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Management of locally advanced non-small cell lung cancer: State of the art and future directions

Cancer Communications 2024年第1期44卷 23-46页

作者： Da Miao Jing Zhao Ying Han Jiaqi Zhou Xiuzhen Li Ting Zhang Wen Li Yang Xia Key Laboratory of Respiratory Disease of Zhejiang Province Department of Respiratory and Critical Care MedicineSecond Affiliated Hospital of Zhejiang University School of MedicineHangzhouZhejiangP.R.China Department of Oncology Shaoxing Second HospitalShaoxingZhejiangP.R.China Department of Medical Oncology Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouZhejiangP.R.China Department of Chemoradiotherapy The Affiliated People’s Hospital of Ningbo UniversityNingboZhejiangP.R.China Key Discipline of Jiaxing Respiratory Medicine Construction Project Jiaxing Key Laboratory of Precision Treatment for Lung CancerAffiliated Hospital of Jiaxing UniversityJiaxingZhejiangP.R.China Department of Pathology Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouZhejiangP.R.China Department of Radiation Oncology Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouZhejiangP.R.China Cancer Center Zhejiang UniversityHangzhouZhejiangP.R.China

Lung cancer is the second most common and the deadliest type of cancer ***,non-small cell lung cancer(NSCLC)is the most com-mon pathological type of lung cancer;approximately one-third of affected patients have locally advanced NSCLC(LA-NSCLC,stage III NSCLC)at *** of its heterogeneity,LA-NSCLC often requires multidisciplinary ***,the prognosis of affected patients is much below satisfac-tion,and the efficacy of traditional therapeutic strategies has reached a *** the emergence of targeted therapies and immunotherapies,as well as the continuous development of novel radiotherapies,we have entered an era of novel treatment paradigm for ***,we reviewed the landscape of relevant therapeutic modalities,including adjuvant,neoadjuvant,and periop-erative targeted and immune strategies in patients with resectable LA-NSCLC with/without oncogenic alterations;as well as novel combinations of chemora-diation and immunotherapy/targeted therapy in unresectable *** addressed the unresolved challenges that remain in the field,and examined future directions to optimize clinical management and increase the cure rate of LA-NSCLC.

关键词： locally advanced non-small cell lung cancer neoadjuvant therapy adjuvant therapy immunotherapy targeted therapy

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Present situation and prospect of immunotherapy for unresectable locally advanced esophageal cancer during peri-radiotherapy

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World Journal of Gastrointestinal Oncology 2024年第1期16卷 1-7页

作者： Feng-Mei Wang Peng Mo Xue Yan Xin-Yue Lin Zhi-Chao Fu Department of Obstetrics and Gynecology Fuzong Clinical Medical College(900th Hospital)Fujian Medical UniversityFuzhou 350025Fujian ProvinceChina Department of Obstetrics and Gynecology Dongfang HospitalXiamen UniversityFuzhou 350025Fujian ProvinceChina Department of Radiotherapy Fuzong Clinical Medical College(900th Hospital)Fujian Medical UniversityFuzhou 350025Fujian ProvinceChina Department of Radiotherapy Dongfang HospitalXiamen UniversityFuzhou 350025Fujian ProvinceChina

Four major studies(Checkmate577,Keynote-590,Checkmate649 and Attraction-4)of locally advanced esophageal cancer published in 2020 have established the importance of immunotherapy,represented by anti-programmed death protein(PD)-1 in postoperative adjuvant treatment and advanced first-line treatment of locally advanced or advanced esophageal cancer and esophagogastric junction cancer,from the aspects of proof of concept,long-term survival,overall survival rate and progression-free *** unresectable or inoperable nonmetastatic esophageal cancer,concurrent radiotherapy and chemotherapy is the standard treatment recommended by various *** its curative effect is still not ideal,it is necessary to explore radical radiotherapy and chemotherapy in the future,and it is considered to be promising to combine them with immunotherapeutic drugs such as *** paper mainly discusses how to combine radical concurrent radiotherapy and chemotherapy with immunotherapy for unresectable local advanced esophageal cancer.

