EFFECTIVENESS OF ENDOBRONCHIAL PHOTODYNAMIC THERAPY IN COMBINATION WITH CHEMOTHERAPY IN NON-SMALL CELL LUNG CANCER

2017 ◽  
Vol 63 (6) ◽  
pp. 882-885
Author(s):  
Andrey Akopov ◽  
Anatoliy Rusanov ◽  
Margarita Urtenova ◽  
Nikita Kazakov ◽  
A. Cheremnykh ◽  
...  

Aim. To evaluate safety and effectiveness of combined treatment of non-small cell lung cancer (NSCLC) including chemotherapy and endobronchial PDT. Methods. Results of treatment for two groups of patients with central advanced NSCLC were compared, 75 patients in each. In arm A first line chemotherapy with endobronchial photodynamic therapy (PDT) was done, in arm B - chemotherapy only. PDT was performed with the use of chlorine based photosensitizers in the dose of 1 mg/kg body weight. Results. Investigated groups were comparable. No serious PDT complications were observed. The number of patients progression (p=0,05) was significantly different in favour of arm A. Remission in arm A was noted in 90% of patients, in arm B - in 76% (p=0,02). One-year survival was 60% and 41% for groups A and B, respectively (р=0,03). Conclusion. Combination of endobronchial PDT and chemotherapy is safe and effective, makes possible to improve results of treatment and survival in central advanced NSCLC.

2012 ◽  
Vol 52 (186) ◽  
Author(s):  
S Shrestha ◽  
P Joshi

Introduction: There is no published data in Nepal regarding the use of gefi tinib in patients with non-small cell lung cancer (NSCLC). Therefore, a retrospective analysis was conducted to evaluate the response and toxicity profi le of Gefi tinib alone in patients with advanced NSCLC and unknown epidermal growth factor receptor (EGFR) status. Methods: A single institutional retrospective study was conducted for the period from January 2004 to December 2006 involving patients with locally advanced or metastatic NSCLC who received gefi tinib as monotherapy Primary objective was to evaluate the objective tumor response rate. Results: A total of 36 patients with advanced NSCLC who received gefi tinib 250 mg orally once daily as 1st, 2nd, 3rd, and 4th line treatment in 7, 14, 9, and 6 patients respectively were included in the analysis. Comparable number of patients pertaining to sex, smoking status, and tumor histology were included. The overall response rate at 3 months was 60% including 47% in males and 68% in females. After one month 38% and 6.6% patients with adenocarcinoma and squamous histology respectively responded to gefi tinib therapy. The median progression-free survival was 5.7 months. Toxicities were generally mild with diarrhea, rash and pruritus being the most commonly observed side effects. Conclusion: In this single-center experience, gefi tinib demonstrated clinically signifi cant response in overall population and provided good palliation in pretreated patients. Keywords: Advanced stage NSCLCs, EGFR-TKIs, Gefitinib, monotherapy, Nepal.


2021 ◽  
Author(s):  
Chen Huang ◽  
Yongmei Dai ◽  
Qianshun Chen ◽  
Feng Li ◽  
Xunyu Xu

Abstract Background: Radical concurrent chemoradiotherapy is the preferred treatment for patients with stage IIIB non-small cell lung cancer (NSCLC), but the prognosis is poor. The emergence of immune checkpoint inhibitors has changed the treatment strategy for advanced NSCLC, providing new opportunities for therapy. However, neoadjuvant immunotherapy of locally advanced NSCLC is still in the exploratory stage. Case presentation: A 47-year-old male with stage IIIB squamous cell lung cancer with invasion of the pulmonary artery, left superior pulmonary vein (LSPV), and left atrium (LA) at diagnosis. The patient’s lesions were significantly reduced after four cycles of combined treatment with tislelizumab and carboplatin plus nab-paclitaxel, he then underwent successful left pneumonectomy with mediastinal lymph node dissection, and postoperative pathology showed a pathologic complete response (pCR). Conclusions: The findings demonstrated that chemotherapy in combination with immunotherapy can provide an opportunity for radical surgery in some patients with locally advanced NSCLC.


