Researchers from the Cancer Hospital Affiliated to Sun Yat-sen University have recently published articles that published the results of the ICOGEN Phase III icogen study and the new findings of the clinical application of PET / CT in nasopharyngeal carcinoma. Related results were published in The Lancet Oncology (impact factor 25.117) and Journal of Clinical Oncology (impact factor 18.038).
In the first article, researchers from the Cancer Hospital Affiliated to Sun Yat-sen University, the Cancer Hospital of the Chinese Academy of Medical Sciences and others have used randomized, double-blind double-simulation, parallel control, multi-center evaluation of icotinib and gefitinib before Phase II / III clinical trials of efficacy and safety of one or two chemotherapy patients with locally advanced or metastatic non-small cell lung cancer.
The first author of the article is Professor Shi Yuankai of Cancer Hospital of Chinese Academy of Medical Sciences and Professor Zhang Li of Cancer Hospital of Sun Yat-sen University. Corresponding author is Academician Sun Yan.
Icotinib hydrochloride is an oral EGFR tyrosine kinase inhibitor. Early clinical studies have shown that it has anti-tumor activity and acceptable toxicity. The researchers collected 27 advanced non-small cell lung cancer patients from China, aged between 18 and 75, who did not respond to one or more platinum-based chemotherapy regimens.
Subjects were randomly divided into two groups, one group received icotinib hydrochloride (125 mg three times daily) and the other group received gefitinib (250 mg once daily) until disease progression or intolerance occurred Toxicity.
The researchers found that compared with the gefitinib group, the patients in the icotinib hydrochloride group had fewer drug-related adverse events, and the difference between the two was statistically significant. The aspect is particularly obvious. The results of the study indicate that for patients with advanced non-small cell lung cancer who have received prior treatment, icotinib hydrochloride is an alternative new treatment method.
The results of these studies were published in abstracts at academic conferences such as the American Congress of Oncology (ASCO), the World Congress of Lung Cancer (WCLC), and the European Annual Meeting of Cancer (ESMO) in 2011 and 2012.
In another article, the research team of Professor Mai Haiqiang of the Nasopharyngology Department of the Cancer Prevention and Treatment Center found that PET / CT was used in N2-3 staging and plasma EBV DNA ≥4000copies / ml in patients with nasopharyngeal cancer. In terms of consideration, this group has benefited the most. The research results are of great significance for guiding the clinical application of PET / CT in nasopharyngeal carcinoma.
Nasopharyngeal cancer (NPC) is more prevalent in South China and Southeast Asia. Radiotherapy is the main treatment for this disease. Early detection of remote metastasis is indispensable for accurate staging and optimal control. Although the 2011 edition of the National Comprehensive Cancer Network Guidelines believes that for NPC patients with WHO type 2 to 3 / N2-3 disease, it is recommended to consider [18F] fluorodeoxyglucose positron emission computed tomography and computed tomography (PET / CT) Remote metastasis detection is carried out, but this view is rarely supported by research.
The researchers collected 583 patients and found 86 (14.8%) patients with distant metastasis; among them, 71 cases (82.6%) were detected by PET / CT and 31 cases (36.0%) were detected by CWU. Multivariate analysis showed that EBV DNA levels in late N and pre-treatment (a significant risk factor for distant metastasis. For the detection of remote metastasis in very low-risk patients, PET / CT is not superior to CWU (N0-1 and EBV DNA, But for low-risk patients (N0-1 and EBV DNA ≥ 4,000 copies / mL and N2-3 and EBV DNA <4,000 copies / mL; P = .039) and moderate-risk patients (N2-3 and EBV DNA ≥ 4,000 copies / mL; P <.001), PET / CT is better than CWU.
Compared with traditional staging methods, PET / CT is more likely to detect distant metastases in NPC patients. The results of this study indicate that patients with stage N2-3 and EBV DNA ≥ 4,000 copies / mL can obtain the greatest benefit in terms of cost and control.
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