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Therapy of non-small cell lung cancer
Abstracts/Lung
Cancer
13 (1995)
231
185-232
iridium-ill-labelled somatostatin analogue DTPA-D-Phe-octreotide. The aim of the study was to investigate whether treatment with a cold somatostatin analogue can affect the imaging of somatostatin receptor scintigraphy. Metho& Three patients with SCLC were treated with 200 ig of cold octreotide three times a day subcutaneously for 7 days. Whole body and planar scintigraphy was performed before and after the treatment. Results: “‘In-DTPAoctreotide uptake was increased in cancer lesions, whereas focaton in normal tissues (liver, spleen, kidneys) decreased. Conclusions: This is the tirst demonstration of an enhance.ment of SCLC imaging following unlabelled somatostatin analogue administration. Similar results have been described by other authors in a limited number of carcinoid tumors.
Y monoclonal antibody (mAb) (cH18A) were investigated. Human adenocarcinoma cell lines (pC7, PC9, and PC14) were used as targets. PC7 and PC9, expressing Lewis Y antigen were lysed by cH18A as effectively as parent mouse anti-Lewis Y mAb (mHl8A) in a dose dependent manner. PC14 with no expression of Lewis Y antigen was not lyscd by any anti-Lewis Y mAbs. cHl8A mAb mediated CDC activities against PC7 and PC9 was enhanced by combined use of mAbs against complement regulatory proteins (CRPs). ADCC mediated by cH18A mAb was augmented with the supplementation of normal human serum. This was inhibited by blocking of CD 1 la or CD 1lb, suggesting the possibility that deposition of cHl8A mAb and C3b/C3bi might promote further anti-tumor effects not only by CDC but by ADCC activity.
Hyperthermia in the treatment of brain metastases from lung cancer. Experience on 17 cases Pontiggia P, Curto FC, Rotella G, Sabato A, Rizzo S, Butti G. Service
Reviews
of Oncologic Hyperihermia, Vecchio 27, I-27100 Pavia.
Casa
di Cum,
Citta
di Pavio,
I/is Parco
Anticancer Res 1995;15:597-601. Medium or long-term survival in metastatic ‘non oat cell’, lung tumors is seldom possible only if surgery can eradicate the lesion. Gut of 17 patients treated with hypcrthermia plus nitrosoureas 16 (94%) responded with clinical improvement, radiological regression or disease stabilization. The survival time of the improved patients was 12,7 months. Hyperthermia in combination with nitrosoureas seems to allow clinically andradiologically satisfactory responses in lung tumors metastatic to the brain. Combined endobronchial and conventional able central lung cancer Bolliger CT, Soler M, Tamm M, Perruchoud Pneumologie,
Kantonsspital,
therapy
of inoper-
AF’. Abteilungfur 4, CH-4031 Basel. Schweiz
Petersgraben
Med Wochenschr 1995;125:1052-9. Up to 85% of patients with bronchogenic carcinoma are inoperable at the time of diagnosis and treatment remains largely palliative. Prognosis depends on the clinical tumor stage. In non-small cell carcinoma the clinical stages (I-IV) are defined according to the TNM classification, whereas in small cell carcinoma limited disease is distinguished from extensive disease. Neither classification accurately takes endobronchial tumor spread into account, At the time of diagnosis up to 30% of all lung cancer patients present with central airway obstruction and clinical signs of dyspnea, atelectasis and pneumonia. Most patients with central airway stenosis have inoperable tumors (stage IIIb and IV) and have until recently undergone conventional treatment consisting exclusively of chemo- and radiotherapy. Currently the best results are obtained with combined chemoradiotherapy. The rapid developments in the area of endobronchial treatment modalities enable us to relieve bronchial obstructions fast and safely. This achieves immediate symptomatic relief which in many cases is a precondition for starting chemo- or radiotherapy. Successful reopening of a major airway helps to prolong local tumor control and thus survival. Patients with inoperable lung cancer and obstruction of central airways should undergo initial endobmnchial therapy followedby conventional chemoradiotherapy. Induction of cytotoric activity against lung adenocarcinoma chimeric anti-Lewis Y antibody Amma A, Shibuya M, Yagita H, Okumura K, Kudoh S. Fourth ofInternal ku. Tokyo
Medicine,
Nippon
Medical
School,
I-I-S
Sendagi,
by Dept. Bunkyo-
II3. Biotherapy (Japan) 1995;9:292-3. The complement dependent cytotoxicity (CDC) and the antibody dependent celhdar cytotoxicity (ADCC) mediated by chimeric anti-Lewis