2017 ◽  
Vol 176 (5) ◽  
pp. 38-42 ◽  
Author(s):  
A. L. Akopov ◽  
I. V. Chistaykov ◽  
A. A. Rusanov ◽  
M. A. Urtenova ◽  
S. Yu. Dvoretskiy ◽  
...  

OBJECTIVE. The research evaluated efficacy of combined treatment of initially nonresectable and inoperable cases of non-small cell lung cancer. The treatment consisted of preoperative endobronchial and intraoperave photodynamic therapies. MATERIAL AND METHODS. The prospective investigation included patients with central non-small cell lung cancer. These cases were initially considered as nonresectable (the trachea was involved in tumor) or inoperable (functional intolerance of pneumoectomy/ bilobectomy). Neoadjuvant chemotherapy (2-6 courses) and endobronchial photodynamic therapy (PDT) were conducted for these patients in preoperative period. PDT of resection edge was carried out during the operation and it was straight away after specimen removal and ipsilateral lymphodissection. RESULTS. The research was made on 38 patients. Lung resections underwent 30 (79 %) patients. Surgeries included 20 pneumoectomies and 10 lobectomies. Bronchial resection was performed by crossing an initially affected zone. It was noted that 5-year survival consisted of 68 %. CONCLUSIONS. Photodynamic therapy was important in combination with chemotherapy and surgical treatment of central non-small cell lung cancer. These measures allowed doctors to decrease the resection volume in part of inoperable patients or patients with initially nonresectable tumors.


Molecules ◽  
2021 ◽  
Vol 26 (4) ◽  
pp. 1056 ◽  
Author(s):  
Nazilah Abdul Satar ◽  
Mohd Nazri Ismail ◽  
Badrul Hisham Yahaya

Cancer stem cells (CSCs) represent a small subpopulation within a tumour. These cells possess stem cell-like properties but also initiate resistance to cytotoxic agents, which contributes to cancer relapse. Natural compounds such as curcumin that contain high amounts of polyphenols can have a chemosensitivity effect that sensitises CSCs to cytotoxic agents such as cisplatin. This study was designed to investigate the efficacy of curcumin as a chemo-sensitiser in CSCs subpopulation of non-small cell lung cancer (NSCLC) using the lung cancer adenocarcinoma human alveolar basal epithelial cells A549 and H2170. The ability of curcumin to sensitise lung CSCs to cisplatin was determined by evaluating stemness characteristics, including proliferation activity, colony formation, and spheroid formation of cells treated with curcumin alone, cisplatin alone, or the combination of both at 24, 48, and 72 h. The mRNA level of genes involved in stemness was analysed using quantitative real-time polymerase chain reaction. Liquid chromatography-mass spectrometry was used to evaluate the effect of curcumin on the CSC niche. A combined treatment of A549 subpopulations with curcumin reduced cellular proliferation activity at all time points. Curcumin significantly (p < 0.001) suppressed colonies formation by 50% and shrank the spheroids in CSC subpopulations, indicating inhibition of their self-renewal capability. This effect also was manifested by the down-regulation of SOX2, NANOG, and KLF4. Curcumin also regulated the niche of CSCs by inhibiting chemoresistance proteins, aldehyde dehydrogenase, metastasis, angiogenesis, and proliferation of cancer-related proteins. These results show the potential of using curcumin as a therapeutic approach for targeting CSC subpopulations in non-small cell lung cancer.


2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A466-A466
Author(s):  
Guo Gui Sun ◽  
Jing Hao Jia ◽  
Peng Gao ◽  
Xue Min Yao ◽  
Ming Da Chen ◽  
...  

