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Yokota E, Iwai M, Yukawa T, Naomoto Y, Haisa M, Monobe Y, Takigawa N, Fukazawa T, Yamatsuji T. Patient-derived tumoroid models of pulmonary large-cell neuroendocrine carcinoma: a promising tool for personalized medicine and developing novel therapeutic strategies. Cancer Lett 2024; 588:216816. [PMID: 38499265 DOI: 10.1016/j.canlet.2024.216816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 03/04/2024] [Accepted: 03/12/2024] [Indexed: 03/20/2024]
Abstract
Pulmonary large-cell neuroendocrine carcinoma (LCNEC), a disease with poor prognosis, is classified as pulmonary high-grade neuroendocrine carcinoma, along with small-cell lung cancer. However, given its infrequent occurrence, only a limited number of preclinical models have been established. Here, we established three LCNEC tumoroids for long-term culture. Whole-exome sequencing revealed that these tumoroids inherited genetic mutations from their parental tumors; two were classified as small-cell carcinoma (S-LCNEC) and one as non-small cell carcinoma (N-LCNEC). Xenografts from these tumoroids in immunodeficient mice mimicked the pathology of the parent LCNEC, and one reproduced the mixed-tissue types of combined LCNEC with a component of adenocarcinoma. Drug sensitivity tests using these LCNEC tumoroids enabled the evaluation of therapeutic agent efficacy. Based on translational research, we found that a CDK4/6 inhibitor might be effective for N-LCNEC and that Aurora A kinase inhibitors might be suitable for S-LCNEC or LCNEC with MYC amplification. These results highlight the value of preclinical tumoroid models in understanding the pathogenesis of rare cancers and developing treatments. LCNEC showed a high success rate in tumoroid establishment, indicating its potential application in personalized medicine.
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Affiliation(s)
- Etsuko Yokota
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
| | - Miki Iwai
- General Medical Center Research Unit, Kawasaki Medical School, Okayama, Japan
| | - Takuro Yukawa
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
| | - Yoshio Naomoto
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
| | - Minoru Haisa
- Kawasaki Medical School General Medical Center, Okayama, Japan; Department of Medical Care Work, Kawasaki College of Health Professions, Okayama, Japan; Kawasaki Geriatric Medical Center, Okayama, Japan
| | | | - Nagio Takigawa
- General Medical Center Research Unit, Kawasaki Medical School, Okayama, Japan; Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan
| | - Takuya Fukazawa
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan; General Medical Center Research Unit, Kawasaki Medical School, Okayama, Japan.
| | - Tomoki Yamatsuji
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
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2
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Iida Y, Wakuda K, Kenmotsu H, Doshita K, Kodama H, Nishioka N, Miyawaki E, Miyawaki T, Mamesaya N, Kobayashi H, Omori S, Ko R, Ono A, Naito T, Murakami H, Sugino T, Gon Y, Takahashi T. Efficacy of second-line chemotherapy in patients with pulmonary large cell neuroendocrine carcinoma. Sci Rep 2024; 14:7641. [PMID: 38561461 PMCID: PMC10984918 DOI: 10.1038/s41598-024-58327-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 03/27/2024] [Indexed: 04/04/2024] Open
Abstract
The efficacy of second-line chemotherapy in patients with pulmonary large cell neuroendocrine carcinoma (LCNEC) is unclear. This study aimed to evaluate the efficacy of second-line chemotherapy in patients with pulmonary LCNEC. We retrospectively reviewed patients with pulmonary LCNEC or possible LCNEC (pLCNEC) who received platinum-based chemotherapy as the first-line treatment. Among these patients, we evaluated the efficacy of second-line treatment by comparing patients with small cell lung cancer (SCLC group). Of the 61 patients with LCNEC or pLCNEC (LCNEC group) who received first-line chemotherapy, 39 patients were treated with second-line chemotherapy. Among the 39 patients, 61.5% received amrubicin monotherapy. The median progression-free survival (PFS) and overall survival (OS) in the LCNEC groups were 3.3 and 8.3 months, respectively. No significant differences in the PFS (hazard ratio [HR]: 0.924, 95% confidence interval [CI] 0.647-1.320; P = 0.664) and OS (HR: 0.926; 95% CI 0.648-1.321; P = 0.670) were observed between the LCNEC and SCLC groups. In patients treated with amrubicin, the PFS (P = 0.964) and OS (P = 0.544) were not different between both the groups. Second-line chemotherapy, including amrubicin, may be considered as a treatment option for patients with pulmonary LCNEC.
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Affiliation(s)
- Yuko Iida
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Kazushige Wakuda
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | | | - Kosei Doshita
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Hiroaki Kodama
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Naoya Nishioka
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Eriko Miyawaki
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Taichi Miyawaki
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Nobuaki Mamesaya
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Haruki Kobayashi
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Shota Omori
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
- Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, Oita, Japan
| | - Ryo Ko
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Akira Ono
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Tateaki Naito
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Haruyasu Murakami
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Takashi Sugino
- Division of Pathology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yasuhiro Gon
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
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3
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Popov P, Steindl A, Wolff L, Bergen ES, Eckert F, Frischer JM, Widhalm G, Fuereder T, Raderer M, Berghoff AS, Preusser M, Kiesewetter B. Clinical characteristics, treatment, and outcome of patients with large cell neuroendocrine carcinoma of the lung and brain metastases - data from a tertiary care center. Clin Exp Metastasis 2024; 41:25-32. [PMID: 38064128 PMCID: PMC10830719 DOI: 10.1007/s10585-023-10250-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 11/21/2023] [Indexed: 02/02/2024]
Abstract
Large cell neuroendocrine carcinoma (LCNEC) of the lung is an aggressive malignancy, with brain metastases (BM) occurring in approximately 20% of cases. There are currently no therapy guidelines for this population as only few data on the management of LCNEC and BM have been published. For this retrospective single center study, patients with LCNEC and BM were identified from the Vienna Brain Metastasis Registry. Data on clinicopathological features, BM-specific characteristics, treatment, and outcome were extracted. In total, 52/6083 (0.09%) patients in the dataset had a diagnosis of LCNEC and radiologically verified BM. Median age at diagnosis of LCNEC and BM was 59.1 and 60.1 years, respectively. Twenty-seven (51.9%) presented with single BM, while 12 (23%) exhibited > 3 BM initially. Neurologic symptoms due to BM were present in n = 40 (76.9%), encompassing neurologic deficits (n = 24), increased intracranial pressure (n = 18), and seizures (n = 6). Initial treatment of BM was resection (n = 13), whole brain radiation therapy (n = 19), and/or stereotactic radiosurgery (n = 25). Median overall survival (mOS) from LCNEC diagnosis was 16 months, and mOS after BM diagnosis was 7 months. Patients with synchronous BM had reduced mOS from LCNEC diagnosis versus patients with metachronous BM (11 versus 27 months, p = 0.003). Median OS after BM diagnosis did not differ between LCNEC patients and a control group of small cell lung cancer patients with BM (7 versus 6 months, p = 0.17). Patients with LCNEC and BM have a poor prognosis, particularly when synchronous BM are present. Prospective trials are required to define optimal therapeutic algorithms.
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Affiliation(s)
- Petar Popov
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Waehringer Guertel 18 - 20, Vienna, A-1090, Austria
| | - Ariane Steindl
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Waehringer Guertel 18 - 20, Vienna, A-1090, Austria
| | - Ladislaia Wolff
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Waehringer Guertel 18 - 20, Vienna, A-1090, Austria
| | - Elisabeth S Bergen
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Waehringer Guertel 18 - 20, Vienna, A-1090, Austria
| | - Franziska Eckert
- Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
| | - Josa M Frischer
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Georg Widhalm
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Thorsten Fuereder
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Waehringer Guertel 18 - 20, Vienna, A-1090, Austria
| | - Markus Raderer
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Waehringer Guertel 18 - 20, Vienna, A-1090, Austria
| | - Anna S Berghoff
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Waehringer Guertel 18 - 20, Vienna, A-1090, Austria
| | - Matthias Preusser
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Waehringer Guertel 18 - 20, Vienna, A-1090, Austria
| | - Barbara Kiesewetter
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Waehringer Guertel 18 - 20, Vienna, A-1090, Austria.
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Khan J, Yasinzai AQK, Matosz S, Khan M, Heneidi S, Mesa H, Chauhan A, Del Rivero J, Karim NA, Ullah A. Pulmonary large cell neuroendocrine carcinoma (LCNEC): a population-based study addressing recent molecular-genetic advances and emerging therapeutic approaches. Clin Exp Med 2023; 23:3947-3955. [PMID: 37060529 DOI: 10.1007/s10238-023-01071-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/05/2023] [Indexed: 04/16/2023]
Abstract
BACKGROUND Large cell neuroendocrine carcinoma (LCNEC) of the lung is a rare, aggressive cancer most commonly found in the lungs but not exclusively, with a worse prognosis than non-small cell lung carcinomas. Currently, LCNEC patients are treated using small cell and non-small cell protocols. This study aims to use the SEER database to identify demographic, clinical, pathological, and therapeutic factors affecting the prognosis and survival of patients with LCNEC of the lung. METHODS Demographic, clinical, and management data of patients with lung LCNEC were extracted from the SEER database for the period 2000-2018. RESULTS In the USA, LCNEC has a higher incidence in elderly white men: M:F ratio = 1.2:1, Caucasian: 83.3%, mean age: 67 ± 10.2 years. The most common treatment modality was chemotherapy only: 29.2%, followed by surgery: 21.5% (but in this group the statuses of chemotherapy were unknown), and combination surgery/chemotherapy: 8.8%. The overall and cause-specific 5-year survival was 17.5% (95% CI 16.3-18.8) and 21.9% (95% CI 20.5-23.4), respectively. By treatment, the best 5-year survival was for surgery alone (48%), followed by multimodality therapy (chemo + surgery + radiation) at 35% (95% CI 27-43). Age > 60 years, male gender, size > 7 cm, and nodal and liver metastasis were independent risk factors associated with increased mortality. CONCLUSION Lung LCNEC is an aggressive neoplasm most common in older white males that presents at an advanced stage despite small primary tumors. Most patients die within 2 years. The best predictor of survival is surgery with chemotherapy. Given its dismal prognosis, new treatment guidelines are needed for this aggressive cancer.
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Affiliation(s)
- Jaffar Khan
- Department of Pathology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | | | - Sabrina Matosz
- Georgia Cancer Center, Medical College of Georgia, Augusta University, Augusta, GA, 30912, USA
| | - Marjan Khan
- Department of Medicine, Marshfield Clinic, Marshfield, WI, USA
| | - Saleh Heneidi
- Molecular Pathology Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - Hector Mesa
- Department of Pathology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Aman Chauhan
- Department of Hematology and Oncology, University of Kentucky, Lexington, USA
| | - Jaydira Del Rivero
- Division of Hematology and Oncology, National Cancer Institute, NIH, Bethesda, MD, 20892, USA
| | - Nagla Abdel Karim
- Inova Schar Cancer Institute, Department of Medicine, University of Virginia, Fairfax, VA, 22031, USA
| | - Asad Ullah
- Department of Pathology and Laboratory Medicine, Vanderbilt University Medical Center, Vanderbilt University, Nashville, TN, 37232, USA.
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Song L, Zhou F, Xu T, Zeng L, Xia Q, Wang Z, Deng L, Li Y, Qin H, Yan H, Huang Z, Mi J, Xu Q, Yang N, Zhou C, Zhang Y. Clinical activity of pembrolizumab with or without chemotherapy in advanced pulmonary large-cell and large-cell neuroendocrine carcinomas: a multicenter retrospective cohort study. BMC Cancer 2023; 23:443. [PMID: 37189075 PMCID: PMC10186661 DOI: 10.1186/s12885-023-10952-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/11/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICI)-based combination strategies have improved the survival outcomes in advanced non-small cell lung cancers; however, data regarding their efficacy remains limited for uncommon histological types, including large-cell carcinoma (LCC) and large-cell neuroendocrine carcinoma (LCNEC). METHODS We retrospectively analyzed a total of 60 patients with advanced LCC and LCNEC - 37 treatment-naïve and 23 pre-treated - who received pembrolizumab with or without chemotherapy. Treatment and survival outcomes were analyzed. RESULTS Of the 37 treatment-naïve patients who received first-line pembrolizumab combined with chemotherapy, the 27 patients with LCC had an overall response rate (ORR) of 44.4% (12/27) and a disease control rate (DCR) of 88.9% (24/27); whereas 10 patients with LCNEC had an ORR of 70% (7/10) and DCR of 90% (9/10). The median progression-free survival (mPFS) was 7.0 months (95% confidence intervals [CI]: 2.2-11.8) and median overall survival (mOS) was 24.0 months (95%CI: 0.0-50.1) for first-line pembrolizumab plus chemotherapy of LCC (n = 27), whereas mPFS was 5.5 months (95%CI: 2.3-8.7) and mOS was 13.0 months (95%CI: 11.0-15.0) for first-line pembrolizumab plus chemotherapy of LCNEC (n = 10). Of the 23 pre-treated patients who received subsequent-line pembrolizumab with or without chemotherapy, mPFS was 2.0 months (95% CI: 0.6-3.4) and mOS was 4.5 months (95% CI: 0.0-9.0) for LCC and mPFS was 3.8 months (95% CI: 0.0-7.6) and mOS was not reached for LCNEC. CONCLUSION Our study provides real-world clinical evidence of the anti-tumor activity of pembrolizumab plus chemotherapy in advanced LCC and LCNEC, indicating that this regimen could serve as a treatment option, particularly as first-line therapy, for improving the survival outcomes of patients with these rare histological subtypes of lung cancer. TRIAL REGISTRATION NCT05023837(ESPORTA, 27/08/2021).
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Affiliation(s)
- Lianxi Song
- Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, China
- Graduate Collaborative Training Base of Hunan Cancer Hospital, Hengyang Medical School, University of South China, Hengyang, 421001, China
- Department of Medical Oncology, Yiyang Center Hospital, Yiyang, 413000, China
| | - Fei Zhou
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China
| | - Tian Xu
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, 410013, China
| | - Liang Zeng
- Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, China
| | - Qing Xia
- Department of Oncology, State Key Laboratory for Oncogenes and Related Genes, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200002, China
| | - Zhan Wang
- Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, China
| | - Li Deng
- Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, China
| | - Yizhi Li
- Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, China
| | - Haoyue Qin
- Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, China
- Graduate Collaborative Training Base of Hunan Cancer Hospital, Hengyang Medical School, University of South China, Hengyang, 421001, China
| | - Huan Yan
- Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, China
- Graduate Collaborative Training Base of Hunan Cancer Hospital, Hengyang Medical School, University of South China, Hengyang, 421001, China
| | - Zhe Huang
- Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, China
- Graduate Collaborative Training Base of Hunan Cancer Hospital, Hengyang Medical School, University of South China, Hengyang, 421001, China
| | - Jinye Mi
- Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, China
- Graduate Collaborative Training Base of Hunan Cancer Hospital, Hengyang Medical School, University of South China, Hengyang, 421001, China
| | - Qinqin Xu
- Department of Medical Oncology, Qinghai Provincial People's Hospital, Xining, 810007, China
| | - Nong Yang
- Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, China
- Graduate Collaborative Training Base of Hunan Cancer Hospital, Hengyang Medical School, University of South China, Hengyang, 421001, China
| | - Caicun Zhou
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China
| | - Yongchang Zhang
- Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, China.
- Graduate Collaborative Training Base of Hunan Cancer Hospital, Hengyang Medical School, University of South China, Hengyang, 421001, China.
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Okabe N, Mine H, Takagi H, Watanabe M, Muto S, Matsumura Y, Shio Y, Suzuki H. Pulmonary large cell carcinoma, highly positive for PD-L1, shows marked response to pembrolizumab: A case report. Thorac Cancer 2021; 12:1141-1144. [PMID: 33605014 PMCID: PMC8017242 DOI: 10.1111/1759-7714.13850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/04/2021] [Accepted: 01/04/2021] [Indexed: 12/15/2022] Open
Abstract
Pulmonary large cell carcinoma (LCC) is classified as a poorly defined entity among non-small cell lung cancers (NSCLCs). At present, there are no effective anticancer drugs, such as molecular targeted drugs, for LCC, and it has been reported that patient prognosis is poor. Recently, the development of immune checkpoint inhibitors (ICIs) has changed the therapeutic strategies for patients with NSCLC. Here, we present a case of LCC successfully treated with pembrolizumab. A 58-year-old man who was a former smoker was diagnosed with LCC. The postoperative stage was T3N2M0. During postoperative adjuvant chemotherapy, swelling of the supraclavicular lymph node was observed and the patient was diagnosed with recurrence. The patient was treated with two regimens of conventional cytotoxic chemotherapy; however, he experienced some hoarseness. Imaging confirmed swelling of the hilar and mediastinal lymph nodes and the patient was subsequently diagnosed with disease progression. Previous surgical specimens when immunostained showed that a high proportion of the tumor cells were positive for expression of programmed death-ligand 1 (PD-L1), and it was decided to commence treatment with pembrolizumab. This treatment resulted in rapid regression of the hilar and mediastinal lymph nodes, and a progression-free period maintained for at least 24 treatment cycles. The patient's hoarseness improved, and the lymph nodes decreased in size. Immunotherapy targeting PD-1/PD-L1 may be an option for patients with PD-L1 positive LCC. This case report suggests that treatment with ICIs may be important in the selection of treatment for not only LCC but also relatively rare NSCLC with high PD-L1 expression.