Small cell lung cancer: State-of-the-art therapy 1994 Ihde DC. Barnard Cancer Cente,: Box 8056, 660 S Euclid, St. Louis, MO 63110. Chest 1995;107:Suppl:243S-8s. In the United States, small cell lung cancer (SCLC) accounts for about 20% of all cases of lung cancer. Without treatment, tumor progression in patients with SCLC is rapid, with a median survival of 2 to 4 months. Modem chemotherapy has yielded multifold increases in median survival, but only minimal improvements have occurred over the last decade. Combination chemotherapy with etoposide/cisplatin prolongs survival, especially in patients with limited disease. In patients at high risk of toxicity from standard combination chemotherapy, singleagent chemotherapy may have a viable role, but whether its efftcacy is comparable to conbination regimens must be established in clinical trials. Clearly, new, more effective drugs will be required for any major improvements in the treatment of SCLC. Combined-modality therapy employing chemotherapy and chest irradiation appears to produce excellent cytotoxic effects and is relatively well tolerated in patients with limited disease. A recent meta-analysis of 13 randomized trials showed a modest but significant 14% reduction in the relative mortality rate of patients receiving chemotherapy/chest irradiation vs those receiving chemotherapy alone. Surgery as sole treatment can produce cures in highly selected patients with limited disease and can reduce the rate of local recurrence. The use of surgery after definitive treatment remains experimental and should not be considered other than in controlled clinical trials. Therapy Klastersky
of non-small cell lung cancer J. Institut Jules Border, Centre de Tumeurs
Lab d ‘Investigation Clin. H.J.Tagnon, I rue Brussels. Lung Cancer (Ireland) 1995;12:Suppl
de I ‘Univ. Heger-Bordei,
Libm, 1000
l:S133-45. A few regimens can give clinical responses and more prolonged survival to the patients with NSCLC who respond. In addition, there is often a suppression of morbid symptoms in those patients. This is the situation that can be obtained in about 30% of the treated patients and, in addition, the treatment corresponds, from the psychological point of view, to what the patient expects. The toxicity of chemotherapy and the resulting morbidity and mortality can, to a large extent, be controlled by a close clinical follow-up and the use of various techniques of supportive care. Such a surveillance of patients probably explains why administration of planned therapy can be less expensive than palliative care. The management of lung cancer Hutas I. Pubnonologiai Klinika, Semmelweis Orvostudomanyi Egyetem, Budapest. Orvoskepzes 1995;70:5-13. Lung cancer is one of the organ manifestations which is most diEcult
Cancer
13 (1995)
231
185-232
iridium-ill-labelled somatostatin analogue DTPA-D-Phe-octreotide. The aim of the study was to investigate whether treatment with a cold somatostatin analogue can affect the imaging of somatostatin receptor scintigraphy. Metho& Three patients with SCLC were treated with 200 ig of cold octreotide three times a day subcutaneously for 7 days. Whole body and planar scintigraphy was performed before and after the treatment. Results: “‘In-DTPAoctreotide uptake was increased in cancer lesions, whereas focaton in normal tissues (liver, spleen, kidneys) decreased. Conclusions: This is the tirst demonstration of an enhance.ment of SCLC imaging following unlabelled somatostatin analogue administration. Similar results have been described by other authors in a limited number of carcinoid tumors.
Y monoclonal antibody (mAb) (cH18A) were investigated. Human adenocarcinoma cell lines (pC7, PC9, and PC14) were used as targets. PC7 and PC9, expressing Lewis Y antigen were lysed by cH18A as effectively as parent mouse anti-Lewis Y mAb (mHl8A) in a dose dependent manner. PC14 with no expression of Lewis Y antigen was not lyscd by any anti-Lewis Y mAbs. cHl8A mAb mediated CDC activities against PC7 and PC9 was enhanced by combined use of mAbs against complement regulatory proteins (CRPs). ADCC mediated by cH18A mAb was augmented with the supplementation of normal human serum. This was inhibited by blocking of CD 1 la or CD 1lb, suggesting the possibility that deposition of cHl8A mAb and C3b/C3bi might promote further anti-tumor effects not only by CDC but by ADCC activity.
Hyperthermia in the treatment of brain metastases from lung cancer. Experience on 17 cases Pontiggia P, Curto FC, Rotella G, Sabato A, Rizzo S, Butti G. Service
Reviews
of Oncologic Hyperihermia, Vecchio 27, I-27100 Pavia.
