• Title/Summary/Keyword: non-small cell

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Therapeutic Effects and Adverse Drug Reactions are Affected by Icotinib Exposure and CYP2C19 and EGFR Genotypes in Chinese Non-Small Cell Lung Cancer Patients

  • Chen, Jia;Zheng, Xin;Liu, Dong-Yang;Zhao, Qian;Wu, Yi-Wen;Tan, Fen-Lai;Wang, Yin-Xiang;Jiang, Ji;Hu, Pei
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7195-7200
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    • 2014
  • Background: The aim of this study was to evaluate how CYP2C19 affects icotinib and metabolite' exposure, and to determine whether the exposure and EGFR genotype influences survival time, tumor metastasis and adverse drug reactions. Materials and Methods: 274 NSCLC patients who accepted 125mg icotinib/t.i.d. were chosen from a phase III study. Blood samples were obtained in $672^{nd}$ ($4^{th}$ week) and $1,680^{th}$ hours ($10^{th}$ week), and plasma was used to quantify the concentration of icotinib and blood cells were sampled to check the genotypes. Clinical data were also collected at the same time, including EGFR genotypes. Plasma concentrations were assessed by HPLC-MS/MS and genotype by sequencing. All data were analyzed through SPSS 17.0 and SAS 9.2. Results: CYP 2C19 genotypes affected bio-transformation from icotinib to M24 and M26, especially in poor-metabolisers. Higher icotinib concentrations (>1000 ng/mL) not only increased patient PFS and OS but also reduced tumor metastasis. Patients with mutant EGFR experienced a higher median PFS and OS (234 and 627 days), especially those with the 19del genotype demonstrating higher PR ratio. Patients who suffered grade II skin toxicity had a higher icotinib exposure than those with grade I skin toxicity or no adverse effects. Liver toxic reactions might occur in patients with greater M20 and M23 plasma concentrations. Conclusions: CYP2C19 polymorphisms significantly affect icotinib, M24 and M26 exposure. Patients with mutant EGFR genotype and higher icotinib concentration might have increased PFS and OS and lower tumor metastasis. Liver ADR events and serious skin effects might be respectively induced by greater M20, M23 and icotinib concentrations.

The Ability of FDG Uptake Ratio and Glut-1 Expression to Predict Mediastinal Lymph Node Metastasis in Resected Non-small Cell Lung Cancer (절제된 비소세포암에서 FDG 섭취비와 Glut-1 발현 정도를 이용한 종격동 림프선 전이 여부 예측)

  • Cho, Suk-Ki;Lee, Eung-Bae
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.506-512
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    • 2010
  • Background: This study was designed to evaluate the FDG uptake ratio of mediastinal node and primary tumors using integrated PET/CT imaging combined with Glut-1 expression of the primary tumor in order to predict the N2 status more accurately in NSCLC patients. Material and Method: Patients who underwent integrated PET/CT scanning with a detectable mSUV for both primary tumors and mediastinal lymph nodes were eligible for this study. The FDG uptake ratio between the mediastinal node and the primary tumor was calculated. Result: The average mSUV of primary tumors and mediastinal nodes were, respectively, $7.4{\pm}2.2$ and $4.2{\pm}2.2$ in N2-positive patients and $7.6{\pm}3.7$ and $2.8{\pm}6.9$ in N2-negative patients. The mean FDG uptake ratio of mediastinal node to primary tumor were $0.58{\pm}0.23$ for malignant N2 lymph nodes and $0.45{\pm}0.20$ for benign lymph nodes (p<0.05). Models which combined Glut-1 expression with an FDG ratio have better diagnostic power than models that use the FDG uptake ratio alone. Conclusion: In some patients with a previous history of pulmonary tuberculosis or other inflammatory lung diseases, an FDG uptake ratio combined with Glut-1 expression may be useful in diagnosing mediastinal node metastasis more exactly.

