-
Medicine Jun 2020The aim of this study is to examine the efficacy of weekly amrubicin (WA) for treating refractory or relapsed non-small cell lung cancer (RRNSCLC).
BACKGROUND
The aim of this study is to examine the efficacy of weekly amrubicin (WA) for treating refractory or relapsed non-small cell lung cancer (RRNSCLC).
METHODS
The literature search will be performed using the Cochrane Library, MEDLINE, EMBASE, CINAHL, PsycINFO, Scopus, Chinese Biomedical Literature Database, WANGFANG, VIP database, and China National Knowledge Infrastructure from inception onwards up to the March 1, 2020. No language limitation will be implemented. Randomized controlled trials that examined the efficacy and safety of WA for the treatment of RRNSCLC will be included. Literature selection, data extraction, and methodological quality assessment will be handled by 2 independent authors. We will invite a third author to disentangle any divergences between 2 authors. We will carry out statistical analysis using RevMan 5.3 software.
RESULTS
This study will summarize current evidence to assess the efficacy and safety of WA for the treatment of RRNSCLC.
CONCLUSIONS
The findings of this study will provide helpful evidence for the clinician, and will promote further studies, as well as clarify the direction of research on WA for the management of RRNSCLC.Study registration number: INPLASY202040168.
Topics: Anthracyclines; Antineoplastic Agents; Carcinoma, Non-Small-Cell Lung; Humans; Lung Neoplasms; Meta-Analysis as Topic; Neoplasm Recurrence, Local; Systematic Reviews as Topic
PubMed: 32569168
DOI: 10.1097/MD.0000000000020454 -
Hinyokika Kiyo. Acta Urologica Japonica Apr 2020A 68-year-old man was diagnosed with prostate cancer (initial serum prostate specific antigen [PSA] 389 ng/ml, stage cT4N1M1c, Gleason score 5+4), and androgen...
A 68-year-old man was diagnosed with prostate cancer (initial serum prostate specific antigen [PSA] 389 ng/ml, stage cT4N1M1c, Gleason score 5+4), and androgen deprivation therapy was initiated. Despite the low serum PSA level, he developed postrenal acute kidney failure 4 years later, with progression of prostate cancer and liver and lung metastases. Serum levels of neuron-specific enolase and pro-gastrinreleasing peptide (tumor markers) were elevated. He underwent re-biopsy of the prostate, and histopathological examination revealed small cell carcinoma. He was initially treated with carboplatin and etoposide therapy. Liver metastases showed partial remission, and serum tumor marker levels were temporarily reduced. However, disease progression was observed after 4 chemotherapy cycles, and he was then treated with an 8-cycle course of amrubicin. Metastases showed shrinkage, and serum tumor marker levels were reduced after 2 chemotherapy cycles. Tumor enlargement recurred after 8 cycles, and the patient is being treated with palliative therapy. Amrubicin therapy may be effective in the treatment of small cell carcinoma of the prostate.
Topics: Aged; Androgen Antagonists; Anthracyclines; Carcinoma, Small Cell; Humans; Male; Neoplasm Recurrence, Local; Prostate-Specific Antigen; Prostatic Neoplasms
PubMed: 32483946
DOI: 10.14989/ActaUrolJap_66_4_121 -
Oxford Medical Case Reports Apr 2020The transformation of adenocarcinoma to small cell lung cancer has been reported as acquisition of resistance to epidermal growth factor receptor (EGFR)-tyrosine kinase...
The transformation of adenocarcinoma to small cell lung cancer has been reported as acquisition of resistance to epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors. We here report a patient who presented histologically confirmed transformation of adenocarcinoma to small cell lung cancer after treatment with immune checkpoint inhibitor. A 65-year-old man was treated with pembrolizumab as first-line therapy and achieved temporarily a stable disease with progression after six cycles of this agent. At that stage, a transbronchial biopsy showed small cell lung cancer, and he was found to have high serum concentrations of neuron-specific enolase despite concentrations of numerous tumor markers, including neuron-specific enolase, having been within normal limits at the time of presentation. The patient thereafter was treated as a small cell carcinoma patient using cisplatin plus irinotecan and amrubicin.