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Affiliation(s)
- Naoyuki Okabe
- Department of Chest SurgeryFukushima Medical University School of MedicineFukushimaJapan
| | - Hayato Mine
- Department of Chest SurgeryFukushima Medical University School of MedicineFukushimaJapan
| | - Hironori Takagi
- Department of Chest SurgeryFukushima Medical University School of MedicineFukushimaJapan
| | - Masayuki Watanabe
- Department of Chest SurgeryFukushima Medical University School of MedicineFukushimaJapan
| | - Satoshi Muto
- Department of Chest SurgeryFukushima Medical University School of MedicineFukushimaJapan
| | - Yuki Matsumura
- Department of Chest SurgeryFukushima Medical University School of MedicineFukushimaJapan
| | - Yutaka Shio
- Department of Chest SurgeryFukushima Medical University School of MedicineFukushimaJapan
| | - Hiroyuki Suzuki
- Department of Chest SurgeryFukushima Medical University School of MedicineFukushimaJapan
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7
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Brancher S, Støer NC, Weiderpass E, Damhuis RAM, Johannesen TB, Botteri E, Strand TE. Metformin use and lung cancer survival: a population-based study in Norway. Br J Cancer 2021; 124:1018-1025. [PMID: 33262518 PMCID: PMC7921644 DOI: 10.1038/s41416-020-01186-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 10/30/2020] [Accepted: 11/05/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND We assessed associations between metformin use and survival in a nationwide Norwegian cohort of lung cancer (LC) patients. METHODS The study linked 22,324 LC patients from the Cancer Registry of Norway diagnosed 2005-2014 with the Norwegian Prescription Database. We estimated associations of pre- and post-diagnostic metformin use with overall survival (OS) and LC-specific survival (LCSS) using multivariable time-fixed and time-dependent Cox regression. RESULTS Pre-diagnostic metformin use was not associated with improved survival in all patients. Nevertheless, pre-diagnostic metformin use was associated with better LCSS in squamous cell carcinoma (SCC) patients (hazard ratio (HR) = 0.79; 95% confidence interval (CI) 0.62-0.99) and in patients with regional stage SCC (HR = 0.67; 95%CI 0.47-0.95). Post-diagnostic metformin use was associated with improved LCSS in all patients (HR = 0.83; 95%CI 0.73-0.95), in patients with SCC (HR = 0.75; 95%CI 0.57-0.98), regional stage LC (HR = 0.74; 95%CI 0.59-0.94), and regional stage SCC (HR = 0.57; 95%CI 0.38-0.86). OS showed similar results. Analyses of cumulative use showed a dose-response relationship in all patients, patients with adenocarcinoma and SCC, and with regional and metastatic LC. CONCLUSIONS Metformin use was associated with improved survival, especially LCSS in patients with regional stage SCC. Further prospective studies are required to clarify the role of metformin in LC treatment.
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MESH Headings
- Adenocarcinoma of Lung/drug therapy
- Adenocarcinoma of Lung/epidemiology
- Adenocarcinoma of Lung/mortality
- Adenocarcinoma of Lung/pathology
- Aged
- Aged, 80 and over
- Carcinoma, Large Cell/drug therapy
- Carcinoma, Large Cell/epidemiology
- Carcinoma, Large Cell/mortality
- Carcinoma, Large Cell/pathology
- Carcinoma, Non-Small-Cell Lung/drug therapy
- Carcinoma, Non-Small-Cell Lung/epidemiology
- Carcinoma, Non-Small-Cell Lung/mortality
- Carcinoma, Non-Small-Cell Lung/pathology
- Carcinoma, Squamous Cell/drug therapy
- Carcinoma, Squamous Cell/epidemiology
- Carcinoma, Squamous Cell/mortality
- Carcinoma, Squamous Cell/pathology
- Combined Modality Therapy
- Female
- Follow-Up Studies
- Humans
- Hypoglycemic Agents/therapeutic use
- Lung Neoplasms/drug therapy
- Lung Neoplasms/epidemiology
- Lung Neoplasms/mortality
- Lung Neoplasms/pathology
- Male
- Metformin/therapeutic use
- Middle Aged
- Norway/epidemiology
- Prognosis
- Small Cell Lung Carcinoma/drug therapy
- Small Cell Lung Carcinoma/epidemiology
- Small Cell Lung Carcinoma/mortality
- Small Cell Lung Carcinoma/pathology
- Survival Rate
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Affiliation(s)
- Suzan Brancher
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil.
| | - Nathalie C Støer
- Norwegian National Advisory Unit on Women's Health, Women's Clinic, Oslo University Hospital, Oslo, Norway
- Cancer Registry of Norway, Oslo University Hospital, Oslo, Norway
| | - Elisabete Weiderpass
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Ronald A M Damhuis
- Department of Research, Comprehensive Cancer Organization, Utrecht, The Netherlands
| | - Tom B Johannesen
- Cancer Registry of Norway, Oslo University Hospital, Oslo, Norway
| | - Edoardo Botteri
- Cancer Registry of Norway, Oslo University Hospital, Oslo, Norway
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8
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Dudnik E, Kareff S, Moskovitz M, Kim C, Liu SV, Lobachov A, Gottfried T, Urban D, Zer A, Rotem O, Onn A, Wollner M, Bar J. Real-world survival outcomes with immune checkpoint inhibitors in large-cell neuroendocrine tumors of lung. J Immunother Cancer 2021; 9:e001999. [PMID: 33597218 PMCID: PMC7893659 DOI: 10.1136/jitc-2020-001999] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Little is known regarding the efficacy of immune checkpoint inhibitors (ICI) in patients with advanced large-cell neuroendocrine lung carcinoma (aLCNEC). METHODS 125 consecutive patients with aLCNEC were identified in the electronic databases of 4 participating cancer centers. The patients were divided into group A (patients who received ICI, n=41) and group B (patients who did not receive ICI, n=84). Overall survival since advanced disease diagnosis (OS DX) and OS since ICI initiation (OS ICI) were captured. RESULTS With a median follow-up of 11.8 months (mo) (IQR 7.5-17.9) and 6.0mo (IQR 3.1-10.9), 66% and 76% of patients died in groups A and B, respectively. Median OS DX was 12.4mo (95% CI 10.7 to 23.4) and 6.0mo (95% CI 4.7 to 9.4) in groups A and B, respectively (log-rank test, p=0.02). For ICI administration, HR for OS DX was 0.59 (95% CI 0.38 to 0.93, p=0.02-unadjusted), and 0.58 (95% CI 0.34 to 0.98, p=0.04-adjusted for age, Eastern Cooperative Oncology Group (ECOG) performance status (PS), presence of liver metastases and chemotherapy administration). In a propensity score matching analysis (n=74; 37 patients in each group matched for age and ECOG PS), median OS DX was 12.5 mo (95% CI 10.6 to 25.2) and 8.4 mo (95% CI 5.4 to 16.9) in matched groups A and B, respectively (log-rank test, p=0.046). OS ICI for patients receiving ICI as monotherapy (n=36) was 11.0 mo (95% CI 6.1 to 19.4). CONCLUSIONS With the limitations of retrospective design and small sample size, the results of this real-world cohort analysis suggest a positive impact of ICI on OS in aLCNEC.
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Affiliation(s)
- Elizabeth Dudnik
- Thoracic Cancer Service, Davidoff Cancer Center, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Samuel Kareff
- Lombardi Comprehensive Cancer Center, MedStar Georgetown University Hospital, Washington, District of Columbia, USA
| | - Mor Moskovitz
- Thoracic Cancer Service, Rambam Health Care Campus, Haifa, Israel
| | - Chul Kim
- Lombardi Comprehensive Cancer Center, MedStar Georgetown University Hospital, Washington, District of Columbia, USA
| | - Stephen V Liu
- Lombardi Comprehensive Cancer Center, MedStar Georgetown University Hospital, Washington, District of Columbia, USA
| | - Anastasiya Lobachov
- Institute of Oncology, Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel
| | - Teodor Gottfried
- Institute of Oncology, Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel
| | - Damien Urban
- Institute of Oncology, Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel
| | - Alona Zer
- Thoracic Cancer Service, Davidoff Cancer Center, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ofer Rotem
- Thoracic Cancer Service, Davidoff Cancer Center, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
| | - Amir Onn
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pulmonology Institute, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Mira Wollner
- Thoracic Cancer Service, Rambam Health Care Campus, Haifa, Israel
| | - Jair Bar
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute of Oncology, Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel
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9
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Lowczak A, Kolasinska-Cwikla A, Osowiecka K, Glinka L, Palucki J, Rzepko R, Doboszynska A, Cwikla JB. Outcomes of Patients with Pulmonary Large Cell Neuroendocrine Carcinoma in I-IV Stage. ACTA ACUST UNITED AC 2021; 57:medicina57020118. [PMID: 33525370 PMCID: PMC7911070 DOI: 10.3390/medicina57020118] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/11/2021] [Accepted: 01/26/2021] [Indexed: 02/06/2023]
Abstract
Background and Objectives: Large cell neuroendocrine cancer is characterised by poor prognosis. The standard of treatment is still not established. The aim of this study was to assess the predictive factors of overall survival (OS) and progression-free survival (PFS) of pulmonary large cell neuroendocrine carcinoma (LCNEC) and combined LCNEC. Materials and Methods: All patients had confirmed pathology stage I-IV disease recorded between period 2002–2018. Survival curves were estimated by Kaplan–Meier method. Uni- and multivariable analysis was conducted using Cox-regression analysis. Results: A total of 132 patients with LCNEC and combined LCNEC were included. Half of them had clinical stage IIIB/C-IV. Patients were treated with radical (n = 67, including surgery alone; resection with neo-adjuvant or adjuvant chemotherapy, radiochemotherapy, or adjuvant radiotherapy; patients treated with radiochemotherapy alone), palliative (n = 41) or symptomatic (n = 24) intention. Seventeen patients were treated with resection margin R1 or R2. Non-small cell carcinoma (NSCLC) chemotherapy (platinum-vinorelbine; PN schedule) and small-cell lung carcinoma (SCLC) chemotherapy approaches (platinum/carboplatinum-etoposide; PE/KE schedule) were administered in 20 and in 55 patients, respectively. The median (95% Confidence Interval (CI)) OS and PFS were 17 months (9.0–36.2 months) and 7 months (3.0–15.0 months), respectively. Patients treated with negative resection margin, with lower clinical stage, without lymph node metastasis, and with size of primary tumour ≤4 cm showed significantly better OS and PFS. The main risk factors with an adverse effect on survival were advanced CS and positive resection margin. Conclusions: Patients with LCNEC characterized poor prognosis. Independent prognostic factors influencing PFS were initial clinical stage and resection margin R0 vs. R1-2.
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Affiliation(s)
- Anna Lowczak
- Department of Pulmonology, Faculty of Medicine, University of Warmia and Mazury in Olsztyn, Jagiellonska 78, 11-041 Olsztyn, Poland;
- Correspondence: ; Tel.: +48-89-532-29-85
| | - Agnieszka Kolasinska-Cwikla
- Department of Oncology and Radiotherapy, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland Roentgena 5, 02-781 Warsaw, Poland;
| | - Karolina Osowiecka
- Department of Psychology and Sociology of Health and Public Health, School of Public Health, University of Warmia and Mazury in Olsztyn, Warszawska 30, 11-041 Olsztyn, Poland;
| | - Lidia Glinka
- Department of Anesthesiology and Intensive Care Faculty of Medicine, University of Warmia and Mazury in Olsztyn, Warszawska 30, 10-082 Olsztyn, Poland;
| | - Jakub Palucki
- Department of Radiology, Maria Sklodowska-Curie Institute of Oncology in Warsaw, Roentgena 5, 02-781 Warsaw, Poland;
| | - Robert Rzepko
- Specialist Hospital in Prabuty, Kuracyjna 30, 82-550 Prabuty, Poland;
| | - Anna Doboszynska
- Department of Pulmonology, Faculty of Medicine, University of Warmia and Mazury in Olsztyn, Jagiellonska 78, 11-041 Olsztyn, Poland;
| | - Jaroslaw B. Cwikla
- Department of Cardiology and Internal Medicine Faculty of Medicine, University of Warmia and Mazury in Olsztyn, Warszawska 30, 10-082 Olsztyn, Poland;
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10
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Beau-Faller M, Pencreach E, Leduc C, Blons H, Merlio JP, Bringuier PP, de Fraipont F, Escande F, Lemoine A, Ouafik L, Denis M, Hofman P, Lacave R, Melaabi S, Langlais A, Missy P, Morin F, Moro-Sibilot D, Barlesi F, Cadranel J. Independent prognostic value of ultra-sensitive quantification of tumor pre-treatment T790M subclones in EGFR mutated non-small cell lung cancer (NSCLC) treated by first/second generation TKI, depends on variant allele frequency (VAF): Results of the French cooperative thoracic intergroup (IFCT) biomarkers France project. Lung Cancer 2019; 140:19-26. [PMID: 31841714 DOI: 10.1016/j.lungcan.2019.10.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 10/09/2019] [Accepted: 10/11/2019] [Indexed: 01/12/2023]
Abstract
OBJECTIVES T790M mutations inEGFR-mutated non-small cell lung cancer (NSCLC) account for nearly 50% of acquired resistance mechanisms to EGFR-TKIs. Earlier studies suggested that tumor T790M could also be detected in TKI-naïve EGFR-mutated NSCLC. The aim of the study is to assess the prevalence and clinical significance of quantification of tumor pre-treatment T790M subclones. MATERIALS AND METHODS We analyzed 366 EGFR-mutated NSCLC patients of the real-life IFCT Biomarkers France study with available pre-treatment formalin-fixed paraffin-embedded (FFPE) tumor DNA before treatment by first/second-generation EGFR-TKI. We used ultra-sensitive Droplet Digital Polymerase Chain Reaction (ddPCR) QX200 (BIO-RAD®, Hercules, CA, USA). All samples were tested in duplicate. RESULTS ddPCR identified T790M in 19/240 specimens (8%). T790M-positive and T790M-negative populations were not different for clinical baseline characteristics. T790M Variant Allele Frequency (VAF) was > 0.01% <0.1%, > 0.1% <1%, > 1% <10%, and >10% in five (26.3%), six (31.6%), six (31.6%), and two (10.5%) patients, respectively. T790M VAF was >0.1% in 11/13 (84%) patients with rapid (<3 months) or usual progression (3-20 months) compared to 0/3 with low progression (>20 months) (p = 0.02). In a Cox model, T790M mutation positivity was correlated with overall survival (OS) and progression-free survival (PFS) for 10% > VAF >1% (hazard ratio [HR] = 2.83, 95% confidence interval [CI] 1.13-7.07, p = 0.03; HR=3.62, 95%CI 1.43-4.92, p = 0.007, respectively) and for VAF >10% (HR = 19.14, 95%CI 4.35-84.26, p < 0.001; HR = 17.89, 95%CI 2.21-144.86, p = 0.007, respectively). CONCLUSION Ultra-sensitive detection of tumor T790M mutation concerned 8% of EGFR-mutated TKI-naïve NSCLC patients and has a negative prognostic value only for T790M VAF over 1%.