FOCAL EPITHELIAL HYPERPLASIA : A CASE REPORT (Focal epithelial hyperplasia : 증례보고)

  • Han, Yu-Ri;Choi, Hyung-Jun;Choi, Byung-Jai;Lee, Jong-Gap
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.4
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    • pp.581-585
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    • 2002
  • Focal epithelial hyperplasia(FEH) is Human papilloma virus - induced, localized proliferation of oral squamous epithelium. FEH usually occurs in the childhood, but occasionally affects the young and middle-aged adults. Sites of the greatest involvement include the labial, buccal and lingual mucosa, but lesions of gingiva or tongue have also been reported. This disease is typically characterized by multiple soft, non-tender flattened papules and plaques. Occasional lesions show a slight papillary surface change. Individual lesions are small, discrete and well demarcated. The histopathologic hallmark of FEH is acanthosis of the oral epithelium. Cells demonstrating viral cytopathic changes including koilocytes or mitosoid cells may be present. The 5-year-old female of this case visited Department of Pediatric Dentistry, College of Dentistry, Yonsei University with a chief complaint of exophytic lesions on gingiva. Sessile papillary papules were detected by clinical examination on buccal gingiva at the maxillary left and right second deciduous molars. The patient did not complain of pain by palpation. An excisional biopsy was carried out for a histological examination and acanthosis was observed. The lesions were diagnosed as FEH. FEH would regress spontaneously after several months or years. Conservative excision may be performed for diagnostic or esthetic purpose. The risk of recurrence after this therapy is minimal, and there is no malignant transformation.

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Neuroendocrine Carcinoma of the Stomach -A Clinicopathologic Study of 18 Cases- (위에 발생한 신경내분비 암종 -18예의 위신경내분비 암종의 임상병리학적 고찰-)

  • Kim Byung Sik;Shin Dong Gyeu;Jang Se Jin;Choi Won Yong;Kim Yong Jin;Yook Jung Hwan;Oh Sung Tae
    • Journal of Gastric Cancer
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    • v.3 no.4
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    • pp.191-194
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    • 2003
  • Purpose: Neuroendocrine carcinomas of the stomach account for only about $0.3\%$ of all gastric tumors. The prognosis of this disease is very poor compared with the common type of gastric adenocarcinoma. The purpose of this retrospective study was to review the clinicopathologic features of 18 cases of this unusual gastric tumor and to establish a treatment strategy for this tumor. Materials and Methods: Excluding 2 cases of non-curative resection and 1 case of operative mortality, 18 cases of typical neuroendocrine carcinoma who had curative resection from January 1991 to December 2000 at Asan Medical Center were analyzed; 6841 gastric cancer patient were treated surgically during the same period. Results: The mean age at the time of diagnosis was 58.6 years (range: $35\∼75$ yr). Sixteen patients were male, and two were female. Eleven tumors ($61.1\%$) developed in the lower part of the stomach, three ($16.7\%$) in the middle part, and three ($16.7\%$) in the upper part. One tumor involved the entire stomach. Eight cases ($44.4\%$) were Borrmann type 2, and six case ($33.3\%$) were Borrmann type 3. The mean tumor size was 6.94 cm (range: $0.6\∼15$ cm). Nine cases ($50\%$) showed recurrence of the disease, and eight of them died within 20 months. Of the nine recurred cases, 7 cases ($77.8\%$) showed liver metastasis. The mean disease-free interval was 6.8 months (range: $2.5\∼11$ months) after surgical resection, and the mean survival was 17.9 months (range: $8\∼40$ months) for recurrence cases. One patient with liver metastasis was treated with a liver-wedge resection just after diagnosis and was still alive for 37.5 months postoperatively. There were 9 deaths after the median follow- up period of 40 months (range: $8\∼72$ months). Conclusion: Gastric neuroendocrine carcinomas frequently recur at the liver, even in early stage cancer, and have a poor prognosis. We experienced a case of successful control of hepatic metastasis by surgical resection and a case of a small cell carcinoma which was successfully controlled with systemic chemotherapy.

