Clinical Observation on Treatment of NonParvicellular Carcinoma of the Lung with Jin Fu Kang Oral Liquid

Jin Fu 坑口头的液体([标志：看见文本]) 用为补充 qi 和有营养的 yin 的繁体中文药做的，与 qi 和 yin 的缺乏在肺癌根据普通症状被开发。在 Jin Fu 坑组的 96 个盒子， 1 个盒子变得完全宽恕(CR ) 术后疗法， 8 个盒子部分宽恕(PR ) ， 52 个盒子不变化(NC ) ，盖住 63.5% 的 PR + NC。在 Jin Fu 坑正化疗的组的 52 个盒子， 11 个盒子得到了 PR 术后疗法， 26 盒子 NC，盖住 71.2% 的 PR + NC。在化疗组的 25 个盒子， 4 个盒子得到了 PR 术后疗法， 11 盒子 NC，盖住 60.0% 的 PR + NC。在 Jin Fu 坑的治疗学的有效性组织的结果表演和 Jin Fu 坑正化疗的组在化疗组比那好。在 Jin Fu 坑组的一个年幸存率和二年的幸存率术后疗法分别地是 67.3% 和 67.3% ；66.7% 和 66.7% 在 Jin Fu 坑正化疗的组；并且 40.3% 和 0.0% 在化疗组织。临床的症状的改进，体重的增加和健康状况(KPS 标记) 的改进 Jin Fu 坑组织的在两个的术后疗法和 Jin Fu 坑正化疗的组在化疗组比那好。免疫学和血克术后疗法的一些指示物极大地在 Jin Fu 坑组，被改进在化疗组，而是在 Jin Fu 坑正化疗的组的没有明显的改进更坏。

Advances in adjuvant systemic therapy for non-small-cell lung cancer

Non-small-cell lung cancer remains a leading cause of death around the world. For most cases, the only chance of cure comes from resection for localised disease, however relapse rates remain high following surgery. Data has emerged over recent years regarding the utility of adjuvant chemotherapy for improving disease-free and overall survival of patients following curative resection. This paper reviews the clinical trials that have been conducted in this area along with the studies integrating radiation therapy in the adjuvant setting. The role of prognostic gene signatures are reviewed as well as ongoing clinical trials including those incorporating biological or targeted therapies.

Molecular Mechanisms Contributing to Resistance to Tyrosine Kinase-Targeted Therapy for Non-Small Cell Lung Cancer

One of the most important pathways in non-small cell lung cancer(NSCLC) is the epidermal growth factor receptor(EGFR) pathway. This pathway affects several crucial processes in tumor development and progression,including tumor cell proliferation,apoptosis regulation,angiogenesis,and metastatic invasion.Targeting EGFR is currently being intensely explored.We are witnessing the development of a number of potential molecular-inhibiting treatments for application in clinical oncology.In the last decade,the tyrosine kinase(TK) domain of the EGFR was identified in NSCLC patients,and it has responded very well with a dramatic clinical improvement to TK inhibitors such are gefitinib and erlotinib.Unfortunately,there were primary and/or secondary resistance to these treatments,as shown by clinical trials.Subsequent molecular biology studies provided some explanations for the drug resistance phenomenon.The molecular mechanisms of resistance need to be clarified.An in-depth understanding of these targeted-therapy resistance may help us explore new strategies for overcoming or reversing the resistance to these inhibitors for the future of NSCLC treatment.

Unresectable stage Ⅲ non-small-cell lung cancer: Have we made any progress?

Lung cancer is responsible for the most cancer deaths worldwide with an incidence that is still rising. One third of patients have unresectable stage ⅢA or stage ⅢB disease. The standard of care for locally advanceddisease in patients with good performance status consists of combined modality therapy in particular concurrent chemoradiotherapy. But despite a lot of efforts done in the past, local control and survival of patients with unresectable stage Ⅲ non-small-cell lung cancer(NSCLC) remains poor. Improving outcomes for patients with unresectable stage Ⅲ NSCLC has therefore been an area of ongoing research. Research has focused on improving systemic therapy, improving radiation therapy or adding a maintenance therapy to consolidate the initial therapy. Also implementation of newer targeted therapies and immunotherapy has been investigated as well as the option of prophylactic cranial irradiation. This article reviews the latest literature on improving local control and preventing distant metastases. It seems that we have reached a plateau with conventional chemotherapy. Radiotherapy dose escalation did not improve outcome although increasing radiation dose-intensity with new radiotherapy techniques and the use of newer agents, e.g., immunotherapy might be promising. In the future well-designed clinical trials are necessary to prove those promising results.

