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Elderly, chemotherapy, lung cancer

Xue-Song Zhang, Kui-Yang Wang, Jin-Qi Gao, Ruo-Jie Li, Qing-Bo Guan, Lei Song
The aim of the study was to investigate the expression of tumor suppressor gene p53 and MMP-9 in non-small cell lung cancer (NSCLC) before and after chemotherapy, and investigate its association with the effect of chemotherapy and prognosis. Fifty-eight elderly NSCLC patients comprised the observation group. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used to detect the expression of p53 and MMP-9 in lung cancer tissues before and after chemotherapy. Immunohistochemistry and western blot analysis were used to detect the expression of p53 and MMP-9 proteins in NSCLC tissue before and after chemotherapy...
October 2018: Oncology Letters
Hideyuki Sone, Satoshi Igawa, Masashi Kasajima, Mikiko Ishihara, Yasuhiro Hiyoshi, Shinji Hosotani, Shuntaro Ohe, Hiroki Ito, Nobuki Kaizuka, Hiroya Manaka, Tomoya Fukui, Hisashi Mitsufuji, Masaru Kubota, Masato Katagiri, Jiichiro Sasaki, Katsuhiko Naoki
BACKGROUND: Previous studies have shown amrubicin (AMR) to be an effective second-line treatment option for small-cell lung cancer (SCLC). However, the efficacy of AMR in elderly patients with relapsed SCLC has not been sufficiently evaluated. METHODS: The medical records of elderly patients with relapsed SCLC who received AMR as second-line chemotherapy were retrospectively reviewed, and their treatment outcomes were evaluated. RESULTS: Thirty-one patients with a median age of 72 years (22 patients with sensitive relapse and 9 with refractory relapse) were analyzed...
August 20, 2018: Thoracic Cancer
Grazia Lazzari, Angela Terlizzi, Giovanna Porrazzo, Salvatore Devicienti, Francesco Perri, Giuseppina Della Vittoria Scarpati, Giovanni Silvano
Advanced squamous cell lung carcinoma in elderly patients has a limited chance of cure with first, second line chemotherapy and radiotherapy. Radiotherapy in advanced non-small-cell lung cancer can be used with curative intent for localized or oligometastatic disease using standard or altered fractionations. Current evidence indicates that radiotherapy via diverse cascade mechanisms is able to invoke both local and systemic immunoresponses promoting tumor cell death through an in situ vaccination effect. Moreover, the advancement in immunotherapies is changing the scenario...
2018: OncoTargets and Therapy
Yusuke Chihara, Koji Date, Yoshizumi Takemura, Nobuyo Tamiya, Yoshihito Kohno, Tatsuya Imabayashi, Yoshiko Kaneko, Tadaaki Yamada, Mikio Ueda, Taichiro Arimoto, Junji Uchino, Yoshinobu Iwasaki, Koichi Takayama
This phase I study was aimed at determining the maximum tolerated dose (MTD) and recommended dose (RD) for oral S-1 plus paclitaxel combination therapy in elderly patients with non-small cell lung cancer (NSCLC). Chemotherapy-naïve patients (age, >70 years) with stage III/IV NSCLC were treated with paclitaxel intravenously at four dose levels (DLs), 60, 70, 80, and 90 mg/m2 , on day 1 and 8, and with S-1 (80 mg/m2 ) orally on days 1-14 every 3 weeks. MTD was defined as the dose at which two of the initial three patients experienced dose-limiting toxicities (DLTs)...
August 18, 2018: Investigational New Drugs
Hisao Imai, Yutaka Yamada, Tomohide Sugiyama, Hiroyuki Minemura, Kyoichi Kaira, Kenya Kanazawa, Takashi Kasai, Takayuki Kaburagi, Koichi Minato
BACKGROUND/AIMS: More than 50% of patients with lung cancer are aged > 65 years, and non-small-cell lung cancer (NSCLC) accounts for 85% of all cases of lung cancer among both elderly and adult patients. Subsequent therapies confound the capability to discern the effect of first-line chemotherapy on overall survival (OS). Therefore, using individual-level data, our study aimed to determine the relationships of progression-free survival (PFS) and post-progression survival (PPS) with OS after first-line epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) treatment in elderly patients with NSCLC harboring sensitive EGFR mutations...
