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ABSTRACT: Paclitaxel plus cisplatin (TP) is used as the standard regimen for patients with advanced non-small cell lung cancer (NSCLC). In this study, we compared the response rate (RR), overall survival (OS), and toxicity of the combined chemotherapy regimen of liposomal paclitaxel plus cisplatin (LP) with those of TP as first-line treatments for advanced NSCLC.
A total of 100 patients were randomly selected to be treated with liposomal paclitaxel or paclitaxel at a dose of 150 mg/m(2) on day 1 plus cisplatin at a dose of 75 mg/m(2) on days 1 and 2 per cycle every 21 days.
All 100 patients were eligible. The median progression free survival was 5.1 months vs 4.2 months, the median OS was 9.0 months vs 9.3 months, and RR was 26% vs 24% in the LP and TP arms, respectively. No significant difference was observed (P=0.110, 0.342 and 0.890, respectively). There was no significant difference between grades 3 and 4 toxicity of the arms (P>0.05). Peripheral neuritis observed in the LP arm was significantly lower than that in the TP arm (8% vs 28%), and the difference was statistically significant (P=0.030).
The effects of LP and TP as first-line therapies for NSCLC are similar. However, peripheral neuritis in the LP arm is significantly lower than in the TP arm.
Zhongguo fei ai za zhi = Chinese journal of lung cancer 04/2012; 15(4):208-12.
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ABSTRACT: To explore the relationship between the expression of excision repair cross-complementation group 1 (ERCC1) and class III ß-tubulin and the clinical characteristics and overall survival of patients with non-small cell lung cancer (NSCLC).
Immunohistochemical analysis was used to determine the protein expression of ERCC1 and class III ß-tubulin in 160 completely resected NSCLC primary tumor samples, 50 of which were paired with adjacent normal tissue samples and another 40 benign lung lesion tissue samples as controls. Clinical data at baseline, disease-free survival and overall survival were also collected. Univariate and multivariate Cox models were used to analyze the risk factors.
In 160 tumor samples, the ERCC1 and class III ß-tubulin positive rates obtained with immunohistochemistry were 46.9% and 49.4%, respectively. Both biomarkers had a higher positive rate in male patients. For patients who did not receive adjuvant chemotherapy, ERCC1 positivity was associated with longer survival (median survival time 73 vs 53 months, p=0.041), while in patients treated with platinum chemotherapy, ERCC1 positivity tended to be associated with poor survival (median survival time 41 vs 54 months, p=0.014). Class III ß-tubulin positivity was also associated with poor survival (median survival time 38 vs 58 months, p<0.001), but had no influence on the survival of patients who did not receive adjuvant chemotherapy.
ERCC1 and class III ß-tubulin could be important survival predictors for completely resected NSCLC patients treated with adjuvant chemotherapy. Further prospective studies need to be performed to test this hypothesis in Chinese patients.
The International journal of biological markers 09/2010; 25(3):141-9. · 1.48 Impact Factor
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ABSTRACT: Serum tumor markers play important roles in diagnosis, response and prognosis monitoring for lung cancer. The clinical significance of serum level of tissue polypeptide specific antigen (TPS) was investigated in diagnosis, response monitoring and prognosis in patients with lung cancer, compared with carcinoembryonic antigen (CEA), precursor of gastrin-releasing peptide (Pro-GRP) and cytokeratin-19-fragments (CYFRA21-1).
Blood samples of eighty-two patients with lung cancer before treatment and some after chemotherapy were measured by ELISA for four tumor markers.
Compared with lung benign diseases group and health control group, the positive rates and levels of TPS, CEA and Pro-GRP in patients with lung cancer were higher, with statistically significant difference. TPS in extensive-small cell lung cancer was significant higher than that in limited-small cell lung cancer. The positive rates and levels of TPS, CEA and Pro-GRP in patients after treatment had significant decreases compared with before treatment. TPS was an independent prognostic factor of non-small cell lung cancer.
TPS is valuable to diagnosis, response monitoring for patients with lung cancer, moreover, it maybe a useful factor of prognosis of non-small cell lung cancer.
Zhongguo fei ai za zhi = Chinese journal of lung cancer 05/2010; 13(5):500-5.
