1
|
Ghosh S, Bhuniya T, Dey A, Koley M, Roy P, Bera A, Gol D, Chowdhury A, Chowdhury R, Sen S. An Updated Review on KRAS Mutation in Lung Cancer (NSCLC) and Its Effects on Human Health. Appl Biochem Biotechnol 2023:10.1007/s12010-023-04748-8. [PMID: 37897621 DOI: 10.1007/s12010-023-04748-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 10/30/2023]
Abstract
The largest cause of cancer-related fatalities worldwide is lung cancer. In its early stages, lung cancer often exhibits no signs or symptoms. Its signs and symptoms often appear when the condition is advanced. The Kirsten rat sarcoma virus oncogene homolog is one of the most frequently mutated oncogenes found in non-small cell lung cancer. Patients who have these mutations may do worse than those who do not, in terms of survival. To understand the nuances in order to choose the best treatment options for each patient, including combination therapy and potential resistance mechanisms, given the quick development of pharmaceuticals, it is necessary to know the factors that might contribute to this disease. It has been observed that single nucleotide polymorphisms altering let-7 micro-RNA might impact cancer propensity. On the other hand, gefitinib fails to stop the oncogenic protein from directly interacting with phosphoinositide3-kinase, which may explain its resistance towards cancer cells. Additionally, Atorvastatin may be able to overpower gefitinib resistance in these cancer cells that have this mutation regardless of the presence of phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha. De novo lipogenesis is also regulated by this virus. To overcome these effects, several targeted therapies have been proposed. One such therapy is to use inhibitors of focal adhesion kinases. When this is inhibited, viral oncogene mutant cancers are effectively stopped because it functions downstream of the virus. Mutant oncoproteins like epidermal growth factor receptor may depend on Heat Shock protein90 chaperones more frequently than they do on natural counterparts that make it more attractive therapeutic target for this virus. Inhibition of the phosphoinositide 3-kinase pathway is frequent in lung cancer, and fabrication of inhibitors against this pathway can also be an effective therapeutic strategy. Blocking programmed cell death ligand1 is another therapy that may help T cells to recognize and eliminate cancerous cells. This homolog is a challenging therapeutic target due to its complex structural makeup and myriad biological characteristics. Thanks to the unrelenting efforts of medical research, with the use of some inhibitors, immunotherapy, and other combination methods, this problem is currently expected to be overcome.
Collapse
Affiliation(s)
- Subhrojyoti Ghosh
- Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, IIT Madras, Chennai, Tamil Nadu, 600036, India.
| | - Tiyasa Bhuniya
- Department of Biotechnology, NIT Durgapur, Mahatma Gandhi Rd, A-Zone, Durgapur, West Bengal, 713209, India
| | - Anuvab Dey
- Department of Biological Sciences and Bioengineering, North Guwahati, Assam, IIT Guwahati, Assam-781039, India
| | - Madhurima Koley
- Department of Chemistry and Chemical Biology, IIT(ISM), Dhanbad, 826004, India
| | - Preeti Roy
- Department of Biotechnology, Indian Institute of Technology, Mandi, India
| | - Aishi Bera
- Department of Biotechnology, Heritage, Institute of Technology, Kolkata, West Bengal, 700107, India
| | - Debarshi Gol
- Department of Biotechnology, Heritage, Institute of Technology, Kolkata, West Bengal, 700107, India
| | - Ankita Chowdhury
- Department of Biotechnology, Heritage, Institute of Technology, Kolkata, West Bengal, 700107, India
| | - Rajanyaa Chowdhury
- Department of Biotechnology, Heritage, Institute of Technology, Kolkata, West Bengal, 700107, India
| | - Shinjini Sen
- Department of Biotechnology, Heritage, Institute of Technology, Kolkata, West Bengal, 700107, India
| |
Collapse
|
2
|
Wang F, Yu X, Han Y, Gong C, Yan D, Yang L, Li J, Liu S. Chemotherapy for advanced pulmonary sarcomatoid carcinoma: a population-based propensity score matching study. BMC Pulm Med 2023; 23:262. [PMID: 37454075 DOI: 10.1186/s12890-023-02541-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023] Open
Abstract
OBJECTIVES Pulmonary sarcomatoid carcinoma (PSC) is a rare histological type of non-small cell lung cancer (NSCLC). There are no specific treatment guidelines for PSC. For advanced PSC (stage II-IV), the role of chemotherapy is still controversial. The purpose of this study was to investigate the effect of chemotherapy on the prognosis of advanced PSC. METHODS A total of 960 patients with advanced PSC from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2019 were enrolled in this study. To investigate the prognostic factors, the Cox proportional hazard regression model was conducted. A total of 642 cases were obtained after propensity score matching (PSM). The Kaplan‒Meier method was applied to compare overall survival (OS) and cancer-specific survival (CSS). RESULTS For all 960 cases included in this study, the Cox proportional hazard model was applied for prognostic analysis. Univariate and multivariate analyses showed that stage, T stage, N stage, M stage, surgery, and chemotherapy were prognostic factors for OS and CSS (P < 0.05). A total of 642 cases were obtained after PSM, with no significant difference between the two groups for all variables. Kaplan‒Meier curves indicated that for OS and CSS, the prognosis was significantly better in the chemotherapy group than in the no-chemotherapy group. CONCLUSIONS For advanced PSC, chemotherapy can significantly improve the OS and CSS of patients. Chemotherapy should be an important part of PSC treatment.
Collapse
Affiliation(s)
- Feng Wang
- Beijing Chest Hospital, Capital Medical University, Beijing, 101125, China
- Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101125, China
| | - Xiangyang Yu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer, Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Yi Han
- Beijing Chest Hospital, Capital Medical University, Beijing, 101125, China
- Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101125, China
| | - Changfan Gong
- Beijing Chest Hospital, Capital Medical University, Beijing, 101125, China
- Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101125, China
| | - Dongjie Yan
- Beijing Chest Hospital, Capital Medical University, Beijing, 101125, China
- Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101125, China
| | - Lei Yang
- Beijing Chest Hospital, Capital Medical University, Beijing, 101125, China
- Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101125, China
| | - Jie Li
- Beijing Chest Hospital, Capital Medical University, Beijing, 101125, China.
- Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101125, China.
| | - Shuku Liu
- Beijing Chest Hospital, Capital Medical University, Beijing, 101125, China.
- Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101125, China.
| |
Collapse
|
3
|
Garcia D, Mambetsariev I, Fricke J, Schmolze D, Afkhami M, Mannan R, Kim P, Therese Dingal S, Nguyen B, Babikian R, Fong Y, Salgia R. Complete response to chemoimmunotherapy with bevacizumab in synchronous multiple primary cancers: pulmonary adenocarcinoma and sarcomatoid carcinoma. Cold Spring Harb Mol Case Stud 2023; 9:mcs.a006262. [PMID: 37160318 DOI: 10.1101/mcs.a006262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/09/2023] [Indexed: 05/11/2023] Open
Abstract
A small percentage of patients have multiple synchronous primary cancers at presentation. In the last five years, many regimens associated with immunotherapy and chemotherapy were approved for first-line metastatic non-small-cell lung cancer (NSCLC) and other solid tumors, but the study of immunotherapy when multiple cancers are present in one patient remains incomplete. Next-generation sequencing biomarkers and immunotherapy markers including PD-L1 can be effectively utilized in the diagnosis and treatment plan for multiple synchronous primary cancers. Immune biomarkers and PD-L1 expression warrant individualized treatments in synchronous primary adenocarcinoma and pulmonary sarcomatoid carcinoma. We describe the case of a patient with pulmonary sarcomatoid carcinoma and lung adenocarcinoma, metastatic to brain de novo. The patient achieved a complete response after only three cycles of carboplatin, paclitaxel, bevacizumab, and atezolizumab and remains free of any evidence of disease after 18 mo of maintenance therapy.
