INTRODUCTION: In lung cancer patients treated with chemotherapy, renal function is an important parameter to be monitored. Since measurement of renal function with either isotope or creatinine clearance is time consuming and expensive, we evaluated which of the following equations: Cockcroft-Gault (CG), Wright, modification of diet in renal disease equation (MDRD), MDRD adjusted for body surface area (BSA) and chronic kidney disease epidemiology collaboration (CKD-EPI) best resembles endogenous creatinine clearance (ECC) and could therefore replace its measurement in clinical practice. METHODS: 218 lung cancer patients, who had their 24-h creatinine secretion in urine measured prior to the start of any chemotherapy, were included. Estimation of renal function was calculated and compared to ECC. RESULTS: There were no major differences in the performance of the tested equations. Mean percentage error of more than 20% and general underestimation was common to all equations. Wright equation performed best although it describes only 43% of ECC variability. Mean measured ECC was 94 mL/min (95% confidence interval [CI]: 90-98 mL/min) and 90 mL/min for Wright equation (95% CI: 87-93 mL/min) (Supp. Fig. 3). MDRD and CKD-EPI equation performed poorest since they do not include any body size descriptor. Large deviations of differences were observed, with a median standard deviation of more than 20% and deviations from ECC exceeding 100%. Wright equation performed best, whereas, despite their leading role in the detection of renal diseases, the MDRD and CKD-EPI equation performed poorest since they do not include any body size descriptor. In the range of ECC(50 mL/(min×1.73 m(2)), the CG equation most often detected a contraindication for cisplatin use. Differences between ECC and calculated values correlated with patients' weight, BSA and body mass index when these were not included in the equation itself. CONCLUSIONS: In evaluating the renal function of lung cancer patients, equations adjusted for body size descriptors should be preferred. Estimated renal function should be interpreted against the characteristics of patient's body size and special attention is needed when these are reaching the extremes.
Multiple drug resistance limits the efficacy of numerous cytotoxic drugs used in the treatment of small cell lung cancer (SCLC). The drug efflux protein ATP-binding cassette transporter B1 (ABCB1) has an important role in this process, and its gene variability may affect chemotherapy outcomes. The aim of our study was to evaluate the associations between ABCB1 polymorphisms G2677T/A, C3435T, and their haplotype with progression-free survival (PFS) and overall survival (OS) in SCLC patients treated with cisplatin-etoposide or cyclophosphamide-epirubicin-vincristine chemotherapy. Our study reported a possible predictive value of ABCB1 polymorphisms G2677T/A, C3435T, and their haplotype for longer PFS and OS in Caucasian SCLC patients treated with chemotherapy. However, to be implemented into routine clinical practice, ABCB1 polymorphisms require further validation.
COBISS.SI-ID: 29829337
ERRC1 gena (excision repair cross-complementing 1) je pogosto raziskovan molekularni marker, saj lahko njegova izraženost v tumorskem tkivu napoveduje manjšo občutljivost za kemoterapijo na osnovi platine. Manjša izražnost ERCC1 se je že izkazala kot napovedni dejavnik večjo učinkovitostjo zdravljenja z platino pri bolnikih z nedrobnoceličnim pljučnim rakom (NSCLC). Podatki o napovedni vrednosti izraženosti ERCC1 pri drobnoceličnem pljučnem raku (SCLC) pa so bili dosedaj zelo omejeni.Zato je naša skupina raziskala vpliv ekspresije ERCC1 gena v primarnem tumorju za odgovor na prvo linijo kemoterapije na osnovi platine pri bolnikih z drobnoceličnim pljučnim rakom (SCLC).V skupini 77 bolnikov s SCLC ni bila ugotovljena korelacija med izraženostjo ERCC1 in odgovorom na kemoterapije na osnovi platine in preživetjem. Za pridobitev dokončnega odgovora o napovednem pomenu ERCC1 za odziv na kemoterapijo je potrebna nadaljna multicentrična prospektivna študija z validirano metodo določanja ekspresije ERCC1.
COBISS.SI-ID: 30115033
Body size, particularly large, is a matter of concern among the lay public. Whether this is justified depends upon the state of health and should be judged individually. For patients with established chronic disease, there is sufficient evidence to support the benefits of large body size, i.e., the obesity paradox. This uniform finding is shared over a variety of cardiovascular, pulmonary, and renal diseases and is counterintuitive to the current concepts on ideal body weight. The scientific community has to increase the awareness about differences for optimal body size in health and disease. Simultaneously, clinicians have to be aware about body weight dynamics implications and should interpret the changes in the context of an underlying disease in order to implement the best available management.
COBISS.SI-ID: 29829081
Continuation of HER2-directed therapy, trastuzumab plus chemotherapy (Cht) showed a significantly improved overall response rate and time to progression compared with chemotherapy alone in women with HER2-positive breast cancer progressing during trastuzumab treatment in retrospective observations. The results of this large, prospective international study did not demonstrate a significant survival benefit for treatment beyond progression with trastuzumab. However, in a post-hoc analysis, patients receiving anti-HER2 treatment as 3rd line therapy showed a better post-progression survival than those not receiving this targeted treatment.
COBISS.SI-ID: 29393369