The Therapeutic Effects of the Radiotherapy Plus TCM Treatment Observed in Senile Non-Parvicellular Lung Cancer Patients at the Late Stage

47 senile non-parvicellular lung cancer patients at stage Ⅲ or Ⅳ were randomly divided into a treatment group (26 cases) treated by radiotherapy plus traditional Chinese medicine (TCM) and a control group (21 cases) treated only by radiotherapy for observation of the therapeutic effects.

Clinical value of Tongguanteng(Radix seu Herba Marsdeniae Tenacissimae) extract combined with chemotherapy in the treatment of advanced non-small cell lung cancer： a Meta-analysis

OBJECTIVE: To investigate the clinical efficacy and safety of Tongguanteng(Radix seu Herba Marsdeniae Tenacissimae) extract combined with chemotherapy in the treatment of advanced non-small celllung cancer(NCSLC) compared with chemotherapy alone.METHODS: Databases including Chinese National Knowledge Infrastructure, China Biology Medicine Disc, Wanfang, and MEDLINE were searched until April 1, 2014. Two assessors independently reviewed each trial. The primary outcome was the effective rate(ER) of Tongguanteng(Radix seu Herba Marsdeniae Tenacissimae) extract combined with chemotherapy. The secondary outcomes included quality of life improvement rate(QOLIR) and adverse reactions. Statistical calculations were performed by using Cochrane Collaboration Review Manager 5.2.RESULTS: A total of 888 patients from 15 studies,13 randomized controlled trials(RCT) and two controlled clinical trials, were included. Compared with chemotherapy alone, Tongguanteng(Radix seu Herba Marsdeniae Tenacissimae) extract plus chemotherapy significantly improved ER [Risk ratio(RR) =1.32, 95% CI,(1.14, 1.54)](based on 15 studies) and QOLIR [RR = 2.04, 95% CI,(1.69, 2.47)](based on 13studies). Compared with chemotherapy alone,Tongguanteng(Radix seu Herba Marsdeniae Tenacissimae) extract plus chemotherapy significantly inhibited chemotherapy-induced white blood cell decline [RR = 0.79, 95% CI,(0.70, 0.90)(based on 10 studies), chemotherapy-induced platelet decline[RR = 0.77, 95% CI,(0.60, 0.98)](based on 8 studies),and significantly alleviated nausea and vomiting(NV) [RR = 0.83, 95% CI,(0.71, 0.97)](based on 7studies). There was no significant difference in hemoglobin decline between the two therapies [RR =0.88, 95% CI,(0.70, 1.09)](based on 6 studies).CONCLUSION: This Meta-analysis suggests that Tongguanteng(Radix seu Herba Marsdeniae Tenacissimae) extract combined with chemotherapy may be more efficacious in the treatment of advanced NSCLC than chemotherapy alone. This effect includes enhancing ER and QOLIR, and weakening chemotherapy toxicity. However, large-scale RCTs are required to further investigate the short- and long-term effects of Tongguanteng(Radix seu Herba Marsdeniae Tenacissimae) extract.

