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<p><b>OBJECTIVE</b>This study aims to evaluate the efficacy and safety of crizotinib for advanced ALK-positive non-small cell lung cancer (NSCLC) patients.</p><p><b>METHODS</b>Twenty-eight patients with advanced ALK-positive NSCLC were given orally crizotinib 250 mg b. i.d., and were followed up to evaluate the therapeutic efficacy and safety.</p><p><b>RESULTS</b>Among the 28 patients, the objective response rate (ORR) was 71.4% (20/28) and disease control rate (DCR) was 92.9% (26/28). Three patients achieved complete response. Seventeen patients had partial response. The most common drug-related adverse events were mild flickering vision and gastrointestinal reaction. Eleven patients experienced flickering vision. Nine patients had nausea and vomiting. Eight patients had diarrhea. They were all reversible and of grade I or II. Only one patient had grade III myelosuppression. Among the 28 patients, 16 cases were disease-free and 12 cases had progressive disease, with a progression-free survival of 8.2 months.</p><p><b>CONCLUSIONS</b>Crizotinib is effective and tolerable in the treatment of advanced ALK-positive NSLCC. However, its long-term treatment efficacy requires to be further studied.</p>
Subject(s)
Humans , Antineoplastic Agents , Therapeutic Uses , Carcinoma, Non-Small-Cell Lung , Drug Therapy , Pathology , Diarrhea , Disease-Free Survival , Lung Neoplasms , Drug Therapy , Pathology , Nausea , Protein Kinase Inhibitors , Therapeutic Uses , Pyrazoles , Therapeutic Uses , Pyridines , Therapeutic Uses , Receptor Protein-Tyrosine Kinases , VomitingABSTRACT
<p><b>BACKGROUND</b>The preclinical experiments and several clinical studies showed icotinib, an oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, in Chinese patients with advanced non-small cell lung cancer (NSCLC) who failed previous chemotherapy. We performed a retrospective study of the efficacy and safety of icotinib monotherapy in a different and more recent sample of Chinese patients.</p><p><b>METHODS</b>The clinical data of 149 patients with advanced NSCLC who were admitted to Zhejiang Cancer Hospital from August 1, 2011 to July 31, 2012 were retrospectively analyzed. All patients were given icotinib treatment after the failure of previous chemotherapy. Univariate and multivariate analyses were conducted based on the Kaplan Meier method and Cox proportional hazards model.</p><p><b>RESULTS</b>The objective response rate was 33/149 and disease control rate was 105/149. No complete response occurred. Median progression free survival (PFS) with icotinib treatment was 5.03 months (95% CI: 3.51 to 6.55). Median overall survival was 12.3 months (95% CI: 10.68 to 13.92). Multivariate analysis showed that the mutation of EGFR and one regimen of prior chemotherapy were significantly associated with longer PFS. At least one drug related adverse event was observed in 65.8% (98/149) of patients, but mostly grade 1 or 2 and reversible and none grade 4 toxicity.</p><p><b>CONCLUSIONS</b>Icotinib monotherapy is an effective and well tolerated regimen for Chinese patients with NSCLC after the failure of chemotherapy. It is a promising agent and further study with icotinib in properly conducted trials with larger patient samples and other ethnic groups is warranted.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Antineoplastic Agents , Therapeutic Uses , Carcinoma, Non-Small-Cell Lung , Drug Therapy , Crown Ethers , Therapeutic Uses , Lung Neoplasms , Drug Therapy , Multivariate Analysis , Proportional Hazards Models , Quinazolines , Therapeutic Uses , Retrospective StudiesABSTRACT
Background and purpose:Methylene tetrahydrofolate reductase (MTHFR) plays an important role in metabolism of folate and DNA methylation. This study aimed to investigate the relationship between methylene tetrahydrofolate reductase (MTHFR) C677T polymorphism and chemotherapy side effects in advanced non-small cell lung cancer (NSCLC) patients. Methods:A total of 100 patients with advanced NSCLC conifrmed by pathology were included into this study in Zhejiang Cancer Hospital from Jun. 2007 to May. 2009. All patients received the combined chemotherapy of platinum drug and gemcitabine. MTHFR genotypes were determined by allele-specific-PCR technology. Results:In the 100 cases, genotype frequency of MTHFR C677T T/T, T/C and C/C were 20%, 44%and 36%, respectively. Compared with patients of T/T and T/C genotype, patients of C/C genotype were correlated with decreased rate of thrombocytopenia to chemotherapy (P=0.039). No signiifcant differences were observed concerning gastrointestinal toxicity. Conclusion:MTHFR C677T gene polymorphism can be used to predict the adverse reactions to platinum-based chemotherapy in patients with advanced NSCLC.
