Objective To investigate the efficacy of Zorifertinib in first-line treatment of patients with untreated epidermal growth factor receptor(EGFR)mutation in non-small-cell lung cancer(NSCLC)with central nervous system(CNS)metastases.Methods Two patients received Zorifertinib as first-line treatment.The response of tumor treatment was evaluated by response evaluation criteria in solid tumors version 1.1(RECEST v1.1)and RANO criteria for brain metastases(RANO-BM).Results Case 1 had EGFR exon 19del mutation and multiple brain metastases at baseline.After 51.4 months of treatment with Zorifertinib,case 1 still maintained partial response(PR)in lung lesions and complete response(CR)in intracranial lesions.Case 2 had EGFR exon 19del mutation and a single brain metastasis at baseline.Case 2 achieved PR in lung lesions and CR in intracranial lesions during the treatment with Zorifertinib.After 13.7 months,lung disease progression(PD)and new single brain metastases occurred.The comprehensive evaluation was PD.Case 1 had three-grade treatment-related adverse events(TRAEs),including dry skin,and other TRAEs were rash,abnormal liver function and diarrhea.The TRAEs were generally controllable.Conclusion Zorifertinib has a good effect on controlling intracranial and extracranial lesions in patients with EGFR-mutated NSCLC with CNS metastases.The efficacy of Zorifertinib is consistent with the EVEREST study.Zorifertinib can be one of the first-line initial treatment options.

Objective:To determine the value of colonoscopy in the diagnosis and treatment of patients with immune checkpoint inhibitor-induced colitis.Methods:Patients who developed colitis and underwent colonoscopy after receiving immune checkpoint inhibitors(ICIs)therapy at Tianjin Medical University General Hospital between December 2020 and December 2023 were reviewed,according to the guidelines of the Chinese Society of Clinical Oncology for the management of ICI-related toxicity.The effect of the treatment and the rela-tionship between prognosis and the pathological features of colonoscopy were analyzed.Results:Patients with ICI-associated colitis who un-derwent colonoscopy had a more than 3 degrees diarrhea,and diffused inflammatory features such as mucosal erythema,exudate,erosion,loss of vascular markings,and edema were observed under the microscope,and the presence of ulcers greater than 1 cm in diameter and/or more than 2 mm deep indicate a poor prognosis for enteritis.Histopathological studies showed changes in glandular structures,such as cryptitis and crypt abscess.The pathological colonoscopic manifestations of patients with microscopic enteritis were inconsistent,and more deep samples should have been taken.Conclusions:The toxicity grading of ICI-associated colitis is not limited to clinical manifestations,but refers to the multi-dimensional analysis of colonoscopic features and histopathological characteristics.Soft colonoscopy can be used as an important follow-up method for patients with colitis,owing to its ease of operation and good tolerance.

Objective:To investigate the value of the combined ultrasound imaging radiomics model for predicting progression-free survival in endocrine therapy for prostate cancer.Methods:A total of 283 prostate cancer patients who received endocrine treatment at the Inner Mongolia Autonomous Region People′s Hospital and the First Hospital of Hohhot from July 2018 to January 2023 were retrospectively collected, of which 198 patients from the Inner Mongolia Autonomous Region People′s Hospital were randomly divided into the training set and the validation set according to the ratio of 7∶3, and 85 patients from the First Hospital of Hohhot served as an independent external test set. They were classified into a progression group and a non-progression group based on whether the patients progressed to desmoplasia-resistant prostate cancer 18 months after the start of endocrine treatment.Based on the two-dimensional ultrasound images, the imaging radiomics features were extracted and the imaging radiomics score (Rad-score) were constructed, the immunopathology and other clinical data were analysed, and three prediction models were constructed using logistic regression: the clinical model, the ultrasonography model, and the ultrasonography-clinical combined model, respectively. The predictive efficacy and clinical utility of the models were assessed by the ROC curves and clinical decision curves.Results:Five ultrasonographic features were included in the ultrasound model; the prostate-specific antigen nadir, the neutrophil-to-lymphocyte ratio before treatment, and the expression level of tumour proliferating cell nuclear antigen 67 (Ki-67) were incorporated into the clinical model; and the Rad score computed from the output of the ultrasound model for the screening features, together with the prostate-specific antigen nadir (PSA nadir), the neutrophil to lymphocyte ratio (NLR) before treatment, and the expression level of Ki-67 were used to construct the ultrasound-clinical joint model. The joint model achieved the highest predictive performance in both the training and validation sets of the three groups of models, with the area under the curve of 0.85 and 0.84, and the clinical decision curve showed good clinical benefit.Conclusions:The combined ultrasound-clinical model constructed in this study based on two-dimensional ultrasound images of prostate cancer before endocrine therapy can predict progression-free survival of endocrine therapy for prostate cancer more accurately.

