Intestinal microbiota to predict risk for immune-related diarrhea in patients with lung cancer patients.

2018 ◽  
Vol 36 (5_suppl) ◽  
pp. 132-132 ◽  
Author(s):  
Tian Liu ◽  
Yi Hu

132 Background: Anti-programmed cell death 1 (PD-1) inhibitors, which enhance cellular immunity via blockade of PD-1, represent an effective option for the treatment of lung cancer and have shown some impressive efficacy. However, the inhibitors can also result in immune-related adverse events, such as immune-related diarrhea. Researches have shown that intestinal microbiota plays a vital role in gastrointestinal dysregulation. Whereas, the relationship between PD-1 inhibitors and immune-related diarrhea is still elusive. In our study, we aim to identify the correlation of intestinal microbiota and immune-related diarrhea, and hope to find specific bacteria as potential biomarkers of immune-related diarrhea. Methods: Twenty-six lung cancer patients who were treated with PD-1 inhibitors from 301 hospital were enrolled for retrospective analysis. And the fecal samples were obtained from patients before the first dose of PD-1 inhibitor. Based on whether they develop diarrhea or not, the patients were subgroup into progressed to diarrhea(PtD) group and diarrhea-free(D-F) group. Immune-related diarrhea was graded according to the National Cancer Institute Common Toxicity Criteria (CTC, version 4.0). And 16S rRNA sequencing was used to profile fecal bacterial composition. Results: There was no significant difference in baseline characteristics, such as microbial richness between PtD group and D-F group (P > 0.05). However, At the phylum level, Bacteroidetes were richer in D-F group, while Firmicutes were poorer, than that in PtD group. At the genus level, two families of the Bacteroidetes phylum ( Bacteroides and Parabacteroides) and a family of the Firmicutes phylum (Phascolarctobacterium) were more abundant in D-F group. Veillonella from Proteobacteria phylum was lower in D-F group than that in PtD group (all P < 0.05). Conclusions: Our study indicates that microbiota variation probably participates in the onset of immune-related diarrhea. Identifying these biomarkers may help us to diagnose the side effect earlier, and provides a novel treatment for immune-related diarrhea due to PD-1 inhibitors.

2020 ◽  
Vol 68 (10) ◽  
pp. 1156-1162
Author(s):  
Yasunori Kaminuma ◽  
Masayuki Tanahashi ◽  
Eriko Suzuki ◽  
Naoko Yoshii ◽  
Hiroshi Niwa

Abstract Objectives Lung cancer patients have been reported to have a high incidence of venous thromboembolism (VTE) and a high recurrence rate of VTE. However, there are no detailed reports of VTE in lung cancer patients who underwent surgery after induction therapy. We examined the incidence and clinical features of VTE in these patients. Methods We retrospectively evaluated 89 patients with non-small cell lung cancer who underwent surgery after induction therapy at our department between April 2009 and March 2018. The incidence of VTE, clinical features, and long-term prognosis were retrospectively examined. Results Among the 89 patients, 4 (4.5%) developed VTE, and there was no significant difference in the background characteristics between patients with and without VTE. All four patients developed VTE during preoperative treatment. In the patients with VTE, anticoagulant therapy with oral anticoagulants was administered after heparinization, and the median duration of anticoagulant therapy was 18.7 months. There were no cases of symptomatic VTE recurrence after surgery, regardless of lung cancer recurrence. Although the overall survival (OS) showed no significant difference between patients with and without VTE, the disease-free survival was significantly shorter in patients with VTE than in those without it (median 6.3 vs. 71.6 months, p < 0.01). Conclusions In induction cases, the incidence of VTE was 4.5%, and it can at least be stated that no symptomatic VTE developed or recurred after surgery. Patients with VTE in induction therapy had short progression-free survival and required careful follow-up after surgery.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hyun-Sung Jung ◽  
Eun-Kee Park ◽  
Jun-Seok Cha ◽  
Jae-Won Lee ◽  
Jong-Chun Lee ◽  
...  