关键词： Esophageal carcinoma locally advanced Radiotherapy Immunotherapy

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Higher radiation dose with a shorter treatment duration improves outcome for locally advanced carcinoma of anal canal

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World Journal of Gastroenterology 2007年第6期13卷 895-900页

作者： Kim Huang Daphne Haas-Kogan Vivian Weinberg Richard Krieg Department of Radiation Oncology University of California San Francisco CA United States Comprehensive Cancer Center Biostatistics Core University of California San Francisco CA United States

AIM： To assess whether radiation dose and duration of treatment influence local control and survival of patients with locally advanced anal cancer treated with definitive chemoradiation. METHODS： Twenty-eight consecutive patients who were treated with definitive radiation therapy for bulky anal cancers （〉 5 cm in size） were reviewed. Nineteen patients had T3 lesions, 8 patients had T4 lesions, and 15 patients had lymph node involvement. The median tumor size was 7.5 cm. All but one patient received concurrent chemoradiation. The median radiation dose was 54 Gy. The median duration of treatment was 58 d. RESULTS： With a median follow-up of 2.5 years in all patients and 7.8 years in living patients, the 2-year local recurrence-free probability was 570 and overall survival rate was 67%. Neither radiation dose nor duration of treatment alone was predictive of either time to local failure or overall survival. However, longer treatment breaks can potentially mask an advantage over higher radiation doses. Therefore, we examined those patients who received ≥ 54 Gy within 60 d, comparing them to the rest of the patients. Of patients who received ≥54 Gy within 60 d, local progression-free probability was 890 versus 420 for the rest of the group （P = 0.01）. CONCLUSION： Local failure is a significant problem in locally advanced carcinomas of-the anal canal. Higher radiation doses with limited treatment breaks may offer an increase in local control and survival.

关键词： Anal carcinoma locally advanced Chemoradiation

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Paclitaxel liposome for injection (Lipusu) plus cisplatin versus gemcitabine plus cisplatin in the first-line treatment of locally advanced or metastatic lung squamous cell carcinoma: A multicenter, randomized, open-label, parallel controlled clinical study

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Cancer Communications 2022年第1期42卷 3-16页

作者： Jie Zhang Yueyin Pan Qin Shi Guojun Zhang Liyan Jiang Xiaorong Dong Kangsheng Gu Huijuan Wang Xiaochun Zhang Nong Yang Yuping Li Jianping Xiong Tienan Yi Min Peng Yong Song Yun Fan Jiuwei Cui Gongyan Chen Wei Tan Aimin Zang Qisen Guo Guangqiang Zhao Ziping Wang Jianxing He Wenxiu Yao Xiaohong Wu Kai Chen Xiaohua Hu Chunhong Hu Lu Yue Da Jiang Guangfa Wang Junfeng Liu Guohua Yu Junling Li Jianling Bai Wenmin Xie Weihong Zhao Lihong Wu Caicun Zhou Department of Medical Oncology Shanghai Pulmonary Hospital&Thoracic Cancer InstituteTongji University School of MedicineShanghai 200433P.R.China Department of Chemotherapy Anhui Provincial HospitalHefeiAnhui 230001P.R.China Department of Oncology Fuzhou Pulmonary Hospital of FujianFuzhouFujian 350008P.R.China Department of Respiratory Medicine the First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan 450052P.R.China Department of Respiration Shanghai Chest HospitalShanghai Jiao Tong UniversityShanghai 200030P.R.China Cancer Center Union Hospital of Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430022P.R.China Department of Medical Oncology the First Affiliated Hospital of Anhui Medical UniversityHefeiAnhui 230032P.R.China Department of Respiration Henan Cancer HospitalZhengzhouHenan 450008P.R.China Department of Medical Oncology the Affiliated Hospital of Qingdao UniversityQingdaoShandong 266000P.R.China Department of Medical Oncology Hunan Cancer HospitalChangshaHunan 410013P.R.China Department of Pulmonary and Critical Care Medicine the First Affiliated Hospital of Wenzhou Medical CollegeShangcai villageWenzhouZhejiang 325000P.R.China Department of Medical Oncology the First Affiliated Hospital of Nanchang UniversityNanchangJiangxi 330006P.R.China Department of Medical Oncology Xiang Yang Central HospitalXiangyangHubei 441021P.R.China Department of Medical Oncology Renmin Hospital of Wuhan UniversityWuhanHubei 430060P.R.China Department of Respiration General Hospital of Eastern Theater Command of Chinese People’s Liberation ArmyNanjingJiangsu 210002P.R.China Department of Medical Oncology Zhejiang Cancer HospitalHangzhouZhejiang 310022P.R.China Cancer Center the First Bethune Hospital of Jilin UniversityChangchunJilin 130021P.R.China Department of Medical Oncology Harbin Medical University Cancer HospitalHarbinHeilongjiang 150081P.R.China Department of Respiratory Medicine Weifang People’s HospitalWeifangShandong

