Lung cancer is the leading cause of cancer mortality worldwide.Even with the applications of excision, radiotherapy, chemotherapy, and gene therapy, the 5 year survival rate is only 15% in the USA. Clinically relevant...Lung cancer is the leading cause of cancer mortality worldwide.Even with the applications of excision, radiotherapy, chemotherapy, and gene therapy, the 5 year survival rate is only 15% in the USA. Clinically relevant laboratory animal models of the disease could greatly facilitate understanding of the pathogenesis of lung cancer, its progression, invasion and metastasis. Transplanted lung cancer models are of special interest and are widely used today. Such models are essential tools in accelerating development of new therapies for lung cancer. In this communication we will present a brief overview of the hosts, sites and pathways used to establish transplanted animal lung tumor models.展开更多
Objective: Several predictors of survival have been identified in EGFR-positive non-small cell lung cancer(NSCLC) patients treated with first generation EGFR inhibitors. Prognostic models of survival outcomes with afa...Objective: Several predictors of survival have been identified in EGFR-positive non-small cell lung cancer(NSCLC) patients treated with first generation EGFR inhibitors. Prognostic models of survival outcomes with afatinib have not been evaluated.Methods: A prognostic tool for overall survival(OS)/progression free survival(PFS) based on pre-treatment clinicopathological factors was developed for EGFR-positive advanced NSCLC patients treated with first-line afatinib using penalised regression of individual-participant data from LUX-Lung 3 and 6(n = 468). Favourable, intermediate and poor risk groups were identified and externally validated using LUX-Lung 1(n = 390) and LUX-Lung 2(n = 129) trials that initiated afatinib following previous chemotherapy or EGFR inhibitor treatment.Results: Discriminative performance was good in the development and validation cohorts. For patients treated with first-line afatinib, the median OS for the favourable, intermediate and poor risk groups were > 47.7, 29.3 and 16.4 months, respectively, and the median PFS were 17.3, 13.2 and 8.3 months, respectively. The improvement in median OS with afatinib use compared to chemotherapy was > 12.4 months for the favourable risk group, whereas no OS benefit was apparent for the poor risk group. The improvement in median PFS with afatinib use compared to chemotherapy was 10.2 months for the favourable risk group and 3.2 months for the poor risk group.Conclusions: A prognostic tool was developed and validated to identify favourable, intermediate and poor risk groups for OS/PFS in EGFR-positive advanced NSCLC patients treated with afatinib. The prognostic groups can inform the likely absolute OS/PFS benefit expected from afatinib compared to chemotherapy in first-line treatment.展开更多
The object of our present study is to develop a piecewise constant hazard model by using an Artificial Neural Network (ANN) to capture the complex shapes of the hazard functions, which cannot be achieved with conventi...The object of our present study is to develop a piecewise constant hazard model by using an Artificial Neural Network (ANN) to capture the complex shapes of the hazard functions, which cannot be achieved with conventional survival analysis models like Cox proportional hazard. We propose a more convenient approach to the PEANN created by Fornili et al. to handle a large amount of data. In particular, it provides much better prediction accuracies over both the Poisson regression and generalized estimating equations. This has been demonstrated with lung cancer patient data taken from the Surveillance, Epidemiology and End Results (SEER) program. The quality of the proposed model is evaluated by using several error measurement criteria.展开更多