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ABSTRACT: Results of studies on genetic polymorphisms of ERCC1 gene in DNA repair pathway which may affect response to platinum-based chemotherapy and survival in patients with non-small cell lung cancer are conflicting. The aim of this study is to prospectively assess the association between single nucleotide polymorphisms of C8092A and codon118 in ERCC1 and drug response in 90 patients with advanced non-small cell lung cancer treated with cisplatin-based chemotherapy.
All patients were treated with cisplatin-based chemotherapy. Genotypes of ERCC1 C8092A and codon118 were examined by sequencing, and the association between genotypes and response was evaluated.
Genotype frequencies of ERCC1 C8092A were CC 40.0% (36/90), CA 48.9% (44/90) and AA 11.1% (10/90), frequencies of codon118 were CC 58.9% (53/90), CT 34.4% (31/90) and TT 6.7% (6/90). There was no significant difference in response rate of patients carrying with CC, compared with CA plus AA in C8092A (33.3% vs 29.6%, P = 0.71). Response rate of patients carrying with CC in ERCC1 118 was 32.1%, 24.3% with CT plus CC (P = 0.43). There was no difference in progression free survival between patients carrying with CC and CT plus TT in C8092A (5.2 months vs 5.4 months, P = 0.62). There was no difference in progression free survival between patients carrying with CC and CA plus AA (5.5 months vs 5.3 months, P = 0.59).
The results suggest that there is no association between polymorphisms in ERCC1 C8092A and codon118 and response in patients with advanced non-small cell lung cancer receiving cisplatin-based chemotherapy.
Zhongguo fei ai za zhi = Chinese journal of lung cancer 04/2010; 13(4):337-41.
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ABSTRACT: Docetaxel is an active agent in the second-line treatment for non-small cell lung cancer (NSCLC), many clinical trials have demonstrated that it has similar efficacy to common first-line regimens for NSCLC. A randomized study was conducted to compare docetaxel plus cisplatin (DC) versus paclitaxel plus cisplatin (PC) for patients with advanced non-small cell lung cancer as the first-line regimen.
Ninety patients with previously untreated advanced non-small cell lung cancer were randomly assigned to receive either DC or PC. Patients received docetaxel 75mg/m(2) on day 1 and cisplatin 75mg/m(2) divided into two doses on days 2 to 3 in DC group and paclitaxel 150mg/m(2) on day 1 and cisplatin 75mg/m(2) divided into two doses on days 2 to 3 in PC group. The cycle of two regimens was repeated every 3 weeks. Response and toxicity were evaluated in patients who completed two cycles of chemotherapy at least.
Overall survival rate was 31.1% in DC group and 33.3 % in PC group. The median survival time was 10.2 months in DC group and 10.4 months in PC group. Median time to tumor progression was 4.4 months in DC group and 4.9 months in PC group. 1- and 2-year survival rate were 35.6% and 8.9% in DC group and 37.8% and 11.1% in PC group respectively. There were no significant differences in response rate, median survival time, median time to tumor progression and survival rate between two groups (P >0.05). Leucopenia, anemia, nausea and vomiting, and alopecia were the most common grade III and IV toxicities in DC and PC groups, there were no significant differences in grade III and IV toxicities between two groups(P >0.05). There were no treatment-related deaths in both groups.
DC has similar response rate and survivals with PC, and its toxicity is well-tolerated. Docetaxel plus cisplatin is an effective first-line treatment of non-small cell lung cancer.
Zhongguo fei ai za zhi = Chinese journal of lung cancer 02/2008; 11(1):110-4.
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ABSTRACT: Topotecan is one of active agents for relapsed small cell lung can-cer (SCLC), some studies have shown that it is effective against SCLC as the first-line drug. This study is to assess the efficacy, toxicity and survival rate of topotecan plus cisplatin (TP) versus etoposide plus carboplatin (CE) in patients with previously untreated SCLC.
Sixty-four patients with previously untreated SCLC were randomly assigned to receive either TP or CE. Topotecan 0.75 mg/(m²×d) via a 30-min intravenous infusion on days 1 to 5 and cisplatin 25 mg/(m²×d) on days 1 to 3 with hydration were given to patients in TP group. Carboplatin 300 mg/m² on day 1 and etoposide 100 mg/d on days 1 to 5 were given to patients in CE group. Treatment was repeated every 21 days. Responses and toxicities were evaluated in patients who received two cycles of chemotherapy. Patients with limited disease SCLC received thoracic irradiation or operation after the completion of chemotherapy.