2018: Chemotherapy
Fabio Gomes, Rebecca Tay, Jaseela Chiramel, Raffaele Califano
Lung cancer is predominantly a disease of the elderly. This subgroup of patients poses many challenges and an appropriate geriatric assessment is crucial for treatment personalisation in order to reduce the risk of over- or under-treatment. Whilst cytotoxic chemotherapy has been the backbone of advanced non-small cell lung cancer (NSCLC) treatment for decades, the development of targeted agents for driver mutations such as EGFR, ALK, BRAF and ROS1 has changed the treatment paradigm and natural history of this disease...
September 2018: Drugs & Aging
Yun-Gyoo Lee, Ju Hyun Lee, Se-Hyun Kim, Yu Jung Kim, Heeyoung Lee, Soyeon Ahn, Joung-Soon Jang, Jong-Seok Lee, Jee Hyun Kim
INTRODUCTION: To determine whether an upfront combination compared to single-agent therapy is beneficial for elderly patients with advanced non-small cell lung cancer (NSCLC) in the real world, a population-based epidemiologic study was conducted. METHODS: Patients ≥70 years with advanced NSCLC from 2007 to 2012 were identified in the National Health Insurance Service Database of Korea. A Cox proportional-hazards regression model and propensity score analysis were used to examine the effect of treatment modality on survival...
August 2018: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Cesare Gridelli, Alessandro Morabito, Luigi Cavanna, Andrea Luciani, Paolo Maione, Laura Bonanno, Virginio Filipazzi, Silvana Leo, Saverio Cinieri, Fortunato Ciardiello, Marco Angelo Burgio, Domenico Bilancia, Diego Cortinovis, Francesco Rosetti, Roberto Bianco, Vittorio Gebbia, Fabrizio Artioli, Roberto Bordonaro, Vittorio Fregoni, Manlio Mencoboni, Fabrizio Nelli, Ferdinando Riccardi, Giuditta di Isernia, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Simona Signoriello, Maria Carmela Piccirillo, Ciro Gallo, Francesco Perrone
Purpose To test the efficacy of adding cisplatin to first-line treatment for elderly patients with advanced non-small-cell lung cancer (NSCLC) within a combined analysis of two parallel phase III trials, MILES-3 and MILES-4. Patients and Methods Patients with advanced NSCLC who were older than age 70 years with Eastern Cooperative Oncology Group performance status 0 to 1 were randomly assigned to gemcitabine or pemetrexed, without or with cisplatin. In each trial, 382 events were required to detect a hazard ratio (HR) of death of 0...
September 1, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Juliet A Carmichael, Daisy Wing-San Mak, Mary O'Brien
Until recently, chemotherapy has remained the mainstay of treatment for the majority of patients with advanced non-small cell lung cancer (NSCLC). Excellent responses have been observed with immune-checkpoint inhibitors, and targeted treatments for those tumours with actionable mutations, resulting in a paradigm shift in the treatment approach for these patients. Elderly patients and those with poor performance status (PS), such as Eastern Cooperative Oncology Group (ECOG) 2, have historically been excluded from clinical trials due to poor outcomes...
July 18, 2018: Cancers
Ho Cheol Kim, Chi Young Jung, Deog Gon Cho, Jae Hyun Jeon, Jeong Eun Lee, Jin Seok Ahn, Seung Joon Kim, Yeongdae Kim, Young Chul Kim, Jung Eun Kim, Boram Lee, Young Joo Won, Chang Min Choi
BACKGROUND: Lung cancer is a leading cause of morbidity and mortality worldwide, and the incidence continues to rise. Although many prognostic factors have been identified, the clinical characteristics and outcomes in Korean lung cancer patients are not well defined. METHODS: Of the 23,254 new lung cancer cases registered at the Korea Central Cancer Registry in 2013, total 489 patients from 19 hospitals were abstracted by the Korean Central Cancer Registry. The clinical data retrospectively analyzed, patients were followed up until December 2015...
