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Anyuan Zhong,1* Xiaolu Xiong,2* Minhua Shi,1 Huajun Xu3 1Department of Respiratory Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 2Department of Endocrinology, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, 3Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, People’s Republic of China*These authors contribute equally to this work Background: Pemetrexed is currently recommended as the second-line treatment for patients with advanced non-small-cell lung cancer (NSCLC). However, it is unclear whether pemetrexed-based doublet therapy improves treatment efficacy and safety. Thus, this meta-analysis was performed to resolve this controversial question. Methods: Electronic databases, including PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched for relevant articles before April 2015. Hazard ratios (HRs) were used to estimate overall survival (OS) and progression-free survival (PFS), and odds ratios (ORs) were used to analyze the overall response rate (ORR) and grade ≥3 toxicities. Subgroup analysis, sensitivity analysis, and publication bias were also evaluated. Results: A total of 2,519 patients from ten randomized controlled trials were included. Compared to pemetrexed alone, PFS and ORR significantly improved in the pemetrexed-based doublet group (HR, 0.86; 95% CI [confidence interval], 0.75–0.99; P=0.038; and OR, 1.98; 95% CI, 1.25–3.12; P=0.003, respectively). However, no statistically significant differences in OS were observed between groups (HR, 0.92; 95% CI, 0.83–1.02; P=0.132). In addition, subgroup analyses indicated that improved OS was only observed in nonsquamous NSCLC patients who received the combination of pemetrexed and erlotinib. An increasing incidence of grade ≥3 neutropenia and thr

Anyuan Zhong,1,* Yufei Xing,1,* Xue Pan,1,* Minhua Shi,1 Huajun Xu2 1Department of Respiratory Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 2Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, People’s Republic of China *These authors contributed equally to this work Background: The association between the expression of programmed cell death-ligand 1 (PD-L1) and survival in patients with non-small-cell lung cancer (NSCLC) is controversial. Thus, we conducted a meta-analysis of all available studies to evaluate the prognostic role of PD-L1 expression in NSCLC.Materials and methods: PubMed, Embase, and Chinese (China National Knowledge Infrastructure and Wanfang) databases were searched to identify all eligible studies evaluating PD-L1 expression and the survival of NSCLC patients. Hazard ratios (HRs) and 95% confidence interval (CI) used to assess overall survival were extracted and pooled. Subgroup, sensitivity, and publication-bias analyses were also performed.Results: Eleven articles reporting 12 studies that included a total of 1,653 patients met the inclusion criteria and were included in the meta-analysis. Higher PD-L1 expression did not correlate with prognosis in terms of overall survival in patients with NSCLC (HR =1.21, 95% CI: 0.85–1.71, P=0.29). However, a subgroup analysis showed a significant association between PD-L1 expression and poor prognosis in Chinese patients with NSCLC (HR =1.55, 95% CI: 1.04–2.29, P=0.03). The sensitivity analysis showed that the pooled results were not affected by the removal of any single study. There was also no significant publication bias.Conclusion: Our meta-analysis indicated no statistically significant difference between PD-L1 expression and prognosis for patients with NSCLC. Additional, high-quality studies with larger sam

AnYuan Zhong, Xue Pan, MinHua Shi Department of Respiratory Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, People’s Republic of ChinaLung cancer is the most commonly diagnosed cancer and the leading cause of cancer death worldwide,1 with the majority of patients presenting with advanced disease.2 Treg cells diminish the activation and function of lymphocytes via cell-cell contact and secretion of soluble mediators.3 PD-1 is expressed on the surface of activated T and B cells and regulates their activation and proliferation.4 PD-L1 binds to the PD-1 receptor, leading to, among other responses, negative regulation of immune activity. Both Tregs and the PD-1/PD-L1 pathway play important roles in lung cancer pathogenesis;5,6 however, the association between these two factors remains poorly understood. Here, we examined PD-1 expression on Tregs, and compared these results with established clinical indicators of lung cancer. These analyses revealed significant expression of PD-1 on Tregs in lung cancer, which may be used to inform clinical diagnoses.

AnYuan Zhong,1 Xue Pan,1 MinHua Shi,1 HuaJun Xu2 1Department of Respiratory Diseases, The Second Affiliated Hospital of Soochow University, Suzhou, 2Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Otolaryngology Institute, Shanghai, People’s Republic of China Abstract: Several studies have reported an association between −148 C/T polymorphism of Axis inhibition protein 2 (Axin2) and cancer risk; however, the results are inconsistent. In this study, a meta-analysis was performed to assess the association between −148 C/T polymorphism of Axin2 and susceptibility to cancer. Published case–control and cohort-based studies from PubMed, Embase, Wanfang, and CNKI were retrieved, and data were manually extracted. The odds ratios (ORs) and 95% confidence intervals (CIs) of the included studies were pooled. Begg’s and Egger’s tests were used to evaluate publication bias. Cumulative and recursive cumulative meta-analyses (CMA) were performed as evidence accumulated to investigate the trends and stability of the effect size. Nine articles with 1,664 cases and 1,796 controls were included. The pooled effect size showed an association between −148 C/T polymorphism and the risk of cancer (dominant model, OR: 0.72, 95% CI: 0.63–0.83; allele model, OR: 0.81, 95% CI: 0.73–0.90). CMA showed an association trend, and the recursive CMA indicated that more evidence is needed to make conclusions about significance. In a subgroup analysis, a significant association between −148 C/T polymorphism and low cancer susceptibility was detected for lung cancer (dominant model, 0.69, 95% CI: 0.56–0.85; recessive model, OR: 0.75, 95% CI: 0.56–0.99; allele model, 0.76, 95% CI: 0.66–0.86). The −148 C/T polymorphism was also associated with low cancer susceptibility among Asians (dominant model, OR: 0.68, 95