中药联合抗肿瘤血管生成药物治疗非小细胞肺癌的研究进展

非小细胞肺癌(NSCLC)是肺癌最为常见的一种病理类型,一半以上的患者确诊时即为进展期肺癌,患者生存期较短。抗肿瘤血管生成药物是目前治疗非小细胞肺癌的重要靶向药物,其临床疗效已获得临床认可,但仍存在耐药性及毒副作用不可耐受的局限性,而中药辨证论治及减毒增效的优点,可减轻药物的不良反应,并提高临床疗效,已成为中西医结合治疗非小细胞肺癌的重要方向。本文主要通过检索2010年1月—2023年6月中国知网、万方、维普及PubMed等数据库中的相关文献,总结近年来不同中药联合各类抗肿瘤血管生成药物治疗NSCLC的相关研究,试从不同角度探讨治疗NSCLC的新思路。

气管镜下介入联合药物注射治疗中央型非小细胞肺癌疗效与安全性研究

目的:评价气管镜下介入联合瘤体药物注射方法对于中央型非小细胞肺癌(non-small cell lung cancer,NSCLC)的有效性和安全性。方法:符合试验入排标准的64名患者,对纳入试验的患者按照1∶1的比例随机分配试验组和对照组,分别给予支气管镜下介入及局部注射顺铂、重组人血管内皮抑素联合含铂双药化疗与单纯含铂双药化疗,比较两组的疗效以及安全性。结果:与对照组相比,试验组患者Karnofsky功能状态(karnofsky performance status,KPS)评分、气促分级均得到明显改善(P<0.05)。试验组的治疗总有效率为78.12%,对照组的总有效率为37.5%,两组间比较差异具有统计学意义(P<0.05),两组生存情况比较差异有统计学意义(P<0.05)。结论:经支气管镜介入联合药物注射治疗中央型NSCLC临床疗效显著,能有效改善临床症状,提高患者生存质量。两组患者不良反应比较,无显著差异,值得推广应用。

奥希替尼在老年非小细胞肺癌患者靶向治疗中的应用效果及对T细胞水平的影响

目的 探讨奥西替尼在老年非小细胞肺癌患者靶向治疗中的效果及对免疫水平的影响。方法 回顾性选择2018年1月至2020年12月老年非小细胞肺癌患者116例研究,根据治疗方法不同分为2组,各58例。对照组采用常规放化疗治疗,观察组在对照组基础上联合奥西替尼治疗,3个月治疗后评估患者效果,比较2组总有效率、T细胞水平(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、肿瘤标志物水平、不良反应发生率。结果 观察组治疗3个月总有效率为44.8%高于对照组25.9%(P<0.05);2组治疗后3个月CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均低于治疗前(P<0.05);CD8^(+)水平高于治疗前(P<0.05);观察组治疗后3个月CD3^(+)(58.95±4.21)%、CD4^(+)(32.59±3.11)%、CD4^(+)/CD8^(+)(1.21±0.22)高于对照组(P<0.05);CD8^(+)(26.81±3.32)%低于对照组(P<0.05);观察组干预3个月后CA125(91±8)U/ml、CYFRA21-1(1.26±0.24)μg/L及癌胚抗原(CEA)水平(34±5)μg/L均低于对照组(P<0.05);2组不良反应发生率差异无统计学意义(P>0.05)。结论 奥西替尼用于老年非小细胞肺癌患者靶向治疗中,能获得较好的总有效率,对患者T细胞水平影响较小,可降低肿瘤标志物水平,未增加不良反应发生率,值得临床推广应用。

立体定向放射治疗在寡转移性非小细胞肺癌治疗中的联合应用

寡转移性非小细胞肺癌(NSCLC)不同于广泛转移的晚期NSCLC,针对寡转移灶局部治疗可获得潜在治愈的可能。立体定向放射治疗(SBRT)作为有效的局部治疗手段,联合化疗、络氨酸激酶抑制剂(TKIs)、免疫检查点抑制剂(ICIs)、抗血管生成等可以为晚期NSCLC病人带来生存获益。该文回顾了SBRT在寡转移性NSCLC的研究,从SBRT对寡转移性NSCLC的治疗效果、SBRT联合TKIs和SBRT联合ICIs的临床研究进展展开综述。