In the past decades a lot of investigations were focused on searching for more accurate markers of lung cancer progression. Researchers indicate that molecular markers may be useful in forecasting of treatment outcome...In the past decades a lot of investigations were focused on searching for more accurate markers of lung cancer progression. Researchers indicate that molecular markers may be useful in forecasting of treatment outcome and overall survival rate in patients with non-small cell lung cancer. The aim of our research was to create a forecasting model in order to identify patients with stage I-II of non-small cell lung cancer and dismal prognosis. Our research covered 254 patients with the early stage of non-small cell lung cancer who underwent a cure from June 2008 till December2012 inthe Department of Thoracic Surgery of Zaporizhzhia Regional Clinical Oncologic Dispensary. Surgery was performed for all patients. Adjuvant chemotherapy was performed for 101 patients. In order to carry out multivariate Cox-regression analysis, STATISTICA 6.0 (StatSoft Inc.) program was used. The most significant from 39 variables were selected (tumor size, histological form of tumor, volume of surgical intervention, volume of conducted lymph node dissection, Ki-67 expression, EGFR expression, E-cadherin expression). We propose the computer system which can forecast survival rate in patients with the early stage of non-small cell lung cancer.展开更多
Summary： The type 1 insulin-like growth factor receptor （IGF-1R） and its downstream signaling com- ponents have been increasingly recognized to drive the development of malignancies, including non-small cell lung c...Summary： The type 1 insulin-like growth factor receptor （IGF-1R） and its downstream signaling com- ponents have been increasingly recognized to drive the development of malignancies, including non-small cell lung cancer （NSCLC）. This study aimed to investigate the effects of IGF-1R and its in- hibitor, AG1024, on the progression of lung cancer. Tissue microarray and immunohistochemistry were employed to detect the expressions of IGF-1 and IGF-1R in NSCLC tissues （n=198）. Western blotting was used to determine the expressions oflGF-1 and phosphorylated IGF-1R （p-IGF-1R） in A549 human lung carcinoma cells, and MTT assay to measure cell proliferation. Additionally, the expressions of IGF-1, p-IGF-1R and IGF-1R in a mouse model of lung cancer were detected by Western blotting and real-time fluorescence quantitative polymerase chain reaction （FQ-PCR）, respectively. The results showed that IGF-1 and IGF-1R were overexpressed in NSCLC tissues. The expression levels of IGF-1 and p-IGF-1R were significantly increased in A549 cells treated with IGF-1 as compared to those treated with IGF-1 ＋AG 1024 or untreated cells. In the presence of IGF-1, the proliferation of A549 cells was significantly increased. The progression of lung cancer in mice treated with IGF-1 was significantly increased as compared to the group treated with IGF-l＋AG1024 or the control group, with the same trend mirrored in IGF-1/p-IGF-1R/IGF-1R at the protein and/or mRNA levels. It was concluded that IGF- 1 and IGF inhibitor AG 1024 promotes lung cancer progression.展开更多
To evaluate the diagnosis model of serum tumor biomarker and several clinical features diagnose and classification for lung cancer, the solid protein chip technology (C-12) was used to detect the biomarkers of SF, CEA...To evaluate the diagnosis model of serum tumor biomarker and several clinical features diagnose and classification for lung cancer, the solid protein chip technology (C-12) was used to detect the biomarkers of SF, CEA, CA242, NSE, CA125, CA19-9 and CA15-3 in serum and several clinical features of tumors and benign disease in elderly lung cancer patients were collected. Set up a discriminating analysis as a function diagnostic model in clinical elderly lung cancer diagnosis and sub-type discrimination. In combination of 2 obvious clinical indicators and 2 serum markers, it is possible to provide a diagnosis tool for lung cancer. With the help of mathematic model, it is promising to reduce the misjudgment risk based on the previous experience and therefore establish a reliable diagnosing function. This model is simple, cost-effective and easy to adapt in practice, and can also be used in screening of large population.展开更多
