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Prognostic factors of refractory NSCLC patients receiving anlotinib hydrochloride as the third-or further-line treatment

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Cancer Biology & Medicine 2018年第4期15卷 443-451页

作者： Jing Wang Yizhuo Zhao Qiming Wang li Zhang Jianhua Shi Zhehai Wang Ying Cheng Jianxing He Yuankai Shi Hao Yu Yang Zhao Weiqiang Chen Yi Luo Xiuwen Wang Kejun Nan Faguang Jin Jian Dong baolan li Zhujun liu Baohui Han Kai li Department of Pulmonary Oncology Tianjin Medical University Cancer Institute and Hospital Department of Respiratory Medicine Shanghai Chest Hospital Department of Medical Oncology Henan Province Tumor Hospital Department of Respiratory Medicine Peking Union Medical College Hospital Department of Medical Oncology Linyi Cancer Hospital Department of Internal Medicine Shandong Cancer Hospital Department of Thoracic Oncology Jilin Cancer Hospital Department of Thoracic Surgery The First Affiliated Hospital of Guangzhou Medical University Department of Medical Oncology Cancer Hospital Chinese Academy of Medical Sciences Department of Biostatistics School of Public Health Nanjing Medical University Department of Respiratory Medicine Lanzhou Military General Hospital Department of Head and Neck Oncology Hunan Cancer Hospital Department of Chemotherapy Qilu Hospital of Shandong University Department of Medical Oncology The First Affiliated Hospital of Xi'an Jiaotong University Department of Respiratory and Critical Diseases Tang Du Hospital Department of Oncology Yunnan Cancer Hospital General Department Capital Medical University Beijing Chest Hospital

Objective:Anlotinib hydrochloride is a multitarget tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor,fibroblast growth factor receptor,platelet-derived growth factor receptor,c-Kit,and c-MET;therefore,it exhibits both antitumor and anti-angiogenetic activities.A phase III trial has shown that anlotinib improved progression-free survival(PFS)and overall survival(OS)in patients with advanced non-small cell lung cancer(NSCLC),who presented with progressive disease or intolerance after standard *** study aimed to analyze the characteristics of patients receiving anlotinib treatment to determine the dominant populations who are fit for the ***:Data were collected from March 2015 to January 2017 from a randomized,double-blind,placebo-controlled,multicenter,phase III trial of anlotinib(ALTER0303).A total of 437 patients were enrolled and randomly allocated(2:1)to the anlotinib and placebo ***–Meier analysis and log-rank test were performed to compare PFS and *** proportional hazards model was adopted for multivariate prognostic ***:Multivariate analysis indicated that high post-therapeutic peripheral blood granulocyte/lymphocyte ratio and elevated alkaline phosphatase levels were independent risk factors for ***,elevated thyroid-stimulating hormone,blood glucose,and triglyceride levels;hypertension;and hand–foot syndrome were independent protective factors of *** posttherapeutic peripheral blood granulocyte/lymphocyte ratio,an Eastern Cooperative Oncology Group(ECOG)score≥2,and the sum of the maximal target lesion length at baseline were independent risk factors of OS,and hypertriglyceridemia was an independent protective factor of ***:This study preliminarily explored the possible factors that affected PFS and OS after anlotinib treatment in patients with advanced refractory NSCLC,and the baseline characteristics of the therapeutically dominant populations were

关键词： Non-small cell lung cancer anlotinib third- or further-line therapy prognostic factor analysis

Prognostic factors in 408 elderly lung cancer patients over 70 years old

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The Chinese-German Journal of Clinical Oncology 2012年第12期11卷 699-704页

作者： Hua Zheng li Tong Ying Hu Weihua Wu Hongmei Zhang baolan li General Department Beijing Chest Hospital of Capital Medical University Beijing 101149 China Department of Oncology Beijing Chest Hospital of Capital Medical University Beijing 101149 China

