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Objective To explore the impact of venous thromboembolism (VTE) on the diagnosis and treatment of lung cancer patients. Methods We retrospectively analyzed the clinical data of lung cancer patients with VTE treated in Peking University Cancer Hospital. The incidence of VTE was calculated and the relation between VTE and lung cancer was analyzed. Results Among 1766 patients with lung cancer, VTE occurred in 115(6.5%) patients. Among 115 VTE cases, there were 78(67.8%) males patients; 82(71.3%) cases were deep venous thrombosis, 21(18.3%) cases were pulmonary embolism, 12(10.4%) cases were deep venous thrombosis with pulmonary embolism; 74(64.3%) cases were symptomatic VTE; 102(88.7%) patients received antithrombotic therapy. Among the patients who received antithrombotic therapy, 97(95.1%) cases chose drug therapy. In drug treatment, 65(67.0%) cases used adequate/standard dose. Among 115 VTE cases, 52(45.2%) patients had improvement or disappearance of thrombus, 32(27.8%) patients had no improvement, and 31(27.0%) patients with unknown results; 11(9.6%) patients had adverse reactions such as bleeding during antithrombotic therapy; 30(26.1%) patients changed antineoplastic treatment plan due to VTE. Conclusion VTE is a common complication of lung cancer patients. Antithrombotic therapy for lung cancer patients with VTE is complex, the treatment effect is not ideal and the risk of adverse reactions such as bleeding is high. VTE has a great impact on the implementation of anti-cancer treatment.

Background: Currently there is no standard therapy recommended for second‐line treatment for thymic carcinoma. Our study compared multidrug chemotherapy, single‐agent chemotherapy, and PD‐1 inhibitors in patients diagnosed with advanced thymic carcinoma who had previous platinum‐based chemotherapy at the clinic. Methods: The study included patients with thymic carcinoma who failed first‐line platinum‐based chemotherapy. Kaplan–Meier methods were applied in the study for estimating the progression‐free survival (PFS) and overall survival (OS) curves. Pearson chi‐square or Fisher's exact chi‐square test was adopted to make comparisons of the objective response rate (ORR) between treatment groups. Cox regression was used for the multivariate analyses in PFS and OS. Results: Among the 92 patients enrolled, multidrug chemotherapy was used in 51 (55.4%) patients for second‐line therapy. Thirty‐six patients (35.9%) received single‐agent chemotherapy, and eight patients (8.7%) underwent PD‐1 inhibitors. The multidrug chemotherapy group showed better efficacy than the other two groups, with an ORR of 35.3% (p = 0.006). The median PFS of multidrug chemotherapy, single‐agent chemotherapy and PD‐1 inhibitors were 5.0 months, 3.0 months, and 4.0 months, respectively (p = 0.008). Patients in the multidrug chemotherapy group also showed an advantage in OS in comparison with the other two treatment groups (p = 0.045), with a median OS of 30.4 months. Multivariate analysis showed that second‐line treatment was independent factor for both PFS (p = 0.035) and OS (p = 0.037). Grade 3–4 AEs were mostly detected in patients receiving multidrug chemotherapy and were primarily hematologic. Treatment‐related mortality was not found in any of the groups. Conclusions: Multidrug chemotherapy had a trend toward a more positive response rate and outcomes in longer survival time than single‐agent chemotherapy and PD‐1 inhibitors. Multidrug chemotherapy is a choice worth considering for second‐line therapy in patients with thymic carcinoma if tolerable. [ABSTRACT FROM AUTHOR]