Humans ; East Asian People ; Nausea/drug therapy* ; Vomiting/drug therapy* ; Antineoplastic Agents/adverse effects* ; Neoplasms/drug therapy*

Objective:To compare the clinical efficacy of laparoscopic inguinal lymph node dissection(L-ILND)and open inguinal lymph node dissection(O-lLND)in the treatment of penile cancer after radical penile cancer surgery. Methods:The clinical outcomes of 63 patients who were diagnosed with penile cancer(TNM staging:T1_3,N0-3,M0)and received L-ILND(41 cases)or O-ILND(22 cases)after radical penile cancer surgery in Department of Urology,Hubei Cancer Hospital,Tongji Medical College,Huazhong University of Science and Technology from 2008 to 2020 were retrospectively studied.The primary endpoint of this study was overall survival,and the secondary endpoints were 5-year overall survival and 5-year cancer-specific survival.The different clinical characteristics were compared between the L-ILND group and O-ILND group.Univariate and multivariate logistic regression analysis was used to study the risk facotrs for postoperative wound complications.Kaplan-Meier method was used for prognosis analysis.COX regression analysis was used to investigate the factors for overall survival prediction. Results:Among the 63 penile cancer patients studied,41 patients received L-ILND and the remaining 22 received O-ILND.There were no statistically significant differences in the baseline characteristics between the two groups of patients.The median overall survival(78 months vs 72 months,P=0.844),5-year overall survival rate(74.5％vs 78.3％,P=0.144),5-year cancer-specific survival rate(77.2％vs 71.4％,P=0.228)showed no obvious difference between L-ILND and O-ILND group.The rate of postoperative wound complications in the O-ILND group was significantly higher than that in the L-ILND group(74％vs 15％,P=0.01 2).The result of multivariate COX regression analysis showed that tumor grade[hazard ratio(H-R)=2.774,P=0.021]and lymph node pathological stage(HR=1.482,P=0.024)were significantly correlated with patients'prognosis. Conclusion:The clinical efficacy of L-ILND and O-ILND is similar,but L-ILND has a higher safety profile and lower incidence of postoperative wound complications.Therefore,L-ILND is a more ideal surgical approach for inguinal lymph node dissection after radical penile cancer surgery.

Tyrosine kinase inhibitor (TKI) have been proved to be effective in the treatment of advanced non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) sensitive mutation, which is superior to chemotherapy. However, there are still some patients with sensitive mutations have primary drug resistance. It may be related to the coexistence of susceptible and resistant mutations of EGFR gene, downstream mutations of EGFR pathway, MET amplification and BIM deletion polymorphism. We present 2 cases of primary drug resistance and analyze the reasons.
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Carcinoma, Non-Small-Cell Lung ; diagnostic imaging ; drug therapy ; genetics ; Disease Progression ; Drug Resistance, Neoplasm ; drug effects ; genetics ; ErbB Receptors ; antagonists & inhibitors ; genetics ; Fatal Outcome ; Humans ; Lung Neoplasms ; diagnostic imaging ; drug therapy ; genetics ; Male ; Middle Aged ; Mutation ; Protein Kinase Inhibitors ; therapeutic use ; Treatment Outcome