Overall response rate was 75.0% in TP group and 68.8% in CE group. The median survival time was 10.5 months in TP group and 9.6 months in CE group. 1-, 2- and 3-year survival rate were 40.6%, 18.8% and 9.4% in TP group and 34.4%, 15.6% and 9.4% in CE group respectively. There were no significant differences in response rate, median survival time and survival rate between two groups (P > 0.05). Myelosuppression, nausea and vomiting, and alopecia were the most common toxicities, there was no significant difference in grade III and IV toxicities between two groups (P > 0.05).
TP has similar response rate and survivals with CE, and its toxicities are acceptable. TP regimen is an effective first-line treatment for SCLC.
Zhongguo fei ai za zhi = Chinese journal of lung cancer 04/2007; 10(2):144-7.
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ABSTRACT: Cisplatin has remarkable anti-tumor effects against various malignancies. Of its severe adverse reactions, nausea and vomiting are considered to be dose-limiting factors in cisplatin therapy. The anti-emetic properties of 5-HT₃ receptor antiagonists, such as ramosetron, can reduce nausea/vomiting. In order to evaluate the clinical efficacy of ramosetron injection against nausea and vomiting in treatment of cisplatin, a randomized control study was performed to compare the efficacy of anti-nausea and vomiting between ramosetron and ondansetron.
A randomized parallel control trial was carried out. One hundred patients were randomized divided into 2 groups: ramosetron group (n=50) and ondansetron group (n=50). Ramosetron was given intravenously 30 minutes before chemotherapy in a dose of 0.3mg. Ondansetron was given intravenously 15 minutes before chemotherapy and after chemotherapy in a dose of 8mg .
The effective rate of nausea by ramosetron was 82%, 72% and 84% for the first three days. The effective rate of nausea by ondansetron in a 3-day period was 84%, 70% and 76% for the first three days. Ramosetron and ondansetron were equally effective in the control of nausea induced by cisplatin. The control rate of vomiting by ramosetron was 88%, 86% and 90% for the first three days. The control rate of vomiting by ondansetron was 80%, 76% and 86% for the first three days. Ramosetron was more effective than ondansetron in controlling vomiting, but without statistical difference between the two groups. The side effects of ramosetron and ondansetron were similar.
Ramosetron can effectively prevent the nausea and vomiting induced by cisplatin chemotherapy. The efficacy of ramosetron in controlling nausea and vomiting is better than that of ondansetron.
Zhongguo fei ai za zhi = Chinese journal of lung cancer 08/2005; 8(4):322-5.
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ABSTRACT: To evaluate the efficacy and toxicity of combined chemotherapy of domestic paclitaxel and vinorelbine plus cisplatin and carboplatin in the treatment of advanced non-small cell lung cancer (NSCLC).
A total of 181 initially treated patients with advanced NSCLC were enrolled in this study and treated by NP (vinorelbine plus cisplatin), TC (domestic paclitaxel plus carboplatin) and TP (domestic paclitaxel plus cisplatin). The efficacy and side effects were analysed after at least two cycles of chemotherapy.
The overall response rates (CR+PR) were 42.4% in the NP arm, 40.3% in the TC arm and 43.3% in the TP arm respectively. No significant statistical difference was found among the three groups ( Chi-square= 0.108 6 , P > 0.05). The median survival times were 8.4 months, 9.4 months and 8.9 months respectively in the NP, TC and TP groups ( P > 0.05). The 1-, 2-, 3-year survival rates were 39.0%, 16.9%, 5.1% in the NP group and 41.9%, 21.0%, 6.5% in the TC group and 40.0%, 18.3%, 5.0% in the TP group respectively. No significant statistical difference was found among the three groups ( Chi-square=0.140 4, P > 0.05). The major side effects were myelosuppression, alopecia and nausea/vomiting in the three groups. There were no chemotherapy-related death among the three groups.
The combined regimens of NP, TC and TP are effective and well-tolerated regimens for advanced NSCLC.
Zhongguo fei ai za zhi = Chinese journal of lung cancer 06/2004; 7(3):236-9.