Objective:To identify the influence on radiosensitivity of lung glandular cancer cells when excisions repair cross-complementing group1(ERCC1) gene was silenced by targeted siR NA.Methods:siR NA which targeting to ERC...Objective:To identify the influence on radiosensitivity of lung glandular cancer cells when excisions repair cross-complementing group1(ERCC1) gene was silenced by targeted siR NA.Methods:siR NA which targeting to ERCC1 and control siR NA was designed and synthesized.The human lung glandular cancer SPC-A-1 cells was transfected.A total of 56 nude mice were divided into two groups,and two kinds of SPC-A-1 cells were transplanted to armpit of right forelimb,to establish the nude mice subcutaneous xenotransplanted tumor model of human lung glandular cancer cells.After the tumor was developed,the nude mice were randomly divided into four groups and accepted different doses of X-Ray radiation,then the change of tumor volume,survival time of mice in every group were recorded and the average lifetime was calculated.Twenty-one days later of X-ray experiment,two mice were taken and sacrificed in each group and the tumors organizations were stripped.The cell apoptosis rate and cell cycle distributions were obtained by FCM(flow cytometry).Results:The volume of tumor which ERCC1 gene was silenced was less than single irradiation group after X-ray irradiation,and the growth speed was slower and the lifetime of mice was lengthened as well(P<0.05).The cells apoptosis rate and the rate of G2/M cells which ERCC1 gene was silenced were higher than the same dose control group and the rate of G_1 cells were lower,which indicated that the cells could be stopped at G_2/M point,the cell proliferation was inhibited,the cell apoptosis was promoted and the radiation sensitivity was improved after the ERCC1 was silenced.Conclusions:The radiation sensitivity of lung glandular tumor could be improved after the ERCC1 gene was silenced by siR NA.展开更多
Background:With industrial and economic development in recent decades in South China,cancer incidence may have changed due to the changing lifestyle and environment.However,the trends of lung cancer and the roles of s...Background:With industrial and economic development in recent decades in South China,cancer incidence may have changed due to the changing lifestyle and environment.However,the trends of lung cancer and the roles of smoking and other environmental risk factors in the development of lung cancer in rural areas of South China remain unclear.The purpose of this study was to explore the lung cancer incidence trends and the possible causes of these trends.Methods:Joinpoint regression analysis and the age-period-cohort(APC) model were used to analyze the lung cancer incidence trends in Sihui,Guangdong province,China between 1987 and 2011,and explore the possible causes of these trends.Results:A total of 2,397 lung cancer patients were involved in this study.A 3-fold increase in the incidence of lung cancer in both sexes was observed over the 25-year period.Joinpoint regression analysis showed that while the incidence continued to increase steadily in females during the entire period,a sharp acceleration was observed in males starting in 2005.The full APC model was selected to describe age,period,and birth cohort effects on lung cancer incidence trends in Sihui.The age cohorts in both sexes showed a continuously significant increase in the relative risk(RR)of lung cancer,with a peak in the eldest age group(80-84 years).The RR of lung cancer showed a fluctuating curve in both sexes.The birth cohorts identified an increased trend in both males and females;however,males had a plateau in the youngest cohorts who were born during 1955-1969.Conclusions:Increasing trends of the incidence of lung cancer in Sihui were dominated by the effects of age and birth cohorts.Social aging,smoking,and environmental changes may play important roles in such trends.展开更多
Objective: To evaluate the cost-effectiveness of atezolizumab plus pemetrexed and platinum-based (APP) in the first-line treatment of non-squamous non- small cell lung cancer (NSCLC). Methods: A partitioned survival m...Objective: To evaluate the cost-effectiveness of atezolizumab plus pemetrexed and platinum-based (APP) in the first-line treatment of non-squamous non- small cell lung cancer (NSCLC). Methods: A partitioned survival model (PSM) was constructed based on the IMpower132 clinical trial. Total cost, quality- adjusted life years (QALY), and incremental cost-effectiveness ratio (ICER) were the main outputs of the model. Deterministic sensitivity analysis and probabilistic sensitivity analysis were adopted to test the uncertainty of the parameters. Results: The results of