6 results on '"EXTENSIVE-DISEASE"'
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2. 原发性食管小细胞癌临床特点及预后生存分析.
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全敏, 唐嘉源, and 陈红
- Abstract
Objective To investigate the clinical characteristics and prognostic factors of the limited-stage disease (LD) and extensive-stage disease (ED) of primary esophageal small cell carcinoma (PESCC). Methods The clinical data and follow-up information of 72 patients with PESCC were retrospectively analyzed. Chi-square test was used to compare the baseline data of patients with LD and ED, Kaplan-Meier method was employed to draw the survival curve of both groups, and Log-rank test was employed to compare survival rates between groups. Univariate and multivariate Cox regression methods were used to analyze the factors affecting the overall survival (OS) of patients with LD and ED. Results A total of 49 patients with LD and 23 patients with ED were included in this study. The median survival time of patients with LD was 18.300 months and that of patients with ED was 10.903 months (P = 0.029) Total protein (TP) value (HR-0.890, 95%CI: 0.805-0.983, P = 0.022 ) and chemotherapy cycle number ( HR = 0.388 95%CI: 0.187- 0.807, P = 0.011 ) were independent prognostic factors of patients with LD. Systemic immune-inflammation index (SII) ( HR = 1.002 95%CI: 1.000-1.004, P = 0.007 ) and C-reactive protein (CRP) ( HR = 1.065, 95%CI: 1.021-1.111, P = 0.004 ) were independent prognostic factors of patients with ED. Conclusion The malignant degree of PESCC is high, and prognosis is poor. Patients with LD and ED have different prognostic factors. Total protein value and chemotherapy cycle are independent prognostic factors of patients with LD. SII and CRP are independent prognostic factors of patients with ED. [ABSTRACT FROM AUTHOR]
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- 2024
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3. The safety and efficacy of amrubicin in the treatment of previously untreated extensive-disease small-cell lung cancer: a meta-analysis.
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Wu, Ji-Feng, Zhou, Jian-Jun, Li, Xin-Ai, Hu, Li-Hui, and Wen, Meng-Li
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LUNG cancer , *PROGRESSION-free survival , *STATISTICAL significance , *META-analysis , *DATABASE searching - Abstract
Background: Extensive-disease small-cell lung cancer (ED-SCLC) has been known to be rapid progression and relapse, despite highly sensitive to chemotherapy. Amrubicin (AMR), a third-generation synthetic anthracycline, was accepted as a feasible alternative compared with the standard first-line chemotherapy for previously untreated ED-SCLC. While, the efficacies of these amrubicin-based regimens are unsatisfactory. Aim: Our meta-analysis was performed to assess the efficacy and toxicity of first-line therapy comparing AMR and chemotherapy in patients with ED-SCLC. Methods: Electronic databases were searched for eligible trials updated on November 2018. Randomized-controlled trials assessing the efficacy and safety of AMR in ED-SCLC were included, of which the interested results were objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and adverse events (AEs). Results: A total of 6 randomized controlled trials were included in this analysis. There are no significant differences in OS (OR=1.03, 95% CI=0.66–1.60, P=0.91), PFS (OR=1.2, 95% CI=10.77–1.88, P=0.41) or ORR (OR=1.31, 95% CI=0.90–1.92, P=0.16) with AMR (OR=0.90, 95% CI=0.76–1.05, P=0.17). The most common treatment-related AEs in the AMR group are leukopenia (OR=3.13, 95% CI=1.22–7.99, P=0.02) and neutropenia (OR=3.25, 95% CI=1.38–7.65, P=0.007). Fatigue, anemia, nausea, vomiting, diarrhea the difference between the two groups had no statistical significance. Conclusion: The results of our analysis indicated that AMR therapy demonstrated non-inferiority to the standard first-line chemotherapy for previously untreated ED-SCLC. Whether it can be accepted as an alternative regimen to the standard first-line chemotherapy is still warranted. [ABSTRACT FROM AUTHOR]
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- 2019
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4. Nivolumab alone and nivolumab plus ipilimumab in recurrent small-cell lung cancer (CheckMate 032): a multicentre, open-label, phase 1/2 trial
- Author
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Rathi N. Pillai, Patrick A. Ott, Scott J. Antonia, Chen Sheng Lin, Matthew H. Taylor, M. Catherine Pietanza, Petri Bono, Paolo A. Ascierto, Jeffry Evans, Filippo de Braud, Joseph Paul Eder, Jose A. Lopez-Martin, Olaf Christensen, Akin Atmaca, Dung T. Le, Michael A. Morse, Dirk Jäger, Padmanee Sharma, Christopher T. Harbison, Emiliano Calvo, Asim Amin, Leora Horn, Ian Chau, Johanna C. Bendell, Clinicum, Translational Cancer Biology (TCB) Research Programme, and Department of Oncology
