Global Cancer Statistics 2022 reported the prevalence and high mortality rate of lung cancer.Notably,non-small cell lung cancer(NSCLC)accounts for the majority of the histologic types1.Precision therapy for lung cance...Global Cancer Statistics 2022 reported the prevalence and high mortality rate of lung cancer.Notably,non-small cell lung cancer(NSCLC)accounts for the majority of the histologic types1.Precision therapy for lung cancer has progressed rapidly and immune checkpoint inhibitors(ICIs)have become a leading research topic.Indeed,ICI therapy has been shown to improve the prognosis of lung cancer patients.展开更多
BACKGROUND Cytokine release syndrome(CRS)is defined as systemic inflammation that usually occurs following chimeric antigen receptor T-cell therapy administration;however,it has not been reported in patients with untr...BACKGROUND Cytokine release syndrome(CRS)is defined as systemic inflammation that usually occurs following chimeric antigen receptor T-cell therapy administration;however,it has not been reported in patients with untreated non-small cell lung cancer to date.CASE SUMMARY A 44-year-old nonsmoking woman presented to the hospital due to fever,palpitation,nausea,and cough for 1 mo and was diagnosed with stage cT3N3M0(IIIc)adenocarcinoma of the lung.Auxiliary examinations revealed elevated cytokine[tumor necrosis factor-α,interleukin(IL)-1β,and IL-6]and inflammatory factor levels,which decreased after treatment with corticosteroids and immunoglobulin and when tumor growth was controlled following chemotherapy,radiotherapy,and antiangiogenesis therapy.However,tumor recurrence was observed.After administration of nivolumab as third-line treatment,the patient’s condition was transiently controlled;however,CRS-like symptoms suddenly emerged,which led to a resurgence of cytokines and inflammatory factors and rapid death.CONCLUSION CRS can develop in treatment-naïve lung cancer patients.Patients with tumorrelated CRS may be at risk of CRS recurrence,aggravation,and onset of immune checkpoint inhibitor-related adverse events.展开更多
Cancer stem cells(CSCs),a small subset of cells in tumors that are characterized by self-renewal and continuous proliferation,lead to tumorigenesis,metastasis,and maintain tumor heterogeneity.Cancer continues to be a ...Cancer stem cells(CSCs),a small subset of cells in tumors that are characterized by self-renewal and continuous proliferation,lead to tumorigenesis,metastasis,and maintain tumor heterogeneity.Cancer continues to be a significant global disease burden.In the past,surgery,radiotherapy,and chemotherapy were the main cancer treatments.The technology of cancer treatments continues to develop and advance,and the emergence of targeted therapy,and immunotherapy provides more options for patients to a certain extent.However,the limitations of efficacy and treatment resistance are still inevitable.Our review begins with a brief introduction of the historical discoveries,original hypotheses,and pathways that regulate CSCs,such as WNT/β-Catenin,hedgehog,Notch,NFkB,JAK/STAT,TGF-β,PI3K/AKT,PPAR pathway,and their crosstalk.We focus on the role of CSCs in various therapeutic outcomes and resistance,including how the treatments affect the content of CSCs and the alteration of related molecules,CSCs-mediated therapeutic resistance,and the clinical value of targeting CSCs in patients with refractory,progressed or advanced tumors.In summary,CSCs affect therapeutic efficacy,and the treatment method of targeting CSCs is stll difficult to determine.Clarifying regulatory mechanisms and targeting biomarkers of CSCs is currently the mainstream idea.展开更多
Background and objective Anlotinib is a newly developed small molecule multiple receptor tyrosine kinase(RTK) inhibitor that was approved for the treatment of patients with lung cancer in China. We aim to report 3 cas...Background and objective Anlotinib is a newly developed small molecule multiple receptor tyrosine kinase(RTK) inhibitor that was approved for the treatment of patients with lung cancer in China. We aim to report 3 cases of rare complication of anlotinib-bronchial fistula(BF) during the treatment of lung cancer patients and summarize the possible causes.Methods We collected three patients who developed BF due to anlotinib treatment, and conducted a search of Medline and Pub Med for medical literature published between 2018 and 2020 using the following search terms: "anlotinib," "lung cancer," and "fistula."Results Our literature search produced two case reports(three patients) which, in addition to our three patients. We collated the patients’ clinical characteristics including demographic information, cancer type, imaging features, treatment received, risk factors for anlotinib related BF, and treatment-related outcomes. The six patients shared some common characteristics: advanced age, male, concurrent infection symptoms, diabetes mellitus(DM), advanced squamous cell and small cell lung cancers, centrally located tumors, tumor measuring ≥5 cm in longest diameter, and newly formed tumor cavitation after multi-line treatment especially after receiving radiotherapy. Fistula types included broncho-pericardial fistula, broncho-pleural fistula, and esophagotracheobronchial fistula. Six patients all died within 6 months.Conclusion Although anlotinib is relatively safe, it is still necessary to pay attention to the occurrence of BF, a rare treatment side effect that threatens the quality of life and overall survival of patients. Anlotinib, therefore, requires selective use and close observation of high-risk patients.展开更多