Casa
di Cum,
Citta
di Pavio,
I/is Parco
Anticancer Res 1995;15:597-601. Medium or long-term survival in metastatic ‘non oat cell’, lung tumors is seldom possible only if surgery can eradicate the lesion. Gut of 17 patients treated with hypcrthermia plus nitrosoureas 16 (94%) responded with clinical improvement, radiological regression or disease stabilization. The survival time of the improved patients was 12,7 months. Hyperthermia in combination with nitrosoureas seems to allow clinically andradiologically satisfactory responses in lung tumors metastatic to the brain. Combined endobronchial and conventional able central lung cancer Bolliger CT, Soler M, Tamm M, Perruchoud Pneumologie,
Kantonsspital,
therapy
of inoper-
AF’. Abteilungfur 4, CH-4031 Basel. Schweiz
Petersgraben
Med Wochenschr 1995;125:1052-9. Up to 85% of patients with bronchogenic carcinoma are inoperable at the time of diagnosis and treatment remains largely palliative. Prognosis depends on the clinical tumor stage. In non-small cell carcinoma the clinical stages (I-IV) are defined according to the TNM classification, whereas in small cell carcinoma limited disease is distinguished from extensive disease. Neither classification accurately takes endobronchial tumor spread into account, At the time of diagnosis up to 30% of all lung cancer patients present with central airway obstruction and clinical signs of dyspnea, atelectasis and pneumonia. Most patients with central airway stenosis have inoperable tumors (stage IIIb and IV) and have until recently undergone conventional treatment consisting exclusively of chemo- and radiotherapy. Currently the best results are obtained with combined chemoradiotherapy. The rapid developments in the area of endobronchial treatment modalities enable us to relieve bronchial obstructions fast and safely. This achieves immediate symptomatic relief which in many cases is a precondition for starting chemo- or radiotherapy. Successful reopening of a major airway helps to prolong local tumor control and thus survival. Patients with inoperable lung cancer and obstruction of central airways should undergo initial endobmnchial therapy followedby conventional chemoradiotherapy. Induction of cytotoric activity against lung adenocarcinoma chimeric anti-Lewis Y antibody Amma A, Shibuya M, Yagita H, Okumura K, Kudoh S. Fourth ofInternal ku. Tokyo
Medicine,
Nippon
Medical
School,
I-I-S
Sendagi,
by Dept. Bunkyo-
II3. Biotherapy (Japan) 1995;9:292-3. The complement dependent cytotoxicity (CDC) and the antibody dependent celhdar cytotoxicity (ADCC) mediated by chimeric anti-Lewis
Small cell lung cancer: State-of-the-art therapy 1994 Ihde DC. Barnard Cancer Cente,: Box 8056, 660 S Euclid, St. Louis, MO 63110. Chest 1995;107:Suppl:243S-8s. In the United States, small cell lung cancer (SCLC) accounts for about 20% of all cases of lung cancer. Without treatment, tumor progression in patients with SCLC is rapid, with a median survival of 2 to 4 months. Modem chemotherapy has yielded multifold increases in median survival, but only minimal improvements have occurred over the last decade. Combination chemotherapy with etoposide/cisplatin prolongs survival, especially in patients with limited disease. In patients at high risk of toxicity from standard combination chemotherapy, singleagent chemotherapy may have a viable role, but whether its efftcacy is comparable to conbination regimens must be established in clinical trials. Clearly, new, more effective drugs will be required for any major improvements in the treatment of SCLC. Combined-modality therapy employing chemotherapy and chest irradiation appears to produce excellent cytotoxic effects and is relatively well tolerated in patients with limited disease. A recent meta-analysis of 13 randomized trials showed a modest but significant 14% reduction in the relative mortality rate of patients receiving chemotherapy/chest irradiation vs those receiving chemotherapy alone. Surgery as sole treatment can produce cures in highly selected patients with limited disease and can reduce the rate of local recurrence. The use of surgery after definitive treatment remains experimental and should not be considered other than in controlled clinical trials. Therapy Klastersky
of non-small cell lung cancer J. Institut Jules Border, Centre de Tumeurs
Lab d ‘Investigation Clin. H.J.Tagnon, I rue Brussels. Lung Cancer (Ireland) 1995;12:Suppl
de I ‘Univ. Heger-Bordei,
Libm, 1000
l:S133-45. A few regimens can give clinical responses and more prolonged survival to the patients with NSCLC who respond. In addition, there is often a suppression of morbid symptoms in those patients. This is the situation that can be obtained in about 30% of the treated patients and, in addition, the treatment corresponds, from the psychological point of view, to what the patient expects. The toxicity of chemotherapy and the resulting morbidity and mortality can, to a large extent, be controlled by a close clinical follow-up and the use of various techniques of supportive care. Such a surveillance of patients probably explains why administration of planned therapy can be less expensive than palliative care. The management of lung cancer Hutas I. Pubnonologiai Klinika, Semmelweis Orvostudomanyi Egyetem, Budapest. Orvoskepzes 1995;70:5-13. Lung cancer is one of the organ manifestations which is most diEcult