Treatment of Advanced Squamous Cell Lung Cancer

Lung cancer is the deadliest cancer in the worldwide. Non-small cell lung cancer (NSCLC) accounts for 85% of lung tumor diagnoses. Squamous cell lung cancer (SQCLC) is a common pathological type, almost 20%-30% of NSCLC. Surgery, chemotherapy, and molecular targeted therapies are the mainstay of treatment for patients with SQCLC. But most patients are diagnosed at advanced stage so that they miss the chance of operation. While noteworthy outcomes have improved with adenocarcinoma of lung with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), a therapeutic plateau for advanced squamous cell lung cancer patients are still not solved. EGFR-TKIs are unsuitable for or mostly ineffective in advanced SQCLC. Patients with advanced SQCLC ramain treated with platinum based chemotherapy. This reciew systematicly describe the treatment of squamous cell carcinoma of the lung

Analysis of the First Diagnosis Symptom and Its Influencing Factors in 500 Patients with Lung Cancer

Background and objective As the morbidity and mortality in lung cancer keep raising, we are here to discuss the effect of clinical features especially the initial symptomon on diagnosis and follow-up treatment of newly diagnosed lung cancer patients. Methods The clinical features of the 500 patients with lung cancer in our hospital from March, 2017 to May, 2017 were analyzed retrospectively, including the initial symptom, stage, biomarkers, pathology, etc. Results There were 266 famle (53.3%), 372 adenocarcinoma (74.4%), 285 smokers (58%), status score of most patients (98.2%) was 0-1. 58.2% (n=291) of all the patients got biomarkers test, of which epidermal growth factor receptor (EGFR) mutations was 61.2%(178/291), anaplasticlymphoma kinase (ALK) fusion gene positive was 4.1% (12/291). Smoking status, initial symptom, pathological typing, TNM staging and EGFR mutation were the main factors affecting follow-up treatment. Conclusion Patients with typical symptoms have shorter diagnosis time. Smoking status, lung cancer-related symptoms, pathology, TNM staging and EGFR mutation status are the main factors that affect the follow-up treatment

Recombinant Human Endostatin in the Treatment of Advanced Lung Squamous Cell Carcinoma

Background and objective Squamous cell carcinoma (SCC) is a common pathological type of non-small cell lung cancer, and advanced lung SCC is incurable. Chemotherapy combined with anti-angiogenesis agents can prolong the patients’ survival time. The aim of the study was to analyze the efficacy and safety of recombinant human endostatin (Endostar) in treating advanced lung SCC. Methods We retrospectively analyzed the short-term efficacy and toxicity of recombinant human endostatin combined with traditional chemotherapy regimens in treating 15 advanced lung squamous cell carcinoma patients in Department of Medical Oncology retrospectively, Cancer Hospital, Chinese Academy of Medical Sciences from November 2011 to May 2015. Treatment-related survival was also analyzed. Results Among the evaluble 14 patients, the best overall response was partial response in 5 patients (35.7%), stable disease in 7 patients (50.0%), and progressive disease in 2 patients (14.3%). The objective response rate (ORR) was 35.7%, and disease control rate (DCR) was 85.7%. The median progression-free survival (PFS) was 9.3 months. The main grade 3 toxicity was neutropenia (2/15, 13.3%) and vomitting (1/15, 6.7%). Conclusion Chemotherapy combined with recombinant human endostatin enabled good objective response in advanced SCC patients and had well security

Effects of Erlotinib on 34 Patients with Advanced Squamous Cell Lung Cancer

Background and objective Epidermal growth factor receptor tyrosine kinase inhinitors (EGFR-TKIs) inhibit tumor growth by affecting signal transduction, and are well tolerated. The aims of this study was to observe the effect of erlotinib in patients with squamous cell lung cancer. Methods The 34 patients with squamous cell lung cancer treated with erlotinib 150 mg orally once daily until disease progression or intolerable adverse reactions. Results The 7 patients were treated with erlotinib as first-line treatment, 6 patients as maintenance therapy (1 case withdrawal of severe toxicity), 9 patients second-line treatment, 5 patients as third-line and 7 patients as further-line therapy. 11 patients died. The median progression-free survival (PFS) was 3.5 months, ranging from 1 month to 55 months (the patient withdrawal of severe toxicity was not included). Conclusion Erlotinib was effective for patients with squamous cell lung cancer who can not tolerate chemotherapy or refused chemotherapy and with unknown EGFR status. Adverse reactions were tolerable

Therapeutic cancer vaccine: phase I clinical tolerance study of Hu-rhEGF-rP64k/Mont in patients with newly diagnosed advanced non-small cell lung cancer

Abstract Background Hu-rhEGF-rP64k/Mont is a biotechnology product for the treatment of advanced non-small cell lung cancer (NSCLC). The vaccine induces a neutralizing antibody-mediated immune response, against the normal circulating self-protein antigen epidermal growth factor (EGF), which prevents its binding to and activation of the EGF receptor, inhibiting the transduction of the signals that drive cancer cell proliferation, survival and spread. This phase I study aimed to evaluate the safety and the immunological response of Hu-rhEGF-rP64k vaccine in NSCLC patients. Results The Hu-rhEGF-rP64k/Mont vaccine showed to be safe and well tolerated, with dizziness, injection-site reactions and tremors being the most commonly reported adverse event. No severe adverse events or death were related to the vaccination. Immune monitoring demonstrated the generation of anti-EGF antibody titers and as a consequence the patients exhibited a decrease in the EGF concentration. In 80% of the vaccinated patients stable disease was achieved. Conclusion Hu-rhEGF-rP64k/Mont elicited a valuable immune response, with good safety profile assuring further clinical development of the vaccine in this population to further confirm the potential benefits on survival. Trial registration Chinese Clinical Trial Registry, ChiCTR-OID-17014048, date 2017/12/20 (retrospectively registered); Chinese Food and Drug Administration, CFDA 2009 L02105, date 2009/04/03; China Drug Trial, CTR20131039