June 19, 2018: Tuberculosis and Respiratory Diseases
Satoshi Igawa, Masayuki Shirasawa, Takahiro Ozawa, Noriko Nishinarita, Yuriko Okuma, Taihei Ono, Ai Sugimoto, Shintaro Kurahayashi, Keisuke Sugita, Hideyuki Sone, Tomoya Fukui, Hisashi Mitsufuji, Masaru Kubota, Masato Katagiri, Jiichiro Sasaki, Katsuhiko Naoki
BACKGROUND: Carboplatin plus etoposide (CE) is a standard treatment for elderly patients with extensive-disease small cell lung cancer (ED-SCLC). However, amrubicin monotherapy (AMR) may be a feasible alternative. We compared the efficacies and safety profiles of CE and AMR for ED-SCLC in elderly patients and chemotherapy-naive patients with poor performance status (PS). METHODS: The records of SCLC patients who received CE or AMR as first-line chemotherapy were retrospectively reviewed and their treatment outcomes evaluated...
August 2018: Thoracic Cancer
Yoshihito Kogure, Hideo Saka, Yuichi Takiguchi, Shinji Atagi, Takayasu Kurata, Noriyuki Ebi, Akira Inoue, Kaoru Kubota, Mitsuhiro Takenoyama, Takashi Seto, Akiko Kada, Takeharu Yamanaka, Masahiko Ando, Nobuyuki Yamamoto, Akihiko Gemma, Yukito Ichinose
BACKGROUND: Treatment with carboplatin (CBDCA) with weekly paclitaxel (PTX) has shown survival benefits compared with vinorelbine or gemcitabine in elderly patients with non-small-cell carcinoma (NSCLC). Docetaxel (DOC), however, remains a standard treatment in NSCLC. The 130-nm albumin-bound formulation of PTX (nab-PTX) has shown activity in NSCLC. Treatment with CBDCA with weekly nab-PTX showed significantly higher efficacy than CBDCA with PTX in patients with squamous histology and significantly increased overall survival (OS) in patients aged 70 years and older...
September 2018: Clinical Lung Cancer
Chrystèle Locher, Nicolas Pourel, Hervé Le Caer, Henri Berard, Jean-Bernard Auliac, Isabelle Monnet, Renaud Descourt, Alain Vergnenègre, Isabelle Martel Lafay, Laurent Greillier, Christos Chouaïd
INTRODUCTION: Few data have been published on the optimal management of elderly patients with locally advanced non-small-cell lung cancers (La-NSCLC). This prospective, multicenter, phase II study was undertaken to evaluate the ability of a comprehensive geriatric assessment (CGA) to select the elderly La-NSCLC patients who potentially may benefit from concurrent radio-chemotherapy. METHODS: The main inclusion criteria were: La-NSCLC, >70 years old, at least one measurable target, ECOG performance status (PS) 0/1 and normal CGA...
July 2018: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Hiroaki Takeoka, Kazuhiko Yamada, Yoshiko Naito, Norikazu Matsuo, Hidenobu Ishii, Takaaki Tokito, Koichi Azuma, Masao Ichiki, Tomoaki Hoshino
BACKGROUND/AIM: The combination of platinum-doublet chemotherapy with bevacizumab has been established as a first-line treatment option in non-elderly patients with non-squamous (non-sq) non-small cell lung cancer (NSCLC). However, the safety and efficacy of this regimen have not yet been fully established in elderly patients. PATIENTS AND METHODS: Chemo-naïve patients with non-sq NSCLC, aged ≥75 years, having a good performance status (Eastern Cooperative Oncology Group performance status 0-1) and adequate organ function were considered eligible...
June 2018: Anticancer Research
James Baumgardner, Ahva Shahabi, Mark Linthicum, Seanna Vine, Christopher Zacker, Darius Lakdawalla
BACKGROUND: Previous research finds significant variation in spending and utilization across regions, with little evidence of differences in outcomes. While such findings have been interpreted as evidence that spending can be reduced without compromising patient outcomes, the link between spending variation and outcomes remains a critical question. OBJECTIVE: To use evidence from geographic variations in spending and an individual-level survival analysis to test whether spending within oncology care episodes is associated with survival, where episodes are defined as in the Center for Medicare and Medicaid Innovation's Oncology Care Model (OCM)...
