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Neoadjuvant chemotherapy of NSCLC

Shan Xian Guo, Yan Jian, Ying Lan Chen, Yun Cai, Qing Yuan Zhang, Fang Fang Tou
Neoadjuvant Chemotherapy has been used for the stage III of non-small cell lung cancer (NSCLC) and has shown good clinical effects. However, the survival benefits of radiation therapy added in induction regimens remains controversial. We therefore conducted a meta-analysis of the published clinical trials to quantitatively evaluate the benefit of preoperative chemoradiotherapy. After searching the database of Pubmed, CNKI, EMBASE, ESMO, The Cochrane Library databases, The American Society of Clinical Oncology and Clinical Trials...
September 28, 2016: Scientific Reports
Joshua K Sabari, Jamie E Chaft
Despite broad advances in molecularly targeted therapies, lung cancer remains the leading cause of cancer related mortality in the United States. Epidermal growth factor receptor (EGFR) mutations occur in approximately 17% of advanced non-small cell lung cancer (NSCLC) in the US population. The remarkable efficacy of small-molecule EGFR tyrosine kinase inhibitors (TKIs) in this unique subset of patients has revolutionized the therapeutic approach to lung cancer. The success of these agents in the metastatic setting leads to the logical question of what role these drugs may have in the adjuvant setting for patients with earlier stage disease...
August 2016: Annals of Translational Medicine
Xiaoliang Zhao, Yanjun Su, Jian You, Liqun Gong, Zhenfa Zhang, Meng Wang, Zhenqing Zhao, Zhen Zhang, Xiaolin Li, Changli Wang
To evaluate the safety and efficacy of combining Endostar antiangiogenic therapy with neoadjuvant chemotherapy for the treatment of stage IIIA (N2) NSCLC, we conducted a randomized, controlled, open-label clinical study of 30 NSCLC patients. Patients were randomly assigned to the test or control groups, which received either two cycles of an NP neoadjuvant chemotherapy regimen combined with Endostar or the NP regimen alone, respectively, at a 2:1 ratio. Efficacy was assessed after 3 weeks, and surgical resection occurred within 4 weeks, in the 26 patients who successfully completed treatment...
August 23, 2016: Oncotarget
Zhengbo Song, Xinmin Yu, Yiping Zhang
OBJECTIVE: Programmed death-ligand 1 (PD-L1) is known to be over-expressed in non-small cell lung cancer (NSCLC). However, the impact of chemotherapy on the altered status of PD-L1 expression has not been examined for NSCLC. The present study was intended to examine the impact of neoadjuvant chemotherapy on PD-L1 expression and its prognostic significance in lung squamous cell carcinoma (SCC). PATIENTS AND METHODS: Matched tumor samples were obtained from 76 SCC patients prior to and after neoadjuvant chemotherapy...
September 2016: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Nicolas Paleiron, Olivier Bylicki, Michel André, Emilie Rivière, Frederic Grassin, Gilles Robinet, Christos Chouaïd
Targeted therapies have markedly improved the management of patients with advanced non-small-cell lung cancer (NSCLC), but their efficacy in localized NSCLC is less well established. The aim of this review is to analyze trials of targeted therapies in localized NSCLC. In patients with wild-type EGFR, tyrosine kinase inhibitors have shown no efficacy in Phase III trials. Few data are available for EGFR-mutated localized NSCLC, as routine biological profiling is not recommended. Available studies are small, often retrospectives, and/or conducted in a single-center making it difficult to draw firm conclusions...
2016: OncoTargets and Therapy
Kai-Lin Yang, Yih-Chen Chang, Hui-Ling Ko, Mau-Shin Chi, Hsin-Ell Wang, Pei-Sung Hsu, Chen-Chun Lin, Diana Yu-Wung Yeh, Shang-Jyh Kao, Jiunn-Song Jiang, Kwan-Hwa Chi
BACKGROUND: For marginally operable stage IIIA non-small-cell lung cancer (NSCLC), surgery might not be done as planned after neoadjuvant concurrent chemoradiotherapy (CCRT) for reasons (unresectable or medically inoperable conditions, or patient refusal). This study aims to investigate the outcomes of a phased CCRT protocol established to maximize the operability of marginally operable stage IIIA NSCLC and to care for reassessed inoperable patients, in comparison with continuous-course definitive CCRT...
June 8, 2016: Clinical Lung Cancer
N Zhang, G-Q Yang, X-M Shao, L Wei
OBJECTIVE: In this study, we investigated the association between lncRNA GAS5 and cisplatin (DDP) resistance in NSCLC and further studied the regulative effect of GAS5 on autophagy and DDP resistance. PATIENTS AND METHODS: GAS5 expression in cancerous and adjacent normal tissues from 15 NSCLC patients received neoadjuvant chemotherapy and the following surgery were measured using qRT-PCR analysis. GAS5 gain-and-loss study was performed using A549 and A549/DDP cells as an in-vitro model to investigate the effect of GAS5 on autophagy and cisplatin sensitivity...