Collapse
Affiliation(s)
- Diogo Garcia
- Department of Medical Oncology, City of Hope, Duarte, California 91010, USA
| | - Isa Mambetsariev
- Department of Medical Oncology, City of Hope, Duarte, California 91010, USA
| | - Jeremy Fricke
- Department of Medical Oncology, City of Hope, Duarte, California 91010, USA
| | - Daniel Schmolze
- Department of Pathology, City of Hope, Duarte, California 91010, USA
| | - Michelle Afkhami
- Department of Pathology, City of Hope, Duarte, California 91010, USA
| | - Rifat Mannan
- Department of Pathology, City of Hope, Duarte, California 91010, USA
| | - Pauline Kim
- Department of Ambulatory Pharmacy, City of Hope, Duarte, California 91010, USA
| | | | - Bao Nguyen
- Department of Diagnostic Radiology, City of Hope, Duarte, California 91010, USA
| | - Razmig Babikian
- Department of Medical Oncology, City of Hope, Duarte, California 91010, USA
| | - Yuman Fong
- Department of Surgery, City of Hope, Duarte, California 91010, USA
| | - Ravi Salgia
- Department of Medical Oncology, City of Hope, Duarte, California 91010, USA;
| |
Collapse
|
4
|
Gow CH, Hsieh MS, Chen YL, Liu YN, Wu SG, Shih JY. Survival outcomes and prognostic factors of lung cancer patients with the MET exon 14 skipping mutation: A single-center real-world study. Front Oncol 2023; 13:1113696. [PMID: 36969059 PMCID: PMC10034335 DOI: 10.3389/fonc.2023.1113696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/23/2023] [Indexed: 03/11/2023] Open
Abstract
IntroductionThe MET exon 14 skipping (METex14) mutation is an important oncogenic driver in lung cancer. We performed a retrospective analysis of clinical data from lung cancer patients with the METex14 mutation to analyze their survival outcomes and associated prognostic factors.MethodsA one-step reverse transcription-polymerase chain reaction to examine the presence of the METex14 mutation was performed using RNA samples from 1374 lung cancer patients with no detected EGFR and ALK mutations. Pathological features and immunohistochemistry (IHC) results for c-MET were analyzed in patients with METex14-positive tumors.ResultsMETex14 was identified in 69 patients with lung cancer, including 53 adenocarcinoma (ADC) and 16 non-ADC patients. In comparison with patients without the METex14 mutation, lung cancer patients harboring the METex14 mutation were generally elderly individuals, never-smokers, and had poor performance scores. A higher frequency of METex14 mutations was detected in pulmonary sarcomatoid carcinoma (PSC) patients (24.3%, n = 9/37). However, stage IV PSC patients with or without the METex14 mutations showed similarly poor overall survival (OS) (p = 0.429). For all 36 METex14-positive lung ADCs, multivariate analysis showed several poor prognostic factors, including strong c-MET IHC staining (p = 0.006), initial brain metastasis (p = 0.005), and administration of only supportive care (p < 0.001). After excluding seven patients who received only supportive care, we further analyzed 29 stage IV lung ADC patients with METex14 mutations who received anti-cancer treatment. Multivariate analysis showed that pemetrexed treatment (p = 0.003), lung radiotherapy (p = 0.020), initial brain metastasis (p = 0.005), and strong c-MET IHC staining (p = 0.012) were independent prognostic factors for OS in these patients.ConclusionsA higher frequency of METex14 mutations was detected in PSC patients. Stage IV PSC patients with or without the METex14 mutations had similarly poor overall survival. Pemetrexed-based chemotherapy, strong c-MET ICH staining, initial brain metastasis, and lung radiotherapy, may help predict survival outcomes in patients with advanced lung ADCs harboring the METex14 mutation.
Collapse
Affiliation(s)
- Chien-Hung Gow
- Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Healthcare Information and Management, Ming-Chuan University, Taoyuan, Taiwan
| | - Min-Shu Hsieh
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Lin Chen
- Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Nan Liu
- Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shang-Gin Wu
- Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Cancer Center, National Taiwan University, Taipei, Taiwan
| | - Jin-Yuan Shih
- Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan
- *Correspondence: Jin-Yuan Shih,
| |
Collapse
|
5
|
He J, Ni J, Li G, Yao J, Ni B. Clinicopathological features and prognostic nomogram of giant cell carcinoma of the lung: A population-based study. THE CLINICAL RESPIRATORY JOURNAL 2023; 17:197-210. [PMID: 36718941 PMCID: PMC9978898 DOI: 10.1111/crj.13586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 12/14/2022] [Accepted: 01/09/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND Due to its rarity, the features and prognosis of giant cell carcinoma of the lung (GCCL) are not well defined. The present study aimed to describe the clinicopathological features and prognostic analysis of this rare disease, compare it with lung adenocarcinoma (LAC), further determine the prognostic factors and establish a nomogram. METHODS Patients diagnosed with GCCL and LAC were identified from the SEER database between 2004 and 2016. The features and survival between GCCL and LAC were compared in the unmatched and matched cohorts after propensity score matching (PSM) analysis. Univariate and multivariate Cox analyses were used to identify the prognostic factors, and a nomogram was constructed. Area under the curve (AUC), C-index, calibration curve and decision curve analysis (DCA) were used to confirm the established nomogram. RESULTS A total of 295 patient diagnosed with GCCL and 149 082 patients with LAC were identified. Compared with LAC, patients with GCCL tend to be younger, male, black and have pathological Grade III/IV GCCL, more proportion of AJCC-TNM-IV, T3/T4 and distant metastases. The 1-, 2- and 5-year OS rates of the patients with GCCL were 21.7%, 13.4% and 7.9%, respectively. The median OS and CSS were 3 and 4 months, respectively. Patients with GCCL had significantly shorter OS and CSS than those with LAC in the unmatched and matched cohorts after PSM. Multivariate Cox analysis demonstrated that T, N and M stages and use of chemotherapy and surgery were independent of survival. Furthermore, we constructed a prognostic nomogram for OS and CSS by using independent prognostic factors. The C-index of OS-specific nomogram is 0.78 (0.74-0.81), and the C-index of CSS-specific nomogram is 0.77 (0.73-0.80). The calibration curve and ROC analysis showed good predictive capability of these nomograms. DCA showed that the nomogram had greater clinical practical value in predicting the OS and CSS of GCCL than TNM staging. CONCLUSION GCCL have distinct clinicopathological characteristics and significantly worse clinical outcomes. Prognostic nomograms for overall survival (OS) and CSS were constructed.
Collapse
Affiliation(s)
- Jiang He
- Department of Thoracic SurgeryThe First Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Jin‐Ping Ni
- Suzhou Kowloon HospitalShanghai Jiaotong University School of MedicineSuzhouChina
| | - Guang‐Bin Li
- Department of Thoracic SurgeryThe First Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Jie Yao
- Department of Thoracic SurgeryThe First Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Bin Ni
- Department of Thoracic SurgeryThe First Affiliated Hospital of Soochow UniversitySuzhouChina
| |
Collapse
|
6
|
Liu X, Zheng Y, Mai S, Tong Y, Yang L, Huang M, Cai R. Case report: an initially unresectable stage III pulmonary sarcomatoid carcinoma qith EGFR mutation achieving pathological complete response following neoadjuvant therapy with osimertinib plus chemotherapy. Front Oncol 2022; 12:1033322. [PMID: 36505870 PMCID: PMC9733669 DOI: 10.3389/fonc.2022.1033322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/07/2022] [Indexed: 11/27/2022] Open
Abstract
Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (EGFR-TKIs) provide dramatic response to patients with advanced EGFR-mutant non-small cell lung cancer (NSCLC). However, the use of neoadjuvant therapy with EGFR-TKIs in EGFR-mutant NSCLC remains controversial, especially in pulmonary sarcomatoid carcinoma (PSC). One patient with initially unresectable stage III (cT4N0M0) PSC was found to carry EGFR mutation by the next generation sequencing. After neoadjuvant therapy with osimertinib plus chemotherapy, radical resection of the right upper lung lesion was achieved, and the pathological results reached pathological complete response (pCR). To the best of our knowledge, this is the first report of an EGFR-mutant patient with initially unresectable stage III PSC achieved pCR by neoadjuvant therapy with osimertinib plus chemotherapy. Therefore, neoadjuvant therapy with EGFR-TKIs may be a viable option for EGFR-mutant PSC patients.
