Studies reporting the Indian prevalence of Epidermal Growth Factor Receptor (EGFR) mutation are mostly single centers with small sample sizes. This systematic review and meta-analysis summarized the available evidence of EGFR mutation epidemiology in Indian patients with adenocarcinoma (ADC) Non-Small Cell Lung Cancer (NSCLC). We conducted a structured literature search in PubMed, and EMBASE databases from January 2004 through October 2019. The primary outcome of interest was prevalence of EGFR mutation by gender, smoking status, and mutation subtype. The review included 34 studies. EGFR mutation prevalence was 39.5% in patients with ADC, and significantly higher in females, non-smokers, and patients with exon 19 deletions. The EGFR mutation frequency in Indian patients with ADC was higher than reported in Caucasians but at a lower range of that reported in East Asians. These findings support the use of EGFR mutation testing to guide choice of treatment.
Background: A latest Meta-analysis on TP53 Arg72Pro polymorphism with gastric cancer (GC) risk was published in 2015 including 20 literatures, while our study included 43 studies.Moreover, the results of previously published original studies were inconsistent and the credibility of the significant correlation between the statistical results has been ignored.Therefore, an updated Meta-analysis was conducted to further explore these associations.Objective: To explore whether these two gene polymorphisms are related to the risk, clinical manifestations, and pathological features of GC.Methods: We searched several Chinese and English databases.The crude odds ratio (OR) with 95% confidence interval (CI) was used to evaluate the correlation.In addition, false positive reporting probability (FPRP), bayesian false discovery probability (BFDP), and Venice criteria were used to assess the reliability of statistically significant correlation.Results: Overall, the TP53 Arg72Pro polymorphism was related to a significantly increased GC risk (AP vs. AA: OR = 1.12, 95% CI = 1.02 -1.24; PP + AP vs. AA: OR = 1.12, 95% CI = 1.02 -1.24; P vs. A: OR = 1.07, 95% CI = 1.00 -1.15).However, after excluding the low quality and Hardy-Weinberg Disequilibrium (HWD) studies, significant changes were found on the TP53 Arg72Pro polymorphism with GC risk in Caucasians (PP vs. AA: OR = 1.48, 95% CI = 1.01 -2.16) and non-gastric cancer control groups (PP vs. AP + AA: OR = 1.33, 95% CI = 1.07 -1.64)).However, the above significant results were considered unreliable after being adjusted with Bayesian error detection probability (BFDP) and false positive
Introduction: DNA repair enzymes continuously monitor DNA to correct damaged nucleotide residues generated by exposure to environmental mutagenic and cytotoxic compounds or carcinogens. Our objective was to investigate the association among XRCC1 (Arg399Gln and Arg194Trp), XRCC3 (Thr241Met), XPD-ERCC2 (Lys751Gln), APE1 (Asp241Glu), PARP-ADPRT (Val762Ala) DNA repair gene polymorphisms and lung cancer in Turkish population. Materials and Methods: Our patient group consists of 90 patients with lung cancer and the control group had 100 healthy individuals all of those smoking. DNA was extracted using the whole blood samples. PCR- RFLP technique was used to investigate the polymorphisms on target genes. Results: There was no significant difference in the genotype distributions of XPD Lys751Gln, XRCC1 Arg194Trp, XRCC3 Thr241Met, APE1 Asp241Glu between lung cancer patients and controls for each polymorphism (p > 0.05). However, there was a significant difference between the genotype distributions of XRCC1 Arg399Gln, and PARP Val762Ala in patients and the control group (p > 0.05). Discussion: Only the polymorphisms of XRCC1 codon 399 and PARP Val762Ala alleles are associated with the risk of lung cancer. Other genotypes were not related to lung cancer.
