Analysis of Progression Patterns and Failure Sites of Patients With Metastatic Lung Adenocarcinoma With EGFR Mutations Receiving First-line Treatment of Tyrosine Kinase Inhibitors
CLINICAL LUNG CANCER
Authors: Li, Xiao-yang; Zhu, Xue-ru; Zhang, Chen-chen; Yu, Wen; Zhang, Bo; Shen, Tian-le; Zhang, Hong-yan; Fu, Xiao-long
Abstract
Analysis of progression patterns and failure sites of first-line tyrosine kinase inhibitor treatment is the prerequisite to refine tyrosine kinase inhibitor treatment individually. Among the 266 patients enrolled, systemic progression and distant failure were the majority failure patterns. Metastasis patterns, osseous metastasis, and maximum diameter of the primary lung lesion at initial diagnosis were the predictive factors for progression patterns and failure sites. Background: Reliable prediction of progression patterns and failure sites for patients with stage IV lung adenocarcinoma is valuable for physicians to deliver personalized tyrosine kinase inhibitor (TKI) treatment. Patients and Methods: We retrospectively enrolled 266 patients who had stage IV lung adenocarcinoma and received first-line TKI treatment from 2013 to 2017 in Shanghai Chest Hospital. The clinical characteristics at initial diagnosis, progression patterns, and failure sites were analyzed with the attempt to identify some predictive factors for progression patterns and failure sites. Results: Among all patients, 62.4% developed systemic progression, and 37.6% developed oli-goprogression. Both cohorts had a median progression-free survival (PFS) of 9 months. The percentage of patients who developed original and distant failure was 39.1% and 60.9%, respectively. Patients with oligometastasis at initial diagnosis were more prone to develop oli-goprogression (odds ratio [OR], 4.370; 95% confidence interval [CI], 1.881-10.151; P =.001), whereas pulmonary metastasis was negatively correlated with oligoprogression (OR, 0.567; 95% CI, 0.330-0.974; P =.04). Both oligometastasis diagnosis (OR, 2.959; 95% CI, 1.347-6.500; P =.007) and the maximum diameter of the primary lung lesion (threshold 3.25 cm: OR, 3.646; 95% CI, 2.041-6.515; P =.0001) were strong predictive factors for original failures. Osseous metastasis at initial diagnosis might be an indication for distant failure (OR, 0.536; 95% CI, 0.316-0.909; P =.021). Conclusion: Over one-half of patients with stage IV lung adenocarcinoma receiving first-line TKI treatment developed systemic progression and distant failure. Metastasis patterns at initial diagnosis was the most important predictive factor for progression patterns and failure sites. The maximum diameter of the primary lung lesion and evidence of osseous metastasis were also found to be significant indicative factors for failure sites. (C) 2020 Published by Elsevier Inc.
PSMD11, PTPRM and PTPRB as novel biomarkers of pancreatic cancer progression
BIOCHIMICA ET BIOPHYSICA ACTA-GENERAL SUBJECTS
Authors: Sahni, Sumit; Krisp, Christoph; Molloy, Mark P.; Nahm, Christopher; Maloney, Sarah; Gillson, Josef; Gill, Anthony J.; Samra, Jaswinder; Mittal, Anubhav
Abstract
Background: Pancreatic ductal adenocarcinoma (PDAC) has the lowest survival rate of all major cancers. Surgery is the only curative intent therapy, but the majority of patients experience disease relapse. Thus, patients who do not benefit from highly morbid surgical resection needs to be identified and offered palliative chemotherapy instead. In this pilot study, we aimed to identify differentially regulated proteins in plasma and plasma derived microparticles from PDAC patients with poor and good prognosis. Methods: Plasma and plasma derived microparticle samples were obtained before surgical resection from PDAC patients. Sequential Windowed Acquisition of all Theoretical fragment ion spectra - Mass Spectrometry (SWATH-MS) proteomic analysis was performed to identify and quantify proteins in these samples. Statistical analysis was performed to identify biomarkers for poor prognosis. Results: A total of 482 and 1024 proteins were identified from plasma and microparticle samples, respectively, by SWATH-MS analysis. Statistical analysis of the data further identified nine and six differentially (log 2 ratio > 1, p < .05) expressed proteins in plasma and microparticles, respectively. Protein tyrosine phosphatases, PTPRM and PTPRB, were decreased in plasma of patients with poor PDAC prognosis, while proteasomal subunit PSMD11 was increased in microparticles of patients with poor prognosis. Conclusion and general significance: A novel blood-based biomarker signature for PDAC prognosis was identified.