Exceptional pemetrexed sensitivity can predict therapeutic benefit from subsequent chemotherapy in metastatic non-squamous non-small cell lung cancer

AbstractPurposeBased on an exceptionally durable response to pemetrexed observed in some patients with metastatic NSCLC, the predictive value of pemetrexed sensitivity to outcomes of subsequent systemic treatment was investigated.MethodsWe retrospectively reviewed the patients with metastatic non-squamous NSCLC treated with pemetrexed monotherapy as their first- or second-line chemotherapy between November 2006 and February 2015. Good (top 5% longest) and poor responders (bottom 12% shortest) were defined according to the duration of pemetrexed maintenance. The first and second post-pemetrexed (PP) systemic treatments were defined as PP1 and PP2 therapies, respectively, to define their progression-free survivals (PFS) as PFS1 and PFS2.ResultsIn a total of 100 patients, 86% of patients received pemetrexed as their second-line chemotherapy, and 34% were classified as good responders. Good and poor responder groups showed 20.5  months and 0.7 months of the median duration of responses, respectively. PP1 and PP2 therapies were done in 74% and 41.9% of patients after failure to pemetrexed. To our surprise, disease control rate (DCR) was significantly higher in the good responder group than poor responder group (69.6% vs 3 7.3%,p  =  0.010) in patients treated with PP1 therapy, and median PFS1 was also significantly longer (5.2 vs 2.2 months,p  
Source: Journal of Cancer Research and Clinical Oncology - Category: Cancer & Oncology Source Type: research

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Metastatic lung cancer has long represented a therapeutic challenge, with treatment primarily consisting of systemic chemotherapy, with limited long-term survival. Patients with limited sites ( ≤ 5) of metastatic disease, known as oligometastatic disease, may derive improved outcomes from aggressive local therapy. Stereotactic ablative radiation therapy (SABR) represent a promising new method of conformal aggressive treatment to oligometastic disease. Herein we report analysis of a prosp ective multi-center phase II trial assess the safety and feasibility of SABR for oligometastatic non-small-cell lung cancer.
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Tags: Publish Only Source Type: research
Condition:   Carcinoma, Non-Small-Cell Lung Interventions:   Biological: Nivolumab;   Drug: Carboplatin;   Drug: Cisplatin;   Drug: Paclitaxel;   Drug: Pemetrexed;   Drug: Placebo Sponsor:   Bristol-Myers Squibb Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
CONCLUSION: By taking chemotherapy, patients expect to increase their odds of survival and want to maintain the quality of life and functionality. A patient's definition of treatment success is often changing as treatment continues, making it appropriate to ensure patient-provider communication throughout their clinical care. The study results are limited to patients with advanced non-small-cell lung cancer and drawn from a predominantly white patient population, mainly from the US Midwest. PMID: 31322990 [PubMed - as supplied by publisher]
Source: JOP - Category: Gastroenterology Authors: Tags: J Oncol Pract Source Type: research
Lung cancer is one of the leading causes of cancer-related deaths in the world. In 2012, lung cancer was responsible for approximately 1.6 million deaths worldwide [1]. Lung cancer may be broadly divided into small cell lung cancer (SCLC) or non-small cell lung cancer (NSCLC), with many distinct histology subtypes in the latter [2]. In contrast to SCLC, where chemotherapy provides the mainstay of treatment with mostly palliative intent, surgery is routinely performed in early stage NSCLC with a curative intent [2,3].
Source: Lung Cancer - Category: Cancer & Oncology Authors: Source Type: research
Authors: Gallo M, De Luca A, Frezzetti D, Passaro V, Maiello MR, Normanno N Abstract Introduction: Circulating tumor cell (CTC) counts represent an attractive strategy for monitoring response to therapy in patients with advanced non-small cell lung cancer (NSCLC). Changes in the CTCs number during the treatment have been proposed as a predictive biomarker of response to both chemotherapy and targeted therapies. Profiling of CTCs might also allow the assessment of the dynamics of predictive biomarkers such as EGFR, ALK, ROS1, and PD-L1, and provide relevant information in patients progressing on treatment with targe...
Source: Expert Review of Molecular Diagnostics - Category: Laboratory Medicine Tags: Expert Rev Mol Diagn Source Type: research
u Huang Huang Lai Low response rate and recurrence are common issues in lung cancer; thus, identifying a potential compound for these patients is essential. Utilizing an in silico screening method, we identified withaferin A (WA), a cell-permeable steroidal lactone initially extracted from Withania somnifera, as a potential anti–lung cancer and anti–lung cancer stem-like cell (CSC) agent. First, we demonstrated that WA exhibited potent cytotoxicity in several lung cancer cells, as evidenced by low IC50 values. WA concurrently induced autophagy and apoptosis and the activation of reactive ox...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Article Source Type: research
ConclusionIn patients not suitable of concurrent radio-chemotherapy, exclusive or sequential hypofractionated schedule using 60  Gy in 20 fractions was well tolerated and presented promising results. Complete local response was a predictor of better outcomes, and any efforts will be made to perform prospective clinical trials to further evaluate hypofractionated regimens with increased lesional BED.
Source: La Radiologia Medica - Category: Radiology Source Type: research
ConclusionsThere are subsets of patients in which one or the other between UFT and CBDCA/PTX is significantly more effective. Selection of adjuvant therapy for NSCLC patients needs to be made taking into consideration the pStage and histological subtype.
Source: International Journal of Clinical Oncology - Category: Cancer & Oncology Source Type: research
ConclusionVinorelbine pharmacokinetics were found to be comparable between Asian and European patients. No relevant influence of ethnicity on vinorelbine bioavailability and clearance for oral and intravenous routes of administration was observed.
Source: Cancer Chemotherapy and Pharmacology - Category: Cancer & Oncology Source Type: research
ConclusionsOur study revealed the clinical characteristics and prognoses of patients who became ineligible for the PACIFIC trial after CRT. Physicians should be careful while prescribing CRT for patients with characteristics such as old age, male gender, and radiation therapy with V20  ≥ 35%.
Source: Cancer Chemotherapy and Pharmacology - Category: Cancer & Oncology Source Type: research
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