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MESH Headings
- Adenocarcinoma of Lung/drug therapy
- Adenocarcinoma of Lung/genetics
- Adenocarcinoma of Lung/pathology
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/genetics
- Carcinoma, Large Cell/drug therapy
- Carcinoma, Large Cell/genetics
- Carcinoma, Large Cell/pathology
- Carcinoma, Non-Small-Cell Lung/drug therapy
- Carcinoma, Non-Small-Cell Lung/genetics
- Carcinoma, Non-Small-Cell Lung/pathology
- Carcinoma, Squamous Cell/drug therapy
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/pathology
- Drug Resistance, Neoplasm
- ErbB Receptors/genetics
- Female
- Follow-Up Studies
- France
- Humans
- Lung Neoplasms/drug therapy
- Lung Neoplasms/genetics
- Lung Neoplasms/pathology
- Male
- Middle Aged
- Mutation
- Prognosis
- Protein Kinase Inhibitors/therapeutic use
- Retrospective Studies
- Survival Rate
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Affiliation(s)
- Michèle Beau-Faller
- Laboratory of Biochemistry and Molecular Biology, Centre Hospitalier Universitaire de Strasbourg, Hôpital de Hautepierre, Strasbourg, France; IRFAC UMR-S1113, Inserm, Université de Strasbourg, Strasbourg, France.
| | - Erwan Pencreach
- IRFAC UMR-S1113, Inserm, Université de Strasbourg, Strasbourg, France
| | - Charlotte Leduc
- Chest Department, Centre Hospitalier Universitaire de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France
| | - Hélène Blons
- HEGP, Biochimie UF de Pharmacogénétique et Oncologie Moléculaire, Paris, France
| | - Jean-Philippe Merlio
- Department of Pathology and Tumor Biology, CHU and University Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - Pierre-Paul Bringuier
- Centre de Biologie et Pathologie Est, Service d'Anatomie et de Cytologie Pathologique, Hospices Civils de Lyon et Université Claude Bernard Lyon 1, Lyon, France
| | - Florence de Fraipont
- UM de Génétique moléculaire: Maladies Héréditaires et Oncologie, Pôle de Biologie et Pathologie, CHU Grenoble Alpes, Grenoble, France; UGA/INSERM U1209/CNRS 5309-Institute for Advanced Biosciences-Université Grenoble Alpes, Grenoble, France
| | - Fabienne Escande
- Laboratoire de Biochimie et Biologie moléculaire, CHRU Lille, LILLE, France
| | - Antoinette Lemoine
- Biochimie et Oncogénétique INSERM UMR-S1193, Hôpital Paul Brousse, Hôpitaux Universitaires Paris-Sud, Villejuif, France
| | - L'Houcine Ouafik
- Aix Marseille Univ, APHM, CNRS, INP, Inst Neurophysiopathol, Faculté de Médecine Secteur Nord, Service de Transfert d'Oncologie Biologique, Marseille, France
| | - Marc Denis
- Laboratoire de Biochimie et Plateforme de Génétique Moléculaire des Cancers, CHU Nantes, Nantes, France
| | - Paul Hofman
- Université Côte d'Azur, and FHU OncoAge, Laboratory of Clinical and Experimental Pathology, Inserm U1081/CNRS 7284, and Hospital-Integrated Biobank (BB-0033-00025) Pasteur Hospital, Nice, France
| | - Roger Lacave
- Faculté de Médecine Sorbonne Université, and Groupe Hospitalier HUEP, Hôpital Tenon, Unité de Génomique des Tumeurs Solides, Assistance Publique-Hôpitaux de Paris, France
| | - Samia Melaabi
- Service de Génétique, Unité de Pharmacogénomique, Institut Curie, Paris, France
| | - Alexandra Langlais
- Department of Biostatistics, French Cooperative Thoracic Intergroup, Paris, France
| | - Pascale Missy
- Clinical Research Unit, French Cooperative Thoracic Intergroup, Paris, France
| | - Franck Morin
- Clinical Research Unit, French Cooperative Thoracic Intergroup, Paris, France
| | - Denis Moro-Sibilot
- Unité d'Oncologie Thoracique, Service Hospitalier Universitaire Pneumologie Physiologie Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Grenoble, France
| | - Fabrice Barlesi
- Aix Marseille University, CNRS, INSERM, CRCM, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Jacques Cadranel
- AP-HP, Hôpital Tenon, Service de Pneumogie, GRC 04 Theranoscan, Sorbonne Université, Paris, France
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11
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Hidaka T, Okuzumi S, Matsuhashi A, Takahashi H, Hata K, Shimizu S, Iwasaki Y. Large Cell Neuroendocrine Carcinoma of the Mediastinum Successfully Treated with Systemic Chemotherapy after Palliative Radiotherapy. Intern Med 2019; 58:563-568. [PMID: 30333385 PMCID: PMC6421155 DOI: 10.2169/internalmedicine.0437-17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Large cell neuroendocrine carcinoma (LCNEC) is a highly malignant cancer originally found in lung in 1991. In extremely rare occasions, primary LCNEC is found in the mediastinum; approximately 40 of such cases have been reported. Due to the limited number of reported cases, a standardized treatment protocol has yet to be established. We report a case of a 66-year-old woman with primary mediastinal LCNEC who presented with superior vena cava syndrome. Emergent radiotherapy was performed, followed by systemic chemotherapy with cisplatin and etoposide, which resulted in a dramatic tumor reduction. This is the first report describing the achievement of a complete response after systemic chemotherapy in a patient with primary LCNEC.
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Affiliation(s)
- Takeaki Hidaka
- Department of Respiratory Medicine, Showa General Hospital, Japan
| | - Saki Okuzumi
- Department of Respiratory Medicine, Showa General Hospital, Japan
| | - Ako Matsuhashi
- Department of Respiratory Medicine, Showa General Hospital, Japan
| | | | - Kazunori Hata
- Department of General Thoracic Surgery, Showa General Hospital, Japan
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12
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Abstract
RATIONALE Pulmonary large-cell neuroendocrine carcinoma (LCNEC) is a rare type of lung cancer, and 40% of patients are in stage IV at initial diagnosis. It has an extremely poor prognosis with a 1-year survival rate of 27%. Patients with LCNEC are predominantly male, older, and heavy smokers. There has been no clinical trial conducted to determine the best treatment for advanced LCNEC. Temozolomide (TMZ) has been successfully used to treat a variety of malignancies, such as glioblastoma multiforme, astrocytoma, non-small-cell lung carcinoma. However, its efficacy in advanced stage pulmonary LCNEC has rarely been studied. PATIENT CONCERNS We present the rare case of a 69-year-old woman with advanced pulmonary LCNEC. She complained of recurrent dry cough for more than 1 month. DIAGNOSES After chest computed tomography (CT) and biopsies of supraclavicular lymph nodes, the diagnosis of stage IIIB LCNEC of the lung was made. INTERVENTIONS Four cycles of chemotherapy with etoposide and cisplatin was administered as the first-line regimen. As the disease progressed, we administered icotinib and liposomal paclitaxel. Finally, we administrated TMZ as the third-line regimen. OUTCOMES The patient showed partial response after 5 months. She has survived for 19 months from the time of diagnosis with a good performance status. LESSONS TMZ appears to be an efficacious option to treat elderly patients with advanced LCNEC.
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Affiliation(s)
| | | | | | - Sheng Tang
- Department of Internal Medicine, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China
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13
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Masotti A, Borzellino G, Zannini G, Laterza E, Ricci F, Morandini G. Efficacy and Toxicity of Vinorelbine-Carboplatin Combination in the Treatment of Advanced Adenocarcinoma or Large-Cell Carcinoma of the Lung. Tumori 2018; 81:112-6. [PMID: 7539964 DOI: 10.1177/030089169508100208] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background The aim of the study was to assess the activity and toxicity of the vinorelbine-carboplatin combination in advanced adenocarcinoma or large-cell carcinoma of the lung. The new vinca derivative, vinorelbine, shows promising activity when combined with cisplatin, but toxicity of the combination is substantial. Methods Accordingly, we substituted carboplatin for cisplatin in the combination in order to improve the therapeutic index. From March 1992 to March 1994, 55 untreated patients with undifferentiated unresectable or metastatic adenocarcinoma or large-cell carcinoma of the lung were recruited. The treatment consisted of a course of carboplatin (300 mg/m2) and vinorelbine (25 mg/m2) repeated every 4 weeks. The only grade 3 toxicity observed was 16 cases of grade 3 vomiting and 2 cases of grade 3 stomatitis. Results The positive response rate was 40% (partial response, 22 patients). In conclusion, the vinorelbine-carboplatin combination may be regarded as an active, safe regimen for the palliative treatment of advanced adenocarcinoma or large-cell carcinoma of the lung.
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Affiliation(s)
- A Masotti
- Division of Pneumology, University of Verona, Ospedale Borgo Trento, Italy
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14
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Hayashi N, Fujita A, Saikai T, Takabatake H, Sotoshiro M, Sekine K, Kawana A. Large Cell Neuroendocrine Carcinoma Harboring an Anaplastic Lymphoma Kinase (ALK) Rearrangement with Response to Alectinib. Intern Med 2018; 57:713-716. [PMID: 29151522 PMCID: PMC5874345 DOI: 10.2169/internalmedicine.9368-17] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Anaplastic lymphoma kinase (ALK) rearrangement is most commonly observed in lung adenocarcinoma in a subset of lung cancer. Large cell neuroendocrine carcinoma (LCNEC) harboring an ALK rearrangement is very rare. Based on the findings from a transbronchial lung biopsy, a 75-year-old non-smoking woman was diagnosed with LCNEC with multiple liver and bone metastases. After seven cycles of cytotoxic chemotherapy, her genotype testing demonstrated ALK rearrangement. Subsequently, she was administered alectinib and exhibited a partial response.
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Affiliation(s)
- Nobuyoshi Hayashi
- Department of Respiratory Medicine, Sapporo Minamisanjyou Hospital, Japan
- Division of Infectious Disease and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College, Japan
| | - Akihisa Fujita
- Department of Respiratory Medicine, Sapporo Minamisanjyou Hospital, Japan
| | - Toyohiro Saikai
- Department of Respiratory Medicine, Sapporo Minamisanjyou Hospital, Japan
| | | | - Mie Sotoshiro
- Department of Respiratory Medicine, Sapporo Minamisanjyou Hospital, Japan
| | - Kyuutarou Sekine
- Department of Respiratory Medicine, Sapporo Minamisanjyou Hospital, Japan
| | - Akihiko Kawana
- Division of Infectious Disease and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College, Japan
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15
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Nakanishi T, Menju T, Nishikawa S, Takahashi K, Miyata R, Shikuma K, Sowa T, Imamura N, Hamaji M, Motoyama H, Hijiya K, Aoyama A, Sato T, Chen‐Yoshikawa TF, Sonobe M, Date H. The synergistic role of ATP-dependent drug efflux pump and focal adhesion signaling pathways in vinorelbine resistance in lung cancer. Cancer Med 2018; 7:408-419. [PMID: 29318780 PMCID: PMC5806107 DOI: 10.1002/cam4.1282] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 10/13/2017] [Accepted: 11/13/2017] [Indexed: 12/31/2022] Open
Abstract
The vinorelbine (VRB) plus cisplatin regimen is widely used to treat non-small cell lung cancer (NSCLC), but its cure rate is poor. Drug resistance is the primary driver of chemotherapeutic failure, and the causes of resistance remain unclear. By focusing on the focal adhesion (FA) pathway, we have highlighted a signaling pathway that promotes VRB resistance in lung cancer cells. First, we established VRB-resistant (VR) lung cancer cells (NCI-H1299 and A549) and examined its transcriptional changes, protein expressions, and activations. We treated VR cells by Src Family Kinase (SFK) inhibitors or gene silencing and examined cell viabilities. ATP-binding Cassette Sub-family B Member 1 (ABCB1) was highly expressed in VR cells. A pathway analysis and western blot analysis revealed the high expression of integrins β1 and β3 and the activation of FA pathway components, including Src family kinase (SFK) and AKT, in VR cells. SFK involvement in VRB resistance was confirmed by the recovery of VRB sensitivity in FYN knockdown A549 VR cells. Saracatinib, a dual inhibitor of SFK and ABCB1, had a synergistic effect with VRB in VR cells. In conclusion, ABCB1 is the primary cause of VRB resistance. Additionally, the FA pathway, particularly integrin, and SFK, are promising targets for VRB-resistant lung cancer. Further studies are needed to identify clinically applicable target drugs and biomarkers that will improve disease prognoses and predict therapeutic efficacies.
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MESH Headings
- ATP Binding Cassette Transporter, Subfamily B/metabolism
- Adenocarcinoma/drug therapy
- Adenocarcinoma/metabolism
- Adenocarcinoma/pathology
- Adenosine Triphosphate/pharmacology
- Adult
- Aged
- Antineoplastic Agents, Phytogenic/pharmacology
- Apoptosis
- Biomarkers, Tumor/metabolism
- Carcinoma, Large Cell/drug therapy
- Carcinoma, Large Cell/metabolism
- Carcinoma, Large Cell/pathology
- Carcinoma, Non-Small-Cell Lung/drug therapy
- Carcinoma, Non-Small-Cell Lung/metabolism
- Carcinoma, Non-Small-Cell Lung/pathology
- Carcinoma, Squamous Cell/drug therapy
- Carcinoma, Squamous Cell/metabolism
- Carcinoma, Squamous Cell/pathology
- Cell Proliferation
- Drug Resistance, Neoplasm
- Female
- Focal Adhesions/drug effects
- Focal Adhesions/metabolism
- Focal Adhesions/pathology
- Follow-Up Studies
- Humans
- Lung Neoplasms/drug therapy
- Lung Neoplasms/metabolism
- Lung Neoplasms/pathology
- Male
- Middle Aged
- Prognosis
- Signal Transduction/drug effects
- Survival Rate
- Tumor Cells, Cultured
- Vinorelbine/pharmacology
- src-Family Kinases/metabolism
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Affiliation(s)
- Takao Nakanishi
- Department of Thoracic SurgeryGraduate School of MedicineKyoto UniversityKyotoJapan
- Department of Thoracic SurgeryKobe‐City Nishi‐Kobe Medical CenterKobeJapan
| | - Toshi Menju
- Department of Thoracic SurgeryGraduate School of MedicineKyoto UniversityKyotoJapan
| | - Shigeto Nishikawa
- Department of Thoracic SurgeryGraduate School of MedicineKyoto UniversityKyotoJapan
| | - Koji Takahashi
- Department of Thoracic SurgeryGraduate School of MedicineKyoto UniversityKyotoJapan
| | - Ryo Miyata
- Department of Thoracic SurgeryGraduate School of MedicineKyoto UniversityKyotoJapan
| | - Kei Shikuma
- Department of Thoracic SurgeryGraduate School of MedicineKyoto UniversityKyotoJapan
| | - Terumasa Sowa
- Department of Thoracic SurgeryGraduate School of MedicineKyoto UniversityKyotoJapan
| | - Naoto Imamura
- Department of Thoracic SurgeryJapanese Red Cross Wakayama Medical CenterWakayamaJapan
| | - Masatsugu Hamaji
- Department of Thoracic SurgeryGraduate School of MedicineKyoto UniversityKyotoJapan
| | - Hideki Motoyama
- Department of Thoracic SurgeryGraduate School of MedicineKyoto UniversityKyotoJapan
| | - Kyoko Hijiya
- Department of Thoracic SurgeryGraduate School of MedicineKyoto UniversityKyotoJapan
| | - Akihiro Aoyama
- Department of Thoracic SurgeryGraduate School of MedicineKyoto UniversityKyotoJapan
| | - Toshihiko Sato
- Institute for Advancement of Clinical and Translational ScienceKyoto University HospitalKyotoJapan
| | | | - Makoto Sonobe
- Department of Thoracic SurgeryGraduate School of MedicineKyoto UniversityKyotoJapan
| | - Hiroshi Date
- Department of Thoracic SurgeryGraduate School of MedicineKyoto UniversityKyotoJapan
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16
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Nokihara H, Lu S, Mok TSK, Nakagawa K, Yamamoto N, Shi YK, Zhang L, Soo RA, Yang JC, Sugawara S, Nishio M, Takahashi T, Goto K, Chang J, Maemondo M, Ichinose Y, Cheng Y, Lim WT, Morita S, Tamura T. Randomized controlled trial of S-1 versus docetaxel in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy (East Asia S-1 Trial in Lung Cancer). Ann Oncol 2017; 28:2698-2706. [PMID: 29045553 PMCID: PMC5834128 DOI: 10.1093/annonc/mdx419] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Chemotherapy remains a viable option for the management of advanced non-small-cell lung cancer (NSCLC) despite recent advances in molecular targeted therapy and immunotherapy. We evaluated the efficacy of oral 5-fluorouracil-based S-1 as second- or third-line therapy compared with standard docetaxel therapy in patients with advanced NSCLC. PATIENTS AND METHODS Patients with advanced NSCLC previously treated with ≥1 platinum-based therapy were randomized 1 : 1 to docetaxel (60 mg/m2 in Japan, 75 mg/m2 at all other study sites; day 1 in a 3-week cycle) or S-1 (80-120 mg/day, depending on body surface area; days 1-28 in a 6-week cycle). The primary endpoint was overall survival. The non-inferiority margin was a hazard ratio (HR) of 1.2. RESULTS A total of 1154 patients (577 in each arm) were enrolled, with balanced patient characteristics between the two arms. Median overall survival was 12.75 and 12.52 months in the S-1 and docetaxel arms, respectively [HR 0.945; 95% confidence interval (CI) 0.833-1.073; P = 0.3818]. The upper limit of 95% CI of HR fell below 1.2, confirming non-inferiority of S-1 to docetaxel. Difference in progression-free survival between treatments was not significant (HR 1.033; 95% CI 0.913-1.168; P = 0.6080). Response rate was 8.3% and 9.9% in the S-1 and docetaxel arms, respectively. Significant improvement was observed in the EORTC QLQ-C30 global health status over time points in the S-1 arm. The most common adverse drug reactions were decreased appetite (50.4%), nausea (36.4%), and diarrhea (35.9%) in the S-1 arm, and neutropenia (54.8%), leukocytopenia (43.9%), and alopecia (46.6%) in the docetaxel arm. CONCLUSION S-1 is equally as efficacious as docetaxel and offers a treatment option for patients with previously treated advanced NSCLC. CLINICAL TRIAL NUMBER Japan Pharmaceutical Information Center, JapicCTI-101155.