Background:Lipusu is the first commercialized liposomal formulation of pacli-taxel and has demonstrated promising efficacy against locally advanced lung squamous cell carcinoma(LSCC)in a small-scale ***,we conducted a multicenter,randomized,phase 3 study to compare the efficacy and safety of cis-platin plus Lipusu(LP)versus cisplatin plus gemcitabine(GP)as first-line treat-ment in locally advanced or metastatic ***:Patients enrolled were aged between 18 to 75 years,had locally advanced(clinical stage IIIB,ineligible for concurrent chemoradiation or surgery)or metastatic(Stage IV)LSCC,had no previous systemic chemother-apy and at least one measurable lesion as per the Response Evaluation Criteria in Solid Tumors(version 1.1)before administration of the trial *** primary endpoint was progression-free survival(PFS).The secondary endpoints included objective response rate(ORR),disease control rate(DCR),overall survival(OS),and safety *** explore the possible predictive value of plasma cytokines for LP treatment,plasma samples were collected from the LP group at baseline and first efficacy evaluation time and were then subjected to analysis by 45-Plex ProcartaPlex Panel 1 to detect the presence of 45 cytokines using the Luminex xMAP *** correlation between treatment outcomes and dynamic changes in the levels of cytokines were evaluated in preliminary ***:The median duration of follow-up was 15.4 months.237 patients in the LP group and 253 patients in the GP group were included in the per protocol set(PPS).In the PPS,the median PFS was 5.2 months versus 5.5 months in the LP and GP group(hazard rtio[HR]:1.03,P=0.742)*** median OS was 14.6 months versus 12.5 months in the LP and GP group(HR:0.83,P=0.215).The ORR(41.8%versus 45.9%,P=0.412)and DCR(90.3%versus 88.1%,P=0.443)were also similar between the LP and GP group.A significantly lower proportion of patients in the LP group experienced adverse events(AEs)le

关键词： chemotherapy cisplatin clinical trial gemcitabine liposomal paclitaxel(Lipusu) locally advanced lung squamous cell carcinoma metastatic multicenter plasma cytokines

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Role of prophylactic hyperthermic intraperitoneal chemotherapy in patients with locally advanced gastric cancer

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World Journal of Gastrointestinal Oncology 2020年第7期12卷 782-790页

作者： Tian-Yu Xie Di Wu Shuo Li Zhao-Yan Qiu Qi-Ying Song Da Guan Li-Peng Wang Xiong-Guang Li Feng Duan Xin-Xin Wang School of Medicine Nankai UniversityTianjin 300071China Department of General Surgery Chinese PLA General HospitalBeijing 100853China

BACKGROUND Gastric cancer is the second most common malignant tumor in China,ranking third among all malignant tumor mortality *** intraperitoneal chemotherapy(HIPEC)has been shown to increase significantly the effectiveness of intraperitoneal chemotherapeutic drugs,prolong the action time of these drugs on intraperitoneal tumor cells,and enhance their diffusion in tumor *** may be one of the best choices for the eradication of residual cancer cells in the abdominal *** The aim of this study was to study the role of preventive HIPEC after radical *** A prospective analysis was performed with patients with c T4 N0-3 M0 gastric cancer to compare the effects of postoperative prophylactic HIPEC plus intravenous chemotherapy with those of routine adjuvant ***’medical records were analyzed,and differences in the peritoneal recurrence rate,diseasefree survival time,and total survival time between groups were *** The first site of tumor recurrence was the peritoneum in 11 cases in the conventional adjuvant chemotherapy group and in 2 cases in the HIPEC group(P=0.020).The 1-year and 3-year disease-free survival rates were 91.9%and 60.4%,respectively,in the conventional adjuvant chemotherapy group and 92.1%and 63.0%,respectively,in the HIPEC *** 1-year and 3-year overall survival rates were 95.2%and 66.3%,respectively,in the conventional adjuvant chemotherapy group and 96.1%and 68.6%,respectively,in the HIPEC *** significant difference in postoperative or chemotherapy complications was observed between *** In patients with c T4 N0-3 M0 gastric cancer,prophylactic HIPEC after radical tumor surgery is beneficial to reduce peritoneal tumor recurrence and prolong survival.

