Effects of magnanimous therapy on coping, adjustment, and living function in advanced lung cancer

Objectives We examined the effects of magnanimous therapy on psychological coping, adjustment, living function, and survival rate in patients with advanced lung cancer.Methods Patients with advanced lung cancer (n = 145) matched by demographics and medical variables were randomly assigned to an individual computer magnanimous therapy group (ic-mt), a group computer magnanimous therapy group (gc-mt), or a control group (ctrl). Over 2 weeks, the ic-mt and gc-mt groups received eight 40-minute sessions of ic-mt or gc-mt respectively, plus usual care; the ctrl group received only usual care. The Cancer Coping Modes Questionnaire (ccmq), the Psychological Adjustment Scale for Cancer Patients (pascp), and the Functional Living Index–Cancer (flic) were assessed at baseline and 2 weeks later. The relationships of changes in those indicators were analyzed, and survival rates were compared.Results The psychological coping style, adjustment, and living function of the ic-mt and gc-mt groups improved significantly after the intervention (p < 0.01). After 2 weeks, significant (p < 0.01) differences between the treatment groups and the ctrl group in coping style, adjustment, and living function suggested successful therapy. The changes in living function were correlated with changes in psychological coping and adjustment. No difference in efficacy between ic-mt and gc-mt was observed. The survival rate was 31.84% in the ic-mt group and 9.375% in the ctrl group at 2 years after the intervention.Conclusions In patients with advanced lung cancer, ic-mt and gc-mt were associated with positive short-term effects on psychological coping style, adjustment, and living function, although the magnitude of the effect did not differ significantly between the intervention approaches. The effects on living function are partly mediated by improvements in psychological coping and adjustment.

Download Full-text

Astragalus Polysaccharide Injection (PG2) Normalizes the Neutrophil-to-Lymphocyte Ratio in Patients with Advanced Lung Cancer Receiving Immunotherapy

Integrative Cancer Therapies ◽

10.1177/1534735421995256 ◽

2021 ◽

Vol 20 ◽

pp. 153473542199525

Author(s):

Shih Ming Tsao ◽

Tz Chin Wu ◽

JiZhen Chen ◽

Feichi Chang ◽

Thomos Tsao

Keyword(s):

Lung Cancer ◽

Overall Survival ◽

Survival Data ◽

Treatment Initiation ◽

Checkpoint Inhibitors ◽

Neutrophil To Lymphocyte Ratio ◽

Advanced Lung Cancer ◽

Control Group ◽

Lymphocyte Ratio ◽

Astragalus Polysaccharide

Objectives: The neutrophil-to-lymphocyte ratio (NLR) is a prognostic marker in patients with cancer receiving immunotherapy. Recent studies have shown that a high NLR was associated with a poor response and decreased survival. However, there is no intervention to reverse abnormally high NLR and improve clinical outcomes. Astragalus polysaccharide injection (PG2) is an immunomodulatory therapy for cancer-related fatigue. This study aimed to examine whether PG2 might normalize the NLR and affect the overall survival of patients with lung cancer treated with immunotherapy. Materials and Methods: We retrospectively examined the medical records of patients with lung cancer treated with immune checkpoint inhibitors (ICIs) between October 1, 2015 and November 30, 2019. All patients received ICI combination chemotherapies, and some similarly received PG2 (Control vs PG2). The NLR was assessed before treatment and 6 weeks after ICI initiation, and the survival data was collected at least 4 years after treatment initiation for the first enrolled patient. Results: Fifty-three patients were included. Six weeks after ICI initiation, 91.3% of the patients in the PG2 group exhibited a predefined “Decrease or no change” in the NLR, which was 28% higher than that in the Control group (63.3%) ( P = .028). The NLR significantly decreased by 31.60% from baseline in the PG2 group ( P = .012), whereas it increased by 5.80% in the Control group ( P = .572). Six weeks after ICI treatment initiation, both groups had a median NLR of 3.73, and the overall survival was also similar (PG2 vs Control, 26.1 months vs 25.4 months, respectively); however, the PG2 group had a higher median baseline NLR than the Control group (PG2 vs Control, 4.51 vs 2.81, respectively). Conclusion: This study demonstrated that PG2 could normalize the NLR in patients with lung cancer receiving ICI combination treatments.

