Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0684249 (lung carcinoma)
 23,830 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From October 1979 to December 1982, 126 patients with locally advanced unresectable or inoperable Stage II (7 patients), Stage IIIA (81 patients), and Stage IIIB (38 patients) non-small cell carcinoma of the lung were treated in a prospective randomized trial using five cycles of CAP (Cytoxan, Adriamycin, and cisplatin), T-CAP (triazinate plus CAP), or V-CAP (VP-16 plus CAP) chemotherapy with thoracic radiation therapy (TRT). TRT consisted of 40 Gy in 10 fractions (split-course) with cycles 3 and 4 of chemotherapy. The treatment field included the primary tumor, ipsilateral hilum, mediastinum, and ipsilateral supraclavicular fossa. All patients were followed until death or for a minimum of 5 years for survivors. The evaluable subgroup consisted of 102 patients who completed TRT. Median and 5-year survivals for the entire group were 14.0 months and 10%, respectively; for the evaluable subgroup, they were 14.8 months and 12%, respectively. There was a trend toward better survival with V-CAP plus TRT than with CAP plus TRT (p = 0.08). Median and 5-year survivals were 16.2 months and 18%, respectively, with V-CAP plus TRT. Of eight prognostic variables analyzed for their association with survival, only Eastern Cooperative Oncology Group performance status (0,1 versus 2) (p = 0.02) and weight loss (less than or equal to 10% versus greater than 10%) (p = 0.05) were significant. Sex, age, T stage, N stage, overall stage, and histologic type were not significantly associated with survival. Failure analysis revealed 83 patients (81%) with identifiable first failures. The median time to first failure was 9.8 months, and the median survival after first failure was 4.7 months. Failure patterns included local failure alone (19%), local and distant (20%), and distant alone (43%). Nineteen percent of patients had no documented progression. Total failure patterns were local in 39% and distant in 63%. Twenty-three patients (23%) had failure in the brain; they accounted for 31% of all distant failures. In 20 of these patients (20% of all patients), this was the only site of failure. There were eight (8%) initial nodal failures in 96 untreated contralateral supraclavicular fossae. No initial failures were seen in any of 101 untreated contralateral hila. The data suggest the following: (a) Combined treatment with V-CAP and TRT yielded excellent results (median survival, 16.2 months; 5-year survival, 18%).(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Results of combination chemotherapy and thoracic radiation therapy for unresectable non-small cell carcinoma of the lung. 255 4

In two different controlled prospective randomized trials the Lung Cancer Study Group has shown that adjuvant CAP chemotherapy is effective in prolonging the disease-free survival. These studies indicate that the adjuvant chemotherapy has its effect by way of diminishing systemic recurrences and that the adjuvant therapy is more effective in non-squamous than in squamous disease. In addition, the benefit of the treatment is more apparent in patients with more advanced, though resectable, disease. It is also becoming clear that chemotherapy either alone or in combination with radiation therapy can result in relatively high response rates in patients with disease localized to the thorax. Indeed, many of these individuals can then undergo surgical resection. It remains to be determined, however, whether or not this preoperative therapy will be effective in prolonging survival. In the future it is quite likely that optimum therapy will involve the use of preoperative treatment either with chemotherapy alone or a combination of chemotherapy and radiation therapy, followed postoperatively with adjuvant chemotherapy with a non-cross resistant regimen. In addition, a major problem is brain recurrences. Indeed the brain was the most frequent site of first recurrence systemically in many of these studies. Thus, more effective therapy directed at CNS disease will have to be developed before major breakthroughs can be anticipated in the surgical adjuvant therapy of lung cancer.
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PMID:Surgical adjuvant chemotherapy in non-small cell lung cancer. 283 30

The Lung Cancer Study Group randomized 141 patients with resected stage II and III adenocarcinoma and large-cell undifferentiated carcinoma to receive postoperative Cytoxan (Bristol-Meyers, Syracuse, NY), Adriamycin (Adria Laboratories, Columbus, Ohio), and cisplatin (CAP) chemotherapy or bacillus Calmette-Guerin (BCG) and levamisole immunotherapy. Careful intraoperative staging was performed on all patients. Before randomization, patients were stratified by stage, weight loss, cardiac arrhythmia, and institution. Prognostic variables such as stage, age, weight loss, and nodal involvement were equally distributed between the two groups. Disease-free survival was significantly prolonged in the group receiving chemotherapy. There was no evidence of a deleterious effect of the immunotherapy. This study indicates that postoperative CAP chemotherapy is effective in prolonging disease-free survival in these patients.
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PMID:Surgical adjuvant therapy for stage II and stage III adenocarcinoma and large-cell undifferentiated carcinoma. 300 26

Sixty patients with advanced squamous cell lung carcinoma were entered in a study comparing the effectiveness of BACON and CAP combination chemotherapy. The CAP regimen was superior to the BACON regimen in response rate (50% vs 33%), median survival time (36 vs 24 weeks), and median time to progression (25 vs 16 weeks). Median survival time for responders was longer in both treated groups than for nonresponders. Side effects were significant, but generally reversible. This study seems to indicate a role for the CAP combination (cyclophosphamide, adriamycin, cisplatinum) as treatment for patients with squamous cell lung carcinoma.
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PMID:Combination chemotherapy in squamous cell carcinoma of the lung. 608 85

