The evolving locally-advanced non-small cell lung cancer landscape: Building on past evidence and experience

Méry, Benoîte; Guy, Jean‐Baptiste; Swalduz, Aurélie; Vallard, Alexis; Guibert, Christelle; Almokhles, H.; Mrad, Majed Ben; Rivoirard, Romain; Falk, Alexander Tuan; Fournel, P.; Magné, Nicolas

doi:10.1016/j.critrevonc.2015.05.020

Cited by 21 publications

(13 citation statements)

References 78 publications

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“…The results of the current study corroborate such a correlation between EQD 2,T and AE (Fig ) with a toxicity increase of 0.5% per 1 Gy increment in total dose. This is important since toxicity is of major concern with any dose escalation strategy . While in a substantial part of the reports radiation techniques were not explicitly mentioned, most studies used 3D used conformal RT.…”

Section: Discussionmentioning

confidence: 99%

“…In summary, it seems that the question of the best possible treatment strategy for stage III patients is a matter of ongoing debate, which can only be resolved by direct comparison of modified fractionation schedules to SOC within a prospective randomized control trial . Such a study must include 18 F‐FDG‐PET‐CT in the diagnostic work‐up and use modern radiation techniques to escalate the dose to the tumor while sparing OARs.…”

Section: Discussionmentioning

confidence: 99%

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Radiation dose escalation with modified fractionation schedules for locally advanced NSCLC: A systematic review

Zehentmayr¹,

Grambozov²,

Kaiser³

et al. 2020

Thoracic Cancer

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Concomitant chemo-radiotherapy (cCRT) with 60 Gy in 30 fractions is the standard of care for stage 111 non-small cell lung cancer (NSCLC). With a median overall survival of 28.7 months at best and maximum locoregional control rates of 70% at two years, the prognosis for these patients is still dismal. This systematic review summarizes data on dose escalation by alternative fractionation, which has been explored as a primary strategy to improve both local control and overall survival over the past three decades. A Pubmed literature search was performed according to the PRISMA guidelines. Because of the large variety of radiation regimens total doses were converted to EQD 2,T . Only studies using an EQD 2,T of at least 49.5 Gy, which corresponds to the conventional 60 Gy in six weeks, were included. In a total of 3256 patients, the median OS was 17 months (range 7.4-30 months). While OS was better for patients treated after the year 2000 (P = 0.003) or with a mandatory 18 F-FDG-PET-CT in the diagnostic workup (P = 0.001), treatment sequence did not make a difference (P = 0.106). The most commonly reported toxicity was acute esophagitis (AE) with a median rate of 24% (range 0%-84%). AE increased at a rate of 0.5% per Gy increment in EQD 2,T (P = 0.016). Dose escalation above the conventional 60 Gy using modified radiation fractionation schedules and shortened OTT yield similar mOS and LRC regardless of treatment sequence with a significant EQD 2,T dependent increase in AE. Key pointsSignificant findings • Modified radiation dose escalation sequentially combined with chemotherapy yields similar outcome as concomitant treatment. • OS is better with the mandatory inclusion of FDG-PET-CT in the diagnostic work-up. • The risk of acute esophagitis increases with higher EQD 2,T . What this study adds • Chemo-radiotherapy (CRT) with modified dose escalation regimens yields OS and LC rates in the range of standard therapy regardless of treatment sequence. This broadens the database of curative options in patients who are not eligible concomitant CRT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Radiation dose escalation with modified fractionation schedules for locally advanced NSCLC: A systematic review

Zehentmayr¹,

Grambozov²,

Kaiser³

et al. 2020

Thoracic Cancer

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“…Comparing with the survival rates of other cancers, 5-years survival rate of lung cancer is lower 1 . Therefore, much more attention has been paid to the discovery of new anticancer drugs 2 .…”

Section: Introductionmentioning

confidence: 89%

Novel indolyl-chalcone derivatives inhibit A549 lung cancer cell growth through activating Nrf-2/HO-1 and inducing apoptosis in vitro and in vivo

Zhao

Dong

Gao

et al. 2017

Sci Rep

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Increasing evidence indicates that Nrf-2, named the nuclear factor-erythroid 2-related factor, may perform anticancer function. In this study, a series of novel substituted phenyl- (3-methyl-1H-indol-2-yl)-prop-2-en-1-one (indolyl-chalcone) derivatives were synthesized and their effects on Nrf-2 activity were observed. We found that compounds 3a-3d and 6c elevated Nrf-2 activity. Then we evaluated their anticancer activities in vitro and in vivo by utilizing human lung cancer cell line A549. The in vitro results showed that among the compounds, 3d performed effectively anti-growth activity by inducing A549 lung cancer cell apoptosis and activating Nrf-2/HO-1 (heme oxygenase-1) pathway. In vivo, we proved that compound 3d inhibited the tumor growth effectively through inducing cell apoptosis without affecting CAM normal angiogenesis. These data suggest that our discovery of a novel Nrf-2 activator compound 3d would provide a new point of human lung cancer treatment.

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“…Improved OS with immunotherapy patients with NSCLC The high rate of patients with advanced disease explains, together with the poor results obtained by chemotherapy [25,26], the small rate of patients (5%) with a 5y-OS [24]. In the last years, the treatment of NSCLC has been completely changed by the development of immunotherapy agents, such as nivolumab and pembrolizumab.…”

Section: Lung Cancermentioning

confidence: 99%

Economic sustainability of anti-PD-1 agents nivolumab and pembrolizumab in cancer patients: Recent insights and future challenges

Tartari

Santoni

Burattini

et al. 2016

Cancer Treatment Reviews

120

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The evolving locally-advanced non-small cell lung cancer landscape: Building on past evidence and experience

Cited by 21 publications

References 78 publications

Radiation dose escalation with modified fractionation schedules for locally advanced NSCLC: A systematic review

Radiation dose escalation with modified fractionation schedules for locally advanced NSCLC: A systematic review

Novel indolyl-chalcone derivatives inhibit A549 lung cancer cell growth through activating Nrf-2/HO-1 and inducing apoptosis in vitro and in vivo

Economic sustainability of anti-PD-1 agents nivolumab and pembrolizumab in cancer patients: Recent insights and future challenges

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