scholarly journals Associations of cytosine deaminase gene polymorphisms with effectiveness of gemcitabine/cisplatin chemotherapy in patients of Xinjiang Uyghur and Han nationality with non-small cell lung cancer

2019 ◽  
Vol 34 (4) ◽  
pp. 389-397
Author(s):  
Jing Li ◽  
Dan Xu ◽  
Jian Huang ◽  
Yan-Na Wang ◽  
Xiao-Ping Ma ◽  
...  

Background: Cytidine deaminase (CDA) polymorphisms may affect the response to gemcitabine/cisplatin chemotherapy in patients with non-small cell lung cancer (NSCLC). This study is designed to investigate the associations of CDA-79A>C and 208G>A polymorphisms and gemcitabine/cisplatin chemotherapy effectiveness in Xinjiang Uyghur and Han patients. Methods: This prospective cohort study enrolled consecutive patients with stage IIIb/IV NSCLC administered gemcitabine/cisplatin chemotherapy at the First Affiliated Hospital, Medical College of Shihezi University and the First People’s Hospital, Kashgar Region. CDA-A79C and CDA-G208A polymorphisms were detected by direct sequencing. Progression-free survival was analyzed by the Kaplan-Meier method. Associations of A79C and G208A polymorphisms with treatment effectiveness and progression-free survival were analyzed using logistic regression and multivariate Cox regression analyses. Subgroup analyses based on ethnicity were performed. Results: The study enrolled 120 patients. A79C and G208A polymorphisms followed the Hardy-Weinberg equilibrium. The frequencies of the AA, AC, and CC genotypes and the A and C alleles of A79C were 52.2%, 29.9%, 17.9%, 67.2%, and 32.8%, respectively, in Han patients and 75.4%, 18.9%, 5.7%, 84.9%, and 5.1%, respectively, in Uyghur patients. Uyghur patients had lower frequencies of A79C-AC/CC genotypes, A79C-C allele, G208A-GA genotype, and G208A-A allele ( P<0.05). Compared with A79C-AA, the odds of ineffective chemotherapy were increased for A79C-AC (odds ratio [OR] 2.818; 95% confidence interval [95% CI] 1.031, 7.705; P=0.043) and A79C-CC (OR 9.864; 95% CI 1.232, 78.966; P=0.031). G208A polymorphisms did not influence chemotherapy effectiveness. Chemotherapy was more effective in Han patients than in Uyghur patients for A79C-AC and G208A-GG. Progression-free survival was longer for A79C-AA versus A79C-AC/CC (10 vs. 7 months, P=0.004) and G208A-GA/AA vs. G208A-AA (12 vs. 8 months, P=0.010). Polymorphisms of A79C (hazard ratio [HR] 1.617; 95% CI 1.009, 2.592; P=0.046) and G208A (HR 2.193; 95% CI 1.055, 4.557; P=0.035) were associated with progression-free survival. Conclusion: For Uyghur and Han ethnic groups, A79C and G208A polymorphisms can be used as a promising biomarker for the chemotherapy efficacy and prognosis of NSCLC.

2017 ◽  
Vol 3 (2) ◽  
pp. 67
Author(s):  
Salman Paris Harahap ◽  
Noorwati Sutandyo ◽  
Cleopas Martin Rumende ◽  
Hamzah Shatri

