Prognostic significance of ground-glass areas within tumours in non-small-cell lung cancer.

OBJECTIVES: To validate or refute the hypothesis that non-small-cell lung cancers (NSCLC) with ground-glass areas (GGA+) within the tumour on high-resolution computed tomography are associated with a more favourable prognosis than those without GGA (GGA-). METHODS: We analysed data from a multicentre observational cohort study in Japan including 5005 patients with completely resected pathological stage I NSCLC, who were excluded from the Japan Clinical Oncology Group (JCOG) 0707 trial on oral adjuvant treatment during the enrolment period. The patients' medical and pathological records were assessed retrospectively by physicians and re-staged according to the 8th tumour, node, metastasis edition. RESULTS: Of the 5005 patients, 2388 (48%) were ineligible for the JCOG0707 trial and 2617 (52%) were eligible but were not enrolled. A total of 958 patients (19.1%) died. Patients with GGA+ NSCLC and pathological invasion ≤3 cm showed significantly better overall survival than others. In patients with tumours with an invasive portion ≤4 cm, GGA+ was associated with better survival. The prognoses of patients with GGA+ T2a and GGA- T1c tumours were similar (5-year overall survival: 84.6% vs 83.1%, respectively). The survival with T2b or more tumours appeared unaffected by GGA, and GGA was not prognostic in these larger tumours. CONCLUSIONS: Patients with GGA+ NSCLC on high-resolution computed tomography and ≤4 cm invasion size may have a better prognosis than patients with solid GGA- tumours of the same T-stage. However, the presence or absence of radiological GGA has little impact on the prognosis of patients with NSCLC with greater (>4 cm) pathological invasion.

Evaluation of S-1 as third- or further-line chemotherapy in advanced non-small-cell lung cancer.

BACKGROUND: No investigation of S-1 monotherapy in previously treated advanced non-small-cell lung cancer (NSCLC) patients has yet been reported. We conducted a retrospective study to evaluate the efficacy and tolerability of S-1 in patients with failure of second- or further-line chemotherapy. PATIENTS AND METHODS: The records of NSCLC patients who had received S-1 monotherapy between January 2005 and November 2006 with the following eligibility criteria were reviewed: previously treated with at least two regimens including platinum and docetaxel in the case of nonadenocarcinoma patients, and including platinum, docetaxel and epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) in the case of adenocarcinoma patients. S-1 was administered for 28 consecutive days, followed by a 14-day drug-free period (42 days in one course). The drug was administered in two divided doses daily at 80 mg/day for patients with a body surface area <1.25 m(2), 100 mg/day for those with a body surface area of 1.25-1.5 m(2), and 120 mg/day for those with a body surface area > or = 1.5 m(2). RESULTS: Thirty-five patients were registered. The median number of courses administered per patient was 2 (range 1-9). The toxicity profile was mild, and grade 3 or more severe toxicity was rare. The overall response and disease control rates were 5.7% and 40%, respectively. The median survival time was 208 days. CONCLUSION: S-1 exhibits modest activity and acceptable toxicity when used as a third or subsequent line of chemotherapy in patients with advanced NSCLC.

Efficacy of amrubicin for non-small cell lung cancer after failure of two or more prior chemotherapy regimens.

BACKGROUND: No investigation of amrubicin monotherapy in pre-treated advanced non-small cell lung cancer (NSCLC) patients has yet been reported. PATIENTS AND METHODS: The records were reviewed of NSCLC patients who had received amrubicin monotherapy between 2003 and 2007 with the following eligibility criteria:previously treated with at least two regimens including platinum and docetaxel for non-adenocarcinoma patients and platinum, docetaxel and epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKI) for adenocarcinoma patients. Amrubicin was administered to both groups at 35 mg/m2 or 40 mg/m2 for 3 consecutive days, every 3 weeks. RESULTS: Thirty-nine patients were registered. The median number of prior chemotherapy regimens was three (range: 2 to 7). The median number of courses per patient was three (range one to 9). The toxicity profile was acceptable with no grade 3 or higher non-hematological toxicity. The overall response rate was 10.2%. The median survival time was 4.8 months. CONCLUSION: Amrubicin exhibits activity and acceptable toxicity as third or subsequent line of chemotherapy for advanced NSCLC.