小分子靶向药物在晚期非小细胞肺癌治疗中的应用合理性评价

目的评价医院采用小分子靶向药物在晚期非小细胞肺癌治疗中的应用合理性,为临床合理用药提供依据。方法收集2021年1—12月于新疆医科大学第一附属医院收治的采用小分子靶向药物治疗的晚期非小细胞肺癌患者病例资料,根据药品说明书、《新型抗肿瘤药物临床应用指导原则(2020年版)》、临床诊疗指南等评价用药合理性。结果94例患者共使用小分子靶向药物136例次,共应用小分子靶向药物11种,总体使用频次中奥希替尼片使用频次最高(19.12%);科室分布中以肿瘤科和呼吸科用药患者最多,肿瘤科使用安罗替尼比例最高(29.31%),呼吸科使用阿美替尼、埃克替尼比例最高(均为23.33%);2021年全院小分子靶向药物中,用药频度位于前3位的分别为奥希替尼、吉非替尼、安罗替尼;限定日费用位于前3位的分别为阿来替尼、克唑替尼、塞瑞替尼;11种药物中,4种药物排序比>1,2种药物排序比=1,5种药物排序比<1;根据小分子靶向药物点评细则,对药物应用合理性进行评价。共发现用药不适宜33例次,超说明书用药2例次。结论对于小分子靶向药物用于晚期NSCLC治疗中,医院在药物选择、剂量、联合用药、超说明书使用等方面存在问题。临床工作中医师应及时与患者、药师、护士进行沟通,不断优化肿瘤患者的治疗方案。同时,医院应建立健全管理制度,不断规范临床用药,为患者安全、有效、合理用药提供保障。

中药联合分子靶向药物治疗非小细胞肺癌用药规律

目的:收集整理中药联合靶向治疗非小细胞肺癌文献数据,分析常用中药组方规律。方法:通过检索中国生物医学文献数据库、万方数据库、中国知网中中药联合靶向药物治疗非小细胞肺癌临床观察的文献,经筛选后运用古今医案云平台进行频次分析、聚类分析、关联规则分析、复杂网络分析等。结果:使用频次排名前3的药物为茯苓、白术、黄芪;功效以清热解毒最多见,中药四气、五味、归经以味甘、性平、归肺经为主;通过关联规则得出核心药对28个;聚类分析得到核心药组5类;复杂网络分析得出治疗非小细胞肺癌联合靶向治疗的核心处方共计11味药。结论:中药联合靶向药物治疗非小细胞肺癌核心中药为茯苓、白术、黄芪;治法以健脾益气为主,以六君子汤为基础方,同时配合燥湿化痰、清热解毒、养阴等治标。

非小细胞肺癌CT动态增强扫描定量参数与病理类型及靶向治疗远期预后的关系分析

目的:探讨非小细胞肺癌(NSCLC)CT动态增强扫描定量参数与病理类型及靶向治疗远期预后的关系。方法:回顾性分析116例NSCLC患者的临床资料。所有患者均予以作用于表皮生长因子受体(EGFR)的靶向药物治疗,于治疗前和治疗后1个月行CT动态增强扫描,获取定量参数[灌注值、强化峰值(PH)、肿块强化达到峰值时间(Tp)],并根据患者存活情况,分为死亡组(30例)和存活组(86例),分析灌注值、PH、Tp与病理类型及靶向治疗远期预后的关系。结果:治疗前,不同病理类型患者CT动态增强扫描定量参数比较,差异均无统计学意义(均P>0.05)。治疗后,灌注值、PH水平下降,Tp更大(均P<0.05)。治疗后,与死亡组比较,存活组灌注值、PH水平更低,Tp更大(P<0.05)。ROC曲线显示,灌注值预测NSCLC患者远期预后的AUC和截点值分别为0.822、0.19 mL·min^(-1)·mL^(-1),PH预测的AUC和截点值分别为0.780、57.61 HU,Tp预测的AUC和截点值分别为0.741、89.92 s;三者联合预测的AUC为0.960,高于单一参数预测(P<0.05)。结论:NSCLC患者CT动态增强扫描定量参数与病理类型无关,与靶向治疗远期预后密切相关。

Prognosis of R1-resection at the bronchial stump in patients with non-small cell lung cancer