Collapse
Affiliation(s)
- Xiguang Liu
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yating Zheng
- Medical Department, 3D Medicines Inc., Shanghai, China
| | - Shijie Mai
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yu Tong
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Lili Yang
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Mengli Huang
- Medical Department, 3D Medicines Inc., Shanghai, China
| | - Ruijun Cai
- Nanfang Hospital, Southern Medical University, Guangzhou, China,*Correspondence: Ruijun Cai,
| |
Collapse
|
7
|
Multimodality Treatment of Pulmonary Sarcomatoid Carcinoma: A Review of Current State of Art. JOURNAL OF ONCOLOGY 2022; 2022:8541157. [PMID: 35368903 PMCID: PMC8975648 DOI: 10.1155/2022/8541157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/11/2022] [Indexed: 01/01/2023]
Abstract
Pulmonary sarcomatoid carcinoma (PSC) is an unconventional non-small-cell lung cancer (NSCLC) that is currently managed under guidelines used for conventional NSCLC and has poor survival. Surgery is the optimal choice for resectable PSC, and the prevalence of mutations in this type of tumor laid the foundation for novel systemic therapies such as targeted therapy and immunotherapy. PSC is resistant to chemotherapy and radiotherapy, and the effects of the 2 therapies are controversial. Targeted therapies have been reported to confer survival benefits, and savolitinib, an oral selective MET tyrosine-kinase inhibitor, has been approved in metastatic patients with MET exon 14 skipping mutations. Expression and positive rate of programmed death ligand 1 in PSC are high; our previous research has also revealed a high mutational burden and a T-cell-inflamed microenvironment of PSC. Correspondingly, immune checkpoint inhibitors have shown preliminary antitumor effects (overall response rates of 40.5% (15/37) and 31.6% (6/19) in two retrospective studies, respectively) in PSC patients. In summary, patients should receive operations at an early stage and multimodality treatments are needed to maximize the benefits of patients with advanced disease.
Collapse
|
8
|
Zheng Y, Fu Y, Zhong Q, Deng R, Zhang Y. The treatment of advanced pulmonary sarcomatoid carcinoma. Future Oncol 2021; 18:727-738. [PMID: 34879738 DOI: 10.2217/fon-2021-1071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Pulmonary sarcomatoid carcinoma (PSC) is a pathological subtype of non-small cell lung cancer. Although the incidence of PSC in lung cancer is very low, it is an aggressive cancer, leading to a poor prognosis. Currently, there is no standard treatment for advanced PSC. Targeted therapy can be used for patients with MET exon 14 mutations and patients with other driver gene mutations may also benefit from treatment. The emergence of immune checkpoint inhibitors also provides potential options for advanced PSC treatment, but more clinical data is needed. Additionally, more research may be warranted to explore the effects of chemotherapy, radiotherapy and antiangiogenic therapy. In this review, the authors summarize the research regarding the treatment of advanced PSC.
Collapse
Affiliation(s)
- Yue Zheng
- Department of Biotherapy, Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041, China
| | - Yang Fu
- Department of Biotherapy, Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041, China
| | - Qin Zhong
- Department of Oncology, The People's Hospital of Guizhou Province, Guiyang 550001, China
| | - Rong Deng
- Department of Oncology, The People's Hospital of Guizhou Province, Guiyang 550001, China
| | - Yu Zhang
- Department of Oncology, The People's Hospital of Guizhou Province, Guiyang 550001, China
| |
Collapse
|
9
|
Otsubo K, Sakai H, Kimura H, Miyazawa T, Marushima H, Kojima K, Furuya N, Mineshita M, Chosokabe M, Koike J, Saji H. Thoracic mesenchymal malignant tumors and programed cell death ligand-1 status: Clinicopathologic and prognostic analysis of eight pulmonary sarcomatoid carcinomas and eight malignant mesotheliomas. Thorac Cancer 2021; 12:3169-3176. [PMID: 34655161 PMCID: PMC8636199 DOI: 10.1111/1759-7714.14177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/14/2021] [Accepted: 09/16/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The current study aimed to evaluate the significance of clinicopathological factors, particularly the immunohistochemistry of programed cell death ligand-1 (PD-L1), in eight cases each of pulmonary sarcomatoid carcinoma (PSC) and malignant pleural mesothelioma (MPM) at our hospital. METHODS From January 2004 to December 2020, a total of 16 consecutive patients (eight with PSC and eight with MPM diagnosed via surgical resection or biopsy) were included in this study. After retrospectively reviewing the patient characteristics, the associations between PD-L1 status and age, sex, stage, histological type, and prognosis were investigated. RESULTS PD-L1-positive staining was observed in four (50%) PSC cases and one (12.5%) MPM case. Among the four PD-L1-positive PSC cases, two showed high PD-L1 expression in the vimentin-positive sarcomatoid compartment. Moreover, among those with PSC, two survived for about 10 years, whereas the others died within 5 years. No clear correlation was found between PD-L1 expression and prognosis. Among the patients with MPM, four survived for more than 2 years, with the longest being 9 years. Among MPM cases who received nivolumab, one patient with positive PD-L1 staining in the sarcomatoid survived, whereas the other with negative PD-L1 staining did not. CONCLUSION The present study showed that sarcomatoid carcinoma had a higher PD-L1 expression compared to non-small-cell lung cancer and that both PSC and MPM tended to exhibit PD-L1 positivity in the sarcomatoid compartment. Moreover, while immune checkpoint inhibitors may somewhat prolong the prognosis of both tumors, further studies with a larger cohort are necessary to confirm our results.
