Correlation analysis of CRP/ALB and P-CRP in the prognosis of non-small cell lung cancer
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Cisplatin plus pemetrexed is considered the standard of care for the first-line treatment of patients with advanced non-squamous non-small-cell lung cancer (NSCLC). However, little is known about the efficacy and safety of this regimen in Japanese patients in a daily clinical setting.We retrospectively analyzed 40 patients who received cisplatin (75 mg/m/(2)) and pemetrexed (500 mg/m(2)) as a first-line treatment for advanced non-squamous NSCLC.Recorded Grade 3 or 4 hematological toxicities included neutropenia in 7 cases (17.5%), leukopenia in 5 cases (12.5%), anemia in 1 case (2.5%), thrombocytopenia in 1 case (2.5%), and febrile neutropenia in 1 case (2.5%). Grade 3 or 4 nonhematological toxicities included anorexia in 3 cases (7.5%), infection in 1 case (2.5%), rash in 1 case (2.5%), and increased transaminase expression in 1 case (2.5%). Therefore, the adverse events were mostly mild. There were no treatment related deaths. The overall response rate was 37.5%, median progression free survival was 5.6 months, and median overall survival (OS) was 18.8 months. In an epidermal growth factor receptor (EGFR) mutation status subgroup analysis, the median OS of patients with wild-type EGFR or unknown status (n=28)was 16.8 months.Cisplatin plus pemetrexed was well tolerated as a first-line treatment and effective in Japanese patients with advanced non-squamous NSCLC.
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In advanced non-small cell lung cancer (NSCLC), the increasing number of active compounds available in second line settings makes overall survival (OS) with maintenance treatment a not frequently observed endpoint. A literature review was conducted to examine whether post-progression survival (PPS) correlates with OS in maintenance trials.
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Vinorelbine
Vindesine
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e18500 Background: TTFields (tumor treating fields) are low intensity, intermediate frequency, alternating electric fields which slow the growth of solid tumors in-vivo, and have shown promise in pilot clinical trials in patients with advanced solid tumors. TTFields are a regional treatment which acts both by interfering with microtubules polymerization and by physical disruption of the cell structure during cytokinesis. It has been shown previously that TTFields sensitize non-small cell lung cultures to Pemetrexed. In-Vivo, TTFields did not increase pemetrexed related toxicity. Methods: A prospective trial was performed in 14, pretreated, stage IIIb-IV, NSCLC patients. Patients with brain metastases were excluded, as were patients with abnormal marrow, kidney, liver or cardiac functions. Patients with history of clinically significant arrhythmias or those having pacemakers were excluded as well. Patients received Pemetrexed 500mg/m 2 IV q3w together with daily TTFields (12 h/day) using a portable medical device (NovoTTF-100L). The device generated 2 direction (AP and Lat), 150 kHz TTFields. Patients were followed every three weeks and had a lung CT every 9 weeks. The primary endpoint was the safety and tolerability of the NovoTTF-100L device in combination with pemetrexed. Results: The 14 patients received an average of 4 courses of pemetrexed (Range 1–9) and a cumulative TTFields treatment time of 182 weeks. The device was well tolerated as indicated in the device log files which showed an average daily use of 11±1 hours. There were no device-related, nor pemetrexed-related SAEs. In addition, no unexpected abnormalities were evident in the lab tests or EKGs, done every 3 weeks for all patients. There were no reports of arrhythmias. The only device related AE seen in all patients was dermatitis under the electrodes. This improved with meticulous skin care, topical steroid use and in extreme cases oral steroids. One patient (7.6%) had a CR, 1 a PR (7.6%), 9 SD (69.2%) and 3 PD (23%). 77% of patients were progression free at 12 weeks and the 6 month survival was 89%. Conclusions: TTFields are well tolerated when given together with pemetrexed. The excellent safety profile and initial efficacy results reported here justify further clinical testing. [Table: see text]
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It is now well established that chemotherapy can exert a significant degree of palliation in women with advanced breast cancer lesions. Secondary drug therapy is ultimately required in most women with disseminated breast cancer. Alkylating agents, antimetabolites, vinca alkaloids, cytostatic antibiotics and miscellaneous agents have been used either as single drugs or in more modern combination regimes.
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Background
The benefits of chemotherapy in advanced lung cancer patients are well known. However, after evaluating patient eligibility, not all patients proposed for chemotherapy by multidisciplinary tumour board (MTB) actually receive it. In routine clinical practice, it is important to review the impact of this decision on patient survival and hospital cancer registry serve this function perfectly. Thus, the aim of the study was to evaluate the overall survival (OS) of advanced lung cancer patients according to delivery of initial chemotherapy between January 2010 and December 2013 at a single institution.
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Newly diagnosed non-small cell lung cancer (NSCLC) pts ≥40% are over ≥70 y. Due to special parameters combined with PS (≥2), geriatric syndromes the therapeutic decision is a real challenge. The comorbidities make their accrual in trials very poor & receive single agent.
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e18055 Background: There is limited information on the impact of race and ethnicity on clinical outcomes and resource utilization during lung cancer treatment. This prospective, observational study is evaluating the impact of ethnicity on disease control rate (DCR) in patients (pts) with NSCLC treated with P in the second-line setting. Methods: Eligibility criteria include stage IIIB or IV NSCLC pts receiving single-agent P for second-line therapy in routine clinical practice. This report describes observations from an early examination of the data of pts from 4 different ethnic origins: Caucasian (C), African (AA), Asian (A), and Hispanic (H). DCR was defined as the rate of complete response (CR) + partial response (PR) + stable disease (SD). Noninferiority of minority patients to C will be concluded if the confidence interval (CI) upper limit of the estimated mean DCR difference is less than 0.14. Results: See Table. Conclusions: Race/ethnicity was associated with differences in baseline characteristics (age, gender, education level, marital status, income, private insurance, and smoking status) that may influence clinical outcomes and resource utilization in the second-line treatment of advanced NSCLC with P. Although the estimates for DCR are similar for each of the ethnic groups, the CIs are not yet sufficiently narrow to formally declare non-inferiority at the prespecified level. Additional data are needed to establish a definitive conclusion. C (N = 305) AA (N = 57) A (N = 27) H (N = 14) P value (C vs. AA) Mean age, yrs 66 63 65 61 0.02 Male, % 53 68 44 57 0.03 Adenocarcinoma, % 63 67 85 79 0.53 Prior surgery, % 30 18 22 50 0.06 Current smoker, % 26 39 0 21 0.06 ECOG PS of 0 or 1, % 78 88 90 83 0.14 Income ≤$25,000, % 28 51 22 36 0.0001 Private health insurance, % 49 29 33 33 0.03 Married, % 62 40 63 43 0.01 Some college, % 40 26 41 36 <0.05 DCR, % 40 41 71 22 − Mean DCR difference, % (CI upper limit of DCR) Ref (NA) −0.03 (0.30) −0.34 (0.19) 0.11 (0.44) − PFS, mos (95% CI) 2.6 (2.3, 3.0) 3.1 (1.9, 3.8) 3.9 (1.8, NE) 2.3 (1.9, 3.7) 0.8 OS, mos (95% CI) 5.9 (5.1, 6.8) 7.8 (3.6, 12.5) NE (1.8, NE) NE (NE, NE) 0.7 Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Lilly Lilly Lilly
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