Tocilizumab has been reported to attenuate the“cytokine storm”in COVID-19 patients.We attempted to verify the effectiveness and safety of tocilizumab therapy in COVID-19 and identify patients most likely to benefit ...Tocilizumab has been reported to attenuate the“cytokine storm”in COVID-19 patients.We attempted to verify the effectiveness and safety of tocilizumab therapy in COVID-19 and identify patients most likely to benefit from this treatment.We conducted a randomized,controlled,open-label multicenter trial among COVID-19 patients.The patients were randomly assigned in a 1:1 ratio to receive either tocilizumab in addition to standard care or standard care alone.The cure rate,changes of oxygen saturation and interference,and inflammation biomarkers were observed.Thirty-three patients were randomized to the tocilizumab group,and 32 patients to the control group.The cure rate in the tocilizumab group was higher than that in the control group,but the difference was not statistically significant(94.12%vs.87.10%,rate difference 95%CI−7.19%–21.23%,P=0.4133).The improvement in hypoxia for the tocilizumab group was higher from day 4 onward and statistically significant from day 12(P=0.0359).In moderate disease patients with bilateral pulmonary lesions,the hypoxia ameliorated earlier after tocilizumab treatment,and less patients(1/12,8.33%)needed an increase of inhaled oxygen concentration compared with the controls(4/6,66.67%;rate difference 95%CI−99.17%to−17.50%,P=0.0217).No severe adverse events occurred.More mild temporary adverse events were recorded in tocilizumab recipients(20/34,58.82%)than the controls(4/31,12.90%).Tocilizumab can improve hypoxia without unacceptable side effect profile and significant influences on the time virus load becomes negative.For patients with bilateral pulmonary lesions and elevated IL-6 levels,tocilizumab could be recommended to improve outcome.展开更多
基金the Hunan Lung Cancer Clinical Medical Research Center(Grant No.2023SK4024 to LW)the Hunan Science and Technology Innovation Program(Grant No.2021SK51121 to LW)the Hunan Cancer Hospital Climb plan(Grant No.ZX2020005-5 to LW)。
文摘Global Cancer Statistics 2022 reported the prevalence and high mortality rate of lung cancer.Notably,non-small cell lung cancer(NSCLC)accounts for the majority of the histologic types1.Precision therapy for lung cancer has progressed rapidly and immune checkpoint inhibitors(ICIs)have become a leading research topic.Indeed,ICI therapy has been shown to improve the prognosis of lung cancer patients.
基金Supported by National Multidisciplinary Cooperative Diagnosis and Treatment Capacity Building Project for Major Diseases(Lung Cancer)National Key R&D Program of China,No.2016YFC1303300Xiangya Clinical Big Data Project of Central South University(Clinical big data project of lung cancer).
文摘BACKGROUND Cytokine release syndrome(CRS)is defined as systemic inflammation that usually occurs following chimeric antigen receptor T-cell therapy administration;however,it has not been reported in patients with untreated non-small cell lung cancer to date.CASE SUMMARY A 44-year-old nonsmoking woman presented to the hospital due to fever,palpitation,nausea,and cough for 1 mo and was diagnosed with stage cT3N3M0(IIIc)adenocarcinoma of the lung.Auxiliary examinations revealed elevated cytokine[tumor necrosis factor-α,interleukin(IL)-1β,and IL-6]and inflammatory factor levels,which decreased after treatment with corticosteroids and immunoglobulin and when tumor growth was controlled following chemotherapy,radiotherapy,and antiangiogenesis therapy.However,tumor recurrence was observed.After administration of nivolumab as third-line treatment,the patient’s condition was transiently controlled;however,CRS-like symptoms suddenly emerged,which led to a resurgence of cytokines and inflammatory factors and rapid death.CONCLUSION CRS can develop in treatment-naïve lung cancer patients.Patients with tumorrelated CRS may be at risk of CRS recurrence,aggravation,and onset of immune checkpoint inhibitor-related adverse events.
基金This work was supported by Advanced Lung Cancer Targeted Therapy Research Foundation of China(CTONG-YC20210303)Chen Xiao-Ping Foundation for the Development of Science and Technology of Hubei Province(CXPJJH121005-01)+2 种基金National Multidisciplinary Cooperative Diagnosis and Treatment Capacity(lung cancer z027002)Health Research Project of Hunan Provincial Health Commission(W20242005)Postdoctoral Fellowship Programof CPSF(GZC20233187).