the base-case analysis illustrated that compared with PP, the incremental cost of APP was CNY 591040.94, the incremental utility was 0.46 QALY, and the ICER was CNY 1291414.83/QALY. Deterministic sensitivity analysis results illustrated that atezolizumab and other parameters have a greater impact on ICER. Probabilistic sensitivity analysis results show that no matter how each parameter changes, under the willingness to pay threshold of 3-times Chinese per capita GDP, the probability of APP has cost-effectiveness is 0. Conclusion: From the perspective of the Chinese health system, APP is not cost-effective for first-line treatment of non-squamous non-small cell lung cancer without sensitizing EGFR or ALK genetic alterations.展开更多
Lung cancer is the most common cause of death from oncological diseases all over the world. Primary treatment of patients with the early stage of non-small cell lung cancer is a surgery. However, after surgery 30% - 8...Lung cancer is the most common cause of death from oncological diseases all over the world. Primary treatment of patients with the early stage of non-small cell lung cancer is a surgery. However, after surgery 30% - 85% of patients undergo disease progression. In order to improve the results of treatment of patients with non-small cell lung cancer it is necessary to separate a group of patients with dismal prognosis for whom adjuvant chemotherapy will permit improving the survival rate. The aim of our research was to create a forecasting model with a view to detect the patients with the early stage of non-small cell lung cancer and dismal prognosis. Our research covered 254 patients with the early stage of non-small cell lung cancer who underwent a cure from June 2008 till December 2012 in the department of thoracic surgery of Zaporizhzhia Regional Clinical Oncologic Dispensary. In order to identify the factors connected with the risks of low survival rate of patients with the early stage of non-small cell lung cancer after curative treatment (surgical treatment, adjuvant chemotherapy), a method of design of neural network models of classification was used. 39 factors were taken for input characteristics. During investigation two forecasting models were built. As follows from the analysis of first forecasting model with the increase of the patient’s BMI, the risk of low patient survival rate statistically and significantly (p = 0.03) decreases, OR = 0.89 (95% CI 0.80 - 0.99) for each kg/m2 index value. The risk of low patient survival rate also decreases (p = 0.02) if he has a squamous cell carcinoma, OR = 0.36 (95% CI 0.15 - 0.88) compared with other histological forms of tumor. The connection between the risk of low patient survival rate and the volume of surgical intervention was discovered (p = 0.01), OR = 3.19 (95% CI 1.29 - 7.86) for patients who underwent a pulmonectomy compared with patients who underwent an upper bilobectomy. As follows from the analysis of second forecasting model with the increase of the patient’s BMI the risk of low patient survival rate statistically and significantly (p = 0.01) decreases;OR = 0.84 (95% CI 0.74 - 0.96) for each kg/m2 index value. It is found that with the increasing level of EGFR expression in the primary tumor, the risk of low patient survival rate statistically and significantly increases (p = 0.04), OR = 1.39 (95% CI 1.01 - 1.90) for each graduation rate. The risk of low patient survival rate also increases when conducting the lymph dissection in the volume D0 - D1.展开更多
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: Kapl...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.展开更多
文摘Lung cancer is the leading cause of cancer mortality worldwide.Even with the applications of excision, radiotherapy, chemotherapy, and gene therapy, the 5 year survival rate is only 15% in the USA. Clinically relevant laboratory animal models of the disease could greatly facilitate understanding of the pathogenesis of lung cancer, its progression, invasion and metastasis. Transplanted lung cancer models are of special interest and are widely used today. Such models are essential tools in accelerating development of new therapies for lung cancer. In this communication we will present a brief overview of the hosts, sites and pathways used to establish transplanted animal lung tumor models.
