1.Expert consensus on the clinical application of antibody drug conjugates in the treatment of malignant tumors (2023 edition).
Chinese Journal of Oncology 2023;45(9):741-762
Antibody-drug conjugates (ADCs) are a class of targeted biological agents that link cytotoxic drugs to monoclonal antibodies through linkers. The monoclonal antibody targets tumor cells and transports small-molecule cytotoxic drugs for specific delivery and minimal off-target side effects. September 30, 2022, 14 anti-tumor ADC drugs have been approved for marketing in the world, and four ADCs have been approved in China. With the improvement of the clinical accessibility of ADC drugs, clinicians urgently need to understand the molecular characteristics and mechanisms of ADCs, and clarify the indications for rational use of drugs. Patients' survival mainly depends on the appropriate dose and course of treatment and also on proper management of adverse reactions. In view of this, on the basis of the "Expert Consensus on the Clinical Application of Antibody-drug Conjugates for the Treatment of Malignant Tumors (2020 edition)" , Professional Committee on Clinical Research of Oncology Drugs, Chinese Anti-Cancer Association fully combines the existing clinical research evidence and the feasibility of current ADC drugs in China to update the consensus content. This consensus aims to provide a systematic overview of ADC drugs, so as to provide practical and effective suggestions and references for clinicians to apply and manage ADC drugs more accurately.
Humans
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Immunoconjugates/therapeutic use*
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Consensus
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Neoplasms/drug therapy*
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Antineoplastic Agents/adverse effects*
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Antibodies, Monoclonal/therapeutic use*
2.Efficacy and Safety of Apatinib in Treating Advanced Colorectal Cancer.
Ning Ning LI ; Jian Feng ZHOU ; Lin ZHAO ; Hong Yan YING ; Ning JIA
Acta Academiae Medicinae Sinicae 2019;41(2):170-174
Objective To assess the efficacy and safety of apatinib in the treatment of advanced colorectal cancer(CRC). Methods The clinical data of 16 CRC patients treated with apatinib after failure of prior lines of treatment were retrospectively analyzed in terms of objective response rate,disease control rate,progression-free survival,overall survival,adverse events,and prognostic factors. Results The efficacy was evaluable in 14 patients,among whom the objective response rate was 7.1% and the disease control rate was 50%.The median progression-free survival was 3 months(95%CI=1.57-4.42),and the median overall survival was 6.5 months(95%CI=4.10-8.89).The safety was evaluable in 16 patients,among whom the most common grade 3 adverse events were hypertensinon(37.5%)and proteinuria(25%).No grade 4 adverse event was observed.Multivariate analysis did not show any factor directly related to survival.Conclusion Apatinib may be effective in treating advanced CRC,with tolerable side effects.
Antineoplastic Agents
;
adverse effects
;
therapeutic use
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Colorectal Neoplasms
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drug therapy
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Humans
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Pyridines
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adverse effects
;
therapeutic use
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Retrospective Studies
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Survival Analysis
3.Interstitial Lung Disease Associated with Combination Chemotherapy of Oxaliplatin, 5-Fluorouracil, and Leucovorin.
Sul PARK ; Jae Jin JUNG ; Goeng Bae KIM ; Hyung Sik YOON ; Sang Hun KO ; Jae Ee KO ; Yeun Seun LEE
The Korean Journal of Gastroenterology 2010;55(5):340-343
Oxaliplatin with 5-fluorouracil plus leucovorin (FOLFOX) has become the standard treatment in patients with colorectal cancer. Among known toxicities induced by oxaliplatin, hematological, gastrointestinal and neurological toxicities are common. However, acute pulmonary toxicity associated with oxaliplatin is unusual. One case of interstitial lung disease associated with the FOLFOX protocol is reported here.
Aged
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Antineoplastic Agents/*adverse effects/therapeutic use
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Antineoplastic Combined Chemotherapy Protocols
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Colorectal Neoplasms/drug therapy
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Fluorouracil/*adverse effects/therapeutic use
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Humans
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Leucovorin/*adverse effects/therapeutic use
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Lung Diseases, Interstitial/chemically induced/*etiology/radiography
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Male
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Organoplatinum Compounds/*adverse effects/therapeutic use
4.Interstitial Lung Disease Associated with Combination Chemotherapy of Oxaliplatin, 5-Fluorouracil, and Leucovorin.