Clinicopathologic Characteristics of the Patients in the Elderly Lung Carcinoma

Background and objective As the prevalence of tobacco and the aging of the population, the incidence of lung cancer in the elderly rises. However, few elderly patients (older than 70 years old) with lung squamous cell carcinoma were involved into the clinical trials, which offered insufficient clinical evidence for these patients. Lung squamous cell carcinoma patients older than 80 years old were included in our study to analyze the clinical characteristics, treatment and prognostic factors, and to explore the optimal treatment choices for these patients. Methods We retrospectively analyzed the clinical features of 38 elderly patients with lung squamous carcinoma and summarized the treatment under the clear diagnosis and clinical staging. Results Elderly patients with squamous cell carcinoma can choose surgery, radiotherapy and chemotherapy based on diagnosis and clinical staging when their physical condition is permitted. Conclusion Because of the short life expectancy of patients more than 80 years old, fewer of them could receive completed and effective treatment, comparing with patients between 70 and 80 years old

Review on Treatment Modalities for Resectable IIIa/N2 Non-small Cell Lung Cancer

Standard treatment for resectable IIIa/N2 non-small-cell lung cancer (NSCLC) is still under debate. Optional treatments include chemotherapy, radiotherapy and surgery, other options include target therapy and immunotherapy. Multidisciplinary treatment has therefore been emphasized by various clinical trials, including bimodality strategy which has been defined as chemotherapy plus surgery or chemotherapy plus radiotherapy, and trimodality treatment which refers to chemotherapy plus surgery and radiotherapy. However, there is still no consensus on the optimal strategy on treating resectable IIIa/N2 NSCLC. Therefore, we reviewed a series of phase II and III clinical trials as well as some meta-analyses and case reports to compare the efficacy of different strategies on survival of cN2 NSCLC, and concluded that for resectable IIIa/N2 NSCLC surgery is recommended, and that strategy of chemotherapy plus surgery may not achieve better survival than that of chemotherapy plus radiotherapy. Size of tumor as well as lymph nodes should be taken into account when choosing optimal therapy, so that promising individualized strategy could be given to patients with resectable stage IIIa/N2 NSCLC

Clinical Analysis of 58 Patients with Small Cell Lung Cancer Combined with Squamous Cell Cancer

Background and objective Small cell lung cancer combined with squamous cell carcinoma are rare. The aim of this study was to analyze the clinicopathological characteristics and treatment, and explored the prognostic factors of this disease. Methods Between January 2004 and December 2012, 58 patients with cytopathologically confirmed small cell lung cancers combined with squamous cell carcinoma were retrospectively analyzed. Kaplan-Meier methods were used to calculate the survival rate, and Log-rank test was used to examine differences between arms. The Cox regression model was used to analyze the independent factors affecting the overall survival (OS). Results The OS of the 58 patients was 22.7 months with a range of 0.3 to 124.3 months. In univariate analysis, Karnofsky performance score before treatment, extensive disease, tumor stage were the considered prognostic factors affecting the OS rate (P<0.05). Cox multivariate analysis showed that only the tumor-node-metastasis (TNM) stage was the independent prognostic factor (P=0.019). The majority of the patients received multimodality therapy and chemotherapy was the main treatment. Distant metastasis was the main reasonfor the treatment failure. Conclusion Combined therapy with chemotherapy as the main treatment should be adopted in therapeutic regimen of the patients with small cell lung cancers combined with squamous cell carcinoma. TNM stage was the independent prognostic factor influencing the OS

Treatment Choice for Advanced Non-small Cell Lung Cancer Patients Who Had Gradual Progression After EGFR-TKIs: 32 Cases Report

Background and objective The epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have been widely used in the treatment of the advanced non-small cell lung cancer (NSCLC), especially in the adenocarcinoma patients with activating EGFR mutations. But there is no published overview of the following treatment. This report through observing the efficacy, toxicity and overall survival of different treatments to the advanced NSCLC patients who had gradual progression after EGFR-TKIs, evaluates the influence of the continued treatment and switching chemotherapy. Methods Retrospective review is conducted on 32 cases of advanced NSCLC patients who experienced treatment failure of EGFR-TKIs. One group accepted the continued treatment and the other group accepted the switching chemotherapy. Results The median overall survival of the continued treatment group is 36.0 months. The respose rate of the switching chemotherapy group is 43.75%, and clinical benefit rate (complete and partial response and stable disease) is 87.5%. The median overall survival is 15.5 months. The main toxicities are nausea, vomiting and hematological toxicities. Conclusion For the advanced NSCLC patients who had gradual progression after EGFR-TKIs, the continued treatment is one of the acceptable choices