PubMed: 32477576
DOI: 10.1093/omcr/omaa026 -
Thoracic Cancer Jul 2020The aim of this study was to assess the efficacy and safety of amrubicin for previously treated malignant pleural mesothelioma.
BACKGROUND
The aim of this study was to assess the efficacy and safety of amrubicin for previously treated malignant pleural mesothelioma.
METHODS
The eligibility criteria were: previously treated unresectable malignant pleural mesothelioma; performance status 0-1; age ≤ 75; adequate hematological, hepatic, and renal function. The patients were injected with 35 mg/m amrubicin on days one, two, and three every 3-4 weeks. The planned number of patients was 32.
RESULTS
The study was terminated due to delay in enrollment and 10 patients were subsequently enrolled (nine males and one female; median age 67 [range 49-73]), of which four had epithelioid tumors, three had sarcomatoid tumors and three had biphasic tumors, respectively. According to the International Mesothelioma Interest Group (IMIG), one, four, and four patients had stage II, III, and IV, respectively, and one had postoperative recurrence. There was one (10%) partial response, four (40%) had stable disease, and five (50%) patients exhibited disease progression. The overall response and disease control rates were 10% (95% CI: 0.3-44.5%) and 60% (95% CI: 26.2-87.8%), respectively. The median progression-free survival time was 1.6 months. The median overall survival time was 6.6 months, and the one-, two-, and three-year survival rates were 23%, 23%, and 0%, respectively. The observed grade 3 or 4 toxicities included neutropenia in six (60%) patients; leukopenia in five (50%) patients; and febrile neutropenia, thrombocytopenia, anemia, and pneumonia in one (10%) patient each.
CONCLUSIONS
There was not enough data to evaluate the efficacy because the study was terminated early. However, amrubicin showed limited activity and acceptable toxicities when used in previously treated malignant pleural mesothelioma patients.
Topics: Aged; Anthracyclines; Antineoplastic Agents; Female; Follow-Up Studies; Humans; Male; Mesothelioma, Malignant; Middle Aged; Neoplasm Recurrence, Local; Pleural Neoplasms; Prognosis; Salvage Therapy; Survival Rate
PubMed: 32462731
DOI: 10.1111/1759-7714.13490 -
Therapeutic Advances in Medical Oncology 2020There is no standard second-line treatment for patients with advanced extra-pulmonary poorly differentiated neuroendocrine carcinoma (EP-PD-NEC). This study explored... (Review)
Review
BACKGROUND
There is no standard second-line treatment for patients with advanced extra-pulmonary poorly differentiated neuroendocrine carcinoma (EP-PD-NEC). This study explored data evaluating second-line treatment in these patients.
METHODS
A search of MEDLINE and EMBASE identified studies reporting survival and/or response data for patients with EP-PD-NEC receiving second-line therapy. Association between various factors (age, gender, ECOG performance status, primary tumour location, morphology, Ki-67, treatment and grade 3/4 haematological toxicity) and response rate (RR), progression-free (PFS) and overall survival (OS) were assessed with a mixed effects meta-regression weighted by individual study sample size. Due to a small sample size, associations were reported quantitatively, based on magnitude of beta coefficient rather than statistical significance.
RESULTS
Of 83 identified studies, 19 were eligible, including 4 prospective and 15 retrospective studies. Analysis comprised 582 patients, with a median number of 19 patients in each study (range 5-100). Median age was 59 years (range 53-66). Median RR was 18% (range 0-50; 0% for single-agent everolimus, temozolomide, topotecan; 50% with amrubicin), median PFS was 2.5 months (range 1.15-6.0) and median OS was 7.64 months (range 3.2-22.0). Studies with a higher proportion of patients with a Ki-67>55% had lower RR (β = -0.73) and shorter OS (β = -0.82).
CONCLUSION
Second-line therapy for patients with advanced EP-PD-NEC has limited efficacy and the variety of regimens used is diverse. Ki-67>55% is associated with worse outcomes. Prospective randomised studies are warranted to enable exploration of new treatment strategies.
PubMed: 32426044
DOI: 10.1177/1758835920915299 -
In Vivo (Athens, Greece) 2020Limited information is available on the occurrence of synchronous malignancy in patients with advanced thymic cancer (TC) who have achieved long-term survival due to...