Background: Thymoma and thymic carcinoma are rare thymic epithelial tumors. We investigated the efficacy of first‐line gemcitabine and cisplatin (GP) chemotherapy versus gemcitabine and cisplatin chemotherapy combined with the anti‐angiogenic drug endostar (GP + E) in advanced thymoma and thymic carcinoma. Methods: The records of 45 patients with invasive metastatic thymomas or thymic carcinomas treated with GP as first‐line therapy between August 2008 and July 2017 at the Department of Respiratory Medicine, Peking University Cancer Hospital and Institute were retrospectively reviewed. Results: Eighteen patients (75%) in the GP + E group achieved a partial response and six (25%) had stable disease. In GP only group, nine (42.8%) patients achieved a partial response, 11 (52.4%) had stable disease, and one (4.8%) had progressive disease. The GP + E group had a significantly higher overall response rate (75% vs. 42.9%; P = 0.028), and median progression‐free survival (PFS) and overall survival (OS) of 19 and 76 months, respectively. In the GP only group, median PFS and OS were 16 and 29 months, respectively. PFS and OS were not significantly different between the groups. Conclusions: GP has moderate efficacy and could represent a suitable first‐line therapy for thymic carcinoma and thymoma. Chemotherapy combined with endostar could improve the overall response rate, but did not prolong PFS or OS. [ABSTRACT FROM AUTHOR]

Background The programmed cell death-1/programmed cell death-1 ligand ( PD-1/ PD- L1) pathway plays a crucial role in tumor evasion. This study evaluated the association between circulating PD-L1 expression and clinical characteristics in patients with advanced non-small cell lung cancer ( NSCLC). Methods A total of 109 advanced NSCLC and 65 healthy patients from the Beijng Cancer Hospital were enrolled in the study. Circulating PD- L1 expression was tested by enzyme-linked immunosorbent assay. The associations between the level of PD- L1 expression and clinicopathologic features and prognosis were statistically analyzed. Results The expression of PD- L1 in advanced NSCLC patients was significantly upregulated compared with the healthy control ( P < 0.001). The expression of PD-L1 was significantly correlated with abdominal organ metastasis ( P = 0.004). A high PD- L1 expression had a worse prognosis than a low expression in patients (18.7 vs. 26.8 month, P < 0.001). Conclusions PD- L1 was elevated in advanced NSCLC patients and may play an important role in tumor immune evasion and patient prognosis. [ABSTRACT FROM AUTHOR]

A PbO 2 electrode integrating electrocatalytic and adsorptive functions was successfully fabricated by embedding layer-by-layer graphene nanoplatelets (GNPs) into β-PbO 2 active layer (GNPs/PbO 2 ) and employed as anode for high-efficient removal of sulfadiazine (SDZ). In electrochemical degradation experiments, SDZ was quickly enriched on the surface of GNPs/PbO 2 film via adsorption and then oxidized by ⋅OH in-site. In terms of the electrocatalytic performance and adsorption of electrode, the optimal electrodeposition time for each β-PbO 2 outer layer was 4 min (GNPs/PbO 2 -4). Compared with conventional PbO 2 electrode, the layer-by-layer GNPs resulted in the smaller crystal size and denser surface of PbO 2 electrode, thus facilitating the generation of active oxygen species. At the same time, the specific surface area, oxygen evolution potential (OEP) of the anode were enhanced and the charge-transfer resistance was reduced. For GNPs/PbO 2 -4 anode, the optimal conditions of electrochemical oxidation of SDZ were identified as initial pH 9, 50 mg/L of SDZ and 20 mA/cm 2 of current density using response surface methodology (RSM), 98.15% of SDZ could be removed in this case. The contribution of radical oxidation and non-radical oxidation to SDZ removal was about 79% and 21%, respectively. Moreover, the reaction pathways of SDZ on the GNPs/PbO 2 -4 electrode involving hydroxylation, radical reaction and ring cleavage were speculated. Finally, the continuous SDZ degradation and accelerated service lifetime test suggested that the GNPs/PbO 2 -4 electrode was shown to be stable and repeatable, and the Pb 2+ concentration was measured to ensure the safety of the treated solution. Consequently, the above findings provide an innovative way to design and prepare an effective and stable PbO 2 electrode for electrochemical degradation of antibiotic wastewater., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Inc. All rights reserved.)

