Showing papers by "Dariusz M. Kowalski published in 2012"

The qualification of docetaxel or erlotinib for second-line therapy should be based on clinical and molecular predictive factors.

Abstract: Background: We evaluated the effectiveness of docetaxel or erlotinib in second-line treatment of non-small cell lung cancer (NSCLC) and focused on the impact of predictive factors o

Mechanisms of resistance to reversible inhibitors of EGFR tyrosine kinase in non-small cell lung cancer.

Abstract: Abnormalities of epidermal growth factor receptor (EGFR) in non-small-cell lung cancer (NSCLC) patients consist of EGFR overexpression and EGFR (HER1) gene mutations. Structural dysfunction of the tyrosine kinase domain of EGFR is associated with the clinical response to tyrosine kinase inhibitors (TKI) in patients with NSCLC. The most common EGFR gene mutations occur as either deletions in exon 19 or as substitution L858R in exon 21 and cause a clinically beneficial response to gefinitib or erlotinib treatment. Unfortunately, the majority of patients finally develop resistance to these drugs. Acquired resistance is linked to secondary mutations localised in the EGFR gene, mainly substitution T790M in exon 20. Through intense research a few different mechanisms of resistance to reversible tyrosine kinase inhibitors have been identified: amplification of MET or IGF-1R genes, abnormalities of PTEN and mTOR proteins as well as rare mutations in EGFR and HER2 genes. Extensively investigated new drugs could be of significant efficiency in NSCLC patients with secondary resistance to reversible EGFR TKI.

Erlotinib in salvage treatment of patients with advanced non-small cell lung cancer: results of an expanded access programme in Poland

Abstract: Aim of the study:Erlotinib and gefitinib are reversible EGFR-TKI administered orally. Results of the phase III study JBR.21 proved the clinical efficacy of erlotinib-based regimens as second- or third-line treatment of advanced NSCLC. We analyze efficacy of treatment with erlotinib in patients suffering from advanced stage NSCLC who participated in the multicentre, international phase IV study ‐ MO 18109 TRUST (expanded access clinical program of Tarceva TM in patients with advanced stage IIIB/IV NSCLC). Our analysis was performed based on clinical data derived from centres with the largest number of patients who received erlotinib. Material and methods: Between May and November 2005, a total of 56 patients (19 women and 37 men) with histologic or cytologic diagnosis of NSCLC were included in the study. The histological diagnosis was: squamouscell ( n= 23), adenocarcinoma ( n= 20), broncho-alveolar carcinoma ( n= 2). In 11 patients the type of NSCLC was not specified. Results:Patients received erlotinib in a single dose of 150 mg per day. Partial response (PR), stable disease (SD) or progressive disease (PD) were observed in 5 (9%), 33 (59%) and 16 (29%) patients respectively. Median PFS was 16.0 weeks. In the study population adverse events (AE) were noted in 12 (21%) patients. Conclusions: Results of the TRUST study in the Polish population confirmed the efficacy of erlotinib in advanced NSCLC after failure of prior platinum-based chemotherapy. Treatment with erlotinib was associated with longer PFS as com pared to the JBR.2 study, whole TRUST study population and Italian population included in the TRUST study.

[Gefitinib in patients with advanced non-small-cell lung cancer].

Abstract: Introduction: Patients with advanced non-small cell lung cancer (NSCLC) have a very poor prognosis Individualization of treatment and identification of therapeutic molecular targets may improve outcomes Gefitinib was introduced recently among several other molecular-targeted drugs of activity in NSCLC Gefitinib is indicated for patients diagnosed with advanced or disseminated NSCLC with an activating mutation in the EGFR (epidermal growth factor receptor) gene The paper summarize experience with gefitinib in the Department of Lung and Thoracic Tumors of Maria Sklodowska-Curie Memorial Cancer Centre and Institute in Warsaw Material and methods: The group of 11 patients diagnosed with advanced NSCLC and activating mutations in the EGFR gene was analyzed Patients were treated from April 2010 to April 2011 Tolerability, objective response rate (ORR) and progression free survival (PFS), which was calculated by the Kaplan-Meier method, were assessed Results: Median observation time from the start of gefitinib treatment was 14 months (range 4,8–19 months) The rate of one-year survival in this group of patients was 91% (10 patients) with 54% of patients (6 patients) surviving one year without progression of disease The ORR rate of 82% and median PFS 114 months were reached No treatment-related deaths were reported Among the complications skin toxicity (82%) and diarrhea (45%) were most frequently observed, in most cases the Common Toxicity Criteria for Adverse Events (CTCAE) first grade Conclusions: The results confirm the literature data on the efficacy and safety profile of gefitinib in the treatment of patients with the diagnosis of advanced NSCLC and activating mutation in the EGFR gene

Elderly patients treatment with non-small-cell lung cancer

Abstract: W Polsce rak pluca jest najczestszą przyczyną zgonow z powodu nowotworow zlośliwych. W zdecydowanej wiekszości (80–85%) rozpoznawany jest niedrobnokomorkowy rak pluca (NDRP). Podczas podejmowania decyzji o leczeniu — oprocz klasycznych czynnikow prognostycznych (stan sprawności fizycznej, stopien zaawansowania klinicznego, stopien utraty masy ciala) — u chorych starszych nalezy wziąc pod uwage czynniki dodatkowe. Nalezą do nich: choroby wspolwystepujące, stan czynnościowy i mentalny, sprawnośc pod wzgledem funkcji poznawczych, stan odzywienia i zapotrzebowanie na pomoc socjalną. Są to elementy tak zwanej calościowej oceny geriatrycznej i mogą one wplywac na czas przezycia chorych na NDRP. W pracy przedstawiono poszczegolne metody leczenia NDRP w aspekcie wieku chorego.

Primary prophylaxis of febrile neutropenia with granulocyte stimulating factors in patient with locally advanced non-small cell lung cancer - case report

Abstract: Przedstawiono przypadek chorej z rozpoznaniem niedrobnokomorkowego raka pluca leczonej w Klinice Nowotworow Pluca i Klatki Piersiowej Centrum Onkologii w Warszawie. Ze wzgledu na stopien zaawansowania chorą zakwalifikowano do leczenia metodą radykalnej chemioradioterapii sekwencyjnej. Z uwagi na wspolwystepujące obciązenia internistyczne i podeszly wiek chorej oraz radykalne zalozenie leczenia zdecydowano o wlączeniu profilaktyki pierwotnej gorączki neutropenicznej (filgrastym). Chorej podano 3 cykle chemioterapii w dawkach naleznych, nie obserwując istotnych klinicznie toksyczności hematologicznych ani pozahematologicznych.