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Neoadjuvant chemotherapy of NSCLC

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https://www.readbyqxmd.com/read/29752325/sequential-versus-concurrent-chemoradiation-therapy-by-surgical-margin-status-in-resected-non-small-cell-lung-cancer
#1
Vivek Verma, Amy C Moreno, Waqar Haque, Penny Fang, Steven H Lin
Background: Postoperative chemoradiotherapy (CRT) for non-small cell lung cancer (NSCLC) can be delivered sequentially (sCRT) or concurrently (cCRT). Without high-volume data, current guidelines recommend either option for patients with negative margins (M-) and cCRT for those with positive margins (M+). In this study, survival was compared between sCRT versus cCRT for M- and M+ disease; survival in patients who underwent sCRT was also assessed with chemotherapy-first versus radiotherapy (RT)-first. Methods: The National Cancer Database was queried for patients with primary NSCLC undergoing surgery followed by CRT...
May 2018: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29718155/robotic-resection-of-stage-iii-lung-cancer-an-international-retrospective-study
#2
Giulia Veronesi, Bernard Park, Robert Cerfolio, Mark Dylewski, Alpert Toker, Jacques P Fontaine, Wael C Hanna, Emanuela Morenghi, Pierluigi Novellis, Frank O Velez-Cubian, Marisa H Amaral, Elisa Dieci, Marco Alloisio, Eric M Toloza
OBJECTIVES: Minimally invasive surgery is accepted for early-stage lung cancer, but its role in locally advanced disease is controversial, especially using a robotic platform. The aim of this retrospective study was to assess the safety and effectiveness of robot-assisted resection in patients with Stage IIIA non-small-cell lung cancer (NSCLC) or carcinoid tumours in the series as a whole and in different subgroups according to adjuvant treatment. METHODS: This was a retrospective multicentre study of consecutive patients with clinically evident or occult N2 disease (210 NSCLC and 13 carcinoid) who, in 2007-2016, underwent robot-assisted resection at 7 high-volume centres...
April 30, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29673125/major-pathologic-response-and-rad51-predict-survival-in-lung-cancer-patients-receiving-neoadjuvant-chemotherapy
#3
Apar Pataer, Ruping Shao, Arlene M Correa, Carmen Behrens, Jack A Roth, Ara A Vaporciyan, Ignacio I Wistuba, Stephen G Swisher
In a previous study, we determined that major pathologic response (MPR) as indicated by the percentage of residual viable tumor cells predicted overall survival (OS) in patients with non-small-cell lung cancer (NSCLC) who received neoadjuvant chemotherapy. In this study, we assessed whether two genes and five protein biomarkers could predict MPR and OS in 98 patients with NSCLC receiving neoadjuvant chemotherapy. We collected formalin-fixed, paraffin-embedded specimens of resected NSCLC tumors from 98 patients treated with neoadjuvant chemotherapy...
April 19, 2018: Cancer Medicine
https://www.readbyqxmd.com/read/29593886/immunotherapy-in-surgically-resectable-non-small-cell-lung-cancer
#4
REVIEW
Dwight Owen, Jamie E Chaft
Surgical resection is the mainstay of therapy for patients with resectable and operable early stage non-small cell lung cancer (NSCLC). Surgery alone yields an unacceptably high rate of lung cancer recurrence. The addition of chemotherapy to surgery as adjuvant or neoadjuvant treatment can improve survival rates by roughly 5% at 5 years. Recently, major advances in cancer immunotherapy have led to better outcomes for many patients with lung cancer. Monoclonal antibodies to programmed death 1 and its ligand are now approved for both first and second line treatment patients with metastatic lung cancer...
February 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29572004/phase-ii-trial-of-preoperative-pemetrexed-plus-carboplatin-in-patients-with-stage-ib-iii-nonsquamous-non-small-cell-lung-cancer-nsclc
#5
John D Hainsworth, David M Waterhouse, Kent C Shih, Ralph V Boccia, Victor M Priego, Michael J McCleod, Fred J Kudrik, Reed Brian Mitchell, Howard A Burris, F Anthony Greco, David R Spigel
OBJECTIVES: The combination of pemetrexed and carboplatin is a standard first-line treatment for patients with advanced NSCLC. In this pilot phase II trial, we evaluated the feasibility of using pemetrexed and carboplatin as neoadjuvant therapy, prior to definitive surgical resection, for patients with localized NSCLC. PATIENTS AND METHODS: Patients with potentially resectable, previously untreated, clinical stage IB-III, nonsquamous NSCLC were eligible for this trial...