The purpose of this research is to study the pulse electrochemical oxidation of paracetamol (PCT) using a novel PbO 2 anode based on pulse electrodeposition strategy (PbO 2 -PE). The pulse electrodeposition strategy used to prepare a PbO 2 anode resulted in rougher surface, higher directional specificity of β(101) and more redox couples of Pb 4+ /Pb 2+ . Additionally, the oxygen evolution potential (OEP) and charge transfer resistance were also improved. When compared to direct current electrochemical oxidation process, pulse electrolysis in had a slightly higher PCT removal efficiency and active species (·OH and active chlorine) production, while 72.04% of energy consumption was saved. The effects of operating parameters on PCT degradation efficiency and specific energy consumption were studied. The findings suggested that the pulse electrochemical oxidation of PCT followed a pseudo-first-order kinetic model, with PCT removal reaching 98.63% after 60 min of electrolysis under optimal conditions. Possible mechanisms describing reaction pathways for PCT were also proposed. Finally, combinating with the economic feasibility and safety evaluation, we could conclude that pulse electrolysis with a PbO 2 -PE electrode was a promising option for improving the practicability of electrochemical treatment for refractory organic wastewater., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Objective: Atezolizumab along with chemotherapy has prolonged the survival of patients with extensive-stage small-cell lung cancer (ES-SCLC) worldwide, although real-world (RW) data are lacking in China. This study was designed to evaluate the efficacy and clinical outcomes of atezolizumab plus etoposide/platinum (EP)., Methods: Data obtained in this retrospective study were captured from six oncology units of five medical facilities from January 2019 to April 2022. For first-line treatments, atezolizumab combined with EP vs. EP alone, we primarily evaluated progression-free survival (PFS); other efficacy indicators, including overall survival (OS), objective response rate (ORR), and patterns of SCLC progression and adverse events (AEs) were assessed., Results: The primary analysis included data from 225 patients, of whom 133 received EP along with atezolizumab (atezolizumab group) and 92 received EP alone (EP group). The PFS duration of the atezolizumab group [7.10 months; 95% confidence interval (95% CI), 6.53-9.00] exceeded that of the EP group (6.50 months; 95% CI, 4.83-7.53). Overall, the hazard ratio (HR) was 0.69 (95% CI, 0.49-0.97) (P=0.029); particularly, the HR was 0.54 (95% CI, 0.36-0.80) among patients undergoing ≥4 chemotherapy cycles and 0.33 (95% CI, 0.20-0.56) among individuals with atezolizumab maintenance. The ORR and disease-control rate (DCR) were similar between the two groups. Because of incomplete OS data, the median OS was not determined for either group. Bone marrow suppression was the most common AE detected (58.6%) in the atezolizumab group. Immune-related AEs occurred in 19 patients in the atezolizumab group (14.3%), with only one case of grade 3 encephalitis., Conclusions: This RW study in China demonstrated improved clinical outcomes of atezolizumab along with EP for ES-SCLC, particularly in the chemosensitive population. These results align with the results of the IMpower133 study, although the impact of this treatment modality on OS warrants additional follow-up studies., (© Chinese Journal of Cancer Research. All rights reserved.)

