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Gounant V, Duruisseaux M, Soussi G, Van Hulst S, Bylicki O, Cadranel J, Wislez M, Trédaniel J, Spano JP, Helissey C, Chouaid C, Molinier O, Dhalluin X, Doucet L, Hureaux J, Cazes A, Zalcman G. Does Very Poor Performance Status Systematically Preclude Single Agent Anti-PD-1 Immunotherapy? A Multicenter Study of 35 Consecutive Patients. Cancers (Basel) 2021; 13:cancers13051040. [PMID: 33801285 PMCID: PMC7958129 DOI: 10.3390/cancers13051040] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Immunotherapies prolong survival of metastatic non-small-cell lung cancer patients. However, their efficacy in patients with very poor general condition is unknown. Best supportive care is the standard of care for these patients because chemotherapy is more toxic and less effective than for patients with good general condition. Most patients die within 1 to 4 months of diagnosis. Consecutive metastatic non-small-cell lung cancer patients with very poor general condition receiving compassionate immunotherapy were accrued by 12 French thoracic oncology departments, over 24 months. Tolerance was acceptable. Overall, 20% of patients were alive at 1 year, and 14% at 2 years. We feel that our study results might suggest that some patients with a very poor general condition (namely those without brain metastases or heavy smokers) could derive long-term benefit from immunotherapy as salvage therapy. We initiated such a prospective phase 2 trial based on these results, which is a cause for hope. Abstract Anti-PD-1 antibodies prolong survival of performance status (PS) 0–1 advanced non-small-cell lung cancer (aNSCLC) patients. Their efficacy in PS 3–4 patients is unknown. Conse- cutive PS 3–4 aNSCLC patients receiving compassionate nivolumab were accrued by 12 French thoracic oncology departments, over 24 months. Overall survival (OS) was calculated using the Kaplan-Meier method. Prognostic variables were assessed using Cox proportional hazards models. Overall, 35 PS 3–4 aNSCLC patients (median age 65 years) received a median of 4 nivolumab infusions (interquartile range [IQR], 1–7) as first- (n = 6) or second-line (n = 29) therapy. At a median of 52-month follow-up (95%CI, 41–63), 32 (91%) patients had died. Median progression-free survival was 2.1 months (95%CI, 1.1–3.2). Median OS was 4.4 months (95%CI, 0.5–8.2). Overall, 20% of patients were alive at 1 year, and 14% at 2 years. Treatment-related adverse events occurred in 8/35 patients (23%), mostly of low-grade. After adjustment, brain metastases (HR = 5.2; 95%CI, 9–14.3, p = 0.001) and <20 pack-years (HR = 4.8; 95%CI, 1.7–13.8, p = 0.003) predicted worse survival. PS improvement from 3–4 to 0–1 (n = 9) led to a median 43-month (95%CI, 0–102) OS. Certain patients with very poor general condition could derive long-term benefit from nivolumab salvage therapy.
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Affiliation(s)
- Valérie Gounant
- Department of Thoracic Oncology, Bichat Claude Bernard Hospital, APHP, CIC Inserm 1425, Université de Paris, 75018 Paris, France; (G.S.); (G.Z.)
- Correspondence:
| | - Michael Duruisseaux
- Respiratory Department, Louis Pradel Hospital, Hospices Civils de Lyon, 69002 Lyon, France;
- Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
| | - Ghassen Soussi
- Department of Thoracic Oncology, Bichat Claude Bernard Hospital, APHP, CIC Inserm 1425, Université de Paris, 75018 Paris, France; (G.S.); (G.Z.)