Download Full-text

Mixture survival models methodology: an application to cancer immunotherapy assessment in clinical trials

10.21203/rs.2.18321/v1 ◽

2019 ◽

Author(s):

Lizet Sanchez ◽

Patricia Lorenzo-Luaces ◽

Claudia Fonte ◽

Agustin Lage

Keyword(s):

Lung Cancer ◽

Clinical Trials ◽

Parametric Models ◽

Survival Models ◽

Advanced Lung Cancer ◽

Control Group ◽

Term Survival ◽

Survival Expectations ◽

Multimodality Test

Abstract Progress in immunotherapy revolutionized the treatment landscape for advanced lung cancer, raising survival expectations beyond those that were historically anticipated with this disease. In the present study, we describe the methods for the adjustment of mixture parametric models of two populations for survival analysis in the presence of long survivors. A methodology is proposed in several five steps: first, it is proposed to use the multimodality test to decide the number of subpopulations to be considered in the model, second to adjust simple parametric survival models and mixture distribution models, to estimate the parameters and to select the best model fitted the data, finally, to test the hypotheses to compare the effectiveness of immunotherapies in the context of randomized clinical trials. The methodology is illustrated with data from a clinical trial that evaluates the effectiveness of the therapeutic vaccine CIMAvaxEGF vs the best supportive care for the treatment of advanced lung cancer. The mixture survival model allows estimating the presence of a subpopulation of long survivors that is 44% for vaccinated patients. The differences between the treated and control group were significant in both subpopulations (population of short-term survival: p = 0.001, the population of long-term survival: p = 0.0002). For cancer therapies, where a proportion of patients achieves long-term control of the disease, the heterogeneity of the population must be taken into account. Mixture parametric models may be more suitable to detect the effectiveness of immunotherapies compared to standard models.

Download Full-text

Lung Cancer Survival in Lithuania: Changes by Histology, Age, and Sex From 2003-2007 to 2008-2012

Cancer Control ◽

10.1177/1073274819836085 ◽

2019 ◽

Vol 26 (1) ◽

pp. 107327481983608 ◽

Cited By ~ 3

Author(s):

Vaida Gedvilaitė ◽

Edvardas Danila ◽

Saulius Cicėnas ◽

Giedrė Smailytė

Keyword(s):

Lung Cancer ◽

Cell Carcinoma ◽

Cancer Survival ◽

Survival Rates ◽

Age Groups ◽

Relative Survival ◽

International Classification Of Diseases ◽

Advanced Lung Cancer ◽

Almost All ◽

Disease Stages

Lung cancer is the most common cancer-related death worldwide. The aim of this study is to describe the most recent survival rates by sex, age group, extent of disease, and histology of lung cancer in Lithuania. The study is based on the Lithuanian Cancer Registry database. The analysis included patients with primary invasive lung cancer diagnosed in 1998 to 2012 (International Classification of Diseases, Tenth Revision C33 and C34). Patients were followed up with respect to vital status until December 31, 2012. Five-year relative survival estimates were calculated using period analysis. Relative survival was calculated as the ratio of the observed survival of patients with cancer and the expected survival of the underlying general population. In our study, the overall 5-year relative survival was low but increased slightly (10.7%) from 2003–2007 to 2008–2012. Positive changes in survival were evident in both sexes, in almost all age groups and for all histological groups and disease stages. Adenocarcinoma relative survival increased from 6.7% in 2003–2007 to 12.8% in 2008–2012 and squamous cell carcinoma increased from 7.4% in 2003–2007 to 11.1% in 2008–2012. Patients with small-cell carcinoma had the worst survival (2.9% in 2003-2007 and 3.6% in 2008–2012). The majority of patients with lung cancer are diagnosed with advanced disease. The number of new cases of advanced lung cancer increased from 35.1% to 37.8%. Despite low overall survival, there were positive changes in survival in both sexes, in almost all age groups, and for all histological groups and disease stages. The survival rate of patients with lung cancer in Lithuania is similar to that in other European countries.