Background The prognosis of R1-resection at the bronchial stump in patients with non-small cell lung cancer （NSCLC） remains unclear.This study intends to identify the prognostic factors and to optimize treatments for these patients under update conditions.Methods The data of 124 NSCLC patients who underwent R1-resection at the bronchial stump was reviewed.There were 41 patients in the surgery group （S）,21 in the postoperative radiotherapy （PORT） group （S＋R）,30 in the postoperative chemotherapy （POCT） group （S＋C）,and 32 in the PORT plus POCT group （S＋R＋C）.The constitute proportion in different groups was tested using the X2 method,univariate analysis was performed using the Kaplan-Meier and log-rank method,and multivariate analysis was done using the Cox hazard regression with entry factors including age,sex,pathological type and stage,classification of the residual disease,and treatment procedure.The process was performed stepwise backward with a maximum iteration of 20 and an entry possibility of 0.05 as well as an excluded possibility of 0.10 at each step.Results In univariate analysis,survival was more favorable for patients with squamous cell carcinoma,early pathological T or N stage,and chemotherapy or radiotherapy.There was no significant difference in the survival for patients with different types of the residual disease,except for the difference between patients with carcinoma in situ and lymphangiosis carcinomatosa （P=0.030）.The survival for patients receiving chemoradiotherapy was superior to that for those undergoing surgery alone （P=0.016）.In multivariate analysis,the pathological type （HR 2.51,95% CI 1.59 to 3.96,P=0.000）,pathological T （HR 1.29,95% CI 1.04 to 1.60,P=-0.021） or N stage （HR 2.04,95% CI 1.40 to 2.98,P=0.000）,and chemotherapy （HR 0.24,95% CI 0.13 to 0.43,P=0.000） were independent prognostic factors.Conclusion Patients with squamous cell carcinoma,early pathological T or N stage,or receiving chemotherapy had a more favorable prognosis.

Tolerability and toxicity of adjuvant cisplatin and gemcitabine for treating non-small cell lung cancer

Background The combination of cisplatin and vinorelbine is an evidence-supported regimen for adjuvant chemotherapy for treating non-small cell lung cancer （NSCLC）. But this doublet has considerable toxicity and unfavorable tolerability, and results in poor compliance. The cisplatin and gemcitabine regimen is one of the most active and well-tolerated regimens against advanced NSCLC, but its toxicity and tolerability has not been adequately evaluated in the adjuvant setting. Methods From a lung cancer database we retrospectively reviewed NSCLC patients receiving adjuvant chemotherapy of cisplatin （75 mg/m2） and gemcitabine （1250 mg/m2） between January 2005 and December 2011. Postoperative demographics, compliance to adjuvant therapy and toxicity were retrieved from medical records. Results A total of 132 patients met the criteria and were included in the study, 96 were male （72.7%） and 36 were female （27.3%）. Median age was 60.5 years old, range 29-75 years, and 41.7% of patients were 〉65 years old. Overall, 68.2% patients received all four planned cycles, and the cumulative dose delivered for gemcitabine was 8333 mg （83.3% of the planned dose） and cisplatin 248 mg （82.7% of the planned dose）. There were no treatment-related deaths. Grade 3/4 neutropenia developed in 47 patients （35.6%） and was the predominant hematologic toxicity. Common grade 3/4 non- hematologic toxicities were nausea/vomiting （22.0%）, infection （12.3%）, and febrile neutropenia （11.4%）. Conclusion Cisplatin and gemcitabine are feasible for use in the adjuvant setting with a favorable toxicity profile and superior tolerabilitv compared with Dublished data on cisDlatin and vinorelbine.

Clinical Observation on 271 Cases of Non-Small Cell Lung Cancer Treated with Yifei Kangliu Yin

To observe the effects of Yifei Kangliu Yin(YFKLY) in treating non-small cell lung cancer (NSCLC). Methods:Two hundred and seventy-one patients with NSCLC were randomly divided into three groups, Group A treated only by YFKLY, Group B treated by the combination of YFKLY and chemotherapy, and Group C treated only by chemotherapy as the control group for control. Results: (1) Of the 127 cases in Group A, 1 case got complete remission (CR), 13 got partial remission (PR), 89 had no change (NC), and 24 had progression of disease (PD), thus CR+PR+NC accounting for 81.10%; of the 80 patients in Group B, 17 got PR , 53 got NC, 10 got PD, PR+NC accounting for 87.50%; of the 64 cases of chemotherapy group, 7 cases got PR, 39 cases got NC, 18 cases got PD, PR+NC accounting for 71.88% (P<0.01). (2) The metastasis rate was 23.52% in Group A, 20.00% in Group B and 35.71% in Group C respectively after treatment. (3) The 1-, 2-, 3- and 4-year survival rate were 73.09%, 32.01%, 13.18% and 13.18% in Group A, 71.85%, 46.35%, 29.19% and 23.35% in Group B and 37.61%, 13.67%, 9.7% and 0% in Group C. The symptoms were improved, and Karnofsky score was elevated in Group A and B. Conclusion: YFKLY could increase survival rate and quality of life, decrease metastasis rate, and enhance the immune function in NSCLC patients.