| | - Sylvie Van Hulst
- Department of Pneumology, University Hospital of Nîmes, 30900 Nîmes, France;
| | - Olivier Bylicki
- Respiratory Disease Unit, Hôpital d’Instruction des Armées Sainte-Anne, 83800 Toulon, France;
| | - Jacques Cadranel
- Department of Pneumology and Thoracic Oncology, Tenon Hospital, APHP, GRC Theranoscan and Curamus Sorbonne Université, 75020 Paris, France;
| | - Marie Wislez
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, INSERM, TeamInflammation, Complement, and Cancer, 75006 Paris, France;
- Oncology Thoracic Unit Pulmonology Department, AP-HP, Hôpital Cochin, 75014 Paris, France
| | - Jean Trédaniel
- Groupe Hospitalier Paris Saint-Joseph, Department of Pneumology, Université de Paris, Sorbonne Paris Cité, Unité INSERM UMR-S 1124, 75014 Paris, France;
| | - Jean-Philippe Spano
- Department of Medical Oncology, Pitié-Salpétrière Hospital, APHP, Sorbonne Université, 75013 Paris, France;
| | - Carole Helissey
- Clinical Research Unit, Hôpital d’Instruction des Armées Bégin, 94160 Saint-Mandé, France;
| | - Christos Chouaid
- Department of Pneumology, Centre Hospitalier Intercommunal de Créteil, University Paris–Est Créteil (UPEC), CEpiA (Clinical Epidemiology and Ageing), EA 7376-IMRB, 94000 Créteil, France;
| | - Olivier Molinier
- Department of Pneumology, Centre Hospitalier Le Mans, 72037 Le Mans, France;
| | - Xavier Dhalluin
- Department of Pneumology and Thoracic Oncology, Calmette Hospital, Centre Hospitalier Universitaire de Lille, 59000 Lille, France;
| | - Ludovic Doucet
- Department of Oncology, Saint Louis Hospital, APHP, 75010 Paris, France;
| | - José Hureaux
- Department of Pneumology, Pόle Hippocrate, University Hospital of Angers, 49100 Angers, France;
| | - Aurélie Cazes
- Department of Pathology, Bichat Claude Bernard Hospital, APHP, Université de Paris, 75018 Paris, France;
| | - Gérard Zalcman
- Department of Thoracic Oncology, Bichat Claude Bernard Hospital, APHP, CIC Inserm 1425, Université de Paris, 75018 Paris, France; (G.S.); (G.Z.)
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Shu Y, Weng S, Zheng S. Metronomic chemotherapy in non-small cell lung cancer. Oncol Lett 2020; 20:307. [PMID: 33093916 DOI: 10.3892/ol.2020.12170] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 07/15/2020] [Indexed: 12/17/2022] Open
Abstract
Metronomic chemotherapy (MCT) is defined as the rhythmic chemotherapy of low-dose cytotoxic drugs with short or no drug-free breaks over prolonged periods. MCT affects tumor cells and the tumor microenvironment. Particularly, the low-dose schedule impairs the repair process of endothelial cells, resulting in an anti-angiogenesis effect. By stimulating the immune system to eliminate tumor cells, MCT induces immunological activation. Furthermore, combined with targeted therapy, anti-angiogenic drugs enhance the efficacy of MCT. The present review is an overview of phase I, II and III clinical trials focusing on the efficacy, toxicity and mechanism of MCT in patients with non-small cell lung cancer (NSCLC). Furthermore, the prospects of MCT in NSCLC have been discussed. The present review indicated that MCT is an efficacious treatment for selected patients with NSCLC, with acceptable systemic side effects and economic viability for public health.
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Affiliation(s)
- Yefei Shu
- Department of Medical Oncology, Hangzhou Cancer Hospital, Hangzhou, Zhejiang 310002, P.R. China
| | - Shanshan Weng
- Department of Medical Oncology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Song Zheng
- Department of Medical Oncology, Hangzhou Cancer Hospital, Hangzhou, Zhejiang 310002, P.R. China.,Department of Medical Oncology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310006, P.R. China
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3
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Jonna S, Reuss JE, Kim C, Liu SV. Oral Chemotherapy for Treatment of Lung Cancer. Front Oncol 2020; 10:793. [PMID: 32426292 PMCID: PMC7212352 DOI: 10.3389/fonc.2020.00793] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 04/22/2020] [Indexed: 12/30/2022] Open
Abstract
The global COVID-19 pandemic has disrupted healthcare delivery, particularly for patients with advanced lung cancer. While certain aspects of care can be safely omitted or delayed, systemic therapy plays an important role in survival and quality of life for patients with advanced lung cancer; limiting access to systemic therapy will compromise cancer-related outcomes. This can be at odds with strategies to mitigate risk of COVID-19 exposure, which include reducing hospital and clinic visits. One important strategy is implementation of oral cancer therapies. Many standard regimens require intravenous infusions but there are specific circumstances where an oral agent could be an acceptable alternative. Integrating oral therapeutics can permit patients to receive effective systemic treatment without the exposure risks associated with frequent infusions. Here, we review currently available oral cytotoxic agents with a potential role in the treatment of lung cancer.