Collapse
Affiliation(s)
- Kanji Otsubo
- Departments of Chest SurgerySt. Marianna University School of MedicineKawasakiJapan
| | - Hiroki Sakai
- Departments of Chest SurgerySt. Marianna University School of MedicineKawasakiJapan
| | - Hiroyuki Kimura
- Departments of Chest SurgerySt. Marianna University School of MedicineKawasakiJapan
| | - Tomoyuki Miyazawa
- Departments of Chest SurgerySt. Marianna University School of MedicineKawasakiJapan
| | - Hideki Marushima
- Departments of Chest SurgerySt. Marianna University School of MedicineKawasakiJapan
| | - Koji Kojima
- Departments of Chest SurgerySt. Marianna University School of MedicineKawasakiJapan
| | - Naoki Furuya
- Division of Respiratory Medicine, Department of Internal MedicineSt. Marianna University School of MedicineKawasakiJapan
| | - Masamichi Mineshita
- Division of Respiratory Medicine, Department of Internal MedicineSt. Marianna University School of MedicineKawasakiJapan
| | - Motohiro Chosokabe
- Department of PathologySt. Marianna University School of MedicineKawasakiJapan
| | - Junki Koike
- Department of PathologySt. Marianna University School of MedicineKawasakiJapan
| | - Hisashi Saji
- Departments of Chest SurgerySt. Marianna University School of MedicineKawasakiJapan
| |
Collapse
|
10
|
Multicenter phase II trial of nintedanib plus docetaxel in second-line treatment in advanced non-squamous non-small cell lung cancer patients refractory to first-line platin-based chemotherapy (REFRACT GFPC 02-15 study). Lung Cancer 2021; 161:122-127. [PMID: 34583220 DOI: 10.1016/j.lungcan.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/02/2021] [Accepted: 09/14/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Advanced non-squamous non-small cell lung cancer (NsqNSCLC) progressing at the induction of a first-line of platin-based chemotherapy is a subgroup of patients with poor prognosis and few second-line treatment options. MATERIALS AND METHODS This single-stage phase II prospective multicenter open-label trial performed in platin-based refractory (i.e. progressing during induction phase of first-line platin-based chemotherapy) advanced NsqNSCLC assessed the efficacy of the nintedanib-docetaxel combination in second-line treatment. The primary endpoint was progression-free survival (PFS) rates at 12 weeks with a cut-off at 30% for ineffectiveness and 50% for minimal efficacy. RESULTS A total of 59 patients from 23 centers were included (mean age, 58.5 years; male gender, 73.6%; performance status 0-1, 100%; former/current smokers, 92.5%; adenocarcinoma, 92.5%, median platin-based first-line chemotherapy, 2). Nintedanib-docetaxel combination was administered for a median of 4 cycles. The rate of PFS at 12 weeks was 39.6% (95% CI, 28.2-56.8). Median PFS was 2.7 (95% CI, 1.4-4.1) months and one-year PFS was 11.8% (95% CI, 4.8-22.2). Median overall survival (OS) was 6.9 (95% CI, 4.3-8.2) months and 12-month OS was 32.1% (95% CI, 19.8-45.0); 18-month OS was 27.6% (95% CI, 16,1-40.4). Twenty-nine (53.7%) patients reported at least one serious treatment-related adverse events leading to permanent discontinuation of at least one study drug in 12 (22.2%) patients. CONCLUSION The predefined minimal efficacy was not demonstrated. However, a number of NsqNSCLC patients refractory to first-line platin-based chemotherapy appeared to benefit from this combination.
Collapse
|
11
|
Chen M, Yang Q, Xu Z, Luo B, Li F, Yu Y, Sun J. Survival Analysis and Prediction Model for Pulmonary Sarcomatoid Carcinoma Based on SEER Database. Front Oncol 2021; 11:630885. [PMID: 34136380 PMCID: PMC8201495 DOI: 10.3389/fonc.2021.630885] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 05/11/2021] [Indexed: 02/05/2023] Open
Abstract
Objective This study aimed to investigate the incidence of the pulmonary sarcomatoid carcinoma (PSC), to compare the clinical characteristics and overall survival (OS) of patients with PSC and those with other non-small-cell lung cancer (oNSCLC), so as to analyze the factors affecting the OS of patients with PSC and construct a nomogram prediction model. Methods Data of patients with PSC and those with oNSCLC diagnosed between 2004 and 2015 from the Surveillance, Epidemiology, and End Results database were collected. The age-adjusted incidence of PSC was calculated. The characteristics of patients with PSC and those with oNSCLC were compared, then the patients were matched 1:2 for further survival analysis. Patients with PSC were randomly divided into training set and testing set with a ratio of 7:3. The Cox proportional hazards model was used to identify the covariates associated with the OS. Significant covariates were used to construct the nomogram, and the C-index was calculated to measure the discrimination ability. The accuracy of the nomogram was compared with the tumor–node–metastasis (TNM) clinical stage, and the corresponding area under the curve was achieved. Results A total of 1049 patients with PSC were enrolled, the incidence of PSC was slowly decreased from 0.120/100,000 in 2004 to 0.092/100,000 in 2015. Before PSM, 793 PSC patients and 191356 oNSCLC patients were identified, the proportion of male, younger patients (<65 years), grade IV, TNM clinical stage IV was higher in the PSC. The patients with PSC had significantly poorer OS compared with those with oNSCLC. After PSM, PSC still had an extremely inferior prognosis. Age, sex, TNM clinical stage, chemotherapy, radiotherapy, and surgery were independent factors for OS. Next, a nomogram was established based on these factors, and the C-indexs were 0.775 and 0.790 for the training and testing set, respectively. Moreover, the nomogram model indicated a more comprehensive and accurate prediction than the TNM clinical stage. Conclusions The incidence of PSC was slowly decreased. PSC had a significantly poor prognosis compared with oNSCLC. The nomogram constructed in this study accurately predicted the prognosis of PSC, performed better than the TNM clinical stage.
Collapse
Affiliation(s)
- Mingjing Chen
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, China.,Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiao Yang
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, China.,Department of Ultrasound, The 941st Hospital of the PLA Joint Logistic Support Force, Xining, China
| | - Zihan Xu
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, China.,Lung Cancer Center, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Bangyu Luo
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Feng Li
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Yongxin Yu
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Jianguo Sun
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, China
| |
Collapse
|
12
|
Abdallah HM, Martinez-Meehan D, Lutfi W, Dhupar R, Grenda T, Schuchert MJ, Christie NA, Luketich JD, Okusanya OT. Adjuvant chemotherapy for pulmonary sarcomatoid carcinoma: A retrospective analysis of the National Cancer Database. J Thorac Cardiovasc Surg 2021; 163:1669-1681.e3. [PMID: 33678508 DOI: 10.1016/j.jtcvs.2021.01.081] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 01/15/2021] [Accepted: 01/21/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Pulmonary sarcomatoid carcinoma (PSC) is a rarely occurring variant of non-small cell lung cancer with sarcoma-like features. Compared with traditional non-small cell lung cancer, PSC patients typically present later and have poorer prognoses, irrespective of stage. The standard of care is resection, but guidelines for the use of adjuvant chemotherapy have not been established. To advance the development of evidence-based management algorithms for PSC after resection, a statistical analysis on a nationwide representative sample of patients was performed. METHODS A retrospective cohort study was performed by querying the National Cancer Database for patients with a diagnosis of PSC between 2004 and 2015. Patients who received complete anatomical resection with or without adjuvant chemotherapy were included. Multivariable regression was used to detect factors associated with the receipt of adjuvant chemotherapy. Multivariable Cox regression of overall survival and Kaplan-Meier survival analysis on propensity-matched groups was conducted to study the association between adjuvant chemotherapy and prognosis. RESULTS We included 1497 patients with PSC in the final analysis. Factors associated with receiving adjuvant chemotherapy were age, histology, and receipt of adjuvant radiation. The results of multivariable Cox analysis and Kaplan-Meier analysis on propensity matched groups yielded similar trends: adjuvant chemotherapy was associated with improved 5-year overall survival for stage II and III disease, but not for stage I disease. CONCLUSIONS Multiple factors are associated with receipt of adjuvant chemotherapy for PSC, and this treatment appears to be associated with improved survival in stage II and stage III, but not stage I patients.
