Cetuximab in combination with concurrent chemoradiotherapy (CRT) in locally advanced non-small cell lung carcinoma (NSCLC): A feasibility study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 7540-7540
Author(s):  
M. M. van den Heuvel ◽  
J. Belderbos ◽  
O. Dalesio ◽  
M. van der Pol ◽  
L. Uitterhoeve ◽  
...  
Keyword(s):  
Advanced Nsclc ◽  
Metabolic Response ◽  
Small Cell Lung Carcinoma ◽  
Treatment Options ◽  
Locally Advanced ◽  
Growth Factor Receptor ◽  
Early Response ◽  
Response Monitoring ◽  
Cell Lung Carcinoma ◽  
Locally Advanced Nsclc

7540 Background: Despite modest benefits from CRT regimens in patients with locally advanced NSCLC, more efficacious treatment options are needed. Cetuximab, a monoclonal antibody that selectively binds to the epidermal growth factor receptor, has demonstrated activity in patients with metastatic NSCLC. This trial was initiated to assess the feasibility of combining cetuximab with concurrent CRT. Methods: Patients with non-operable locally advanced NSCLC received cetuximab (400 mg/m2 on day 1, 250 mg/m2 q1w from weeks 2–6) in combination with cisplatin (6 mg/m2 q1d from weeks 2–6), and RT (66 Gy in 24 fractions from weeks 2–6). Results: Between April and July 2008, 12 consecutive, eligible patients entered the study. The mean age was 61 years (range: 43–77) and 50% were male. Baseline NSCLC staging was: IIb (1 patient), IIIa (5 patients), and IIIb (6 patients). Treatment was generally well tolerated. Acne-like rash and radiation esophagitis were the most common side effects (grade ≤3 according to CTCAE v 3.0) (see table). No unexpected toxicities were observed. Early-response monitoring using PET-CT scans was performed 4 weeks after the last fraction of RT in 10/12 patients. A metabolic response was seen in 50% (complete: 3 patients; partial: 2 patients) of patients. One patient showed progressive disease. Conclusions: Cetuximab added to CRT in patients with NSCLC was generally well tolerated and produced promising early clinical responses. A randomized phase II study comparing CRT with CRT and cetuximab is ongoing. [Table: see text] [Table: see text]

A randomized, multicenter phase II study investigating additional weekly cetuximab to concurrent chemoradiotherapy in locally advanced non-small cell lung carcinoma: Reporting on the efficacy.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 7019-7019 ◽  
Author(s):  
Michel M van den Heuvel ◽  
Andrew D. Vincent ◽  
Wilma Uyterlinde ◽  
Joachim Aerts ◽  
Fredirike Koppe ◽  
...  
Keyword(s):  
Phase Ii ◽  
Concurrent Chemoradiotherapy ◽  
Advanced Nsclc ◽  
Phase Ii Study ◽  
Small Cell Lung Carcinoma ◽  
Locally Advanced ◽  
High Dose ◽  
Cell Lung Carcinoma ◽  
Multicenter Phase ◽  
Locally Advanced Nsclc

7019 Background: Modest benefits from concurrent chemoradiotherapy (CRT) in patients with locally advanced NSCLC warrant more effective treatment regimen. Cetuximab, a monoclonal antibody against the epidermal growth factor receptor has shown activity in NSCLC. Feasibility data and toxicity have been published previously. We report treatment outcome of a multicenter phase II study of the combination of high dose accelerated RT and daily dose cisplatin with or without weekly cetuximab. Methods: Patients with locally advanced NSCLC received accelerated RT (66 Gy in 24 fractions) and concurrent daily cisplatin (6 mg/m2) with (Arm A) or without (Arm B) additional weekly cetuximab (400 mg/m2 loading dose one week prior to the RT start followed by weekly 250 mg/m2). The Objective Local Response Control (OLRC) was determined at 6 and 24 weeks after treatment using response evaluation criteria in solid tumours criteria. Results: Between Feb 2009 and May 2011, 102 patients were included. Median follow-up was 13 months. Patients and tumor characteristics are shows in the Table. Stage distribution was: II (8%), IIIa (51%), and IIIb (40%). The CRT was well tolerated. The OLRC at 24 weeks was 79% in Arm A and 80% in Arm B. The one-year progression free survival and overall survival were 58% (45%-76%) and 76% (64%-91%) for Arm A and 49% (35%-68%) and 72% (58%-89%) for Arm B respectively. Conclusions: The addition of cetuximab to low dose cisplation CRT does not improve OLRC in an unselected patient cohort but data on longterm disease control and survival are to be awaited. [Table: see text]

AN OBSERVATIONAL STUDY TO EVALUATE THE RESPONSE AND TOXICITY WITH CONVENTIONAL FRACTIONATION AND HYPO FRACTIONATED RADIOTHERAPY FOR LOCALLY ADVANCED NON SMALL CELL LUNG CARCINOMA FOLLOWING INDUCTION CHEMOTHERAPY

