Outcome of treatment with 2nd and 3rd generation platinum-based chemotherapy in advanced non-small cell carcinoma (NSCLC): A single institute experience

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 18169-18169
Author(s):  
K. Khodadad ◽  
M. R. Malekzadegan ◽  
N. Hashemi ◽  
A. Azadi ◽  
A. H. Abdollah Shamshirsaz ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Advanced Nsclc ◽  
Large Cell Carcinoma ◽  
Large Cell ◽  
Study Groups ◽  
Female Ratio ◽  
2Nd Generation ◽  
Platinum Based Chemotherapy

18169 Background: The cornerstone of treatment in patients with advanced NSCLC is chemotherapy. During past years 3rd generation cytotoxic drugs have replaced 2nd generation drugs in combination with platinum. Although some trials suggest that newer agents are less toxic and with better response rates compared to older ones, but overall survival outcomes are similar. Methods: Between 1999- 2005, 275 patients with advanced NSCLC (unresectable IIIA, IIIB and IV) have been treated in our center with either frontline 2nd (204 pts.) or 3rd (71 pts.) generation, platinum-based regimens. Retrospectively we analyzed the outcome of treatment (i.e. response rate and overall survival) in these patients according to the generation of chemotherapy regimen. Results: Male/female ratio was 3.6/1 and mean age 58.9. Pathology subtypes includes: adenocarcinoma (49.8%), squamous cell carcinoma (28%), undiff. NSCLC (21.8%) and large cell carcinoma (0.4%). The RR was higher with 3rd generation protocols compared to 2nd generations (47.9% vs 26.5%, P = 0.001) but the median OS in both groups was statistically non-significant (12.07 vs 10.57 m). Analyzing RR and OS in different pathology subtypes shows that in adenocarcinoma and squamous cell ca. the RR is higher with 3rd generation compared to 2nd generation (40.5% vs 20%, P=0.01 & 72.8% vs 27.3%, P=0.005 respectively), but the OS between these two generations was not statistically significant in both pathology subtypes. In undiff. NSCLC the outcome between 2nd and 3rd generation is non-significant in terms of OS and RR. The distribution of different stages in both study groups was statistically similar. Conclusions: Based on this study the 3rd generation protocols in the treatment of advanced NSCLC is superior to 2nd generation protocols in term of RR, although the median OS is statistically non-significant. No significant financial relationships to disclose.

scholarly journals Clinico-epidemiological and pathological profile of lung cancer: a hospital based observational study in Western part of Rajasthan, India

2020 ◽  
Vol 7 (6) ◽  
pp. 965
Author(s):  
C. R. Choudhary ◽  
Suresh Kumar Yogi ◽  
Gopal Purohit ◽  
Hemant Borana ◽  
Govind Desai ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Surgical Techniques ◽  
Large Cell Carcinoma ◽  
Large Cell ◽  
Dust Exposure ◽  
Female Ratio ◽  
Silica Dust

Background: Lung cancer is the most common cancer causing deaths in men and women world-wide, responsible for over 1 million deaths annually. Although, advances in surgical techniques and combined therapies lung cancer remains a disease with a poor prognosis. Aim of the study was to evaluate the clinico-epidemiological and pathological profile in diagnosed case of lung cancer patients, presenting in the K N Chest hospital.Methods: Initial evaluation after obtaining informed consent, demography, history, clinicoradiological findings of patients and relevant investigations was recorded. Histopathological reports reviewed.Results: Our study included 108 patients with confirmed cases of lung cancer.The mean age of the patients was 57.50 years. The male:  female ratio was 5.8:1. Cough was the most common presenting symptom (77.78%) followed by chest pain (62.33%). Clubbing was most commonly associated with squamous cell carcinoma. Most common radiological presentation was consolidation (42.59%) followed by mass lesion (30.55%). Most common histopathological type of lung cancer found in this study was squamous cell carcinoma 47(43.52%) followed by adenocarcinoma 42 (38.89%). Small cell carcinoma was present in 15 (13.89%) and large cell carcinoma was present in 4 (3.70%) study group. The most common pathological cell type in silica dust exposed patient in this study was squamous cell carcinoma followed by adenocarcinoma with occupational history of > 10 years of silica dust exposure in stone mines.Conclusions: Squamous cell carcinoma still remains the commonest histological subtype followed by adenocarcinoma.

