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Wang Y.Y.,Beijing University Oncology College
Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases | Year: 2013

To identify potential prognosis related clinical and molecular factors in malignant pleural mesothelioma (MPM). Seventy-nine patients with MPM treated in Beijing Cancer Hospital from June 1996 to May 2012 were enrolled in this study. Clinical and pathological data were collected, including age, gender, smoking status, treatment, response, and molecular biomarkers such as thymidylate synthetase (TS) expression, echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) gene rearrangement. The primary endpoint was overall survival (OS). SPSS 16.0 statistical analysis software was used for univariate analysis. The expression of TS was detected by immunohistochemistry (IHC). Fluorescence in situ hybridization (FISH) was performed to detect EML4-ALK gene rearrangement. Efficacy of the chemotherapy regimen including pemetrexed was analyzed with these molecular biomarkers. The median survival time (MST) of all patients was 15.5 months (95% CI: 10.6 - 20.4). Univariate survival analysis revealed that treatment factors including receiving operation, systemic chemotherapy, pemetrexed-based chemotherapy and capability of receiving second (or above) line chemotherapy were significantly related with OS. The MST of patients receiving operation was 5.4 months (95% CI: 3.6 - 7.3), significantly shorter than the 17.7months (95% CI: 11.8 - 23.5) in those who didn't receive operation (P = 0.030). Patients receiving systemic chemotherapy had a longer MST of 18.0 months (95% CI: 12.3 - 23.8) as compared to the 7.9 months (95% CI: 1.1 - 14.7) in those who didn't (P = 0.001). The MST of pemetrexed-based chemotherapy was 21.9 months (95% CI: 14.1-29.7) compared with 8.8 months (95% CI: 4.2 - 13.4) of regimens without pemetrexed (P = 0.000). For patients capable of receiving second (or above) line chemotherapy the MST was longer (21.0 months, 95% CI: 12.7 - 29.3) than those who could not (12.1 month, 95% CI: 6.4 - 17.8 month), P = 0.022. For the 42 patients treated with pemetrexed-based chemotherapy, the objective response rate (ORR) was 33.3% (14/42), the disease control rate (DCR) was 78.6% (33/42), the median progression-free survival (PFS) was 4.8 months (95% CI: 3.6 - 6.0) and MST was 21.9 months (95% CI: 14.1 - 29.7). Twenty-nine patients provided adequate specimens for detection of TS expression and 6 cases (20.7%) were positive. EML4-ALK gene rearrangement was studied in 32 patients and 6 (18.8%) were positive. TS expression was found to be inversely related to PFS of pemetrexed-based chemotherapy (P = 0.041). The MST was 19.6 months (95% CI: 6.0 - 7.9) in EML4-ALK-positive patients and 9.57 months (95% CI: 2.7 - 4.3) in negative ones (P = 0.159). Systemic chemotherapy especially pemetrexed-based regimen was proved to be a superior option for MPM with a significantly prolonged OS. Correlation between TS expression or EML4-ALK rearrangement and outcome of pemetrexed-based chemotherapy for MPM may contribute to future individualized treatment, which needs further validation from large-scale prospective studies. Source


An T.,Beijing University Oncology College | Huang Z.,Beijing Ji Shui Tan Hospital | Wang Y.,Beijing University Oncology College | Wang Z.,Beijing University Oncology College | And 2 more authors.
Chinese Journal of Lung Cancer | Year: 2011

Background and objective The epidermal growth factor receptor tyrosine kinase inhibitor (EGFRTKI) shows favorable antitumor activity against chemorefractory non-small cell lung cancer (NSCLC). However, patients with advanced NSCLC have limited treatment options available if they are refractory to EGFR-TKI. To study the influence of the retreatment EGFR-TKI after failure of first-line TKI, we carried out this retrospective study. Methods Total 71 patients were analyzed who experienced treatment failure from their initial use of EGFR-TKI. After a period of time, they were retreated with TKI as tumor progression was observed. Results Of the 71 patients who received retreatment TKI, it was observed in 7% in partial response (PR), 36.6% in stable disease (SD), 56.3% in progressive disease (PD). Disease control rate (DCR) was 43.7%. Twenty-six (36.6%) patients were well controlled by retreatment with TKI monotherapy for not less than 3 months. Five (7.0%) patients had partial response. Exon 21 mutation, PFS not less than 6 months during initial treatment TKI, and the interval not less than 3 months between initial treatment, and retreatment with TKI was associated with a good progression free survival based on univariate COX analysis (P=0.034; P=0.013; P=0.046). Conclusion It has been shown the possibility that retreatment with TKI might be useful when (1) Exon 21 has active mutation, (2) initial treatment shows a favorable PFS (≥ 6 months), and (3) there has been a period of time (≥3 months) following the termination of the initial TKI treatment. Source


