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Noronha V, Budukh A, Chaturvedi P, Anne S, Punjabi A, Bhaskar M, Sahoo TP, Menon N, Shah M, Batra U, Nathany S, Kumar R, Shetty O, Ghodke TP, Mahajan A, Chakrabarty N, Hait S, Tripathi SC, Chougule A, Chandrani P, Tripathi VK, Jiwnani S, Tibdewal A, Maheshwari G, Kothari R, Patil VM, Bhat RS, Khanderia M, Mahajan V, Prakash R, Sharma S, Jabbar AA, Yadav BK, Uddin AK, Dutt A, Prabhash K. Uniqueness of lung cancer in Southeast Asia. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 27:100430. [PMID: 39157507 PMCID: PMC11328770 DOI: 10.1016/j.lansea.2024.100430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/07/2024] [Accepted: 05/17/2024] [Indexed: 08/20/2024]
Abstract
Lung cancer varies between Caucasians and Asians. There have been differences recorded in the epidemiology, genomics, standard therapies and outcomes, with variations according to the geography and ethnicity which affect the decision for optimal treatment of the patients. To better understand the profile of lung cancer in Southeast Asia, with a focus on India, we have comprehensively reviewed the available data, and discuss the challenges and the way forward. A substantial proportion of patients with lung cancer in Southeast Asia are neversmokers, and adenocarcinoma is the common histopathologic subtype, found in approximately a third of the patients. EGFR mutations are noted in 23-30% of patients, and ALK rearrangements are noted in 5-7%. Therapies are similar to global standards, although access to newer modalities and molecules is a challenge. Collaborative research, political will with various policy changes and patient advocacy are urgently needed.
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Affiliation(s)
- Vanita Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Atul Budukh
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Pankaj Chaturvedi
- Department of Surgical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Srikanth Anne
- Department of Medical Oncology, GSL Medical College, Rajahmundry, Andhra Pradesh, India
| | - Anshu Punjabi
- Department of Pulmonary Medicine, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Maheema Bhaskar
- Department of Pulmonary Medicine, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Tarini P. Sahoo
- Consultant Medical Oncologist, Silverline Hospital, Bhopal, Madhya Pradesh, India
| | - Nandini Menon
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Minit Shah
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Ullas Batra
- Department of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Shrinidhi Nathany
- Molecular Diagnostics Section, Department of Pathology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
| | - Rajiv Kumar
- Department of Pathology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Omshree Shetty
- Department of Pathology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Trupti Pai Ghodke
- Department of Pathology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Abhishek Mahajan
- Department of Imaging, The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK
- Honorary Senior Lecturer, University of Liverpool, UK
| | - Nivedita Chakrabarty
- Department of Radiodiagnosis, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Supriya Hait
- Integrated Cancer Genomics Laboratory, Advanced Centre for Treatment Research Education in Cancer (ACTREC), Tata Memorial Centre, Navi Mumbai, Maharashtra, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | | | - Anuradha Chougule
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Pratik Chandrani
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Virendra Kumar Tripathi
- Department of Surgical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Sabita Jiwnani
- Department of Surgical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Anil Tibdewal
- Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Guncha Maheshwari
- Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Rushabh Kothari
- Consultant Medical Oncologist, Oncowin Cancer Centre, Ahmedabad, India
| | - Vijay M. Patil
- Consultant Medical Oncologist, PD Hinduja Hospital & Medical Research Centre, Khar and Mahim, Mumbai, India
| | - Rajani Surendar Bhat
- Interventional Pulmonology and Palliative Medicine, Sparsh Hospitals, Bangalore, India
| | - Mansi Khanderia
- Department of Medical Oncology, Mazumdar Shaw Cancer Centre, Narayana Health City, Bommasandra, Bangalore, Karnataka, India
| | - Vandana Mahajan
- PG Integrated Counselling, Cancer Counsellor and Palliative Care Coach and Cancer Survivor, India
| | - Ravi Prakash
- British Broadcasting Corporation (BBC), Based in Ranchi, Jharkhand, India
| | - Sanjeev Sharma
- NGO Excellence Program, Patient Advocate, Lung Connect, Mumbai, India
| | | | - Birendra Kumar Yadav
- Department of Clinical Oncology, Purbanchal Cancer Hospital, Birtamode Jhapa State, Koshi, Nepal
