肺癌临床研究最新进展——来自ASCO的报告

 一年一度的ＡＳＣＯ ,总是给人带来一些希望 ,也给人留下一些遗憾。希望在于 :癌症的分子靶向治疗终于走出实验室并在临床试验中带来鼓舞人心的前景 ,Ｉｒｅｓｓａ和Ｃ2 2 5在肺癌的应用 ,让我们看到一种新的希望。而遗憾呢 ?借用Ｓａｕｓｅ的大会发言 ,是“ｅｖｅｒｙｔｈｉｎｇ ,ｅｖｅｒｙｗｈｅｒｅ”。在探索肺癌最佳治疗模式过程中 ,我们就像小脚女人一样 ,小步挪移 ,而蓦然回首 ,才发现一些我们自以为是的治疗模式 ,原来存在重大缺陷 ,它只是对病人的一种过度治疗。笔者借参加ＡＳＣＯ之便 ,参与和复习了本次大会所有的肺癌临床研究论坛的论文 ,写就这篇综述 ,期望同道们能分享这些肺癌临床研究的最新信息。1局限期小细胞肺癌治疗的进步回顾历史是明了未来研究方向的最好方法。尽管近几年的ＡＳＣＯ大会都有激动人心的临床前研究结果 ,但无可否认 ,手术、放疗和化疗仍是肺癌治疗的主打力量。利用系统评估方法 ,数量化地对过去已完成的研究进行评价 ,总结出可供目前利用的最好证据、指明未来相关的研究方向 ,是近几年ＡＳ ＣＯ会议的一大特色。今年也不例外。Ｊａｎｎｅ等[1] 研究评估了局限期小细胞肺癌的生存期变化。     

肺癌治疗研究进展——2001年ASCO会议综述之二

美国临床肿瘤学会(ASCO)第37届年会报告有关肺癌的论文共346篇,论文综述l篇,内容丰富,其中内科治疗、化放联合治疗的论文占绝大部分. 1非小细胞肺癌(NSCLC) 1.1每周疗法 每周疗法即为每周给化疗药1次的方法.每周疗法治疗NSCLC的方案组成与去年ASCO会议报告的有所不同,去年每周疗法以单药为主,今年每周疗法特点是联合用药,2药或3药联合,连用3周休一周,再重复,或连用5～6周.联合方案组成的药多为泰素(TAX)、泰素帝(DOC)和卡铂(CBP)或顺铂(PDD)、健择(GEM)和诺维本(NVB),治疗Ⅲ、Ⅳ期NSCLC有效率为16%～61%.     

2007年ASCO会议小细胞肺癌治疗研究进展

综述2007年ASCO会议上小细胞肺癌外科手术的地位与作用、预防性全脑照射、一线化疗、二线化疗及靶向治疗等的研究进展。     

非小细胞肺癌的治疗——2001年ASCO会议综述之三

一年一度的ASCO大会是临床肿瘤学界最重要的学术年会,2001年会议同往年一样,肺癌的处理成为与会者所关注的热点之一.本届ASCO会议有关肺癌的主题主要集中在两方面,一是非小细胞肺癌治疗的争论,二是肺癌的靶向治疗.从大的方面看,单一手段如手术治疗、放射治疗的作用,综合治疗的合理性;小的细节如化疗的三药联合或两药联合,非铂类方案的应用等方面均作了大量探讨.因此,会议主持者Sause用“无处不是、无处不在”来评价对肺癌治疗的争论,确实十分恰当.     

肺癌的治疗研究概况--2000年ASCO会议综述之七

美国临床肿瘤学会（ASCO）第36届年会于2000年5月19～23日在美国新奥尔良举行。这次会议收集有关肺癌的论文摘要及综述280余篇，其中小细胞肺癌（SCLC）约40余篇。非小细胞肺癌（NSCLC）占绝大部分。有些研究的最新趋势引人注目。     