Wang Y.,Beijing University Oncology College | Liu L.,Beijing University Oncology College | Wu M.,Beijing University Oncology College | Zhong J.,Beijing University Oncology College | And 7 more authors.
Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases | Year: 2015

OBJECTIVE: To evaluate the response, toxicity and prognostic factors of amrubicin in the therapy of small cell lung cancer (SCLC).METHODS: Thirty-one SCLC patients treated with amrubicin in Beijing Cancer Hospital from Dec.2008 to Apr.2013, including 21 males and 10 females, aged from 32 to 75 years, were enrolled in this study. Amrubicin was injected intravenously with 40 mg/m² d1-3, Q21 d or combined with cisplatin 60 mg/m² d1, Q 21 d. The first line chemotherapy regimens included amrubicin plus cisplatin in 11 cases, etopside plus platin in 18 cases and other drugs in 2 cases. The second and more line chemotherapy treatments included amrubicin in 20 cases, topotican in 14 cases and others in 28 cases. SPSS 16.0 statistical analysis software was used to analyze the clinical characteristics and survivals.RESULTS: The median progression free survival (PFS) of patients receiving amrubicin plus cisplatin and single amrubicin were 7.5 months (95% CI: 6.2 to 8.8 ) and 4.1 months (95% CI:1.2 to 7.0) respectively (P= 0.090). There were 16 refractory patients whose disease progressed within 3 months after first line chemotherapy and 15 sensitive patients who had tumor progression after more than 3 months; the median survival time (MST) were 14.2 months (95% CI 11.1-17.3) and 21.3 months (95% CI 15.7-26.9) respectively (P= 0.018). Patients treated with amrubicin plus cisplatin as first line therapy had a prolonged median PFS compared with etopside plus platin, which were 7.5 months (95% CI:6.2-8.8) vs. 4.6 months (95% CI:1.7-7.5) (P= 0.055). Patients received amrubicin, topotican or other drugs as second or more line therapy had median PFS of 4.1 months (95% CI: 1.2-7.0), 1.4 months (95% CI: 0.8-2.0) and 1.6 months (95% CI:1.2-1.9) respectively (P= 0.013), while the median PFS was 5.6 months (95% CI: 2.0-9.2), 1.4 months (95% CI: 0.6-2.2) and 1.4 months (95% CI: 0.8-2.0) (P= 0.005 and 0.003) in refractory patients.CONCLUSIONS: Amrubicin as second or more line treatment was shown to be an effective and safe drug for SCLC patients with a significant survival benefit compared with other drugs, especially in refractory patients. It suggested that amrubicin might be one of the preferred therapies for refractory SCLC. Source


Wu M.,Beijing University Oncology College | Wang Y.,Beijing University Oncology College | An T.,Beijing University Oncology College | Zhao J.,Beijing University Oncology College | And 7 more authors.
Chinese Journal of Lung Cancer | Year: 2011

Background and objective As there is a sharp increase in the incidence of lung cancer in women in recent years, it has brought broad concerns with its unique clinical and epidemiological characteristics and better prognosis. The aim of this study is to analyze the clinical data of women with advanced non-small cell lung cancer (NSCLC) retrospectively to explore the prognostic factors. Methods Clinical data of 541 female patients with advanced NSCLC were collected and followed up till death. The primary endpoint is overall survival (OS). SPSS 11.0 statistical analysis software was used for univariate and multivariate analysis. Results The mean age is 59 years (20 years-86 years), adenocarcinoma account for 80.2% (434/541). The median OS was 15 months (95%CI: 13.87-16.13), and 1, 2, 5-year survival rates were 58.8%, 23.7% and 3.20% respectively. Univariate analysis showed that clinical stage, ECOG score, weight loss, clinical symptoms, liver/bone/brain metastasis and received more than one chemotherapy regimen, good response to the first-line chemotherapy, EGFR-TKI targeted therapy and radiotherapy treatment were significantly correlated with the OS and survival rate (P<0.05). Combined with multivariate analysis, weight loss before treatment, ECOG score, received EGFR-TKI targeted therapy and response to first-line chemotherapy were independent prognostic factor for survival (P<0.05). Conclusion There is a higher percentage of adenocarcinoma in female NSCLC. Weight loss before treatment, ECOG score, EGFR-TKI targeted therapy and response to first-line chemotherapy may become independent prognostic factors for survival of female patients with advanced NSCLC. Source

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