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Objective To investigate the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) on patients with lung adenosquamous carcinoma, and to analyze relative factors. Methods From August 2007 to July 2017, 40 patients who were pathologically diagnosed as lung adenosquamous carcinoma in our hospital and received EGFR TKIs treatment were retrospectively analyzed. All patients underwent EGFR mutation detection, resulted in 11 wild type, 13 19Del, 13 21L858R mutations, and 3 uncommon EGFR mutations in 20 exon and 19/21 complex mutation. A higher frequency of EGFR mutation was found in non-smokers and patients with adenocarcinoma components over 50. 0%. Results Twenty-six (65.0%) patients had disease progression after EGFR TKIs treatment, with a median progression-free survival (PFS) of 5.5 months (95% Cl 0.52-10.49 months). A total of 20 (50.0%) patients died with an median overall survival (OS) of 15 months (95% Cl 11.03-18.97 months). Multivariate analysis showed that gender, age, smoking, histopathological subtypes, EGFR mutations, and brain metastasis had no influence on PFS (all P>0.05). Gender, age, smoking, histopathological subtypes, and the presence of brain metastasis during TKI treatment had no influence on OS (P>0.05) , while EGFR mutation is the only influencing factor of OS (P<0.05) in the current study. Conclusions EGFR TKIs had modest efficacy in lung adenosquamous carcinoma, especially in patients with EGFR mutation. Based on the pathological features, EGFR mutation and EGFR TKIs treatment should be introduced into the routine clinical practice to improve the survival of patients with lung adenosquamous carcinoma. [ABSTRACT FROM AUTHOR]

Objective: To describe the actual efficacy of programmed death-1 (PD-1)/ programmed-death ligand 1 (PD-L1) inhibitors in patients with metastatic non-small cell lung cancer (NSCLC) and explore potential prognostic predictive biomarkers. Methods: Patients with metastatic NSCLC who were treated with PD-1/PD-L1 inhibitors at Cancer Hospital, Chinese Academy of Medical Sciences from January 2016 to December 2019, either as monotherapy or in combination with other agents, were consecutively enrolled into this study. We retrospectively collected the data of demographics, clinical information and pathologic assessment to evaluate the therapeutic efficacy and conduct the survival analysis. Major endpoint of our study is progression-free survival (PFS). Secondary endpoints include objective response rate (ORR), disease control rate (DCR) and overall survival (OS). Results: The ORR of 174 patients who underwent PD-1/PD-L1 inhibitor was 28.7%, and the DCR was 79.3%. Immune-related adverse events (irAEs) occurred in 23 patients (13.2%). Brain metastasis, line of treatment, and treatment patterns were associated with the ORR of metastatic NSCLC patients who underwent immunotherapy (P<0.05). After a median follow-up duration of 18.8 months, the median PFS was 10.5 months (ranged from 1.5 to 40.8 months) while the median OS was not reached. The 2-year survival rate was estimated to be 63.0%. The pathologic type was related with the PFS of metastatic NSCLC patients who underwent immunotherapy (P=0.028). Sex, age, brain metastasis and autoimmune diseases were associated with OS (P<0.05). Analysis of the receptor characteristic curve (ROC) of neutrophil/lymphocyte ratio (NLR) predicting ORR of immunotherapy in metastatic NSCLC showed that the areas under the curve of NLR before immunotherapy (NLR(C0)), NLR after one cycle of immunotherapy (NLR(C1)) and ΔNLR were 0.600, 0.706 and 0.628, respectively. Multivariate logistic regression analysis showed that NLR(C1) was an independent factor of the ORR of metastatic NSCLC patients who underwent immunotherapy (OR=0.161, 95% CI: 0.062-0.422), and the efficacy of combination therapy was better than that of single agent (OR=0.395, 95% CI: 0.174-0.896). The immunotherapy efficacy in patients without brain metastasis was better than those with metastasis (OR=0.291, 95% CI: 0.095-0.887). Multivariate Cox regression analysis showed that NLR(C1) was an independent influencing factor of PFS of metastatic NSCLC patients after immunotherapy (HR=0.480, 95% CI: 0.303-0.759). Sex (HR=0.399, 95% CI: 0.161-0.991, P=0.048), age (HR=0.356, 95% CI: 0.170-0.745, P=0.006) were independent influencing factors of OS of metastatic NSCLC patients after immunotherapy. Conclusions: PD-1/PD-L1 inhibitors are proved to be efficacious and have tolerable toxicities for patients with metastatic NSCLC. Patients at advanced age could still benefit from immunotherapy. Brain metastasis is related to compromised response. Earlier application of immunotherapy in combination with other modalities enhances the efficacy without elevating risk of irAEs. NLR(C1) is an early predictor of clinical outcome. The OS of patients younger than 75 years may be improved when treated with immunotherapy. [ABSTRACT FROM AUTHOR]