BACKGROUND
Limited information is available on the occurrence of synchronous malignancy in patients with advanced thymic cancer (TC) who have achieved long-term survival due to sequential chemotherapy. Here, we present two cases of hematological malignancies in long-term survivors with advanced TC.
CASE REPORTS
A 56-year-old man underwent surgical resection following the diagnosis of TC with a histological indication of squamous cell carcinoma. He received sequential chemotherapy, including carboplatin plus paclitaxel, amrubicin, and S-1, due to multiple pulmonary metastases. After >4 years of first-line chemotherapy, he developed consistent myelosuppression and a definite diagnosis of acute promyelocytic leukemia was made following bone marrow analysis. A 49-year-old man with advanced TC received carboplatin plus paclitaxel with amrubicin as second-line therapy due to recurrence. Amrubicin was administered for 54 cycles but T-cell lymphoblastic lymphoma without recurrence of TC was confirmed following transbronchial nodal biopsy due to marked lymphadenopathy.
CONCLUSION
Physicians should be alert to the occurrence of hematological malignancy in patients with thymic cancer.
Topics: Cancer Survivors; Combined Modality Therapy; Hematologic Neoplasms; Humans; Male; Middle Aged; Neoplasm Staging; Neoplasms, Second Primary; Positron Emission Tomography Computed Tomography; Thymus Neoplasms; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 32354955
DOI: 10.21873/invivo.11938 -
In Vivo (Athens, Greece) 2020Concurrent chemoradiotherapy (CCRT) is the gold standard for limited-stage small-cell lung cancer (LS-SCLC); however, most patients inevitably experience relapse. We...
BACKGROUND
Concurrent chemoradiotherapy (CCRT) is the gold standard for limited-stage small-cell lung cancer (LS-SCLC); however, most patients inevitably experience relapse. We hypothesized consolidation amrubicin following CCRT to be a potential treatment for LS-SCLC.
PATIENTS AND METHODS
All enrolled patients were treated using induction CCRT consisting of four cycles of etoposide and cisplatin plus concurrent thoracic radiotherapy. Eligible patients then received three cycles of amrubicin as consolidation therapy (consolidation population). The primary endpoint was the 2-year progression-free survival rate in the consolidation population.
RESULTS
Of the 36 intention-to-treat patients, 28 (78%) received amrubicin and 24 (67%) completed all planned treatments. The 2-year progression-free survival rate and overall response rate were 35.7% and 86%, respectively. The median progression-free and overall survival were 14.3 and 60.9 months, respectively. There were no treatment-related deaths in the intention-to-treat population.
CONCLUSION
This study was terminated due to slow patient accrual; however, this treatment strategy was feasible and demonstrated promising efficacy.
Topics: Aged; Anthracyclines; Antineoplastic Agents; Chemoradiotherapy; Combined Modality Therapy; Consolidation Chemotherapy; Female; Humans; Lung Neoplasms; Male; Middle Aged; Neoplasm Staging; Small Cell Lung Carcinoma; Treatment Outcome
PubMed: 32111801
DOI: 10.21873/invivo.11855 -
Thoracic Cancer Feb 2020Amrubicin chemotherapy is a treatment option for patients with non-small cell lung cancer (NSCLC) after third-line treatment in Japan. Although topoisomerase-II...
BACKGROUND
Amrubicin chemotherapy is a treatment option for patients with non-small cell lung cancer (NSCLC) after third-line treatment in Japan. Although topoisomerase-II (Topo-II), a target of amrubicin, has been reported to be a prognostic or predictive marker for chemosensitivity and clinical outcomes in various types of malignancies, its effects in the Japanese population remain unknown.
METHODS
Data regarding 44 patients with advanced NSCLC treated with amrubicin between April 2004 and May 2014 were retrospectively analyzed. We evaluated the expression levels of Topo-II by immunohistochemical staining of tumor specimens obtained via biopsy or surgical resection.
RESULTS
The majority of enrolled patients were men (68%) with a median age of 67 (range, 43-78) years. The most common histological type was adenocarcinoma (70%). High Topo-II expression was observed in 13 (30%) of the 44 patients. The median progression-free survival and overall survival (OS) durations were 1.8 and 8.8 months, respectively. While there was no significant association between Topo-II expression and progression-free survival, patients with low Topo-II expression had significantly longer OS than did those with high Topo-II expression. Good performance status and low expression of Topo-II were all significantly associated with a favorable OS.