Download Full-text

Adjuvant chemotherapy after complete resection in non-small-cell lung cancer. West Japan Study Group for Lung Cancer Surgery.

Journal of Clinical Oncology ◽

10.1200/jco.1996.14.4.1048 ◽

1996 ◽

Vol 14 (4) ◽

pp. 1048-1054 ◽

Cited By ~ 203

Author(s):

H Wada ◽

S Hitomi ◽

T Teramatsu

Keyword(s):

Lung Cancer ◽

Body Weight ◽

Adjuvant Chemotherapy ◽

Oral Administration ◽

Small Cell Lung Cancer ◽

Survival Rates ◽

Small Cell ◽

Control Group ◽

Small Cell Lung ◽

Control Groups

PURPOSE We performed a study to determine whether postoperative mild chemotherapy to maintain the patient's quality of life (QOL) and immunoactivity could also prolong survival. SUBJECT AND METHODS From December 1985 to July 1988, 323 patients with completely resected primary non-small-cell lung cancer (stage I to III) were enrolled. The subjects were randomized into three treatment groups, as follows: cisplatin (CDDP) 50 mg/m2 body surface, vindesine (VDS) 2 to 3 mg/kg body weight for three courses, and 1-year oral administration of tegafur (FT) plus uracil (UFT) 400 mg/kg body weight (CVUft group, 115 patients); 1-year oral administration of UFT 400 mg/kg body weight (Uft group, 108 patients); or surgical treatment only (control group, 100 patients). RESULTS The overall 5-year survival rates were 60.6% for the CVUft group and 64.1% for the Uft group versus 49.0% for the control group. The results of statistical testing were P = .053 (log-rank test) and P = .044 (generalized Wilcoxon test) among the three groups, P = .083 (log-rank) and P = .074 (Wilcoxon) between the CVUft and the control groups, and P = .022 (log-rank) and P = .019 (Wilcoxon) between the Uft and the control groups, which indicates higher survival rates in the CVUft and the Uft groups compared with the control group. A multivariate statistical analysis on prognostic factors using Cox's proportional hazards model was performed with the following results: P = .037, hazards ratio = 0.64 with a 95% confidence interval (CI) of 0.42 to 0.97 (control v CVUft group); and P = .009, hazards ratio = 0.55 with a 95% CI of 0.36 to 0.86 (control v Uft group). CONCLUSION Significantly favorable results were obtained in the CVUft and Uft groups compared with surgery alone. These data showed significant prognostic advantages in the postoperative adjuvant chemotherapy groups.

Download Full-text

Beneficial Effects of Adenosine Triphosphate on Nutritional Status in Advanced Lung Cancer Patients: A Randomized Clinical Trial

Journal of Clinical Oncology ◽

10.1200/jco.2002.20.2.371 ◽

2002 ◽

Vol 20 (2) ◽

pp. 371-378 ◽

Cited By ~ 15

Author(s):

Hendrik J. Agteresch ◽

Trinet Rietveld ◽

Leon G.M. Kerkhofs ◽

J. Willem O. van den Berg ◽

J. H. Paul Wilson ◽

...

Keyword(s):