2021 ◽  
pp. 7-9
Author(s):  
Sujata Sarkar ◽  
Gautam Bhattacharjee ◽  
Tamohan Chaudhuri
Keyword(s):  
Induction Chemotherapy ◽  
Advanced Nsclc ◽  
Small Cell Lung Carcinoma ◽  
Locally Advanced ◽  
Hypofractionated Radiotherapy ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Fractionated Radiotherapy ◽  
Conventional Fractionation ◽  
Locally Advanced Nsclc

Aims & Objectives: To evaluate the response and toxicity with Conventional fractionation and hypofractionated radiotherapy for locally advanced NSCLC following induction chemotherapy. To assess and compare following for locally advanced NSCLC with Conventional and hypo fractionated radiotherapy following induction chemotherapy. Materials And Methods: This prospective observational study was conducted at Saroj Gupta Cancer Centre and Research Institute, Kolkata; accrual was from June 2016 to September 2017. Data was collected from all patients who had been cytological / histopathologically and radiological proven stage III Non Small Cell Lung Carcinoma; fullling eligibility criteria, were recruited after obtaining informed consent. Results And Analysis: We found that the association between response at the END OF RT in two groups was not statistically signicant (p=0.8559). Association between Dermatitis highest grade at end of RT in two groups was not statistically signicant (p=0.5201). Association between Response 6 months after RT in two groups was not statistically signicant (p=0.7667). Association between Response 9 months after RT in two groups was not statistically signicant (p=0.9255). Association between Dermatitis. Conclusion & Summary: Our study showed hypofractionated radiotherapy is non-inferior to Conventional radiotherapy with equivalent overall response and toxicity and well tolerable. In patients with poor performance status who cannot tolerate concurrent chemo radiation, induction chemotherapy with hypofractionated radiotherapy regimen can be considered as a treatment of choice with manageable toxicities.

scholarly journals HIF-1α Levels in patients receiving chemoradiotherapy for locally advanced non-small cell lung carcinoma

2019 ◽  
Vol 65 (10) ◽  
pp. 1295-1299
Author(s):  
Cigdem Usul Afsar ◽  
Pelin Uysal
Keyword(s):  
Small Cell Lung Carcinoma ◽  
Locally Advanced ◽  
Hypoxia Inducible Factor ◽  
Small Cell ◽  
Enzyme Linked Immunosorbent Assay ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Hypoxia Inducible Factor 1 ◽  
Locally Advanced Nsclc ◽  
Before And After

SUMMARY AIM To examine the relationship between treatment response and hypoxia-inducible factor-1 alpha (HIF-1α) levels in patients with locally advanced non-small cell lung cancer (NSCLC) who received chemoradiotherapy (CRT). METHODS Eighty patients with NSCLC were included in the study and treated at Acibadem Mehmet Ali Aydınlar University Medical Faculty. HIF-1 α levels were measured before and after CRT by the enzyme-linked immunosorbent assay (ELISA) method. RESULTS Patients’ stages were as follows; stage IIIA (65%) and stage IIIB (35%). Squamous histology was 45%, adenocarcinoma was 44%, and others were 11%. Chemotherapy and radiotherapy were given concurrently to 80 patients. Forty-five (56%) patients received cisplatin-based chemotherapy, and 35 (44%) received carboplatin-based chemotherapy. Serum HIF-1α levels (42.90 ± 10.55 pg/mL) after CRT were significantly lower than the pretreatment levels (63.10 ± 10.22 pg/mL, p<0.001) in patients with locally advanced NSCLC. CONCLUSION The results of this study revealed that serum HIF-1α levels decreased after CRT. Decrease of HIF-1α levels after the initiation of CRT may be useful for predicting the efficacy of CRT.

scholarly journals PO-0888: Response monitoring by 18FDG-PET in locally advanced NSCLC treated with concurrent chemoradiotherapy

2017 ◽  
Vol 123 ◽  
pp. S488 ◽  
Author(s):  
J.N.A. Van Diessen ◽  
M. La Fontaine ◽  
M. Van den Heuvel ◽  
W. Vogel ◽  
J.S.A. Belderbos ◽  
...  
Keyword(s):  
Concurrent Chemoradiotherapy ◽  
Advanced Nsclc ◽  
Locally Advanced ◽  
Response Monitoring ◽  
18Fdg Pet ◽  
Locally Advanced Nsclc