| | - A.F.M. Kamal Uddin
- Department of Radiation Oncology, National Institute of Ear Nose and Throat, Dhaka, Bangladesh
| | - Amit Dutt
- Integrated Cancer Genomics Laboratory, Advanced Centre for Treatment Research Education in Cancer (ACTREC), Tata Memorial Centre, Navi Mumbai, Maharashtra, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
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Kumar R, Gothi D, Anand S, Khan S, Malhotra N. Survival among patients with lung cancer managed at a tertiary care center in North India. Monaldi Arch Chest Dis 2024. [PMID: 39077862 DOI: 10.4081/monaldi.2024.3045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 05/24/2024] [Indexed: 07/31/2024] Open
Abstract
Though there has been advancement in the management of lung cancer, it is not well utilized due to its limited availability and high cost. This is a prospective observational study done at a tertiary care center from January 2014 to December 2022, involving patients with primary lung cancer. After tumor-node-metastasis staging and molecular testing, the patients received chemotherapy, radiotherapy, surgery, targeted therapy, and immunotherapy in various combinations as per the prevailing National Comprehensive Cancer Network Guidelines. 92 patients were enrolled in the study, with the mean age being 58.94±10.33 and 72 (78.26%) being males. 69 (75%) patients were either current or former smokers. 78 (84.78%) patients had an Eastern Cooperative Oncology Group (ECOG) score of 0-2 while the remaining had an ECOG of 3-4. 80 (86.95%) patients had non-small cell lung cancer (NSCLC) [44 (47.83%) adenocarcinoma, 25 (27.17%) squamous cell carcinoma, and 11 (11.95%) NSCLC: not otherwise specified], while 12 (13.04%) patients had small cell lung cancer. One (1.08%) patient each presented in stage I and stage II, 31 (33.69%) patients presented in stage III, and 59 (64.13%) patients presented in stage IV. 44 patients with adenocarcinoma were subjected to mutational analysis, and an epidermal growth factor receptor mutation was found in 13 (29.5%) patients. None of the patients had ALK mutation, ROS-1 rearrangement, or BRAF mutation. PD-L1 expression was evaluated in 9 patients with NSCLC, and it was found in 6 (66.66%) patients. The overall mean survival was 12.7 months. The mean survival for patients with stages I, II, III, and IV was 70, 96, 8.1, and 12.7 months, respectively. Survival in stage IV was better than in stage III, as the eligible patients received targeted therapy and immunotherapy. Targeted therapy and immunotherapy have improved survival. Molecular analysis should be done whenever indicated, and eligible patients must be administered targeted therapy and immunotherapy.
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Affiliation(s)
- Rahul Kumar
- Department of Pulmonary, Critical Care and Sleep Medicine, ESI-PGIMSR, Basaidarapur, New Delhi.
| | - Dipti Gothi
- Department of Pulmonary, Critical Care and Sleep Medicine, ESI-PGIMSR, Basaidarapur, New Delhi.
| | - Shweta Anand
- Department of Chest and Respiratory Medicine, Delhi State Cancer Institute, Delhi.
| | - Shazia Khan
- Department of Pulmonary Medicine, American International Institute of Medical Sciences, Udaipur, Rajasthan.
| | - Nipun Malhotra
- Department of Pulmonary, Critical Care and Sleep Medicine, ESI-PGIMSR, Basaidarapur, New Delhi.
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Nethan S, Cherian M, Brain E, Ganguli A, Tullu F, Musolino N, Hariprasad R, Sullivan R, Mehrotra R. Cancer in the older Indian population: Understanding the current context in an emerging economy. J Geriatr Oncol 2022; 13:273-281. [PMID: 34776381 DOI: 10.1016/j.jgo.2021.10.013] [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: 01/21/2021] [Revised: 08/30/2021] [Accepted: 10/25/2021] [Indexed: 10/19/2022]
Abstract
India is considered a demographically young country with over 65% of the population aged below 35 years. However, improvements in maternal and child health, and infectious diseases, have created a rapid epidemiological transition with an aging population (8.6% in 2011) with a projected increase (19% by 2050), equating to 104 million. In addition to the well-articulated issues surrounding the care of the older patients with cancer, the Indian context as an emerging economy provides additional social, political, economic and clinical challenges. This review addresses the key issues and possible solutions germane to both policymakers in India and other emerging economies. Extension of cancer prevention, equal, optimal treatment opportunities, and inclusion in clinical trials, akin to the younger population, must be encouraged. Various national health initiatives require effective implementation, to provide uniform, evidence-based, cancer care across India. Designated geriatric oncology departments, and required care at the primary healthcare level are essential.