Non-small cell lung cancers (NSCLCs) represent over 80% of all malignant lung tumours and are one of the leading causes of cancer death throughout the world.First-and second-line treatment of advanced or metastatic NSCLCs has changed dramatically during the last two decades with the development of novel immunotherapies (e.g., checkpoint inhibitors targeting PD-1, PD-L1, and CTLA-4) sparing NSCLC patients from the toxic effects of chemotherapy.However, only 15% -20% of all patients respond to treatment.In order to improve response rates, experimental and clinical evidence has provided the basis for further evaluating the combination of co-stimulatory and inhibitory monoclonal antibodies to improve the anti-tumour immune response.Innovative second-and third-generation immuno-oncology drugs are currently evaluated in ongoing phase I-III trials (either alone or in combination) including the new checkpoint inhibitor target TIGIT (T cell immunoreceptor with Ig and ITIM domains).TIGIT functions as an inhibitory immunoglobin receptor which is overexpressed by different immune cells including effector and memory CD4 + T and CD8 + T cells, regulatory T cells (T regs ), follicular T helper cells (T fh ), and natural killer cells.Targeting the interaction between the receptors of the TIGIT receptors (e.g., CD96, CD112R, CD226, TIGIT and their corresponding binding partners) has become an innovative strategy for the next concepts of cancer immunotherapy that has the potential to synergize with PD-1/PD-L1checkpoint inhibition.Currently, four anti-TIGIT monoclonal antibodies are currently being studied in phase III trials in NSCLCs: 1) tiragolumab (SKYSCRAPER programme); 2) vibostolimab (KEYVIVE programme); 3) domvanalimab (ARC programme), and 4) ociperlimab (Ad-vanTIG programme).The vast majority of these studies are ongoing; however, the SKYSCRAPER-01 trial (tiragolumab in NSCLC) and the SKYSCRAPER-02 trial (tiragolumab in SCLC) were negative and did not meet their primary endpoint.The underlying preclinical and clinical mechanisms of these unexpectedly negative studies are currently far from being clear and the results How to cite this paper:
This article summarized the nursing problems and corresponding nursing strategies of 18 cases of external diaphragm pacemakers in the application of elderly patients with lung cancer after thoracic surgery.Timely psychological care, correct operation, close observation and infection prevention during treatment can effectively optimize the use of external diaphragm pacemakers, improve respiratory muscle function, and the quality of life after lung cancer surgery in elderly patients.
Objective: Capmatinib and tepotinib, two recently FDA-approved and highly specific small-molecule inhibitors of c-MET exon 14 skipping mutations are new and important therapeutic options for the treatment of NSCLC patients harbouring c-MET alterations. However, the precise role of these molecules as a new treatment option is still not fully defined. Methods: In an attempt to further evaluate the contributions of c-MET inhibitors to the armamentarium of treatment options for advanced and metastatic NSCLCs, relevant phase II and III studies were retrospectively analyzed in terms of ORR and mPFS (mOS numbers are still not available for current c-MET trials and therefore not considered for statistical purposes). Results: Treatment of advanced and metastatic NSCLC patients harbouring c-MET exon 14 skipping mutations with the novel and highly selective c-MET inhibitors is significantly superior (p < 0.0001) when compared with standard chemotherapy. However, when c-MET inhibitors are compared with immunotherapy or the combination of immunotherapy and chemotherapy, no significant differences in terms of ORR and PFS were found, but treatment with c-MET reported be much more tolerable. Conclusion: The novel and highly selective c-MET inhibitors capmatinib and tepotinib are promising novel treatment options for patients with c-MET-dysregulated NSCLC primarily in the first-line setting, albeit a clear mOS benefit has not yet been established. Since immunotherapy did not appear to be particularly effective in NSCLC patients harbouring c-MET alterations, the vast majority of these patients are treated with immunotherapy plus chemotherapy. C-Met inhibitors appear to be equally effective and thereby sparing patients from the toxic effects of the chemotherapy. The routine testing of c-MET exon 14 skipping mutations should be performed as the GEOMETRY mono-1 data clearly showed higher response rates with capmatinib in treatment-naive than in pretreated patients, indicating that c-MET exon 14 skipping mutations should preferably be molecularly assessed at baseline. C-MET exon 14 skipping mutations are, therefore, clear biomarkers of response to c-MET inhibitors.
Immune-checkpoint inhibitors are extensively used in cancer treatment and have transformed the therapeutic landscape by inducing durable responses. Immunotherapy with checkpoint inhibitors targeting programmed death 1 (PD-1) receptor and programmed death ligand-1 (PDL-1) are used alone or with chemotherapy for treatment of metastatic non-small cell lung cancer (NSCLC). There is a great need for improving outcomes of patients with early stage NSCLC after surgical resection and with recent F. D. A. approval, immune checkpoint inhibitors are used as neoadjuvant or adjuvant therapy to enable curative resection and prevent or delay disease progression. In this article, we review the clinical studies evaluating the role of adjuvant and neoadjuvant immune checkpoint inhibitors in NSCLC and discuss the role of immunotherapy with radiation therapy in locally advanced non-metastatic NSCLC.