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Effects of probiotic, prebiotic, and synbiotic with and without feed restriction on performance, hematological indices and carcass characteristics of broiler chickens

  • Abdel-Hafeez, Hassan M.;Saleh, Elham S.E.;Tawfeek, Samar S.;Youssef, Ibrahim M.I.;Abdel-Daim, Asmaa S.A.
    • Asian-Australasian Journal of Animal Sciences
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    • v.30 no.5
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    • pp.672-682
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    • 2017
  • Objective: This study was conducted to investigate the effects of probiotic, prebiotic and synbiotic with and without feed restriction on broilers performance, blood parameters, carcass characteristics, and feed cost of production from 1 to 56 days of age. Methods: Two hundred and forty unsexed one day-old chicks of Arbor Acres breed were used. Two trials, I and II, were conducted, with 120 birds in both. Each trial was divided into 4 equal groups. The birds in trial I were fed ad libitum throughout the experiment, while the chicks in trial II were fed ad libitum during the first week of age, then subjected to 5 hours/d of feed restriction from the beginning of the second week up to the end of the experiment. In both trials, the birds in group 1 were fed on a control diet while the other groups were given the same control diet supplemented either with a probiotic in group 2, prebiotic in group 3, or synbiotic in group 4. Results: It was found that chicks fed diets supplemented with probiotic, prebiotic and synbiotic (with and without feed restriction) exhibited higher body weight and feed efficiency than chicks fed the control diets. The feed additives in both trials did not affect hemoglobin, serum total protein, albumin, globulin, glucose, and total cholesterol, except the packed cell volume which was increased in the additive treatments with restriction at the end of the experiment. Moreover, the dietary treatments did not influence the carcass yield. However, the relative weights of liver, gizzard and proventriculus, small intestine and bursa of fabricius were found to be increased. The additives decreased the visible fat in the carcass, with more decreasing effect in the additive groups with restriction. The lowest feed cost per kg of weight gain was observed in the birds fed diets supplemented with synbiotic, probiotic and prebiotic. Feed restriction improved the feed conversion ratio, economic return, but decreased the feed intake, serum total cholesterol and visible fat in comparison with non-restricted groups. Conclusion: The biological feed additives could be routinely added to broiler diets, especially when a feed restriction program is followed. Finally, it can be recommended to restrict feed, and add probiotic or synbiotic to increase weight, improve feed conversion rate and reduce feed cost of production.

Selection of White Asparagus Varieties Suitable for Shading Culture (차광재배에 적합한 화이트 아스파라거스 품종 선발)

  • Seong, Ki Cheol;Kim, Dong Hwan;Kim, Chun Hwan;Moon, Doo Kyong
    • Journal of Bio-Environment Control
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    • v.22 no.2
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    • pp.81-86
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    • 2013
  • This experiment was carried out to select white asparagus varieties suitable for shading culture in greenhouse. Eight white and one green varieties were tested. Seeds were sown in 72-cell trays in a glasshouse on 24 Dec. 2008 and the seedlings were transplanted in a P.E house on 22 May 2009. Planting distances were 30 cm apart in a raw and 125 cm between the raws. For white asparagus production, small tunnel ($210cm{\times}160cm$) was established inside the P.E house, and covered with black and white P.E film (0.1 mm) on 5 March 2010. Days to sprouting took 5 days in 'Ravel' variety and took 16 to 18 days in 'Backlim', 'Horlim', 'Herkolim' varieties. The number of spear was highest in 'Ravel' with 6 and lowest in 'Backlim' with 3.7. The spear weight was heaviest in 'Herkolim' with 25.6 g and lightest in 'Ravel' with 15.6 g. The highest total yield was in 'Herkolim' with 296 kg/10a, followed by 'Super welcome' with 275 kg/10a and lowest in 'Rapsody' with 176 kg/10a. Marketable yields in 'Super welcome' and 'Herkolim' were 241 kg/10a and 239 kg/10a, respectively, and the yield was lowest in 'Rapsody' with 139 kg/10a. The L grade (over 20 g of spear weight) was highest in 'Herkolim'. Accordingly, 'Herkolim' was the most suitable white asparagus variety among the tested varieties for shading cultivation in greenhouse.