Objective: The incidence and mortality of lung cancer in people over 70 years were increased in the past 10 years. We defined age 70 years as boundary line of the elderly patients in lung cancer and analyzed and identified the factors affecting prognosis. Methods: A retrospective study had enrolled 408 cases of lung cancer aged over 70 years old and SPSS13.0 software was used in univariate analysis and COX regression analysis to analyze factors affecting prognosis, such as gender, age, complications, symptoms, pathological type, clinical stage, effusion, surgery, radiotherapy, chemotherapy and so on. Results: In univariate analysis, symptoms, stage, effusion, surgery, chemotherapy and chemotherapy cycles showed affecting prognosis significantly. In COX regression analysis, it showed that clinical stage (P = 0.000), surgery (P = 0.013), chemotherapy cycles (P = 0.001) were independent prognostic factors. Conclusion: Elderly lung cancer patients could be benefit from surgery and adjuvant chemotherapy while early stage. At late stage, their survival time may be prolonged when receive chemotherapy at least 4 cycles. Single-agent chemotherapy would be a good choice for elderly lung cancer. Effusion, particularly, pericardial effusion significantly influenced the prognosis, so that it should be effectively controlled.

关键词： lung neoplasm geriatrics prognosis

Icotinib, an EGFR-TKI, for the treatment of brain metastases in non-small cell lung cancer:a retrospective study

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Oncology and Translational Medicine 2016年第6期2卷 268-274页

作者： Qunhui Wang Hua Zheng Ying Hu Baohua Lu Fanbin Hu Hongmei Zhang baolan li Department of Oncology Beijing Chest Hospital Capital Medical University

Objective Treatment of brain metastases from non-small cell lung cancer(NSCLC) is a challenge because of the poor prognosis. Icotinib is a new type of oral epidermal growth factor receptor(EGFR) tyrosine kinase inhibitor(TKI) used in the treatment of advanced NSCLC. The aim of this study was to evaluate the efficacy of icotinib in NSCLC patients with brain *** This study reviewed records of 51 NSCLC patients with brain metastases who took icotinib 125 mg, 3 times a day. Response rate, progression free survival, and overall survival were analyzed. SPSS software version 17.0 was used for univariate analysis, and Cox regression analysis to analyze factors affecting survival. Results Thirty-six cases had partial response, 6 cases had stable disease, and 10 cases had progressive disease. In 31 cases, EGFR gene mutation test were performed. EGFR was mutated in 26 cases and was with wild-type in 5 cases. In patients with EGFR mutations, 23 patients responded to icotinib [the disease control rate(DCR) was 88.5%], significantly higher than in patients with wild-type EGFR(1 patient, DCR 20%)(P = 0.005). The overall median progression-free survival(PFS) was 7.6 months. PFS was longer in the patients with EGFR mutations than in those with wild type EGFR(7.8 months vs 1.2 months, P = 0.03). The overall median overall survival(OS) time was 10.7 months. OS was longer in patients with EGFR mutations than in those with wild type EGFR(15.1 months vs 6.7 months, P = 0.003). The main side effects of the treatment were skin rash and diarrhea; no stage 3 or 4 toxic effects occurred. Univariate analysis demonstrated that OS was related to sex, Eastern Cooperative Oncology Group performance status(ECOG PS), smoking history, and EGFR mutation. Multivariate analysis showed that OS was independently related to sex, ECOG PS, and EGFR *** Icotinib has a favorable effect on NSCLC patients with brain metastases harboring EGFR mutations. Icotinib can be a new choice

关键词： non-small cell lung cancer(NSCLC) brain metastases icotinib epidermal growth factor receptor(EGFR)

The expression of vascular endothelial growth factor(VEGF)/endostatin(ES)and VEGF receptor 2(VEGFR2)/ES is associated with NSCLC prognosis

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Oncology and Translational Medicine 2021年第4期7卷 149-154页

作者： Yuan Yang Baohua Lu baolan li Weiying li Mei Jiang Wentao Yue Qunhui Wang Tongmei Zhang General Department of Medicine Beijing Chest HospitalCapital Medical UniversityBeijing 101149China Laboratory of Cell Biotechnology Beijing Tuberculosis and Thoracic Tumor Research InstituteBeijing 101149China