Objective: To analyze various immune cytokines (NKG2D, IL-12, IL-15, IL-18, DC cells, TNF-a, IFN-r) and peripheral blood of patients with non-small cell lung cancer (NSCLC) at different times after chemotherapy. Changes in CD4+, CD8+, Th17 and IgG, IgM, and IgA levels. Methods: A total of 118 NSCLC patients who attended the Oncology Department of the Affiliated Hospital of Chengde Medical College from September 2018 to September 2021 were selected as the research objects, and the patients were ana-lyzed at different time points (before chemotherapy, after the first chemotherapy, and after the second chemotherapy). The effects of NKG2D, IL-12, IL-15, IL-18, DC cells, TNF-A, IFN-r, CD4+, CD8+ Th17, IgG, IgM and IgA levels in peripheral blood at different time points (before chemotherapy, after the first chemotherapy and after the second chemotherapy) were analyzed. The changes of NKG2D, IL-12, IL-15, IL-18, DC cells, TNF-A, IFN-r and the levels of CD4+, CD8+ Th17, IgG, IgM and IgA in peripheral blood were compared at each time point. Results: NKG2D, IL-12, IL-15, IL-18, TNF-a, IFN-r gradually decreased before chemotherapy, one week after chemotherapy, and two weeks after chemotherapy, the difference was statistically significant, but DC cells were not significant Variety. CD4+ and CD8+ both increased significantly, and the levels of Th17, IgG, IgM, and IgA gradually decreased. Conclusion: In the course of chemotherapy, all immune factors except DC cells were significantly decreased compared with those before chemotherapy, and the decrease of immune factors except DC cells was positively correlated with the length of chemotherapy cycle. If additional immunotherapy is needed, it should be carried out in the early stage of chemotherapy.
Background: In the present study, autophagy-related long non-coding RNAs (lncRNAs) in lung adenocarcinoma (LUAD) were screened for diagnosis and prognosis, and the molecular mechanisms of LUAD at the genetic level were investigated. Methods: From The Cancer Genome Atlas (TCGA) database, 497 gene expression data and 436 clinical data of LUAD cases were collected for analysis. In addition, 232 autophagy-related genes (ARGs) were extracted from the Human Autophagy Database (HADb). Spearman rank correlation test and the Akaike information criterion (AIC) were performed to screen the data. After filtering, a survival model including three autophagy-related lncRNAs was generated. Based on the following formula: risk score = ΣCoef gene i×Gene i expression, the risk score of all LUAD patients could be calculated. LUAD patients were divided into two groups based on risk score for survival curve using Kaplan-Meier survival analysis. Both univariate and multivariate survival analyses were used to determine whether the three lncRNAs were independent prognostic factors using the survival package in R. Furthermore, the receiver operating characteristic (ROC) curves of clinical data were created to assess the stability of the survival model. Finally, the Gene Set Enrichment Analysis (GSEA) was used for analysis of related pathways. Results: A prognostic model consisting of three lncRNAs (AC011477.2, AC099850.3, and TRG-AS1) was generated for analysis. The 5-year survival rate in the high-risk group was 26.51% (95% CI: 0.1842 - 0.382), which was statistically lower than in the low-risk group 41.6% (95% CI: 0.307 - 0.563, P < 0.05). The area under the ROC curve (AUC) of risk score was 0.700, indicating a higher diagnostic accuracy of risk score. The results of GSEA showed enrichment in 36 pathways, including pyrimidine metabolism, pentose phosphate pathway, citric acid cycle, and cell cycle in the high-risk group, and FC-EPSILON-RI signal pathway, intestinal immune network produced by IgA, and ABC transporters in the low-risk group. Conclusion: The prognosis model composed of autophagy-related lncRNAs, AC011477.2, AC099850.3, and TRG-AS1, in LUAD can be used to predict the prognosis of LUAD patients and is expected to improve clinical treatment.
With advances in targeted and personalized treatment for lung cancer, molecular analysis of tumors is routinely performed for sequencing of treatment options in patients with advanced non-small-cell lung cancer (NSCLC). Oncogene addiction due to driver mutations includes EGFR exon 20 insertion mutations, MET amplification, EML4-AL, KRAS G12C point mutations, RET rearrangements, HER2 amplification and mutations, and FGFR amplification and translocations. A re-biopsy at the time of tumor recurrence or progression after first-line treatment failure is important for further molecular assessment and personalized therapy. However, repeat tumor biopsies are fraught with challenges including access to the tumor, sample inadequacy, patient consent, patient performance status, safety, or physician's choice or assessment. Cytological specimens are gaining importance but are limited due to validation difficulties. Liquid biopsies, which are minimally invasive have shown promise to assess dynamic biomarkers using ctDNA analysis and are thus frequently considered in routine clinical practice in advanced NSCLC patients to guide further targeted treatment. Here we present a comprehensive review that emphasizes the significance of performing tumor re-biopsy in advanced stage NSCLC patients following resistance to first-line treatment and simultaneously highlights the current challenges in performing the same and the current status and future perspectives of liquid biopsy in NSCLC.