Sul PARK ; Jae Jin JUNG ; Goeng Bae KIM ; Hyung Sik YOON ; Sang Hun KO ; Jae Ee KO ; Yeun Seun LEE
The Korean Journal of Gastroenterology 2010;55(5):340-343
Oxaliplatin with 5-fluorouracil plus leucovorin (FOLFOX) has become the standard treatment in patients with colorectal cancer. Among known toxicities induced by oxaliplatin, hematological, gastrointestinal and neurological toxicities are common. However, acute pulmonary toxicity associated with oxaliplatin is unusual. One case of interstitial lung disease associated with the FOLFOX protocol is reported here.
Aged
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Antineoplastic Agents/*adverse effects/therapeutic use
;
Antineoplastic Combined Chemotherapy Protocols
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Colorectal Neoplasms/drug therapy
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Fluorouracil/*adverse effects/therapeutic use
;
Humans
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Leucovorin/*adverse effects/therapeutic use
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Lung Diseases, Interstitial/chemically induced/*etiology/radiography
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Male
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Organoplatinum Compounds/*adverse effects/therapeutic use
6.Chemotherapy induced liver abnormalities: an imaging perspective.
Ankush SHARMA ; Roozbeh HOUSHYAR ; Priya BHOSALE ; Joon Il CHOI ; Rajesh GULATI ; Chandana LALL
Clinical and Molecular Hepatology 2014;20(3):317-326
Treating patients undergoing chemotherapy who display findings of liver toxicity, requires a solid understanding of these medications. It is important for any clinician to have an index of suspicion for liver toxicity and be able to recognize it, even on imaging. Cancer chemotherapy has evolved, and newer medications that target cell biology have a different pattern of liver toxicity and may differ from the more traditional cytotoxic agents. There are several hepatic conditions that can result and keen clinical as well as radiographic recognition are paramount. Conditions such as sinusoidal obstructive syndrome, steatosis, and pseudocirrhosis are more commonly associated with chemotherapy. These conditions can display clinical signs of acute hepatitis, liver cirrhosis, and even liver failure. It is important to anticipate and recognize these adverse reactions and thus appropriate clinical action can be taken. Often times, patients with these liver manifestations can be managed with supportive therapies, and liver toxicity may resolve after discontinuation of chemotherapy.
Adult
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Aged
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Antibiotics, Antineoplastic/adverse effects/therapeutic use
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Antimetabolites, Antineoplastic/adverse effects/therapeutic use
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Antineoplastic Agents/*adverse effects/therapeutic use
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Antineoplastic Agents, Alkylating/adverse effects/therapeutic use
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Drug-Induced Liver Injury/etiology/radiography
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Enzyme Inhibitors/adverse effects/therapeutic use
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Fatty Liver/etiology/radiography
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Female
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Humans
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Immunotherapy
;
Liver Cirrhosis/etiology/radiography
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Liver Diseases/etiology/*radiography
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Male
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Middle Aged
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Neoplasms/therapy
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Tomography, X-Ray Computed
7.A meta analysis of gemcitabine plus platinum chemotherapy compared with single-agent chemotherapy in the treatment of non-small cell lung cancer.
Yunjiu GOU ; Lingjuan ZHANG ; Qimei YANG ; Rongfang ZHANG ; Huiling GUO ; Lei JIANG ; Kehu YANG ; Jinhui TIAN
Chinese Journal of Lung Cancer 2010;13(3):216-223
BACKGROUND AND OBJECTIVEWhether gemcitabine plus platinum chemotherapy is superior to gemcitabine or platinum single-agent chemotherapy for patients with non-small cell lung cancer (NSCLC) is still in dispute, and the aim of this study is to evaluate the efficacy and safety of gemcitabine combining platinum chemotherapy for patients with NSCLC.
METHODSWe searched relevant randomized controlled trials (RCTs) from VIP, CBM, CNKI, the Cochrane library, PUBMED and EMBASE. We traced the related references and experts in this field and communicated with other authors to obtain the information that has not been found. We made quality assessment of qualified RCTs assessed by the exclusion and inclusion criteria and used RevMan 5.0 provided by the Cochrane Collaboration to perform meta-analysis.