CONCLUSION
Low expression of Topo-II was identified as an independent prognostic factor for longer survival in patients with NSCLC receiving amrubicin, a Topo-II inhibitor.
KEY POINTS
Significant findings of the study The median progression-free survival and overall survival (OS) durations were 1.8 and 8.8 months, respectively. While there was no significant association between Topo-II expression and progression-free survival, patients with low Topo-II expression had significantly longer OS than did those with high Topo-II expression. Good performance status and low expression of Topo-II were all significantly associated with a favorable OS. What this study adds This study is the first to assess the effects of topoisomerase-II (Topo-II), a target of amrubicin, as a prognostic or predictive marker for chemosensitivity and clinical outcomes in the Japanese population.
Topics: Adult; Aged; Anthracyclines; Antineoplastic Agents; Biomarkers, Tumor; Carcinoma, Non-Small-Cell Lung; DNA Topoisomerases, Type II; Female; Follow-Up Studies; Gene Expression Regulation, Enzymologic; Gene Expression Regulation, Neoplastic; Humans; Lung Neoplasms; Male; Middle Aged; Prognosis; Retrospective Studies; Survival Rate
PubMed: 31901017
DOI: 10.1111/1759-7714.13289 -
In Vivo (Athens, Greece) 2019To evaluate treatment efficacy of cisplatin, etoposide, and irinotecan combined therapy (PEI), platinum-rechallenge chemotherapy (Pt-Re) and amrubicin monotherapy (AMR)...
BACKGROUND/AIM
To evaluate treatment efficacy of cisplatin, etoposide, and irinotecan combined therapy (PEI), platinum-rechallenge chemotherapy (Pt-Re) and amrubicin monotherapy (AMR) for patients with sensitive relapsed small cell lung cancer (SCLC).
PATIENTS AND METHODS
We defined sensitive relapse as treatment-free interval (TFI) ≥90 days. We retrospectively collected patients' data from medical records between September 2002 and December 2016. Patients with sensitive relapsed SCLC who received second-line chemotherapy were separated into those treated with PEI, with Pt-Re, or with AMR.
RESULTS
Seventy-one patients (16 PEI group, 27 Pt-Re group, and 28 AMR group) were assessable for efficacy. No significant differences in patient characteristics were found among the three groups. The median overall survival (MST) was 29.3 months in the PEI group, 24.6 months in the Pt-Re group, and 20.6 months in the AMR group (p=0.042).
CONCLUSION
A significant difference was observed in the overall survival of patients treated with PEI, Pt-Re and AMR and the MST of PEI was the longest.
Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Female; Humans; Kaplan-Meier Estimate; Lung Neoplasms; Male; Middle Aged; Prognosis; Recurrence; Retreatment; Retrospective Studies; Small Cell Lung Carcinoma; Treatment Outcome
PubMed: 31662561
DOI: 10.21873/invivo.11727 -
Internal Medicine (Tokyo, Japan) Jan 2020Paraneoplastic syndromes are frequently observed in lung cancer, especially in small cell lung cancer (SCLC). Although there have been many reports on paraneoplastic...
Paraneoplastic syndromes are frequently observed in lung cancer, especially in small cell lung cancer (SCLC). Although there have been many reports on paraneoplastic syndromes, few reports have been published on SCLC that simultaneously produces antidiuretic hormone (ADH) and adrenocorticotropic hormone (ACTH), and these reports described the prognosis of such cases as extremely poor. We herein present a rare case of a Japanese woman with SCLC accompanied by syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and Cushing's syndrome. The survival of the patient was prolonged by the long-term administration of amrubicin.
Topics: Adrenocorticotropic Hormone; Aged; Anthracyclines; Antineoplastic Agents; Cushing Syndrome; Female; Humans; Inappropriate ADH Syndrome; Lung Neoplasms; Paraneoplastic Syndromes; Prognosis; Small Cell Lung Carcinoma; Survival Rate; Vasopressins
PubMed: 31511478
DOI: 10.2169/internalmedicine.2838-19