancer patients. Materials & methods: This is a retrospective review of 50 non-small-cell lung cancer patients receiving ICIs with metformin (cohort A) or without metformin (cohort B). Patients were also stratified by ICIs as second-/third-line therapy. Results: Overall response rate and disease control rate were higher in cohort A (41.1 vs 30.7%, p = 0.4 and 70.5 vs 61.6%, p = 0.5, respectively). Median overall survival and progression-free survival were also higher in cohort A (11.5 vs 7.6 months, p = 0.5 and 4.0 vs 3.0 months, p = 0.6, respectively). On subset analysis (second-/third-line ICIs), overall response rate, disease control rate, median overall survival, progression-free survival were also higher in cohort A. Conclusion: Despite the small-sample size, we observed improved clinical outcomes in patients who received ICIs in combination with metformin.

目的：研究二甲双胍联合免疫检查点抑制剂（ICIs）治疗非小细胞肺癌癌症的临床疗效。材料与方法：这是一项对50例非小细胞肺癌癌症患者进行的回顾性综述，这些患者接受了含二甲双胍的ICIs（a组）或不含二甲双胍的ICIs（B组）。患者也按照ICIs进行分层，作为二线/三线治疗。结果：队列A的总有效率和疾病控制率较高（分别为41.1%和30.7%，p=0.4和70.5%和61.6%，p=0.5）。队列A的中位总生存期和无进展生存期也较高（分别为11.5个月和7.6个月，p=0.5和4.0个月和3.0个月，p=0.6）。在亚组分析（二线/三线ICIs）中，队列A的总有效率、疾病控制率、中位总生存率、无进展生存率也较高。结论：尽管样本量较小，但我们观察到接受ICIs联合二甲双胍治疗的患者的临床结果有所改善。

引用次数: 52

Stereotactic body radiation therapy in early-stage NSCLC: historical review, contemporary evidence and future implications. 早期NSCLC的立体定向身体放射治疗：历史回顾、当代证据和未来意义。

IF 0.9 Q4 RESPIRATORY SYSTEM

Lung Cancer Management

Pub Date : 2019-02-27 eCollection Date: 2019-02-01 DOI: 10.2217/lmt-2018-0013

Stephen Abel, Shaakir Hasan, Zachary D Horne, Athanasios Colonias, Rodney E Wegner

Clinical use of stereotactic body radiation therapy (SBRT) has increased dramatically over the last 2 decades and is the current standard-of-care in cases of inoperable early stage non-small-cell lung cancer. While surgical resection remains the standard-of-care for operable patients, several ongoing clinical trials are investigating the role of SBRT in these operative candidates as well. Taking into consideration the expanding role and utility of SBRT, this paper will: review the historical basis of SBRT; examine landmark trials establishing the framework for the current body of evidence; discuss areas of active and future research; and identify epidemiological trends that are likely to further increase the use of SBRT.

立体定向身体放射治疗（SBRT）的临床应用在过去20年中急剧增加，是目前无法手术的早期非小细胞肺癌癌症患者的治疗标准。虽然手术切除仍然是可手术患者的标准护理，但一些正在进行的临床试验也在调查SBRT在这些候选手术中的作用。考虑到SBRT的扩展作用和效用，本文将：回顾SBRT的历史基础；审查为现有证据体系建立框架的具有里程碑意义的审判；讨论当前和未来的研究领域；并确定可能进一步增加SBRT使用的流行病学趋势。

引用次数: 0

Targeting claudin-3 suppresses stem cell-like phenotype in nonsquamous non-small-cell lung carcinoma. 靶向克劳丁-3可抑制非鳞状非小细胞肺癌的干细胞样表型。

IF 0.9 Q4 RESPIRATORY SYSTEM

Lung Cancer Management

Pub Date : 2019-02-26 eCollection Date: 2019-02-01 DOI: 10.2217/lmt-2018-0010

Lin Ma, Wu Yin, Heliang Ma, Ihab Elshoura, Lan Wang

Aim: To determine the role of claudin-3 in cancer stemness in nonsquamous non-small-cell lung carcinoma (NSCLC).

