ObjectiveTo systematically review the efficacy and safety of crizotinib in the treatment of non-small cell lung cancer (NSCLC).MethodWe electronically searched databases including the Cochrane Library (Issue 5, 2017), PubMed, Embase, China Biology Medicine Database, China National Knowledge Internet Database, VIP Database and Wangfang Data from the establishment to May 2017. The randomized controlled trials (RCTs), non-RCTs, case series and case reports on crizotinib for NSCLC were included. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, assessed the methodological quality of included studies, then make Meta-analysis and descriptive analysis.ResultA total of 15 studies were included, including 4 RCTs, 1 non-RCT, 4 case series and 6 case reports. The results indicated that the progression-free survival time of crizotinib group was 8 months, which was better than chemotherapy group (4.6 months). The results of Meta-analysis showed that the response rate in the crizotinib group was higher than that in the chemotherapy group [RR=2.35, 95%CI (1.59, 3.46), P<0.000 1]. The one year survival rate in the crizotinib group was 74.5%-78.6%. The incidences of adverse reactions including dysopsia, dysgeusia, diarrhea, vomiting, constipation, transaminase lifts, upper respiratory tract infection, edema and dizziness in the crizotinib group were higher than those in the chemotherapy group (P<0.05), while the incidences of adverse reactions including leukopenia, thrombocytopenia, alopecia and fatigue in crizotinib group were lower than those in the chemotherapy group (P<0.05). Subgroup analysis under precision treatment showed the progression-free survival time of anaplastic lymphoma kinase (ALK)-positive group was 8 months, and it was longer than ALK-negative group of 4 months.ConclusionsBased on current evidence, crizotinib is better than chemotherapy for NSCLC. Due to limited quality of the included studies, the above conclusion needs to be verifed by more high quality studies.
ObjectiveTo explore the suppression of Wnt-1 pathway on non-small cell lung cancer (NSCLC) by establishing a NSCLC nude mice model of transplanting tumor in Xuanwei county. MethodsThere were 21 mice with tumor weight from 16-18 g and we divided them into a blank group (n=7), a control group (n=7), and an experiment group (n=7). The blank group were injected with saline, the control group were injected with docetaxel, and the experimental group were injected with Wnt-1 antibody. The mice were executed and the tumor specimens were obtained after six injections. We compared the volumes of the specimens and the inhibition rates of tumor among the three groups. ResultsThere was a statistical difference in volume between the blank group and the experiment group as well as the control group on the 21th and 27th day (P=0.002,P=0.000). The experiment within mice's body showed that both docetaxel and Wnt-1 antibody could inhibit NSCLC from growing, and the inhibition effect of docetaxel was stronger. ConclusionThe interdiction of Wnt-1 pathway is functional to restrain the growth of tumor. The docetaxel and Wnt-1 antibody have a positive effect on the treatment of NSCLC.
ObjectiveTo evaluate the clinical efficacy and safety of artieral infusion chemotherapy combined with 125I seed implantation in treatment of non-small cell lung cancer (NSCLC). MethodsBetween February 2012 to June 2014, 34 patients with unresectable NSCLC received 125I seed implantation, in which 16 patients also received artieral infusion chemotherapy. All the patients were followed up and two months after 125I seed implantation the thoracic CT scanning was carried out in all patients. The response to treatment was evaluated in accordance with Response Evaluation Criteria in Solid Tumors and the accumulated survival rate was analyzed by means of Kaplan-Meier. ResultsThe operation successful rate was 100% and no severe complications were observed. Two months later the thoracic CT scanning showed that patients who only received 125I seed implantation with a total effective rate of 72.2% and those received artieral infusion chemotherapy combined with 125I seed implantation with an effective rate of 87.5%, with no significant difference between two groups in the effective rate (χ2=1.122, P>0.05). Median survival time of two groups was 361 days and 470 days (χ2=2.985, P < 0.05), respectively. Survival rate of 1 year was 43.5% and 83.5%(χ2=4.101, P < 0.05), respectively. ConclusionArtieral infusion chemotherapy combined with 125I seed implantation is safe, reliable and effective in treatment of unresectable NSCLC, which can prolong the patient's survival time.
Objective To systematically review the prognostic and clinicopathological value of FOXM1 expression in non-small cell lung cancer (NSCLC). Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 1, 2016), CNKI, WanFang Data and CBM were searched to collect cohort studies about the prognostic value of FOXM1 expression in NSCLC from inception to May 30th 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. Results A total of 8 cohort studies, involving 781 patients were included. The results of meta-analysis showed that FOXM1 expression was higher in tumor stage Ⅲ to Ⅳ than stageⅠtoⅡ(OR=2.24, 95%CI 1.25 to 4.01,P=0.007). Higher FOXM1 expression group had a shorter overall survival (HR=1.77, 95%CI 1.42 to 2.22,P<0.000 01) and disease-free survival (HR=1.96, 95%CI 1.04 to 3.17,P=0.04) than those of the lower FOXM1 expression group. Conclusion Current evidence shows that FOXM1 expression is associated with NSCLC stage. Furthermore, FOXM1 overexpression may be prognosis biomarker for NSCLC patients. Due to the limited quantity and quality of included studies, the above conclusions are needed to be verified by more high quality studies.