2012年ASCO年会乳腺癌热点报道

第48 届美国临床肿瘤学会（ ASCO） 年会于2012 年6 月1 ～5 日在美国芝加哥举行。本届 ASCO 年会围绕＂合作征服癌症（ collaborating to conquer cancer） ＂的主题,对全球范围内的各种常见恶性肿瘤进行了全方位的探讨,为恶性肿瘤的诊治提供了一些新的启示和方向。在本届 ASCO 年会上,乳腺癌仍是各国学者关注的重点和热点,参会专家们从化学治疗、靶向治疗等方面对乳腺癌进行了深入研究和讨论。本文就本届 ASCO 年会中值得大家关注的内容和新试验结果的临床价值进行综述。     

启东市2001年-2007年肺癌生存率分析

背景与目的生存率研究是反映癌症预后的一个重要指标。本研究旨在对启东2001年-2007年全人群肺癌登记病例进行生存率分析,为预后评价及防治提供依据。方法 4,451例登记病例的生存(死亡)情况随访截止于2009年12月31日;剔除只有死亡医学证明书(death certificate only,DCO)病例,实际纳入分析4,382例。用SURV 3.01软件计算观察生存率(observed survival,OS)及相对生存率(relative survival,RS),并应用Hakulinen氏似然比检验法进行统计学检验。结果肺癌1年、3年、5年OS分别为23.73%、11.89%和10.01%,1年、3年、5年RS分别为24.86%、13.69%和12.73%。其中男性1年、3年、5年RS分别为23.70%、12.58%和11.73%,女性1年、3年、5年RS分别为27.89%、16.53%和15.21%,女性生存率高于男性,两组之间的差异具有统计学意义(χ2=13.77,P=0.032)。15岁-34岁、35岁-44岁、45岁-54岁、55岁-64岁、65岁-74岁及75+岁各年龄组的5年RS分别为35...     

2008年ASCO非小细胞肺癌研究热点报道

2008年5月30日-6月3日,第44届ASCO年会在美国芝加哥召开,非小细胞肺癌(NSCLC)的内科治疗仍是大会讨论的主题之一.     

抗肿瘤血管生成:肺癌治疗新希望——2006年ASCO新进展

近年来抗肿瘤血管生成治疗逐渐成为肺癌靶向治疗的热点。前不久刚结束的2006年ASCO大会公布了贝伐单抗及小分子血管内皮生长因子受体(VEGFR)酪氨酸激酶抑制剂(TKI)的研究新进展,其结果令人鼓舞。VEGF是一种细胞因子,它能诱导内皮细胞增生、蛋白酶的表达、抗内皮细胞凋亡和细胞重组,最终形成毛细血管。在病理血管生成方面,它还能增强血管的通透性,形成不成熟的血管网络。血管上皮生长因子能够刺激血管内皮细胞的增生,在大多数人体肿瘤组织中(包括肺癌),VEGF的表达大大高于其他正常组织[1]。研究证实贝伐单抗以VEGF作为靶点,具有一…     

2006年非小细胞肺癌新热点

 含铂方案辅助化疗是非小细胞肺癌（NSCLC）完全切除术后的标准治疗，对Ⅰb期NSCLC术后化疗尚存争议。有手术禁忌证的早期NSCLC可选择安全有效的局部治疗新方法，如射频消融和立体定向照射。Ⅲa（N2）期NSCLC多学科综合治疗模式尚无标准，应避免行全肺切除术。分子靶向治疗药物在晚期NSCLC一线、二线治疗中有不俗的疗效。药理基因组学的研究结果可能指导肺癌的个体化治疗。     

ASCO 2013: new developments in lung cancer

At American Society of Clinical Oncology meeting 2013, some new data were presented, which might have a practice-changing potential. Epidermal growth factor receptor mutational testing was successfully performed in plasma samples, giving hope that tumor biopsies might be replaced by a more comfortable blood analysis. Some studies focused on new second-generation anaplastic lymphoma kinase inhibitors, which showed an impressive efficacy even in crizotinib refractory patients in phase I/II studies and support a sequence of tyrosine kinase inhibitors (TKIs) in this sub-entity of non-small-cell lung cancer (NSCLC). Immunological strategies are worth being tested also in lung cancer, as different strategies have proven first signs of efficacy (MUC1 antigen-specific cancer immunotherapy, programmed cell death ligand 1). Finally, a large phase III trial found that a new oral vascular endothelial growth factor receptor, fibroblast growth factor receptor, and platelet-derived growth factor receptor TKI (nintedanib) combined with docetaxel improved outcome in second-line NSCLC patients when compared with docetaxel monotherapy.     