Materials & methods: In vitro/vivo extreme limiting dilution analysis and the side population assay were used to investigate the role of claudin-3 in regulating cancer stemness in nonsquamous NSCLC.

Results & conclusion: Claudin-3 depletion decreased the formation rates of spheres and tumors and increased cisplatin sensitivity. Claudin-3 was also identified as one downstream target of estrogen receptor-α in regulating cancer stemness. Moreover, targeting CLDN-3 transcription by small molecules including withaferin A, estradiol and fulvestrant suppressed cancer stemness and reversed chemoresistance. These results demonstrated claudin-3 is one positive regulator of cancer stemness in nonsuqamous NSCLC.

目的：确定Claudin-3在非鳞状非小细胞肺癌（NSCLC）癌症干性中的作用：材料与方法：采用体外/体内极限稀释分析和侧群试验研究Claudin-3在非鳞状非小细胞肺癌中调控癌症干性的作用：结果与结论：Claudin-3耗竭降低了球体和肿瘤的形成率，增加了顺铂的敏感性。Claudin-3也被确定为雌激素受体-α调控癌症干性的下游靶点之一。此外，以CLDN-3转录为靶点的小分子药物，包括雌激素受体α（withaferin A）、雌二醇（estradiol）和氟维司群（fulvestrant），可抑制癌症干性并逆转化疗耐药性。这些结果表明，claudin-3是非鳞状NSCLC癌症干性的一个积极调节因子。

引用次数: 0

We need to educate young lung cancer patients about menopause risk. 我们需要对年轻肺癌患者进行更年期风险教育。

IF 0.9 Q4 RESPIRATORY SYSTEM

Lung Cancer Management

Pub Date : 2019-02-12 eCollection Date: 2019-02-01 DOI: 10.2217/lmt-2018-0018

Fahad Faruqi, Elizabeth Cathcart-Rake, Kathryn J Ruddy

引用次数: 0

Lung stereotactic body radiotherapy after past ablative therapy: a single institution case series. 既往消融治疗后肺立体定向放射治疗:单一机构病例系列。

IF 2.8 Q4 RESPIRATORY SYSTEM

Lung Cancer Management

Pub Date : 2018-12-21 eCollection Date: 2018-11-01 DOI: 10.2217/lmt-2018-0012

Rodney E Wegner, Nissar Ahmed, Shaakir Hasan, Lana Y Schumacher, Athanasios Colonias

Aim: Non-small-cell lung cancer recurs locally 10-40% of the time after local therapy, presenting a therapeutic challenge given poor pulmonary reserve. Herein, we seek to evaluate the safety and efficacy of stereotactic body radiotherapy (SBRT) for retreatment of such patients.

Methods: We identified and reviewed clinical outcomes in ten patients with recurrent non-small-cell lung cancer after past vicryl mesh brachytherapy.

Results: Ten patients with a median age of 77 were treated to a median dose of 48 Gy in five fractions. Local control at 1 year was 88%. There was one distant failure at 29 months. There was no significant toxicity after SBRT.

Conclusion: SBRT is safe and effective when used for re-irradiation after past ablative therapies.

目的:非小细胞肺癌在局部治疗后10-40%的时间局部复发，由于肺储备不良，对治疗提出了挑战。在此，我们试图评估立体定向放射治疗(SBRT)对此类患者再治疗的安全性和有效性。方法:我们确定并回顾了10例复发的非小细胞肺癌患者在过去的薇基网近距离治疗后的临床结果。结果:10例中位年龄为77岁的患者分5组接受中位剂量48 Gy的治疗。1年局部控制率为88%。在29个月的时候有一次遥远的失败。SBRT后无明显毒性反应。结论:SBRT用于既往消融治疗后的再照射是安全有效的。

引用次数: 1

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