ObjectiveTo systematically review the efficacy and safety of intrapleural injection of endostar combined with cisplatin in treatment of non-small cell lung cancer (NSCLC) with malignant pleural effusion. MethodsDatabases including PubMed, The Cochrane Library (Issue 2, 2016), EMbase, Web of Science, CNKI, VIP and WanFang Data were searched to collect randomized controlled trials (RCTs) about endostar combined with cisplatin for NSCLC with malignant pleural effusion from inception to February 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. ResultsA total of 10 RCTs involving 610 patients were finally included. The results of meta-analysis showed that: The overall response rate and the improvement rate of quality of life in the endostar combined with cisplatin group were higher than that of the cisplatin alone group (RR=1.71, 95%CI 1.49 to 1.95, P<0.00001; RR=1.68, 95%CI 1.44 to 1.96, P<0.00001, respectively). However, There were no significant differences between two groups in incidence of gastrointestinal reaction, incidence of leucopenia and incidence of thrombocytopenia (all P values>0.05). ConclusionCompared with cisplatin, intrapleural injection of endostar combined with cisplatin can improve the overall response rate and improve the quality of life of NSCLC patients with malignant pleural effusion. Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusion.
The National Comprehensive Cancer Network (NCCN) has updated and released the latest content of the NCCN guidelines for the clinical diagnosis and treatment of non-small cell lung cancer (NSCLC) in the version 1, 2022. Based on high-quality clinical evidence and the latest research progress of the diagnosis and treatment of NSCLC, the guidelines have been widely recognized and welcomed by clinicians around the world. Compared with the version 7, 2021, the new version has been updated and revised in some parts of chapters and sections, mainly focusing on targeted therapies and molecular testing. This article will interpret the updated therapy content of the new version.
ObjectiveTo systematically review the economic evaluations of anaplastic lymphoma kinase (ALK)-tyrosine kinase inhibitors (TKIs) in the treatment of ALK-positive non-small cell lung cancer (NSCLC). MethodsPubMed, Web of Science, The Cochrane Library, CNKI, VIP and WanFang Data databases were electronically searched to collect economic evaluations of ALK-TKIs in the treatment of ALK-positive NSCLC from inception to July 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, a systematic review was performed. ResultsA total of 20 studies were included. 18 of the included studies were cost-utility analyses based on the models. The method of survival data extrapolation involved the standard parameter model and the standard parameter model with a hazard ratio adjusting. 10 studies considered or included the disutility value of adverse events. 18 studies performed cost estimation on direct costs. In China, 45% of the included studies were first-line treatment, the results showed that ALK-TKIs were less economical than chemotherapy, and second-/third-generation ALK-TKIs were less economical than crizotinib. Only 1 studies were second-line treatment, the result showed that crizotinib was more economical than chemotherapy. ConclusionThe economic evaluation results of ALK-TKIs in ALK-positive NSCLC vary according to treatment stage and national scenario, and there is also room for optimization of methodological application in this field.
The resistance of non-small cell lung cancer (NSCLC) to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) has been brought into focus. COX-2 signal pathway was found to be closely related to EGFR signal pathway by recent researches, and there has been a growing interest to focus the researches on whether COX-2 pathway inhibition improves the efficacy of EGFR-TKIs in treating advanced NSCLC. In this review, we will illustrate recent advances of combined inhibition of EGFR and COX-2 signal pathways in NSCLC therapy.
ObjectiveTo summarize our initial experience in robot-assisted left upper lobectomy for non-small cell lung cancer. MethodsFour patients with non-small cell lung cancer underwent robot-assisted left upper lobectomy with da Vinci S surgical system (Intuitive Surgical, California) in General Hospital of Shenyang Military Area Command between March and August 2013. There were 3 male and 1 female patients, and their age was 58.8 years (range:49-67 years). We used general anesthesia with double lumens trachea cannula. The patients set in right lateral decubitus position with jackknife. We used 3 arms of the robot system. A single direction lobectomy procedure or an anatomic lobectomy procedure was used according to the differentiation of fissure. Systemic lymph node dissection was performed for all patients. ResultsFour patients with left upper lobectomy were completed with total robotic procedure without conversion. Postoperative pathological examination showed all the patients were of all adenocarcinoma with 2 patients inⅠA stage and 2 patients inⅢA stage. The range of operating time was 100-150 min, intraoperative blood loss was 30-80 ml and no blood transfusion was needed for the patients. The drainage time was 6-20 days. All of the 4 patients were discharged smoothly. The patients were followed up for 10-15 months without recurrence or metastasis. ConclusionRobot-assisted left upper lobectomy is safe and feasible for non-small cell lung cancer.
Objective To systematically evaluate the efficiency and safety of Vandetanib plus Docetaxel versus Docetaxel alone for advanced non-small cell lung cancer (NSCLC). Methods The randomized controlled trials (RCTs) of Vandetanib plus Docetaxel versus Docetaxel for NSCLC published before October 26, 2010 were searched in EMbase, The Cochrane Library, PubMed, Wanfang database, VIP Database, China National Knowledge Infrastructure(CNKI), and China biological medical literature database. The methodological quality of the included studies was evaluated according to the Cochrane assessment handbook 5.0.2, and the meta-analysis was conducted by using RevMan 5.0 software. Results A total of 3 RCTs involving 1 626 patients were included. The meta-analysis showed that there were positive effects between the Vandetanib group and the control group in the overall response rate (OR=1.81, 95%CI 1.37 to 2.38, Plt;0.000 1), disease control rate and 1-year survival rate; and all studies showed that Vandetanib could significantly lengthen the progression-free survival. Conclusion The Vandetanib group is superior to the control group for its better effectiveness and fewer adverse effects, and it is worth referring and applying in clinic.