关键词： Hyperthermic intraperitoneal chemotherapy Gastric cancer Prognosis locally advanced Overall survival Disease-free survival

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Management of borderline and locally advanced pancreatic cancer:Where do we stand?

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World Journal of Gastroenterology 2014年第9期20卷 2255-2266页

作者： Jin He Andrew J Page Matthew Weiss Christopher L Wolfgang Joseph M Herman Timothy M Pawlik Department of Surgery Johns Hopkins Hospital Baltimore MD 21287 United States Department of Radiation Oncology Johns Hopkins Hospital Baltimore MD 21287 United States

Many patients with pancreas cancer present with locally advanced pancreatic cancer(LAPC).The principle tools used for diagnosis and staging of LAPC include endoscopic ultrasound,axial imaging with computed tomography and magnetic resonance imaging,and diagnostic *** definition of resectability has historically been vague,as there is considerable debate and controversy as to the definition of *** the patient with LAPC,there is some level of involvement of the surrounding vascular structures,which include the superior mesenteric artery,celiac axis,hepatic artery,superior mesenteric vein,or portal *** feasible,most surgeons would recommend possible surgical resection for patients with borderline LAPC,with the goal of an R0 *** initially unresectable LAPC,neoadjuvant should be strongly ***,these patients should be offered neoadjuvant therapy,and the tumor should be assessed for possible response and eventual *** efficacy of neoadjuvant therapy with this approach as a bridge to potential curative resection is broad,ranging from 3%-79%.The different modalities of neoadjuvant therapy include sin-gle or multi-agent chemotherapy combined with radiation,chemotherapy alone,and chemotherapy followed by chemotherapy with *** review focuses on patients with LAPC and addresses recent advances and controversies in the field.

关键词： Pancreas locally advanced Chemotherapy Radiation Irreversible electroporation Pancreatic cancer

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Concurrent chemoradiotherapy using gemcitabine and nedaplatin in recurrent or locally advanced head and neck squamous cell carcinoma

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World Journal of Clinical Cases 2022年第11期10卷 3414-3425页

作者： Rui-Xue Huo Ying-Ying Jin Yong-Xue Zhuo Xiao-Tong Ji Yu Cui Xiao-Jing Wu Yi-Jia Wang Long Zhang Wen-Hua Zhang Yu-Mei Cai Cheng-Cheng Zheng Rui-Xue Cui Qian-Ye Wang Zhen Sun Feng-Wei Wang Department of Oncology Tianjin Union Medical CenterTianjin 300000China School of Medicine Nankai UniversityTianjin 300000China Laboratory of Oncologic Molecular Medicine Tianjin Union Medical CenterTianjin 300000China

BACKGROUND Patients with recurrent or locally advanced head and neck squamous cell carcinoma(HNSCC)typically have limited treatment options and poor *** To evaluate the efficacy and safety of two drugs with potent radio-sensitization properties including gemcitabine and nedaplatin as concurrent chemoradiotherapy regimens in treating *** This single-arm prospective study enrolled patients with HNSCC to receive gemcitabine on days 1 and 8 and nedaplatin on days 1 to 3 for 21 *** radiation therapy with a conventional fraction was delivered 5 days per *** response rate(ORR),disease control rate,and toxicity were observed as primary *** survival(OS)and progression free survival were recorded and analyzed as secondary *** A total of 24 patients with HNSCC were *** the median 22.4-mo follow-up,both ORR and disease control rate were 100%.The one-year OS was 75%,and one-year progression-free survival(PFS)was 66.7%(median PFS was 15.1 mo).Recurrent HNSCC patients had a poorer prognosis than the treatment-naïve patients,and patients who achieved complete response had better survival than those in the PR group(all P<0.05).The most common grade 1-4(100%)or grade 3-4 toxicities(75%)were hematological,and the most common grade 3-4 non-hematological toxicity was mucositis in 17(71%)*** Gemcitabine plus nedaplatin with concurrent chemoradiotherapy is a therapeutic option for HNSCC with predictable *** the high adverse event rate,the optimized dose and schedule must be further explored.