June 2018: Journal of Managed Care & Specialty Pharmacy
Giuseppe Corona, Milena Gusella, Anna Gaspardo, Gianmaria Miolo, Laura Bertolaso, Elisa Pezzolo, Felice Pasini, Agostino Steffan, Donatella Caruso
A rapid and sensitive LC-MS/MS method for therapeutic drug monitoring oral vinorelbine (VRL) metronomic anticancer chemotherapy has been developed and validated. Analysis of VRL and its main active metabolite 4-O-deacetylvinorelbine (M1) was performed in whole blood matrix. Both analytes were extracted by protein precipitation and separated on an Onyx monolith C18 , 50 × 2 mm column then quantified by positive electrospray ionization and multiple reaction monitoring mode. The LLOQ was 0.05 ng/mL for both VRL and M1...
May 10, 2018: Biomedical Chromatography: BMC
Hisao Imai, Hiroyuki Minemura, Tomohide Sugiyama, Yutaka Yamada, Kyoichi Kaira, Kenya Kanazawa, Takashi Kasai, Takayuki Kaburagi, Koichi Minato
PURPOSE: Epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) is effective as first-line chemotherapy for patients with advanced non-small-cell lung cancer (NSCLC) harboring sensitive EGFR mutations. However, whether the efficacy of second-line cytotoxic drug chemotherapy after first-line EGFR-TKI treatment is similar to that of first-line cytotoxic drug chemotherapy in elderly patients aged ≥ 75 years harboring sensitive EGFR mutations is unclear. Therefore, we aimed to investigate the efficacy and safety of cytotoxic drug chemotherapy after first-line EGFR-TKI treatment in elderly patients with NSCLC harboring sensitive EGFR mutations...
July 2018: Cancer Chemotherapy and Pharmacology
Hossein Borghaei, Yeun Mi Yim, Annie Guerin, Irina Pivneva, Sherry Shi, Mayank Gandhi, Raluca Ionescu-Ittu
OBJECTIVES: Elderly patients with advanced non-small lung cancer (aNSCLC) represent a high-risk patient population due to disease burden, comorbidities, and performance status, particularly after progressing on first-line therapy. Among elderly patients who receive second-line therapy, treatment related toxicities can have substantial impact on both clinical and economic outcomes. This study assessed the impact of severe adverse events (AEs) during second-line therapy on overall survival (OS) and all-cause heathcare costs in elderly with aNSCLC...
May 2018: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Yasuaki Miyazaki, Kazuo Yamabe, Nobuyasu Hayashi, Toshiya Michiura, Tomo Nakagawa, Satoshi Hyuga, Tomotaka Murotani, Makio Nagaoka
The safety and feasibility of the chemotherapy for super-elderly patients over 85 years old have not been clarified yet. We report an extremely aged patient with recurrent rectal cancer that was successfully treated with chemotherapy. A 85-year-old woman underwent Hartmann procedure for rectal cancer. Nine months after surgery, CT scan revealed liver metastases in S5 and S7. We administered capecitabine plus bevacizumab chemotherapy. Liver metastases were disappeared after 6 courses. Although grade 2 hypertension was appeared, no other adverse event occurred...
April 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Eugenie Younger, Saskia Litière, Axel Le Cesne, Olivier Mir, Hans Gelderblom, Antoine Italiano, Sandrine Marreaud, Robin Lewis Jones, Alessandro Gronchi, Winette T A van der Graaf
BACKGROUND: Almost half of patients diagnosed with soft tissue sarcoma (STS) are older than 65 years; however, the outcomes of elderly patients with metastatic disease are not well described. PATIENTS AND METHODS: An elderly cohort of patients aged ≥65 years was extracted from the European Organization for Research and Treatment of Cancer (EORTC) Soft Tissue and Bone Sarcoma Group database of patients treated with first-line chemotherapy for advanced STS within 12 EORTC clinical trials...
April 12, 2018: Oncologist
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