BackgroundEffective options are limited for patients with non–small-cell lung cancer (NSCLC) whose disease progresses after first-line chemotherapy. Camrelizumab is a potent anti-PD-1 monoclonal antibody and has shown promising activity in NSCLC. We assessed the activity and safety of camrelizumab for patients with previously treated, advanced NSCLC patients with negative oncogenic drivers.MethodsPatients who progressed during or following platinum-based doublet chemotherapy were enrolled. All patients received camrelizumab(200 mg)every 3 weeks or in combination with chemotherapy until loss of clinical benefit. The primary endpoint was objective response rate (ORR), other endpoints included disease control rate (DCR), progression-free survival (PFS) and safety.ResultsBetween Aug 5, 2019, and Jun 19, 2020, we enrolled 29 patients, 25 patients were available evaluated, ORR and DCR was 36% (9/25) and 92% (23/25), respectively. 25 of 29 patients were still receiving the treatment, the median PFS was not yet achieved. Compared with those without reactive cutaneous capillary endothelial proliferation (RCCEP), patients with RCCEP had higher ORR (60% vs. 28.6%). Treatment-related adverse events (AEs) occurred in 69.0% of patients (all Grade), and the most common were RCCEP (37.9%), pneumonitis (6.9%), and chest congestion (6.9%). Treatment-related grade 3 to 4 adverse events occurred in 10.3% of patients.ConclusionsIn patients with previously treated advanced NSCLC, camrelizumab demonstrated improved ORR and DCR, compared with historical data of the 2nd line chemotherapy, with a manageable safety profile. While patients with RCCEP derived greater benefit from camrelizumab. Further studies are needed in large sample size trials.


Author(s):  
Mona L. Martin ◽  
Julia Correll ◽  
Andrew Walding ◽  
Anna Rydén

Abstract Purpose To describe symptoms and side effects experienced by patients with advanced non-small cell lung cancer (NSCLC), assess how patients allocate sensations (i.e. symptoms or side effects) to either the disease or its treatment, and evaluate how patients balance side effects with treatment benefits. Methods Qualitative sub-studies were conducted as part of two clinical trials in patients treated for advanced NSCLC (AURA [NCT01802632]; ARCTIC [NCT02352948]). Results Interviews were conducted with 23 patients and 19 patients in the AURA and ARCTIC sub-studies, respectively. The most commonly experienced symptoms/side effects were respiratory (81% of patients), digestive (76%), pain and discomfort (76%), energy-related (71%), and sensory (62%). Patients identified a sensation as a treatment side effect if they had not experienced it before, if there was a temporal link between the sensation and receipt of treatment, and/or if their doctors consistently told or asked them about it in relation to side effects. Themes that emerged when patients talked about their cancer treatment and its side effects related to the serious nature of their advanced disease and their treatment expectations. Patients focused on treatment benefits, wanting a better quality of life, being hopeful, not really having a choice, and not thinking about side effects. Conclusions In these two qualitative sub-studies, patients with advanced NSCLC valued the benefits of their treatment regardless of side effects that they experienced. Patients weighed their options against the seriousness of their disease and expressed their willingness to tolerate their side effects in return for receiving continued treatment benefits.


2019 ◽  
Vol 20 (23) ◽  
pp. 6026
Author(s):  
Hwani Ryu ◽  
Hyo Jeong Kim ◽  
Jie-Young Song ◽  
Sang-Gu Hwang ◽  
Jae-Sung Kim ◽  
...  

We previously reported on a poly (ADP-ribose) polymerase (PARP) 1/2 inhibitor N-(3-(hydroxycarbamoyl)phenyl)carboxamide (designated KJ-28d), which increased the death of human ovarian cancer BRCA1-deficient SNU-251 cells. In the present study, we further investigated the antitumor activities of KJ-28d in BRCA-proficient non-small cell lung cancer (NSCLC) cells to expand the use of PARP inhibitors. KJ-28d significantly inhibited the growth of NSCLC cells in vitro and in vivo, and induced DNA damage and reactive oxygen species in A549 and H1299 cells. Combined treatment with KJ-28d and ionizing radiation led to increased DNA damage responses in A549 and H1299 cells compared to KJ-28d or ionizing radiation alone, resulting in apoptotic cell death. Moreover, the combination of KJ-28d plus a DNA-damaging therapeutic agent (carboplatin, cisplatin, paclitaxel, or doxorubicin) synergistically inhibited cell proliferation, compared to either drug alone. Taken together, the findings demonstrate the potential of KJ-28d as an effective anti-cancer therapeutic agent for BRCA-deficient and -proficient cancer cells. KJ-28d might have potential as an adjuvant when used in combination with radiotherapy or DNA-damaging agents, pending further investigations.


