RESUMO
Background: Lung cancer is the top cause of mortality in males and the second largest cause of cancer-related fatalities in women worldwide. Non-small cell lung cancer (NSCLC) cases are discovered at an advanced stage, raising major challenges in disease management and survival outcomes. This study aimed to investigate the clinical findings and management of stage IIIB and IV NSCLC patients for better decision-making, disease management, and understanding of this fatal disease. Methods: In this cohort study of 340 patients, a total of 140 (41.2%) were diagnosed with advanced-stage NSCLC at a mean age of 64 years. The electronic data of patients from 2015 to 2021 who met the inclusion criteria were retrieved from two tertiary hospitals in Riyadh, Saudi Arabia, and an Excel sheet was used to record the variables. Patients' data including all categorical variables such as gender, stage, metastasis, ALK, EGFR, and ROS, etc., and continuous variables such as age and body mass index (BMI) were retrieved and analyzed. Results: The multivariate Cox-regression model indicated that smoking was the significant risk factor of death for two-thirds of male smokers (37.9%), with a median survival time of 123 days. Disease progression was higher with pleural and brain metastasis, and localized metastasis was the highest in 75% of patients. The intent of treatment was mainly palliative, however, a statistically significant association was found with the simultaneous use of chemotherapy and immunotherapy. Patients' response to first-line treatment revealed a significant improvement if chemotherapy treatment was maintained at the same dose without interruption of dosage. Conclusions: The overall cure and survival rates for NSCLC remain low, particularly in metastatic disease. Therefore, continued research into new drugs and combination therapies is required for better decision-making to expand the clinical benefit to a broader patient population and to improve outcomes in NSCLC.
RESUMO
Glioblastoma is a fast-growing primary brain tumor observed in adults with the worst prognosis. Preclinical studies have demonstrated the encouraging anticancer activity of statins. This study evaluated the efficacy of atorvastatin in combination with standard therapy in patients with glioblastoma. In this prospective, open-label, single-arm, phase II study, patients were treated with atorvastatin in combination with the standard glioblastoma therapy comprising radiotherapy and temozolomide. The primary endpoint was progression-free survival (PFS) at 6 months (PFS-6). Among 36 patients enrolled from January 2014 to January 2017, the median age was 52 (20-69) years; 22% of the patients were aged ≥60 years, and 62% were male. Patients received atorvastatin for a median duration of 6.2 (0.3-28) months. At a median follow-up of 19 months, the PFS-6 rate was 66%, with a median PFS of 7.6 (5.7-9.4) months. In terms of Grade ≥ 3 hematological adverse events, thrombocytopenia and neutropenia occurred in 7% and 12% of patients, respectively. In multivariate analyses, high baseline low-density lipoprotein levels were associated with worse survival (P = 0.046). Atorvastatin was not shown to improve PFS-6. However, this study identified that high low-density lipoprotein levels are an independent predictor of poor cancer-related outcomes. Future clinical trials testing statins should aim to enroll patients with slow-growing tumors.Clinical trial information: NCT0202957 (December 12, 2013).
