scholarly journals P3.01-078 Outcome of Stage IIIb Non-small Cell Lung Cancer (NSCLC) Patients – A Single Tertiary Center Experience

2017 ◽  
Vol 12 (11) ◽  
pp. S2232
Author(s):  
T. Mehmood
2014 ◽  
Vol 29 (2) ◽  
pp. 112-119 ◽  
Author(s):  
Rui-chao Li ◽  
Li-jun Zheng ◽  
Ming-hao Fang ◽  
Shi-ying Yu

Non-small cell lung cancer (NSCLC) is a leading cause of death worldwide. The upregulation of the epidermal growth factor receptor (EGFR) due to mutations has been observed in a number of cancers, and tyrosine kinase inhibitors (TKIs), such as gefitinib and erlotinib, which specifically target EGFR signaling, have been used to treat NSCLC patients. The presence of EGFR mutations was previously shown to confer sensitivity to TKIs. In this study, we evaluated the correlation between EGFR mutations and response to erlotinib in Chinese NSCLC patients. We recruited 36 patients with stage IIIB/IV NSCLC who had failed first-line chemotherapy, and treated them with erlotinib. We used immunohistochemistry to determine EGFR expression, and we screened for mutations using PCR analysis. We used Cox regression analysis and Kaplan-Meier curves for survival analysis. We found that 8 patients had exon 19 mutations, while 3 patients had exon 21 mutations. An Eastern Cooperative Oncology Group (ECOG) grade of 2 was a significant negative predictor of overall survival (OS). Patients with EGFR mutations showed a significantly better OS compared to those without EGFR mutations. Additionally, multivariate analysis showed that erlotinib-treated stage IV patients had a significantly longer progression-free survival (PFS) compared to stage IIIB patients. Patients with EGFR mutations also had a significantly better PFS compared to those without EGFR mutations. The overall remission rate (22.2%) and disease control rate (75%) were significantly higher compared to the rates after second-line chemotherapy (<10%). In conclusion, the presence of EGFR mutations could be a marker to predict the therapeutic efficacy of erlotinib and the prognosis in Chinese NSCLC patients.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 17138-17138
Author(s):  
P. Nouyrigat ◽  
A. Madroszyk ◽  
C. Audigier-Valette ◽  
B. Escarguel ◽  
D. Andreotti ◽  
...  

17138 Background: The objective of the study is to determine if the switch to a gemcitabin (G) and irinotecan (I) is efficient after low efficacy of a docetaxel (D) and cisplatin (C) regimen for advenced non small cells carcinoma (NSCLC). Methods: Eligible patients were above 18 years old and under 75, with stage IIIb or IV NSCLC. No previously chemotherapy, WHO = 0, 1, 2 under 60 and WHO = 0, 1 under 60. mesurable target. Treatment D and C = 75 mg/m2 were given wekks 1, 4 and 7. After evaluation on week 10: in case of objective response 3 more cycles of DC were administred, if not a switch was performed with G 1000 mg/m2 and I 100 mg/m2 given as 90 minutes infusion J1-J8 every 3 weeks before a new evaluation after 3 cycles. Results: 21 patients entered the study, median age 57 (37–74). Stage IIIb = 8, IV = 13. Efficacy: we observed 8 patients with objective response (38%). Among 13 patients without an objective response after 3 DC only 4 patients received the switch treatment of GI. We found no new objective respons among them. Conclusions: For non responsive NSCLC patients to docetaxel-cisplatin regimen the treatment by gemcitabin-irinotecan does not seem relevant. No significant financial relationships to disclose.


Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3828
Author(s):  
Anello Marcello Poma ◽  
Rossella Bruno ◽  
Iacopo Pietrini ◽  
Greta Alì ◽  
Giulia Pasquini ◽  
...  

Pembrolizumab has been approved as first-line treatment for advanced Non-small cell lung cancer (NSCLC) patients with tumors expressing PD-L1 and in the absence of other targetable alterations. However, not all patients that meet these criteria have a durable benefit. In this monocentric study, we aimed at refining the selection of patients based on the expression of immune genes. Forty-six consecutive advanced NSCLC patients treated with pembrolizumab in first-line setting were enrolled. The expression levels of 770 genes involved in the regulation of the immune system was analysed by the nanoString system. PD-L1 expression was evaluated by immunohistochemistry. Patients with durable clinical benefit had a greater infiltration of cytotoxic cells, exhausted CD8, B-cells, CD45, T-cells, CD8 T-cells and NK cells. Immune cell scores such as CD8 T-cell and NK cell were good predictors of durable response with an AUC of 0.82. Among the immune cell markers, XCL1/2 showed the better performance in predicting durable benefit to pembrolizumab, with an AUC of 0.85. Additionally, CD8A, CD8B and EOMES showed a high specificity (>0.86) in identifying patients with a good response to treatment. In the same series, PD-L1 expression levels had an AUC of 0.61. The characterization of tumor microenvironment, even with the use of single markers, can improve patients’ selection for pembrolizumab treatment.


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