Efficacy and safety of concurrent chemoradiotherapy in ECOG 2 patients with locally advanced non-small-cell lung cancer: a subgroup analysis of a randomized phase III trial
Nan Bi,Lipin Liu,Jun Liang,Shixiu Wu,Ming Chen,Changxing Lv,Lujun Zhao,Anhui Shi,Wei Jiang,Yaping Xu,Zongmei Zhou,Jingbo Wang,Wenqing Wang,Dongfu Chen,Zhouguang Hui,Jima Lv,Hongxing Zhang,Qinfu Feng,Zefen Xiao,Xin Wang,Tao Zhang,Weibo Yin,Junling Li,Jie He,Luhua Wang +24 more
TL;DR: CCRT provided ECOG 2 patients promising outcome with acceptable toxicities and EP might be superior to PC in terms of safety profile in the setting of CCRT for ECOG2 patients.
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Abstract: There is no consensus on the therapeutic approach to ECOG 2 patients with locally advanced non-small-cell lung cancer (LA-NSCLC), despite the sizable percentage of these patients in clinical practice. This study focused on the efficacy, toxicity and the optimal chemotherapy regimen of CCRT in ECOG 2 patients in a phase III trial. Patients capable of all self-care with bed rest for less than 50% of daytime were classified as ECOG 2 subgroup. A subgroup analysis was performed for ECOG 2 patients recruited in the phase III trial receiving concurrent EP (etoposide + cisplatin)/PC (paclitaxel + carboplatin) chemotherapy with intensity-modulated radiation therapy (IMRT) or three-dimensional conformal external beam radiation therapy (3D-CRT). A total of 71 ECOG 2 patients were enrolled into the study. Forty-six (64.8%) patients were treated with IMRT technique. The median overall survival (OS) and progression free survival (PFS) for ECOG 2 patients were 16.4 months and 9 months, respectively. No difference was observed in treatment compliance and toxicities between ECOG 2 patients and ECOG 0–1 patients. Within the ECOG 2 group (31 in the EP arm and 40 in the PC arm), median OS and 3-year OS were 15.7 months and 37.5% for the EP arm, and 16.8 months and 7.5% for the PC arm, respectively (p = 0.243). The incidence of grade ≥ 3 radiation pneumonitis was higher in the PC arm (17.5% vs. 0.0%, p = 0.014) with 5 radiation pneumonitis related deaths, while the incidence of grade 3 esophagitis was numerically higher in the EP arm (25.8% vs. 10.0%, p = 0.078). CCRT provided ECOG 2 patients promising outcome with acceptable toxicities. EP might be superior to PC in terms of safety profile in the setting of CCRT for ECOG 2 patients. Prospective randomized studies based on IMRT technique are warranted to validate our findings. ClinicalTrials.gov registration number: NCT01494558. (Registered 19 December 2011).
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Blocking hsa_circ_0074027 suppressed non-small cell lung cancer chemoresistance via the miR-379-5p/IGF1 axis.
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Prävention, Diagnostik, Therapie und Nachsorge des Lungenkarzinoms
W. Schütte,S. Gütz,W. Nehls,Torsten Blum,W. Brückl,Nina Buttmann-Schweiger,Reinhard Büttner,Petros Christopoulos,Sandra Delis,Karl-Matthias Deppermann,Nikolas Dickgreber,Wilfried E. Eberhardt,S Eggeling,J. Fleckenstein,Michael Flentje,Nikolaj Frost,Frank Griesinger,C. Grohé,André H. Gröschel,Matthias Guckenberger,Erich Hecker,Hans Hoffmann,R. Huber,K. Junker,H. Kauczor,Jens Kollmeier,Klaus Kraywinkel,Marcus Krüger,Christiane Kugler,Miriam Möller,Ursula Nestle,Bernward Passlick,Joachim Pfannschmidt,Martin Reck,Niels Reinmuth,C. Rübe,R. Scheubel,Christian Schumann,Martin Sebastian,M. Serke,Erich Stoelben,Martin Stuschke,Michael Thomas,Amanda Tufman,Dirk Vordermark,C. Waller,J. Wolf,Martin Wolf,Dag Wormanns +48 more
TL;DR: Die Leitlinie zur Prävention, Diagnostik, Therapie und Nachsorge des Lungenkarzinoms trägt der aktuellen Situation Rechnung und beinhaltet die Verpflichtung der Vorstellung aller neu diagnostizierten Patienten im interdisziplinären pneumoonkologischen Tumorboard, die CT-Screening für asymptomatische Risikopersonen, Vorgehen beim inzidentellen Lungenrundherd, molekulare Testung aller NSCLC unabhängig vom Subtyp, adjuvante TKI-Therapie bei Vorliegen einer EGFR-Mutation, adjuvante Konsolidierung mit Checkpointinhibitor bei PD-L1 ≥ 50%, Erhebung des PD-L1-Status, nach Radiochemotherapie bei PD-L1-pos. Tumoren Konsolidierung mit Checkpointinhibitor, adjuvante Konsolidierung mit Checkpointinhibitor bei PD-L1 ≥ 50% im Stadium IIIA, Erweiterung des therapeutischen Spektrums bei PD-L1 ≥ 50%, unabhängige PD-L1-Status, neue zielgerichtete Therapieoptionen und die Einführung der Immunchemotherapie in der SCLC Erstlinie.
3
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Meta-Analysis of Concomitant Versus Sequential Radiochemotherapy in Locally Advanced Non–Small-Cell Lung Cancer
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Sequential vs Concurrent Chemoradiation for Stage III Non–Small Cell Lung Cancer: Randomized Phase III Trial RTOG 9410
Walter J. Curran,Rebecca Paulus,Corey J. Langer,Ritsuko Komaki,Jin S. Lee,Stephen L. Hauser,Stephen L. Hauser,Benjamin Movsas,Benjamin Movsas,Todd H. Wasserman,Seth A. Rosenthal,Elizabeth Gore,Mitchell Machtay,William T. Sause,James D. Cox +14 more
TL;DR: Concurrent delivery of cisplatin-based chemotherapy with TRT confers a long-term survival benefit compared with the sequential delivery of these therapies.
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Impact of Intensity-Modulated Radiation Therapy Technique for Locally Advanced Non–Small-Cell Lung Cancer: A Secondary Analysis of the NRG Oncology RTOG 0617 Randomized Clinical Trial
Stephen G. Chun,Chen Hu,Hak Choy,R.U. Komaki,Robert Timmerman,Steven E. Schild,Jeffrey A. Bogart,Michael C. Dobelbower,Walter Bosch,James M. Galvin,V.S. Kavadi,Samir Narayan,Puneeth Iyengar,Clifford G. Robinson,Raymond B. Wynn,Adam Raben,Mark E. Augspurger,Robert MacRae,Rebecca Paulus,Jeffrey D. Bradley +19 more
TL;DR: IMRT was associated with lower rates of severe pneumonitis and cardiac doses in NRG Oncology clinical trial RTOG 0617, which supports routine use of IMRT for locally advanced NSCLC.