RESULTSFour RCTs were eligible and included 984 patients. Meta analysis results suggested that: compared with gecitabine single-agent chemotherapy, the combination had a statistically significant benefit in increasing the response rate (OR = 3.29, 95% CI: 1.79-6.05, P = 0.000 1) and 2-year survival rate (OR = 3.22, 95% CI: 1.45-7.12, P = 0.004) while increased the risk of the incidence of adverse reactions, especially the grade 3-4 thrombocytopenia (RR = 8.16, 95% CI: 1.71-39.07, P = 0.009); compared with cisplatin single-agent chemotherapy, the combination had a statistically significant benefit in increasing the response rate (OR = 3.51, 95% CI: 2.20-5.60, P < 0.01) and 1-year survival rate (OR = 1.67, 95% CI: 1.16-2.41, P = 0.006) while increased the risk of the incidence of adverse reactions, especially the grade 3-4 thrombocytopenia (OR = 28.55, 95% CI: 14.06-57.04, P < 0.01).
CONCLUSIONCompared with single-agent chemotherapy, the combining can significantly improve the efficiency and survival rate while increase the toxicity rare. The results still need to be proved by high quality RCTs.
Antineoplastic Agents ; adverse effects ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; mortality ; Deoxycytidine ; adverse effects ; analogs & derivatives ; therapeutic use ; Humans ; Lung Neoplasms ; drug therapy ; mortality ; Platinum ; adverse effects ; therapeutic use ; Treatment Outcome
9.Comparing two arsenic trioxide administration methods in APL therapy.
Jin ZHOU ; Ran MENG ; Bao-feng YANG
Chinese Medical Journal 2004;117(9):1411-1413
10.A Meta-Analysis of Efficacy and Adverse Effects of Lobaplatin and Cisplatin in the Treatment of Malignant Pleural Effusion.
Shihui MIN ; Qiangqiang ZHENG ; Bailu ZHANG ; Danli YAN ; Rulan WANG ; Zihan QU ; Lu LI ; Jiewei LIU ; Qinghua ZHOU
Chinese Journal of Lung Cancer 2019;22(2):90-98
BACKGROUND:
The aim of this study is to systematically evaluate the efficacy and adverse effects of Lobaplatin and Cisplatin in the treatment of malignant pleural effusion.
METHODS:
The databases of Medline (PubMed), Embase, Web of Science, Cochrane, Wanfang, CNKI and VIP were retrieved so as to search the studies about the randomized controlled clinical trials (RCT) that compared the Lobaplatin and Cisplatin for malignant pleural effusion. The main outcome indicators include objective response rate, complete response, partial response, nephrotoxicity, chest pain, gastrointestinal reaction, myelosuppression, fever response and hepatotoxicity. Relative risk was used as the effect size, which was expressed as 95% confidence interval. The meta-analysis was performed using Stata 14.0 statistical software.
RESULTS:
A total of 12 RCTs and 720 MPE patients were included. The results showed that the ORR (RR=1.27, 95%CI: 1.15-1.40, P<0.001), CR (RR=1.39, 95%CI: 1.09-1.78, P=0.007), PR (RR=1.21, 95%CI: 1.02-1.42, P=0.026) in LBP thoracic perfusion chemotherapy were significantly higher than those in DDP thoracic perfusion chemotherapy. The incidence of nephrotoxicity (RR=0.31, 95%CI: 0.13-0.71, P=0.005) and gastrointestinal reactions (RR=0.44, 95%CI: 0.31-0.62, P<0.001) in the LBP group were significantly lower than those in DDP group.
CONCLUSIONS
Compared with DDP pleural perfusion chemotherapy, the ORR, CR and PR of LBP pleural perfusion chemotherapy for MPE are significantly better than DDP, and its nephrotoxicity and gastrointestinal reactions are remarkably lower than DDP.
Antineoplastic Agents
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adverse effects
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therapeutic use
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Cisplatin
;
adverse effects
;
therapeutic use
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Cyclobutanes
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adverse effects
;
therapeutic use
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Humans
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Organoplatinum Compounds
;
adverse effects
;
therapeutic use
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Pleural Effusion, Malignant
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drug therapy
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Randomized Controlled Trials as Topic