Objective The aim of our study was to detect the expression of angiogenesis inhibitory proteins and angiogenesis promotive proteins in the postoperative tumor tissue of non-small cell lung cancer(NSCLC)*** also investigated the relationship of protein expression with clinical characteristics and *** We examined the expression of vascular endothelial growth factor(VEGF),VEGF receptor 2(VEGFR2),and endostatin(ES)proteins in 255 specimens resected from NSCLC patients,using immune histochemistry(IHC).We then evaluated the relationships between the expression of the three proteins and clinical characteristics such as stage,histological type,differentiation,gender,tobacco use,and *** to the value of VEGF/ES,we divided the cohort into angiogenesis-promoting group A,angiogenesis-inhibiting group A,and balance group *** survival differences in the three groups were evaluated to determine the prognostic value of VEGF/***,we tested the prognostic value of VEGFR2/*** VEGF-positive expression was observed in 93 patients(36.4%).VEGF expression was not correlated with the clinical ***2-positive expression was observed in 103 patients(40.4%).The expression of VEGFR2 was correlated with the clinical stage(χ^(2)=21.414,P=0.045)and histological type(χ^(2)=26.911,P=0.008).ES-positive expression was observed in 140 patients(54.9%).The expression of ES was correlated with the clinical stage(χ^(2)=26.504,P=0.009).When evaluating the prognostic values of VEGF/ES and VEGFR2/ES,the prognosis of the angiogenesis balance group was similar to that of the angiogenesis-inhibiting *** minimum survival time was observed in the angiogenesis-promoting *** VEGF/ES and VEGFR2/ES in resected tumors have prognostic value in postoperative NSCLC *** survival time of the population with predominant angiogenic factors was short.

关键词： non-small cell lung cancer(NSCLC) angiogenesis clinical characteristics prognosis

ⅢA-N2期非小细胞肺癌根治术后放疗疗效影响因素的研究进展

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中华放射肿瘤学杂志 2020年第10期29卷 909-912页

作者：田翠孟李宝兰首都医科大学附属北京胸科医院放疗科 101149 首都医科大学附属北京胸科医院综合科 101149

随着现代放疗技术的进步,术后放疗在根治术后ⅢA-N2期非小细胞肺癌中的地位受到重视。目前,由于缺乏大规模前瞻性的随机对照研究,术后放疗的价值一直受到争议。大量回顾性研究证实术后放疗疗效与不同临床病理特征有很强的相关性,本文对... 详细信息

随着现代放疗技术的进步,术后放疗在根治术后ⅢA-N2期非小细胞肺癌中的地位受到重视。目前,由于缺乏大规模前瞻性的随机对照研究,术后放疗的价值一直受到争议。大量回顾性研究证实术后放疗疗效与不同临床病理特征有很强的相关性,本文对影响术后放疗疗效的因素进行分析总结,探讨术后放疗获益亚组人群,实现精准的术后放疗。

关键词：癌,非小细胞肺/术后放射疗法治疗结果研究进展

Investigation of therapeutic modalities of G719X, an uncommon mutation in the EGFR gene in non-small cell lung cancer

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Oncology and Translational Medicine 2019年第2期5卷 91-97页

作者： Hua Zheng Yuan Gao Zan liu Zhe Qian Tongmei Zhang Jie li Hongmei Zhang Qunhui Wang Fanbin Hu baolan li Department of Medical Oncology Beijing Chest Hospital Capital Medical University

Objective G719 X is the most frequently seen uncommon mutation of the epidermal growth factor receptor(EGFR) gene, which is a point mutation at exon 18 with three common subtypes, G719 A/G719 C/G719 S. This study explored the clinicopathological characteristics of the G719 X mutation and investigated the efficacy of EGFR-tyrosine kinase inhibitor(TKI) treatment and chemotherapy in patients with the G719 X mutation; the survival rate after these different treatment modalities were then analyzed in order to provide evidence for clinical *** Clinical data of 41 patients with the G719 X mutation admitted in the Beijing Chest Hospital, Capital Medical University from September 2014 to July 2018, were collected and the EGFR mutations were detected by amplification refractory mutation system-polymerase chain reaction(ARMS-PCR). The clinicopathological characteristics of the G719 X mutation were analyzed, and the relationship among the G719 X mutation, the efficacy of different treatment modalities, and the progression-free survival(PFS) was analyzed. Results Of the 41 cases, 24(58.5%) were G719 X single mutations and 17(41.5%) were compound mutations, including G719 X/S768 I, G719 X/L861 Q, G719 X/19 del, and G719 X/c-Met compound mutation. The objective response rate(ORR) of first-line EGFR-TKI therapy was 50%(6/12), the disease control rate(DCR) was 83.3%(10/12), and the median PFS(mPFS) was 9 months. After resistance to EGFR-TKI in the previous treatment, the ORR(71.4%, 5/7) and DCR(100%, 7/7) were still high following EGFR-TKIs, by an mPFS of 8 months. The ORR of chemotherapy was 33.3%(2/6), the DCR was 100%(6/6), and the mPFS was 6 months. Conclusion G719 X is an uncommon mutation of the EGFR gene and is sensitive to many EGFR-TKIs. It can be treated with the second-or third-generation EGFR-TKIs after resistance to the first-generation EGFR-TKIs. G719 X mutation also showed favorable effect to chemotherapy.