Lung Cancer ◽

Clinical Trial ◽

Body Composition ◽

Body Weight ◽

Energy Expenditure ◽

Randomized Clinical Trial ◽

Energy Intake ◽

Advanced Lung Cancer ◽

Control Group ◽

Muscle Area

PURPOSE: In a randomized clinical trial in patients with advanced non–small-cell lung cancer (NSCLC), infusion with adenosine 5′-triphosphate (ATP) inhibited loss of body weight and quality of life. In the present article, the effects of ATP on body composition, energy intake, and energy expenditure as secondary outcome measures in the same patients are reported. PATIENTS AND METHODS: Patients with NSCLC, stage IIIB or IV, were randomized to receive either 10 intravenous, 30-hour ATP infusions every 2 to 4 weeks or no ATP. Fat mass (FM), fat-free mass (FFM), and arm muscle area were assessed at 4-week intervals for 28 weeks. Food intake, body cell mass (BCM), and resting energy expenditure (REE) were assessed at 8-week intervals for 16 weeks. Between-group differences were tested for statistical significance by repeated-measures analysis of covariance. RESULTS: Fifty-eight patients were randomized (28 ATP, 30 control). No change in body composition over the 28-week follow-up period was found in the ATP group, whereas, per 4 weeks, the control group lost 0.6 kg of FM (P = .004), 0.5 kg of FFM (P = .02), 1.8% of arm muscle area (P = .02), and 0.6% of BCM/kg body weight (P = .054) and decreased 568 KJ/d in energy intake (P = .0001). Appetite also remained stable in the ATP group but decreased significantly in the control group (P = .0004). No significant differences in REE between the ATP and control groups were observed. CONCLUSION: The inhibition of weight loss by ATP infusions in patients with advanced NSCLC is attributed to counteracting the loss of both metabolically active and inactive tissues. These effects are partly ascribed to maintenance of energy intake.

Download Full-text

CYP3A5*3 genotypes and advanced non-small cell lung cancer development

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.21030 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 21030-21030 ◽

Cited By ~ 1

Author(s):

A. Nogal ◽

A. Coelho ◽

A. Araújo ◽

I. Azevedo ◽

A. Faria ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Tobacco Smoke ◽

Small Cell ◽

Cancer Development ◽

Advanced Lung Cancer ◽

Control Group ◽

Small Cell Lung ◽

Functional Polymorphisms

21030 Background: Lung cancer is the most common cancer in Europe (381.500 new cases in 2004) and the third in the U.S.A (172.570 new cases in 2005). Smoking is one of the major causes of lung cancer: there are many procarcinogens present in tobacco smoke that, when activated, contribute to the development of this disease. The CYP3A subfamily represents a group of enzymes responsible for the metabolism of many currently used drugs, exogenous carcinogens and endogenous molecules such as steroids. Two of the major enzymes in this family, CYP3A4 and CYP3A5, activate polycyclic aromatic hydrocarbons such as benzo[a]pyrene and other procarcinogens present in tobacco smoke. Functional polymorphisms, such as CYP3A5*3 (associated with the lack of the CYP3A5 protein), could alter individual susceptibility to lung cancer. The aim of our study was to evaluate the influence of this polymorphism in the development of lung cancer. Methods: DNA samples were extracted from peripheral blood cells of 203 patients with non small cell lung cancer, including 42 non- smokers and 156 smokers or former smokers (no data available for the other 5 patients) and 162 blood donors. The CYP3A5*3 polymorphism was analysed through PCR-RFLP (SspI). Analysis of data was performed using the computer software SPSS for windows. The odds ratio (OR) and its 95% confidence interval (CI) were calculated as a measure of the association between CYP3A5*3 genotypes and NSCLC progression. Results: We found significant statistical differences between the control group and the patients with advanced stages (III and IV) of epidermoid and undifferentiated NSCLC (p=0.04; OR = 0.48; 95% CI = 0.232–0.977). Conclusions: Individual differences in the metabolism of carcinogens may influence the susceptibility to cancer development and behaviour. Our preliminary results suggest that the carriers CYP3A5*3 polymorphism are at lower risk of developing advanced lung cancer. This is probably due to a decreased activation of procarcinogens present in tobacco smoke in result of the lack of CYP3A5 caused by the CYP3A5*3 polymorphism. This is consistent with the hypothesis of a cumulative effect of carcinogens on the aggressive behaviour of the disease. No significant financial relationships to disclose.

Download Full-text

Early use of home health care on health care utilization for patients with advanced lung cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e19015 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e19015-e19015

Author(s):

Steven Rousey ◽

Kiran Krishan Lassi ◽

Jodi Wieczorek ◽

James Essler ◽

Marie Brown ◽

...