Collapse
Affiliation(s)
| | | | - Waseem Lutfi
- Department of Surgery, Penn Medicine, Philadelphia, Pa
| | - Rajeev Dhupar
- Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pa; Surgical Services Division, VA Pittsburgh Healthcare System, Pittsburgh, Pa
| | - Tyler Grenda
- Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pa
| | - Matthew J Schuchert
- Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pa
| | - Neil A Christie
- Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pa
| | - James D Luketich
- Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pa
| | - Olugbenga T Okusanya
- Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pa.
| |
Collapse
|
13
|
Lefebvre C, Martin E, Hendriks LEL, Veillon R, Puisset F, Mezquita L, Ferrara R, Sabatier M, Filleron T, Dingemans AMC, Besse B, Raherisson C, Mazières J. Immune checkpoint inhibitors versus second line chemotherapy for patients with lung cancer refractory to first line chemotherapy. Respir Med Res 2020; 78:100788. [PMID: 32980653 DOI: 10.1016/j.resmer.2020.100788] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 05/17/2020] [Accepted: 08/20/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Anti Programmed Death-ligand (PD1/PD-L1) directed immune-checkpoint-inhibitors (ICI) are widely used to treat patients with advanced non-small cell lung cancer (NSCLC) who progress after first line chemotherapy. The best strategy after early progression under first line has not been specifically studied. PATIENTS AND METHODS We conducted a multicenter, retrospective study including all consecutive NSCLC patients progressing within the first 3 months following introduction of first-line chemotherapy and being treated with second line ICI monotherapy or chemotherapy between March 2010 and November 2017. We analysed the clinicopathological data and outcome under second line chemotherapy vs. second line ICI: objective response rate (ORR), progression-free survival (PFS), overall survival (OS. RESULTS We identified 176 patients with refractory disease, 99 who received subsequent immunotherapy and 77 undergoing chemotherapy. The 2 populations were comparable regarding the main prognostic criteria, median age was 60, main histology was adenocarcimoma (68.2%). PFS was not significantly different between both treatments 1.9 [1.8-2.1] versus 1.6 month [1.4-2.0] (P=0.125). Compared to chemotherapy, ICI treated patients had a superior OS (P=0.03) (Median [95% CI] OS 4.6 [2.8-6.7] versus 4.2 months [3.4-5.9] and a non-significant improvement in ORR (17.2% versus 7.9%, respectively, P=0.072). Poor performance status (ECOG PS≥2) and a higher number of metastatic sites (≥3) were associated with poorer prognosis. KRAS-mutated patients did not seem to benefit more from ICI than chemotherapy. CONCLUSIONS ICI appears to be the preferred second-line treatment for patients who are refractory to first line chemotherapy.
Collapse
Affiliation(s)
- C Lefebvre
- Department of Pneumology, University Hospital of Bordeaux, 33604 Pessac, France
| | - E Martin
- Biostatistics Unit, Institut Claudius Regaud, IUCT-O, Toulouse, France
| | - L E L Hendriks
- Department of Pulmonology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - R Veillon
- Department of Pneumology, University Hospital of Bordeaux, 33604 Pessac, France
| | - F Puisset
- Pharmacy department IUCT (Institut Universitaire du Cancer) Oncopole, Institut Claudius-Regaud, Toulouse, France
| | - L Mezquita
- Institut d'Oncologie Thoracique, Institut Gustave Roussy, Villejuif, France
| | - R Ferrara
- Institut d'Oncologie Thoracique, Institut Gustave Roussy, Villejuif, France
| | - M Sabatier
- Pharmacy department IUCT (Institut Universitaire du Cancer) Oncopole, Institut Claudius-Regaud, Toulouse, France
| | - T Filleron
- Biostatistics Unit, Institut Claudius Regaud, IUCT-O, Toulouse, France
| | - A-M C Dingemans
- Department of Pulmonology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - B Besse
- Institut d'Oncologie Thoracique, Institut Gustave Roussy, Villejuif, France
| | - C Raherisson
- Department of Pneumology, University Hospital of Bordeaux, 33604 Pessac, France
| | - J Mazières
- Pulmonology Department, Toulouse University Hospital, Université Paul Sabatier, Toulouse, France.
| |
Collapse
|
14
|
Wang M, Liu Y, Qian X, Li D, You H, Wei N, Tang Y. Giant cell carcinoma of the lung presenting as an isolated cyst containing air: A case report. Medicine (Baltimore) 2019; 98:e15689. [PMID: 31096508 PMCID: PMC6531044 DOI: 10.1097/md.0000000000015689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Pulmonary sarcomatoid carcinomas (PSCs) are rare tumors within the sarcomatoid carcinoma group. Giant cell carcinoma of the lung (GCCL) is a rare type of PSCs that consists entirely of highly pleomorphic tumor giant cells; the prognosis is poor. PATIENT CONCERNS A patient presented with a single cyst and was diagnosed with GCCL. The patient was a 59-year-old male who was admitted to the hospital with a cough. A chest computerized tomography (CT) scan showed a single, thin-walled cyst containing air in the left upper lobe of the lung. Bronchoscopy revealed chronic bronchitis. The initial diagnosis was pulmonary infection and the patient was treated with antibiotics. The cyst wall increased in thickness, and the cyst eventually formed a cavity. DIAGNOSIS Surgery was performed, and a diagnosis of GCCL was established. The stage was pT1bN1M0 (equal to stage IIB). INTERVENTIONS The patient underwent video-assisted thoracoscopic surgery and 4 cycles of adjuvant chemotherapy consisting of cisplatin and docetaxel. After 9 months, the patient occurred mediastinal lymph node metastasis, and received radiotherapy (60Gy/30F). OUTCOMES His prognosis was good without progression (complete response) based on serial CT scans over 9 months of follow-up evaluations, then the patient occurred mediastinal lymph node metastasis. The patient lived during 30 months of follow-up, after which he was lost to follow-up. CONCLUSION A solitary pulmonary parenchymal cystic lesion usually suggests an infectious disease or congenital abnormality; however, a cystic lesion is occasionally encountered in GCCL.
Collapse
Affiliation(s)
- Meifang Wang
- Department of Pulmonary and Critical Care Medicine
| | - Yuquan Liu
- Department of Pulmonary and Critical Care Medicine
| | - Xin Qian
- Department of Pulmonary and Critical Care Medicine
| | - Dan Li
- Department of Pathology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
| | - Hui You
- Department of Pulmonary and Critical Care Medicine
| | - Na Wei
- Department of Pulmonary and Critical Care Medicine
| | - Yijun Tang
- Department of Pulmonary and Critical Care Medicine
| |
Collapse
|
15
|
Hendriksen BS, Hollenbeak CS, Reed MF, Taylor MD. Perioperative chemotherapy is not associated with improved survival in stage I pleomorphic lung cancer. J Thorac Cardiovasc Surg 2019; 158:581-591.e11. [PMID: 31122617 DOI: 10.1016/j.jtcvs.2019.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 03/14/2019] [Accepted: 04/07/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Pulmonary pleomorphic carcinoma represents an understudied, rare, and aggressive histologic subtype of non-small cell lung cancer. Better understanding of rare disease subtypes allows for improved individualization of patient care. This study aimed to evaluate current trends in treatment and survival of pleomorphic carcinoma. METHODS The National Cancer Database was used to identify patients with staged, pleomorphic carcinoma and adenocarcinoma between 2004 and 2015. Patient characteristics and treatments were compared using χ2 tests. Cox proportional hazard models examined survival by stage after controlling for confounders. Propensity score matched Kaplan-Meier curves estimated survivor functions stratified by stage. Differences in survival following treatment for stage I pleomorphic carcinoma with surgery alone versus surgery plus chemotherapy were compared with Cox proportional hazard models and Kaplan-Meier survival curves. RESULTS One thousand four hundred eight patients with pleomorphic carcinoma and 607,561 patients with adenocarcinoma were identified. Pleomorphic carcinoma accounted for 0.1% of all non-small cell lung cancers. Pleomorphic disease had poorer overall 5-year survival compared with adenocarcinoma for stages I through IV (49.4% vs 59.1%, 34.5% vs 43.8%, 16.9% vs 28.4%, and 5.7% vs 7.8%, respectively; P < .0047 for all). Perioperative chemotherapy was used more frequently for pleomorphic disease (17.5% vs 6.1%; P < .001). For stage I pleomorphic cancer, treatment with surgery alone (n = 253) and surgery with chemotherapy (n = 57) had overall 5-year survival rates of 55.2% and 53.7%, respectively, and were not significantly different (P = .2868). CONCLUSIONS Pulmonary pleomorphic carcinoma is rare and aggressive, with worse survival when compared with adenocarcinoma. Perioperative chemotherapy has not demonstrated significant survival benefits in stage I pleomorphic cancer.