基金supported by a grant from Cancer Council South Australia’s Beat Cancer Project on behalf of its donors and the State Government through the Department of Health (Grant No.1159924 and 1127220)funded by a Postdoctoral Fellowship from the National Breast Cancer Foundation, Australia (Grant No.PF-17-007)
文摘Objective: Several predictors of survival have been identified in EGFR-positive non-small cell lung cancer(NSCLC) patients treated with first generation EGFR inhibitors. Prognostic models of survival outcomes with afatinib have not been evaluated.Methods: A prognostic tool for overall survival(OS)/progression free survival(PFS) based on pre-treatment clinicopathological factors was developed for EGFR-positive advanced NSCLC patients treated with first-line afatinib using penalised regression of individual-participant data from LUX-Lung 3 and 6(n = 468). Favourable, intermediate and poor risk groups were identified and externally validated using LUX-Lung 1(n = 390) and LUX-Lung 2(n = 129) trials that initiated afatinib following previous chemotherapy or EGFR inhibitor treatment.Results: Discriminative performance was good in the development and validation cohorts. For patients treated with first-line afatinib, the median OS for the favourable, intermediate and poor risk groups were > 47.7, 29.3 and 16.4 months, respectively, and the median PFS were 17.3, 13.2 and 8.3 months, respectively. The improvement in median OS with afatinib use compared to chemotherapy was > 12.4 months for the favourable risk group, whereas no OS benefit was apparent for the poor risk group. The improvement in median PFS with afatinib use compared to chemotherapy was 10.2 months for the favourable risk group and 3.2 months for the poor risk group.Conclusions: A prognostic tool was developed and validated to identify favourable, intermediate and poor risk groups for OS/PFS in EGFR-positive advanced NSCLC patients treated with afatinib. The prognostic groups can inform the likely absolute OS/PFS benefit expected from afatinib compared to chemotherapy in first-line treatment.
文摘The object of our present study is to develop a piecewise constant hazard model by using an Artificial Neural Network (ANN) to capture the complex shapes of the hazard functions, which cannot be achieved with conventional survival analysis models like Cox proportional hazard. We propose a more convenient approach to the PEANN created by Fornili et al. to handle a large amount of data. In particular, it provides much better prediction accuracies over both the Poisson regression and generalized estimating equations. This has been demonstrated with lung cancer patient data taken from the Surveillance, Epidemiology and End Results (SEER) program. The quality of the proposed model is evaluated by using several error measurement criteria.
文摘In the past decades a lot of investigations were focused on searching for more accurate markers of lung cancer progression. Researchers indicate that molecular markers may be useful in forecasting of treatment outcome and overall survival rate in patients with non-small cell lung cancer. The aim of our research was to create a forecasting model in order to identify patients with stage I-II of non-small cell lung cancer and dismal prognosis. Our research covered 254 patients with the early stage of non-small cell lung cancer who underwent a cure from June 2008 till December2012 inthe Department of Thoracic Surgery of Zaporizhzhia Regional Clinical Oncologic Dispensary. Surgery was performed for all patients. Adjuvant chemotherapy was performed for 101 patients. In order to carry out multivariate Cox-regression analysis, STATISTICA 6.0 (StatSoft Inc.) program was used. The most significant from 39 variables were selected (tumor size, histological form of tumor, volume of surgical intervention, volume of conducted lymph node dissection, Ki-67 expression, EGFR expression, E-cadherin expression). We propose the computer system which can forecast survival rate in patients with the early stage of non-small cell lung cancer.
基金supported by grants from the Young Science Foundation of Wuhan Central Hospital(No.YQ15A01)the National Natural Science Foundation of China(No.81501985and No.81272590)
文摘Summary： The type 1 insulin-like growth factor receptor （IGF-1R） and its downstream signaling com- ponents have been increasingly recognized to drive the development of malignancies, including non-small cell lung cancer （NSCLC）. This study aimed to investigate the effects of IGF-1R and its in- hibitor, AG1024, on the progression of lung cancer. Tissue microarray and immunohistochemistry were employed to detect the expressions of IGF-1 and IGF-1R in NSCLC tissues （n=198）. Western blotting was used to determine the expressions oflGF-1 and phosphorylated IGF-1R （p-IGF-1R） in A549 human lung carcinoma cells, and MTT assay to measure cell proliferation. Additionally, the expressions of IGF-1, p-IGF-1R and IGF-1R in a mouse model of lung cancer were detected by Western blotting and real-time fluorescence quantitative polymerase chain reaction （FQ-PCR）, respectively. The results showed that IGF-1 and IGF-1R were overexpressed in NSCLC tissues. The expression levels of IGF-1 and p-IGF-1R were significantly increased in A549 cells treated with IGF-1 as compared to those treated with IGF-1 ＋AG 1024 or untreated cells. In the presence of IGF-1, the proliferation of A549 cells was significantly increased. The progression of lung cancer in mice treated with IGF-1 was significantly increased as compared to the group treated with IGF-l＋AG1024 or the control group, with the same trend mirrored in IGF-1/p-IGF-1R/IGF-1R at the protein and/or mRNA levels. It was concluded that IGF- 1 and IGF inhibitor AG 1024 promotes lung cancer progression.