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Affiliation(s)
- Sushma Jonna
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States
| | - Joshua E. Reuss
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, United States
| | - Chul Kim
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States
| | - Stephen V. Liu
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States
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Simsek C, Esin E, Yalcin S. Metronomic Chemotherapy: A Systematic Review of the Literature and Clinical Experience. JOURNAL OF ONCOLOGY 2019; 2019:5483791. [PMID: 31015835 PMCID: PMC6446118 DOI: 10.1155/2019/5483791] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 12/24/2018] [Accepted: 02/05/2019] [Indexed: 02/07/2023]
Abstract
Metronomic chemotherapy, continuous and dose-dense administration of chemotherapeutic drugs with lowered doses, is being evaluated for substituting, augmenting, or appending conventional maximum tolerated dose regimens, with preclinical and clinical studies for the past few decades. To date, the principle mechanisms of its action include impeding tumoral angiogenesis and modulation of hosts' immune system, affecting directly tumor cells, their progenitors, and neighboring stromal cells. Its better toxicity profile, lower cost, and easier use are main advantages over conventional therapies. The evidence of metronomic chemotherapy for personalized medicine is growing, starting with unfit elderly patients and also for palliative treatment. The literature reviewed in this article mainly demonstrates that metronomic chemotherapy is advantageous for selected patients and for certain types of malignancies, which make it a promising therapeutic approach for filling in the gaps. More clinical studies are needed to establish a solidified role for metronomic chemotherapy with other treatment models in modern cancer management.
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Affiliation(s)
- Cem Simsek
- Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Ece Esin
- Department of Medical Oncology, A.Y. Ankara Training Hospital, Ankara, Turkey
| | - Suayib Yalcin
- Department of Medical Oncology, Hacettepe University, Ankara, Turkey
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Camerini A, Banna GL, Cinieri S, Pezzuto A, Mencoboni M, Rosetti F, Figueiredo A, Rizzo P, Ricci A, Langenhoven L, Santo A, Addeo A, Amoroso D, Barata F. Metronomic oral vinorelbine for the treatment of advanced non-small cell lung cancer: a multicenter international retrospective analysis. Clin Transl Oncol 2018; 21:790-795. [PMID: 30448956 DOI: 10.1007/s12094-018-1989-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 11/09/2018] [Indexed: 01/14/2023]
Abstract
PURPOSE Metronomic oral vinorelbine (MOV) could be a treatment option for unfit patients with advanced non-small cell lung cancer (NSCLC) based on its safety profile and high patient compliance. METHODS We retrospectively collected data on 270 patients [median age 76 (range 48-92) years, M/F 204/66, PS 0 (27)/1 (110)/≥ 2 (133), median of 3 serious comorbidities] with stage IIIB-IV NSCLC treated with MOV as first (T1) (67%), second (T2) (19%) or subsequent (T3) (14%) line. Schedules consisted of vinorelbine 50 mg (138), 40 mg (68) or 30 mg (64) three times a week continuously. RESULTS Patients received an overall median of 6 (range 1-25) cycles with a total of 1253 cycles delivered. The overall response rate was 17.8% with 46 partial and 2 complete responses and 119 patients (44.1%) experienced stable disease > 12 weeks with an overall disease control rate of 61.9%. Median overall time to progression was 5 (range 1-21) months [T1 7 (1-21), T2 5.5 (1-19) and T3 4 (1-19) months] and median overall survival 9 (range 1-36) months [T1 10 (1-31), T2 8 (1-36) and T3 6.5 (2-29) months]. Treatment was extremely well tolerated with 2% (25/1253) G3/4 toxicity (mainly G3 fatigue and anemia) and no toxic deaths. We observed the longer OS 14 (range 7-36) months in a subset of squamous NSCLC patients receiving immunotherapy after metronomic oral vinorelbine. CONCLUSION We confirmed MOV as an extremely safe treatment in a large real world population of advanced NSCLC with an interesting activity mainly consisting of long-term disease stabilization. We speculate the possibility of a synergistic effect with subsequent immunotherapy.