Objective To explore the safety and therapeutic effect of programmed death I ( PD-I ) antibody combined with chemotherapy as a neoadjuvant therapy for patients with stage II to fil non-small cell lung cancer ( NSCLC) . Methods Thirteen patients, who had been diagnosed as stage II -fil NSCLC and received PD-I inhibitor plus chemotherapy as a neoadjuvant treatment in National Cancer Center/Cancer Hospital were recruited. The patients received consecutive neoadjuvant chemotherapy for 21 days as a cycle,md the therapeutic efficacy was evaluated after two cycles. Results At the last time of follow-up on December 2 ., 2019 ., the objective response rate ( ORR) and disease control rate ( OCR) of these patients were 61 .5% ( 95%, C/ 30.9%•-92. I%·) and 100%, ., respectively. The downregulation rate of disease stage was 61 . 5%· ( 8/ 13) . The respectable rate was 38. 5%, ( 5/ I 3 ) ., among them, the major pathologic response ( MPTI) was 60. 0%, ( 3/5) and the complete pathologic response ( CPR ) was 20. 0%· ( 1/5). The neoadjuvant chemotherapy displayed a low incidence of adverse reaction. The main grade 3 to 4 toxicities were nuetropenia (38.5%•),and leukopenia (23.1%,). There was no significant immune-related toxicity. The safety,md tolerability of perioperative period of patients underwent resection were promising. Conclusions Immunotherapy combined with chemotherapy as a neoadjuvm1t treatment is an effective., low-toxicity treatment manner, which has perioperative safety and high rate of MPR for patients with resectable NSCLC. It is a promising treatment option for patients with stage II to fil NSCLC. [ABSTRACT FROM AUTHOR]

Objective To investigate the principles of differential diagnosis of pulmornary infiltrates in cancer patients during the outbreak of novel coronavirus ( 2019-nCoV) by analyzing one case of lymphoma who presented pulmonary ground-glass opacities ( GGO) after courses of chemotherapy. Methods Baseline demographics and clinicopathological data of eligible patients were retrieved from medical records. Information of clinical manifestations, history of epidemiology, lab tests and chest CT semi images of visiting patients from February 13 to February 28 were collected. Literatures about pulmonary infiltrates in cancer patients were scared from databases including PUBMED, EMBASE and CNKI. Results Among the 139 cancer patients who 1mderwent chest CT scans before chemotherapy, pulmonary infiltrates were identified in eight patients ( 5.8%,), five of whom were characterized with GGOs in lungs. 2019-nCoV nucleic acid testing was performed in three patients mid the results were negative. One case was a 66-year-old man who was diagnosed with non-Hodgkin lymphoma and underwent CHOP chemotherapy regimen. His chest CT scan image displayed multiple GGOs in lungs and the complete blood count showed decreased lymphocies. This patient denied any contact with confirmed/suspected cases of 2019-nCoV infection, fever or other respiratory symptoms. Considering the negative result of nuclear acid testing., this patient was presumptively diagnosed with viral pneumonia and an experiential anti-infection treatment had been prescribed for him. Conclusions The 2019 novel coronavirus disease ( COVID-19 ) complicates the clinical scenerio of pulmonary infiltrates in cancer patients. The epidemic history, clinical mm1ifcstation, CT scm1 image and lab test should be taken into combined consideration. The 2019-nCoV nuclear acid testing might be applied in more selected patients. Active anti-infection treatment and surveillance of patient condition should be initiated if infectious disease is considered. [ABSTRACT FROM AUTHOR]

