The latest medical research on Lung Cancer
The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about lung cancer gathered by our medical AI research bot.
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Feasibility and reliability of evaluate PD-L1 expression determination using small biopsy specimens in non-small cell lung cancer.Thoracic Cancer
Programmed cell death ligand-1 (PD-L1) is a useful biomarker in non-small cell lung cancer (NSCLC) patients who would probably benefit from immunotherapy. In most patients with advanced stage NSCLC, only small biopsy specimens were available for the evaluation of PD-L1 expression. In this study, we evaluated the feasibility and reliability of PD-L1 testing on small biopsy samples.
Small specimens of advanced NSCLC patients obtained via endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), endobronchial biopsy (EBB), or computed tomography (CT)-guided core-needle biopsy were collected. Tumor cell count and tissue sufficiency for PD-L1 immunohistochemistry (IHC) were evaluated and compared. The clinical course of patients who received immunotherapy in the study population was also examined.
Tissue acquisitions for PD-L1 testing in three groups were all above 90%, with no statistically significant differences. The PD-L1 expressions levels were concordant in most patients with more than one sample (8/11). In the EBB group, PD-L1-positive patients had higher objective response rate (ORR) (53.2% vs. 26.9%, p = 0.048) and longer progression-free survival (PFS) (312 vs. 179 days, p = 0.035) than PD-L1 negative patients. In the core needle biopsy group, patients with positive PD-L1 expression also trended to have higher ORR and longer PFS. However, in the EBUS-TBNA group, both ORR and PFS were similar between patients with positive or negative PD-L1 expression.
This study showed that EBUS-TBNA, EBB, and core needle biopsy provides adequate samples for PD-L1 testing. The predictive value of PD-L1 expression on different small samples still warrants further studies.
Disseminated intravascular coagulation complicating diagnosis of ROS1-mutant non-small cell lung cancer: A case report and literature review.Thoracic Cancer
Disseminated intravascular coagulation (DIC) is a rare paraneoplastic complication in advanced solid malignancies, with success of treatment and su...
Association of anaplastic lymphoma kinase variants and alterations with ensartinib response duration in non-small cell lung cancer.Thoracic Cancer
Here, we aimed to assess the association of ALK variants and alterations with ensartinib response duration in NSCLC, and explore the potential value of computed tomography (CT) radiomic features in predicting progression-free survival (PFS).
We enrolled 88 patients with identified ALK variant NSCLC in a multicenter phase 2 trial, and assessed the impact of ALK variants and secondary ALK alterations on the clinical outcome (response duration) of patients receiving ensartinib. We also established a multifactorial model of clinicopathological and quantitative CT radiomic features to predict PFS and risk stratification. Kaplan-Meier analysis was conducted to identify risk factors for tumor progression.
Univariate analysis indicated a statistical difference (p = 0.035) in PFS among ALK variants in three classifications (V1, V3, and other variants). Secondary ALK alterations were adversely associated with PFS both in univariate (p = 0.008) and multivariate (p = 0.04) analyses and could identify patients at high risk for early progression in the Kaplan-Meier analysis (p = 0.002). Additionally, response duration to crizotinib <1 year and liver metastasis were adversely associated with PFS. The combined model, composed of clinicopathological signature and CT radiomic signature, showed good prediction ability with the area under the receiver operating characteristic curve being 0.85, and 0.89 in the training and validation dataset respectively.
Our study showed that secondary ALK alterations were adversely associated with ensartinib efficacy, and that ALK variants might not correlate with PFS. The quantitative radiomic signature provided added prognostic prediction value to the clinicopathological features.
Epicardial carvernous hemangioma: The diagnostic challenge of a middle mediastinal mass.Thoracic Cancer
Primary tumors in the middle mediastinum are rare and pose diagnostic challenges. Lymphomas, mediastinal cysts and thymomas most frequently affect ...
Occurrence of hypertension during third-line anlotinib is associated with progression-free survival in patients with squamous cell lung cancer (SCC): A post hoc analysis of the ALTER0303 trial.Thoracic Cancer
There is a lack of targeted therapeutic options for squamous cell lung cancer (SCC). Accelerated hypertension is an issue with many targeted therapies for lung cancer. This study aimed to analyze the efficacy of anlotinib, based on progression-free survival (PFS) and overall survival (OS) in patients with SCC, stratified by hypertension and Eastern Cooperative Oncology Group (ECOG) score.
