Jindi Han

Circulating PD-L1 in NSCLC patients and the correlation between the level of PD-L1 expression and the clinical characteristics

The programmed cell death‐1/programmed cell death‐1 ligand (PD‐1/PD‐L1) pathway plays a crucial role in tumor evasion. This study evaluated the association between circulating PD‐L1 expression and clinical characteristics in patients with advanced non‐small cell lung cancer (NSCLC).

Efficacy and safety of extended use of platinum-based doublet chemotherapy plus endostatin in patients with advanced nonsmall cell lung cancer

Abstract The aim of this study was to investigate the efficacy and safety of the extended use of platinum-based doublet chemotherapy (PT-DC) plus endostatin in patients with advanced nonsmall cell lung cancer (NSCLC). We performed a retrospective analysis of 200 newly diagnosed advanced NSCLC patients who had received at least 1 cycle of endostatin plus PT-DC between September 2009 and November 2014. Of these patients, 155 received 4 or more cycles of therapy (the extended therapy group), while 45 received less than 4 cycles of therapy (the control group). Clinical tumor responses, progression-free survival (PFS), overall survival (OS), and toxicity profiles were recorded and retrospectively analyzed. In the extended therapy group, 67 patients (43.2%) achieved a best overall response rate of partial response (PR), while in the control group, 13 patients (28.9%) had a best overall response rate of PR. After a median follow-up of 15.9 months, the median PFS and OS were 8.0 and 23.1 months in the extended arm and 5.8 and 14.0 months in the control arm, respectively. There were statistically significant differences in median PFS and OS between these 2 arms. Hematologic and gastrointestinal toxicities occurred more frequently in the extended therapy group, but no statistically significant difference was detected in grade 3 to 4 toxicities overall between these 2 groups. In conclusion, extended treatment using endostatin combined with PT-DC can provide additional survival benefits and satisfactory toxicity profiles in previously untreated patients with NSCLC, which merits further evaluation in a larger prospective study.

Analysis of prognostic factors of 80 advanced NSCLC patients treated with gefitinib for more than 6 months

BACKGROUND Some clinical predictors can be used to evaluate the efficacy of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapy for non-small cell lung cancer (NSCLC), including female, East-Asian, non-smoker, adenocarcinoma, skin rash, etc. The aim of this study is to explore the prognosis of advanced NSCLC patients treated with gefitinib for more than 6 months. METHODS Eighty advanced NSCLC patients treated with gefitinib for more than 6 months were collected from January, 2005 to March, 2010. The association of their clinical characteristics with median progression-free survival time (PFS) was analysed. RESULTS Significantly longer median PFS were found in patients with > 70 years old, earlier clinical stage (IIIb), non-bone metastasis (27 months vs 12 months; 32 months vs 12 months; 16 months vs 10 months, P < 0.05). There was no significant difference in median PFS between ECOG performance status 0-1 group and 2-4 group, between more than 4 cycles of chemotherapy and 1-4 cycles, between PFS of chemotherapy > 6 months group and ≤6 months group, however, ECOG 0-1 group and more than 4 cycles of chemotherapy or PFS of chemotherapy > 6 months group seemed to have longer median PFS (15 months vs 10 months; 16 months vs 12 months; 14 months vs 12 months). Compared with no skin rash and grade 0-I rash group, the patients with rash or grade ≥II rash had longer median PFS (16 months vs 13 months, P=0.171; 19 months vs 11 months, P=0.085). The median PFS was not related with sex, smoking index, pathological types, metastatic sites except bone, treatment strategy, etc (P > 0.05). CONCLUSIONS For gefitinib treatment, longer median PFS is likely to be obtained in patients with > 70 years old, earlier clinical stage (IIIb), non-bone metastasis.

Efficacy, safety and predictive indicators of apatinib after multilines treatment in advanced nonsquamous nonsmall cell lung cancer: Apatinib treatment in nonsquamous NSCLC

Patients with advanced nonsquamous nonsmall cell lung cancer (NSCLC) who experienced progression with two or more lines chemotherapy have no treatment options that clearly confer a survival benefit. As a novel vascular endothelial growth factor receptor‐2 tyrosine kinase inhibitor, apatinib has a certain antitumor effect for various solid tumors. The present study evaluated the efficacy and safety of apatinib in advanced nonsquamous NSCLC as salvage treatment in Chinese real‐world practice.

Clinical characteristics associated with non-small-cell lung cancer harboring ALK rearrangements in Chinese patients

AIM The ALK inhibitor, crizotinib, has demonstrated effectiveness in patients with non-small-cell lung cancer harboring ALK rearrangements. As few studies of the clinical characteristics of Chinese patients with ALK rearrangements have been reported, we conduct this study to gain more understanding in such area among Chinese patients. PATIENTS & METHODS We undertook a retrospective study of 288 non-small-cell lung cancer patients admitted to our institution over a period of 4.5 years. RESULTS Following testing, 14.9% of the patients (43/288) were found to be ALK fusion gene positive. Patient data including gender, age, smoking status, EGFR mutation status and medical imaging data were collected and analyzed. CONCLUSION The findings suggested that patients with ALK rearrangements are more likely to be young, have EGFR wild-type, and more likely to exhibit mucus secretion, solid tumor growth, lymph node metastasis and pleural metastasis.

Retrospective study of surgery versus non-surgical management in limited-disease small cell lung cancer

The role of surgery in limited small cell lung cancer (SCLC) is still controversial. To assess the role of surgery in SCLC we performed a retrospective analysis of survival in a group of limited stage patients, who were managed with trimodal therapy including surgery, or with chemotherapy and radiotherapy.

Multivariate Analysis of Prognostic Factors in the Eldly Patients with Small Cell Lung Cancer: A Study of 160 Patients

BACKGROUND AND OBJECTIVE Lung cancer is currently the leading cause of cancer death, two thirds of patients are over the age of 65. Small cell lung cancer (SCLC) accounts for about 15%-20% of all lung cancer. The objective of this study is to evaluate the survival of patients older than 65 with SCLC and analyze the independent prognostic factors in this group of patients. METHODS A retrospective study has enrolled 160 cases of lung cancer aged over 65. The prognostic factors were analyzed by Kaplan-Meier and Cox multivariate proportional hazards model. RESULTS ① The median follow-up time was 12 (2-109) months. 1-, 3-, and 5-year survival rate was 47.1%, 13.0%, 9.6% respectively, and 74.4%, 25.0%, 19.7% for limited-stage (LD), and 36.8%, 8.7%, 5.8% for extensive-stage (ED). Median survival time (MST) of all the patients was 12 months, 24 months for LD and 11 months for ED, respectively. ② Multivariate analysis suggested that performance status (PS) pre-treatment, the change of PS after treatment, stage, liver metastases and thoracic radiotherapy were the independent prognostic factors in all patients. ③ For LD-SCLC patients, PS pre-treatment, thoracic radiotherapy were the independent prognostic factors. The model of thoracic radiotherapy (concurrent chemoradiation vs sequential chemoradiation, early concurrent chemoradiation vs late concurrent chemoradiation) and prophylactic cranial irradiation (PCI) did not show significant difference. ④ For ED-SCLC patients, sex, the change of PS after treatment, chemotherapy, liver metastases, thoracic radiotherapy, PCI were the independent prognostic factors. CONCLUSIONS The survival time is related to PS and thoracic radiotherapy in eldly patients. Besides, it is also related to sex, chemotherapy, liver metastases and PCI for ED-SCLC.