Collapse
Affiliation(s)
- Brandon S Hendriksen
- Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, Pa.
| | - Christopher S Hollenbeak
- Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, Pa; Department of Health Policy and Administration, The Pennsylvania State University, University Park, Pa; Department of Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey, Pa
| | - Michael F Reed
- Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, Pa
| | - Matthew D Taylor
- Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, Pa
| |
Collapse
|
16
|
Weng SS, Cao Y, Tang XJ, Zhu LZ, Tan YN, Dong CX, Chen JQ, Shen H, Yuan Y. Epidemiological features of lung giant cell carcinoma and therapy for patients with EGFR mutations based on case reports and the surveillance, epidemiology, and end results (SEER) database. Oncotarget 2018; 8:25323-25333. [PMID: 28445978 PMCID: PMC5421933 DOI: 10.18632/oncotarget.15831] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 02/06/2017] [Indexed: 12/20/2022] Open
Abstract
Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are the standard first line treatment for advanced non-small cell lung cancer (NSCLC) with sensitive EGFR mutations. Among NSCLC, giant cell carcinoma of the lung (GCCL) is a rare pathological subtype with poor prognosis, with no confirmed evidence about its epidemiological features or therapeutic efficiency of EGFR-TKIs. We present two advanced GCCLs with sensitive EGFR mutations, also collected the cases of GCCL from our hospital and the Surveillance, Epidemiology, and End Results (SEER) program. Kaplan-Meier methods and Cox proportional hazards modeling were used to perform the survival analyses. Both two cases of advanced GCCL with sensitive EGFR mutations benefited from EGFR-TKIs. Twelve GCCLs were recorded in our hospital from May 2006 to July 2015. GCCL is associated with males (83.3%) and smoking status (63.6%). The EGFR mutation rate was 40.0%. In SEER database, the total number of GCCLs was 184, 0.11% for all NSCLCs. In Kaplan-Meier analysis, the 5-year overall survival of GCCL patients was significantly lower than that of non-GCC NSCLC (16% and 19%; P<0.001), and it was confirmed in multivariate analysis. Further survival analyses indicated that male were more susceptible to GCCL and GCCL was prone to metastasize. Only age and M stage were independent prognostic factors for GCCL in the multivariate analysis. In conclusion, GCCL was an unfavorable prognostic factor and associated with males and metastasis. GCCL patients with sensitive EGFR mutations may also benefit from EGFR-TKI, we therefore recommend the evaluation of EGFR in the treatment of advanced GCCL.
Collapse
Affiliation(s)
- Shan-Shan Weng
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Ying Cao
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Xiu-Jun Tang
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Li-Zhen Zhu
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Yi-Nuo Tan
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Cai-Xia Dong
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Jia-Qi Chen
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Hong Shen
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Ying Yuan
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| |
Collapse
|
17
|
Molecular classification of pulmonary sarcomatoid carcinomas suggests new therapeutic opportunities. Ann Oncol 2017; 28:1597-1604. [DOI: 10.1093/annonc/mdx162] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Indexed: 01/10/2023] Open
|
18
|
Mansfield AS, Roden AC, Boland JM. Towards a Molecular Classification of Pulmonary Sarcomatoid Carcinomas. J Thorac Oncol 2017; 12:910-912. [DOI: 10.1016/j.jtho.2017.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 04/20/2017] [Indexed: 12/25/2022]
|
19
|
Teramoto K, Ozaki Y, Hanaoka J, Sawai S, Tezuka N, Fujino S, Daigo Y, Kontani K. Predictive biomarkers and effectiveness of MUC1-targeted dendritic-cell-based vaccine in patients with refractory non-small cell lung cancer. Ther Adv Med Oncol 2017; 9:147-157. [PMID: 28344660 PMCID: PMC5349424 DOI: 10.1177/1758834016678375] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The dendritic cell (DC)-based vaccine targeting the highly immunogenic tumor antigen, MUC1, has been promising for a cancer immunotherapy; however, predictive biomarkers for beneficial clinical responses of the vaccine remain to be determined. METHODS DCs loaded with MUC1-derived peptide were subcutaneously administered to patients with MUC1-positive non-small cell lung cancer (NSCLC) that was refractory to standard anticancer therapies, every 2 weeks. The effectiveness and tolerability of the vaccine were evaluated, and predictive biomarkers of clinical responses were explored. RESULTS Between August 2005 and May 2015, 40 patients received the vaccines. The median survival time (MST) after the initial vaccination was 7.4 months, and the 1-year survival rate was 25.0%. The MST for patients who received more than six vaccinations was 9.5 months, and the 1-year survival rate was 39.3%. In this cohort, patients who experienced immune-related adverse events, including skin reactions at the vaccination site and fever, had significantly longer survival times compared with patients without those immune-related adverse events (12.6 versus 6.7 months, p = 0.042). Longer survival times were also observed in patients whose peripheral white blood cells contained >20.0% lymphocytes (12.6 versus 4.5 months; p = 0.014). MUC1-specific cytotoxic immune responses were achieved in all of seven patients analyzed who received six vaccinations. CONCLUSION The MUC1-targeted DC-based vaccine induced an antitumor immune response that promoted prolonged survival of patients with refractory NSCLC. The occurrence of immune-related adverse events and having a higher percentage of peripheral lymphocytes were predictive biomarkers of a beneficial clinical response during cancer immunotherapy for NSCLC.
Collapse
Affiliation(s)
- Koji Teramoto
- Department of Medical Oncology and Surgery, Shiga University of Medical Science, Seta-Tsukinowa, Otsu, Shiga 520-2192, Japan
| | - Yoshitomo Ozaki
- Department of Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Jun Hanaoka
- Department of Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Satoru Sawai
- Departments of Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Noriaki Tezuka
- Department of Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Shozo Fujino
- Department of Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Yataro Daigo
- Department of Medical Oncology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Keiichi Kontani
- Department of Respiratory, Breast and Endocrine Surgery, Kagawa University Faculty of Medicine, Kita-gun, Kagawa, Japan
| |
Collapse
|
20
|
High co-expression of PD-L1 and HIF-1α correlates with tumour necrosis in pulmonary pleomorphic carcinoma. Eur J Cancer 2016; 60:125-35. [DOI: 10.1016/j.ejca.2016.03.012] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 03/09/2016] [Accepted: 03/10/2016] [Indexed: 01/01/2023]
|
21
|
Vieira T, Antoine M, Hamard C, Fallet V, Duruisseaux M, Rabbe N, Rodenas A, Cadranel J, Wislez M. Sarcomatoid lung carcinomas show high levels of programmed death ligand-1 (PD-L1) and strong immune-cell infiltration by TCD3 cells and macrophages. Lung Cancer 2016; 98:51-58. [PMID: 27393506 DOI: 10.1016/j.lungcan.2016.05.013] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Revised: 05/03/2016] [Accepted: 05/19/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Pulmonary sarcomatoid carcinomas (SC) are rare tumors, associated with worse prognosis and resistant to platinum-based regimens. Therapies targeting the PD-1/PD-L1 pathway are an emerging treatment for lung cancer. By characterizing intra-tumoral immune infiltration and evaluating PD-L1 expression, it could be possible to predict the efficacy of these new treatments. MATERIALS AND METHODS From 1997 to 2013, data from all patients with SC who underwent lung resection was collected. Tumor-immune infiltration and PD-L1 expression were studied by immunochemistry tests, analyzing CD3 (clone SP7), CD4 (clone 1F6), CD8 (clone C8/144b), CD20 (clone L26), CD163 (clone 10D6), MPO (clone 59A5), and PD-L1 (clone 5H1). Results were compared to those of 54 NSCLC. RESULTS In total, 75 SC were included. Forty (53%) SC expressed PD-L1 vs 11 NSCLC (20%) (p<0.0001). CD3+ tumor-infiltrating lymphocytes and CD163+ tumor-associated macrophages were more important in SC than in NSCLC (median 23% [17-30] of tumoral surface vs 17% [7-27], p=0.011 and 23% [17-30] vs 20% [13-23], p=0.002, respectively). In SC, the presence of Kirsten Ras (KRAS) mutations, blood vessel invasion, and TTF1+ positivity were associated with PDL1 expression. On multivariate analysis, only CD163+ macrophages and blood-vessel invasion were associated with tumoral PD-L1 expression. High levels of tumor-infiltrating lymphocytes (CD3+ or CD4+ and not CD8+) constituted a factor of good prognosis on survival. Interestingly, PD-L1 expression distinguishes subpopulations within tumor-infiltrating lymphocytes (CD3+ or CD4+) with different prognosis CONCLUSIONS PD-L1 expression was higher in SC than in NSCLC as well as immune-cell infiltration by TCD3 cells and macrophages. This suggests that targeting the PD-1/PD-L1 pathway could represent a new potential therapy.