关键词： lung neoplasms EGFR uncommon mutation G719X target therapy

免疫检查点抑制剂在驱动基因阳性晚期非小细胞肺癌中的应用进展

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中国肺癌杂志 2021年第3期24卷 188-195页

作者：张同梅(综述) 李宝兰(审校) 首都医科大学附属北京胸科医院综合科北京市结核病胸部肿瘤研究所北京101149

随着肿瘤精准医学的发展,驱动基因阳性非小细胞肺癌(non-small cell lung cancer,NSCLC)患者接受靶向治疗极大地改善了生存和预后,但不管是哪代靶向药物均不可避免的会经历耐药,患者会面临无靶可用的局面。免疫检查点抑制剂因其特有的... 详细信息

随着肿瘤精准医学的发展,驱动基因阳性非小细胞肺癌(non-small cell lung cancer,NSCLC)患者接受靶向治疗极大地改善了生存和预后,但不管是哪代靶向药物均不可避免的会经历耐药,患者会面临无靶可用的局面。免疫检查点抑制剂因其特有的长拖尾效应,能给部分晚期NSCLC患者带来长生存。越来越多的研究显示免疫治疗同样可为部分驱动基因阳性NSCLC患者带来获益,但免疫治疗介入的时机、治疗方案的选择以及预测生物标记物等问题仍不十分明确,值得进一步探讨。

关键词：肺肿瘤驱动基因免疫检查点抑制剂预测

Bronchoscopic biopsy for diagnosis of lung cancer in the absence of visible endobronchial abnormalities

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Oncology and Translational Medicine 2016年第2期2卷 115-118页

作者： Hua Zheng Baohua Lu Qunhui Wang Fanbin Hu Weimin Ding baolan li Department of Oncology Beijing Chest HospitalCapital Medical University Department of Endoscopy Beijing Chest HospitalCapital Medical University

Objective Bronchoscopy has been extensively used in the diagnosis of respiratory diseases, and par- ticularly, malignant diseases. However, endoscopists do not normally perform bronchoscopic biopsy in Case lesions are undetected via bronchoscopy. The aim of this study was to evaluate whether performing bron- choscopic biopsy could be established in the diagnosis of lung cancer in case of endobronchial abnormali- ties undetectable to the naked eye. Methods We retrospectively analyzed 109 cases between January 2008 and December 2012. The in- clusion criteria were confirmed lung cancer diagnosis, transbronchial biopsy performed in the absence of visible endobronchial manifestations, brushing, and bronchoalveolar lavage （BAL） according to the images obtained from high-resolution computed tomography （HRCT）. Data regarding age, sex, pathology, tumor stage; the method of diagnosis; location of primary lesion （central, peripheral, or intermediate）; tumor size, mediastinal lymph node metastasis, and the serum carcinoembryonic antigen （CEA） value were collected. The Pearson chi-square test or Fisher＇s exact and McNemar tests were used in the univadate analysis. Results Among the 109 patients, the diagnosis of 37 （33.9%） patients was confirmed through bronchos- copy. Brushing and BAL had higher positive detection rates than biopsy （P = 0.004）. There were no differ- ences in the positive detection rates between the sex, pathology, lesion location, tumor size, lymph node metastasis, and the serum CEA value （P〈 0.05 for all groups）. Conclusion Despite the normal appearance of the endobronchial manifestations, lesions undetectable by bronchoscopy could be indicated. Therefore, we suggest performing bronchoscopic biopsy and that brushing and BAL might increase the positive detection rate of bronchoscepic examination.

关键词： bronchoscope lung cancer biopsy

lipid accumulation product-a novel metabolic index related to serum alanine aminotransferase level in apparently healthy adults

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Lipid accumulation product-a novel metabolic index related t...