[Primary germ cell tumor in the mediastinum-report of 47 cases].

OBJECTIVE: To investigate the clinical characterstics, effective treatment and prognosis in patients with primary germ cell tumors in the mediastinum. METHODS: The data of 47 such patients treated from 1967 to 2005 were retrospectively reviewed. RESULTS: Of these 47 patients, 41 were male and 6 female with a median age of 26 years; 8 (17.0%) had seminoma, and 39 (83.0%) non-seminoma. The overall 1-, 3-, 5-year survival rate was 63.4%, 37.5% and 34.8% with a median survival time of 16 months; which was 100%, 83.3% and 83.3% for seminoma and 56.4%, 30% and 27.3% for nonseminoma, respectively. The pathologic type was found to be the only independent prognostic factor (P = 0.045). CONCLUSION: Primary mediastinal serminoma is sensitive to radiotherapy or chemotherapy with a good prognosis, but the prognosis of primary mediastinal non-seminoma is poor. Cisplatin-based chemotherapy still plays a key role in the treatment of primary mediastinal non-seminoma as the survival of those has been improved.

Phase II study of cisplatin/etoposide and endostar for extensive-stage small-cell lung cancer.

PURPOSE: To investigate the efficacy and safety of endostar, a novel recombinant human endostatin, plus cisplatin, and etoposide in patients with extensive-stage small-cell lung cancer (ED-SCLC). PATIENTS AND METHODS: Chemotherapy-naïve patients with histologically confirmed, measurable ED-SCLC were enrolled. Treatment consisted of cisplatin (25 mg/m(2)) administered intravenously (IV) on days 1-3; etoposide (120 mg/m(2)) administered intravenously (IV) on days 1-3; endostar (15 mg) administered intravenously (IV) on days 1-14 every 21 days for up to four cycles. The primary objective was to assess the progression-free survival (FPS). Secondary objectives were to assess the objective response rate, median overall survival (OS), and treatment-related toxicity. RESULTS: Thirty-three patients were enrolled, the median age of the patients was 53 years (range, 29-74), twenty-three patients (69.7%) were men and 10 patients were women. Eastern Cooperative Oncology Group performance status scores were 0, 1,and 2 in 30.3, 60.6, and 9.1% of the patients, respectively. The overall response rate was 69.7%, one patient (3%) had a complete response, and 22 patients (66.7%) had partial responses. Five patients (15.1%) had stable disease; the median PFS was 5.0 months (95% CI, 4.2-5.6 months), and the 6-month PFS was 33.3%. The median OS was 11.5 months (95% CI, 9.6-13.4 months), and the 1-year OS was 38.1% (95% CI, 26-50.1%). Sixteen patients (48.5%) had at least one grade 3/4 adverse events; the most common grade 3/4 hematologic toxicity included neutropenia in 57.6%, thrombocytopenia in 12.1% of patients. The most common grade 3/4 non-hematologic toxicities included fatigue in 15.2%, nausea/vomiting in 9.1%, diarrhea in 6.1%, anorexia in 6.1%, mucositis in 6.1% of patients. CONCLUSION: The addition of rh-endostain to cisplatin and etoposide in patients with ED-SCLC results in slightly improved PFS and OS relative to historical controls who received this chemotherapy regimen alone. This regimen appears to be well tolerated; the promising results suggest the further randomized phase III trial to define endostar's impact on SCLC treatment.

Erlotinib in advanced non-small-cell lung cancer after gefitinib failure.

PURPOSE: To evaluate the efficacy and safety of erlotinib in advanced non-small-cell lung cancer after failure of gefitinib treatment. PATIENTS AND METHODS: Patients with advanced or metastatic NSCLC, who had progressed after gefitinib treatment, were included in this study; patients received erlotinib 150 mg/day until disease progression or intolerable toxicity. RESULTS: Twenty-one patients were included in this study. Among them, 14 (66.7%) were male and 7 (33.3%) were female; median age was 63 years; 10 (47.6%) patients were smokers; 9 (42.9%)patients had squamous cell carcinoma subtype; 8 (38.1%) patients had adenocarcinoma subtype and 4 (19%) patients had the other NSCLC subtype. Out of 21 patients, 2 (9.5%) had PR and 4 (19.0%) had SD, giving an overall response rate of 9.5% and a disease control rate of 28.5%. The median TTP were 55 days, the median OS were 135 days. Two patients with PR to erlotinib treatment were female never smokers with adenocarcinoma histology and both had partial response to prior gefitinib treatment. Three of four patients with a SD to erlotinib treatment also had SD from prior gefitinib therapy. Smoking history, histology and response to erlotinib were significantly correlated with survival. The most common toxic effects were skin rash. CONCLUSIONS: Erlotinib may be an option for a more highly selected subset of patients, especially those who had already benefited from prior gefitinib treatment.