Immune checkpoint inhibitor (ICI) has become one of the important therapeutic strategies for the patients with advanced non-small cell lung cancer (NSCLC). The latest clinical studies have shown that immunotherapy can bring more survival benefits to patients with early lung cancer and operable patients with locally advanced lung cancer. However, the strategies of neoadjuvant immunotherapy, the timing of operation, the evaluation system of curative effect, predictive markers and other problems still need to be explored in the clinical practice of large samples. This paper reviews the progress of neoadjuvant immunotherapy in NSCLC.

Objective To explore the treatment effect and failure patterns associated with different clinical target volume on patients with esophageal carcinoma treated with 5-filed intensity modulated radiotherapy (IMRT), and to determine whether involved field irradiation (IFI) is practicable in these patients. Methods A total of 88 patients with esophageal carcinoma between January 2012 to June 2014 underwent IMRT in our hospital, were divided into IFI group and elective nodal irradiation(ENI) group according to the CTV range for a concurrent control study. Results One-year and two-year survival rate in IFI group and ENI group were 75.0%, 45.5% and 70.5%, 43.2% respectively (P > 0.05). Local failure rate in IFI and ENI groups was 27.3% and 22.7% respectively, distant metastasis failure rates 22.7% and 18.2% respectively and regional failure rate outside the radiation field 11.4% and 4.5%, which showed no statistical difference (P > 0.05). Subgroup analysis indicated failure outside the radiation field tended to increase for primary lesion located in the up thoracic or clinical stageⅠ in IFI group. The volume dose histogram of lung V5, V20, V30 and mean lung dose of ENI group were greater than that of IFI group, while V5 of lung and the mean lung dose had statistical difference. Conclusions The survival rate and local control rate have no significant differencein IFI group and ENI group, so IFI is feasible for some esophageal carcinoma, but it should be cautious to choose IFI for those primary lesion located in the up thoracic or clinical stageⅠ.

With the advent of the times of immunotherapy and the emergence of a variety of unconventional response patterns such as delayed response and pseudo-progressive disease,a variety of immune-related efficacy evaluation criteria such as immune-related response criteria,immune-related response evaluation criteria in solid tumor and immune response evaluation criteria in solid tumor have been proposed successively.The evaluation principles and judgment results of these criteria are distinctly different from the traditional response evaluation criteria.In particular,the newly proposed immune response evaluation criteria in solid tumor introduces two new concepts of unconfirmed progressive disease and confirmed progressive disease and provides a new response evaluation model for solid tumors,which is expected to provide solutions to some of the most urgent clinical problems under the times of cancer immunotherapy.

Small cell lung cancer (SCLC) is a highly malignant tumor with a very poor prognosis; therefore, more effective treatments are urgently needed for patients afflicted with the disease. In recent years, emerging molecular classifications based on key transcription factors of SCLC have provided more information on the tumor pathophysiology, metastasis, immune microenvironment, and acquired therapeutic resistance and reflected the intertumoral heterogeneity of the various SCLC phenotypes. Additionally, advances in genomics and single-cell sequencing analysis have further revealed the high intratumoral heterogeneity and plasticity of the disease. Herein, we review and summarize these recent lines of evidence and discuss the possible pathogenesis of SCLC.
Humans ; Small Cell Lung Carcinoma/genetics* ; Lung Neoplasms/genetics* ; Prognosis ; Genomics ; Phenotype ; Tumor Microenvironment

Objective:To develop an assessment instrument for evaluating Filial Piety Value Scale among Children Whose Parents were Advanced Cancer Patients and to test the reliability and validity of the tool.Methods:Through literature review, semi-structured interview and expert letter consultation, the first version of the Filial Piety Value Scale (FVS) was developed. A convenience sampling method was adopted to recruit 352 children of patients with advanced cancer as respondents. Item analysis, reliability and validity were adopted to evaluate the items, and finally the formal version of FVS was developed.Results:The Internal Consistency of FVS was 0.86, and the content validity index of each item was 0.93-1.00.Two factors were extracted from exploratory factor analysis, and the cumulative contribution rate of variance was 60.25%. The two factors were named as Care (10 items) and Respect (5 items).The correlation coefficient between the total score of FVS and the total score of Filial Piety Values Index (FVI) was 0.496, and the correlation coefficient between the FVS total score and FVI Care and Respect score was 0.50 and 0.46, and the results were statistically significant ( P<0.01). Conclusion:The Filial Piety Value Scale of children whose parents were advanced cancer patients has good reliability and validity, which can be used to evaluate the filial piety value of children whose parents are advanced cancer.