AbstractThe Asbestos Injury Relief Act in Korea requires that asbestos exposure be assessed through clinical examination and chest computed tomography (CT). However, a more specific measurement of asbestos characteristics in the lung tissue may be appropriate. We aimed to investigate the asbestos burden and characterize asbestos fibers in patients with lung cancer and ultimately assess the relationship between occupational and environmental asbestos exposure and lung cancer in Korea. We evaluated 37 lung cancer patients (LCPs) from Busan. The factors affecting asbestos burden in LCPs were analyzed using a multiple regression analysis. History of asbestos exposure (environmental/occupational), male sex, and old age were the main factors affecting asbestos burden in lung tissues of LCPs. These factors had an approximate 37% adjusted coefficient of determination. There was a significant difference in the length of asbestos fibers (4.06–37.6 µm vs. 4.26–91.7 µm) and aspect ratio (4.5–151.9 vs. 5.6–735.6) between those who were occupationally exposed to asbestos and those who were environmentally exposed (P < 0.01). Therefore, both environmental/occupational exposure to asbestos should be strongly managed to reduce the risk of lung cancer, and exposure should be assessed according to the characteristics of asbestos fibers in the lung tissue.


2020 ◽  
Vol 38 (4) ◽  
pp. 172-175
Author(s):  
Md Harun Or Rashid ◽  
Quadrat E Elahi ◽  
Md Ashraful Alam ◽  
Fatima Sarker

Background: To compare the survival rate of paclitaxel plus cisplatin (PC arm), paclitaxel plus gemcitabine (PG arm) and gemcitabine plus cisplatin (GC arm) in chemotherapy patients with non resectable lung cancer. Methods: This was a retrospective observational study to evaluate chemotherapy response among non resectable lung cancer patients with their survival at cancer center CMH, Dhaka since 01 July 2013 to 31 March 2015. One hundred fifty-four (154) non resectable lung cancer patients were randomly divided into three groups, 50 patients in PC arm, 51 patients in PG arm and 53 patients in GC arm. In PC arm paclitaxel 175 mg/m2 (day 1) with cisplatin 75mg/m2 (day 1), in PG arm Paclitaxel 175 mg/m2 (day 1) with gemcitabine 1000 mg/m2 (days 1 and 8) and in GC arm gemcitabine 1000 mg/m2 (days 1 and 8) with cisplatin 100mg/m2 (day 1). Results: Patients characteristics were similar between the three groups. The overall response rate was 40% in the PC arm,43.1% in the PG arm, 43.4% in the GC arm. The median survival time in PC arm was 8.5 months, in PG arm was 8.8 months, in GC arm was 9.2 months. The major side effect was myelosuppression which accounts 71% patients. The average treatment costs were 57% and 30% lower in PC arm as compared with GC and PG arm respectively. Conclusion: The median survival time, disease free survival time and 1-year survival rate in PC, PG, GC arms without significant difference. Treatment were well tolerable; quality of life parameter was mostly similar but paclitaxel with cisplatin was most cost effective than others chemotherapy regimen. J Bangladesh Coll Phys Surg 2020; 38(4): 172-175


2018 ◽  
Vol 36 (5_suppl) ◽  
pp. 148-148
Author(s):  
Xuan Zheng ◽  
Yi Hu ◽  
Junxun Ma ◽  
Fan Zhang ◽  
Danyang Sun ◽  
...  

148 Background: PD-1 inhibitors have shown significant clinical activity in different cancer types. However, responses in pts with NSCLC are variable, and insights are needed to identify a predictive biomarker of response with greater diagnostic accuracy. Here we tested the hypothesis tha tserum TNF-a level is predictive of response to anti-PD-1 treatment. Methods: NSCLC patients treated with nivolumab or pembrolizumab were studied. Pts received nivolumab (3mg/kg, q2w) or pembrolizumab ( 2mg/kg, q3w). Pts on anti-PD1 were classified as either responders (R) deriving clinical benefit (with SD, PR, CR) or non-responders (NR) not deriving clinical benefit (PD) based on RECIST criteria.Serum was collected at baseline; at 2-3 weeks after the first dose (early stage); and at the time of response evaluation. Serum TNF-a levels were determined by Luminex kit. Changes in serum TNF-a levels and their strength of association with response were compared with Non-parametric Analysis. Results: Evaluable plasma samples were collected from twenty-one NSCLC patients treated with nivolumab or pembrolizumab. There was no significant difference in baseline serum TNF-a levels in responders (n = 15) vs non-responders (n = 6). Between baseline and early stage ,serum TNF-a levels significantly increased in responders (P = 0.010), while in non-responders, no significant change was found. High early change rate of serum TNF-a levels ( > 50%) was observed only in responders(n = 7).At early stage, responders had significantly higher serum TNF-a levels than non-responders(P = 0.008). We found no significant difference in serum TNF-a levels at the time of response evaluation. Conclusions: Early changes in serum TNF-a levels and high serum TNF-a levels at early stage in non-small cell lung cancer patients correlate to response to anti-PD-1 treatment.