This was a post hoc analysis of a multicenter, double-blind, phase III ALTER0303 randomized controlled trial. Only patients with SCC were included. The occurrence of hypertension during the study period was defined according to CTCAE 4.03. OS and PFS were the primary and secondary endpoints, respectively. The patients were stratified according to hypertension and ECOG score, respectively.
The median PFS in the patients who developed hypertension was longer than in those who did not (7.2 (95% CI: 3.5-11.0) versus 3.2 (95% CI: 1.2-5.3) months, p = 0.001; HR (95% CI), 0.4 (0.2-0.8)). In the ECOG 0 patients, the median PFS in the patients who developed hypertension versus those who did not was 5.6 vs. 1.8 months, respectively (Figure 2(d)). In the ECOG 1 patients, the median PFS in the patients who developed hypertension versus those who did not was 7.0 (95% CI: 3.0-11.0) vs. 4.8 (95% CI: 1.2-8.5) months (p = 0.043). No statistically significant differences were found in OS in the stratified analyses.
The occurrence of hypertension might be a clinical indicator predicting the efficacy of third-line anlotinib treatment in patients with SCC.
Pseudocirrhosis due to liver metastasis from lung adenocarcinoma.Thoracic Cancer
Pseudocirrhosis is a radiological diagnosis of cirrhosis without histological evidence and occurs as a complication of liver metastases from solid ...
Comparison of perioperative and survival outcomes between sublobar resection and lobectomy of patients who underwent a second pulmonary resection.Thoracic Cancer
Repeat pulmonary resection is widely accepted in clinical practice. This study aimed to compare sublobar resection (segmentectomy or wedge resection) with lobectomy in the treatment of patients who underwent a second pulmonary resection.
This study retrospectively included patients who underwent lobectomy or sublobar resection for second pulmonary resection. 1:1 propensity score matching (PSM) was performed to balance selection bias. Clinicopathological features, perioperative and survival outcomes of lobectomy and sublobar resection were compared.
A total of 308 patients who underwent second pulmonary resection were identified: 71 (23.1%) who underwent lobectomy and 237 (76.9%) who underwent sublobar resection. After PSM, 58 patients for each group were selected with well-balanced clinicopathological characteristics. In patients who underwent sublobar resection, significantly shorter chest tube duration (days) (median, 4 vs. 2, p < 0.001) and postoperative hospital stay (days) (median, 6 vs. 4, p < 0.001) were observed. There was no significant difference in overall survival between these two groups after the second and first surgery (p = 0.65, p = 0.98), respectively. Subgroup analysis according to the type of the first resection showed consistent results.
Sublobar resection may be considered as an alternative option for second pulmonary resection due to its perioperative advantages and similar survival outcomes compared with lobectomy.
Efficacy and safety profile of combining programmed cell death-1 (PD-1) inhibitors and antiangiogenic targeting agents as subsequent therapy for advanced or metastatic non-small cell lung cancer (NSCLC).Thoracic Cancer
Previous studies have demonstrated that PD-1 inhibitors are effective in the treatment of advanced or metastatic non-small cell lung cancer (NSCLC). However, whether the combination of PD-1 inhibitors and antiangiogenic agents benefit advanced NSCLC patients as subsequent therapy remains unknown. In this study, we retrospectively reviewed the efficacy and safety profile of this combination strategy as subsequent therapy for NSCLC patients in a real-world setting.
A total of 30 patients with advanced NSCLC, who progressed after at least two cycles of platinum-based chemotherapy or targeted therapy and subsequently received combination therapy with a PD-1 inhibitor and antiangiogenic agent, were included in this study. The safety profile and efficacy were also investigated.
At the time of a median follow-up period of 10.7 months, 28 patients had experienced progression of disease and 16 patients had died. The median progression-free survial (mPFS) was 5.0 months (95% confidence interval [CI]: 3.179-6.821), and the median overall survival (mOS) was 14.3 months (95% CI: 8.912-19.659). The objective response rate (ORR) and the disease control rate (DCR) were 10.3% and 72.4%, respectively (0 complete remission, three partial responses and 18 stable disease in 29 patients with measurable lesions). Patients with PD-L1 expression of at least 1% of tumor cells (n = 5) had relatively longer mPFS compared to those with PD-L1-negative tumors (n = 14), (11.6 months vs. 3.7 months). Treatment was suspended in two patients due to grade 3 immune-related pneumonia and pancreatitis, respectively. No novel adverse events (AEs) or grade 4 AEs were observed.