June 2016: European Review for Medical and Pharmacological Sciences
Yifan Zheng, Michael T Jaklitsch, Raphael Bueno
Locally advanced (stage IIIA) non-small cell lung cancer (NSCLC) is confined to the chest, but requires more than surgery to maximize cure. Therapy given preoperatively is termed neoadjuvant, whereas postoperative therapy is termed adjuvant. Trimodality therapy (chemotherapy, radiation, and surgery) has become the standard treatment regimen for resectable, locally advanced NSCLC. During the past 2 decades, several prospective, randomized, and nonrandomized studies have explored various regimens for preoperative treatment of NSCLC...
July 2016: Surgical Oncology Clinics of North America
Jarrod D Predina, Jane Keating, Ollin Venegas, Sarah Nims, Sunil Singhal
Non-small Cell Lung Cancer (NSCLC) remains a deadly disease despite aggressive treatment protocols which incorporate chemotherapy, radiation and surgery. These traditional approaches have reached a plateau in therapeutic benefit. There is emerging evidence suggesting that immunotherapy can serve as an alternative treatment modality for NSCLC. Our group has nearly two decades of experience involving immuno-gene therapy with Ad.hIFN-α and Ad.hIFN-β in human mesothelioma trials, and has observed both safety and efficacy in treatment of Thoracic malignancies...
April 2016: Discovery Medicine
Paolo Borghetti, Fernando Barbera, Marco Lorenzo Bonù, Francesca Trevisan, Stefano Ciccarelli, Paola Vitali, Marta Maddalo, Luca Triggiani, Nadia Pasinetti, Sara Pedretti, Bartolomea Bonetti, Gianluca Pariscenti, Andrea Tironi, Alberto Caprioli, Michela Buglione, Stefano Maria Magrini
PURPOSE: To describe the pattern of recurrence in resected pN1 non-small cell lung cancer (NSCLC) and to identify factors predicting an increased risk of locoregional recurrence (LR) or distant metastasis (DM) to define a selected population who may benefit from postoperative radiotherapy (PORT). METHODS: 285 patients with resected pN1 NSCLC were identified. Patients with positive surgical margins, undergoing neoadjuvant treatment or PORT, were excluded. LR was defined as first event of recurrence at the surgical bed, ipsilateral hilum or mediastinum, and other sites were considered as DM...
September 2016: La Radiologia Medica
Arne Warth, Volker Endris, Albrecht Stenzinger, Roland Penzel, Alexander Harms, Thomas Duell, Amir Abdollahi, Michael Lindner, Peter Schirmacher, Thomas Muley, Hendrik Dienemann, Ludger Fink, Alicia Morresi-Hauf, Nicole Pfarr, Wilko Weichert
BACKGROUND: Large scale sequencing efforts defined common molecular alterations in non-small cell lung cancer (NSCLC) and revealed potentially druggable mutations. Yet, systematic data on the changes of the respective molecular profiles under standard therapy in NSCLC are limited. RESULTS: 14 out of 68 observed coding mutations (21%) and 6 out of 33 (18%) copy number variations (CNV) were lost or gained during therapy. Mutational and CNV changes clustered in 6/37 (16%) and 3/37 (8%) patients...
May 17, 2016: Oncotarget
W Schreiner, W Dudek, S Lettmaier, S Gavrychenkova, R Rieker, R Fietkau, H Sirbu
The role of surgical lung resection following neo-adjuvant radio-chemotherapy (RCT) in patients with locally advanced non-small cell lung cancer (NSCLC) is yet not clearly defined. The aim of our study was to analyze the postoperative survival and to identify relevant prognostic factors. 46 patients underwent curative resections after neo-adjuvant RCT for locally advanced NSCLC (IIIA/IIIB) between February 2008 and February 2015. A retrospective data analysis regarding preoperative regression status, perioperative mortality, postoperative survival, patho-histological remission, relapse pattern and other prognostic factors was performed...
June 2016: Zentralblatt Für Chirurgie
Jian Shi, Huichai Yang, Xiaoyang Duan, Lihua Li, Lulu Sun, Qian Li, Junjun Zhang
PURPOSE: The present study aimed to investigate the value of apolipoproteins, including ApoA-1, ApoC-III, and ApoE, in patients with small cell lung cancer (SCLC) as potential biomarkers for diagnosis, prognosis, and cancer progression. MATERIALS AND METHODS: Lung samples were collected from 89 patients with SCLC. Nineteen lung samples from non-small cell lung cancer (NSCLC) patients and 12 normal lung tissues were used as controls. Expression profiles of ApoA-1, ApoC-III, and ApoE in different samples were examined using immunohistochemical methods, and the expression levels were correlated with cancer types, treatment, and outcomes using chi-square and Mann-Whitney tests...