FDG-PET in the assessment of metabolic response in patients with NSCLC treated with nivolumab: Preliminary results.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e20554-e20554
Author(s):  
Lucas Goldfarb ◽  
Boris Duchemann ◽  
Kader Chouahnia ◽  
Lea Gomez ◽  
Gabriel Pop ◽  
...  
Keyword(s):  
Disease Progression ◽  
Fdg Pet ◽  
Metabolic Response ◽  
Small Cell Lung Carcinoma ◽  
Performance Status ◽  
Locally Advanced ◽  
Cost Benefit ◽  
Large Cell ◽  
Cell Lung Carcinoma ◽  
Systemic Involvement

e20554 Background: Immunotherapy becomes a standard treatment in non-small-cell lung carcinoma (NSCLC), locally advanced or metastatic, after prior chemotherapy. Because of systemic involvement and heterogeneity of the tumoral disease, methods of assessment are complex and the role of PET-FDG is not well established. The objective of the present study is to describe the results of FDG-PET in the evaluation of patients with NSCLC treated with checkpoint inhibitor (OPDIVO®, Nivolumab) in our academic center. Methods: A retrospective analysis of FDG-PET’s data was performed in 16 patients (performance status: 1), with NSCLC (13 adenocarcinoma, 2 squamous cell carcinoma and 1 large cell neuroendocrine carcinoma) and progression after at least one line of treatment, and treated with Nivolumab. All patients had an FDG-PET before and at 2 months (M2) of treatment. Patients showing progression at M2 had a third PET at M3 to confirm disease progression. Disease responses were assessed according to PERCIST criteria. Patients were considered as responders to Nivolumab treatment, if the treatment was pursued at least 6 months, or as non-responders if the treatment was pursued less than 6 months. Pseudoprogression was defined as a disease progression at M2, which was not confirmed on FDG-PET control at M3. Results: Assessment by FDG-PET after 2 months of treatment showed 8/16 partial metabolic responses (PMR), 6/16 progressive diseases (PD), 1/16 stable disease (SD) and 1/16 complete metabolic response (CMR). Among the patients with PMR, SD or CMR at M2 (n = 10), 90% (9/10) were considered as responders and 10% (1/10) as non-responder. Nivolumab was discontinued in patients with PD. One patient showed a pseudo progression at M2 (PMR at M3), and was eventually classified as non-responder. Conclusions: These results show an association between the metabolic response at M2 and the continuation of the treatment with Nivolumab in NSCLC patients. 90% of patients with early metabolic response showed a sustained response with Nivolumab. FDG-PET could be helpful in the therapeutic strategy of these patients and deserves to be assessed in prospective trials including a cost/benefit evaluation.

scholarly journals Clinical and Cost Implications of Universal Versus Locally Advanced-Stage and Advanced-Stage-Only Molecular Testing for Epidermal Growth Factor Receptor Mutations and Anaplastic Lymphoma Kinase Rearrangements in Non–Small Cell Lung Carcinoma: A Tertiary Academic Institution Experience

2016 ◽  
Vol 140 (4) ◽  
pp. 358-361 ◽  
Author(s):  
Jennifer L. Sauter ◽  
Kelly J. Butnor
Keyword(s):  
Early Stage ◽  
Small Cell Lung Carcinoma ◽  
Locally Advanced ◽  
Growth Factor Receptor ◽  
Molecular Testing ◽  
Advanced Stage ◽  
Early Stage Disease ◽  
Cell Lung Carcinoma ◽  
Anaplastic Lymphoma ◽  
Stage Disease

Although epidermal growth factor receptor (EGFR)– and anaplastic lymphoma kinase (ALK)–directed therapies are not approved for patients with early-stage non–small cell lung carcinoma (NSCLC), many institutions perform EGFR and ALK testing for all patients with NSCLC at the time of initial diagnosis. Current consensus guidelines recommend EGFR testing and suggest ALK testing at the time of initial diagnosis for patients with advanced disease.Context.— To examine the cost and clinical impact of EGFR and ALK testing of patients with early-stage NSCLC.Objectives.— Records from all patients with a diagnosis of NSCLC made on a nonresection specimen at our institution during a single calendar year (2012) were reviewed, and a cost analysis was performed.Design.— Of 133 total patients, 47 (35%) had early-stage (stage I or II) disease and 86 (65%) had locally advanced (stage III) or advanced (stage IV) disease at presentation. Eight of 47 patients with early-stage disease (17%) had progression/recurrence during 18 to 30 months of follow-up, 6 of 8 (75%) of whom had pathologic confirmation of progression/recurrence. The estimated additional cost of EGFR and ALK testing for all newly diagnosed patients with NSCLC at our institution is $75 200 per year, compared to testing only patients with locally advanced and advanced-stage disease.Results.— The cost of universal molecular testing of NSCLC is substantial. EGFR and ALK testing of patients with early-stage disease appears to have negligible clinical impact, as most patients do not have disease recurrence/progression. Those whose disease recurs/progresses typically undergo rebiopsy. Our findings do not support the practice of universal EGFR and ALK testing in NSCLC at the time of initial diagnosis.Conclusions.—

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