Pulmonary Large Cell Carcinoma Lacking Squamous Differentiation Is Clinicopathologically Indistinguishable From Solid-Subtype Adenocarcinoma

2013 ◽  
Vol 138 (5) ◽  
pp. 626-635 ◽  
Author(s):  
David H. Hwang ◽  
David P. Szeto ◽  
Anthony S. Perry ◽  
Jacqueline L. Bruce ◽  
Lynette M. Sholl
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Clinical Features ◽  
Squamous Cell ◽  
Lung Tumor ◽  
Neuroendocrine Differentiation ◽  
Large Cell Carcinoma ◽  
Large Cell ◽  
World Health ◽  
Thyroid Transcription Factor 1

Context Pulmonary large cell carcinoma (LCC) includes tumors not readily diagnosed as adenocarcinoma (ADC) or squamous cell carcinoma on morphologic grounds, without regard to immunophenotype, according to the World Health Organization (WHO). This ambiguous designation may cause confusion over selection of mutation testing and directed therapies. Several groups have proposed the use of immunohistochemistry (IHC) to recategorize LCC as ADC or squamous cell carcinoma; however, it remains unclear if strictly defined LCCs are a clinicopathologically distinct lung tumor subset. Objective —To compare the pathologic, molecular, and clinical features of 2 morphologically similar tumors: solid-subtype ADC and LCC. Design Tumors were included on the basis of solid growth pattern; tumors with squamous or neuroendocrine differentiation were excluded. Solid ADC (n = 42) and LCC (n = 57) were diagnosed by using WHO criteria (5 intracellular mucin droplets in ≥2 high-power fields for solid ADC) and tested for KRAS, EGFR, and ALK alterations. Results —Both solid ADC and LCC groups were dominated by tumors with “undifferentiated”-type morphology and both had a high frequency of thyroid transcription factor 1 expression. KRAS was mutated in 38% of solid ADCs versus 43% of LCCs (P = .62). One ALK-rearranged and 1 EGFR-mutated tumor were detected in the solid ADC and LCC groups, respectively. There were no significant differences in clinical features or outcomes; the prevalence of smoking in both groups was greater than 95%. Conclusions Other than a paucity of intracellular mucin, LCC lacking squamous or neuroendocrine differentiation is indistinguishable from solid-subtype ADC. We propose the reclassification of these tumors as mucin-poor solid adenocarcinomas.

scholarly journals A Case of Synchronous Triple Primary Lung Cancers Composed of Adenocarcinoma, Squamous Cell Carcinoma and Large Cell Carcinoma in the Right Lung.

Haigan ◽  
1996 ◽  
Vol 36 (2) ◽  
pp. 147-154 ◽  
Author(s):  
Yuichiro Takeda ◽  
Masahiro Seike ◽  
Shigeto Kawachi ◽  
Tatsurou Watanabe ◽  
Shouji Kudoh ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Large Cell Carcinoma ◽  
Large Cell ◽  
Lung Cancers ◽  
The Right

Combination chemotherapy with bleomycin, etoposide, and cisplatin in metastatic non-small-cell lung cancer.

1985 ◽  
Vol 3 (11) ◽  
pp. 1478-1485 ◽  
Author(s):  
D Osoba ◽  
J J Rusthoven ◽  
K A Turnbull ◽  
W K Evans ◽  
F A Shepherd
Keyword(s):  
Lung Cancer ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cell Lung Cancer ◽  
Performance Status ◽  
Large Cell Carcinoma ◽  
Large Cell ◽  
Small Cell ◽  
Entire Group ◽  
Small Cell Lung