Pendahuluan. Salah satu terapi dari kanker paru jenis Non-Small Cell Lung Cancer (NSCLC) stadium lanjut adalah kemoterapi. Jenis kemoterapi yang sering digunakan di Indonesia adalah cisplatin- toposide dan cisplatin-docexatel. Tolak ukur keberhasilan pengobatan adalah kesintasan dan Progression Free Survival (PFS). Keberhasilan kemoterapi dipengaruhi oleh banyak faktor, seperti resistensi terhadap sitostatika, dosis, intensitas pemberian, jenis kemoterapi, jenis histologi, stadium, perfoma status, komorbiditas dan sosial ekonomi. Di Indonesia, pendanaan dan jenis rejimen kemoterapi masih merupakan masalah terhadap keberhasilan terapi.Metode. Penelitian menggunakan desain kohort retrospektif dengan analisis kesintasan. Pasien yang dimasukkan dalam penelitian ini adalah pasien kanker paru jenis NSC stadium lanjut (minimal stadium IIIa), yang datang ke Rumah Sakit Kanker Dharmais (RSKD) dan Rumah Sakit dr. Cipto Mangunkusumo (RSCM) Jakarta pada Januari 2006–Desember 2010 yang baru pertama kali dikemoterapi sampai selesai, sebanyak 6 kali dan dilakukan pengamatan 2 tahun. Data dianalisis dengan program SPSS 16.0 dan dilakukan analisis cox regression yang ditampilkan dalam kurva Kaplan Meier.Hasil. Didapatkan sebanyak 55 pasien menggunakan cisplatin-etoposide (EC) dan 55 pasien menggunakan cisplatindocexatel (DC). Terdapat perbedaan kesintasan 1 tahun EC sebesar 30,9% dan DC sebesar 47,3% dengan nilai p= 0,030. Sementara itu, pada kesintasan 2 tahun, juga terdapat perbedaan EC sebesar 0% dan DC sebesar 5,5%, dengan nilai p= 0,003, demikian juga median time survival antara EC selama 27 minggu dengan DC selama 38 minggu (p <0,016). Dibandingkan DC, kemoterapi EC dapat meningkatkan risiko kematian dengan HR 1,684 (IK95% 1,010-2,810). Selain itu,terdapat perbedaan PFS 24 minggu antara kemoterapi EC (54,5%) dan DC (32,7%) dengan nilai p= 0,022.Simpulan. Kesintasan cisplatin-docexatel lebih baik bila dibandingkan dengan cisplatin-etoposide, demikian juga dengan progression free survival.Kata Kunci: cisplatin-docexatel, cisplatin-etoposide, kesintasan, NSCLC, PFS Comparison of Chemotherapy Regiments between Cisplatin Etoposide and Cisplatin-Docetaxel on 2-Year and Progression-Free Survival in Late-Stage Non-Small Cell Lung Cancer PatientsIntroduction. Chemotherapy is one of therapy choices for the advanced Non-Small Cell Lung Cancer (NSCLC). The success in therapy is measured with the 1-year survival, 2-year survival and the Progression Free Survival (PFS). The success is influenced by many factors: resistant to the citostatic, dosage, administer intensity, chemotherapy regiment, type histology, stage, performance status, comorbidity and social economic. In Indonesia, funding and chemotherapy regiment become the challenge for the success of therapy.Methods. The study used the Retrospective Cohort study with survival analysis. The Patients included in this study were the advanced NSC Lung Cancer (At least Stadium IIIa) who came to RSKD and RSCM during Jan 2006 – December 2010 for their first chemotherapy until finished the cycle (6 times) and had monitored for 2 years. Data was analyzed using cox regression analysis SPSS 16.0, and featured on the Kaplan Meier Curve. Results. Fifty five patients used EC and the other 55 patients used DC. There’s difference on survival where 1 year survival EC is 30,9% and DC is 47,3%, with p 0.030. Two year survival CE is 0% and for DC is 5.5%, with p 0.003. Also with the Median time survival between EC for 27 weeks and DC for 38 weeks with p < 0.016. Compared to DC, EC chemotherapy can increase the death risk by HR 1,684 (CI 95% 1,010-2,810), twenty four weeks PFS with EC is 54.5%, DC is 32.7% with p= 0.022. Conclusions. The survival with cisplatin-docexatel is better compared to cisplatin-etoposide, this applies to PFS as well. Keywords: cisplatin docetaxel, cisplatin etoposide, NSCLC, PFS, Survival


2014 ◽  
Vol 76 (5) ◽  
pp. 218 ◽  
Author(s):  
Myoung-Rin Park ◽  
Yeon-Hee Park ◽  
Jae-Woo Choi ◽  
Dong-Il Park ◽  
Chae-Uk Chung ◽  
...  