Clinical benefit of gemcitabine plus cisplatin 3-week regimen for patients with advanced non-small cell lung cancer: a prospective observational study

Background Platinum-based chemotherapy has been proved effective in patients with advanced non-small cell lung cancer (NSCLC). This study evaluated the effectiveness and safety of first-line chemotherapy with gemcitabine plus cisplatin (GEM-Cis) 3-week regimen in routine care of Chinese patients with advanced NSCLC. Methods Two hundred and twenty-one patients with NSCLC stage IIIb or IV were enrolled and 209 were eligible for effectiveness and safety analysis. The median age was 58 (range 29 to 79) years. The percents of cases in stage Ⅳ and stage Ⅲb were 52.2% and 47.8%; of Karnofsky performance score (KPS) less than 80 and 80-100 were 37.3% and 62.7% and of adeno-cancer and non-adeno-cancer were 59.8% and 40.2%. The average number of completed chemotherapy cycles was three. Measures of effectiveness included clinical benefit, significant clinical response (SCR) and adverse effects of GEM-Cis in the treatment of NSCLC at stages Ⅲb/Ⅳ.Results KPS increased from 79±9 at baseline to 86±10 after chemotherapy (P<0.01). Lung cancer symptom scale (LCSS) score of pain, dyspnea and cough increased from 77±24, 74±22 and 63±19 to 92±15, 90±14 and 86± 15, respectively (P<0.01). The clinical benefit rate was 85.2% [95% confidence interval (CI) 80.3%-90.0%]. The SCR was 89.5% (95% CI 85.3%-93.7%). Median survival time was 7.8 months (95% CI 7.1 months-9.1 months). Sixty-four patients (30.6%) experienced an adverse effect that was deemed clinically significant. Only one patient (0.5%) was hospitalized due to chemotherapy related adverse effects. Life-threatening toxicity was observed in two patients (1.0%).Conclusion First-line chemotherapy with GEM-Cis in the routine care of Chinese patients with advanced NSCLC is effective and safe.

Advancements in next-generation sequencing for diagnosis and treatment of non-small-cell lung cancer

In recent years, lung cancer has been the most commonly diagnosed cancer globally; 1.6 million people died of lung cancer in 2012 globally, making lung cancer the leading cause of cancer-related deaths.1,2 Lung cancer can be mainly histologically classified into two types: non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC), ac-counting for approximately 85% and 15% of cases, respectively.3 NSCLC can be further classified as squamous cell carcinoma, adenocarcinoma, and large-cell lung carcinoma, among which lung adenocarci-noma is the most common primary malignant tumor. Unfortunately, most NSCLC cases are diagnosed at a late stage when the survival rate is low; the 5-year survival rate is approximately 16%.