2015 ◽  
Vol 30 (3) ◽  
pp. 282-285 ◽  
Author(s):  
Xinxin Meng ◽  
Chen Xiao ◽  
Yuguang Zhao ◽  
Lin Jia ◽  
Yang Tang ◽  
...  

Background: MicroRNA-21 (miR-21) has previously been demonstrated as a potential biomarker in diagnosis of various human tumors. This meta-analysis was performed to evaluate the possibility of miR-21 as a biomarker for early detection of lung cancer. Methods: Relevant lung cancer-related miRNA microarray datasets were collected from the NCBI Gene Expression Omnibus (GEO) database and EBI ArrayExpress database up to February 2014. Quality control of the output data was estimated using Limma package and ExiMiR package in R. Standardized mean difference (SMD) with 95% confidence intervals (CIs) from selected datasets was pooled. Heterogeneity was assessed using Cochran's Q test and the I2 statistic, and a p value <0.0.05 or I2 >50% was defined as significant heterogeneity. Furthermore, sensitivity analysis was conducted to evaluate the stability of the pooled results. Four miRNA datasets (GSE24704, GSE17681, GSE27486 and GSE40738) from blood samples were selected, including 153 lung cancer patients and 109 healthy people. Results: The pooled results generated by random-effects model revealed that no significant difference was observed between case and control groups (SMD = 0.58; 95% CI, −0.04 to 1.19; p = 0.07) with significant heterogeneity (p = 0.0032, I2 = 78.2%; p = 0.06). Sensitivity analysis indicated that the results of the meta-analysis were stable. Conclusions: MiR-21 expression levels in whole blood and peripheral blood cells did not show significant differences between lung cancer patients and healthy controls, and it might be ineffective to measure miR-21 expression to achieve an early diagnosis of lung cancer.


2021 ◽  
Author(s):  
Hongbin Zhou ◽  
Zhewen Chen ◽  
Ying Chen ◽  
Jiuke Li ◽  
Sa Ye

Abstract Background: Nitric oxide (NO) plays an important role in lung cancer. However, the results of previous studies about NO in the occurrence, progress and therapy were not consistent. Therefore, we conducted a meta-analysis to evaluate the relationship between NO and lung cancer.Method: We carried out comprehensive search in the databases, and collected related studies. The data of fraction of exhaled nitric oxide (FeNO) or blood NO in different populations (lung cancer patients and control subjects) and different time points (before therapy and after therapy) were extracted by two investigators. A random effect model was applied to analyze the differences of FeNO and blood NO in different populations and different time points. To further compare NO level of each subgroup with different pathological types and different stages, a network meta-analysis (NMA) was performed.Results: 50 studies including 2551 cases and 1691 controls were adopted in this meta-analysis. The FeNO (SMD 3.01, 95% CI 1.89-4.13, p < 0.00001) and blood NO (SMD 1.34, 95% CI 0.84-1.85, p < 0.00001) level in lung cancer patients was much higher than that in control subjects. NMA model indicated blood NO level in each cancer type except SCLC was higher than that in control patients. There was no significant difference of blood NO level among four kinds of lung cancer patients. Blood NO level in LCC patients (SUCRA=83.5%) was the highest. Blood NO level in advanced stage but not early stage was higher than that in control subjects. Patients in advanced stage (SUCRA=95.5%) had the highest blood NO level. No significant difference of FeNO (SMD -0.04, 95% CI -0.46-0.38, p > 0.05) and blood NO level (SMD -0.36, 95% CI -1.08-0.36, p > 0.05) was observed between pretreatment and posttreatment in all patients. However, FeNO level elevated (SMD 0.28, 95% CI 0.04-0.51, p = 0.02) and blood NO level decreased in NSCLC patients (SMD -0.95, 95% CI -1.89-0.00, p = 0.05) after therapy. Conclusion: FeNO and blood NO level would contribute to diagnosis of lung cancer and evaluation of therapy effect, especially for NSCLC patients.


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