76% and a median survival time of 5.3 months in our patients. The ORR in our study is similar with that in a previous report, but the median survival in our study is a little shorter than in their study [1] and [11]. Possible reasons for this could be that patients in our study were all with stage IV disease and almost 30% of them were platinum resistant, whereas only 74.8% of the patients with NSCLC in the previous study

were stage IV [1]. However, when pemetrexed or docetaxel was combined with CT-PFNECII, the combination approach showed an ORR of 23.53% and a median survival time of 9.5 months in our patients with platinum-pretreated NSCLC. Considering that the ORRs were only 9.1% and 8.8% for pemetrexed and docetaxel, respectively, in the previous study [1], these data

are quite encouraging. In addition, we found that CT-PFNECII could efficiently control lung tumor–related chest pain or dyspnea even within 72 hours in all patients GSI-IX cell line who had these symptoms before. This suggests that 5% ethanol-cisplatin injected intratumorally could have potent antitumor activity against platinum-pretreated NSCLC. Our previous studies in mouse xenografts showed that 5% ethanol could inhibit the ABCG2 pump in tumor cells as well Selleck APO866 as drive the penetration of cisplatin into tumor cells [10] and [12]. Our results also support the previous findings that decreased platinum accumulation in NSCLC tumor tissues might be an important mechanism of platinum resistance in patients with NSCLC

[13]. Compared with a median survival of 5.2 months produced Glutamate dehydrogenase by docetaxel and 9.4 months by selumetinib plus docetaxel in patients with platinum-pretreated KRAS-mutant NSCLC, the median survival of 9.5 months by our combination treatment shows promising potential [14]. In contrast to the median survival of 7.6 months for gefitinib in platinum-pretreated NSCLC and 5.3 months for erlotinib in platinum-resistant NSCLC, the median survival of 9.5 months by our combination approach suggests that it might compare favorably to the more expensive EGFR TKIs [7] and [8]. Intratumoral injection of chemotherapeutic agents in ethanol mixtures might also be effective in treating other types of cancer. Studies by Pietronigro and his colleagues showed that intratumoral injection of chemotherapeutic agent bis-chloroethylnitrosourea, dissolved in 100% ethanol could produce a 40% cure rate in rats bearing intracranial T9 tumors and 72% SD in patients with recurrent malignant glioma [15], [16] and [17]. However, our previous results showed that the chemotherapeutic agent cisplatin, when dissolved in high concentrations of ethanol such as 50% ethanol, produced minimal tumor inhibition [10] and [18]. However, the glioma tumors in patients in the Pietronigro studies were smaller than the tumors in our patients. We speculate that smaller tumors might be easier to be suffused by 100% ethanol, leading to complete tumor necrosis.