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Affiliation(s)
- A Camerini
- Medical Oncology, Versilia Hospital - ASL Toscana Nord-Ovest, via Aurelia 335, 55043, Lido di Camaiore, LU, Italy.
| | - G L Banna
- Division of Medical Oncology, Cannizzaro Hospital, via Messina 829, 95126, Catania, Italy
| | - S Cinieri
- Medical Oncology, Perrino Hospital, Strada Statale 7 per Mesagne, 72100, Brindisi, Italy
| | - A Pezzuto
- Department of Cardio-Thoracic-Vascular Science, S. Andrea Hospital, Via di Grottarossa, 1035, 00189, Rome, Italy
| | - M Mencoboni
- Medical Oncology, ASL 3 Genovese, Ospedale Villa Scassi, Corso Onofrio Scassi 1, 16121, Genoa, Italy
| | - F Rosetti
- Medical Oncology, ULSS3 Serenissima, Distretto Mirano-Dolo, Via Pasteur, 30031, Dolo, VE, Italy
| | - A Figueiredo
- Pneumology, Centro Hospitalar e Universitario de Coimbra, Avenida Doutor Bissaya Barreto S/N, Praceta De Mota Pinto, Celas-Coimbra, Portugal
| | - P Rizzo
- Medical Oncology, Perrino Hospital, Strada Statale 7 per Mesagne, 72100, Brindisi, Italy
| | - A Ricci
- Department of Molecular and Clinical Medicine, S. Andrea Hospital, Via di Grottarossa, 1035, 00189, Rome, Italy
| | - L Langenhoven
- Clinical Oncology, Panorama Oncology Centre, 43 Hennie Winterbach St, Panorama, Cape Town, 7500, South Africa
| | - A Santo
- Medical Oncology, University Hospital of Verona, Piazzale Aristide Stefani 1, 37126, Verona, Italy
| | - A Addeo
- Oncology Department, University Hospital Geneva, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland
| | - D Amoroso
- Medical Oncology, Versilia Hospital - ASL Toscana Nord-Ovest, via Aurelia 335, 55043, Lido di Camaiore, LU, Italy
| | - F Barata
- Pneumology, Centro Hospitalar e Universitario de Coimbra, Avenida Doutor Bissaya Barreto S/N, Praceta De Mota Pinto, Celas-Coimbra, Portugal
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Sacco PC, Maione P, Palazzolo G, Gridelli C. Treatment of advanced non-small cell lung cancer in the elderly. Expert Rev Respir Med 2018; 12:783-792. [PMID: 30092728 DOI: 10.1080/17476348.2018.1510322] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Lung cancer is predominantly a disease that affects the elderly; about 30-40% of lung cancers are diagnosed in patients aged 70 or more. The increasing number of elderly patients over the next decades is generating a new social and health problem; despite that, these patients are underrepresented in clinical trials and undertreated in clinical practice. Areas covered: The main difficulty in treating elderly patients is to maximize the therapy benefits while minimizing the treatment risk. Elderly patients show a vulnerable clinical profile due to the higher prevalence of comorbid disease, higher polypharmacy interactions and aged organ dysfunction that increase the risk of mortality and toxicity with cancer treatments compared to younger patients. Expert commentary: The choice to treat or not to treat elderly patients cannot be taken only on the basis of the chronological age. Thus, the clinical approach should be to select patients who are effectively suitable for treatment having a better individual functional reserve and a better life expectancy. Elderly patients are a heterogeneous population and those who are fit to receive cancer treatment can be treated similarly to younger patients.