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Affiliation(s)
- Suzanne Nethan
- Project ECHO (Extension for Community Healthcare Outcomes) - India, Building No 76 (2nd Floor), Okhla Phase III, Okhla Industrial Area, New Delhi 110020, India.
| | - Meena Cherian
- International Society of Geriatric Oncology (SIOG), International Environmental House 2, Chemin de Balexert 7-9, 1219 Chatelaine, Switzerland.
| | - Etienne Brain
- Department of Clinical Research & Medical Oncology, Institut Curie (Hôpital René Huguenin), 35 Rue Dailly, 92210 St Cloud, France.
| | - Atreyi Ganguli
- WHO India Country Office, 537, A Wing, Nirman Bhawan, Maulana Azad Road, New Delhi 110011, India.
| | - Fikru Tullu
- WHO India Country Office, 537, A Wing, Nirman Bhawan, Maulana Azad Road, New Delhi 110011, India.
| | - Najia Musolino
- International Society of Geriatric Oncology (SIOG), International Environmental House 2, Chemin de Balexert 7-9, 1219 Chatelaine, Switzerland.
| | - Roopa Hariprasad
- Division of Clinical Oncology, Indian Council of Medical Research (ICMR), National Institute of Cancer Prevention & Research (NICPR), I-7, Sector 39, Noida 201301, Uttar Pradesh, India.
| | | | - Ravi Mehrotra
- India Cancer Research Consortium (ICMR-DHR), Ministry of Health and Family Welfare, Department of Health Research, First Floor, Indian Red Cross Society (IRCS) Building, 1, Red Cross Road, New Delhi 110001, India; Centre for Health Innovation and Policy (CHIP) Foundation, 361, Sector 15A, Noida, Uttar Pradesh 201301, India.
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Mohan A, Garg A, Gupta A, Sahu S, Choudhari C, Vashistha V, Ansari A, Pandey R, Bhalla AS, Madan K, Hadda V, Iyer H, Jain D, Kumar R, Mittal S, Tiwari P, Pandey RM, Guleria R. Clinical profile of lung cancer in North India: A 10-year analysis of 1862 patients from a tertiary care center. Lung India 2020; 37:190-197. [PMID: 32367839 PMCID: PMC7353932 DOI: 10.4103/lungindia.lungindia_333_19] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 12/24/2019] [Accepted: 01/17/2020] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Over the past few years, the demographic profile of lung cancer has changed. However, most reports are limited by small numbers, short follow-up period, and show an inconsistent pattern. A comprehensive evaluation of changing trends over a long period has not been done. MATERIALS AND METHODS Consecutive lung cancer patients were studied over a 10-year period from January 2008 to March 2018 at the All India Institute of Medical Sciences, New Delhi, and relevant clinical information, and survival outcomes were analyzed. RESULTS A total of 1862 patients were evaluated, with mean (SD) age of 59 (11.1) years, and comprising 82.9% males. Majority were smokers (76.2%) with median smoking index of 500 (interquartile range [IQR]: 300-800). Adenocarcinoma (ADC) was the most common type (34%), followed by squamous cell carcinoma (SCC - 28.6%) and small cell lung cancer (SCLC) (16.1%). Over the 10-year period, ADC increased from 9.5% to 35.9%, SCC from 25.4% to 30.6%, and non-small cell lung cancer -not otherwise specified (NSCLC-NOS) decreased from 49.2% to 21.4%. The proportion of females with lung cancer increased although smoking rates remained similar. Majority of NSCLC (95%) continued to be diagnosed at an advanced stage (3 or 4). Epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) rearrangements were present in 25.3% and 11.5% ADC patients, respectively. The median overall survival was 8.8 months (IQR 3.7-19) for all patients and 12.57 (IQR 6.2-28.7) months among the 1013 patients who were initiated on specific treatment (chemotherapy, targeted therapy, radiotherapy, or surgery). Never-smokers were younger, more likely to be female and educated, had a higher prevalence of ADC and EGFR/ALK mutations, and had better survival. CONCLUSION Among this large cohort, our center seems to follow the global trend with increasing incidence of ADC. EGFR mutation positivity was similar to existing reports, while higher ALK positivity was detected. A characteristic phenotype of never-smokers with lung cancer was elucidated which demonstrated better survival.