文摘Cancer stem cells(CSCs),a small subset of cells in tumors that are characterized by self-renewal and continuous proliferation,lead to tumorigenesis,metastasis,and maintain tumor heterogeneity.Cancer continues to be a significant global disease burden.In the past,surgery,radiotherapy,and chemotherapy were the main cancer treatments.The technology of cancer treatments continues to develop and advance,and the emergence of targeted therapy,and immunotherapy provides more options for patients to a certain extent.However,the limitations of efficacy and treatment resistance are still inevitable.Our review begins with a brief introduction of the historical discoveries,original hypotheses,and pathways that regulate CSCs,such as WNT/β-Catenin,hedgehog,Notch,NFkB,JAK/STAT,TGF-β,PI3K/AKT,PPAR pathway,and their crosstalk.We focus on the role of CSCs in various therapeutic outcomes and resistance,including how the treatments affect the content of CSCs and the alteration of related molecules,CSCs-mediated therapeutic resistance,and the clinical value of targeting CSCs in patients with refractory,progressed or advanced tumors.In summary,CSCs affect therapeutic efficacy,and the treatment method of targeting CSCs is stll difficult to determine.Clarifying regulatory mechanisms and targeting biomarkers of CSCs is currently the mainstream idea.
文摘Background and objective Anlotinib is a newly developed small molecule multiple receptor tyrosine kinase(RTK) inhibitor that was approved for the treatment of patients with lung cancer in China. We aim to report 3 cases of rare complication of anlotinib-bronchial fistula(BF) during the treatment of lung cancer patients and summarize the possible causes.Methods We collected three patients who developed BF due to anlotinib treatment, and conducted a search of Medline and Pub Med for medical literature published between 2018 and 2020 using the following search terms: "anlotinib," "lung cancer," and "fistula."Results Our literature search produced two case reports(three patients) which, in addition to our three patients. We collated the patients’ clinical characteristics including demographic information, cancer type, imaging features, treatment received, risk factors for anlotinib related BF, and treatment-related outcomes. The six patients shared some common characteristics: advanced age, male, concurrent infection symptoms, diabetes mellitus(DM), advanced squamous cell and small cell lung cancers, centrally located tumors, tumor measuring ≥5 cm in longest diameter, and newly formed tumor cavitation after multi-line treatment especially after receiving radiotherapy. Fistula types included broncho-pericardial fistula, broncho-pleural fistula, and esophagotracheobronchial fistula. Six patients all died within 6 months.Conclusion Although anlotinib is relatively safe, it is still necessary to pay attention to the occurrence of BF, a rare treatment side effect that threatens the quality of life and overall survival of patients. Anlotinib, therefore, requires selective use and close observation of high-risk patients.
基金This work was supported by the Department of Science and Technology of Anhui Province and Health Commission of Anhui Province(No.202004a07020001)the China National Center for Biotechnology Development(No.2020YFC0843800).
文摘Tocilizumab has been reported to attenuate the“cytokine storm”in COVID-19 patients.We attempted to verify the effectiveness and safety of tocilizumab therapy in COVID-19 and identify patients most likely to benefit from this treatment.We conducted a randomized,controlled,open-label multicenter trial among COVID-19 patients.The patients were randomly assigned in a 1:1 ratio to receive either tocilizumab in addition to standard care or standard care alone.The cure rate,changes of oxygen saturation and interference,and inflammation biomarkers were observed.Thirty-three patients were randomized to the tocilizumab group,and 32 patients to the control group.The cure rate in the tocilizumab group was higher than that in the control group,but the difference was not statistically significant(94.12%vs.87.10%,rate difference 95%CI−7.19%–21.23%,P=0.4133).The improvement in hypoxia for the tocilizumab group was higher from day 4 onward and statistically significant from day 12(P=0.0359).In moderate disease patients with bilateral pulmonary lesions,the hypoxia ameliorated earlier after tocilizumab treatment,and less patients(1/12,8.33%)needed an increase of inhaled oxygen concentration compared with the controls(4/6,66.67%;rate difference 95%CI−99.17%to−17.50%,P=0.0217).No severe adverse events occurred.More mild temporary adverse events were recorded in tocilizumab recipients(20/34,58.82%)than the controls(4/31,12.90%).Tocilizumab can improve hypoxia without unacceptable side effect profile and significant influences on the time virus load becomes negative.For patients with bilateral pulmonary lesions and elevated IL-6 levels,tocilizumab could be recommended to improve outcome.