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Affiliation(s)
- H Nokihara
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - S Lu
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai
| | - T S K Mok
- Department of Clinical Oncology, State Key Laboratory in Oncology in South China, The Chinese University of Hong Kong, Hong Kong, China.
| | - K Nakagawa
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka
| | - N Yamamoto
- Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Y K Shi
- Department of Medical Oncology, National Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing
| | - L Zhang
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - R A Soo
- Department of Hematology-Oncology, National University Hospital, Cancer Science Institute of Singapore, Singapore
| | - J C Yang
- Department of Oncology, National Taiwan University Hospital and National Taiwan University Cancer Center, Taipei, Taiwan
| | - S Sugawara
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Miyagi
| | - M Nishio
- Department of Thoracic Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo
| | - T Takahashi
- Department of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka
| | - K Goto
- Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - J Chang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - M Maemondo
- Department of Thoracic Oncology, Miyagi Cancer Center, Miyagi
| | - Y Ichinose
- Department of Cancer Information Research, National Kyushu Cancer Center, Clinical Research Institute, Fukuoka, Japan
| | - Y Cheng
- Department of Thoracic Oncology, Jilin Cancer Hospital, Changchun, China
| | - W T Lim
- Department of Medical Oncology, National Cancer Center Singapore, Singapore
| | - S Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto
| | - T Tamura
- Thoracic Center, St Luke's International Hospital, Tokyo, Japan
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17
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Gong X, Liu J, Zhang D, Yang D, Min Z, Wen X, Wang G, Li H, Song Y, Bai C, Li J, Zhou J. GLIPR1 modulates the response of cisplatin-resistant human lung cancer cells to cisplatin. PLoS One 2017; 12:e0182410. [PMID: 28771580 PMCID: PMC5542429 DOI: 10.1371/journal.pone.0182410] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 07/18/2017] [Indexed: 01/01/2023] Open
Abstract
Background and objective Chemotherapy drugs, such as cisplatin (DDP), improve the survival of patients with lung cancer by inducing apoptosis in cancer cells, which quickly develop resistance to DDP through uncharacterized mechanisms. Glioma Pathogenesis-Related Protein 1 (GLIPR1) plays an important role in cell proliferation, migration and apoptosis. However, the expression and function of GLIPR1 in mediating DDP resistance in human lung adenocarcinoma A549/DDP and human large cell lung cancer H460/DDP cells has not yet been reported. Methods In this study, real-time PCR (RT-PCR) and western blot were used to examine the mRNA and protein expression of GLIPR1, respectively. Bright-field microscopy, the cell counting kit-8 (CCK-8) assay, flow cytometry analysis and JC-1 dye were used to measure the cellular morphology, proliferation, apoptosis and mitochondrial membrane potential, respectively. Results Compared to human lung adenocarcinoma A549 cells, the mRNA and protein expression of GLIPR1 were significantly increased in DDP-resistant A549/DDP cells (p < 0.05). Similarly, the mRNA level of GLIPR1 in DDP-resistant H460/DDP cells was also significantly higher than that in DDP-sensitive H460 cells (p < 0.05). Silencing of GLIPR1 in A549/DDP and H460/DDP cells led to increased apoptosis via a mitochondrial signaling pathway following incubation with various concentrations of DDP. Furthermore, GLIPR1 downregulation markedly reduced the protein expression of Bcl-2, and increased the cleaved Poly (ADP-Ribose) Polymerase (PARP) and cleaved caspase-3 in DDP-resistant A549/DDP cells. Conclusion In this study, we demonstrated for the first time that GLIPR1 could modulate the response of DDP-resistant A549/DDP and H460/DDP cells to cisplatin. Therefore, GLIPR1 deserves further investigation in the context of none-small lung cancer (NSCLC).
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Affiliation(s)
- Xin Gong
- Department of Pulmonary Medicine, Shanghai Respiratory Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jing Liu
- Department of Pathology, The Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Dan Zhang
- Department of Pulmonary Medicine, Shanghai Respiratory Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Dawei Yang
- Department of Pulmonary Medicine, Shanghai Respiratory Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhihui Min
- Biomedical Research Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaoxing Wen
- Department of Pulmonary Medicine, Shanghai Respiratory Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Guifang Wang
- Department of Pulmonary Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Huayin Li
- Department of Pulmonary Medicine, Shanghai Respiratory Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuanlin Song
- Department of Pulmonary Medicine, Shanghai Respiratory Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Chunxue Bai
- Department of Pulmonary Medicine, Shanghai Respiratory Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China
- State Key Laboratory of Respiratory Disease, Guangzhou Medical University, Guangzhou, China
| | - Jing Li
- Department of Pulmonary Medicine, Shanghai Respiratory Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China
- * E-mail: (JZ); (JL)
| | - Jian Zhou
- Department of Pulmonary Medicine, Shanghai Respiratory Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China
- * E-mail: (JZ); (JL)
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18
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Derks JL, van Suylen RJ, Thunnissen E, den Bakker MA, Groen HJ, Smit EF, Damhuis RA, van den Broek EC, Speel EJM, Dingemans AMC. Chemotherapy for pulmonary large cell neuroendocrine carcinomas: does the regimen matter? Eur Respir J 2017; 49:1601838. [PMID: 28572122 PMCID: PMC5898951 DOI: 10.1183/13993003.01838-2016] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 03/05/2017] [Indexed: 11/05/2022]
Abstract
Pulmonary large cell neuroendocrine carcinoma (LCNEC) is rare. Chemotherapy for metastatic LCNEC ranges from small cell lung carcinoma (SCLC) regimens to nonsmall cell lung carcinoma (NSCLC) chemotherapy regimens. We analysed outcomes of chemotherapy treatments for LCNEC.The Netherlands Cancer Registry and Netherlands Pathology Registry (PALGA) were searched for patients with stage IV chemotherapy-treated LCNEC (2003-2012). For 207 patients, histology slides were available for pathology panel review. First-line platinum-based combined chemotherapy was clustered as "NSCLC-t", comprising gemcitabine, docetaxel, paclitaxel or vinorelbine; "NSCLC-pt", with pemetrexed treatment only; and "SCLC-t", consisting of etoposide chemotherapy.A panel review diagnosis of LCNEC was established in 128 out of 207 patients. NSCLC-t chemotherapy was administered in 46% (n=60), NSCLC-pt in 16% (n=20) and SCLC-t in 38% (n=48) of the patients. The median (95% CI) overall survival for NSCLC-t chemotherapy was 8.5 (7.0-9.9) months, significantly longer than patients treated with NSCLC-pt, with a median survival of 5.9 (5.0-6.9) months (hazard ratio 2.51, 95% CI 1.39-4.52; p=0.002) and patients treated with SCLC-t chemotherapy, with a median survival of 6.7 (5.0-8.5) months (hazard ratio 1.66, 95% CI 1.08-2.56; p=0.020).In patients with LCNEC, NSCLC-t chemotherapy results in longer overall survival compared to NSCLC-pt and SCLC-t chemotherapy.
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Affiliation(s)
- Jules L Derks
- Dept of Pulmonary Diseases, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | - Erik Thunnissen
- Dept of Pathology, VU University Medical Centre, Amsterdam, The Netherlands
| | - Michael A den Bakker
- Dept of Pathology, Maasstad Hospital, Rotterdam, The Netherlands
- Dept of Pathology, Erasmus MC, Rotterdam, The Netherlands
| | - Harry J Groen
- Dept of Pulmonary Diseases, University of Groningen and University Medical Centre, Groningen, The Netherlands
| | - Egbert F Smit
- Dept of Pulmonary Diseases, VU Medical Center, Amsterdam, The Netherlands
- Dept of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Ronald A Damhuis
- Dept of Research, Comprehensive Cancer Association, Utrecht, The Netherlands
| | | | - Ernst-Jan M Speel
- Dept of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Both authors contributed equally
| | - Anne-Marie C Dingemans
- Dept of Pulmonary Diseases, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Both authors contributed equally
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19
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Pu X, Li W, Lu B, Wang Z, Yang M, Fan W, Meng L, Lv Z, Xie Y, Wang J. Single pemetrexed is noninferior to platinum-based pemetrexed doublet as first-line treatment on elderly Chinese patients with advanced nonsquamous nonsmall cell lung cancer. Medicine (Baltimore) 2017; 96:e6002. [PMID: 28296721 PMCID: PMC5369876 DOI: 10.1097/md.0000000000006002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND To evaluate the clinical efficacy and toxicity of single pemetrexed treatment compared with platinum-based pemetrexed doublet pemetrexed-based as first-line treatment for advanced nonsquamous nonsmall cell lung cancer (NS-NSCLC) in elderly Chinese patients. METHODS The study retrospectively reviewed 175 elderly Chinese patients with NS-NSCLC from June 2010 to September 2013: 90 patients received single pemetrexed treatment, 45 received pemetrexed plus oxaliplatin, and 40 received pemetrexed plus carboplatin. Clinical efficacy was assessed using disease control rate (DCR), overall survival (OS), and progression-free survival (PFS). RESULTS DCR, OS, and PFS did not significantly differ between single pemetrexed treatment (OS: 14.9 months; DCR: 62.2%; PFS: 3.3 months), pemetrexed plus oxaliplatin (OS: 16.5 months; DCR: 71.1%; PFS: 4.5 months), and pemetrexed plus carboplatin (OS: 15.5 months; DCR: 70.0%; PFS: 4.6 months) groups. Pemetrexed treatment caused significantly lower incidences of adverse events, such as hepatotoxicity and peripheral nerve injury. Performance status (PS), TNM stage, and Thymidylate synthase (TS) expression were predictive factors of DCR. Pemetrexed chemotherapy cycles, PS, and TNM stage were independent prognostic factors. CONCLUSIONS Single pemetrexed was noninferior to platinum-based pemetrexed doublet for clinical efficacy and safety in elderly Chinese patients with advanced NS-NSCLC. Chemotherapy cycles, performance status, and TNM stage were independent prognostic factors.
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Affiliation(s)
- Xiaolin Pu
- Department of Oncology, Changzhou No. 2 People's Hospital, the Affiliated Hospital of Nanjing Medical University, Changzhou
- Department of Oncology, Department of Clinical Epidemiology, Jiangsu Province Geriatric Institute
| | - Wei Li
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University
| | - Binbin Lu
- Department of Oncology, The Second Affiliated Hospital of Nanjing Medical University
| | - Zhaoxia Wang
- Department of Oncology, The Second Affiliated Hospital of Nanjing Medical University
| | - Min Yang
- Department of Oncology, Jiangsu Province Geriatric Institute
| | - Weifei Fan
- Department of Oncology, Jiangsu Province Geriatric Institute
| | - Lijuan Meng
- Department of Oncology, Jiangsu Province Geriatric Institute
| | - Zhigang Lv
- Central Laboratory, Jiangsu Province Geriatric Institute, Nanjing, China
| | - Yuchun Xie
- Central Laboratory, Jiangsu Province Geriatric Institute, Nanjing, China
| | - Jun Wang
- Department of Oncology, Jiangsu Province Geriatric Institute
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20
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Liu DJ, Fu XL, Liu W, Zheng LY, Zhang JF, Huo YM, Li J, Hua R, Liu Q, Sun YW. Clinicopathological, treatment, and prognosis study of 43 gastric neuroendocrine carcinomas. World J Gastroenterol 2017; 23:516-524. [PMID: 28210088 PMCID: PMC5291857 DOI: 10.3748/wjg.v23.i3.516] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 12/05/2016] [Accepted: 12/19/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To provide more information and therapeutic methods about gastric neuroendocrine carcinomas (G-NECs) which occur rarely but are highly malignant and clinically challenging.
METHODS We retrospectively analyzed the clinicopathological characteristics, treatments, and prognosis of 43 G-NEC patients at our hospital between January 2007 and December 2014. The diagnosis was based on the 2010 World Health Organization criteria.
RESULTS Forty-three G-NECs containing 39 small cell carcinomas and 4 large cell NECs with Ki67 > 60% were included in this study, accounting for only 0.95% of all gastric carcinomas. The median patient age was 62 years (range, 33-82) and the male-to-female ratio was 4.4:1. All patients underwent surgery, including 38 curative resections and 5 palliative resections. Among these 43 patients, nearly half (48.84%) of these tumors were located in the cardiac region of the stomach, regional lymph node metastasis was found in 31 cases (72.09%), and liver metastasis was found in 6 cases (13.95%). Follow-up information was got for 40 patients. Twenty-three die of this disease with a median survival of 31 mo (range 1-90). The 1-year, 2-year, 3-year, and 5-year survival rate was 77.50%, 57.04%, 44.51%, and 35.05%, respectively. Survival was better in patients with tumor located in the cardiac region of the stomach, less than 7 lymph nodes metastasis and no liver metastasis. Five patients did not undergo postoperative chemotherapy, and the median survival time for these patients was 15 mo. For the remaining 34 patients who received postoperative chemotherapy, the median survival time was 44 mo and those received etoposide, cisplatin, and Paclitaxel survived the best. One patient with resected liver metastasis who received postoperative Capecitabine plus Oxaliplatin and Paclitaxel systemic chemotherapy plus octreotide LAR (30 mg intramuscularly, every 4 wk, for 2 years) has survived for 74 mo with no recurrence.
CONCLUSION G-NECs are mostly nonfunctioning, which lead to a delay in detection. Local and/or distant metastases were noticed in most patients when diagnosed, and they required postoperative medical treatment. Adjuvant etoposide, cisplatin plus Paclitaxel systemic chemotherapy is recommended for these patients.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Carcinoma, Large Cell/drug therapy
- Carcinoma, Large Cell/mortality
- Carcinoma, Large Cell/pathology
- Carcinoma, Large Cell/surgery
- Carcinoma, Neuroendocrine/drug therapy
- Carcinoma, Neuroendocrine/mortality
- Carcinoma, Neuroendocrine/pathology
- Carcinoma, Neuroendocrine/surgery
- Carcinoma, Small Cell/drug therapy
- Carcinoma, Small Cell/mortality
- Carcinoma, Small Cell/pathology
- Carcinoma, Small Cell/surgery
- Chemotherapy, Adjuvant/methods
- Female
- Follow-Up Studies
- Humans
- Liver Neoplasms/drug therapy
- Liver Neoplasms/mortality
- Liver Neoplasms/secondary
- Liver Neoplasms/surgery
- Lymphatic Metastasis
- Male
- Middle Aged
- Neoplasm Recurrence, Local/epidemiology
- Neoplasm Recurrence, Local/therapy
- Prognosis
- Retrospective Studies
- Stomach Neoplasms/drug therapy
- Stomach Neoplasms/mortality
- Stomach Neoplasms/pathology
- Stomach Neoplasms/surgery
- Survival Analysis
- Survival Rate
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21
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Moriya R, Hokari S, Shibata S, Koizumi T, Tetsuka T, Ito K, Hashidate H, Tsukada H. Histological Transformation to Large Cell Neuroendocrine Carcinoma from Lung Adenocarcinoma Harboring an EGFR Mutation: An Autopsy Case Report. Intern Med 2017; 56:2013-2017. [PMID: 28768973 PMCID: PMC5577079 DOI: 10.2169/internalmedicine.56.7452] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein report a 58-year-old Japanese woman who survived 14 years after surgery for lung adenocarcinoma harboring an epidermal growth factor receptor (EGFR) exon 19 deletion. She developed recurrence, for which she underwent multimodal therapy, including EGFR-tyrosine kinase inhibitor (TKI) administration. She ultimately died from a rapidly progressive right lung tumor that was resistant to EGFR-TKI. According to the autopsy findings, she had combined large-cell neuroendocrine carcinoma (LCNEC) and adenocarcinoma in the right lung, which retained an EGFR exon 19 deletion in both components. Therefore, the histological transformation to LCNEC can be a mechanism of acquired EGFR-TKI resistance.
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MESH Headings
- Adenocarcinoma/genetics
- Adenocarcinoma/pathology
- Adenocarcinoma of Lung
- Autopsy
- Carcinoma, Large Cell/drug therapy
- Carcinoma, Large Cell/genetics
- Carcinoma, Large Cell/pathology
- Carcinoma, Neuroendocrine/drug therapy
- Carcinoma, Neuroendocrine/genetics
- Carcinoma, Neuroendocrine/pathology
- Drug Resistance, Neoplasm/genetics
- ErbB Receptors/genetics
- Fatal Outcome
- Female
- Humans
- Lung Neoplasms/drug therapy
- Lung Neoplasms/genetics
- Lung Neoplasms/pathology
- Middle Aged
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/genetics
- Neoplasm Recurrence, Local/pathology
- Neoplasms, Multiple Primary/drug therapy
- Neoplasms, Multiple Primary/genetics
- Neoplasms, Multiple Primary/pathology
- Protein Kinase Inhibitors/therapeutic use
- Sequence Deletion
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Affiliation(s)
- Rika Moriya
- Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Japan
| | - Satoshi Hokari
- Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Japan
| | - Satoshi Shibata
- Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Japan
| | - Takeshi Koizumi
- Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Japan
| | - Takafumi Tetsuka
- Department of Respiratory Medicine, Niigata City General Hospital, Japan
| | - Kazuhiko Ito
- Department of Respiratory Medicine, Niigata City General Hospital, Japan
| | | | - Hiroki Tsukada
- Department of Respiratory Medicine, Niigata City General Hospital, Japan
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22
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Daido W, Yamasaki M, Saito N, Ishiyama S, Deguchi N, Taniwaki M, Daga H, Ohashi N. [Effectiveness of Nivolumab in Large-Cell Neuroendocrine Carcinoma of the Lung - A Report of Two Cases]. Gan To Kagaku Ryoho 2017; 44:59-62. [PMID: 28174381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND The anti-programmed death-1 antibody nivolumab is an important treatment option for non-small-cell lung carcinoma.However, its effectiveness for large-cell neuroendocrine carcinomas(LCNEC)is still controversial.Here, we report 2 cases of LCNECs that responded to nivolumab.Case 1: A 62-year-old man received chemotherapy and radiotherapy for stage III A lung adenocarcinoma.One year later, another lung lesion was observed and diagnosed as LCNEC using surgical lung biopsy.Although he subsequently received some chemotherapy regimens, the patient developed new brain metastasis, expanded mediastinal lesion, and increased levels of the tumor marker pro-gastrin releasing peptide(ProGRP).We started nivolumab as the sixth-line treatment.In response, ProGRP levels significantly decreased and the mediastinal lesion became smaller.Case 2: A 55-year-old man was diagnosed with stage III A LCNEC and received chemotherapy and radiotherapy.The primary lesion was controlled; however, lung metastases developed and chemotherapy was unable to control them.We provided treatment with nivolumab as the third-line therapy.The tumor marker ProGRP decreased and the lung metastases became smaller. CONCLUSION Nivolumab can be a valuable treatment option for LCNEC.