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Affiliation(s)
- Anant Mohan
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Avneet Garg
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Aditi Gupta
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Satyaranjan Sahu
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Chandrashekhar Choudhari
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Vishal Vashistha
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Ashraf Ansari
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rambha Pandey
- Department of Radiotherapy, All India Institute of Medical Sciences, New Delhi, India
| | - Ashu Seith Bhalla
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Karan Madan
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Hadda
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Hariharan Iyer
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Deepali Jain
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Saurabh Mittal
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Pawan Tiwari
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ravindra M Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Randeep Guleria
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
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Belmokhtar KY, Tajir M, Boulouiz R, Bennani A, Brahmi SA, Alloubi I, Kouismi H, Kamaoui I, Skiker I, Afqir S, Abda N, Bellaoui M, Mezouar L. [Lung cancer in Eastern Morocco: where do we stand?]. Pan Afr Med J 2019; 34:177. [PMID: 32153717 PMCID: PMC7046119 DOI: 10.11604/pamj.2019.34.177.19934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 10/29/2019] [Indexed: 01/22/2023] Open
Abstract
Introduction Lung cancer is the most common cancer in men living Eastern Morocco. We here present the first report on the clinical, pathological and therapeutic features of lung cancer in Eastern Morocco. Methods We conducted a retrospective study of 738 patients diagnosed with lung cancer at the Hassan II, Oncology Center between October 2005 and December 2014. Results Among the cases studied, 671 patients were men and 67 women; 95.01% of men and 1.54% of women were smokers. The average age of patients was 59.1 ± 11.9 years. Most patients (97%) were diagnosed at advanced stage disease. Only 4 out of 227 patients with advanced adenocarcinoma underwent molecular test. In addition, no patient in our series received targeted therapy. In this series, 20.46% of patients had less than 50 years. Compared to patients aged 50 years and older, cannabis consumption was higher (p<0.001) in patients less than 50 years and as well as a higher rate of adenocarcinoma (p<0.01). By contrast, in these patients, tobacco consumption was lower (p<0.001) as well as the rate of squamous cell carcinoma (p<0.01) and small cell cancer (p<0.05). Conclusion Unlike Western countries, in Eastern Morocco lung cancer is diagnosed late, affects younger people and access to molecular tests is still very limited. These results justify the need to implement effective programs against lung cancer as well as to facilitate access to molecular tests and new therapeutic tools in Eastern Morocco.
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Affiliation(s)
- Karam Yahya Belmokhtar
- Genetics Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed Premier, Oujda, Morocco
| | - Mariam Tajir
- Genetics Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed Premier, Oujda, Morocco
| | - Redouane Boulouiz
- Genetics Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed Premier, Oujda, Morocco
| | - Amal Bennani
- Genetics Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed Premier, Oujda, Morocco
| | - Sami Aziz Brahmi
- Faculty of Medicine and Pharmacy of Oujda, University Mohammed Premier, Mohammed VI University Hospital, Oujda, Morocco.,Hassan II Oncology Center, Oujda, Morocco
| | - Ihsan Alloubi
- Faculty of Medicine and Pharmacy of Oujda, University Mohammed Premier, Mohammed VI University Hospital, Oujda, Morocco
| | - Hatim Kouismi
- Faculty of Medicine and Pharmacy of Oujda, University Mohammed Premier, Mohammed VI University Hospital, Oujda, Morocco
| | - Imane Kamaoui
- Faculty of Medicine and Pharmacy of Oujda, University Mohammed Premier, Mohammed VI University Hospital, Oujda, Morocco
| | - Imane Skiker
- Faculty of Medicine and Pharmacy of Oujda, University Mohammed Premier, Mohammed VI University Hospital, Oujda, Morocco
| | - Said Afqir
- Faculty of Medicine and Pharmacy of Oujda, University Mohammed Premier, Mohammed VI University Hospital, Oujda, Morocco.,Hassan II Oncology Center, Oujda, Morocco
| | - Naima Abda
- Faculty of Medicine and Pharmacy of Oujda, University Mohammed Premier, Mohammed VI University Hospital, Oujda, Morocco
| | - Mohammed Bellaoui
- Genetics Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed Premier, Oujda, Morocco
| | - Loubna Mezouar
- Faculty of Medicine and Pharmacy of Oujda, University Mohammed Premier, Mohammed VI University Hospital, Oujda, Morocco.,Hassan II Oncology Center, Oujda, Morocco
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Translatable gene therapy for lung cancer using Crispr CAS9-an exploratory review. Cancer Gene Ther 2019; 27:116-124. [PMID: 31222183 DOI: 10.1038/s41417-019-0116-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 04/29/2019] [Accepted: 05/19/2019] [Indexed: 12/12/2022]
Abstract
Gene therapy using CRISPR Cas9 technique is rapidly gaining popularity among the scientific community primarily because of its versatility, cost-effectiveness, and high efficacy. While the laboratory-based experiments and findings making use of CRISPR as a gene editing tool are available in ample amounts, the question arises that how much of these findings are actually translatable into measures helping in combating particular disease conditions. In this review, we highlight the important studies and findings done till now in the perspective of lung cancer with an in-depth analysis of various clinical trials associated with the use of CRISPR Cas9 technology in the field of cancer research.
