Treatment Of Advanced Non-small Cell Lung Cancer And Study On Circumvention Of Drug Resistance

Purpose: Through observing the effect、toxicity and overall survival of gemcitabine(GEM) combined with cisplantin(DDP) as first-line treatment of advanced non-small-cell lung cancer(NSCLC), we evaluate the importance of different gemcitabine dosage in the regimen.Methods: Retrospective review is conducted on107cases of chemotherapy-naive advanced NSCLC patients treated with GEM and DDP from March2003to March2009. Some patients received GEM<1100mg/m (low dosage group) while others received GEM≥1100mg/m2(high dosage group) on days1and8, and all received DDP75-80mg/m2on day1or30mg/m2for three days by intravenous administration, with21days as one cycle. Each patient received2-4cycles chemotherapy.Results: The total clinical response rate (complete and partial response) of low dosage group is30.9%, and clinical benefit rate (complete and partial response and stable disease) is81.8%. While the total clinical response rate (complete and partial response) of high dosage group is28.8%, and clinical benefit rate (complete and partial response and stable disease) is73.1%. After median follow-up of3.33years, the median overall survival periods are652days and331days respectively. The main toxicities are nausea, vomiting and hematological toxicities. Other toxicities are slight and tolerable.Conclusion: Combined chemotherapy with GEM plus DDP as first-line treatment to advanced NSCLC is an effective and feasible regimen, which is one of the standard regimens. And GEM<1100mg/m2is more suitable for Chinese. Background and Purpose: The epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have been widely used in the treatment of the advanced non-small cell lung cancer (NSCLC), especially in the adenocarcinoma patients with activating EGFR mutations. But there is no published overview of the following treatment. This report through observing the efficacy、toxicity and overall survival of different treatments to the advanced NSCLC patients who had gradual progression after EGFR-TKIs, evaluates the influence of the continued treatment and switching chemotherapy.Methods: Retrospective review is conducted on32cases of advanced NSCLC patients who experienced treatment failure of EGFR-TKIs. One group accepted the continued treatment and the other group accepted the switching chemotherapy.Results:The median overall survival of the continued treatment group is36.0months. The response rate of the switching chemotherapy group is43.25%, and clinical benefit rate (complete and partial response and stable disease) is86.5%. The median overall survival is15.5months. The main toxicities are nausea, vomiting and hematological toxicities.Conclusion:For the advanced NSCLC patients who had gradual progression after EGFR-TKIs, the continued treatment is one of the acceptable choices. Background and Purpose:Although a multitude of promising anti-cancer drugs have been developed over the past50years, effective delivery of the drugs to diseased cells remains a challenge. Recently, nanoparticles have been used as drug delivery vehicles due to their high delivery efficiencies and the possibility to circumvent cellular drug resistance.Methods:However, the lack of biocompatibility and inability to engineer spatially addressable surfaces for multi-functional activity remains an obstacle to nanoparticles widespread use. Here we present a novel drug carrier system based on self-assembled, spatially addressable DNA origami nanostructures that confronts these limitations. Doxorubicin, a well-known anti-cancer drug, was non-covalently attached to DNA origami nanostructures through intercalation.Results: A high level of drug loading efficiency was achieved and the complex exhibited prominent cytotoxicity not only to regular human breast adenocarcinoma cancer cells, but more importantly to Doxorubicin-resistant cancer cells, inducing a remarkable reversal of phenotype resistance.Conclusion:DNA origami has immense potential as an efficient, biocompatible drug carrier and delivery vehicle in the treatment of cancer.