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Affiliation(s)
- Paola C Sacco
- a Division of Medical Oncology , "S.G.Moscati" Hospital , Avellino , Italy
| | - Paolo Maione
- a Division of Medical Oncology , "S.G.Moscati" Hospital , Avellino , Italy
| | | | - Cesare Gridelli
- a Division of Medical Oncology , "S.G.Moscati" Hospital , Avellino , Italy
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Bilir C, Durak S, Kızılkaya B, Hacıbekiroglu I, Nayır E, Engin H. Efficacy of metronomic vinorelbine in elderly patients with advanced non-small-cell lung cancer and poor performance status. ACTA ACUST UNITED AC 2017; 24:e199-e204. [PMID: 28680287 DOI: 10.3747/co.24.3486] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Metronomic chemotherapy-administration of low-dose chemotherapy-allows for a prolonged treatment duration and minimizes toxicity for unfit patients diagnosed with advanced non-small-cell lung cancer (nsclc). METHODS Oral metronomic vinorelbine at 30 mg thrice weekly was given to 35 chemotherapy-naïve patients who were elderly and vulnerable to toxicity and who had been diagnosed with advanced nsclc. RESULTS Median age in this male-predominant cohort (29:6) was 76 years (range: 65-86 years). Histology was squamous cell carcinoma in 21 patients and adenocarcinoma in 14. There were no complete responses and 9 partial responses, for an overall response rate of 26%. Stable disease was seen in 15 patients (43%), and 11 patients (31%) had progressive disease. The 1-year survival rate was 34%, and the 2-year survival rate was 8%. The survival analysis showed a median progression-free survival duration of 4 months (range: 2-15 months) and an overall survival duration of 7 months (range: 3-24 months). CONCLUSIONS Metronomic vinorelbine had an acceptable efficacy and safety profile in elderly patients with multiple comorbidities who had been diagnosed with advanced nsclc. Metronomic vinorelbine could be a treatment option for elderly patients with poor performance status who are unfit for platinum-based chemotherapy and intravenous single-agent chemotherapy, and who are not candidates for combination modalities.
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Affiliation(s)
- C Bilir
- Department of Medical Oncology, Faculty of Medicine, Sakarya University, Sakarya
| | - S Durak
- Department of Internal Medicine, Faculty of Medicine, Recep Tayyip Erdogan University, Rize
| | - B Kızılkaya
- Department of Internal Medicine, Faculty of Medicine, Recep Tayyip Erdogan University, Rize
| | - I Hacıbekiroglu
- Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne
| | - E Nayır
- Department of Medical Oncology, Necip Fazıl City Hospital, Kahramanmaras; and
| | - H Engin
- Department of Medical Oncology, Faculty of Medicine, Sakarya University, Sakarya
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Biganzoli L, Lichtman S, Michel JP, Papamichael D, Quoix E, Walko C, Aapro M. Oral single-agent chemotherapy in older patients with solid tumours: A position paper from the International Society of Geriatric Oncology (SIOG). Eur J Cancer 2015; 51:2491-500. [DOI: 10.1016/j.ejca.2015.08.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 08/09/2015] [Indexed: 10/23/2022]
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9
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Camerini A, Puccetti C, Donati S, Valsuani C, Petrella MC, Tartarelli G, Puccinelli P, Amoroso D. Metronomic oral vinorelbine as first-line treatment in elderly patients with advanced non-small cell lung cancer: results of a phase II trial (MOVE trial). BMC Cancer 2015; 15:359. [PMID: 25943747 PMCID: PMC4424528 DOI: 10.1186/s12885-015-1354-2] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 04/23/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Metronomic oral vinorelbine could be a safe option for elderly patients with advanced non small cell lung cancer (NSCLC). Metronomic administration of chemotherapy leads to a cytostatic action shifting treatment target from cancer cell to tumor angiogenesis. METHODS 43 chemotherapy naive elderly (≥ 70 yrs) PS 0-2 patients with stage IIIB-IV NSCLC were prospectively recruited. Median age was 80 yrs (M/F 36/7) with predominantly squamous histology. PS distribution was 0-1(16)/2(27) with a median of 3 serious co-morbid illnesses. Study treatment consisted of oral vinorelbine 50mg three times weekly (Monday-Wednesday-Friday) continuously until