Lung cancer is the leading cause of cancer related death in the United States killing over 130,000 people each year.While a combination of chemo and radiation therapy may be effective, surgery is still required for many patients.Without surgery, the disease may progress and lead to metastases.We sought to determine if treatment with anti-non-muscle myosin IIA antibody would inhibit movement of the cells in the presence and absence of glabridin (an isoflavonoid compound shown to inhibit cell migration by inhibiting myosin).We compared inhibition by glabridin to that of an anti-non-muscle myosin IIA antibody and a combination therapy of both at 12 and 24 hours post wound creation.Cells that took up the anti-non-muscle myosin IIA antibody were greatly inhibited in motility and exhibited no significant change in wound healing.Glabridin treatment resulted in a dramatic increase in wound size within 12 hours and regeneration within 24 hours.The greatest decrease in motility was observed in cells treated with the combination of both glabridin and anti-non-muscle myosin IIA antibody.By 24 hrs, cell migration had halted due to death of the cells resulting from this combination.Further testing needs to be done to determine a safe mode of delivery of the combination therapy to ensure only local distribution.Controlled release drug delivery depot systems have been used as a means to provide local release of drugs intra-tumorally or adjacent to the cancerous tissue after surgical resection and have great potential.
Introduction: Non-small cell lung cancer is the most common lung cancer. Despite the therapeutic advances, its prognosis is very reserved. Aim: Determine the different prognostic factors of patients with metastatic non-small cell lung cancer and their correlation with patient survival. Methods: A retrospective study was conducted at the medical oncology department of Hassan II University Hospital in Fez, collecting 405 patients during a period of 10 years, from January 2008 to January 2018. The statistical analysis of the results was done by the software SPSS version 23, the survival was calculated by the Kaplan-Meier method. The Cox method was used to study prognostic factors. Results: The average age of our patients was 59 years, with a sex ratio M/F of 6.1. In multivariate analysis, we found a significant correlation between the deterioration of survival and an age greater than 75 years (p = 0.023), a general degraded state (p Conclusion: The prognostic factors of metastatic NSCLC in our patients were PS, age, anemia, hypoalbuminemia and inflammatory syndrome. We propose to validate all the factors identified by retrospective studies by prospective studies in order to guarantee the best chances of survival for patients.
Lymphomas are neoplastic transformations that affect lymphoid cells. Diffuse large B-cell non-Hodgkin’s lymphoma has a high degree of cell proliferation, accounting for 30% of all lymphomas. Lung cancer is the leading cause of death worldwide and the recommended treatment is chemotherapy. Among the main complications resulting from non-Hodgkin’s lymphoma, lung cancer and chemotherapy used in their treatment, we can mention sepsis, acute kidney injury and febrile neutropenia. Febrile neutropenia can occur by suppressing the production of neutrophils. Sepsis, a widespread infection, is the main cause of acute kidney injury, which can also be caused by hydroelectrolytic complications or by nephrotoxicity. This is a report of a smoking patient with metastatic lung cancer who sought care due to progressive dysphagia, cough with chest pain, fever, and lower airways critical obstruction due to mediastinal lymphadenopathy, being diagnosed with diffuse large B-cell non-Hodgkin’s lymphoma. The patient evolved to death because of a significant worsening of the ventilatory pattern of multifactorial cause, mainly due to sepsis, acute kidney injury, and febrile neutropenia. The patient had mostly classic characteristics of her comorbidities, however, the overlapping of interrelated comorbidities led to the outcome of death. What is unusual about the present case report is that the patient’s characteristics, such as age, sex, and ethnicity, are opposite to those described as risk factors for diffuse large B-cell non-Hodgkin’s lymphoma.
Background: Several previous researchers have investigated the prognostic value of serum tumor markers, especially carcinoembryonic antigen (CEA).Only a limited number of studies reported the usefulness of serum tumor markers for lung squamous cell carcinoma (SQ).We aimed to examine the significance of serum tumor markers for lung SQ.Methods: Eighty-five lung SQ patients who underwent surgery and followed more than 5-year were included.The ratios of 5-year survivors to all patients in groups with several clinicopathologic factors, including tumor markers, were compared.We also compared the clinicopathologic factors between central type and peripheral type SQ.Results: The majority of patients were male gender and current/ former smokers.Age, pN status, cytokeratin-19 fragment (CYFRA 21-1), squamous cell carcinoma antigen (SCC), and comorbid interstitial pneumonia (IP) were associated with the ratio of 5-year survivors significantly.When patients were compared based on tumor location, high p-stage and CYFRA 21-1 were related to central type SQ.Conclusion: Both SCC and CYFRA 21-1 appeared to be useful prognostic markers for patients with lung SQ.Furthermore, CYFRA 21-1 was related to central type SQ.
