Combination of paclitaxel and bevacizumab in heavily pre-treated non-small-cell lung cancer (NSCLC) patients: a case series study on 15 Patients

2013 ◽  
Vol 100 (12) ◽  
pp. E30-E37 ◽  
Author(s):  
Sylvestre Le Moulec ◽  
Julien Hadoux ◽  
Éric Gontier ◽  
Cyrus Chargari ◽  
Carole Helissey ◽  
...  
2020 ◽  
Author(s):  
zhao jing ◽  
Rongjin Zhou ◽  
Huaxiang He ◽  
Shixiu Wu

Abstract Background: Although concurrent chemoradiotherapy (CRT) was recommend as standard of care in patients with stage III unresectable non-small cell lung cancer (NSCLC), many patients refused or were not eligible for chemotherapy in clinical practice. These patients often receive RT alone with 5-year OS rate of about 5-6%. This addressed a common clinical challenge of treating these patients. Immune-checkpoint inhibitors have demonstrated objective antitumor responses in patients with advanced NSCLC, but it is unclear how these agents can be used in the curative therapy with concurrent radiation. Case presentation: Here we described, the case series, the effect of stage III unresectable NSCLC patients who refused chemotherapy received radiation and anti-PD-1 immunotherapy. Three patients with stage III unresectable NSCLC were treated with radiotherapy concurrently with anti-PD-1 agent (pembrolizumab) between May 2018 and August 2018 in our hospital. Two patients experienced partial response and one patient experienced stable disease. One patient developed the liver metastasis 4 months after the treatment. All patients had no local-regional recurrence. No patient experienced ≥ grade 3 adverse event (AE), and no patient discontinued treatment because of an AE. Conclusions: Concurrent treatment with radiation and pembrolizumab for unresectable stage III NSCLC patients who refused chemotherapy demonstrated its efficacy and acceptable tolerance. Further investigations are warranted to determine its role in the management of these patients.


Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3828
Author(s):  
Anello Marcello Poma ◽  
Rossella Bruno ◽  
Iacopo Pietrini ◽  
Greta Alì ◽  
Giulia Pasquini ◽  
...  

Pembrolizumab has been approved as first-line treatment for advanced Non-small cell lung cancer (NSCLC) patients with tumors expressing PD-L1 and in the absence of other targetable alterations. However, not all patients that meet these criteria have a durable benefit. In this monocentric study, we aimed at refining the selection of patients based on the expression of immune genes. Forty-six consecutive advanced NSCLC patients treated with pembrolizumab in first-line setting were enrolled. The expression levels of 770 genes involved in the regulation of the immune system was analysed by the nanoString system. PD-L1 expression was evaluated by immunohistochemistry. Patients with durable clinical benefit had a greater infiltration of cytotoxic cells, exhausted CD8, B-cells, CD45, T-cells, CD8 T-cells and NK cells. Immune cell scores such as CD8 T-cell and NK cell were good predictors of durable response with an AUC of 0.82. Among the immune cell markers, XCL1/2 showed the better performance in predicting durable benefit to pembrolizumab, with an AUC of 0.85. Additionally, CD8A, CD8B and EOMES showed a high specificity (>0.86) in identifying patients with a good response to treatment. In the same series, PD-L1 expression levels had an AUC of 0.61. The characterization of tumor microenvironment, even with the use of single markers, can improve patients’ selection for pembrolizumab treatment.


Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1794
Author(s):  
Alice Indini ◽  
Erika Rijavec ◽  
Francesco Grossi

Immune checkpoint inhibitors (ICIs) targeting the programmed cell death (PD)-1 protein and its ligand, PD-L1, and cytotoxic T-lymphocyte-associated antigen (CTLA)-4, have revolutionized the management of patients with advanced non-small cell lung cancer (NSCLC). Unfortunately, only a small portion of NSCLC patients respond to these agents. Furthermore, although immunotherapy is usually well tolerated, some patients experience severe immune-related adverse events (irAEs). Liquid biopsy is a non-invasive diagnostic procedure involving the isolation of circulating biomarkers, such as circulating tumor cells (CTC), cell-free DNA (cfDNA), and microRNAs (miRNAs). Thanks to recent advances in technologies, such as next-generation sequencing (NGS) and digital polymerase chain reaction (dPCR), liquid biopsy has become a useful tool to provide baseline information on the tumor, and to monitor response to treatments. This review highlights the potential role of liquid biomarkers in the selection of NSCLC patients who could respond to immunotherapy, and in the identification of patients who are most likely to experience irAEs, in order to guide improvements in care.


Sign in / Sign up

Export Citation Format

Share Document