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Nair CK, Mathew AP, George PS. Lung cancer: Presentation and pattern of care in a cancer center in South India. Indian J Cancer 2018; 54:164-168. [PMID: 29199682 DOI: 10.4103/ijc.ijc_56_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND In India lung cancer is the most commonly diagnosed malignancy in males and an increasing trend in the incidence is reported from the National Cancer Registry programme. AIMS The aim of this study is to find out the recent trends in presentation and management of lung cancer at Regional Cancer Centre, Trivandrum. METHODS Published reports of hospital based cancer registries (HBCR) and population based cancer registries (PBCR) of Trivandrum were compared with reported statistics from other parts of India and global data. RESULTS Lung is the leading site of cancer in males (15%) getting treatment at Regional Cancer Centre , Trivandrum in 2013 as per the HBCR. There is an increase in the age adjusted incidence rate of lung cancer among males in the Trivandrum PBCR from 14.6 to 18.5 during 2012 -2014. Among the patients who were treated at the Center majority (55.2%) presented with distant metastases with adenocarcinoma as the most common histological type (28.5%) and only 15.7% had undergone treatment with curative intent. CONCLUSIONS Lung cancer is the major cancer affecting males in India with a high incidence in Trivandrum and a very low percentage of patients receiving curative treatment which could be due to the high prevalence of tuberculosis and scarce availability of facilities and trained manpower for thoracic oncology.
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Affiliation(s)
- C Krishnan Nair
- Department of Surgical Oncology, Regional Cancer Centre, Trivandrum, Kerala, India
| | - A P Mathew
- Department of Surgical Oncology, Regional Cancer Centre, Trivandrum, Kerala, India
| | - P S George
- Department of Cancer Epidemiology and Biostatistics, Regional Cancer Centre, Trivandrum, Kerala, India
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8
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Paliwal P, Rajappa S, Santa A, Mohan M, Murthy S, Lavanya N. Clinical profile and outcomes of patients with Stage IV adenocarcinoma of lung: A tertiary cancer center experience. Indian J Cancer 2017; 54:197-202. [PMID: 29199690 DOI: 10.4103/0019-509x.219595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND There is limited Indian data on clinical profile and treatment outcomes for patients with Stage IV adenocarcinoma of lung. AIM We aimed to prospectively study the clinical profile and treatment outcomes for patients with Stage IV adenocarcinoma of lung at a tertiary cancer center. MATERIALS AND METHODS One hundred and ninetyfour patients with Stage IV adenocarcinoma of lung were prospectively analyzed for demographic and molecular profile (epidermal growth factor receptor [EGFR] and echinodermal microtubuleassociated proteinlike 4anaplastic lymphoma kinase [EML4ALK] mutations). Patients with EGFR and EML4ALK mutations were treated with tyrosine kinase inhibitors. Patients without these mutations were treated with standard chemotherapy regimens. Maintenance chemotherapy was offered to patients as per standard guidelines. Clinical outcomes measured were response rate (RR), progressionfree survival (PFS), and overall survival (OS). RESULTS Median age of patients was 56 years (range, 26-82) with a male:female ratio of 2.3:1. EGFR and ALK mutation testing was feasible in 169 (87.1%) and 164 (84.5%), respectively, and detected in 37.9% and 5.5% patients, respectively. Overall RR, PFS and OS of whole cohort were 44.3%, 6.9, and 15.5 months, respectively. PFS and OS of mutated group (EGFR, EML4ALK) were longer than nonmutated group (10.5 vs. 5.4 months, P < 0.0001 and 21.5 vs. 11 months, P = 0.0001, respectively). PFS and OS of patients who received pemetrexed maintenance were longer than those who did not receive maintenance (8.5 vs. 6.5 months, P = 0.1613 and 18.5 vs. 12.5 months, P = 0.0219, respectively). CONCLUSIONS Mutation testing at diagnosis is feasible in the vast majority of patients with Stage IV adenocarcinoma of the lung. Patients with EGFR or EML4ALK mutation and those who received pemetrexed maintenance had better clinical outcomes.