In recent years, the incidence of lung adenocarcinoma has been increasing, and now it has become the largest type of non-small cell lung cancer (NSCLC). Currently, treatment of advanced NSCLC consists of several modalities: systemic chemotherapy, local radiation therapy, and targeted therapy (including most recently immunotherapy). In the past decade, the discovery of new molecular subtypes, the search for tumor driver gene mutations, the development of targeted molecular targeted drugs, or targeted therapy to suppress tumor angiogenesis and regulate tumor immune response have been the main directions of NSCLC research and clinical diagnosis and treatment. At present, platinum-based chemotherapy is widely used in NSCLC patients clinically. Platinum-based chemotherapy drugs can effectively prolong the survival time of patients and improve their quality of life, but the incidence of adverse reactions is still high. Therefore, it is necessary to find a drug that can improve the efficacy of patients and reduce the adverse reactions of platinum chemotherapy drugs to NSCLC patients.
A NF1 (neurofibromatosis 1) patient developed multiple necrotic lung metastases from a sciatic malignant peripheral nerve sheath tumor (MPNST) invading the superficial femoral artery.The first diagnosis was metastases of a non-small-cell adenocarcinoma because the right calf MPNST was not clinically noticeable ant that the chest/abdomen PET/CT did not include the region of the legs.When the MPNST was diagnosed, new histological analysis on the metastases changed the diagnosis to that of epithelioid undifferentiated sarcoma.The article deals with the sometimes-delayed diagnosis in those NF1 patients with large palpable masses and chronic pain pre-existing the malignant transformation, and discusses the difficulty of the biopsy of necrotic metastases.
We report two cases of brain metastasis from a lung adenocarcinoma. Magnetic Resonance Imaging (MRI) appearance was closely correlated with the macroscopic and microscopic findings that showed multiples nodules of a well-differentiated papillary adenocarcinoma with secreting tubules, surrounded by mucoid fluid.
Lung cancer is one of the leading causes of death worldwide, accounting for an estimated 2.1 million cases in 2018. To analyze the risk factors behind the lung cancer survival, this paper employs two main models: Kaplan-Meier estimator and Cox proportional hazard model [1]. Also, log-rank test and wald test are utilized to test whether a correlation exists or not, which is discussed in detail in later parts of the paper. The aim is to find out the most influential factors for the survival probability of lung cancer patients. To summarize the results, stage of cancer is always a significant factor for lung cancer survival, and time has to be taken into account when analyzing the survival rate of patients in our data sample, which is from TCGA. Future study on lung cancer is also required to make improvement for the treatment of lung cancer, as our data sample might not represent the overall condition of patients diagnosed with lung cancer; also, more appropriate and advanced models should be employed in order to reflect factors that can affect survival rate of patients with lung cancer in detail.
Introduction: Apart from smoking as the known risk factor for lung cancer, recent developments implicate occupational exposure to carcinogens, indoor air pollution and dietary factors as other causative agents. In our study, we have analyzed the clinical and pathological profile of lung cancer patients treated at our center over a period of 8 years. Aim: To find the demographic and clinicopathological profile of lung cancer patients admitted to the oncology unit. Methods: This retrospective record based analysis includes a cohort of 1248 patients diagnosed with lung cancer, at a tertiary cancer care center in Bangalore, South India. This study includes data of patients admitted during the period 2010 to 2018, retrieved from the Hospital’s Electronic Medical Records (EMR). Their demographic profile, clinical correlates, radiological profile and diagnostic details were studied. Benign tumours, malignant pleural disease and sarcomatoid tumors were excluded from this study. Results: Adenocarcinoma (AC) was detected among 70.4% of patients, Squamous cell carcinoma (SCC) among 15.3% and Small cell lung cancer (SCLC) among 14.3% of lung cancer admissions. Male to female ratio was 2.95:1. It was found that the median age of lung cancer patients was 61 years. >60% of lung cancer patients were from the 51 - 70 year age-group. Across the three types of cancers among the patients in Stage 3B to 4 strata, >35% received palliative chemotherapy and >20% received palliative chemotherapy + radiation. Conclusion: In our study, AC is the most common histological subtype (>70%) of lung cancer. The outcome of lung cancer patients can be considerably impacted by addressing risk factors through preventive measures implemented in the community.