April 2018: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
https://www.readbyqxmd.com/read/29571989/neoadjuvant-treatment-followed-by-surgery-versus-definitive-chemoradiation-in-stage-iiia-n2-non-small-cell-lung-cancer-a-multi-institutional-study-by-the-oncologic-group-for-the-study-of-lung-cancer-spanish-radiation-oncology-society
#6
F Couñago, N Rodriguez de Dios, S Montemuiño, J Jové-Teixidó, M Martin, P Calvo-Crespo, M López-Mata, M P Samper-Ots, J L López-Guerra, T García-Cañibano, V Díaz-Díaz, L de Ingunza-Barón, M Murcia-Mejía, P Alcántara, J Corona, M M Puertas, M Chust, M L Couselo, E Del Cerro, J Moradiellos, S Amor, A Varela, I J Thuissard, D Sanz-Rosa, B Taboada
OBJECTIVES: The role of surgery in stage IIIA-N2 non-small cell lung cancer (NSCLC) is an actively debated in oncology. To evaluate the value of surgery in this patient population, we conducted a multi-institutional retrospective study comparing neoadjuvant chemoradiotherapy or chemotherapy plus surgery (CRTS) to definitive chemoradiotherapy (dCRT). MATERIAL AND METHODS: A total of 247 patients with potentially resectable stage T1-T3N2M0 NSCLC treated with either CRTS or dCRT between January 2005 and December 2014 at 15 hospitals in Spain were identified...
April 2018: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
https://www.readbyqxmd.com/read/29515398/pulmonary-sarcoidosis-activation-following-neoadjuvant-pembrolizumab-plus-chemotherapy-combination-therapy-in-a-patient-with-non-small-cell-lung-cancer-a-case-report
#7
Ghina Fakhri, Reem Akel, Ziad Salem, Ayman Tawil, Arafat Tfayli
Background: Pembrolizumab is a humanized monoclonal antibody which serves to enhance the antitumor immune response by targeting programmed cell death 1 receptor. The use of pembrolizumab plus carboplatin/pemetrexed combination therapy results in improvement in overall survival and progression-free survival rates for non-small cell lung cancer (NSCLC) patients as compared to chemotherapy alone. However, numerous immune-mediated toxicities of pembrolizumab have been reported. Case Presentation: We report the case of a 74-year-old male patient diagnosed with stage IIIA programmed death-ligand 1-positive non-small cell lung adenocarcinoma treated with 4 cycles of carboplatin/pemetrexed plus pembrolizumab combination therapy followed by 2 cycles of pembrolizumab treatment...
September 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/29484562/concurrent-versus-sequential-chemoradiation-therapy-in-completely-resected-pathologic-n2-non-small-cell-lung-cancer-propensity-matched-analysis-of-the-national-cancer-data-base
#8
Amy C Moreno, Waqar Haque, Vivek Verma, Penny Fang, Steven H Lin
BACKGROUND: Following complete resection of pN2 non-small cell lung cancer (NSCLC), national guidelines recommend either sequential (sCRT) or concurrent chemoradiotherapy (cCRT). This is the largest study to date evaluating survival between both approaches. In sCRT patients, sequencing 'chemotherapy first' versus 'radiotherapy first' was also addressed. METHODS: The National Cancer Data Base (NCDB) was queried for patients with primary NSCLC undergoing surgery (without neoadjuvant radiotherapy or chemotherapy), pN2 disease with negative surgical margins, and receiving postoperative CRT...
May 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29454534/sarcomatoid-carcinoma-of-the-lung-the-mayo-clinic-experience-in-127-patients
#9
Kunlatida Maneenil, Zhiqiang Xue, Ming Liu, Jennifer Boland, Fengying Wu, Shawn M Stoddard, Julian Molina, Ping Yang
BACKGROUND: Pulmonary sarcomatoid carcinoma (PSC) is an unusual form of non-small-cell lung cancer (NSCLC). Because of its rarity and heterogeneity, the treatment and prognosis of PSC have not been clearly described. METHODS AND MATERIALS: We retrospectively evaluated all patients with a diagnosis of PSC from 1997 to 2015 at the Mayo Clinic (Rochester, MN). The clinical characteristics, treatment details, and outcomes were collected. The survival rates of the PSC patients were compared with those for other subtypes of NSCLC...
May 2018: Clinical Lung Cancer
https://www.readbyqxmd.com/read/29425685/out-of-the-darkness-and-into-the-light-new-strategies-for-improving-treatments-for-locally-advanced-non-small-cell-lung-cancer
#10
Yun Zhang, Qin Lin, Ting Xu, Weiye Deng, Jinming Yu, Zhongxing Liao, Jinbo Yue
The standard treatment for locally advanced non-small cell lung cancer (LA NSCLC) includes surgery, radiotherapy, chemotherapy, or some combination of these modalities. Many clinical trials have been conducted in attempts to intensify treatment for LA NSCLC, but with little improvement. A therapeutic plateau had been reached, with no major progress in extending survival for patients with this disease. However, several recent trials of newer targeted therapies and immunotherapies may shed new light on potential therapeutic breakthroughs...