Keyword(s):

Lung Cancer ◽

Health Care ◽

Home Care ◽

Emergency Room ◽

Home Health Care ◽

Home Health ◽

Advanced Lung Cancer ◽

Control Group ◽

Emergency Room Visits ◽

Early Use

e19015 Background: Patients with advanced lung cancer historically have required significant use of health care resources including hospitalizations, ICU admissions and emergency room visits which are often related to inadequately controlled symptoms. Most patients with advanced lung cancer prefer to remain in their own home as much as possible and are willing to work with home nursing resources, if available. The purpose of this pilot study was to determine the effect of early use of home health care on health care utilization for patients with advanced lung cancer. Methods: Betweem May 2011 and May 2012, 18 patients were enrolled in a pilot program to explore early use of home care for individuals with advanced lung cancer. Inclusion criteria consisted of a diagnosis of stage III/IV lung cancer (any histology) and home care eligibility using Medicare criteria. The endpoints were hospitalization rate, number of ICU admissions and emergency room visits. The results were compared to an historical control group (562 patients with advanced lung cancer diagnosed between 2006 and 2011). Binomial confidence interval (CI) was used to estimate the 95% CIs and Fisher's exact test was used to assess the p-values. Results: Results at one year showed the hospitalization rates for the pilot group and the control group were 44% (95% CI, 22-69) and 78% (95% CI, 74-81), respectively (p<0.01) and the ER visit rate was 17% (95% CI, 4-41) and 41% (95% CI, 37-45), respectively (p=0.049). The ICU admission rates were 0% and 11% in the two groups, respectively, and this difference was not statistically significant. Home care visits ranged from 1-77 with an average of 12 visits per patient. The estimated cost of the home care program for the duration of enrollment was $2,330 per patient. Conclusions: Early use of home health care for patients with advanced lung cancer appears to reduce the rates of hospitalization and emergency room visits when compared with historical controls, and though the results were not statistically significant, none of the 18 patients in the pilot group were admitted to the ICU. A larger multi-institutional study will examine the potential of this simple intervention for cost saving, enhanced care quality and improved patient satisfaction.

Download Full-text

Experience of Hepatocellular Cancer Therapy with Multikinase Inhibitors in the Republic of Bashkortostan

Creative Surgery and Oncology ◽

10.24060/2076-3093-2020-10-3-183-189 ◽

2020 ◽

Vol 10 (3) ◽

pp. 183-189

Author(s):

Sh. Kh. Gantsev ◽

O. N. Lipatov ◽

K. V. Menshikov ◽

D. S. Tursumetov ◽

Kh. S. Saydulaeva

Keyword(s):

Overall Survival ◽

Chronic Hepatitis ◽

Survival Rate ◽

Survival Rates ◽

Elevated Serum ◽

Malignant Neoplasm ◽

Progression Free Survival ◽

Control Group ◽

Overall Survival Rate ◽

Free Survival

Introduction. Hepatocellular carcinoma (HCC) is the most common primary malignant neoplasm of the liver. During the early stages, HCC is asymptomatic, which makes X-ray examination a particularly important diagnostic tool. According to WHO data, the mortality rate from HCC was 782,000 in 2018. HCC is associated with a number of risk factors: a high viral load, liver cirrhosis, detected HBeAg and elevated serum HBsAg levels. Inhibitors of tyrosine kinase receptors increase the overall survival and progression-free survival rates in patients with metastatic HCC. In this article, we conduct an analysis of results of the REFLECT study obtained for Russian patients by the Republican Clinical Oncological Dispensary, Ufa.Materials and methods. The experimental group included 9 patients (52.9%) receiving Lenvatinib. The control group included 8 patients (47.1%)) underwent therapy with Sorafenib at a dose of 800 mg per day 7 (41.17%) patients had a history of chronic hepatitis, of which hepatitis B and chronic hepatitis C was confirmed in 6 and 1 cases, respectively.Results and discussion. Over the period from 2017 up to the present, progression-free survival was observed in three patients (17.6%), of which 2 and 1 received Lenvatinib and Sorafenib, respectively. Overall survival was 10.5 months. The median overall survival rate in the experimental and control groups was 9.8 and 11.2 months, respectively. These parameters are considered comparable, provided that the sample was small.Conclusions. The use of Lenvatinib demonstrated the efficacy comparable to that of Sorafenib in terms of the overall survival rate in patients with inoperable HCC. Lenvatinib allowed statistically and clinically significant improvement in the progression-free survival and time to progression to be achieved.