去泛素化酶JOSD2通过调控DNA损伤修复影响非小细胞肺癌细胞对抗肿瘤药物的敏感性

目的:研究去泛素化酶含约瑟芬结构域2蛋白(JOSD2)对非小细胞肺癌(NSCLC)恶性进展的调控作用及其分子机制。方法:从基因表达数据库下载NSCLC转录组表达数据及临床资料,利用主成分分析、limma差异分析和基因表达量分析考察NSCLC中表达水平显著上调的去泛素化酶相关基因;利用KaplanMeier生存分析算法考察不同去泛素化酶对NSCLC患者总生存期的影响;利用基因本体论富集分析和基因集富集分析考察高表达JOSD2的患者中信号通路的变化情况;利用基因集变异分析和皮尔逊相关性分析考察JOSD2表达水平与DNA损伤反应(DDR)通路的相关性;利用蛋白质印迹法考察JOSD2和DNA损伤修复通路相关蛋白的表达水平;利用免疫荧光法考察JOSD2在细胞内亚定位的变化;利用磺酰罗丹明染色法考察敲低JOSD2对DNA损伤类药物的敏感性。结果:与癌旁组织比较,NSCLC组织中JOSD2的表达量显著上调(P<0.05),且与NSCLC患者的不良预后显著相关(P<0.05);与低表达JOSD2的组织比较,高表达JOSD2的NSCLC组织中DDR相关途径显著激活(均P<0.05),且JOSD2的表达水平与DDR相关途径激活程度呈显著正相关(均P<0.01);与对照组比较,过表达JOSD2显著促进NSCLC细胞系的DDR过程,此外,DNA损伤剂处理可显著提高JOSD2的细胞核定位,而敲低JOSD2显著增强NSCLC细胞对DNA损伤剂的敏感性(均P<0.05)。结论:JOSD2通过促进DNA损伤修复途径调控NSCLC的恶性进展,而敲低JOSD2可显著增强NSCLC细胞对DNA损伤剂的敏感性。

程序性死亡蛋白-1抑制剂单药治疗老年晚期非小细胞肺癌患者的疗效及安全性研究

背景以程序性死亡蛋白-1(PD-1)抑制剂为代表的免疫治疗近年来逐步成为晚期非小细胞肺癌(NSCLC)的标准治疗方案,改变了该病的治疗格局。大部分PD-1抑制剂相关研究排除了70或75岁以上的老年晚期NSCLC患者,使得老年患者使用PD-1抑制剂治疗的疗效及安全性数据相对较少。目的本研究旨在探讨PD-1抑制剂在老年晚期NSCLC患者中的疗效及安全性。方法选取2018年10月至2021年11月在甘肃中医药大学第四附属医院胸外科和肿瘤科接受PD-1抑制剂单药治疗的65岁及以上的晚期NSCLC患者,最终纳入符合标准的患者63例。本研究中PD-1抑制剂均为已经在中国获批上市的PD-1抑制剂单抗,包括卡瑞利珠单抗、信迪利单抗和帕博利珠单抗。通过医院电子病历系统整理患者接受治疗后的疗效及安全性数据,并对患者进行定期随访获取长期生存数据,随访至2022-03-15,收集患者PD-1抑制剂的疗效资料、老年晚期NSCLC患者的预后情况和接受PD-1抑制剂治疗的毒副作用情况,采用Cox比例风险模型探讨老年晚期NSCLC患者预后的影响因素。结果63例老年晚期NSCLC患者的中位年龄为71(65,89)岁。接受PD-1抑制剂治疗期间的最佳疗效评估结果显示无患者完全缓解,14例患者获得部分缓解,21例患者疾病稳定,28例患者疾病进展。PD-1抑制剂单药治疗晚期NSCLC患者的客观缓解率(ORR)为22.2%(14/63),疾病控制率(DCR)为66.7%(14/21)。预后数据提示63例老年晚期NSCLC患者的中位无进展生存期(PFS)为3.3(2.0,4.6)个月。中位OS为10.2(6.1,14.3)个月。接受PD-1单药治疗期间,63例老年晚期NSCLC中46例患者出现了治疗相关的毒副作用(73.0%),其中3级以上的毒副作用发生率为14.3%(9/63)。常见的毒副作用类型有乏力、腹泻、皮疹和肝功能异常,发生率分别为23.8%(15/63)、19.1%(12/63)、15.9%(10/63)和14.3%(9/63)。Cox比例风险回归分析结果显示,东部肿瘤协作组(ECOG)体质状态评分和转移病灶数目是老年晚期NSCLC患者接受PD-1抑制剂后PFS的独立影响因素(HR=0.56、0.48)。结论PD-1抑制剂单药在老年晚期NSCLC患者中具有初步的疗效和可耐受的安全性。ECOG体质状态评分和转移病灶数目可能是影响该类患者PFS的潜在风险因素。