Collapse
Affiliation(s)
- Thibault Vieira
- Sorbonne Universités, UPMC Univ. Paris 06, GRC n°04, Theranoscan, F-75252 Paris, France; AP-HP, Hôpital Tenon, service de Pneumologie, F-75970 Paris, France
| | - Martine Antoine
- Sorbonne Universités, UPMC Univ. Paris 06, GRC n°04, Theranoscan, F-75252 Paris, France; AP-HP, Hôpital Tenon, service d'anatomopathologie, F-75970 Paris, France
| | - Cécile Hamard
- Sorbonne Universités, UPMC Univ. Paris 06, GRC n°04, Theranoscan, F-75252 Paris, France; AP-HP, Hôpital Tenon, service de Pneumologie, F-75970 Paris, France
| | - Vincent Fallet
- Sorbonne Universités, UPMC Univ. Paris 06, GRC n°04, Theranoscan, F-75252 Paris, France; AP-HP, Hôpital Tenon, service de Pneumologie, F-75970 Paris, France
| | - Michael Duruisseaux
- Sorbonne Universités, UPMC Univ. Paris 06, GRC n°04, Theranoscan, F-75252 Paris, France
| | - Nathalie Rabbe
- Sorbonne Universités, UPMC Univ. Paris 06, GRC n°04, Theranoscan, F-75252 Paris, France
| | - Anita Rodenas
- AP-HP, Hôpital Tenon, service d'anatomopathologie, F-75970 Paris, France
| | - Jacques Cadranel
- Sorbonne Universités, UPMC Univ. Paris 06, GRC n°04, Theranoscan, F-75252 Paris, France; AP-HP, Hôpital Tenon, service de Pneumologie, F-75970 Paris, France
| | - Marie Wislez
- Sorbonne Universités, UPMC Univ. Paris 06, GRC n°04, Theranoscan, F-75252 Paris, France; AP-HP, Hôpital Tenon, service de Pneumologie, F-75970 Paris, France.
| |
Collapse
|
22
|
Wislez M, Domblides C, Cortot A, Lemoine A. Mutations at the splice sites of exon 14 of MET gene: a new target for sarcomatoid carcinomas? ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:96. [PMID: 27047955 DOI: 10.21037/atm.2016.01.12] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Marie Wislez
- 1 Pulmonary Medicine Unit, AP-HP, Hôpital Tenon, Paris, France ; 2 GRC n°04, Theranoscan, Sorbonne Universités, UPMC Université de Paris 06, Paris, France ; 3 Pulmonary Medicine Unit, Hôpital Calmette, Lille, France ; 4 Department of Biochemistry and Oncogenetics, AP-HP, Hôpital Paul Brousse, Université Paris-Sud, Paris, France
| | - Charlotte Domblides
- 1 Pulmonary Medicine Unit, AP-HP, Hôpital Tenon, Paris, France ; 2 GRC n°04, Theranoscan, Sorbonne Universités, UPMC Université de Paris 06, Paris, France ; 3 Pulmonary Medicine Unit, Hôpital Calmette, Lille, France ; 4 Department of Biochemistry and Oncogenetics, AP-HP, Hôpital Paul Brousse, Université Paris-Sud, Paris, France
| | - Alexis Cortot
- 1 Pulmonary Medicine Unit, AP-HP, Hôpital Tenon, Paris, France ; 2 GRC n°04, Theranoscan, Sorbonne Universités, UPMC Université de Paris 06, Paris, France ; 3 Pulmonary Medicine Unit, Hôpital Calmette, Lille, France ; 4 Department of Biochemistry and Oncogenetics, AP-HP, Hôpital Paul Brousse, Université Paris-Sud, Paris, France
| | - Antoinette Lemoine
- 1 Pulmonary Medicine Unit, AP-HP, Hôpital Tenon, Paris, France ; 2 GRC n°04, Theranoscan, Sorbonne Universités, UPMC Université de Paris 06, Paris, France ; 3 Pulmonary Medicine Unit, Hôpital Calmette, Lille, France ; 4 Department of Biochemistry and Oncogenetics, AP-HP, Hôpital Paul Brousse, Université Paris-Sud, Paris, France
| |
Collapse
|
23
|
Sonic Hedgehog Pathway Activation Is Associated With Resistance to Platinum-Based Chemotherapy in Advanced Non-Small-Cell Lung Carcinoma. Clin Lung Cancer 2015; 17:301-8. [PMID: 26762562 DOI: 10.1016/j.cllc.2015.12.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 12/03/2015] [Accepted: 12/09/2015] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Chemoresistance is a major challenge in the treatment of advanced non-small-cell lung cancer (NSCLC). Because the Sonic hedgehog (Shh) pathway is reactivated in NSCLC, we investigated an association between chemoresistance and Shh activation. PATIENTS AND METHODS From a cohort of 178 patients with advanced NSCLC treated with platinum-based chemotherapy as first-line treatment, we selected all surgical tumor samples at diagnosis (n = 36). Shh activation was evaluated through Gli1 and Gli2 expression using immunohistochemistry (quantitative score). In vitro treatment studies with cisplatin or vismodegib (Shh pathway inhibitor), or both, were performed on NSCLC cell lines (H322 and A549) and primary cultures from patients with sarcomatoid carcinoma (n = 4). RESULTS Of the 36 patients, 12 had NSCLC refractory to chemotherapy (R-patients, 33.3%) and 24 had controlled disease (C-patients). Gli1 expression did not differ between the R- and C-patients (P = .35). Gli2 expression was more often positive in the R-patients (41.7% vs. 8.3%; P = .02). Progression-free survival (PFS) and overall survival (OS) in patients with a Gli2-positive score was 2.1 and 8.0 months, respectively, compared with 6.7 and 18.0 months for patients with a Gli2-negative score (P = .03 and P = .002, respectively). On multivariate analysis, the Gli2 score correlated independently with PFS (hazard ratio [HR], 2.64; 95% confidence interval [CI], 1.05-6.63; P = .04) and OS (HR, 4.36; 95% CI, 1.67-11.36; P = .003). The sarcomatoid carcinoma cell lines were more resistant to cisplatin than were the H838 and A549 cell lines. The cisplatin-vismodegib combination displayed a synergistic cytotoxic effect in the most chemoresistant cells in vitro. CONCLUSION The Shh pathway is associated with resistance to platinum-based chemotherapy in NSCLC.