Background: Anaplastic lymphoma kinase ( ALK ) gene rearrangement is a series of mutations of non-small cell lung cancer (NSCLC) patients. Since 2011, multiple ALK inhibitors (ALKis) have been developed and launched for targeted therapy. In this study, we sought to investigate different strategies of sequential applying the ALKis and their clinical benefits to the overall survival (OS)., Methods: A total of 176 patients with advanced NSCLC (stage IIIB-IV) harboring the ALK rearrangement were included in this cohort study. They were diagnosed between February 1, 2012 and November 19, 2019 at Peking University Cancer Hospital. Clinical characters were reviewed from patients' records. Strategies of drugs, progression-free survival (PFS) and OS were collected during the follow-ups. The Kaplan-Meier method and multivariate Cox proportional-hazard analysis were used to conduct the analyses survival and to examine the relationship between the variables and OS., Results: A significantly longer OS was observed either in patients treated with crizotinib [N=106, median OS (mOS): 32.9 months] or in patients treated with a next-generation ALKi [N=34, mOS: not reached (NR)] as the initial ALKi, compared with patients treated with conventional chemotherapy but no ALKi (N=36, mOS: 10.3 months, P<0.001). After disease progression with initial crizotinib, patients who received no ALKi had shorter OS than those who received only crizotinib beyond progressive disease (CBPD) (mOS: 9.7 vs. 20.3 months; P=0.015), only subsequent next-generation ALKis (mOS: 9.7 vs. 41.1 months; P<0.001), and CBPD followed with subsequent next-generation ALKis (mOS: 9.7 months vs. NR; P<0.001). Patients treated with 2 types of ALKi had better survival than those treated with 1 ALKi (mOS: 45.8 vs. 21.3 months, P=0.003), but no such survival benefit was observed in patients treated with ≥3 ALKis (P=0.366)., Conclusions: ALKis have been shown to be clinically effective in treating NSCLC patients with ALK rearrangements. In the case of disease progression with crizotinib, either of CBPD or sequential other ALKis can extend patients' OS. The sequential application of multiple ALKis was found to be better than it of single ALKi in prolonging OS. However, the question of which inhibitor to select as the initial inhibitor needs to be examined further in future studies., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-22-622/coif). The authors have no conflicts of interest to declare., (2022 Journal of Thoracic Disease. All rights reserved.)

In this study, electrochemical oxidation of Acid Orange 7 (AO 7) azo dye has been investigated using a Fe-doped PbO 2 electrode. The degradation of AO 7 followed pseudo-first-order reaction kinetics. The removals of AO 7, chemical oxygen demand (COD) and total organic carbon (TOC) were 87.15%, 49.88% and 44.94% after 60 min of electrolysis at the optimal conditions (Na 2 SO 4 concentration 0.1 M, initial pH 5, initial AO 7 concentration 100 mg L -1 and applied current density 20 mA cm -2 ), respectively. And the corresponding degradation rate constant was 0.035 min -1 . The intermediates formed during electrochemical process were identified, and a possible degradation pathway was proposed, which was initiated by the oxidation of azo bond (-NN-), hydroxylation and substitution reaction of -NH 2 and -SO 3 H under the attack of OH, and ended with the formation of mineralization products such as NH 4 + , NO 3 - , SO 4 2- , CO 2 and H 2 O. The toxicity of treated AO 7 solution towards Vibrio fischeri increased slightly at first and then rapidly reduced to non-toxicity with prolonging time. The results indicate that electrochemical oxidation of AO 7 using Fe-doped PbO 2 electrode is a promising way., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Radiotherapy combined with chemotherapy or molecular targeted therapy remains the standard of treatment for brain metastases from non-small cell lung cancer (NSCLC). The aim of this study is to determine if the deferral of brain radiotherapy impacts patient outcomes., Methods: Between May 2003 and December 2015, a total of 198 patients with brain metastases from NSCLC who received both brain radiotherapy and systemic therapy (chemotherapy or targeted therapy) were identified. The rate of grade 3-4 adverse reactions related to chemotherapy and radiotherapy had no significant difference between two groups. 127 patients received concurrent brain radiotherapy and systemic therapy, and 71 patients received deferred brain radiotherapy after at least two cycles of chemotherapy or targeted therapy. Disease specific-graded prognostic assessment was similar in early radiotherapy group and deferred radiotherapy group., Results: Median overall survival (OS) was longer in early radiotherapy group compared to deferred radiotherapy group (17.9 months vs 12.6 months; P=0.038). Progression free survival (PFS) was also improved in patients receiving early radiotherapy compared to those receiving deferred radiotherapy (4.0 months vs 3.0 months; P<0.01). Receiving tyrosine kinase inhibitor (TKI) therapy after the diagnosis of brain metastases as any line therapy improved the OS (20.0 months vs 10.7 months; P<0.01), whereas receiving TKI as first line therapy did not (17.9 months vs 15.2 months; P=0.289)., Conclusions: Our study suggests that the use of deferred brain radiotherapy may resulted in inferior OS in patients with NSCLC who develop brain metastases. A prospective multi-central randomized study is imminently needed.

