Pathologic complete response in advanced non-small-cell lung cancer following preoperative chemotherapy: implications for the design of future non-small-cell lung cancer combined modality trials.

1993 ◽  
Vol 11 (9) ◽  
pp. 1757-1762 ◽  
Author(s):  
K M Pisters ◽  
M G Kris ◽  
R J Gralla ◽  
M B Zaman ◽  
R T Heelan ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Preoperative Chemotherapy ◽  
Cell Lung Cancer ◽  
Advanced Nsclc ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Small Cell ◽  
Small Cell Lung ◽  
Major Objective

PURPOSE This report determines the incidence of pathologic complete response in patients with locally advanced non-small-cell lung cancer (NSCLC) treated with mitomycin, vinca alkaloid, and high-dose cisplatin (MVP) chemotherapy, and estimates the effect of MVP on survival. PATIENTS AND METHODS We have identified and reviewed the course of 21 patients with advanced NSCLC who achieved a pathologic complete response following a median of three preoperative MVP combination chemotherapy courses including vinblastine or vindesine, cisplatin (120 mg/m2), and mitomycin (n = 19). RESULTS All patients had a major objective response following preoperative chemotherapy and nine (43%) had a clinical complete response. Nine patients with pathologic complete responses were among 73 entered on a preoperative chemotherapy program, yielding an incidence estimate of 12% (95% confidence interval, 6% to 22%). The median survival duration for all 21 patients has not been reached. The median follow-up duration is now 68 months (range, 17 to 109). Survival estimates are 90% at 1 year, 62% at 3 years, and 54% at 5 years. Nine patients have relapsed with initial sites of recurrence as follows: brain (n = 5), other systemic sites (n = 3), and locoregional (n = 1). One patient died in the postoperative period. Eleven patients remain disease-free and all have excellent functional status. CONCLUSION We have observed pathologic complete responses in approximately 12% of advanced NSCLC patients treated with preoperative MVP chemotherapy. These pathologically determined responses were seen only in patients with major objective responses clinically. Pathologic complete response predicts excellent survival and functional level and should be considered a major end point in the evaluation of preoperative chemotherapy programs.

Surgically Proven Complete Response of Stage III Non-Small Cell Lung Cancer after Cisplatin-Enhanced Radiotherapy. Clinical Implications and Long-Term Results

2003 ◽  
Vol 89 (1) ◽  
pp. 16-19
Author(s):  
Amedeo Vittorio Bedini ◽  
Luca Tavecchio ◽  
Vincenzo Delledonne ◽  
Stefano Michele Andreani
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Small Cell ◽  
Stage Iii ◽  
Clinical Implications ◽  
Small Cell Lung

Aims and Background Pathologic complete response in locally advanced non-small cell lung cancer is the main end point of combined therapies (chemotherapy and/or radiotherapy). Surgery after an induction treatment can improve local control, allowing the histologic assessment of treatment activity by means of resection or extensive biopsies. Methods Thirty patients surgically assessed without viable tumor after concurrent radiotherapy and continuous infusion of low-dose cisplatin, owing to an initially unresectable stage III non-small-cell lung cancer, were the object of evaluation to assess clinical implications, short- and long-term surgical results. Results The specificity rate of the preoperative restaging was 36.6%. The surgical procedures consisted of 22 resections and of extensive biopsies in 8 cases. The operative mortality was 4% (1/25) for procedures other than right pneumonectomy (3/5). No patient received postoperative chemotherapy. Eleven distant progressions, 4 local recurrences, and 4 new primary tumors were assessed as initial failures. The 8-year overall survival was 36%. Conclusions Pathologic complete response after cisplatin-enhanced radiotherapy cannot be satisfactorily assessed by clinical means. Surgery is required to obtain a reliable evaluation; however, right pneumonectomy should be contraindicated because of prohibitive risk. Although an effective local treatment can cure patients with advanced stage III disease, the addition of chemotherapy seems advisable to improve tumor relapse control.