Early or Late Gefitinib, Which is Better for Survival? - Retrospective Analysis of 228 Korean Patients with Advanced or Metastatic NSCLC

  • Kim, Dong-Gun;Kim, Min-Kyoung;Bae, Sung-Hwa;Koh, Sung-Ae;Park, Sung-Woo;Kim, Hyun-Je;Kim, Myung-Jin;Jang, Hyo-Jin;Lee, Kyung-Hee;Lee, Kwan-Ho;Chung, Jin-Hong;Shin, Kyung-Chul;Ryoo, Hun-Mo;Hyun, Myung-Soo
    • Journal of Yeungnam Medical Science
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    • v.28 no.1
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    • pp.31-44
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    • 2011
  • Background: The optimal timing of treatment with EGFR-tyrosine kinase inhibitors (EGFR-TKI) in NSCLC patients has not yet been determined. Methods: We separated 228 patients with advanced /metastatic NSCLC treated with gefitinib into an early gefitinib group (patients who received gefitinib as first- or second-line treatment) and a delayed gefitinib group (patients who received gefitinib as third or fourth-line treatment) and attempted to determine whether the timing of gefitinib treatment affected clinical outcomes. Results: Median overall survival (OS), progression free survival (PFS), and median OS from first-line treatment of advanced/metastatic disease (OSt) for 111 patients in the early gefitinib group were 6.2 months, 3.3 months, and 11.6 months. However, median OS, PFS, and OSt for 84 patients in the delayed gefitinib group were 7.8 months, 2.3 months, and 22.7 months. No differences in OS and PFS were observed between the 2 groups. However, OSt was significantly longer in the delayed gefitnib group. Timing of gefitinib therapy was one of the independent predictors of OSt. Hb ${\geq}$ 10 g/dl, and having never smoked, and ECOG performance status ${\leq}1$ were independent predictors of better PFS. Conclusion:Deferral of gefitinib therapy in patientswith advanced ormetastatic NSCLC may be preferable if they are able to tolerate chemotherapy.

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Verification of the Correlation between Progression-free Survival and Overall Survival Considering Magnitudes of Survival Post-progression in the Treatment of Four Types of Cancer

  • Liu, Li-Ya;Yu, Hao;Bai, Jian-Ling;Zeng, Ping;Miao, Dan-Dan;Chen, Feng
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.1001-1006
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    • 2015
  • Background: With development and application of new and effective anti-cancer drugs, the median survival post-progression (SPP) is often prolonged, and the role of the median SPP on surrogacy performance should be considered. To evaluate the impact of the median SPP on the correlation between progression-free survival (PFS) and overall survival (OS), we performed simulations for treatment of four types of cancer, advanced gastric cancer (AGC), metastatic colorectal cancer (MCC), glioblastoma (GBM), and advanced non-small-cell lung cancer (ANSCLC). Materials and Methods: The effects of the median SPP on the statistical properties of OS and the correlation between PFS and OS were assessed. Further, comparisons were made between the surrogacy performance based on real data from meta-analyses and simulation results with similar scenarios. Results: The probability of a significant gain in OS and HR for OS was decreased by an increase of the SPP/OS ratio or by a decrease of observed treatment benefit for PFS. Similarly, for each of the four types of cancer, the correlation between PFS and OS was reduced as the median SPP increased from 2 to 12 months. Except for ANSCLC, for which the median SPP was equal to the true value, the simulated correlation between PFS and OS was consistent with the values derived from meta-analyses for the other three kinds of cancer. Further, for these three types of cancer, when the median SPP was controlled at a designated level (i.e., < 4 months for AGC, < 12 months for MCC, and <6 months for GBM), the correlation between PFS and OS was strong; and the power of OS reached 34.9% at the minimum. Conclusions: PFS is an acceptable surrogate endpoint for OS under the condition of controlling SPPs for AGC, MCC, and GBM at their limit levels; a similar conclusion cannot be made for ANSCLC.