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Affiliation(s)
- Wakako Daido
- Dept. of Respiratory Disease, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital
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23
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Rudin CM, Pietanza MC, Bauer TM, Ready N, Morgensztern D, Glisson BS, Byers LA, Johnson ML, Burris HA, Robert F, Han TH, Bheddah S, Theiss N, Watson S, Mathur D, Vennapusa B, Zayed H, Lally S, Strickland DK, Govindan R, Dylla SJ, Peng SL, Spigel DR. Rovalpituzumab tesirine, a DLL3-targeted antibody-drug conjugate, in recurrent small-cell lung cancer: a first-in-human, first-in-class, open-label, phase 1 study. Lancet Oncol 2016; 18:42-51. [PMID: 27932068 DOI: 10.1016/s1470-2045(16)30565-4] [Citation(s) in RCA: 357] [Impact Index Per Article: 44.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 09/13/2016] [Accepted: 09/16/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Rovalpituzumab tesirine is a first-in-class antibody-drug conjugate directed against delta-like protein 3 (DLL3), a novel target identified in tumour-initiating cells and expressed in more than 80% of patients with small-cell lung cancer. We aimed to assess the safety and activity of rovalpituzumab tesirine in patients who progressed after one or more previous regimen. METHODS We conducted a phase 1 open-label study at ten cancer centres in the USA. Eligible patients were aged 18 years or older and had histologically or cytologically confirmed small-cell lung cancer or large-cell neuroendocrine tumours with progressive measurable disease (according to Response Evaluation Criteria in Solid Tumors [RECIST], version 1.1) previously treated with one or two chemotherapeutic regimens, including a platinum-based regimen. We assigned patients to dose-escalation or expansion cohorts, ranging from 0·05 mg/kg to 0·8 mg/kg rovalpituzumab tesirine intravenously every 3 weeks or every 6 weeks, followed by investigation of the dose schedules 0·3 mg/kg and 0·4 mg/kg every 6 weeks and 0·2 mg/kg every 3 weeks. Primary objectives were to assess the safety of rovalpituzumab tesirine, including the maximum tolerated dose and dose-limiting toxic effects. The primary activity endpoint was objective response by intention-to-treat analysis. This study is registered with ClinicalTrials.gov, number NCT01901653. The study is closed to enrolment; this report focuses on the cohort with small-cell lung cancer. FINDINGS Between July 22, 2013, and Aug 10, 2015, 82 patients were enrolled, including 74 patients with small-cell lung cancer and eight with large-cell neuroendocrine carcinoma, all of whom received at least one dose of rovalpituzumab tesirine. Dose-limiting toxic effects of rovalpituzumab tesirine occurred at a dose of 0·8 mg/kg every 3 weeks, including grade 4 thrombocytopenia (in two of two patients at that dose level) and grade 4 liver function test abnormalities (in one patient). The most frequent grade 3 or worse treatment-related adverse events in 74 patients with small-cell lung cancer were thrombocytopenia (eight [11%]), pleural effusion (six [8%]), and increased lipase (five [7%]). Drug-related serious adverse events occurred in 28 (38%) of 74 patients. The maximum tolerated dose of rovalpituzumab tesirine was 0·4 mg/kg every 3 weeks; the recommended phase 2 dose and schedule is 0·3 mg/kg every 6 weeks. At active doses of rovalpituzumab tesirine (0·2 mg/kg or 0·4 mg/kg every 3 weeks or 0·3 mg/kg or 0·4 mg/kg every 6 weeks), 11 (18%) of 60 assessable patients had a confirmed objective response. 11 (18%) of 60 assessable patients had a confirmed objective response, including ten (38%) of 26 patients confirmed to have high DLL3 expression (expression in 50% or more of tumour cells). INTERPRETATION Rovalpituzumab tesirine shows encouraging single-agent antitumour activity with a manageable safety profile. Further development of rovalpituzumab tesirine in DLL3-expressing malignant diseases is warranted. FUNDING Stemcentrx Inc.
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MESH Headings
- Aged
- Antibodies, Monoclonal, Humanized/therapeutic use
- Antineoplastic Agents/therapeutic use
- Benzodiazepinones/therapeutic use
- Carcinoma, Large Cell/drug therapy
- Carcinoma, Large Cell/immunology
- Carcinoma, Large Cell/pathology
- Carcinoma, Neuroendocrine/drug therapy
- Carcinoma, Neuroendocrine/immunology
- Carcinoma, Neuroendocrine/pathology
- Dose-Response Relationship, Drug
- Female
- Follow-Up Studies
- Humans
- Immunoconjugates/pharmacology
- Immunoconjugates/therapeutic use
- Intracellular Signaling Peptides and Proteins/immunology
- Lung Neoplasms/drug therapy
- Lung Neoplasms/immunology
- Lung Neoplasms/pathology
- Male
- Maximum Tolerated Dose
- Membrane Proteins/immunology
- Middle Aged
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/immunology
- Neoplasm Recurrence, Local/pathology
- Neoplasm Staging
- Prognosis
- Small Cell Lung Carcinoma/drug therapy
- Small Cell Lung Carcinoma/immunology
- Small Cell Lung Carcinoma/pathology
- Survival Rate
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Affiliation(s)
| | | | - Todd M Bauer
- Tennessee Oncology PLLC, Nashville, TN, USA; Sarah Cannon Research Institute, Nashville, TN, USA
| | - Neal Ready
- Duke University Medical Center, Durham, NC, USA
| | | | | | - Lauren A Byers
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Melissa L Johnson
- Tennessee Oncology PLLC, Nashville, TN, USA; Sarah Cannon Research Institute, Nashville, TN, USA
| | - Howard A Burris
- Tennessee Oncology PLLC, Nashville, TN, USA; Sarah Cannon Research Institute, Nashville, TN, USA
| | - Francisco Robert
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL, USA
| | - Tae H Han
- Stemcentrx Inc, South San Francisco, CA, USA
| | | | - Noah Theiss
- Ventana Medical Systems Inc, Tucson, AZ, USA
| | - Sky Watson
- Ventana Medical Systems Inc, Tucson, AZ, USA
| | | | | | - Hany Zayed
- Stemcentrx Inc, South San Francisco, CA, USA
| | | | | | | | | | | | - David R Spigel
- Tennessee Oncology PLLC, Nashville, TN, USA; Sarah Cannon Research Institute, Nashville, TN, USA
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24
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Naidoo J, Santos-Zabala ML, Iyriboz T, Woo KM, Sima CS, Fiore JJ, Kris MG, Riely GJ, Lito P, Iqbal A, Veach S, Smith-Marrone S, Sarkaria IS, Krug LM, Rudin CM, Travis WD, Rekhtman N, Pietanza MC. Large Cell Neuroendocrine Carcinoma of the Lung: Clinico-Pathologic Features, Treatment, and Outcomes. Clin Lung Cancer 2016; 17:e121-e129. [PMID: 26898325 PMCID: PMC5474315 DOI: 10.1016/j.cllc.2016.01.003] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 01/05/2016] [Accepted: 01/12/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND Large cell neuroendocrine carcinoma (LCNEC) accounts for approximately 3% of lung cancers. Pathologic classification and optimal therapies are debated. We report the clinicopathologic features, treatment and survival of a series of patients with stage IV LCNEC. MATERIALS AND METHODS Cases of pathologically-confirmed stage IV LCNEC evaluated at Memorial Sloan Kettering Cancer Center from 2006 to 2013 were identified. We collected demographic, treatment, and survival data. Available radiology was evaluated by Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 criteria. RESULTS Forty-nine patients with stage IV LCNEC were identified. The median age was 64 years, 63% of patients were male, and 88% were smokers. Twenty-three patients (n = 23/49; 47%) had brain metastases, 17 at diagnosis and 6 during the disease course. Seventeen LCNEC patients (35%) had molecular testing, of which 24% had KRAS mutations (n = 4/17). Treatment data for first-line metastatic disease was available on 37 patients: 70% (n = 26) received platinum/etoposide and 30% (n = 11) received other regimens. RECIST was completed on 23 patients with available imaging; objective response rate was 37% (95% confidence interval, 16%-62%) with platinum/etoposide, while those treated with other first-line regimens did not achieve a response. Median overall survival was 10.2 months (95% confidence interval, 8.6-16.4 months) for the entire cohort. CONCLUSION Patients with stage IV LCNEC have a high incidence of brain metastases. KRAS mutations are common. Patients with stage IV LCNEC do not respond as well to platinum/etoposide compared with historic data for extensive stage small-cell lung cancer; however, the prognosis is similar. Prospective studies are needed to define optimum therapy for stage IV LCNEC.
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Affiliation(s)
- Jarushka Naidoo
- Upper Aerodigestive Division, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD.
| | | | - Tunc Iyriboz
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Kaitlin M Woo
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Camelia S Sima
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - John J Fiore
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Mark G Kris
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Gregory J Riely
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Piro Lito
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Afsheen Iqbal
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Stephen Veach
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Stephanie Smith-Marrone
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Inderpal S Sarkaria
- Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Lee M Krug
- Department of Immuno-Oncology, Bristol Myers-Squibb, New York, NY
| | - Charles M Rudin
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY
| | - William D Travis
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Natasha Rekhtman
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Maria C Pietanza
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY
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25
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Kentepozidis N, Economopoulou P, Christofyllakis C, Chelis L, Polyzos A, Vardakis N, Koinis F, Vamvakas L, Katsaounis P, Kalbakis K, Nikolaou C, Georgoulias V, Kotsakis A. Salvage treatment with irinotecan/cisplatin versus pemetrexed/cisplatin in patients with non-small cell lung cancer pre-treated with a non-platinum-based regimen in the first-line setting: a randomized phase II study of the Hellenic Oncology Research Group (HORG). Clin Transl Oncol 2016; 19:317-325. [PMID: 27492015 DOI: 10.1007/s12094-016-1532-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 07/12/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Platinum-based chemotherapy is the standard front-line treatment for patients with advanced non-small cell lung cancer (NSCLC). However, non-platinum combinations of third-generation chemotherapeutic agents are considered an alternative therapeutic option for patients who cannot tolerate the toxic effects of platinum compounds. In this study, the efficacy and toxicity of the combination of irinotecan plus cisplatin (IC) was compared to pemetrexed plus cisplatin (PC) regimen, in platinum-naïve patients with advanced NSCLC, who had been previously treated with the combination of a taxane plus gemcitabine. PATIENTS AND METHODS A total of 124 patients with locally advanced or metastatic NSCLC were randomly assigned to either irinotecan 110 mg/m2 on day 1 and 100 mg/m2 on day 8 plus cisplatin 80 mg/m2 on day 8 every 3 weeks (IC arm) or pemetrexed 500 mg/m2 plus cisplatin 80 mg/m2 on day 1 every 3 weeks (PC arm). The primary endpoint of the study was the overall response rate (ORR). RESULTS The ORR and median progression-free survival (PFS) in the IC arm were 18 % and 3.3 months, respectively, while in the PC arm were 19 % and 4.2 months (p = ns). Median overall survival (OS) was significantly higher in patients with PC (6.9 vs. 10.9; p = 0.013). PC regimen had a better toxicity profile compared to IC, with a statistically significant lower incidence of grade 3/4 neutropenia (3 vs. 31 %; p = 0.0001) and diarrhea (1.6 vs. 14.7 %, p = 0.018). CONCLUSIONS In patients with advanced NSCLC pretreated with docetaxel/gemcitabine, the combination of pemetrexed/cisplatin is associated with increased OS and is better tolerated than the combination of irinotecan/cisplatin and should be considered as a valid therapeutic option for platinum-naive, previously treated patients. CLINICALTRIALS. GOV IDENTIFIER NCT00614965.
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Affiliation(s)
- N Kentepozidis
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - P Economopoulou
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - Ch Christofyllakis
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - L Chelis
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - A Polyzos
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - N Vardakis
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - F Koinis
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - L Vamvakas
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - P Katsaounis
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - K Kalbakis
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - Ch Nikolaou
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - V Georgoulias
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - A Kotsakis
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece.
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26
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Planchard D, Besse B, Groen HJM, Souquet PJ, Quoix E, Baik CS, Barlesi F, Kim TM, Mazieres J, Novello S, Rigas JR, Upalawanna A, D'Amelio AM, Zhang P, Mookerjee B, Johnson BE. Dabrafenib plus trametinib in patients with previously treated BRAF(V600E)-mutant metastatic non-small cell lung cancer: an open-label, multicentre phase 2 trial. Lancet Oncol 2016; 17:984-993. [PMID: 27283860 DOI: 10.1016/s1470-2045(16)30146-2] [Citation(s) in RCA: 570] [Impact Index Per Article: 71.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 05/06/2016] [Accepted: 05/06/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND BRAF mutations act as an oncogenic driver via the mitogen-activated protein kinase (MAPK) pathway in non-small cell lung cancer (NSCLC). BRAF inhibition has shown antitumour activity in patients with BRAF(V600E)-mutant NSCLC. Dual MAPK pathway inhibition with BRAF and MEK inhibitors in BRAF(V600E)-mutant NSCLC might improve efficacy over BRAF inhibitor monotherapy based on observations in BRAF(V600)-mutant melanoma. We aimed to assess the antitumour activity and safety of dabrafenib plus trametinib in patients with BRAF(V600E)-mutant NSCLC. METHODS In this phase 2, multicentre, non-randomised, open-label study, we enrolled adult patients (aged ≥18 years) with pretreated metastatic stage IV BRAF(V600E)-mutant NSCLC who had documented tumour progression after at least one previous platinum-based chemotherapy and had had no more than three previous systemic anticancer therapies. Patients with previous BRAF or MEK inhibitor treatment were ineligible. Patients with brain metastases were allowed to enrol only if the lesions were asymptomatic, untreated (or stable more than 3 weeks after local therapy if treated), and measured less than 1 cm. Enrolled patients received oral dabrafenib (150 mg twice daily) plus oral trametinib (2 mg once daily) in continuous 21-day cycles until disease progression, unacceptable adverse events, withdrawal of consent, or death. The primary endpoint was investigator-assessed overall response, which was assessed by intention to treat in the protocol-defined population (patients who received second-line or later treatment); safety was also assessed in this population and was assessed at least once every 3 weeks, with adverse events, laboratory values, and vital signs graded according to the Common Terminology Criteria for Adverse Events version 4.0. The study is ongoing but no longer recruiting patients. This trial is registered with ClinicalTrials.gov, number NCT01336634. FINDINGS Between Dec 20, 2013, and Jan 14, 2015, 59 patients from 30 centres in nine countries across North America, Europe, and Asia met eligibility criteria. Two patients who had previously been untreated due to protocol deviation were excluded; thus, 57 eligible patients were enrolled. 36 patients (63·2% [95% CI 49·3-75·6]) achieved an investigator-assessed overall response. Serious adverse events were reported in 32 (56%) of 57 patients and included pyrexia in nine (16%), anaemia in three (5%), confusional state in two (4%), decreased appetite in two (4%), haemoptysis in two (4%), hypercalcaemia in two (4%), nausea in two (4%), and cutaneous squamous cell carcinoma in two (4%). The most common grade 3-4 adverse events were neutropenia in five patients (9%), hyponatraemia in four (7%), and anaemia in three (5%). Four patients died during the study from fatal adverse events judged to be unrelated to treatment (one retroperitoneal haemorrhage, one subarachnoid haemorrhage, one respiratory distress, and one from disease progression that was more severe than typical progression, as assessed by the investigator). INTERPRETATION Dabrafenib plus trametinib could represent a new targeted therapy with robust antitumour activity and a manageable safety profile in patients with BRAF(V600E)-mutant NSCLC. FUNDING GlaxoSmithKline.
