A Review of Recent Advances in the Treatment of Elderly and Poor Performance NSCLC

Carmichael, Juliet; Mak, Daisy Wing-san; O’Brien, Mary

doi:10.3390/cancers10070236

Cited by 36 publications

(31 citation statements)

References 111 publications

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“…However, drug resistance and severe systemic toxicity seriously affect the prognosis and quality of life of patients [3,7]. To overcome the defects of these drugs, various studies of combination chemotherapy for the treatment of NSCLC have been conducted [11,12,33]. Previous research has indicated that EGFR inhibitors could enhance the curative effects of DOX in tumor cells [19] and indicated that the combination of DOX with an EGFR inhibitor was a potential synergistic chemotherapy for NSCLC.…”

Section: Synergistic Effects Of Erlotinib Apatinib and Icotinib Combmentioning

confidence: 99%

Dual Loading of Nanoparticles with Doxorubicin and Icotinib for the Synergistic Suppression of Non-Small Cell Lung Cancer

Zhan

Jia

et al. 2020

Int. J. Med. Sci.

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Background: Combination chemotherapy plays an important role in the clinical therapy of non-small cell lung cancer (NSCLC). However, the pharmacokinetic differences between drugs are an insurmountable barrier in traditional treatment. For the synergistic therapy of NSCLC, synergistic nanoparticles (EDS NPs) loaded with both an EGFR inhibitor and doxorubicin (DOX) were designed and prepared. Methods: Erlotinib, apatinib and icotinib were evaluated for optimal combination with DOX in treatment of NSCLC via CCK-8 assay. Then the cationic amphipathic starch (CSaSt) and hyaluronic acid (HA) were applied to coencapsulate DOX and EGFR inhibitor to form the EDS NPs. EDS NPs were evaluated in NSCLC cell lines (A549, NCI-H1975 and PC9) and NSCLC xenograft mouse models. Results: Icotinib was found to be the optimal synergistic drug in combination with DOX in the tested. Subsequently, icotinib and DOX were coencapsulated in the NPs. EDS NPs were roughly spherical with an average size of 65.7±6.2 nm and possessed stable loading and releasing properties. In the in vitro investigation, EDS NPs could efficiently deliver payloads into cells, exhibited cytotoxicity and produced strong anti-migration properties. In vivo hypotoxicity was confirmed by acute toxicity and hemolytic assays. The in vivo distribution showed that EDS NPs could enhance accumulation in tumors and decrease nonspecific accumulation in normal organs. EDS NPs significantly promoted the in vivo synergistic effects of icotinib and DOX in the mouse model. Conclusions: The study suggests that EDS NPs possess noteworthy potential for development as therapeutics for NSCLC clinical chemotherapy.

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Section: Synergistic Effects Of Erlotinib Apatinib and Icotinib Combmentioning

confidence: 99%

Dual Loading of Nanoparticles with Doxorubicin and Icotinib for the Synergistic Suppression of Non-Small Cell Lung Cancer

Zhan

Jia

et al. 2020

Int. J. Med. Sci.

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“…This results in greater toxicity and dose reductions in older patients. It seems that body composition measurements may be helpful in targeted dose titration in future (35).…”

Section: Pharmacological Therapymentioning

confidence: 99%

Undertreatment or overtreatment – how far from each other in geriatric oncology?

Kocik

2020

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The mortality due to cancers of older patients, in age above 65 years of life, in comparison to younger is higher in majority of these diseases. It has been also reported that seniors are frequently denied the treatment according to current standards of therapy, thus suffer from undertreatment. There is solid evidence from controlled trials that older patients may tolerate pharmacological therapies in some cancers as well as young, providing they are under good supportive care. At the same time aggressive multimodal treatment may cause immediate or delayed side effects and exhaustion of reserves of the vital organs in elderly. This may cause a general deterioration, a decompensation of comorbidities, an evolution of geriatric syndromes and premature death, not directly caused by cancer. Such situation in aged cancer patients should be called the overtreatment. In diseases with better prognosis, with effective screening methods and large choice of treatment options like breast cancer, survival is getting better, although not in the eldest. The worse prognosis in old breast cancer patients may be caused to some extent by undertreatment. More fatal tumors like NSCLC await further optimization of cancer therapy towards better toxicity profile to avoid overtreatment.

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“…A review by Carmichael et al . 5 discusses trials studying these checkpoint inhibitors for the treatment of advanced NSCLC that include elderly patients and gives information regarding subgroup analyses by age. One of the included studies is a trial by Reck et al .…”

Section: Chemotherapy Tolerance In the Agedmentioning

confidence: 99%

Recent advances in non-surgical management of cancer in the elderly

et al. 2018

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This article summarizes the seminal publications from mid-2016 through 2017 in the area of medical care for older adults with cancer. Areas addressed include chemotherapy tolerance and efficacy in the aged, geriatric fitness assessments, and advancements in palliative and supportive care. The practice-changing finding from this past year’s publications is that antipsychotics should not be used in the management of terminal delirium in older adults receiving palliative care. The other trials demonstrated an improved understanding of the utility of geriatric assessments in patients with cancer, developed the body of information about which chemotherapy agents are safe and effective in older adults (and which are not), and expanded our understanding of good palliative and supportive care.

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A Review of Recent Advances in the Treatment of Elderly and Poor Performance NSCLC

Cited by 36 publications

References 111 publications

Dual Loading of Nanoparticles with Doxorubicin and Icotinib for the Synergistic Suppression of Non-Small Cell Lung Cancer

Dual Loading of Nanoparticles with Doxorubicin and Icotinib for the Synergistic Suppression of Non-Small Cell Lung Cancer

Undertreatment or overtreatment – how far from each other in geriatric oncology?

Recent advances in non-surgical management of cancer in the elderly

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