文摘To evaluate the diagnosis model of serum tumor biomarker and several clinical features diagnose and classification for lung cancer, the solid protein chip technology (C-12) was used to detect the biomarkers of SF, CEA, CA242, NSE, CA125, CA19-9 and CA15-3 in serum and several clinical features of tumors and benign disease in elderly lung cancer patients were collected. Set up a discriminating analysis as a function diagnostic model in clinical elderly lung cancer diagnosis and sub-type discrimination. In combination of 2 obvious clinical indicators and 2 serum markers, it is possible to provide a diagnosis tool for lung cancer. With the help of mathematic model, it is promising to reduce the misjudgment risk based on the previous experience and therefore establish a reliable diagnosing function. This model is simple, cost-effective and easy to adapt in practice, and can also be used in screening of large population.
基金supported by Foundation and Frontier Issues of Science and Technology Department of Henan Province (NO.122300410066)
文摘Objective:To identify the influence on radiosensitivity of lung glandular cancer cells when excisions repair cross-complementing group1(ERCC1) gene was silenced by targeted siR NA.Methods:siR NA which targeting to ERCC1 and control siR NA was designed and synthesized.The human lung glandular cancer SPC-A-1 cells was transfected.A total of 56 nude mice were divided into two groups,and two kinds of SPC-A-1 cells were transplanted to armpit of right forelimb,to establish the nude mice subcutaneous xenotransplanted tumor model of human lung glandular cancer cells.After the tumor was developed,the nude mice were randomly divided into four groups and accepted different doses of X-Ray radiation,then the change of tumor volume,survival time of mice in every group were recorded and the average lifetime was calculated.Twenty-one days later of X-ray experiment,two mice were taken and sacrificed in each group and the tumors organizations were stripped.The cell apoptosis rate and cell cycle distributions were obtained by FCM(flow cytometry).Results:The volume of tumor which ERCC1 gene was silenced was less than single irradiation group after X-ray irradiation,and the growth speed was slower and the lifetime of mice was lengthened as well(P<0.05).The cells apoptosis rate and the rate of G2/M cells which ERCC1 gene was silenced were higher than the same dose control group and the rate of G_1 cells were lower,which indicated that the cells could be stopped at G_2/M point,the cell proliferation was inhibited,the cell apoptosis was promoted and the radiation sensitivity was improved after the ERCC1 was silenced.Conclusions:The radiation sensitivity of lung glandular tumor could be improved after the ERCC1 gene was silenced by siR NA.
基金supported by the National High Technology Research and Development Program of China(No.2012AA02A501)the Special Fund for Public Health Trade(No.201202014)
文摘Background:With industrial and economic development in recent decades in South China,cancer incidence may have changed due to the changing lifestyle and environment.However,the trends of lung cancer and the roles of smoking and other environmental risk factors in the development of lung cancer in rural areas of South China remain unclear.The purpose of this study was to explore the lung cancer incidence trends and the possible causes of these trends.Methods:Joinpoint regression analysis and the age-period-cohort(APC) model were used to analyze the lung cancer incidence trends in Sihui,Guangdong province,China between 1987 and 2011,and explore the possible causes of these trends.Results:A total of 2,397 lung cancer patients were involved in this study.A 3-fold increase in the incidence of lung cancer in both sexes was observed over the 25-year period.Joinpoint regression analysis showed that while the incidence continued to increase steadily in females during the entire period,a sharp acceleration was observed in males starting in 2005.The full APC model was selected to describe age,period,and birth cohort effects on lung cancer incidence trends in Sihui.The age cohorts in both sexes showed a continuously significant increase in the relative risk(RR)of lung cancer,with a peak in the eldest age group(80-84 years).The RR of lung cancer showed a fluctuating curve in both sexes.The birth cohorts identified an increased trend in both males and females;however,males had a plateau in the youngest cohorts who were born during 1955-1969.Conclusions:Increasing trends of the incidence of lung cancer in Sihui were dominated by the effects of age and birth cohorts.Social aging,smoking,and environmental changes may play important roles in such trends.