Pre-medications of weekly taxanes in advanced non-small cell lung cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 18210-18210
Author(s):  
X. Huang ◽  
Z. Ye ◽  
Y. Lin
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Advanced Nsclc ◽  
Complete Response ◽  
Small Cell ◽  
Chinese Patients ◽  
Weekly Paclitaxel ◽  
Small Cell Lung ◽  
Grade 3

18210 Background: Taxane is a widely accepted treatment in advanced non-small cell lung cancer (NSCLC). However, a standard pre-medication for weekly taxane has not been established at present. We conducted this study to evaluate the efficacy,safety and pre-medication of weekly paclitaxel /docetaxel schedule in the treatment of advanced NSCLC and to obtain an optimal pre-medication protocol for weekly paclitaxel /docetaxel. Methods: From December 2001 to June 2006, 78 patients with advanced NSCLC (Stage III, IV) were recruited from Department of Chemotherapy, Jiangsu Cancer Hospital and Research Institute. Eleven cases were treated with paclitaxel 80–100 mg/m 2 by intravenous infusion(ivi)on days 1 and 8, 23 cases were treated with paclitaxel 50–80 mg/m2 ivi on days 1, 8 and 15, 14 cases were treated with docetaxel 25–35 mg/m2 ivi on days 1,8 and 15,30 cases were treated with docetaxel 35–45 mg/m2 ivi on days 1 and 8, all combined with a platinum(cisplatin, oxaliplatin or carboplatin), followed by 1 week rest. Four pre-medications were attempted. Results: All 78 patients received a total of 202 courses of treatment. Dose limiting toxicity was myelosuppression. Grade 3 and 4 leukopenia occurred in 19.2% (15/78) of patients. Of the 56 eligible patients who completed at least 2 courses, no patient had a complete response, 20 achieved a partial response and 5 patients showed progression. Toxicity profile of pre-medications included: hypersensitivity (1 case), hypopotassemia (8 cases), myasthenia (5 cases), hiccup (1 case), infection (2 cases). No treatment related death occurred in this study. Conclusions: Weekly administration of paclitaxel/docetaxel is a safe and active protocol for Chinese patients with advanced NSCLC. Our recommendations for weekly pre-medication of taxane are: dexamethasone 2.25 mg-7.5 mg orally 12 h and 2 h before, promethazine 25 mg intramuscularly and cimetidine 600 mg ivi 30 min before paclitaxel; oral dexamethasone 4.5 mg-7.5 mg twice daily for three consecutive days (the day before, the day of, and the day after docetaxel), promethazine 25 mg intramuscularly and cimetidine 600 mg ivi 30 min before docetaxel. No significant financial relationships to disclose.

Clinical Prediction of Pathologic Complete Response in Superior Sulcus Non-Small Cell Lung Cancer

2016 ◽  
Vol 101 (1) ◽  
pp. 211-217 ◽  
Author(s):  
Mara B. Antonoff ◽  
Wayne L. Hofstetter ◽  
Arlene M. Correa ◽  
Jennifer M. Bell ◽  
Boris Sepesi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Small Cell ◽  
Clinical Prediction ◽  
Small Cell Lung ◽  
Superior Sulcus

Complete Response Following Preoperative Chemotherapy for Resectable Non-Small Cell Lung Cancer

CHEST Journal ◽  
2005 ◽  
Vol 128 (3) ◽  
pp. 1442-1447 ◽  
Author(s):  
Bernard Milleron ◽  
Virginie Westeel ◽  
Elisabeth Quoix ◽  
Denis Moro-Sibilot ◽  
Denis Braun ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Preoperative Chemotherapy ◽  
Cell Lung Cancer ◽  
Complete Response ◽  
Small Cell ◽  
Small Cell Lung

Complete response with anti-PD-L1 antibody following progression on anti-PD-1 antibody in advanced non-small cell lung cancer

2020 ◽  
Vol 13 (8) ◽  
pp. e236101
Author(s):  
Navdeep Singh ◽  
Nagashree Seetharamu
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Advanced Nsclc ◽  
Checkpoint Inhibitors ◽  
Complete Response ◽  
Small Cell ◽  
Small Cell Lung ◽  
Doublet Chemotherapy ◽  
Platinum Doublet

Immune-checkpoint inhibitors (ICI), specifically inhibitors of programmed death ligand-1 (PD-L1) and receptor (PD-1) are the new standard of care for the treatment of patients with advanced non-small cell lung cancer (NSCLC) in front line setting as monotherapy or along with chemotherapy. Many of these agents are also approved for use in subsequent lines of treatment on progression on platinum doublet chemotherapy. Nivolumab, pembrolizumab and atezolizumab are currently approved ICI for advanced NSCLC. To date, no study has reported efficacy and safety of alternate PD-1/PD-L1 inhibitors in patients with NSCLC who have progressed on one ICI. Here, we report a case of a patient with advanced NSCLC who had a complete response to atezolizumab, following progression of disease on platinum doublet chemotherapy and then, nivolumab monotherapy.

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