May 1, 2018: Cancer Letters
https://www.readbyqxmd.com/read/29410947/before-or-after-evolving-neoadjuvant-approaches-to-locally-advanced-non-small-cell-lung-cancer
#11
REVIEW
Jennifer Lewis, Erin A Gillaspie, Evan C Osmundson, Leora Horn
The treatment of patients with stage IIIA ( N 2) non-small cell lung cancer (NSCLC) is one of the most challenging and controversial areas of thoracic oncology. This heterogeneous group is characterized by varying tumor size and location, the potential for involvement of surrounding structures, and ipsilateral mediastinal lymph node spread. Neoadjuvant chemotherapy, administered prior to definitive local therapy, has been found to improve survival in patients with stage IIIA ( N 2) NSCLC. Concurrent chemoradiation has also been evaluated in phase III studies in efforts to improve control of locoregional disease...
2018: Frontiers in Oncology
https://www.readbyqxmd.com/read/29338734/comparing-the-benefits-of-chemoradiotherapy-and-chemotherapy-for-resectable-stage-iii-a-n2-non-small-cell-lung-cancer-a-meta-analysis
#12
REVIEW
Yuqiao Chen, Xiong Peng, Yuan Zhou, Kun Xia, Wei Zhuang
BACKGROUND: Induction chemotherapy has been shown to improve survival of patients with stage III A/N2 (T1-3, N2, M0) non-small cell lung cancer (NSCLC), followed by resection, but the benefits of neoadjuvant radiotherapy still remain controversial. METHODS: PubMed, Embase, and Cochrane library databases were searched for relevant randomized controlled trials (RCTs) comparing the outcomes of induction chemoradiotherapy over induction chemotherapy, in patients with resectable stage IIIA/N2 NSCLC...
January 16, 2018: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29314062/postneoadjuvant-adjuvant-chemotherapy-in-resected-n1-non-small-cell-lung-cancer-with-residual-nodal-disease
#13
James W Smithy, Joshua E Rosen, Sarah J Gao, Anthony W Kim
BACKGROUND AND OBJECTIVES: Nodal positivity following neoadjuvant chemotherapy in locally advanced non-small cell lung cancer (NSCLC) is considered a poor prognostic sign, but little data are available on the efficacy of adjuvant chemotherapy in these cases. This analysis sought to determine whether adjuvant chemotherapy was associated with increased survival in NSCLC patients with residual N1 disease at resection. METHODS: Patients from the National Cancer Database (NCDB) with cN1T1-2M0 NSCLC treated with neoadjuvant chemotherapy and definitive resection between 2006 and 2012 were identified...
December 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29239731/practice-patterns-and-outcomes-for-pemetrexed-plus-platinum-doublet-as-neoadjuvant-chemotherapy-in-adenocarcinomas-of-lung-looking-beyond-the-usual-paradigm
#14
V Noronha, S Zanwar, A Joshi, V M Patil, A Mahajan, A Janu, J P Agarwal, P Bhargava, A Kapoor, K Prabhash
AIMS: Neoadjuvant chemotherapy (NACT) is the standard of care in non-small cell lung cancers (NSCLC) with locally advanced N2 disease. There is a scarcity of data for the pemetrexed-platinum regimen as NACT. Also, apart from N2 disease, the role of NACT in locally advanced NSCLCs for tumour downstaging is unclear. MATERIALS AND METHODS: Non-metastatic adenocarcinomas of lung treated with pemetrexed-platinum-based NACT were analysed. The patients with locoregionally advanced N2 disease and those who were borderline candidates for upfront definitive treatment were planned for NACT after discussion in a multidisciplinary clinic...
January 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/29199667/mediastinal-staging-for-non-small-cell-lung-cancer-revisited-it-is-being-done-under-aegis-of-icon-and-lung-cancer-consortium-asia
#15
REVIEW
D Pandey, P Ramanathan, R Pandey, K Prabhash
Mediastinal staging is a crucial factor in the decision making in patients with non-metastatic non-small cell lung cancer (NSCLC). Mediastinoscopy has historically been the gold standard for this purpose. With the advent of PET-CT, the role of an invasive staging modality like mediastinoscopy has been diminishing. Newer developments in endoscopic staging like EBUS and EUS-FNA have also provided means to get a cytological diagnosis of enlarged lymph nodes. With the meta-analyses showing encouraging results of neoadjuvant chemotherapy in operable lung cancers including the early stage disease, the sanctity of invasive mediastinal staging for the sole purpose for selecting patients for upfront surgery is debatable...