Collapse
|
24
|
Qian Z, Qingshan C, Chun J, Huijun Z, Feng L, Qiang W, Qiang X, Min Z. High expression of TNFSF13 in tumor cells and fibroblasts is associated with poor prognosis in non-small cell lung cancer. Am J Clin Pathol 2014; 141:226-33. [PMID: 24436270 DOI: 10.1309/ajcp4jp8bzomheaw] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES To examine high expression of tumor necrosis factor ligand superfamily member 13 (TNFSF13), which is correlated with several malignancies. METHODS TNFSF13 messenger RNA expression in tumor cells and fibroblasts in a cohort of patients with non-small cell lung cancer (NSCLC) was analyzed by quantitative real-time polymerase chain reaction and immunohistochemistry using a tissue microarray. RESULTS TNFSF13 expression was significantly higher in lung adenocarcinomas compared with squamous cell carcinomas (P = .022). High TNFSF13 expression in NSCLC stroma was related with low differentiation (P = .045) and sex (male > female, P = .005). Cox proportional hazards regression univariate and multivariable analysis revealed TNFSF13 expression in NSCLC tumor cells (P = .007) or fibroblasts (P = .027) as an independent prognostic factor in the 5-year overall survival rate. CONCLUSIONS Our findings indicate TNFSF13 is a prognostic factor in NSCLC and suggest TNFSF13 may be a novel therapeutic target for NSCLC.
Collapse
Affiliation(s)
- Zhao Qian
- Hospital of Integrated Traditional Chinese and Western Medicine of Zhejiang Province, Tuberculosis Diagnosis and Treatment Center of Zhejiang Province, China
| | - Cai Qingshan
- Hospital of Integrated Traditional Chinese and Western Medicine of Zhejiang Province, Tuberculosis Diagnosis and Treatment Center of Zhejiang Province, China
| | - Jin Chun
- Hospital of Integrated Traditional Chinese and Western Medicine of Zhejiang Province, Tuberculosis Diagnosis and Treatment Center of Zhejiang Province, China
| | - Zhu Huijun
- Department of Pathology, Nantong University Affiliated Hospital, Nantong, Jiangsu Province, China
| | - Li Feng
- Hospital of Integrated Traditional Chinese and Western Medicine of Zhejiang Province, Tuberculosis Diagnosis and Treatment Center of Zhejiang Province, China
| | - Wei Qiang
- Hospital of Integrated Traditional Chinese and Western Medicine of Zhejiang Province, Tuberculosis Diagnosis and Treatment Center of Zhejiang Province, China
| | - Xia Qiang
- Hospital of Integrated Traditional Chinese and Western Medicine of Zhejiang Province, Tuberculosis Diagnosis and Treatment Center of Zhejiang Province, China
| | - Zhu Min
- Hospital of Integrated Traditional Chinese and Western Medicine of Zhejiang Province, Tuberculosis Diagnosis and Treatment Center of Zhejiang Province, China
| |
Collapse
|
25
|
Metro G, Chiari R, Bennati C, Cenci M, Ricciuti B, Puma F, Flacco A, Rebonato A, Giannarelli D, Ludovini V, Bellezza G, Ferolla P, Minotti V, Crinò L. Clinical Outcome With Platinum-Based Chemotherapy in Patients With Advanced Nonsquamous EGFR Wild-Type Non–Small-Cell Lung Cancer Segregated According to KRAS Mutation Status. Clin Lung Cancer 2014; 15:86-92. [DOI: 10.1016/j.cllc.2013.08.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 07/23/2013] [Accepted: 08/06/2013] [Indexed: 01/08/2023]
|
26
|
Vieira T, Girard N, Ung M, Monnet I, Cazes A, Bonnette P, Duruisseaux M, Mazieres J, Antoine M, Cadranel J, Wislez M. Efficacy of first-line chemotherapy in patients with advanced lung sarcomatoid carcinoma. J Thorac Oncol 2013; 8:1574-7. [PMID: 24389441 DOI: 10.1097/01.jto.0000437008.00554.90] [Citation(s) in RCA: 138] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Sarcomatoid carcinomas (SCs) are rare tumors that may arise in the lung, accounting for 0.4% of non-small-cell lung cancers; the prognosis is poor. Only few retrospective small-size series have studied the efficacy of chemotherapy (CT) for metastatic SC. METHODS Multicenter study of patients with advanced or metastatic SC who received first-line CT. Clinical characteristics at baseline, response to first-line CT (Response Evaluation Criteria in Solid Tumors version 1.1), progression-free survival (PFS), and overall survival (OS) were retrospectively collected. RESULTS Ninety-seven patients were included. Median age was 62 (54-72) years. The majority of patients were men (70%), white (84%), and smokers (84%). Overall, 73% of patients received first-line platinum-based CT. At first tumor evaluation, 69% of patients experienced progression, 31% had disease control, and 16.5% had partial response. Partial response was observed in 20% of patients receiving platinum-based CT, and in none of those receiving non-platinum-based CT (p = 0.018). Median PFS was 2.0 months (confidence interval [CI] 95%: 1.8-2.3). PFS was not statistically different between patients receiving or not receiving a platinum-based CT. Median OS was 6.3 months (CI 95%: 4.7-7.8). There was a trend toward better OS for patients treated with platinum-based CT (7.0 months [CI 95%: 4.9-9.0] versus 5.3 months [CI 95%: 2.8-7.6]; p = 0.096). In multivariate analysis, disease control at first evaluation (hazard ratio = 0.38 [CI 95%: 0.21-0.59]) and at platinum-based CT (hazard ratio = 0.92 [CI 95%: 0.85-0.99]) was associated with better OS. CONCLUSION SC is associated with poor prognosis and high rate of resistance to conventional first-line CT. New therapeutic strategies are needed, based on better knowledge of the carcinogenesis of SC.
Collapse
Affiliation(s)
- Thibault Vieira
- Departments of *Pneumology and **Pathology, Hospital Tenon, APHP, Paris, France; †Laboratory ER2 et GRC-04 UPMC, Paris, France; ‡Department of Respiratory Medicine, Hospital Louis Pradel, Hospices Civils de Lyon, Lyon, France; §Department of Pneumology, Hospital Larrey, CHU Toulouse, Université de Toulouse III, Toulouse, France; ‖Department of Pneumology, Intercommunal Hospital Center, Créteil, France; ¶Department of Pathology, Hospital Georges Pompidou, APHP, Paris, France; and #Department of Thoracic Surgery, Hospital Foch, Suresnes, France
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
High cofilin-1 levels correlate with cisplatin resistance in lung adenocarcinomas. Tumour Biol 2013; 35:1233-8. [PMID: 24018823 DOI: 10.1007/s13277-013-1164-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 08/29/2013] [Indexed: 12/17/2022] Open
Abstract
High cofilin-1 levels have been shown to be an accurate prognostic biomarker in non-small cell lung cancer (NSCLC) and a predictive factor in drug resistance. Herein we explore the role of cofilin-1 in cis-diamminedichloroplatinum(II) (cisplatin) resistance. We evaluated cofilin-1 levels in intrinsically cisplatin-resistant A549 (ICR-A549) cells and determined the cisplatin toxicity in A549 cells transiently transfected and overexpressing CFL1 plasmid. Moreover, expression levels (activity) of the CFL1 gene network were analyzed in a cisplatin-resistant human lung adenocarcinoma cell panel. ICR-A549 cells, selected by challenging parental cells with 10-fold drug GI50 value, presented a sixfold increase in cisplatin GI50 value and an increased cofilin-1 immunocontent (P < 0.01). In addition, cells transfected with cofilin-1 became more resistant to cisplatin (P < 0.01). High activity of the CFL1 gene network was found in a cisplatin-resistant adenocarcinoma cell panel (P < 0.01). In vitro evidences suggest that cofilin-1 is a biological predictor of cisplatin resistance, supporting new treatment initiatives based on cofilin-1 levels to guide chemotherapeutic interventions in NSCLC patients.
Collapse
|