Precision detection techniques have promoted the development of individualized diagnosis and treatment of tumors in the era of precision medicine. At the same time, clinical demands of precision treatments have further driven the development and application of precision detection techniques. In recent years, precision medical detection techniques realized rapid transformations from low-throughput to high-throughput genomic sequencing, from tissue biopsies to liquid biopsies, and from multicell promiscuous detection to single cell precision sequencing. All these changes have promoted the emergence and development of new technologies, new targets, and new drugs in the era of precision oncology medicine. In the future, multi-dimensional combined detection could help to improve the accuracy of precision medicine; ctDNA methylation detection analysis could broaden the research field of precision medicine; and the transformation of clinical trial design could also contribute to promote the in-depth development of precision medicine.

近年来，免疫检查点抑制剂在肺癌治疗中取得突破性进展，正迅速改变着肺癌的治疗模式，也标志着免疫治疗2.0时 代的到来。新的肿瘤治疗模式对精准医学提出更高要求，对程序性死亡受体1（programmed death 1, PD-1） /程序性死亡配体1 （programmed death ligand 1, PD-L1）抑制剂预后生物标志物也在不断地探索之中，主要包括以下几个方面：PD-L1表达水平、肿瘤 基因组异质性与肿瘤新抗原、 T细胞特点、肿瘤微环境以及机体整体状态等。本文将针对目前PD-1/PD-L1抑制剂在肺癌免疫治 疗中的潜在生物标志物最新临床研究进展及其研究前景进行综述。

Immune checkpoint signaling pathway mediates tumor immune escape through various mechanisms. In recent years, studies on immune checkpoint inhibitors have made great breakthroughs in various tumors. However, characteristics of the tumor cells, abnormal presentation of the antigens, functional gene mutations, tumor immune microenvironment, internal environment of patients and metabolic factors can all lead to primary or secondary resistance to immunotherapy. The exploration of the molecular mechanism and response strategy of immunotherapy is the key to further expand the beneficial population treated by immune checkpoint inhibitors and realize the accurate treatment.

Epidermal growth factor receptor ( EGFR ) mutations are common oncogenic driver mutations in patients with non-small cell lung cancer (NSCLC). The application of EGFR-tyrosine kinase inhibitors (TKIs) is beneficial for patients with advanced and early-stage NSCLC. With the development of next-generation sequencing technology, numerous patients have been found to have more than one genetic mutation in addition to a single EGFR mutation; however, the efficacy of conventional EGFR-TKIs and the optimal treatments for such patients remain largely unknown. Thus, we review the incidence, prognosis, and current treatment regimens of EGFR compound mutations and EGFR concomitant mutations to provide treatment recommendations and guidance for patients with these mutations.
Humans ; Carcinoma, Non-Small-Cell Lung/genetics* ; Lung Neoplasms/genetics* ; Protein Kinase Inhibitors/pharmacology* ; Mutation/genetics* ; ErbB Receptors

Objective:To investigate the filial piety value level and the influencing factors of filial piety among children whose parents were diagnosed as advanced cancer.Methods:A convenient sampling method was used to recruit 383 participants in Tumor Hospital, Tianjin Medical University.Results:The total score of Filial Piety Value Scale among children whose parents were advanced cancer patients was (66.50±4.10) . The age of the patient, the number of hospitalization and the degree of awareness of the condition, the age of the children, whether the child was the-only-child, whether the child was living with the patient, and the average daily care time influenced the filial piety values of children whose parents were advanced cancer patients ( Z=16.64-62.94, U=2.04-4.27, P<0.05). Conclusion:Children whose parents were with advanced cancer have a better understanding of filial piety. Nurses understand the values of filial piety of children in the context of traditional filial piety and family care mode in China, which can enhance the experience of filial piety and filial piety of both children and parents, also improve the mental health problems of patients, and finally improve the quality of life of patients with advanced cancer.