A combination of PD-1 inhibitors and antiangiogenic targeting agents may be beneficial for patients with advanced or metastatic NSCLC as subsequent treatment, especially for patients with PD-L1 protein expression positive, and treatment is well tolerated.
miR-21-5p/SMAD7 axis promotes the progress of lung cancer.Thoracic Cancer
Lung cancer is one of the most common malignant tumors threatening human health. The aim of this study was to investigate the function of miR-21-5p in lung cancer progression.
We analyzed the expression levels of miR-21-5p in lung cancer tissues and cell lines. The qRT-PCR and MTT assays were performed after transfection with miR-21-5p mimic, inhibitor and negative control into lung cancer cells.
Luciferase reporter assays showed miR-21-5p directly target SMAD7. The miR-21-5p inhibitor significantly suppressed lung cancer cell proliferation, invasion and migration. We found that SMAD7 was upregulated in lung cancer tissue. In addition, we found that SMAD7 inhibited lung cancer cell proliferation and miR-21-5p mimic damaged the inhibitory effect of SMAD7.
miRNA-21-5p may promote cell proliferation, migration and invasion by spoiling SMAD7 expression in lung cancer cells.
History and current situation of neoadjuvant treatment for locally advanced esophageal cancer.Thoracic Cancer
Esophageal cancer is one of the most commonly diagnosed malignant tumors, especially in north China. Surgery is one of the major treatments. Howeve...
tRNA-derived fragments: tRF-Gly-CCC-046, tRF-Tyr-GTA-010 and tRF-Pro-TGG-001 as novel diagnostic biomarkers for breast cancer.Thoracic Cancer
tRNA-derived fragments (tRFs) have been found to play a regulatory role in the occurrence and development of many tumors. The aim of this study was to identify the expression of tRFs in breast cancer and their ability to serve as diagnostic markers for breast cancer.
Total RNA was extracted from breast cancer and paracancerous tissues (n = 83), as well as from the sera of breast cancer patients (n = 214) and healthy donors (n = 113) using trizol reagents. Expression of tRFs was then detected by q-PCR, and analyzed using t-test and ROC to illuminate their potential as biomarkers for breast cancer.
Our results demonstrated that tRFs: tRF-Gly-CCC-046, tRF-Tyr-GTA-010 and tRF-Pro-TGG-001 were downregulated in both tissues and sera from breast cancer patients as well as early-stage patients compared with those in the healthy donors. More importantly, the three tRFs were capable of serving as circulating biomarkers of diagnostics and early diagnosis of breast cancer, possessing areas under the curve (AUC) of 0.7871 and 0.7987, respectively.
tRFs: tRF-Gly-CCC-046, tRF-Tyr-GTA-010 and tRF-Pro-TGG-001 are downregulated in breast cancer and early breast cancer and act as new potential biomarkers for the diagnosis and early diagnosis of breast cancer.
Icotinib alone or with bevacizumab as first-line therapy in Chinese patients with advanced nonsquamous non-small cell lung cancer and activating EGFR mutations: A retrospective study.Thoracic Cancer
This study focused on comparing the safety and therapeutic effects between icotinib monotherapy and icotinib plus bevacizumab combined therapy in non-small cell lung cancer (NSCLC) cases harboring EGFR mutations.
Data were collected retrospectively from the Cancer Institute and Hospital of Tianjin Medical University between October 2018 and December 2019, where the NSCLC cases that harbored EGFR mutations underwent first-line therapy with icotinib in the presence or absence of bevacizumab. This study included 90 cases, of which 60 patients were in the icotinib group (I) and 30 in the icotinib plus bevacizumab group (IB).
The follow-up period to evaluate median PFS in our study was 18 months. Median PFS was 18.0 months (95% confidence interval [CI]: 14.7-21.3) with icotinib plus bevacizumab and 11 months (95% CI: 8.9-13.1) with icotinib alone (hazard ratio 0·54, 95% CI: 0.31-0.92; p = 0.029). According to the subgroup analyses based on the type of EGFR genomic aberration, a prolonged median PFS was observed in the cases harboring exon 21 point mutation (Ex21.L858R) in the IB group compared to the I group (not reached vs. 11 months [8.8-13.2], p = 0.021). However, the difference between the cases harboring exon 19 deletions in the EGFR gene was not significant. The DCR and ORR were comparable between both groups. Substantially higher incidences of hypertension and proteinuria were observed in the combined group compared to the icotinib monotherapy group.
This is the first study to provide further evidence of the benefits of applying icotinib in combination with bevacizumab as first-line treatment for advanced NSCLC cases harboring EGFR mutations. However, these findings need to be verified through prospective phase 3 clinical studies.