关键词： Chemoradiotherapy Gemcitabine Nedaplatin Head and neck cancer Recurrent locally advanced

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Benefit of neoadjuvant concurrent chemoradiotherapy for locally advanced perihilar cholangiocarcinoma

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World Journal of Gastroenterology 2017年第18期23卷 3301-3308页

作者： Jang Han Jung Hyun Jik Lee Hee Seung Lee Jung Hyun Jo In Rae Cho Moon Jae Chung Jeong Youp Park Seung Woo Park Si Young Song Seungmin Bang Division of Gastroenterology Department of Internal Medicine Hallym University Dongtan Sacred Heart Hospital Division of Gastroenterology Department of Internal Medicine and Yonsei Institute of Gastroenterology Yonsei University College of Medicine

To clarify the role of neoadjuvant concurrent chemoradiotherapy (NACCRT) followed by surgical resection for localized or locally advanced perihilar cholangiocarcinoma (CCA).METHODSWe retrospectively reviewed 57 patients who underwent surgical resection with or without NACCRT for perihilar CCA; 12 patients received NACCRT and 45 patients did not received NACCRT. Patients with locally advanced perihilar CCA requiring NACCRT were defined as follows: (1) a mass involving unilateral branches of the portal vein or hepatic artery with insufficient volume of the anticipated remnant lobe; or (2) an infiltrating mass in the main portal vein that was too long for reconstruction, identified at preoperative *** median disease-free survival (DFS) durations of the neoadjuvant and non-neoadjuvant CCRT groups were 26.0 and 15.1 mo, respectively (P = 0.91). The median overall survival (OS) durations of the neoadjuvant and non-neoadjuvant CCRT groups were 32.9 and 27.1 mo, respectively (P = 0.26). The NACCRT group showed a downstaging tendency compared to the non-NACCRT group as compared with the tumor stage confirmed by histological examination after surgery and the tumor stage confirmed by imaging test at the time of diagnosis (P = 0.01).CONCLUSIONNACCRT does not prolong DFS and OS in localized or locally advanced perihilar CCA. However, NACCRT may allow tumor downstaging and improve tumor resectability.

关键词： Klatskin tumor locally advanced Survival rate Neoadjuvant therapy Chemoradiotherapy

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Advances in translational therapy for locally advanced gastric cancer

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World Journal of Clinical Cases 2023年第11期11卷 2405-2411页

作者： Kai Zhao Ying Na Hui-Min Xu Department of General Surgery Weifang People's HospitalWeifang 261041Shandong ProvinceChina

Translational therapy refers to a combination of chemotherapy,radiotherapy,targeted therapy,and immunotherapy for patients with advanced gastric cancer who are initially unable to undergo R0 *** treatment can achieve partial or complete remission of the unresectable tumors to meet the criteria for R0 resection,thus enabling the patients to prolong their survival time and improve their quality of *** gastric cancer,translational therapy has been tried and *** present,there are a large number of patients with locally advanced gastric cancer in China,and the selection of suitable patients for transla-tional therapy to prolong objective survival and improve survival quality is one of the hot spots in the field of gastric cancer research.

关键词： Translational therapy locally advanced Gastric cancer Chemotherapy Radiotherapy treatment Targeted therapy

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Intestinal autotransplantation:the next level of complexity in locally advanced pancreatic cancer

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Hepatobiliary Surgery and Nutrition 2023年第4期12卷 604-606页

作者： Artur Rebelo Jorg Kleeff Department of Visceral Vascular and Endocrine SurgeryUniversity Hospital Halle(Saale)Martin-Luther-University Halle-WittenbergHalleGermany

Pancreatic ductal adenocarcinoma(PDAC)remains a devastating disease,and selecting patients who might benefit from complex arterial resection continues to be a ***,in the era of modern multimodal treatments,surgery for pancreatic cancer has become increasingly *** chemotherapy regimens such as modified-FOLFIRINOX(mFOLFIRINOX)and nab-paclitaxel/gemcitabine are effective in a significant proportion of patients.

关键词： Pancreatic cancer with intestinal autotransplantation locally advanced arterial resection

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