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Affiliation(s)
- P Paliwal
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital, Hyderabad, Telangana, India
| | - S Rajappa
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital, Hyderabad, Telangana, India
| | - A Santa
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital, Hyderabad, Telangana, India
| | - Mvtk Mohan
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital, Hyderabad, Telangana, India
| | - S Murthy
- Department of Pathology, Basavatarakam Indo American Cancer Hospital, Hyderabad, Telangana, India
| | - N Lavanya
- Department of Pathology, Basavatarakam Indo American Cancer Hospital, Hyderabad, Telangana, India
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Abstract
Purpose: Nivolumab is one of the most extensively studied immune checkpoint inhibitors across various tumor types. In this narrative review, the current clinical efficacy and safety data of anti-programmed death-1 (PD-1) nivolumab for nonsmall cell lung cancer (NSCLC) and renal cell cancer (RCC) are elucidated. Methods: Systematic search was done on Pubmed, Medline, Embase, Web of Knowledge, and Cochrane Central through September 2016 for controlled prospective interventional studies of nivolumab across two indications - NSCLC and RCC. There was heterogeneity at all levels of abstraction; hence, author did not plan to provide a meta-analysis, but instead, a narrative elaboration of results structured around the conceptual frameworks. Results: Checkpoint receptor PD-1 is a negative regulatory molecule expressed by activated T and B lymphocytes. Binding of PD-1 to its ligands, programmed death-ligands 1 and 2, results in the downregulation of lymphocyte activation. Nivolumab is a fully human PD-1 immune checkpoint inhibitor. Nivolumab inhibits the interaction between PD-1 and its ligands and promotes immune responses including antitumor immune response and antigen-specific T-cell responses to both foreign antigens as well as self-antigens. In 2013, the Food and Drug Administration granted fast track designation for nivolumab in NSCLC, RCC, and melanoma. Conclusion: The encouraging literature on nivolumab lends credibility to the promise of immune checkpoint blockade, not just in terms of its feasibility as an oncotherapeutic strategy but also as a key tool of the future in the therapeutic approaches against advanced cancers.
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Baburao A, Narayanswamy H. Clinico-Pathological Profile and Haematological Abnormalities Associated with Lung Cancer in Bangalore, India. Asian Pac J Cancer Prev 2016; 16:8235-8. [PMID: 26745066 DOI: 10.7314/apjcp.2015.16.18.8235] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lung cancer is one of the most common types of cancer causing high morbidity and mortality worldwide. An increasing incidence of lung cancer has been observed in India. OBJECTIVES To evaluate the clinic- pathological profile and haematological abnormalities associated with lung cancer in Bangalore, India. MATERIALS AND METHODS This prospective study was carried out over a period of 2 years. A total of 96 newly diagnosed and histopathologically confirmed cases of lung cancer were included in the study. RESULTS Our lung cancer cases had a male to female ratio of 3:1. Distribution of age varied from 40 to 90 years, with a major contribution in the age group between 61 and 80 years (55.2%). Smoking was the commonest risk factor found in 69.7% of patients. The most frequent symptom was cough (86.4%) followed by loss of weight and appetite (65.6%) and dyspnea (64.5%). The most common radiological presentation was a mass lesion (55%). The most common histopathological type was squamous cell carcinoma (47.9%), followed by adenocarcinoma (28.1%) and small cell carcinoma (12.5%). Distant metastasis at presentation was seen in 53.1% patients. Among the haematological abnormalities, anaemia was seen in 61.4% of patients, leucocytosis in 36.4%, thrombocytosis in 14.5% and eosinophilia in 19.7% of patients. Haematological abnormalities were more commonly seen in non small cell lung cancer. CONCLUSIONS Squamous cell carcinoma was found to be the most common histopathological type and smoking still remains the major risk factor for lung cancer. Haematological abnormalities are frequently observed in lung cancer patients, anaemia being the commonest of all.
