Is prophylactic cranial irradiation (PCI) needed in patients with extensive-stage small cell lung cancer showing complete response to first-line chemotherapy?

Is prophylactic cranial irradiation (PCI) needed in patients with extensive-stage small cell lung cancer showing complete response to first-line chemotherapy? Radiother Oncol. 2018 May 07;: Authors: Nosaki K, Seto T, Shimokawa M, Takahashi T, Yamamoto N Abstract Throughout the entire world, prophylactic cranial irradiation (PCI) is the standard care for patients with small cell lung cancer (SCLC) in whom a favorable therapeutic effect is achieved after front-line treatment, regardless of whether the disease is in the limited stage or extensive stage. In the EORTC study, PCI was shown to confer a survival benefit for patients with extensive-stage small cell lung cancer (ES-SCLC) who experienced any positive response after initial chemotherapy. However, the Japan study failed to confirm a survival benefit. As a result, the guidelines in Japan recommend that PCI should not be carried out in cases of ES-SCLC. Complete response (CR) subset analysis in the Japan study suggested that PCI did not provide a survival benefit for patients with ES-SCLC. PCI with a risk of adverse events has poor significance, even if the patients show CR to chemotherapy. PMID: 29747871 [PubMed - as supplied by publisher]
Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology - Category: Radiology Authors: Tags: Radiother Oncol Source Type: research

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Large cell neuroendocrine carcinoma (LCNEC) and small cell lung carcinoma (SCLC) are aggressive neuroendocrine tumors with poor survival rates [1 –3]. For stage IV SCLC, treatment has not advanced significantly over the last decades and consists of palliative chemotherapy. The same applies to stage IV LCNEC, were no standard treatment exists and palliative chemotherapy with SCLC and non-small cell lung cancer (NSCLC) regimens are both deeme d appropriate [4]. Recently, targeted therapy focusing on delta like protein 3 (DLL3) has received attention to improve outcomes for SCLC and LCNEC [5].
Source: Lung Cancer - Category: Cancer & Oncology Authors: Source Type: research
Purpose of review The current article reviews the state of art of prevention strategies for brain metastases from solid tumors and touches both old pivotal studies and new directions of personalized molecular approaches. Recent findings Prophylactic cranial irradiation (PCI) has a definite role in the prevention of relapse into the brain for patients with small cell lung cancer (SCLC) responding to chemotherapy and radiotherapy as it prolongs overall survival (OS). However, the risk of late cognitive deficit following whole brain radiotherapy (WBRT) in this patient population is still not well known. Conversely, PCI s...
Source: Current Opinion in Oncology - Category: Cancer & Oncology Tags: BRAIN AND NERVOUS SYSTEM: Edited by Marc Sanson Source Type: research
ConclusionsQuantifying CT density change within irradiated lung parenchyma may offer a novel approach to predict radiation associated pulmonary toxicities. Measuring density changes across patient cohorts receiving TRT with novel systemic therapies may help to identify combined treatment strategies likely to be associated with diminished risk of toxicity.Legal entity responsible for the studyThe authors.FundingBristol-Myers Squibb.DisclosureS. Kim: Research grant / Funding (institution): Bristol-Myers Squibb. S.A. Rosenberg: Advisory / Consultancy: Novocure. J.E. Gray: Honoraria (self), Advisory / Consultancy, Research gra...
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research
ConclusionsThe combination of LUR and IRI is well tolerated, with no unexpected toxicities. Myelosuppression was dose-limiting, but predictable and manageable. The RD is LUR 2.0  mg/m2 on D1 + IRI 75  mg/m2 on D1 and D8 q3w with GCSF. Notable antitumor activity was observed, especially in SCLC, EC, GB and STS. Expansion in these indications is warranted.Clinical trial identificationNCT02611024.Legal entity responsible for the studyPharmaMar SA.FundingPharmaMar.DisclosureS. Ponce Aix: Advisory / Consultancy: Roche; Speaker Bureau / Expert testimony: Roche, BMS, MSD. G. Cot é: Advisory / Consultancy: Agi...
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research
ConclusionsIn this analysis, nivo was not associated with HP in the pbo-controlled CheckMate 451 trial. These data are consistent with the previous analysis of ATTRACTION-2, suggesting that reports of HP with immunotherapy may reflect some patients ’ natural course of disease.Clinical trial identificationCheckMate 451 trial: NCT02538666.ONO-4538-12/ATTRACTION-2 trial: NCT02267343.Editorial acknowledgementStephen Gutkin and Jay Rathi, MA, of Spark Medica Inc, funded by Bristol-Myers Squibb.Legal entity responsible for the studyBristol-Myers Squibb and ONO Pharmaceutical Co. Ltd.FundingBristol-Myers Squibb and ONO Phar...
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research
ConclusionsPamiparib combined with ld TMZ continues to demonstrate promising antitumor activity and remains generally well tolerated in pts with advanced solid tumors.Clinical trial identificationNCT03150810.Editorial acknowledgementIra Mills, PhD, and Shannon Davis at Ashfield Healthcare Communications, Middletown, CT.Legal entity responsible for the studyBeiGene USA, Inc.FundingBeiGene USA, Inc.DisclosureA. Stradella: Honoraria (self): Roche; Honoraria (self): Celgene; Honoraria (self): Pfizer. M.L. Johnson: Research grant / Funding (institution): BerGenBio; Research grant / Funding (institution): Lilly; Research grant /...
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research
Conclusion: DAC may exert an anti-cancer effect, which can lead to tumor regression. This is supposed to be achieved by the combined DAC's immunomodulatory, anti-angiogenic, anti-metastatic, anti-proliferative, and pro-apoptotic effects mediated through multiple signaling pathways. We propose that DAC can be used as a complementary medicine to prolong the life expectancy and improve the life quality of SCLC patients. PMID: 31561410 [PubMed - in process]
Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research
CONCLUSION: A high proportion of small cell lung cancer tumors express proteins related to Shh pathway, and over-expression of Shh is correlated with poor prognosis. PMID: 31538424 [PubMed - in process]
Source: Yonsei Medical Journal - Category: Universities & Medical Training Authors: Tags: Yonsei Med J Source Type: research
Lung cancer is the leading cause of cancer-related death worldwide. Small cell lung cancer (SCLC) accounts for approximately 15% of all lung cancer cases [1,2]. Disappointingly, the response rate to first-line chemotherapy and the overall survival (OS) have not improved in the last two decades [3].
Source: Lung Cancer - Category: Cancer & Oncology Authors: Source Type: research
Roche today announced that the European Commission has approved and granted marketing authorisation for Tecentriq ® (atezolizumab) in combination with chemotherapy (carboplatin and etoposide) for the initial (first-line) treatment of adults with extensive-stage small cell lung cancer (ES-SCLC).
Source: Roche Investor Update - Category: Pharmaceuticals Source Type: news
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