Fifty-three patients with recurrent and advanced stage (III and IV) non-small-cell lung cancer (NSCLC) were treated with a combination of bleomycin, etoposide (VP-16-213), and cis-diamminedichloroplatinum (BEP). Forty-eight patients were appraisable for response. The response rates were 44% for the entire group, 57% in 30 patients with combined squamous-cell and large-cell carcinoma, and 22% in 18 patients with adenocarcinoma (40%, 50%, and 19%, respectively, if patients not appraisable for response are included as nonresponders). The median survival time of patients with squamous-cell and large-cell carcinoma was slightly longer than that of patients with adenocarcinoma (23 weeks v 19 weeks). Patients with responsive disease survived significantly longer (median, 34 weeks) than did patients with unresponsive disease (median, 16 weeks) (P = .001). In the entire group, the median survival time of patients with an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 was better (23 weeks) than of those with a status of 2 or 3 (15 weeks), but this difference was not seen in the subgroup with squamous-cell and large-cell carcinoma (24 weeks v 23 weeks, respectively). Thus, the performance status was not of prognostic value in the histologic subgroups experiencing the best response rate. There were two treatment-related deaths, but otherwise the toxicity of BEP was acceptable. Only four of the 119 treatment cycles were followed by fever even though there was significant neutropenia (0.5 X 10(9)/L) after 20 of 97 treatment cycles. The majority of patients receiving BEP experienced relief of cough, hemoptysis, pain, and fatigue associated with their disease. There was a good correlation between objective responses and palliation of symptoms. Thus, BEP offers good palliation, particularly for patients with squamous-cell and large-cell lung cancer.

Lung Cancer - Part I

2019 ◽  
Author(s):  
Jeffrey Crawford ◽  
John Strickler
Keyword(s):  
Lung Cancer ◽  
Squamous Cell Carcinoma ◽  
Small Cell Lung Cancer ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cell Lung Cancer ◽  
Large Cell Carcinoma ◽  
Large Cell ◽  
Small Cell ◽  
Small Cell Lung

In the United States, lung cancer is the second most common cancer, surpassed only by prostate cancer in men and breast cancer in women. But lung cancer is the leading cause of cancer deaths, accounting for 29% and 26% of all cancer-related deaths in men and women, respectively. The four major pathologic cell types of lung cancer are small cell carcinoma, adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. Because they have overlapping clinical behaviors and responses to treatment, adenocarcinoma, squamous cell carcinoma, and large cell carcinoma are generally grouped together in the category of non–small cell lung cancer (NSCLC). This review discusses both NSCLC and small cell lung cancer (SCLC), including lung cancer in those who have never smoked, prevention of lung cancer, with sections on diagnosis, biomarkers, treatment, and supportive care.  This review contains 7 figures, 10 tables, and 74 references. Keywords: lung cancer, mediastinoscopy, chemoradiotherapy, TNM staging system, pulmonary parenchyma, segmentectomy

Lung Cancer - Part I

2019 ◽  
Author(s):  
Jeffrey Crawford ◽  
John Strickler
Keyword(s):  
Lung Cancer ◽  
Squamous Cell Carcinoma ◽  
Small Cell Lung Cancer ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cell Lung Cancer ◽  
Large Cell Carcinoma ◽  
Large Cell ◽  
Small Cell ◽  
Small Cell Lung

In the United States, lung cancer is the second most common cancer, surpassed only by prostate cancer in men and breast cancer in women. But lung cancer is the leading cause of cancer deaths, accounting for 29% and 26% of all cancer-related deaths in men and women, respectively. The four major pathologic cell types of lung cancer are small cell carcinoma, adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. Because they have overlapping clinical behaviors and responses to treatment, adenocarcinoma, squamous cell carcinoma, and large cell carcinoma are generally grouped together in the category of non–small cell lung cancer (NSCLC). This review discusses both NSCLC and small cell lung cancer (SCLC), including lung cancer in those who have never smoked, prevention of lung cancer, with sections on diagnosis, biomarkers, treatment, and supportive care.  This review contains 7 figures, 10 tables, and 74 references. Keywords: lung cancer, mediastinoscopy, chemoradiotherapy, TNM staging system, pulmonary parenchyma, segmentectomy

Lung Cancer Part II

2019 ◽  
Author(s):  
Jeffrey Crawford
Keyword(s):  
Lung Cancer ◽  
Squamous Cell Carcinoma ◽  
Small Cell Lung Cancer ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cell Lung Cancer ◽  
Large Cell Carcinoma ◽  
Large Cell ◽  
Small Cell ◽  
Small Cell Lung