The overall 5-year survival of surgically resected non-small cell lung cancer (NSCLC) remains less than 50% and is unlikely to improve until there are effective systemic adjuvant therapies. Two studies of the Lung Cancer Study Group (LCSG) have shown a modest impact of adjuvant CAP chemotherapy on disease-free and overall survival. In addition, a Finnish study, which randomized patients with T1-T3, N0 disease to CAP chemotherapy or follow-up, has also demonstrated an improvement in recurrence-free survival, as well as overall survival, at 5 and 10 years. On the other hand, an LCSG trial of adjuvant CAP in Stage I NSCLC (T2, N0, T1 N1) showed no benefit, although compliance with treatment was poor. Similarly, adjuvant trials using vindesine and cisplatin have not demonstrated benefit in studies done in Montreal and New York. Clearly, more effective systemic therapy is needed and must be evaluated in randomized trials in which patients have been carefully staged intra-operatively. Biological markers, such as vascular invasiveness, oncogene mutations and other factors may allow identification of specific subsets of patients at high risk of recurrence who can be targeted for aggressive adjuvant approaches in the future.
Lung Cancer 1995 Apr
PMID:Adjuvant chemotherapy: results and perspectives. 755 33

Disseminated micrometastatic disease limits the effectiveness of even the most aggressive locoregional treatment strategies in patients with early stage non-small cell lung cancer. One trial of the Lung Cancer Study Group (LCSG) demonstrated a significant decrease in the hazard rate for distant recurrence produced by adjuvant CAP chemotherapy after surgical resection and radiation therapy. French investigators found a significant decrease in distant metastases formation following sequential chemotherapy, radiation, and then additional chemotherapy compared to radiation alone in patients with stage III disease. However, other completed trials are either inconclusive, incompletely analyzed thus far or show no evidence of an effect of adjuvant chemotherapy on distant metastases. Additional data from recently completed or current trials will hopefully clarify the impact of adjuvant chemotherapy on distant micrometastases in patients with potentially curable non-small cell lung cancer (NSCLC).
Lung Cancer 1994 Mar
PMID:Does adjuvant chemotherapy decrease distant metastasis formation in patients with non-small cell lung cancer? 808 9

Small cell carcinoma of the lung is a separate clinical and pathological entity with characteristics of early and wide dissemination, and also great sensitivity on chemotherapy and radiotherapy. We evaluated results of therapy of patients with pathohistological verification of small cell carcinoma of the lung with use two polychemotherapy regimes (VCAV and CAP) particular or in combination with radiotherapy. We achieved the best results with application VCAV regime alone (local response 100%, complete response 78.6%, partial response 21.4%) or, in combination with radiotherapy in relation on CAP regime. Our results, when compared to experiences of foreign authors, though we evaluated it on minority series, also demonstrated better results when both regimes of polychemotherapy were used.
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PMID:[Evaluation of polychemotherapy of small cell lung carcinoma]. 962 75

Thymic tumours are rare diseases that for most of the cases are cured with surgery and eventually adjuvant radiotherapy. However, about 30% of patients present with advanced stage or relapsing tumours, which require administration of chemotherapy. While cisplatin-adriamycin-cyclophosphamide combination is regularly prescribed, other drugs have been assessed in the literature. Our aim is to evaluate the effectiveness (response rate) of systemic treatments, whatever the therapeutic line, including chemotherapy, targeted therapies and immunotherapies, in thymoma and thymic carcinoma, using the principles of evidence-based medicine. A systematic review was designed using the PICO system, by an experienced librarian and clinicians' experts in thoracic oncology, through the Ovid Medline system. Only phase II-IV trials and retrospective studies including at least 14 patients treated with the same regimen were considered. Articles were independently selected by at least two investigators. Fifty-five eligible articles were retrieved. Sixty% were dealing with platinum-based regimens, mainly cisplatin, and showed overall similar activity (mostly response rate above 50%) independently of the line of treatment or histological type (thymoma versus thymic carcinoma). Non-platinum based regimens included octreotide-prednisone and capecitabine-gemcitabine. Promising data of immunotherapy with antiPDL1 antibody (pembrolizumab) requires confirmation. Based on available data, the most popular and active regimens are cisplatin-anthracycline (CAP or ADOC) or cisplatin-etoposide combinations that should be recommended when considering first-line chemotherapy in thymoma or thymic carcinoma.
Lung Cancer 2018 12
PMID:Systemic treatments for thymoma and thymic carcinoma: A systematic review. 3052 89

Assessment of ALK gene rearrangements is strongly recommended by the Molecular Testing Guideline for Selection of Lung Cancer Patients proposed by IASLC, AMP, and CAP at the time of diagnosis for patients with advanced stage disease. Non-small-cell lung cancer (NSCLC) with ALK gene rearrangements or the resulting fusion proteins have been, for the most part, successfully targeted with ALK tyrosine kinase inhibitors (TKIs). The most frequent rearrangement, the EML4-ALK oncogenic fusion, has more than 10 distinct variants, each with a discrete breakpoint in EML4 Recent studies have suggested that EML4-ALK variants may have differential responses to TKIs. Additionally, non-EML4-ALK fusions that result from ALK rearrangements with diverse 5' partners could possibly have varied biologic and clinical implications in their therapeutic responses and outcomes of patients with NSCLC. Existing literature documents at least 20 non-EML4 fusion partners for ALK, and the clinical responsiveness to crizotinib ranges from increased sensitivity to resistance. This underscores the importance of identifying the precise 5' fusion partner to ALK before initiation of therapy. Herein we report the identification of a novel SLMAP-ALK fusion in a patient with NSCLC.
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PMID:Targeting SLMAP-ALK-a novel gene fusion in lung adenocarcinoma. 3116 Mar 57