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MESH Headings
- Adenocarcinoma/drug therapy
- Adenocarcinoma/genetics
- Adenocarcinoma/secondary
- Adult
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/genetics
- Carcinoma, Large Cell/drug therapy
- Carcinoma, Large Cell/genetics
- Carcinoma, Large Cell/secondary
- Carcinoma, Non-Small-Cell Lung/drug therapy
- Carcinoma, Non-Small-Cell Lung/genetics
- Carcinoma, Non-Small-Cell Lung/secondary
- Female
- Follow-Up Studies
- Humans
- Imidazoles/administration & dosage
- Lung Neoplasms/drug therapy
- Lung Neoplasms/genetics
- Lung Neoplasms/pathology
- Lymphatic Metastasis
- Male
- Middle Aged
- Mutation/genetics
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/genetics
- Neoplasm Recurrence, Local/pathology
- Neoplasm Staging
- Oximes/administration & dosage
- Prognosis
- Proto-Oncogene Proteins B-raf/genetics
- Pyridones/administration & dosage
- Pyrimidinones/administration & dosage
- Survival Rate
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Affiliation(s)
| | - Benjamin Besse
- Gustave Roussy, Villejuif, France; Paris-Sud University, Orsay, France
| | - Harry J M Groen
- University of Groningen, Groningen, Netherlands; University Medical Center Groningen, Groningen, the Netherlands
| | | | - Elisabeth Quoix
- University Hospital, Nouvel Hôpital Civil, Strasbourg, France
| | | | - Fabrice Barlesi
- Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Multidisciplinary Oncology & Therapeutic Innovations Department, Hôpital Nord, Marseille, France
| | - Tae Min Kim
- Seoul National University Hospital, Seoul, South Korea
| | - Julien Mazieres
- Rangueil-Larrey Hospital, Toulouse, France; Paul Sabatier University, Toulouse, France
| | - Silvia Novello
- Department of Oncology, University of Turin, Orbassano, Italy
| | - James R Rigas
- The Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | | | | | - Pingkuan Zhang
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
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27
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Kwon YS, Im KS, Choi DI. Ovarian large cell neuroendocrine carcinoma in the youngest woman. EUR J GYNAECOL ONCOL 2016; 37:244-246. [PMID: 27172753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Large cell neuroendocrine carcinoma (LCNC) of the ovary is a rare tumor in gynecologic oncologic field. An 18-year-old woman presented with abdominal distention and a pelvic mass measuring ten cm in diameter, who previously underwent laparoscopic ovarian cystectomy due to large borderline mucinous ovarian neoplasm 18 months prior. A debulking operation was optimally performed, which included total abdominal hysterectomy with bilateral salpingo-oophorectomy, bilateral pelvic lymph node dissection, bilateral paraaortic lymph node dissection, omentectomy, optimal debulking of gastrohepatic mass and subdiaphragmatic mass, and pelvic peritonectomy. Despite adjuvant chemotherapy with paclitaxel and carboplatin, the patient died of progressive disease seven months after surgery. The authors report the youngest case of LCNC of the ovary, that failed chemotherapy and had the previous history of the conservative surgical treatment due to mucinous borderline tumor.
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28
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Tissot C, Toffart AC, Villar S, Souquet PJ, Merle P, Moro-Sibilot D, Pérol M, Zavadil J, Brambilla C, Olivier M, Couraud S. Circulating free DNA concentration is an independent prognostic biomarker in lung cancer. Eur Respir J 2015; 46:1773-80. [PMID: 26493785 DOI: 10.1183/13993003.00676-2015] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 07/05/2015] [Indexed: 12/25/2022]
Abstract
Plasma circulating cell-free (cf)DNA is of interest in oncology because it has been shown to contain tumour DNA and may thus be used as liquid biopsy. In nonsmall cell lung cancer (NSCLC), cfDNA quantification has been proposed for the monitoring and follow-up of patients. However, available studies are limited and need to be confirmed by studies with larger sample sizes and including patients who receive more homogenous treatments. Our objective was to assess the predictive and prognostic value of plasma cfDNA concentration in a large series of patients with NSCLC and treated with a standard chemotherapy regimen.We included samples from lung cancer patients recruited into the Pharmacogenoscan study. The cfDNA of 218 patients was extracted and quantified by fluorometry before and after two or three cycles of platinum-based chemotherapy. The association between baseline and post-chemotherapy concentrations and treatment response, assessed by RECIST (response evaluation criteria in solid tumours) or patient survival was analysed.Patients with high cfDNA concentrations (highest tertile) at baseline had a significantly worse disease-free and overall survival than those with lower concentrations (lowest and middle tertiles) (median overall survival 10 months (95% CI 10.7-13.9) versus 14.2 months (95% CI 12.6-15.8), respectively; p=0.001). In multivariate analysis, increased baseline concentration of cfDNA was an independent prognostic factor. However, we did not find any association between cfDNA concentration and response to treatment.cfDNA may be a biomarker for the assessment of prognosis in NSCLC. However, total concentration of cfDNA does not appear to predict chemotherapy response.
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MESH Headings
- Adenocarcinoma/blood
- Adenocarcinoma/drug therapy
- Adenocarcinoma/pathology
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers/blood
- Biomarkers, Tumor/blood
- Carcinoma, Large Cell/blood
- Carcinoma, Large Cell/drug therapy
- Carcinoma, Large Cell/pathology
- Carcinoma, Non-Small-Cell Lung/blood
- Carcinoma, Non-Small-Cell Lung/drug therapy
- Carcinoma, Non-Small-Cell Lung/pathology
- Carcinoma, Squamous Cell/blood
- Carcinoma, Squamous Cell/drug therapy
- Carcinoma, Squamous Cell/pathology
- DNA/blood
- DNA, Neoplasm/blood
- Female
- Fluorometry
- Humans
- Lung Neoplasms/blood
- Lung Neoplasms/drug therapy
- Lung Neoplasms/pathology
- Male
- Middle Aged
- Neoplasm Staging
- Prognosis
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Affiliation(s)
- Claire Tissot
- Department of Acute Respiratory Medicine and Thoracic Oncology Department, Lyon Sud Hospital and Lyon University Cancer Institute, Lyon University Hospital, Pierre Bénite, France International Agency for Research on Cancer, Molecular Mechanisms and Biomarkers Group, Lyon, France
| | - Anne-Claire Toffart
- Université Grenoble 1, INSERM, U 823, Institut A Bonniot, Université J Fourier, La Tronche, France Thoracic Oncology Unit, Teaching Hospital A Michallon, Grenoble, France
| | - Stéphanie Villar
- International Agency for Research on Cancer, Molecular Mechanisms and Biomarkers Group, Lyon, France
| | - Pierre-Jean Souquet
- Department of Acute Respiratory Medicine and Thoracic Oncology Department, Lyon Sud Hospital and Lyon University Cancer Institute, Lyon University Hospital, Pierre Bénite, France
| | - Patrick Merle
- Thoracic Oncology Unit, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Denis Moro-Sibilot
- Université Grenoble 1, INSERM, U 823, Institut A Bonniot, Université J Fourier, La Tronche, France Thoracic Oncology Unit, Teaching Hospital A Michallon, Grenoble, France
| | - Maurice Pérol
- Thoracic Oncology Unit, Lyon Cancer Centre Léon Bérard, Lyon, France
| | - Jiri Zavadil
- International Agency for Research on Cancer, Molecular Mechanisms and Biomarkers Group, Lyon, France
| | - Christian Brambilla
- Université Grenoble 1, INSERM, U 823, Institut A Bonniot, Université J Fourier, La Tronche, France Thoracic Oncology Unit, Teaching Hospital A Michallon, Grenoble, France
| | - Magali Olivier
- International Agency for Research on Cancer, Molecular Mechanisms and Biomarkers Group, Lyon, France
| | - Sébastien Couraud
- Department of Acute Respiratory Medicine and Thoracic Oncology Department, Lyon Sud Hospital and Lyon University Cancer Institute, Lyon University Hospital, Pierre Bénite, France EMR 3738 "Therapeutic Targeting in Oncology", Lyon Sud - Charles Mérieux Faculty of Medicine, Lyon 1 University, Oullins, France
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Michelsen L, Sørensen JB. Platinum-Vinorelbine Induction Chemotherapy plus Bevacizumab With and Without Pemetrexed Switch Maintenance in Advanced NSCLC. Anticancer Res 2015; 35:6255-6259. [PMID: 26504059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Little information is available until today regarding the effect of platinum-doublet chemotherapy with bevacizumab followed by pemetrexed as a sole maintenance treatment. Original data concerns different induction regimens plus bevacizumab with bevacizumab maintenance to progression in advanced non-squamous non-small cell lung cancer (NSCLC). PATIENTS AND METHODS Two consecutive groups of patients with advanced non-squamous NSCLC received carboplatin, vinorelbine and bevacizumab for four cycles. Group A (2010-2012) did not receive any maintenance therapy, whereas group B (2012-2013) received pemetrexed switch maintenance (500 mg/m(2)) every three weeks until disease progression. RESULTS The median progression-free survival (PFS) was 4.4 months and 7.3 months (p<0.001) and one-year survival was 42% and 52% for Group A (n=20) and B (n=22) patients, respectively. Disease control rates were 65% and 86% (p=0.104). Deep venous thrombosis and pulmonary embolism occurred in three (15%) and seven (32%) patients in group A and B, respectively. CONCLUSION The inferior PFS (p<0.001) without maintenance suggests that induction treatment including bevacizumab should not be planned without subsequent maintenance treatment. Whether it is better to use pemetrexed or bevacizumab, or a combination of both, as maintenance therapy is not yet established.
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Affiliation(s)
- Linda Michelsen
- Department of Oncology, Finsen Centre-National University Hospital, Copenhagen, Denmark
| | - Jens Benn Sørensen
- Department of Oncology, Finsen Centre-National University Hospital, Copenhagen, Denmark
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30
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Singapore Cancer Network (SCAN) Lung Cancer Workgroup. Singapore Cancer Network (SCAN) Guidelines for the Use of Systemic Therapy in Advanced Non-Small Cell Lung Cancer. Ann Acad Med Singap 2015; 44:449-62. [PMID: 26763063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION The SCAN lung cancer workgroup aimed to develop Singapore Cancer Network (SCAN) clinical practice guidelines for the use of systemic therapy in advanced non-small cell lung cancer (NSCLC) in Singapore. MATERIALS AND METHODS The workgroup utilised a modified ADAPTE process to calibrate high quality international evidence-based clinical practice guidelines to our local setting. RESULTS Five international guidelines were evaluated- those developed by the National Comprehensive Cancer Network (2014), the European Society of Medical Oncology (2014), the National Institute of Clinical Excellence (2012), the Scottish Intercollegiate Guidelines Network (2014) and Cancer Care Council Australia (2012). Recommendations on systemic treatment for advanced NSCLC were produced. CONCLUSION These adapted guidelines form the SCAN guidelines 2015 for systemic therapy of advanced or metastatic NSCLC.
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31
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Li F, Chen G, Jiao S. Bevacizumab Combined with Chemotherapy as First-line Therapy for Advanced Non-Small Cell Lung Cancer: A Retrospective Study. Hepatogastroenterology 2015; 62:797-801. [PMID: 26902004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND/AIMS This study was designed to investigate the effect of bevacizumab plus chemotherapy such as pemetrexed and carboplatin followed by maintenance bevacizumab in patients with advanced, nonsquamous nonsmall cell lung cancer. METHODOLOGY Previously untreated patients with advanced, non-squamous nonsmall cell lung cancer received bevacizumab 15 mg/kg, pemetrexed 500 mg/m2 and carboplatin atan area under the concentration-time curve of 6 intravenously on day 1 every 21 days. Responding or stable patients who completed 6 cycles then received bevacizumab maintenance every 21 days until disease progression. In total, 32 patients were entered on the study. RESULTS No complete responses were observed, and 16 patients (50%) had a partial response. Sixteen patients (50%) displayed disease stability. The progression-free survival was 11.92 ± 6.12 months, and the overall survival was 12.52 ± 5.56 months. Treatment-related grade adverse events were obsearved gastrointestinal reaction (68%), rash (2%), Pectoralgia (1%), headache (1%), rlopecia (1%), renal function (1%), liver function (1%), and diarrhea (1%). CONCLUSIONS Combined pemetrexed, and carboplatin followed by maintenance bevacizumab was well tolerated and displayed remarkable effect in patients with advanced, nonsquamous nonsmall cell lung cancer.
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32
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Daghfous H, Kotti A, Ayadi A, Belloumi N, Ben Miled K, Kilani T, Tritar F. [Case report of tonsillar metastasis of large cell carcinoma of the lung treated with chemotherapy]. Tunis Med 2015; 93:120-122. [PMID: 26337316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Vilmar A, Santoni-Rugiu E, Cillas JGF, Huarriz M, Sørensen JB. Insulin-like growth factor receptor 1 mRNA expression as a prognostic marker in advanced non-small cell lung cancer. Anticancer Res 2014; 34:2991-2996. [PMID: 24922664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND The insulin-like growth factor 1 receptor (IGF1R) has yet to be established as a biomarker in non-small cell lung cancer (NSCLC) but could prove useful in customized chemotherapy. We explored its prognostic value using both quantitative real-time reverse transcriptase polymerase chain reaction (qRT-PCR) and immunohistochemistry (IHC). MATERIALS AND METHODS Analyses of IGF1R were performed on patients with advanced NSCLC, included in a randomized chemotherapy trial, having large, representative tissue samples. IGF1R mRNA and protein expression were correlated to clinical end-points. RESULTS Surgical tissue samples were available from 33 patients deemed inoperable. IGF1R status varied according to histopathology. Patients with tumors positive for IGF1R mRNA expression had a shorter progression-free and overall survival when compared to the negative sub-group (6.1 vs. 7.4 months, p=0.039 and 10.9 vs. 14.3 months, p=0.038, respectively). IGF1R protein expression showed a similar, although non-significant tendency. CONCLUSION IGF1R mRNA expression may be a prognostic biomarker in advanced NSCLC and should be investigated in a larger population.
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MESH Headings
- Adenocarcinoma/drug therapy
- Adenocarcinoma/genetics
- Adenocarcinoma/mortality
- Adenocarcinoma/secondary
- Adolescent
- Adult
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Carcinoma, Large Cell/drug therapy
- Carcinoma, Large Cell/genetics
- Carcinoma, Large Cell/mortality
- Carcinoma, Large Cell/secondary
- Carcinoma, Non-Small-Cell Lung/drug therapy
- Carcinoma, Non-Small-Cell Lung/genetics
- Carcinoma, Non-Small-Cell Lung/mortality
- Carcinoma, Non-Small-Cell Lung/secondary
- Carcinoma, Squamous Cell/drug therapy
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/mortality
- Carcinoma, Squamous Cell/secondary
- Cohort Studies
- Female
- Follow-Up Studies
- Humans
- Immunoenzyme Techniques
- Lung Neoplasms/drug therapy
- Lung Neoplasms/genetics
- Lung Neoplasms/mortality
- Lung Neoplasms/pathology
- Male
- Middle Aged
- Neoplasm Staging
- Prognosis
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Real-Time Polymerase Chain Reaction
- Receptor, IGF Type 1/genetics
- Receptor, IGF Type 1/metabolism
- Reverse Transcriptase Polymerase Chain Reaction
- Survival Rate
- Young Adult
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Affiliation(s)
- Adam Vilmar
- Department of Oncology, Finsen Centre, National University Hospital, Copenhagen, Denmark Laboratory of Pharmacogenomics, Division of Oncology, Center for Applied Medical Research, University of Navarra, Pamplona, Spain
| | - Eric Santoni-Rugiu
- Department of Pathology, Diagnostic Centre, National University Hospital, Copenhagen, Denmark
| | - Jesus Garcia-Fon Cillas
- Laboratory of Pharmacogenomics, Division of Oncology, Center for Applied Medical Research, University of Navarra, Pamplona, Spain
| | - Marsisol Huarriz
- Laboratory of Pharmacogenomics, Division of Oncology, Center for Applied Medical Research, University of Navarra, Pamplona, Spain
| | - Jens Benn Sørensen
- Department of Oncology, Finsen Centre, National University Hospital, Copenhagen, Denmark
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Fujimura Y, Nakahara O, Otao R, Goto H, Baba H. [A case of large cell neuroendocrine carcinoma of the stomach with liver metastasis effectively treated with S-1 and CDDP combination therapy]. Gan To Kagaku Ryoho 2014; 41:369-371. [PMID: 24743286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A 73-year-old man was referred to our hospital because of appetite loss and weight loss in January 2009. Endoscopy showed an advanced type II gastric tumor at the middle of the gastric wall, and computed tomography showed multiple liver metastases. Immunohistological examination confirmed a diagnosis of large cell neuroendocrine carcinoma which was chromogranin A(+), CD56(+), and synaptophysin(+). Oral administration of S-1(100mg/body)was given 5 days on and 2 days off, while cisplatin(CDDP 40 mg/body)was administered intravenously once every 2 weeks. The patient achieved a partial response(PR), and no serious adverse effects were observed. This case suggests that S-1/CDDP chemotherapy may be an effective treatment in patients with large cell neuroendocrine carcinoma of the stomach.