In the United States, lung cancer is the second most common cancer, surpassed only by prostate cancer in men and breast cancer in women. But lung cancer is the leading cause of cancer deaths, accounting for 29% and 26% of all cancer-related deaths in men and women, respectively. The four major pathologic cell types of lung cancer are small cell carcinoma, adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. Because they have overlapping clinical behaviors and responses to treatment, adenocarcinoma, squamous cell carcinoma, and large cell carcinoma are generally grouped together in the category of non–small cell lung cancer (NSCLC). This review discusses treatment of both NSCLC and small cell lung cancer (SCLC). This review 2 figures, 19 tables, and 90 references. Keywords: lung cancer, mediastinoscopy, chemoradiotherapy, TNM staging system, pulmonary parenchyma, segmentectomy

scholarly journals CYFRA21-1 tests in the diagnosis of non-small cell lung cancer: A meta-analysis

2019 ◽  
Vol 34 (3) ◽  
pp. 251-261 ◽  
Author(s):  
Lei Fu ◽  
Rong Wang ◽  
Ling Yin ◽  
Xiaopu Shang ◽  
Runtong Zhang ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lung Adenocarcinoma ◽  
Cell Carcinoma ◽  
Likelihood Ratio ◽  
Squamous Cell ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Large Cell Carcinoma ◽  
Large Cell

Objective: The aim of the study was to evaluate the diagnostic value of soluble fragment of cytokeratin 19 (CYFRA21-1) tests in detecting non-small cell lung cancer (NSCLC), including squamous cell carcinoma, lung adenocarcinoma, and large cell carcinoma. Methods: The relevant studies were identified from PubMed, Embase and the Cochrane Library before November 2018. Summary estimates for sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of CYFRA21-1 tests for the diagnosis of NSCLC were calculated using the random effects model. A summary receiver operating characteristic (SROC) curve was used to assess the overall effectiveness of the test. Meta-DiSc 1.4 and Stata11.0 were applied to the statistical analysis. Publication bias was detected using Egger’s test. Results: A total of 22 studies consisting of 7910 NSCLC patients (squamous cell carcinoma/lung adenocarcinoma/large cell carcinoma) and 2630 benign lesions patients that met the inclusion criteria were included. The meta-analysis showed that CYFRA21-1 tests had a relatively high accuracy for squamous cell carcinoma detection and a lower accuracy for lung adenocarcinoma detection. The overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of CYFRA21-1 tests for squamous cell carcinoma detection were 0.72 (95% confidence interval (CI) 0.70, 0.74), 0.94 (95% CI 0.92, 0.95), 9.73 (95% CI 7.06, 13.40), 0.37 (95% CI 0.29, 0.47), and 27.30 (95% CI 17.68, 42.16), respectively. The area under the SROC curve was 0.9171 (Q* = 0.8500). No publication bias was tested in the squamous cell carcinoma (P = 0.567) and lung adenocarcinoma (P = 0.378) groups. Conclusions: CYFRA21-1 tests might be appropriate for detecting squamous cell carcinoma.

Vindesine in the Treatment of Squamous Cell Carcinoma (Who I), Adenocarcinoma (Who III), and Large Cell Carcinoma (who IV) of the Lung

1982 ◽  
Vol 68 (6) ◽  
pp. 531-535 ◽  
Author(s):  
Eros Ferrazzi ◽  
Yittorina Zagonel ◽  
Orazio Vinante ◽  
Enzo Galligioni ◽  
Giovanni L. Pappagallo ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Single Agent ◽  
Previous Treatment ◽  
Large Cell Carcinoma ◽  
Large Cell ◽  
Pretreated Patients ◽  
Previously Treated ◽  
Histologic Types

The antineoplastic activity of vindesine was evaluated in 57 patients with non-small-cell carcinoma of the lung. 53 patients were fully evaluable for response and toxicity. Twenty-seven patients had squamous cell carcinoma (WHO I), 14 had adenocarcinoma (WHO III), and 12 had large cell carcinoma (WHO IV). Forty percent of patients were previously treated. Vindesine was administered at a weekly i.v. dose of 3 mg/m2. Partial remissions were observed in 2 of 12 patients with large cell carcinoma and in 1 of 27 patients with squamous cell carcinoma. Among 14 patients with adenocarcinoma, 3 minor responses were observed. Drug-related toxic effects (mainly leukopenia with manageable and reversible neurotoxicity) required modification of dose in 41 % of patients: this finding and previous treatment may have adversely affected the response rate. It is concluded that vindesine as a single agent has some activity in large cell carcinoma. Activity in the other histologic types was minimal but not totally absent and deserves further evaluation, possibly in non-pretreated patients.

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