Download Full-text

Histone methyltransferase SETD1A participates in lung cancer progression

10.21203/rs.3.rs-66780/v2 ◽

2020 ◽

Author(s):

Mei Du ◽

Piping Gong ◽

Yun Zhang ◽

Yanguo Liu ◽

Xiaozhen Liu ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Progression ◽

Epithelial Mesenchymal Transition ◽

Survival Rates ◽

Normal Lung ◽

Control Group ◽

Cancer Tissue ◽

Mesenchymal Transition ◽

Cancer Symptoms ◽

Mechanistic Analysis

Abstract Lung cancer is the leading cause of cancer-related death worldwide, with an estimated 1.2 million deaths each year. Despite advances in lung cancer treatment, 5-year survival rates are lower than ~15%, which is attributes to diagnosis limitations and current clinical drug resistance. Recently, more evidence has suggested that epigenome dysregulation is associated with the initiation and progress of cancer, and targeting epigenome-related molecules improves cancer symptoms. Interestingly, some groups reported that the level of methylation of histone 3 lysine 4 (H3K4me3) was increased in lung tumors and participated in abnormal transcriptional regulation. However, a mechanistic analysis is not available. In this report, we found that the SET domain containing 1A (SETD1A), the enzyme for H3K4me3, was elevated in lung cancer tissue compared to normal lung tissue. Knockdown of SETD1A in A549 and H1299 cells led to defects in cell proliferation and epithelial-mesenchymal transition (EMT), as evidenced by inhibited WNT and TGFβ pathways, compared with the control group. Xenograft assays also revealed a decreased tumor growth and EMT in the SETD1A silenced group compared with the control group. Mechanistic analysis suggested that SETD1A might regulate tumor progression via several critical oncogenes, which exhibited enhanced H3K4me3 levels around transcriptional start sites in lung cancer. This study illustrates the important role of SETD1A in lung cancer and provides a potential drug target for treatment.

Download Full-text

Patient-Reported Outcome-Based Symptom Management Versus Usual Care After Lung Cancer Surgery: A Multicenter Randomized Controlled Trial

Journal of Clinical Oncology ◽

10.1200/jco.21.01344 ◽

2022 ◽

Author(s):

Wei Dai ◽

Wenhong Feng ◽

Yuanqiang Zhang ◽

Xin Shelley Wang ◽

Yangjun Liu ◽

...

Keyword(s):

Lung Cancer ◽

Usual Care ◽

Symptom Management ◽

Intervention Group ◽

Lung Cancer Surgery ◽

Patient Reported Outcome ◽

Cancer Surgery ◽

Interquartile Range ◽

Control Group ◽

Patient Reported

PURPOSE We aimed to evaluate the efficacy and feasibility of patient-reported outcome (PRO)-based symptom management in the early period after lung cancer surgery. METHODS Before surgery, patients with clinically diagnosed lung cancer were randomly assigned 1:1 to receive postoperative PRO-based symptom management or usual care. All patients reported symptoms on MD Anderson Symptom Inventory-Lung Cancer presurgery, daily postsurgery, and twice a week after discharge for up to 4 weeks via an electronic PRO system. In the intervention group, treating surgeons responded to overthreshold electronic alerts driven by any of the five target symptom scores (score ≥ 4 on a 0-10 scale for pain, fatigue, disturbed sleep, shortness of breath, and coughing). The control group patients received usual care and no alerts were generated. The primary outcome was the number of symptom threshold events (any target symptom with a score of ≥ 4) at discharge. Per-protocol analyses were conducted. RESULTS Of the 166 participants, 83 were randomly allocated to each group. At discharge, the intervention group reported fewer symptom threshold events than the control group (median [interquartile range], 0 [0-2] v 2 [0-3]; P = .007). At 4 weeks postdischarge, this difference was maintained between the intervention and control groups (median [interquartile range], 0 [0-0] v 0 [0-1]; P = .018). The intervention group had a lower complication rate than the control group (21.5% v 40.6%; P = .019). Surgeons spent a median of 3 minutes managing an alert. CONCLUSION PRO-based symptom management after lung cancer surgery showed lower symptom burden and fewer complications than usual care for up to 4 weeks postdischarge.

Download Full-text