2009 ◽  
Vol 27 (26) ◽  
pp. 4274-4280 ◽  
Author(s):  
George R. Blumenschein ◽  
Ulrich Gatzemeier ◽  
Frank Fossella ◽  
David J. Stewart ◽  
Lisa Cupit ◽  
...  

PurposeSorafenib is an oral multikinase inhibitor that targets the Ras/Raf/MEK/ERK mitogenic signaling pathway and the angiogenic receptor tyrosine kinases, vascular endothelial growth factor receptor 2 and platelet-derived growth factor receptor β. We evaluated the antitumor response and tolerability of sorafenib in patients with relapsed or refractory, advanced non–small-cell lung cancer (NSCLC), most of whom had received prior platinum-based chemotherapy.Patients and MethodsThis was a phase II, single-arm, multicenter study. Patients with relapsed or refractory advanced NSCLC received sorafenib 400 mg orally twice daily until tumor progression or an unacceptable drug-related toxicity occurred. The primary objective was to measure response rate.ResultsOf 54 patients enrolled, 52 received sorafenib. The predominant histologies were adenocarcinoma (54%) and squamous cell carcinoma (31%). No complete or partial responses were observed. Stable disease (SD) was achieved in 30 (59%) of the 51 patients who were evaluable for efficacy. Four patients with SD developed tumor cavitation. Median progression-free survival (PFS) was 2.7 months, and median overall survival was 6.7 months. Patients with SD had a median PFS of 5.5 months. Major grades 3 to 4, treatment-related toxicities included hand-foot skin reaction (10%), hypertension (4%), fatigue (2%), and diarrhea (2%). Nine patients died within a 30-day period after discontinuing sorafenib, and one patient experienced pulmonary hemorrhage that was considered drug related.ConclusionContinuous treatment with sorafenib 400 mg twice daily was associated with disease stabilization in patients with advanced NSCLC. The broad activity of sorafenib and its acceptable toxicity profile suggest that additional investigation of sorafenib as therapy for patients with NSCLC is warranted.


2012 ◽  
Vol 30 (36) ◽  
pp. 4501-4507 ◽  
Author(s):  
Andrea Ardizzoni ◽  
Marcello Tiseo ◽  
Luca Boni ◽  
Andrew D. Vincent ◽  
Rodolfo Passalacqua ◽  
...  

Purpose To compare efficacy of pemetrexed versus pemetrexed plus carboplatin in pretreated patients with advanced non–small-cell lung cancer (NSCLC). Patients and Methods Patients with advanced NSCLC, in progression during or after first-line platinum-based chemotherapy, were randomly assigned to receive pemetrexed (arm A) or pemetrexed plus carboplatin (arm B). Primary end point was progression-free survival (PFS). A preplanned pooled analysis of the results of this study with those of the NVALT7 study was carried out to assess the impact of carboplatin added to pemetrexed in terms of overall survival (OS). Results From July 2007 to October 2009, 239 patients (arm A, n = 120; arm B, n = 119) were enrolled. Median PFS was 3.6 months for arm A versus 3.5 months for arm B (hazard ratio [HR], 1.05; 95% CI, 0.81 to 1.36; P = .706). No statistically significant differences in response rate, OS, or toxicity were observed. A total of 479 patients were included in the pooled analysis. OS was not improved by the addition of carboplatin to pemetrexed (HR, 90; 95% CI, 0.74 to 1.10; P = .316; P heterogeneity = .495). In the subgroup analyses, the addition of carboplatin to pemetrexed in patients with squamous tumors led to a statistically significant improvement in OS from 5.4 to 9 months (adjusted HR, 0.58; 95% CI, 0.37 to 0.91; P interaction test = .039). Conclusion Second-line treatment of advanced NSCLC with pemetrexed plus carboplatin does not improve survival outcomes as compared with single-agent pemetrexed. The benefit observed with carboplatin addition in squamous tumors may warrant further investigation.


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