Suggestion for a New Grading Scale for Radiation Induced Pneumonitis Based on Radiological Findings of Computerized Tomography: Correlation with Clinical and Radiotherapeutic Parameters in Lung Cancer Patients

  • Kouloulias, Vassilios;Zygogianni, Anna;Efstathopoulos, Efstathios;Victoria, Oikonomopoulou;Christos, Antypas;Pantelis, Karaiskos;Koutoulidis, Vassilios;Kouvaris, John;Sandilos, Panagiotis;Varela, Maria;Aytas, Ilknur;Gouliamos, Athanasios;Kelekis, Nikolaos
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.2717-2722
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    • 2013
  • Background: The objective of this research is the computed axial tomography (CT) imaging grading of radiation induced pneumonitis (RP) and its correlation with clinical and radiotherapeutic parameters. Materials and Methods: The chest CT films of 20 patients with non-small cell lung cancer who have undergone threedimensional conformal radiation therapy were reviewed. The proposed CT grading of RP is supported on solely radiological diagnosis criteria and distinguishes five grades. The manifestation of RP was also correlated with any positive pre-existing chronic obstructive pulmonary disease (COPD) history, smoking history, the FEV1 value, and the dosimetric variable V20. Results: The CT grading of RP was as follows: 3 patients (15%) presented with ground glass opacity (grade 1), 9 patients (45%) were classified as grade 2, 7 patients (35%) presented with focal consolidation, with or without elements of fibrosis (grade 3), and only one patient (5%) presented with opacity with accompanying atelectasis and loss of pulmonary volume (grade 4). Both univariate and multivariate analysis revealed as prognostic factors for the radiological grading of RP the reduction of FEV1 and the V20 (P=0.026 and P=0.003, respectively). There was also a significant (P<0.001) correlation of radiological grading of RP with FEV1 and V20 (spearman rho 0.92 and 0.93, respectively). Conclusions: The high correlation of the proposed radiological grading with the FEV1 and the V20 is giving a satisfactory clinical validity. Although the proposed grading scale seems relevant to clinical practice, further studies are needed for the confirmation of its validity and reliability.

The Codon 399 Arg/Gln XRCC1 Polymorphism is Associated with Lung Cancer in Indians

  • Natukula, Kirmani;Jamil, Kaiser;Pingali, Usha Rani;Attili, Venkata Satya Suresh;Madireddy, Umamaheshwar Rao Naidu
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5275-5279
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    • 2013
  • Background: The XRCC1 (X-ray repair cross complimenting group-I) gene in BER (base excision repair) pathway is essential for DNA repair process. Polymorphisms in this gene are associated with variations in the repair efficiency which might predispose individuals to development of various cancers. Two variants of XRCC1gene (at codon 399), Gln/Gln and Arg/Gln, have been shown to be related to lowered DNA repair capacity and increased genomic instability in multiple studies. Hence our investigation focused on genotyping these variants to correlate with other multiple risk factors in lung cancer (NSCLC) patients since we hypothesized that these variants of the XRCC1 gene might influence disease susceptibility. Materials and Methods: We examined the frequency of the polymorphism in one hundred cases and an almost equal number of controls after recording their demographics with a structured questionnaire. Genomic DNA from blood samples was extracted for PCR studies, followed by RFLP to determine the variants. The significance of the data was statistically analyzed. Results: The three genotypes in cases and controls were Arg/Arg (40% and 54.45%); Gln/Gln (19% and 9.90%), and Arg/Gln (41.0% and 35.64%) respectively. Among these 3 genotypes, we found Gln/Gln and Arg/Gln to show association with lung cancer. Correlating these genotypes with several parameters, we also found that these two variants were associated with risk in males (p<0.05) and with smoking habits (p<0.05). In females Arg/Gln genotype showed association with stage of the disease (p=0.04). This is the first report in South Indian scenario where Arg399Gln genotypes were found to be associated with stage of the disease in females. Conclusions: It is concluded that XRCC1 genotypes Gln/Gln and Arg/Gln may influence cancer susceptibility in patients with smoking habits and these functional SNPs in XRCC1 gene may act as attractive candidate biomarkers in lung cancer for diagnosis and prognosis.