Objective Adenosquamous carcinoma of lung is an uncommon subtype with more aggressive behavior and poor prognosis than adenocarcinoma and squamous cell carcinoma. This study was aimed to investigate the clinicopathological characteristics and prognostic factors of lung adenosquamous carcinoma. Methods The pathological features and follow-up data of 133 patients were collected and the prognostic factors of these patients were retrospectively analyzed. Results Among the 133 patients, 81 cases (60.9%) smoked. Among the 62 patients whose percentage of histological components were identified, 45 cases had >50% adenocarcinoma components, and 17 cases had >50% squamous cell carcinoma components. 55 patients had lymph node metastasis at the first visit. All patients accepted at least one test of tumor driven gene mutation, and the results showed that the mutation rate of EGFR was 50.8% (67/132), the mutation rate of K-ras was 8.6% (11/128), the ALK-positive rate was 4.2% (2/48). The gender, smoking status, and the proportion of pathological components were the main influence factors of EGFR mutation status. The median overall survival was 28 months, the rates of 1-year, 3-year, and 5-year survival were 72.9%, 23.3%, and 9.0%, respectively. EGFR tyrosine kinase inhibitors (TKIs) treatment was an independent risk factor for prognose of these patients (P=0.024). Conclusions Lung adenosquamous carcinoma is a rare subtype with high malignancy and poor prognosis. Early diagnosis and driven-mutation-based individualized therapy may improve the survival of patients with lung adenosquamous carcinoma. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to analyze the trend of incidence， clinicopathological characteristics and therapy of young (less than 40 years old) patients with advanced lung adenocarcinoma，and to identify the prognostic factors. Methods The clinical data of 198 young patients with advanced lung adenocarcinoma were collected from the Cancer hospital and Institute of Chinese academy of Medical Sciences from January 2001 to June 2012. To analyze the trend of incidence，clinicopathological characteristics and therapy and evaluate the independent prognostic factors affecting survival time with Cox proportional hazards model. Results From 2001 to 2012，the incidence of lung adenocarcinoma in young patients was increased year by year. Among the 198 patients，92 were males and 106 were females. Their age was from 20 to 40 with a median age of 34 years. Most patients had poorly differentiated adenocarcinoma ( 46. 7%) whereas 36.7% of the cases had moderately differentiated tumor. Among the 198 patients，there were 25 patients with stage III B (12.6%) and 173 (87.4%) cases of stage IV cancer.The 1-， 3- and 5-year survival rates were 70.7%，21.6% and 10.3%，respectively. Among the198 cases，patients who received epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy， the median OS (25.6 months) was significantly longer than that of patients who never received EGFR-TKI therapy ( 13.3 months) (P<0.001). Since 2009, the number of cases detected for EGFR gene was gradually increased， and the median OS of patients diagnosed from 2010 to 2012 was 22 months，significantly higher than that of 16 months of patients diagnosed during 2001-2009 (P = 0.019). The Cox regression analysis showed that the performance status，extra-pulmonary metastasis and whether received EGFR-TKI therapy were independent prognostic factors. Conclusions The incidence rate of lung adenocarcinoma in young patients has an increasing trend. They have a high proportion of women and of poor differentiation. The patients can get benefits from EGFR-TKI therapy. Mutivariate Cox regression analysis shows that the performance status, extra-pulmonary metastasis and whether received EGFR-TKI therapy are independent prognostic factors for young patients with advanced lung adenocarcinoma. [ABSTRACT FROM AUTHOR]

Objective To observe the safety and short-term efficacy of sigle drug albumin-bound paclitaxel (ABP) in the treatment of elderly patients with advanced non-small cell lung cancer (NSCLC). Methods A total of 23 elderly patients with advanced NSCLC who received weekly ABP regimen (130 mg/m2/week) in our hospital from October 2011 to March 2014 were retrospectively evaluated. The short-term efficacy, progression-free survival (PFS), and overall survival (OS) were analyzed. Results The median treatment period was 4 cycles (2-10 cycles). Partial response, stable disease, progressive disease, overall response rate, and disease control rate were 26.1%, 43.5%, 30.4%, 26.1% and 69.6%, respectively. The median PFS was 5.33 months (95% CI: 2.95-7.70 months), while the median OS was 40.33 months (95% CI: 29.82-50.83 months). Major adverse events included leucopenia (82.6%), neutropenia (78.3%), nausea or vomiting (56.5%), fatigue (52.2%), peripheral neuropathy (26.1%), myalgia/arthralgia (30.4%), thrombocytopenia (13.0%) and arrhythmia (4.3%). The patients accompanied with chronic diseases had significantly higher incidence rate of peripheral neuropathy and myalgia/arthralgia compared with the patients without accompanied chronic diseases (50.0% vs. 9.1% and 66.7% vs. 9.1%, P<0.05 for both). Conclusion The weekly single drug ABP regimen is effective and well-tolerated in elderly patients with advanced NSCLC. [ABSTRACT FROM AUTHOR]