January 2017: Indian Journal of Cancer
https://www.readbyqxmd.com/read/29168933/role-of-chemotherapy-and-targeted-therapy-in-early-stage-non-small-cell-lung-cancer
#16
REVIEW
Misako Nagasaka, Shirish M Gadgeel
Adjuvant platinum based chemotherapy is accepted as standard of care in stage II and III non-small cell lung cancer (NSCLC) patients and is often considered in patients with stage IB disease who have tumors ≥ 4 cm. The survival advantage is modest with approximately 5% at 5 years. Areas covered: This review article presents relevant data regarding chemotherapy use in the perioperative setting for early stage NSCLC. A literature search was performed utilizing PubMed as well as clinical trial.gov. Randomized phase III studies in this setting including adjuvant and neoadjuvant use of chemotherapy as well as ongoing trials on targeted therapy and immunotherapy are also discussed...
January 2018: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/29163832/neoadjuvant-chemotherapy-followed-by-surgery-versus-upfront-surgery-in-non-metastatic-non-small-cell-lung-cancer-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#17
Xiao-Nan Zhang, Lei Huang
Background: The favorable effect of postoperative chemotherapy on long-term survival has been well acknowledged in non-small cell lung cancer (NSCLC), while the role of neoadjuvant chemotherapy (NAC) remains obscure. This meta-analysis enrolling high-quality randomized controlled trials (RCTs) aimed at comparing NAC followed by surgery with upfront surgery (US) in efficacy and safety among non-metastatic NSCLC patients. Materials and Methods: Relevant literatures were searched systematically from MEDLINE, EMBASE, and the Cochrane Library...
October 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/29136212/neoadjuvant-and-adjuvant-therapy-for-stage-iii-non-small-cell-lung-cancer
#18
REVIEW
Shun-Ichi Watanabe, Kazuo Nakagawa, Kenji Suzuki, Kazuya Takamochi, Hiroyuki Ito, Jiro Okami, Keiju Aokage, Hisashi Saji, Hiroshige Yoshioka, Yoshitaka Zenke, Tadashi Aoki, Yasuhiro Tsutani, Morihito Okada
The treatments for advanced non-small cell lung cancer (NSCLC) should control both local and microscopic systemic disease, because the 5-year survival of patients with Stage III NSCLC who underwent surgical resection alone has been dismal. One way to improve surgical outcome is the administration of chemotherapy before or after the surgical procedure. During the last two decades, many clinical studies have focused on developing optimal adjuvant or neoadjuvant chemotherapy regimens that can be combined with surgical treatment and/or radiotherapy...
December 1, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29114590/oncological-outcomes-from-trimodality-therapy-receiving-definitive-doses-of-neoadjuvant-chemoradiation-%C3%A2-60-gy-and-factors-influencing-consideration-for-surgery-in-stage-iii-non-small-cell-lung-cancer
#19
Melissa A L Vyfhuis, Neha Bhooshan, Whitney M Burrows, Michelle Turner, Mohan Suntharalingam, James Donahue, Elizabeth M Nichols, Josephine Feliciano, Søren M Bentzen, Shahed Badiyan, Shamus R Carr, Joseph Friedberg, Charles B Simone, Martin J Edelman, Steven J Feigenberg, Pranshu Mohindra
Purpose: Guidelines for locally advanced non-small cell lung cancer (LA-NSCLC) recommend definitive chemoradiation therapy (CRT) for cN2-N3 disease, reserving surgery for patients with minimal nodal involvement at presentation. The current literature suggests that surgery after CRT for stage III NSCLC can improve freedom-from-recurrence (FFR) but has not consistently demonstrated an improvement in overall survival, perhaps partly due to the low (45-50.4 Gy) preoperative doses delivered that result in low rates of mediastinal nodal clearance...
July 2017: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/29036790/predictors-for-the-efficacy-of-endostar-combined-with-neoadjuvant-chemotherapy-for-stage-iiia-n2-nsclc
#20
Xiaoliang Zhao, Xiaohua Wen, Wei Wei, Yanjun Su, Jian You, Liqun Gong, Zhenfa Zhang, Meng Wang, Jianyu Xiao, Xiyin Wei, Changli Wang
BACKGROUND: Endostar (rh-endostatin) is a new recombinant human endostatin, which could inhibit cell proliferation, angiogenesis, and tumor growth. OBJECTIVE: To explore anti-angiogenesis short-term efficacy combined with neoadjuvant chemotherapy for stage IIIA (N2) non-small cell lung cancer (NSCLC), and identify the potential predictive factors. METHODS: We pathologically examined 26 patients diagnosed with stage IIIA (N2) NSCLC who received NP chemotherapy alone or combined with Endostar, respectively...
December 12, 2017: Cancer Biomarkers: Section A of Disease Markers
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