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Male ,0301 basic medicine ,Lung Neoplasms ,IRINOTECAN ,THERAPY ,Gastroenterology ,0302 clinical medicine ,Antineoplastic Combined Chemotherapy Protocols ,METASTATIC MELANOMA ,MYASTHENIA-GRAVIS ,DOCETAXEL ,education.field_of_study ,Antibodies, Monoclonal ,EXTENSIVE-DISEASE ,Middle Aged ,Prognosis ,3. Good health ,Survival Rate ,Nivolumab ,Oncology ,Tolerability ,Docetaxel ,030220 oncology & carcinogenesis ,Female ,TREATMENT OPTIONS ,medicine.drug ,medicine.medical_specialty ,3122 Cancers ,Population ,Ipilimumab ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,COMBINATION ,education ,Aged ,Neoplasm Staging ,III TRIAL ,business.industry ,UNTREATED MELANOMA ,Rovalpituzumab tesirine ,Interim analysis ,Small Cell Lung Carcinoma ,Surgery ,Regimen ,030104 developmental biology ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
Summary Background Treatments for small-cell lung cancer (SCLC) after failure of platinum-based chemotherapy are limited. We assessed safety and activity of nivolumab and nivolumab plus ipilimumab in patients with SCLC who progressed after one or more previous regimens. Methods The SCLC cohort of this phase 1/2 multicentre, multi-arm, open-label trial was conducted at 23 sites (academic centres and hospitals) in six countries. Eligible patients were 18 years of age or older, had limited-stage or extensive-stage SCLC, and had disease progression after at least one previous platinum-containing regimen. Patients received nivolumab (3 mg/kg bodyweight intravenously) every 2 weeks (given until disease progression or unacceptable toxicity), or nivolumab plus ipilimumab (1 mg/kg plus 1 mg/kg, 1 mg/kg plus 3 mg/kg, or 3 mg/kg plus 1 mg/kg, intravenously) every 3 weeks for four cycles, followed by nivolumab 3 mg/kg every 2 weeks. Patients were either assigned to nivolumab monotherapy or assessed in a dose-escalating safety phase for the nivolumab/ipilimumab combination beginning at nivolumab 1 mg/kg plus ipilimumab 1 mg/kg. Depending on tolerability, patients were then assigned to nivolumab 1 mg/kg plus ipilimumab 3 mg/kg or nivolumab 3 mg/kg plus ipilimumab 1 mg/kg. The primary endpoint was objective response by investigator assessment. All analyses included patients who were enrolled at least 90 days before database lock. This trial is ongoing; here, we report an interim analysis of the SCLC cohort. This study is registered with ClinicalTrials.gov, number NCT01928394. Findings Between Nov 18, 2013, and July 28, 2015, 216 patients were enrolled and treated (98 with nivolumab 3 mg/kg, three with nivolumab 1 mg/kg plus ipilimumab 1 mg/kg, 61 with nivolumab 1 mg/kg plus ipilimumab 3 mg/kg, and 54 with nivolumab 3 mg/kg plus ipilimumab 1 mg/kg). At database lock on Nov 6, 2015, median follow-up for patients continuing in the study (including those who had died or discontinued treatment) was 198·5 days (IQR 163·0–464·0) for nivolumab 3 mg/kg, 302 days (IQR not calculable) for nivolumab 1 mg/kg plus ipilimumab 1 mg/kg, 361·0 days (273·0–470·0) for nivolumab 1 mg/kg plus ipilimumab 3 mg/kg, and 260·5 days (248·0–288·0) for nivolumab 3 mg/kg plus ipilimumab 1 mg/kg. An objective response was achieved in ten (10%) of 98 patients receiving nivolumab 3 mg/kg, one (33%) of three patients receiving nivolumab 1 mg/kg plus ipilimumab 1 mg/kg, 14 (23%) of 61 receiving nivolumab 1 mg/kg plus ipilimumab 3 mg/kg, and ten (19%) of 54 receiving nivolumab 3 mg/kg plus ipilimumab 1 mg/kg. Grade 3 or 4 treatment-related adverse events occurred in 13 (13%) patients in the nivolumab 3 mg/kg cohort, 18 (30%) in the nivolumab 1 mg/kg plus ipilimumab 3 mg/kg cohort, and ten (19%) in the nivolumab 3 mg/kg plus ipilimumab 1 mg/kg cohort; the most commonly reported grade 3 or 4 treatment-related adverse events were increased lipase (none vs 5 [8%] vs none) and diarrhoea (none vs 3 [5%] vs 1 [2%]). No patients in the nivolumab 1 mg/kg plus ipilimumab 1 mg/kg cohort had a grade 3 or 4 treatment-related adverse event. Six (6%) patients in the nivolumab 3 mg/kg group, seven (11%) in the nivolumab 1 mg/kg plus ipilimumab 3 mg/kg group, and four (7%) in the nivolumab 3 mg/kg plus ipilimumab 1 mg/kg group discontinued treatment due to treatment-related adverse events. Two patients who received nivolumab 1 mg/kg plus ipilimumab 3 mg/kg died from treatment-related adverse events (myasthenia gravis and worsening of renal failure), and one patient who received nivolumab 3 mg/kg plus ipilimumab 1 mg/kg died from treatment-related pneumonitis. Interpretation Nivolumab monotherapy and nivolumab plus ipilimumab showed antitumour activity with durable responses and manageable safety profiles in previously treated patients with SCLC. These data suggest a potential new treatment approach for a population of patients with limited treatment options and support the evaluation of nivolumab and nivolumab plus ipilimumab in phase 3 randomised controlled trials in SCLC. Funding Bristol-Myers Squibb.