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Affiliation(s)
- Archana Baburao
- Department of Pulmonary Medicine, Kempegowda Institute of Medical Sciences, Bangalore, India E-mail :
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Ugurluoglu C, Kurtipek E, Unlu Y, Esme H, Duzgun N. Importance of the Cell Block Technique in Diagnosing Patients with Non-Small Cell Carcinoma Accompanied by Pleural Effusion. Asian Pac J Cancer Prev 2015; 16:3057-60. [DOI: 10.7314/apjcp.2015.16.7.3057] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Hajmanoochehri F, Mohammadi N, Zohal MA, Sodagar A, Ebtehaj M. Epidemiological and clinicopathological characteristics of lung cancer in a teaching hospital in Iran. Asian Pac J Cancer Prev 2015; 15:2495-500. [PMID: 24761853 DOI: 10.7314/apjcp.2014.15.6.2495] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lung cancer is one of the most commonly diagnosed cancers and the most frequent cause of cancer-related death worldwide. In Iran, it ranks second and third as the cancer-causing death in men and women, respectively. We carried out this study to find out the demographic, clinical, and histological characteristics and risk factors of lung cancer in a referral tertiary center in Iran. MATERIALS AND METHODS A retrospective study was conducted on cases of primary lung cancer based on the results of registered cancer reports of cytological and pathological specimens between March 2001 and March 2012. Demographic variables, clinical manifestations, histology and location of tumors were determined based on the data found in the medical records of each patient. Definite or probable etiologic factors were identified. Data analysis was performed with SPSS version 16 and a p-value ≤ 0.05 was considered as significant. RESULTS A total of 203 patients, with a mean age of 65.7 years (SD=11.2), with primary lung cancer were identified, 81.3% being men. Of the total, 110 cases (54.2%) were living in urban areas. In 53.2% of cases, the site of tumor was on the right side and in 72.9% of cases the lesion was centrally located. The histological types of lung cancer were squamous cell carcinoma (SCC) in 107 cases (52.7%), adenocarcinoma (AC) in 30 cases (14.8%), and small cell carcinoma (SC) in 27 cases (13.3%). Significant correlations between the gender and residence, smoking, and the histological type and location (central or peripheral) of tumor were found. The percentage of smokers was 75.2% in men and 15.8% in women. CONCLUSIONS Smoking was the most important risk factor and squamous cell carcinoma the most common histological type of lung cancer in our study. Male sex and being a smoker was associated with histological types of SCC while being nonsmoker had relationship with adenocarcinoma.
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Affiliation(s)
- Fatemeh Hajmanoochehri
- Department ofPathology, Faculty of Medicine, Metabolic Disease Research Center, Qazvin University of Medical Sciences, Qazvin, IranE-mail :
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Saikia BJ, Phukan RK, Sharma SK, Sekhon GS, Mahanta J. Interaction of XRCC1 and XPD gene polymorphisms with lifestyle and environmental factors regarding susceptibility to lung cancer in a high incidence population in North East India. Asian Pac J Cancer Prev 2014; 15:1993-9. [PMID: 24716924 DOI: 10.7314/apjcp.2014.15.5.1993] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to explore the role of XRCC1 (Arg399Gln) and XPD (Lys751Gln) gene polymorphisms, lifestyle and environmental factors as well as their possible interactions in propensity to develop lung cancer in a population with high incidence from North East India. MATERIALS AND METHODS A total of 272 lung cancer cases and 544 controls were collected and XRCC1 (Arg399Gln) and XPD (Lys751Gln) genotypes were analyzed using a polymerase chain reaction based restriction fragment length polymorphism assay. Conditional multiple logistic regression analysis was used to calculate adjusted odds ratios and 95% confidence intervals after adjusting for confounding factors. RESULTS The combined Gln/Gln genotype of XRCC1 and XPD genes (OR=2.78, CI=1.05-7.38; p=0.040) was significantly associated with increased risk for lung cancer. Interaction of XRCC1Gln/Gln genotype with exposure of wood combustion (OR=2.56, CI=1.16-5.66; p=0.020), exposure of cooking oil fumes (OR=3.45, CI=1.39-8.58; p=0.008) and tobacco smoking (OR=2.54, CI=1.21-5.32; p=0.014) and interaction of XPD with betel quid chewing (OR=2.31, CI=1.23-4.32; p=0.009) and tobacco smoking (OR=2.13, CI=1.12-4.05; p=0.022) were found to be significantly associated with increased risk for lung cancer. CONCLUSIONS Gln/Gln alleles of both XRCC1 and XPD genes appear to amplify the effects of household exposure, smoking and betel quid chewing on lung cancer risk in the study population.