May 2016: Yonsei Medical Journal
Xiao-Ling Xu, Li Dan, Wei Chen, Shuang-Mei Zhu, Wei-Min Mao
BACKGROUND: Approximately 30% of all cases of nonsmall-cell lung cancer (NSCLC) are of a locally advanced (IIIA or IIIB) stage. However, surgical therapy for patients with stage IIIA (N2) NSCLC is associated with a disappointing 5-year survival rate. The optimal treatment for stage IIIA (N2) NSCLC is still in dispute. METHODS: A literature search was performed in the PubMed, Embase, and MEDLINE databases (last search updated in March 2015), and a meta-analysis of the available data was conducted...
2016: OncoTargets and Therapy
Giuseppe Lo Russo, Sara Pusceddu, Claudia Proto, Marianna Macerelli, Diego Signorelli, Milena Vitali, Monica Ganzinelli, Rosaria Gallucci, Nicoletta Zilembo, Marco Platania, Roberto Buzzoni, Filippo de Braud, Marina Chiara Garassino
Lung large cell neuroendocrine carcinoma (L-LCNEC) is a rare, aggressive, and difficult-to-treat tumor. It is classified as a neuroendocrine subtype of large cell lung carcinoma (LCLC) belonging to the non-small cell lung cancer (NSCLC) group, but it is also included in the neuroendocrine tumor (NET) group. Most of the available data related to its treatment derive from retrospective analyses or small case series. For patients with L-LCNEC, prognosis is generally very poor. In early stages (I-II-III), surgery is recommended but does not seem to be sufficient...
June 2016: Tumour Biology: the Journal of the International Society for Oncodevelopmental Biology and Medicine
R Ferrara, S Pilotto, U Peretti, M Caccese, S Kinspergher, L Carbognin, N Karachaliou, R Rosell, G Tortora, E Bria
INTRODUCTION: Although the advent of target therapy for lung cancer has brought about outstanding results, this benefit is confined to a subgroup of molecularly selected patients, whereas for most non-small cell lung cancer (NSCLC) patients, chemotherapy still represents the milestone of treatment. Since their introduction into clinics, microtubule targeting agents (MTA), including vinca alkaloids and taxanes, have been extensively used for NSCLC in different settings and combinations...
June 2016: Expert Opinion on Pharmacotherapy
Xue-Fei Hu, Liang Duan, Ge-Ning Jiang, Chang Chen, K E Fei
Patients with mediastinal lymph node (LN) downstaging following neoadjuvant chemotherapy exhibit improved outcomes compared with patients with persistent N2 disease. The aim of this study was to compare clinicopathological characteristics and survival between patients with unexpected and expected persistent N2 disease following surgery for non-small-cell lung cancer (NSCLC). This retrospective analysis included 348 patients with NSCLC who underwent surgery following chemotherapy at the Shanghai Pulmonary Hospital, Tongji University School of Medicine, between 1995 and 2012...
February 2016: Molecular and Clinical Oncology
Jin Sheng, Wenfeng Fang, Juan Yu, Nan Chen, Jianhua Zhan, Yuxiang Ma, Yunpeng Yang, Yan Huang, Yanhuang, Hongyun Zhao, Li Zhang
The effects of treatments to programmed death ligand-1 (PD-L1) expression is unknown. The aim of this study was to investigate the impact of neoadjuvant chemotherapy (NACT) on PD-L1 expression in non-small cell lung cancer (NSCLC) patients. PD-L1 expression was detected by immunohistochemistry (IHC) method in 32 paired tumor specimens pre and post-NACT. The positivity of PD-L1 on tumor cells (TCs) changed from 75% to 37.5% after NACT (p = 0.003). Cases with IHC score of 1, 2, 3 all underwent apparent decrease (p = 0...
2016: Scientific Reports
Tian Yang, Mingwei Chen, Tianjun Chen, Asmitananda Thakur
Copper transporter family proteins may regulate the chemoresistance of non-small cell lung cancer (NSCLC) to platinum-based anticancer drugs. The present study aimed to investigate the expression of these proteins in lung cancer tissue specimens for association with clinicopathological data and patient responses to chemotherapy and survival. A total of 54 patients with surgically resected NSCLC that received first-line platinum-based doublet chemotherapy were recruited in the present study, and the paraffin-embedded pre-treatment tumor tissue specimens were subjected to immunohistochemical analysis for the expression of human copper transporter 1 (hCtr1) and copper-transporting p-type adenosine triphosphatase 1 (ATP7A) and 2 (ATP7B)...
October 2015: Oncology Letters
Soumyajit Roy, Sushmita Pathy, Rakesh Kumar, Bidhu K Mohanti, Vinod Raina, Anand Jaiswal, Sameer Taywade, Kavita Garg, Sanjay Thulkar, Anant Mohan, Sandeep Mathur, Digamber Behera
OBJECTIVE: The study assessed the role of (18)F-fluorodeoxyglucose ((18)F-FDG) Positron emission tomography (PET)/computed tomography (CT) in evaluating the prognostic value of metabolic response for progression-free survival (PFS) and overall survival (OS) in patients with locally advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Thirty patients with locally advanced NSCLC were enrolled in this prospective study and randomly allocated to one of two treatment arms...
February 2016: Nuclear Medicine Communications
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