文摘Objective: To evaluate the cost-effectiveness of atezolizumab plus pemetrexed and platinum-based (APP) in the first-line treatment of non-squamous non- small cell lung cancer (NSCLC). Methods: A partitioned survival model (PSM) was constructed based on the IMpower132 clinical trial. Total cost, quality- adjusted life years (QALY), and incremental cost-effectiveness ratio (ICER) were the main outputs of the model. Deterministic sensitivity analysis and probabilistic sensitivity analysis were adopted to test the uncertainty of the parameters. Results: The results of the base-case analysis illustrated that compared with PP, the incremental cost of APP was CNY 591040.94, the incremental utility was 0.46 QALY, and the ICER was CNY 1291414.83/QALY. Deterministic sensitivity analysis results illustrated that atezolizumab and other parameters have a greater impact on ICER. Probabilistic sensitivity analysis results show that no matter how each parameter changes, under the willingness to pay threshold of 3-times Chinese per capita GDP, the probability of APP has cost-effectiveness is 0. Conclusion: From the perspective of the Chinese health system, APP is not cost-effective for first-line treatment of non-squamous non-small cell lung cancer without sensitizing EGFR or ALK genetic alterations.
文摘Lung cancer is the most common cause of death from oncological diseases all over the world. Primary treatment of patients with the early stage of non-small cell lung cancer is a surgery. However, after surgery 30% - 85% of patients undergo disease progression. In order to improve the results of treatment of patients with non-small cell lung cancer it is necessary to separate a group of patients with dismal prognosis for whom adjuvant chemotherapy will permit improving the survival rate. The aim of our research was to create a forecasting model with a view to detect the patients with the early stage of non-small cell lung cancer and dismal prognosis. Our research covered 254 patients with the early stage of non-small cell lung cancer who underwent a cure from June 2008 till December 2012 in the department of thoracic surgery of Zaporizhzhia Regional Clinical Oncologic Dispensary. In order to identify the factors connected with the risks of low survival rate of patients with the early stage of non-small cell lung cancer after curative treatment (surgical treatment, adjuvant chemotherapy), a method of design of neural network models of classification was used. 39 factors were taken for input characteristics. During investigation two forecasting models were built. As follows from the analysis of first forecasting model with the increase of the patient’s BMI, the risk of low patient survival rate statistically and significantly (p = 0.03) decreases, OR = 0.89 (95% CI 0.80 - 0.99) for each kg/m2 index value. The risk of low patient survival rate also decreases (p = 0.02) if he has a squamous cell carcinoma, OR = 0.36 (95% CI 0.15 - 0.88) compared with other histological forms of tumor. The connection between the risk of low patient survival rate and the volume of surgical intervention was discovered (p = 0.01), OR = 3.19 (95% CI 1.29 - 7.86) for patients who underwent a pulmonectomy compared with patients who underwent an upper bilobectomy. As follows from the analysis of second forecasting model with the increase of the patient’s BMI the risk of low patient survival rate statistically and significantly (p = 0.01) decreases;OR = 0.84 (95% CI 0.74 - 0.96) for each kg/m2 index value. It is found that with the increasing level of EGFR expression in the primary tumor, the risk of low patient survival rate statistically and significantly increases (p = 0.04), OR = 1.39 (95% CI 1.01 - 1.90) for each graduation rate. The risk of low patient survival rate also increases when conducting the lymph dissection in the volume D0 - D1.
文摘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.