BRAF gene mutation is found in about 2%-4% of the patients with non-small cell lung cancer (NSCLC). This type of NSCLC is characterized by high malignancy, low efficacy of chemotherapy and poor prognosis. Although the combination treatment of BRAF inhibitor and MEK inhibitor has achieved remarkable results in advanced NSCLC patients with BRAF V600E mutation, which has been written into the National Comprehensive Cancer Network (NCCN) guidelines, severe side effects of the combination therapy are frequently observed. There isn't effective treatment strategy after drug resistance, and targeted therapy for non-V600E mutation patients is still lacking. In this paper, we summarized the researches on expression of immune markers in NSCLC patients with mutant BRAF and analyzed the studies on efficacy of immune checkpoint inhibitor (ICI), so as to provide more options for prolonging survival of the patients.
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BACKGROUND: Chemotherapy is the most important method for cancer treatment. However, chemotherapy induced nausea and vomiting (CINV) has a profound effect on patients. In recent years, there have been new antiemetic drugs, such as aprepitant. We review the curative effect of aprepitant with tropisetron and dexamethasone for prevention of nausea and vomiting in patients receiving Cisplatin chemotherapy. METHODS: Observation is divided into three stages. Whole study phase (0-120 h after chemotherapy administration), acute phases (0-24 h), and delayed phase (24 h-120 h). The primary endpoints were complete response (CR) and complete prevention (CP) during the three different study phase. RESULTS: In the whole study phase, 86.02% of patients achieved CR; in acute phases and delayed phases were 89.25%, 87.1%, respectively. CP were 46.22%, 83.87%, 45.16%, respectively. Anti-CINV effect was significantly associated with age distribution (P=0.008). CONCLUSIONS Aprepitant with tropisetron and dexamethasone prevented effectively CNIV for patients receiving Cisplatin chemotherapy. This combination could improve the quality of life and the compliance of patient with chemotherapy.
Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents ; adverse effects ; Aprepitant ; Cisplatin ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Morpholines ; pharmacology ; Nausea ; chemically induced ; prevention & control ; Quality of Life ; Vomiting ; chemically induced ; prevention & control

Targeted therapy is one of the major treatment modalities in advanced non-small cell lung cancer (NSCLC) with sensitive driver gene mutations. BRAF is considered a promising oncogenic driver in NSCLC after the discovery of epidermal growth factor receptor (EGFR) mutation, anaplastic lymphoma kinase (ALK) fusion and ROS1 rearrangement. BRAF V600E mutation accounts for more than half of BRAF mutations, which is a potential therapeutic target for advanced NSCLC. This review aims to summarize the advancements of BRAF gene mutation and targeted therapy for BRAF mutation in NSCLC.
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Carcinoma, Non-Small-Cell Lung ; drug therapy ; enzymology ; genetics ; pathology ; Drug Resistance, Neoplasm ; genetics ; Humans ; Lung Neoplasms ; drug therapy ; enzymology ; genetics ; pathology ; Molecular Targeted Therapy ; methods ; Mutation ; Proto-Oncogene Proteins B-raf ; genetics

BACKGROUND: Malignant pleural effusion (MPE) refers to pleural effusion which arises from primary malignant tumor of pleura or other pleural metastatic tumors. Injection of elemene in chest makes good effect on the treatment of MPE, and is widely used in clinic. Adverse effects also exist, but the severe adverse effects and relevant managements are rarely reported. The aim of this study is to observe the adverse reactions induced by the treatment of malignant pleural effusion through elemene injection and to explore the solutions. METHODS: A retrospective analysis was made on 14 cases of patients receiving intra-pleural injections with elemene, and the incidence of severe adverse reactions of 7 cases were disscussed in detail. RESULTS: Most of the severe adverse reactions caused by elemene were severe chest pain, dyspnea, wheezing, clouding of consciousness and coagulopathy. CONCLUSIONS Strict screening, full preprocessing and close monitoring are necessary to prevent serious adverse reactions caused by elemene injection in the treatment of malignant pleural effusion.
Aged ; Female ; Humans ; Injections ; Male ; Middle Aged ; Pleural Effusion, Malignant ; drug therapy ; Retrospective Studies ; Sesquiterpenes ; administration & dosage ; adverse effects ; therapeutic use ; Thorax