骨肉瘤内科治疗研究进展：ASCO会议（2007）展望

骨肉瘤是一种起源于间叶组织的恶性肿瘤，是骨骼系统最常见的恶性肿瘤，多发于青少年。手术、放化疗对骨肉瘤的疗效仍然有限，新辅助化疗、生物靶向治疗、免疫疗法及中医中药已成为骨肉瘤治疗新的发展方向，但骨肉瘤治疗研究仍有待新的突破。2007年ASCO会议报告了有关骨肉瘤治疗最新研究进展，本文结合目前国内外研究对骨肉瘤的内科治疗现状作一浅要综述。     

CT screening for lung cancer: update 2007

Screening is the pursuit of the early diagnosis of cancer before symptoms occur. The purpose of early diagnosis is to provide early treatment, which potentially prevents death from the cancer. The usefulness of screening depends on how early the cancer can be diagnosed and how many deaths can be prevented by early treatment as compared with later symptom-prompted diagnosis and treatment. The goal of the Early Lung Cancer Action Project investigators was to develop an efficient methodology that would provide an ever-accumulating, continually updated body of evidence for evaluation of emerging new technologies for screening for cancer. This methodology recognizes that screening is a sequential process that starts with the pursuit of the early diagnosis of cancer followed by early treatment. It also recognizes that diagnostic research is fundamentally different from treatment research. To fully understand the current discussions on the evidence for lung cancer screening, key definitions are provided, including the differentiation between the first, baseline round of screening and all subsequent rounds of repeat screening and baseline and repeat cancers and their distribution by cell type. These definitions are critical in analyzing the results of various screening reports as they are not used by all. To provide optimal screening, a regimen for the diagnostic workup must be specified starting with the definition of the initial test, its positive result, and the workup for a positive result leading to a diagnosis of cancer. Assessment of diagnostic performance does not require a control group, but does require confirmation of the diagnosis. For assessment of the effectiveness of early treatment, a comparison group is needed. The comparison group may be formed by randomly assigning people with screen-diagnosed lung cancer to immediate or delayed treatment, as has been done for prostate cancer. This provides a direct assessment of any potential overdiagnosis of the cancer resulting from screening. Alternatively, a quasiexperimental control group can be used consisting of participants diagnosed with the cancer who have refused or delayed their treatment even though they are candidates for it.     

Selected breast cancer highlights from the ASCO 2012

The abstracts are a selection of clinically relevant papers presented at the American Society of Clinical Oncology (ASCO) 2012. The results of the EMILIA study were a milestone presented at the meeting. A total of 991 patients with metastatic Human Epidermal Growth Factor Receptor 2 (HER2)-positive breast cancer had been pretreated with a taxane and trastuzumab. They were randomized into two groups: Trastuzumab emtansine conjugate (T-DM1) or capecitabine-lapatinib. Significant differences were found with regard to progression-free survival and the two-year overall survival. Another study analyzed the relevance of the hormone-receptor (HR) status for the prognosis of patients with operable HER2-overexpressing breast cancer. A significant difference in the risk of the development of brain metastases was found depending on the HR status. In the MA.27 study, patients received adjuvant therapy with aromatase inhibitors. A significant proportion of cases reported therapy of osteoporosis, mainly with bisphosphonates. Osteoporosis therapy influenced recurrence-free survival. In another study, the prognostic influence of Ki-67 was evaluated before and after neoadjuvant chemotherapy with TAC (docetaxel/doxorubicin/cyclophosphamide). A metaanalysis analyzed the possible discordance between the HR status and the HER2 status in the primary tumor as compared to metastasis in 2,806 breast cancer patients. The estrogen-receptor (ER)-, and the progesterone-receptor (PR) status as well as the HER2 status changed in a significant proportion of cases. Parenteral nutrition in 129 terminal oncological patients with progressive cancer was investigated within a randomized placebo-controlled trial. They either received one liter of 0.9 % physiological saline subcutaneously or placebo. Survival, symptoms of dehydration, and quality of life were analyzed.