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Hata A, Katakami N, Tanaka K, Takeshita J, Matsumoto T, Monden K, Nagata K, Masago K, Kaji R, Fujita S, Tachikawa R, Otsuka K, Otsuka K, Tomii K. Bevacizumab plus weekly paclitaxel with or without carboplatin for previously-treated non-squamous non-small cell lung cancer. Anticancer Res 2014; 34:275-281. [PMID: 24403474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM The aim of this retrospective study was to evaluate bevacizumab combined with weekly paclitaxel with and without carboplatin in pre-treated patients with non-squamous non-small cell lung cancer (NSCLC). PATIENTS AND METHODS Between November 2009 and October 2011, 43 pre-treated patients with non-squamous NSCLC received bevacizumab (15 mg/kg, day 1) plus weekly paclitaxel (60-80 mg/m(2), days 1, 8, 15) with carboplatin (area under the curve=4-5, day 1) (n=36), or bevacizumab plus weekly paclitaxel (n=7) alone every four weeks. RESULTS The response rate and disease control rates were 48.8% (21/43) and 86.0% (37/43), respectively. Median progression-free survival was 5.7 months, and overall survival was 14.5 months. Grade 3/4 neutropenia was observed in 37.2% of patients and peripheral neurotoxicity in 0%. No bevacizumab-related death was observed. CONCLUSION Even for heavily pre-treated patients, bevacizumab plus weekly paclitaxel with or without carboplatin was effective and tolerable in non-squamous NSCLC.
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Affiliation(s)
- Akito Hata
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation, 2-2, Minatojima-minamimachi, Chuo-ku, Kobe, Japan.
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36
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Cvijovic G, Micic D, Kendereski A, Zoric S, Sumarac-Dumanovic M, Tatic S, Trivic A, Pejkovic-Stamenkovic D, Jeremic D. Ectopic calcitonin secretion in a woman with large cell neuroendocrine lung carcinoma. Hormones (Athens) 2013; 12:584-90. [PMID: 24457407 DOI: 10.14310/horm.2002.1447] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Serum calcitonin (CT) is a sensitive but not specific marker for medullary thyroid carcinoma (MTC). There are a large number of conditions that may elevate CT levels. CASE REPORT Herein we present the case of a 47-year old woman with Hashimoto thyroiditis, goiter, cervical lymphadenopathy and high CT and CEA levels. After surgical extirpation of the lymph node neuroendocrine cancer metastasis was suspected. Computed tomography of the chest showed a tumor mass on the right lung. Bronchoscopy was performed and pathological and immunohistochemical analysis revealed large cell neuroendocrine lung cancer (LCNEC). After chemotherapy, significant reduction of tumor mass was achieved with a moderate decrease in CT levels in parallel. CONCLUSIONS We present a female with LCNEC, a condition which is usually observed in older men (7(th) decade) and is not associated with CT secretion. Hashimoto thyroiditis is associated with increased incidence of different types of cancers (e.g. thyroid, colon). No reports at present exist on the incidence of lung cancers in patients with thyroid disease.
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Affiliation(s)
- Goran Cvijovic
- Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Faculty of Medicine, University of Belgrade, Serbia
| | - Dragan Micic
- Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Faculty of Medicine, University of Belgrade, Serbia
| | - Aleksandra Kendereski
- Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Faculty of Medicine, University of Belgrade, Serbia
| | - Svetlana Zoric
- Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Clinical Center of Serbia, Serbia
| | - Mirjana Sumarac-Dumanovic
- Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Faculty of Medicine, University of Belgrade, Serbia
| | - Svetislav Tatic
- Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Institute of Pathology, Faculty of Medicine, University of Belgrade, Serbia
| | - Aleksandar Trivic
- Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Institute for Otorhynolaryngology and Maxillofacial Surgery, Clinical Center of Serbia, Serbia
| | | | - Danka Jeremic
- Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Clinical Center of Serbia, Serbia
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37
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Tanno S, Onodera H, Inoue S, Honda R, Nagashima K, Ohsaki Y. [An elderly patient with large cell neuroendocrine carcinoma(LCNEC)for whom chemotherapy with irinotecan and split-dose cisplatin(CDDP)proved very effective]. Gan To Kagaku Ryoho 2013; 40:1205-1208. [PMID: 24047780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Large cell neuroendocrine carcinoma(LCNEC)is a rare malignant disease with a poor and the clinical outcome. Although no standard chemotherapy regimen has been developed, LCNEC should be treated in a manner similar to that used for small cell lung cancer because of their similar chemosensitivity and aggressive characteristics, even though LCNEC is classified as non-small cell lung cancer. A 78-year-old man was admitted with the complaint of convulsions on the left side of his body. A chest computed tomographic(CT)scan on admission demonstrated a 4 cm mass in a left lung S9. Brain magnetic resonance imaging(MRI)revealed enhanced tumors in the left occipital lobe. The brain tumor was surgically resected and histological findings were diagnosed as LCNEC. After induction of 4 courses with irinotecan and split-dose cisplatin chemotherapy, a partial response was obtained. After 4 courses, the tumor size was increased, and the chemotherapy was changed to amrubicin. The patient is alive and with no relapse.
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Affiliation(s)
- Sachie Tanno
- Dept. of Respiratory Medicine, Sapporo Higashi Tokushukai Hospital, Japan
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38
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Kobold S, Völk S, Clauditz T, Küpper NJ, Minner S, Tufman A, Düwell P, Lindner M, Koch I, Heidegger S, Rothenfuer S, Schnurr M, Huber RM, Wilczak W, Endres S. Interleukin-22 is frequently expressed in small- and large-cell lung cancer and promotes growth in chemotherapy-resistant cancer cells. J Thorac Oncol 2013; 8:1032-42. [PMID: 23774470 DOI: 10.1097/jto.0b013e31829923c8] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION In lung cancer, interleukin-22 (IL-22) expression within primary tissue has been demonstrated, but the frequency and the functional consequence of IL-22 signaling have not been addressed. This study aims at analyzing the cellular effects of IL-22 on lung carcinoma cell lines and the prognostic impact of IL-22 tissue expression in lung cancer patients. METHODS Biological effects of IL-22 signaling were investigated in seven lung cancer cell lines by Western blot, flow cytometry, real-time polymerase chain reaction, and proliferation assays. Tumor tissue specimens of two cohorts with a total of 2300 lung cancer patients were tested for IL-22 expression by immunohistochemistry. IL-22 serum concentrations were analyzed in 103 additional patients by enzyme-linked immunosorbent assay. RESULTS We found the IL-22 receptor 1 (IL-22-R1) to be expressed in six of seven lung cancer cell lines. However IL-22 signaling was functional in only four cell lines, where IL-22 induced signal transducer activator of transcription 3 phosphorylation and increased cell proliferation. Furthermore, IL-22 induced the expression of antiapoptotic B-cell lymphoma 2, but did not rescue tumor cells from carboplatin-induced apoptosis. Cisplatin-resistant cell lines showed a significant up-regulation of IL-22-R1 along with a stronger proliferative response to IL-22 stimulation. IL-22 was preferentially expressed in small- and large-cell lung carcinoma (58% and 46% of cases, respectively). However, no correlation between IL-22 expression by immunohistochemistry and prognosis was observed. CONCLUSION IL-22 is frequently expressed in lung cancer tissue. Enhanced IL-22-R1 expression and signaling in chemotherapy-refractory cell lines are indicative of a protumorigenic function of IL-22 and may contribute to a more aggressive phenotype.
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Affiliation(s)
- Sebastian Kobold
- Department of Internal Medicine IV, Division of Clinical Pharmacology and Center of Integrated Protein Science, Ludwig-Maximilians Universität München, Member of the German Center for Lung Research, Munich, Germany.
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39
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Cojocaru DC, Dima-Cozma C, Postolache P. Metachronous lung cancer--case presentation. Rev Med Chir Soc Med Nat Iasi 2013; 117:686-689. [PMID: 24502036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Multiple primary tumors can be synchronous when detected simultaneously or metachronous when detected after a variable time interval. We present the case of a 62-year-old female patient with a history of keratinized squamous cell carcinoma of the cervix, stage T3bNxM, operated, and treated by chemotherapy and radiation therapy which develops after three years a large cell neuroendocrine carcinoma of the lung detected by imaging. Of major importance in the selection of the optimal therapeutic approach was the accurate determination of the histological type of the metachronous tumor by microscopy and immunohistochemical techniques. The discrete respiratory symptoms and the absence of lung imaging screening accounted for tumor development to an inoperable stage, thus emphasizing the importance of close monitoring of the oncologic patient, thus greatly increasing their chances of survival.
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Affiliation(s)
| | - Corina Dima-Cozma
- Cardiovascular Rehabilitation Clinic, University of Medicine and Pharmacy "Grigore T. Popa"- Iasi
| | - Paraschiva Postolache
- Pulmonary Rehabilitation Clinic, University of Medicine and Pharmacy "Grigore T. Popa"- Iasi
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40
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Wei Y, Xu Y, Han X, Qi Y, Xu L, Xu Y, Yin L, Sun H, Liu K, Peng J. Anti-cancer effects of dioscin on three kinds of human lung cancer cell lines through inducing DNA damage and activating mitochondrial signal pathway. Food Chem Toxicol 2013; 59:118-28. [PMID: 23764357 DOI: 10.1016/j.fct.2013.05.054] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 05/20/2013] [Accepted: 05/22/2013] [Indexed: 01/04/2023]
Abstract
Dioscin, a natural steroid saponin, has been widely investigated. However, its anti-cancer activities on human lung cancer cells are still unknown. In the present paper, the inhibitory effects of dioscin were investigated, and the results showed that dioscin inhibited the proliferation of human A549, NCI-H446 and NCI-H460 cancer cells. DNA damage and cell apoptosis in dioscin-treated cells were found through single cell gel electrophoresis and in situ terminal deoxynucleotidyl transferase dUTP nick-end labeling assays. Furthermore, dioscin caused mitochondrial structure changes and blocked cell cycle at S phase based on transmission electron microscope and flow cytometry analysis. In addition, dioscin treatment caused the release of cytochrome c from mitochondria into cytosol. The activities of Caspase-3 and -9 in dioscin-treated groups were significantly increased compared with control group. Western blotting analysis showed that dioscin significantly down-regulated the expressions of Bcl-2 and Bcl-xl, and up-regulated the expressions of Bax, Bak and Bid. Our results indicate that dioscin has anticancer activities against human lung cancer cells through inducing cell cycle arrest, DNA damage and activating mitochondrial signal pathway.
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Affiliation(s)
- Yongli Wei
- College of Pharmacy, Dalian Medical University, Dalian 116044, China
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41
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Avila Martínez RJ, Hernández Voth A, Villena Garrido V. Spontaneous hemothorax as a presenting form of bronchogenic carcinoma. Arch Bronconeumol 2013; 49:455. [PMID: 23602323 DOI: 10.1016/j.arbres.2013.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 02/17/2013] [Accepted: 02/18/2013] [Indexed: 11/19/2022]
MESH Headings
- Aged
- Antineoplastic Agents/therapeutic use
- Carcinoma, Bronchogenic/complications
- Carcinoma, Bronchogenic/diagnosis
- Carcinoma, Bronchogenic/drug therapy
- Carcinoma, Bronchogenic/genetics
- Carcinoma, Large Cell/complications
- Carcinoma, Large Cell/diagnosis
- Carcinoma, Large Cell/drug therapy
- Carcinoma, Large Cell/genetics
- ErbB Receptors/antagonists & inhibitors
- ErbB Receptors/genetics
- Female
- Gefitinib
- Genes, erbB-1
- Hemothorax/etiology
- Humans
- Lung Neoplasms/complications
- Lung Neoplasms/diagnosis
- Lung Neoplasms/drug therapy
- Lung Neoplasms/genetics
- Molecular Targeted Therapy
- Mutation
- Neoplasm Proteins/antagonists & inhibitors
- Neoplasm Proteins/genetics
- Pleural Effusion, Malignant/diagnostic imaging
- Pleural Effusion, Malignant/etiology
- Pulmonary Atelectasis/etiology
- Quinazolines/therapeutic use
- Rupture, Spontaneous
- Solitary Pulmonary Nodule/diagnosis
- Solitary Pulmonary Nodule/diagnostic imaging
- Tomography, X-Ray Computed
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42
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Nishijima Y, Hirata H, Himeno A, Kida H, Matsumoto M, Takahashi R, Otani Y, Inoue K, Nagatomo I, Takeda Y, Kijima T, Tachibana I, Fujimura Y, Kumanogoh A. Drug-induced thrombotic thrombocytopenic purpura successfully treated with recombinant human soluble thrombomodulin. Intern Med 2013; 52:1111-4. [PMID: 23676600 DOI: 10.2169/internalmedicine.52.9180] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 61-year-old woman with recurrent non-small cell lung cancer presented with thrombocytopenia, microangiopathic hemolytic anemia, neurological abnormalities, renal failure and a fever that appeared during chemotherapy with gemcitabine and bevacizumab. She was diagnosed with drug-induced thrombotic thrombocytopenic purpura (TTP). After the discontinuation of chemotherapy, the administration of recombinant human soluble thrombomodulin and fresh-frozen plasma rapidly ameliorated the TTP. Hypertension preceded the onset of TTP and required the administration of quadruple therapy on admission. However, after three months, the hypertension was controllable without anti-hypertensive drugs. Twelve months later, the ninth course of vinorelbine was administered safely, preventing the patient's lung cancer from progressing.
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MESH Headings
- Acute Kidney Injury/etiology
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/adverse effects
- Antihypertensive Agents/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Bevacizumab
- Carcinoma, Large Cell/complications
- Carcinoma, Large Cell/drug therapy
- Carcinoma, Non-Small-Cell Lung/complications
- Carcinoma, Non-Small-Cell Lung/drug therapy
- Cisplatin/administration & dosage
- Combined Modality Therapy
- Deoxycytidine/administration & dosage
- Deoxycytidine/adverse effects
- Deoxycytidine/analogs & derivatives
- Docetaxel
- Erlotinib Hydrochloride
- Female
- Glutamates/administration & dosage
- Guanine/administration & dosage
- Guanine/analogs & derivatives
- Humans
- Hypertension/drug therapy
- Hypertension/etiology
- Lung Neoplasms/complications
- Lung Neoplasms/drug therapy
- Middle Aged
- Oxonic Acid/administration & dosage
- Pemetrexed
- Plasma
- Purpura, Thrombotic Thrombocytopenic/chemically induced
- Purpura, Thrombotic Thrombocytopenic/drug therapy
- Purpura, Thrombotic Thrombocytopenic/therapy
- Pyridines/administration & dosage
- Quinazolines/administration & dosage
- Recombinant Proteins/therapeutic use
- Solubility
- Taxoids/administration & dosage
- Tegafur/administration & dosage
- Thrombomodulin/therapeutic use
- Gemcitabine
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Affiliation(s)
- Yu Nishijima
- Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine, Japan
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43
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Akopov AL, Rusanov AA, Chistiakov IV, Urtenova MA, Kazakov NV, Gerasin AV, Papaian GV. [Application of photodynamic therapy to reduce the amount of resection for non-small cell lung cancer]. Vopr Onkol 2013; 59:740-744. [PMID: 24624784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A prospective analysis of results of combined treatment of 22 patients with central stage II-III non-small cell lung cancer (NSCLC) was performed (the defeat of the main bronchi or lower parts of the trachea), which initially had been regarded as unresectable or inoperable (12 patients for functional reasons could not pass pneumonectomy, and in 10 patients a contraindication to primary surgery was the involvement of the distal trachea in tumor), but underwent surgery after preoperative treatment.Combination therapy included preoperative endobronchial photodynamic therapy (PDT) and chemotherapy followed by surgery and intraoperative PDT resection margins. PDT was carried out with the use of chlorine E6 (Radachlorin) and light wavelength of 662 nm. Overall response rate after neoadjuvant treatment was 82 %, endoscopic remission was observed in 21 of 22 patients (95%). 10 patients underwent pneumonectomy, 12--lobectomy. 19 surgical interventions were regarded as radical (R0--86%), 3--as microscopically non-radical (R1--14%). Degree of lymphatic metastasis spreading pN0 was detected in 6 patients (27 %), pN1--in 14 (64%) and pN2--in 2 patients (9%). Surgical lethality was 5%. In the late time of the whole observation period none of the patients developed local recurrence. One-year survival was 95%, 3-year--91%. PDT can play an important role in combination with surgical treatment for NSCLC and reduces the amount of resection in part of initially unresectable or inoperable patients.
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44
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Tanimoto H, Hamasaki A, Akimoto Y, Honda H, Takao Y, Okamoto K, Teramoto M, Teramoto H, Kaneko M, Oshita T. [A case of large cell neuroendocrine carcinoma (LCNEC) of the uterine cervix successfully treated by postoperative CPT-11+CDDP chemotherapy after non-curative surgery]. Gan To Kagaku Ryoho 2012; 39:1439-1441. [PMID: 22996787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A 31-year-old woman, gravida 3 para 3, visited a local clinic because of post-coital bleeding. She was diagnosed as having a uterine-cervical tumor and was referred to our hospital. Large cell neuroendocrine carcinoma (LCNEC) of the uterine cervix was pathologically shown by biopsy. The patient was initially treated by radical hysterectomy. Postoperative pathological examination revealed a direct invasion to the parametrium and the positive resection margin. Postoperatively, she was treated by CPT-11+CDDP. One course of treatment was 60mg/m² of CPT-11 administered on day 1, 8 and 15, and 60 mg/m² of CDDP on day 1, with an intermission after administration for 7 days. Six courses were carried out. This treatment resulted in complete remission. A follow-up at the outpatient clinic revealed the patient had been tumor-free for one year and three months after the first treatment. We suggest that postoperative chemotherapy with CPT-11+CDDP might be useful in the treatment of patients with LCNEC of the uterine cervix.