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Affiliation(s)
- Bhaskar Jyoti Saikia
- Regional Medical Research Centre, N.E. Region (ICMR), Dibrugarh, Assam, India E-mail :
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Li CH, Liu MY, Liu W, Li DD, Cai L. Randomized control study of nedaplatin or cisplatin concomitant with other chemotherapy in the treatment of advanced non-small cell lung cancer. Asian Pac J Cancer Prev 2014; 15:731-6. [PMID: 24568487 DOI: 10.7314/apjcp.2014.15.2.731] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To observe the short-term efficacy, long-term survival time and adverse responses with nedaplatin (NDP) or cisplatin (DDP) concomitant with other chemotherapy in treating non-small cell lung cancer. MATERIALS AND METHODS A retrospective, randomized, control study was conducted, in which 619 NSCLC patients in phases III and IV who were initially treated and re-treated were randomly divided into an NDP group (n=294) and a DDP group (n=325), the latter being regarded as controls. Chemotherapeutic protocols (CP/DP/GP/NP/TP) containing NDP or DDP were given to both groups. Patients in both groups were further divided to evaluate the clinical efficacies according to initial and re-treatment stage, pathological pattern, type of combined chemotherapeutic protocols, tumor stage and surgery. RESULTS The overall response rate (ORR) and disease control rate (DCR) in the NDP group were 48.6% and 95.2%, significantly higher than in the DDP group at 35.1% and 89.2%, respectively (P<0.01). In NSCLC patients with initial treatment, squamous carcinoma and phase III, there were significant differences in ORR and DCR between the groups (P<0.05), while ORR was significant in patients with adenocarcinoma, GP/TP and in phase IIIa (P<0.05). There was also a significant difference in DCR in patients in phase IIIb (P<0.05). According to the statistical analysis of survival time of all patients and of those in clinical phase III, the NDP group survived significantly longer than the DDP group (P<0.01). The rates of decreased hemoglobin and increased creatinine, nausea and vomiting in the NDP group were evidently lower than in DDP group (P<0.05). CONCLUSION NDP concomitant with other chemotherapy is effective for treating NSCLC, with higher clinical efficacy than DDP concomitant with chemotherapy, with advantages in prolonging survival time and reducing toxic and adverse responses.
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Affiliation(s)
- Chun-Hong Li
- Department of Internal Medical Oncology, The Affiliated Tumor Hospital of Harbin Medical University, Harbin, China E-mail :
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Sharma JD, Kalita M, Barbhuiya JA, Lahon R, Sharma A, Barman D, Kataki AC, Roy BD. Descriptive report on pattern of variation in cancer cases within selected ethnic groups in Kamrup Urban District of Assam, 2009-2011. Asian Pac J Cancer Prev 2014; 15:6381-6. [PMID: 25124629 DOI: 10.7314/apjcp.2014.15.15.6381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The global burden of cancer is continuously increasing. According to recent report of the National Cancer Registry Programme (NCRP) on time trends it is estimated that future burden of cancer cases for India in 2020 will be 1,320,928. It is well known that knowledge of the incidence of cancer is a fundamental requirement of rational planning and monitoring of cancer control programs. It would help health planners to formulate public health policy if relevant ethnic groups were considered. North East-India alone contains over 160 Scheduled Tribes and 400 other sub-tribal communities and groups, whose cancer incidence rates are high compared to mainland India. As since no previous study was done focusing on ethnicity, the present investigation was performed. MATERIALS AND METHODS In this paper PBCR-Guwahati data on all cancer registrations from January 2009 to December 2011 for residents of the Kamrup Urban District, comprising an area of 261.8 sq. km with a total population of 900,518, including individual records with information on sex, age, ethnicity and cancer site are provided. Descriptive statistics including age adjusted rates (AARs) were taken as provided by NCRP. For comparison of proportional incidence ratios (PIR) the Student's t test was used, with p<0.05 considered as statistically significant. RESULTS AND CONCLUSIONS Differences in leading sites of Kamrup Urban District since from the beginning of the PBCR-Guwahati were revealed among different ethnic groups by this study. The results should help policy makers to formulate different strategies to control the level of burden as well as for treatment planning. This study also suggests that age is an important factor of cancer among different ethnic populations as well as for overall population of Kamrup District of Assam.
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Affiliation(s)
- Jagannath Dev Sharma
- Population Based Cancer Registry, Indian Council of Medical Research, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India E-mail :
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Dilli UD, Yildırim M, Suren D, Alikanoglu A, Kaya V, Goktas S, Yildiz M, Sezer C, Gunduz S. Lack of any Prognostic Role of Insulin-Like Growth Factor-1 Receptor in Non-Small Cell Lung Cancer. Asian Pac J Cancer Prev 2014; 15:5753-7. [DOI: 10.7314/apjcp.2014.15.14.5753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Sharma JD, Kalit M, Nirmolia T, Saikia SP, Sharma A, Barman D. Cancer: Scenario and Relationship of Different Geographical Areas of the Globe with Special Reference to North East-India. Asian Pac J Cancer Prev 2014; 15:3721-9. [DOI: 10.7314/apjcp.2014.15.8.3721] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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