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Objective To observe the efficacy,toxic side effects, survival time and quality of life (QOL) of vinorelbine and vinorelbine plus carboplatin in elderly patients with stage Ⅲ b/Ⅳ non-small cell lung cancer(NSCLC).Methods Eighty patients aged 65 years or over with stage Ⅲ b/Ⅳ non-small cell lung cancer were randomly divided into two groups.One group was treated with vinorelbine (vinorelbine 25 mg/m2 iv d1,8, repeated every 21 days), the other group was treated with vinorelbine plus carboplatin(vinorelbine 25 mg/m2 iv at day 1 and 8 and earboplatin AUC5 iv at day 1, repeated every 21 days).Results The response rate(RR), median survival time(MST) and 1-year survival rate were 35.0%, 9.0 months and 35.0% in vinorelbine group and were 42.5%, 10.0 months and 37.5% in vinorelbine plus carboplatin group respectively.There was no significant difference between two groups(χ2 =0.296,P=0.586).The incidences of Ⅲ-Ⅳ degree granulocytopenia (χ2 =7.168,P=0.014), Ⅲ-Ⅳ degree thrombocytopenia (χ2 = 5.165,P=0.048)and Ⅲ-Ⅳ degree nausea and vomiting (χ2 =6.275, P =0.025) were significantly higher in the combined chemotherapy group than in the vinorelbine treatment group.The scores of lung cancer symptom scale (LCSS) of appetite loss(χ2 =2.600,P=0.011), fatigue(χ2 =3.169,P=0.002) and pain(χ2 =2.257,P=0.027) were more higher in the vinorelbine treatment group than in the combined chemotherapy group.Conclusions Vinorelbine regimen is effective, well tolerated and more favorable for the elderly NSCLC patients.
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Background and purpose:Pemetrexed is a multitargeted anti-metabolite. Pemetrexed has been approved as the second-line treatment in non-small cell lung cancer. Our aim was to evaluate the clinical effi ciency and toxicity of pemetrexed in treatment of advanced retreated non-small cell lung cancer. Methods:17 advanced retreated NSCLC patients received pemetrexed at a dose of 500 mg/m2, the chemotherapy was repeated every 21 days on two cycles until progressive disease or untolerant adverse effects. Results:Among 17 patients, the overall response rate was 11.8%, the clinical benefi t rate was 76.5%, and the main toxicity was hematological toxicties. Conclusions: Pemetrexed is effective in treatment of advanced retreated non-small lung cancer and the toxicity can be well tolerated.
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Objective: To observe the safety and clinical efficacy of tumor antigen-pulsed dendritic cell(DC) vaccine in treatment of advanced malignant tumor.Methods: Ninety-one patients with non-small cell lung cancer,colon and rectal cancer,melanoma,renal carcinoma,breast cancer and other malignant tumors were enrolled in this study.All patients met the selecting standard and signed informed consent.Human dendritic cells were obtained from peripheral blood monocytes by culturing them with granulocyte macrophage-colony stimulating factor and interleukin-4.DC vaccine was prepared from tumor antigen pulsed immature dendritic cells in vitro.Patients received the vaccine therapy once every week and one cycle was defined as once every week for 3 weeks.Results: All the patients received 96 cycles of DC vaccine treatment.Symptoms of toxicity included fever,shivering,aching pain of muscle,asthenia,itching,stifle and transient fatigue;most of the symptoms automatically recovered.Clinical efficacy of the treatment was evaluated in 76 patients.Thirty-one of the 76 patients were stable after treatment and 45 were in progressive situation,with the clinical benefiting rate being 40.8%.Eighty-five patients were followed up.The median time for progression was 2.6 months;the overall survival time was 0.9-30.6 months;and the median survival period was 4.5 months,with the one year survival rate being 9.2%.Conclusion: The results suggest that the DC vaccine therapy is well tolerated in treating patients with advanced malignant tumors and has satisfactory clinical benefit;the clinical value of DC vaccine therapy needs to be further observed.