2021 ◽  
pp. 38-38
Author(s):  
Bojan Radojicic ◽  
Marija Radojicic ◽  
Miroslav Misovic ◽  
Dejan Kostic

Background/Aim. About 1.8 million new lung cancer cases are diagnosed in the world every year, and about 1.6 million cases are with fatal outcome. Despite improvements in treatment in previous decades, the survival of patients with lung cancer is still poor. The five-year survival rate is about 50% for patients with localized disease, 20% for patients with regionally advanced disease, 2% for patients with metastatic disease, and about 14% for all stages. The median survival of patients with untreated NSCLC in the advanced stage is four to five months and the annual survival rate is only 10%. The main goal of the research is to obtain and analyze the results of treatment with concomitant chemotherapy in terms of its efficacy and toxicity in selected patients with locally advanced inoperable non-small cell lung cancer. Methods. The study included data analysis of 31 patients of both sexes who were diagnosed and pathohistologically verified with NSCLC in inoperable stage III and were referred by the Council for Malignant Lung Diseases to the Radiotherapy Department of the Military Medical Academy for concomitant chemoradiotherapy treatment. Upon expiry of the three-month period from the performed radiation treatment, the tumor resonance was assessed on the basis of MSCT examination of the chest and upper abdomen according to RECIST 1.1 criteria (Response Evaluation Criteria in Solid Tumors). According to the same criteria, progression-free survival (PFS) was also assessed every three months during the first two years, then every 6 months or until the onset of disease symptoms, as well as overall survival (OS). Result. The median progression-free survival is 13 months, and the median overall survival is 20 months. During and immediately after RT, 9 (29%) patients had a grade 2 or higher adverse event. Conclusion. The use of concomitant chemoradiotherapy in patients in the third stage of locally advanced inoperable non-small cell lung cancer provides a good opportunity for a favorable therapeutic outcome, with an acceptable degree of acute and late toxicity, and represents the standard therapeutic approach for selected patients in this stage of the disease.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e21107-e21107
Author(s):  
Tyler Fugere ◽  
Ples Spradley ◽  
Ahmad Mazen Safar

e21107 Background: C-Reactive Protein (CRP) is a non-specific inflammatory marker and reflects tissue destruction seen in metastatic cancer (ca). We have observed a tight correlation with CRP trends mirroring ca activity, hence it may prove to be a valuable marker to monitor response to Immuno-Oncology (IO) in non-small cell lung cancer (NSCLC) patients (pts). Once CRP levels stabilized, IO discontinuation was offered, and consenting pts were closely observed. This strategy resulted in shortened IO duration and impressive treatment-free progression-free survival (tf-PFS). We sought to examine the validity of this strategy using the rate of return to any form of ca therapy within 6 months after stopping IO. Methods: We analyzed all pts of a single provider since 2016 with stage IV NSCLC who had CRP checked while on IO, totaling 23 pts. We excluded pts who stopped IO for reasons besides stable CRP values (5 progressed on IO, 3 died while on IO, 1 had side effects, 1 stopped for a clinical trial, 1 opted to complete 2 years of IO, and 2 are still on IO). Of the remaining 10 patient cohort, all pts were males treated at the VA with ages between 56-75 years at diagnosis. 50% of the cohort had adenocarcinoma and 50% had squamous cell carcinoma. Results: Using the CRP trend to shorten the duration of IO resulted in durable drug-free holidays with none of the cohort returning to any form of ca therapy within 6 months and comparable rates of overall survival (OS) despite shorter IO duration. In KEYNOTE-042, the median OS for pts on the pembrolizumab arm was 16.7 months in the overall population and 20 months in the TPS ≥50% subgroup. Pts were treated for up to 35 months. In our cohort, median OS was 38 months, with all pts currently still alive, and median number of doses of IO was 9 cycles, or approximately 7 months. Our pts had ongoing progression free survival (PFS) after stopping treatment, which we report as tf-PFS. The median tf-PFS of our cohort was 23.5 months. Conclusions: In pts with stage IV NSCLC treated with IO, CRP appears promising as a marker to tailor IO therapy addressing tumor and clinical heterogeneity. Responding pts with stable CRP levels can be safely taken off IO. CRP should be monitored with stable values indicating continued PFS. tf-PFS rather than PFS may serve as a surrogate for cure and carries significant impact for pts financially, socially, and psychologically. [Table: see text]


Sign in / Sign up

Export Citation Format

Share Document