disease progression, unacceptable toxicity or patient refusal. Primary endpoints were overall response rate (ORR), clinical benefit (CB--disease response plus disease stabilization >12 weeks) and safety. Health-related QoL (HRQoL) was also assessed with FACT-L V4 scoring questionnaire. We conducted an exploratory time-course analysis of VEGF and thrombospondin-1 (TSP1) serum levels in a subgroup of patients. RESULTS Patients received a median of 5 (range 1-21) cycles with a total of 272 cycles delivered. ORR was 18.6% with 7 partial and 1 complete responses; 17/43 experienced stable disease lasting more than 12 weeks leading to an overall CB of 58.1%. Median time to progression was 5 (range 2-21) and median overall survival 9 (range 3-29) months. Treatment was well tolerated with rare serious toxicity. Regardless of severity main toxicities observed were anemia in 44%, fatigue in 32.4%, and diarrhoea 10.5%. FACT-L v4 scores did not significantly vary during treatment. Baseline VEGF levels were lower and showed a rapid increase during treatment in non-responders pts only while TSP1 levels did not change. CONCLUSIONS Metronomic oral vinorelbine is safe in elderly patients with advanced NSCLC with an interesting activity mainly consisting in long-term disease stabilization coupled with an optimal patient compliance (Eudra-CT 2010-018762-23, AIFA OSS on 26 February 2010).
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Affiliation(s)
- Andrea Camerini
- Medical Oncology, Versilia Hospital and Istituto Toscano Tumori, Lido di Camaiore, Italy.
| | - Cheti Puccetti
- Medical Oncology, Versilia Hospital and Istituto Toscano Tumori, Lido di Camaiore, Italy.
| | - Sara Donati
- Medical Oncology, Versilia Hospital and Istituto Toscano Tumori, Lido di Camaiore, Italy.
| | - Chiara Valsuani
- Medical Oncology, Versilia Hospital and Istituto Toscano Tumori, Lido di Camaiore, Italy.
| | | | - Gianna Tartarelli
- Medical Oncology, Versilia Hospital and Istituto Toscano Tumori, Lido di Camaiore, Italy.
| | - Paolo Puccinelli
- Medical Oncology, Versilia Hospital and Istituto Toscano Tumori, Lido di Camaiore, Italy.
| | - Domenico Amoroso
- Medical Oncology, Versilia Hospital and Istituto Toscano Tumori, Lido di Camaiore, Italy.
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Switch maintenance treatment with oral vinorelbine and bevacizumab after induction chemotherapy with cisplatin, gemcitabine and bevacizumab in patients with advanced non-squamous non-small cell lung cancer: a phase II study. Med Oncol 2015; 32:134. [DOI: 10.1007/s12032-015-0587-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 03/14/2015] [Indexed: 10/23/2022]
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Barletta G, Genova C, Rijavec E, Burrafato G, Biello F, Sini C, Dal Bello MG, Coco S, Truini A, Vanni I, Alama A, Beltramini S, Grassi MA, Boccardo F, Grossi F. Oral vinorelbine in the treatment of non-small-cell lung cancer. Expert Opin Pharmacother 2014; 15:1585-99. [PMID: 24972635 DOI: 10.1517/14656566.2014.934224] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Originally formulated as an intravenous (i.v.) agent, vinorelbine is also currently available as an oral chemotherapeutic agent. Oral vinorelbine has demonstrated significant activity in different settings for NSCLC, including adjuvant treatment for resected disease, concurrent chemoradiation for locally advanced NSCLC and palliative chemotherapy for recurrent/metastatic NSCLC, as part of combination schedules or as a single-agent treatment. AREAS COVERED The authors explored the available data describing the use of oral vinorelbine in NSCLC. PubMed articles and abstracts presented at international conferences were analysed, and relevant trials were reported and discussed. Specific settings, including the treatment of elderly and unfit patients and metronomic schedules including oral vinorelbine, were evaluated. Available pharmacoeconomic data were also assessed. EXPERT OPINION Oral vinorelbine is an appealing agent, particularly as part of combination regimens containing platinum derivatives, although it can have a role as a single-agent treatment as well. Its safety profile is generally favourable and its route of administration is generally preferred by patients receiving chemotherapy. Compared to i.v. vinorelbine and other antineoplastic agents, oral vinorelbine has been reported to be advantageous in terms of cost savings.