Background and Objective: Chemotherapy is a highly efficient primary treatment for extensive-stage small cell lung cancer (ES-SCLC). However, patients receiving such treatment are prone to develop drug resistance. Local treatment is palliative and thus can alleviate the local symptoms and improve quality of life, but limited evidence is available for prolonging survival. Hence, this study evaluated the role of local treatment in chemotherapy of patients with ES-SCLC., Methods: A total of 302 ES-SCLC cases were enrolled in this retrospective study. Prognostic factors were analyzed by Kaplan-Meier and Cox multivariate proportional hazards model., Results: Median progression-free survival (PFS) and median survival time (MST) of the patients were 4.4 and 10.4 months, respectively. 1-, 2-, and 3-year survival rates were 37.8%, 10.2% and 4.4%, correspondingly. The MST of the primary tumor radiotherapy plus chemotherapy group was 14.3 months, whereas that of the chemotherapy group was 8.2 months (P<0.01). The MSTs of multiple-site, single-site, and non-metastasis local treatments were 18.7, 12.3 and 8.9 months, respectively (P<0.01). The MSTs of initiative, passive, and non-metastasis local treatments were 16.0, 10.9 and 9.4 months, correspondingly (P<0.01). The MSTs of patients with prophylactic cranial irradiation (PCI) and those without PCI were 19.8 and 9.9 months, respectively (P<0.01). Primary tumor radiotherapy, metastasis local treatment, and PCI were independent prognostic factors for ES-SCLC., Conclusions: Primary tumor radiotherapy, metastasis local treatment, and PCI can significantly improve survival in patients with ES-SCLC.
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Background and Objective: Lung cancer is currently the leading cause of cancer death, two thirds of patients are over the age of 65. Small cell lung cancer (SCLC) accounts for about 15%-20% of all lung cancer. The objective of this study is to evaluate the survival of patients older than 65 with SCLC and analyze the independent prognostic factors in this group of patients., Methods: A retrospective study has enrolled 160 cases of lung cancer aged over 65. The prognostic factors were analyzed by Kaplan-Meier and Cox multivariate proportional hazards model., Results: ① The median follow-up time was 12 (2-109) months. 1-, 3-, and 5-year survival rate was 47.1%, 13.0%, 9.6% respectively, and 74.4%, 25.0%, 19.7% for limited-stage (LD), and 36.8%, 8.7%, 5.8% for extensive-stage (ED). Median survival time (MST) of all the patients was 12 months, 24 months for LD and 11 months for ED, respectively. ② Multivariate analysis suggested that performance status (PS) pre-treatment, the change of PS after treatment, stage, liver metastases and thoracic radiotherapy were the independent prognostic factors in all patients. ③ For LD-SCLC patients, PS pre-treatment, thoracic radiotherapy were the independent prognostic factors. The model of thoracic radiotherapy (concurrent chemoradiation vs sequential chemoradiation, early concurrent chemoradiation vs late concurrent chemoradiation) and prophylactic cranial irradiation (PCI) did not show significant difference. ④ For ED-SCLC patients, sex, the change of PS after treatment, chemotherapy, liver metastases, thoracic radiotherapy, PCI were the independent prognostic factors., Conclusions: The survival time is related to PS and thoracic radiotherapy in eldly patients. Besides, it is also related to sex, chemotherapy, liver metastases and PCI for ED-SCLC.