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- 2016
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5. [Medical treatment of small cell lung cancer: Can we leave the area of cisplatin-etoposide?]
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Pujol JL, Roch B, Pujol CN, and Goze C
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- Antibodies, Monoclonal, Humanized therapeutic use, Aurora Kinase A antagonists & inhibitors, Benzodiazepinones therapeutic use, DNA Damage, DNA Modification Methylases metabolism, DNA Repair, DNA Repair Enzymes metabolism, Dacarbazine analogs & derivatives, Dacarbazine therapeutic use, Enhancer of Zeste Homolog 2 Protein antagonists & inhibitors, Humans, Immunoconjugates therapeutic use, Lung Neoplasms genetics, Lung Neoplasms pathology, Poly(ADP-ribose) Polymerase Inhibitors therapeutic use, Protein Serine-Threonine Kinases antagonists & inhibitors, Receptors, Notch metabolism, Small Cell Lung Carcinoma genetics, Small Cell Lung Carcinoma pathology, Temozolomide, Tumor Suppressor Proteins metabolism, Antineoplastic Agents therapeutic use, Lung Neoplasms drug therapy, Small Cell Lung Carcinoma drug therapy
- Abstract
Small cell lung cancer accounts for 14% of all lung cancers. It remains a major challenge for oncology as the progresses made in the past three decades are modest. After a rapid overview of current knowledge regarding somatic genomic alterations, this state-of-art addresses pathways to improve small-cell lung cancer outcome such as the targeting of DNA damage repair mechanisms firstly anti-PARPs, inhibitory molecules of EZH2, derepression of the NOTCH pathway, rovalbituzumab-tesirine, inhibition of serine/threonine Aurora A kinase, temozolomide and its dependence on methylation of the MGMT promoter. This first chapter suggests the beginning of precision medicine in small cell lung cancer. The last section focuses on the development of immuno-oncological agents and the information collected from phase 1 and 2 studies: the low intensity of PD-L1 tissue expression and the possible relationship of the activity of these agents as a function of tumor mutational burden are pointed out., (Copyright © 2018 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2018
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6. A Phase II/III study comparing carboplatin and irinotecan with carboplatin and etoposide for the treatment of elderly patients with extensive-disease small-cell lung cancer (JCOG1201).
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Eba J, Shimokawa T, Nakamura K, Shibata T, Misumi Y, Okamoto H, Yamamoto N, and Ohe Y
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- Aged, Aged, 80 and over, Camptothecin administration & dosage, Camptothecin analogs & derivatives, Carboplatin administration & dosage, Disease-Free Survival, Drug Administration Schedule, Etoposide administration & dosage, Female, Humans, Irinotecan, Japan, Lung Neoplasms pathology, Male, Middle Aged, Patient Selection, Small Cell Lung Carcinoma pathology, Survival Analysis, Treatment Outcome, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Lung Neoplasms drug therapy, Small Cell Lung Carcinoma drug therapy
- Abstract
A randomized Phase II/III trial commenced in Japan in December 2013. Carboplatin plus etoposide is the current standard treatment for elderly extensive-disease small-cell lung cancer. The purpose of this study is to confirm the superiority of carboplatin plus irinotecan in terms of overall survival over carboplatin plus etoposide for elderly extensive-disease small-cell lung cancer patients in a Phase II/III design. A total of 370 patients will be accrued from 38 Japanese institutions within 5 years. In the Phase II part, the primary endpoint is the response rate of the carboplatin plus irinotecan arm and the secondary endpoint is adverse events. In the Phase III part, the primary endpoint is overall survival and the secondary endpoints are progression-free survival, response rate, adverse events, serious adverse events and symptom score. This trial has been registered at the UMIN Clinical Trials Registry as UMIN000012605 (http://www.umin.ac.jp/ctr/index.htm)., (© The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
- Published
- 2015
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