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Affiliation(s)
- Giulia Barletta
- UOS Tumori Polmonari, IRCCS AOU San Martino - IST Istituto Nazionale per la Ricerca sul Cancro , Genova , Italy
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Jouveshomme S, Canoui-Poitrine F, Le Thuaut A, Bastuji-Garin S. Results of platinum-based chemotherapy in unselected performance status (PS) 2 patients with advanced non-small cell lung cancer: a cohort study. Med Oncol 2013; 30:544. [DOI: 10.1007/s12032-013-0544-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Accepted: 03/15/2013] [Indexed: 01/05/2023]
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LeCaer H, Greillier L, Corre R, Jullian H, Crequit J, Falchero L, Dujon C, Berard H, Vergnenegre A, Chouaid C. A multicenter phase II randomized trial of gemcitabine followed by erlotinib at progression, versus the reverse sequence, in vulnerable elderly patients with advanced non small-cell lung cancer selected with a comprehensive geriatric assessment (the GFPC 0505 study). Lung Cancer 2012; 77:97-103. [DOI: 10.1016/j.lungcan.2012.02.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Revised: 02/03/2012] [Accepted: 02/05/2012] [Indexed: 12/27/2022]
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Zhou J, Gao B. [The status and prospects of treatment protocols for elderly patients with non-small cell lung cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2011; 14:598-605. [PMID: 21762630 PMCID: PMC6000275 DOI: 10.3779/j.issn.1009-3419.2011.07.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
近年来,老年晚期肺癌发病率和死亡率呈明显上升趋势,但老年患者总体接受积极治疗的人数却明显少于非老年患者,同时因受到社会、经济、家庭等医疗以外诸多因素的影响,老年晚期肺癌患者治疗现状不容乐观。现就当前国内外老年非小细胞肺癌患者的治疗现状和趋势作一综述。
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Affiliation(s)
- Jianping Zhou
- Department of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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Zheng H, Tong L, Hu Y, Wu W, Zhang H, Li B. [Prognostic factors in 408 elderly lung cancer patients more than 70 years old]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2011; 14:502-6. [PMID: 21645453 PMCID: PMC5999885 DOI: 10.3779/j.issn.1009-3419.2011.06.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND OBJECTIVE With the aging of the population, the incidence of lung cancer in elderly rises. It showed that the incidence and mortality of lung cancer in people over 70 years were increased in the past 10 years. We defined age 70 as boundary line of the elderly patients in lung cancer. The aim of this study is to analyze the factors of affecting prognosis. METHODS A retrospective study had enrolled 408 cases of lung cancer aged over 70 and SPSS 13.0 software was used in univariate analysis and COX regression analysis to analyze factors affecting prognosis, such as gender, age, complications, symptoms, pathological type, clinical stage, effusion, surgery, radiotherapy, chemotherapy and so on. RESULTS In univariate analysis, symptoms, stage, effusion, surgery, chemotherapy and chemotherapy cycles showed affecting prognosis significantly. In COX regression analysis, it showed that clinical stage (P<0.001), surgery (P=0.013), chemotherapy cycles (P=0.001) were independent prognostic factors. CONCLUSION Elderly lung cancer patients could be benefit from surgery and adjuvant chemotherapy while early stage. At late stage, their survival time may be prolonged when receive chemotherapy at least 4 cycles. Single-agent chemotherapy would be a good choice for elderly lung cancer. Effusion, particularly, pericardial effusion significantly influenced the prognosis, so that it should be effectively controlled.
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Affiliation(s)
- Hua Zheng
- General Department, Beijing Chest Hospital of Capital Medical University, Beijing 101149, China.
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