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45
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Kemp KC, Nell MJ, VAN Rensburg CEJ, Swarts JC. Cytotoxicity of ruthenocene-containing β-diketones. Anticancer Res 2012; 32:2915-2918. [PMID: 22753755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Ferrocene-containing β-diketones and cisplatin, [(NH(3))(2)PtCl(2)], possess strong antineoplastic activity. No information is available regarding the anticancer activity of the corresponding ruthenocene complexes. This study examined the cytotoxicity of stable ruthenocene-containing β-diketones. The results were related to the cytotoxicity of cisplatin and the ease of ruthenium electrochemical oxidation. MATERIALS AND METHODS The ruthenocene-containing β-diketones RcCOCH(2)COR where Rc=Ru(II)(C(5)H(5))(C(5)H(4)) and R=CF(3) (1), CH(3) (2), Ph=C(6)H(5) (3) and Fc=Fe(II)(C(5)H(5))(C(5)H(4)) (4) were tested for cytotoxicity against HeLa (human cervix epithelioid) cancer, COR L23 (human large cell lung carcinoma) and the platinum-resistant CoLo 320DM (human colorectal) and COR L23/CPR cancer cell lines. Cell survival was measured by means of the colourimetric 3-(4,5-dimethylthiazol-2-yl)-diphenyltetrazolium bromide (MTT) assay. RESULTS The 50% cell growth inhibition (IC(50)) values of 1-4 towards the cells ranged between 8.2 and 84.6 μmol dm(-3), with 1 being the most cytotoxic complex. Drug activity was directly proportional to the electron density on the ruthenium centre as well as the oxidation potential of the ruthenium core but inversely proportional to the pK(a) of the β-diketones. The strongest activity was observed against the COR L23 cell line, and the weakest activity against COR L23 CPR. CONCLUSION A drug activity-structural relationship exists for ruthenocene-containing β-diketones in that drugs with the lowest electron density on the ruthenium centre are more cytotoxic. Compounds with larger ruthenium oxidation potentials and stronger acid strength (i.e. smaller pK(a) values) are more cytotoxic.
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Affiliation(s)
- K Christian Kemp
- Department of Chemistry, University of the Free State, Bloemfontein 9300, Republic of South Africa
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An SJ, Huang YS, Chen ZH, Su J, Yang Y, Chen JG, Yan HH, Lin QX, Yang JJ, Yang XN, Zhou Q, Zhang XC, Wu YL. Posttreatment plasma VEGF levels may be associated with the overall survival of patients with advanced non-small cell lung cancer treated with bevacizumab plus chemotherapy. Med Oncol 2012; 29:627-32. [PMID: 21461966 DOI: 10.1007/s12032-011-9924-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Accepted: 03/22/2011] [Indexed: 12/26/2022]
Abstract
We sought to find blood-based biomarkers that can be used to predict efficacy in advanced non-small cell lung cancer patients treated with bevacizumab plus chemotherapy. Blood was collected before treatment and after 6 weeks of therapy from patients who were participating in a phase 4 trial. Plasma vascular endothelial growth factor (VEGF) levels were evaluated by ELISA. A total of eight single nucleotide polymorphisms in four candidate genes were analyzed by PCR and sequencing. A total of 45 patients enrolled in a clinical trial at Guangdong General Hospital between August 2007 and March 2008 were used as subjects. The median survival times of OS was 25.6 and 13.4 months in the low and high groups, respectively, when the median posttreatment plasma VEGF level (46.63 pg/ml) was used as the cut-off point (P = 0.0284). Patients carrying the AA genotype at the -6C > A polymorphism in laminin 5 (LN5) were more likely to exhibit reduced hemoglobin compared with patients carrying the CA/CC genotype (OR = 8.364, χ(2) = 5.34, P = 0.021). Similar associations were found at the -89A > G and -260C > A polymorphisms in LN5. Patients with the CC genotype at the -6C > A polymorphism in LN5 had an increased risk of neutropenia than those with the CA/AA genotype (OR = 4.444, χ(2) = 5.116, P = 0.030). Our results show improved survival in patients with lower posttreatment plasma VEGF levels treated with bevacizumab plus chemotherapy; thus, the posttreatment plasma VEGF level may be a promising biomarker to predict clinical benefit early in the course of therapy. Polymorphisms in LN5 were associated with a reduced level of hemoglobin and neutropenia.
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MESH Headings
- Adenocarcinoma/drug therapy
- Adenocarcinoma/metabolism
- Adenocarcinoma/mortality
- Adult
- Aged
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Bevacizumab
- Carcinoma, Large Cell/drug therapy
- Carcinoma, Large Cell/metabolism
- Carcinoma, Large Cell/mortality
- Carcinoma, Non-Small-Cell Lung/drug therapy
- Carcinoma, Non-Small-Cell Lung/metabolism
- Carcinoma, Non-Small-Cell Lung/mortality
- Cell Adhesion Molecules/genetics
- Enzyme-Linked Immunosorbent Assay
- Female
- Follow-Up Studies
- Humans
- Lung Neoplasms/drug therapy
- Lung Neoplasms/metabolism
- Lung Neoplasms/mortality
- Male
- Middle Aged
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/metabolism
- Neoplasm Recurrence, Local/mortality
- Neoplasm Staging
- Organoplatinum Compounds/administration & dosage
- Polymorphism, Genetic/genetics
- Prognosis
- Survival Rate
- Vascular Endothelial Growth Factor A/metabolism
- Kalinin
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Affiliation(s)
- She-Juan An
- Medical Research Center of Guangdong General Hospital, Guangdong Lung Cancer Institute, Guangdong Academy of Medical Sciences, 510080 Guangzhou, Guangdong, Peoples Republic of China
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47
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Sun JM, Ahn MJ, Ahn JS, Um SW, Kim H, Kim HK, Choi YS, Han J, Kim J, Kwon OJ, Shim YM, Park K. Chemotherapy for pulmonary large cell neuroendocrine carcinoma: similar to that for small cell lung cancer or non-small cell lung cancer? Lung Cancer 2012; 77:365-70. [PMID: 22579297 DOI: 10.1016/j.lungcan.2012.04.009] [Citation(s) in RCA: 110] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Revised: 03/25/2012] [Accepted: 04/05/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND There is controversy regarding palliative chemotherapy for large cell neuroendocrine carcinoma (LCNEC). We evaluated whether advanced LCNEC should be treated similarly to small cell lung cancer (SCLC) or non-small cell lung cancer (NSCLC). PATIENTS AND METHODS The clinical reports and tumor specimens of 45 consecutive patients who were diagnosed with advanced LCNEC were reviewed. They were divided into SCLC (n=11) and NSCLC regimen groups (n=34) according to first-line chemotherapeutic regimens. RESULTS Most patients were male (96%) and smokers (93%) with a median age of 64 years. Neuroendocrine differentiation was established in 42 (93%) tumors by immunohistochemical analyses. Regarding the efficacy of first-line chemotherapy in the SCLC and NSCLC regimen groups, the response rates were 73% and 50% (P=0.19), and the median progression-free survival times were 6.1 and 4.9 months (P=0.41), respectively. The difference in overall survival between the two treatment groups was 7.3 months (16.5 vs. 9.2 months, P=0.10). There was also a considerable difference in the type and efficacy of salvage chemotherapeutic regimens between the two groups: salvage regimens with irinotecan, platinum, or taxanes were commonly used with relatively high objective responses in the SCLC regimen group, whereas frequently used agents in the NSCLC regimen group such as pemetrexed, gefitinib, or erlotinib were associated with no objective response. CONCLUSION Regarding palliative chemotherapy for advanced LCNEC, treatment similar to SCLC is more appropriate than NSCLC.
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Affiliation(s)
- Jong-Mu Sun
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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48
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Dediu M, Ion O, Ion R, Alexandru A, Median D, Gal C, Horvat T, Motas C, Motas N. Impact of adjuvant chemotherapy in stage IB non-small-cell lung cancer: an analysis of 112 consecutively treated patients. J BUON 2012; 17:317-322. [PMID: 22740212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE The impact of adjuvant chemotherapy (CT) in the management of radically resected stage IB non-small cell lung cancer (NSCLC) is highly debated. The aim of this study was to evaluate the outcome of this category of patients treated at our institution. METHODS We retrospectively analysed the survival data of patients with pathologic stage IB NSCLC, who received at least 1 cycle of adjuvant CT. CT was planned to be platinum based and to be delivered for 6 cycles. RESULTS One hundred and twelve consecutively treated patients were evaluated. PATIENT CHARACTERISTICS median age 60 years, median tumor diameter 4 cm, 87% underwent lobectomy and 13% pneumonectomy, 58% had visceral pleural involvement (VPI). After a median follow up of 46 months, the estimated 5-year disease-free (DFS) and overall survival (OS) rates were 68% and 77%, respectively. The mean number of CT cycles was 5.2 (range 3-6), with 82% of patients receiving ≥ 5 cycles. The median cisplatin dose intensity (DI) was 22 mg/m(2)/week, and the relative DI was 85%. Median total cisplatin (CDDP) dose/patient was 416 mg/m(2). A total of 31 (27.6%) relapses were recorded, of which 81% were distant. Multivariate analysis showed no significant interaction between overall survival and the following variables: gender, type of surgery, histology, tumor volume, VPI. CONCLUSION Our results compare favorably with the historical data evaluating the outcome of stage IB patients treated by surgery alone in a customary medical setting. Overall, our data support the use of adjuvant CT in stage IB NSCLC patients.
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Affiliation(s)
- M Dediu
- Department of Medical Oncology, Institute of Oncology, Bucharest, Romania.
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49
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Besse B, Planchard D, Veillard AS, Taillade L, Khayat D, Ducourtieux M, Pignon JP, Lumbroso J, Lafontaine C, Mathiot C, Soria JC. Phase 2 study of frontline bortezomib in patients with advanced non-small cell lung cancer. Lung Cancer 2011; 76:78-83. [PMID: 22186627 DOI: 10.1016/j.lungcan.2011.09.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Revised: 09/08/2011] [Accepted: 09/12/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND Preliminary results indicated that bortezomib (B) (Velcade*) as a single agent may have activity in pretreated NSCLC patients with similar or lesser toxicity compared to chemotherapy. This phase II study was initiated to determine the efficacy of single-agent B in chemonaïve patients with advanced NSCLC. An early tumor assessment (after 6 weeks of therapy) was performed to allow for rapid and appropriate management of non-responding patients. METHODS Patients received B (1.5 mg/m2) twice a week for 2 consecutive weeks (days 1, 4, 8, and 11) followed by a 10-day rest period. The primary endpoint was non-progression rate (NPR) after 6 weeks of treatment. Secondary endpoints included response rate, progression-free survival (PFS), overall survival (OS), and safety. Exploratory analyses included FDG-PET response at 6 weeks and circulating tumors cell (CTC) assessment at day 1 of each cycle in a subset of patients. RESULTS 18 patients were enrolled from 06/06 to 02/07 from 3 French institutions. DEMOGRAPHICS male/female 15/3; median age 66 (54-79); PS 0/1/2, 3/12/3; pathology: adenocarcinoma 11, squamous cell carcinoma 5, large-cell carcinoma 2; smoking status never/former/current 1/10/7; stage IIIB/IV 2/16. Seventeen patients received B and 16 were assessable (1 early withdrawal and 1 progression at D26). The most frequent toxicity was fatigue (17 patients). Twelve patients (71%) had at least one grade 3 toxicity: 4 haematological, 1 infection, 5 gastro-intestinal toxicity, 9 fatigue, 1 neuropathy. The non-progression rate was 59% [33-82%] at 6 weeks (10/17 patients). No objective response was seen. With a median follow-up of 12.3 months, the median PFS and OS were 2.4 and 9.8 months respectively. Eleven deaths occurred. No PET response was observed, and CTC were detected only in 1 out of 8 patients evaluated. CONCLUSIONS Although according to the protocol rules the trial should not be stopped, the lack of any objective response either by CT-scan or PET-CT, along with substantial toxicity, did not argue in favor of the current strategy of B as a single agent in the front-line setting of NSCLC.
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MESH Headings
- Adenocarcinoma/drug therapy
- Adenocarcinoma/mortality
- Adenocarcinoma/pathology
- Aged
- Antineoplastic Agents/therapeutic use
- Boronic Acids/therapeutic use
- Bortezomib
- Carcinoma, Large Cell/drug therapy
- Carcinoma, Large Cell/mortality
- Carcinoma, Large Cell/pathology
- Carcinoma, Non-Small-Cell Lung/drug therapy
- Carcinoma, Non-Small-Cell Lung/mortality
- Carcinoma, Non-Small-Cell Lung/pathology
- Carcinoma, Squamous Cell/drug therapy
- Carcinoma, Squamous Cell/mortality
- Carcinoma, Squamous Cell/pathology
- Female
- Follow-Up Studies
- Humans
- Lung Neoplasms/drug therapy
- Lung Neoplasms/mortality
- Lung Neoplasms/pathology
- Lymphatic Metastasis
- Male
- Maximum Tolerated Dose
- Middle Aged
- Neoplasm Grading
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/pathology
- Neoplasm Staging
- Neoplastic Cells, Circulating/pathology
- Prognosis
- Pyrazines/therapeutic use
- Survival Rate
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Affiliation(s)
- Benjamin Besse
- Département de Médecine, Institut Gustave Roussy, Villejuif, France
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50
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Aparicio A, Tzelepi V, Araujo JC, Guo CC, Liang S, Troncoso P, Logothetis CJ, Navone NM, Maity SN. Neuroendocrine prostate cancer xenografts with large-cell and small-cell features derived from a single patient's tumor: morphological, immunohistochemical, and gene expression profiles. Prostate 2011; 71:846-56. [PMID: 21456067 PMCID: PMC3883511 DOI: 10.1002/pros.21301] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2010] [Accepted: 09/26/2010] [Indexed: 01/24/2023]
Abstract
BACKGROUND Small-cell carcinoma (SCC) of the prostate is an AR-negative variant of prostate cancer found at progression in 10-20% of castrate-resistant disease. Its finding predicts a distinct clinical course and a poor prognosis. Large-cell neuroendocrine carcinoma (LCNEC) is a much rarer variant that behaves similarly to SCC. The biological mechanisms that drive these disease variants are poorly understood. METHODS Eight tumor fragments from the salvage pelvic exenteration specimen of a patient with castrate-resistant prostate carcinoma were subcutaneously implanted into 6- to 8-week-old male CB17 SCID mice. Serial tissue sections and tissue microarrays of the resulting MDA PCa 144 xenograft lines were used for histopathologic and immunohistochemical characterization of the xenografts and their tissue of origin. RNA from two representative xenograft sublines was used for gene-expression profiling. RESULTS All eight fragments formed tumors: four of the MDA PCa 144 xenograft sublines had morphologic characteristics of SCC and four, of LCNEC. All retained high fidelity to their parent tumor tissue, which remained stable through serial passages. Morphological transitions in the specimen of origin suggested LCNEC represents an intermediate step between adenocarcinoma and SCC. Over 2,500 genes were differentially expressed between the SCC (MDA PCa 144-13) and the LCNEC (MDA PCa 144-4) sublines and enriched in "Nervous System Development" Gene Ontology subtree. CONCLUSION The eight xenograft models described represent the spectrum of neuroendocrine carcinomas in prostate cancer and will be valuable preclinical tools to study the pathogenesis of and therapy targets for this increasingly recognized subset of lethal prostate cancer.
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MESH Headings
- Aged
- Animals
- Antineoplastic Agents/therapeutic use
- Carcinoma, Large Cell/drug therapy
- Carcinoma, Large Cell/pathology
- Carcinoma, Large Cell/radiotherapy
- Carcinoma, Neuroendocrine/drug therapy
- Carcinoma, Neuroendocrine/pathology
- Carcinoma, Neuroendocrine/radiotherapy
- Carcinoma, Small Cell/drug therapy
- Carcinoma, Small Cell/pathology
- Carcinoma, Small Cell/radiotherapy
- Gene Expression Profiling
- Gene Expression Regulation, Neoplastic
- Humans
- Male
- Mice
- Mice, SCID
- Prostate-Specific Antigen
- Prostatic Neoplasms/drug therapy
- Prostatic Neoplasms/pathology
- Prostatic Neoplasms/radiotherapy
- Xenograft Model Antitumor Assays
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Affiliation(s)
- Ana Aparicio
- Department of Genitourinary Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
- Correspondence to: Department of Genitourinary Medical Oncology, Unit 1374, 1515 Holcombe Boulevard, Houston, TX 77030-4009. Tel: 713-563-6969; Fax: 713-745-1625;
| | - Vasiliki Tzelepi
- Department of Genitourinary Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
| | - John C. Araujo
- Department of Genitourinary Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
| | - Charles C. Guo
- Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
| | - Shoudan Liang
- Department of Bioinformatics and Computational Biology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
| | - Patricia Troncoso
- Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
| | - Christopher J. Logothetis
- Department of Genitourinary Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
| | - Nora M. Navone
- Department of Genitourinary Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
| | - Sankar N. Maity
- Department of Genitourinary Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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