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PRACTICE GUIDELINES

Guide to Clinical Preventive Services, 2010-2011: Section 2

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National Guideline Clearinghouse | Cancer Care Ontario and American Society of Clinical Oncology adjuvant chemotherapy and adjuvant radiation therapy for stages I-IIIA resectable non-small-cell lung cancer guideline.

www.guidelines.gov -

National Guideline Clearinghouse | (1) American Society of Clinical Oncology clinical practice guideline update on chemotherapy for stage IV nonsmall-cell lung cancer. (2) 2011 focused update of 2009 American Society of Clinical Oncology clinical practi

www.guidelines.gov -

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PATIENT RESOURCES

DLEC1 - deleted in lung and esophageal cancer 1 - Genetics Home Reference

ghr.nlm.nih.gov - 1/9/12

CDC - Fact Sheet - Health Effects of Cigarette Smoking - Smoking & Tobacco Use

www.cdc.gov - 1/10/12

Expert Reviewers - Genetics Home Reference

ghr.nlm.nih.gov - 1/9/12

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Lung Cancer

New Mutation May Act as Driver in Subset of Patients

RESEARCH REPORT
Anna Azvolinsky
A study has identified a gene fusion from a never-smoker lung cancer patient that may act as a driver in a subset of lung cancer cases. The results suggest that the newly identified fusion is not that rare and that the mutation exists in primary lung adenocarcinomas. The fusion was identified from sequencing the genome and transcriptome of cancerous tissue and normal tissue from a 33-year-old never-smoker.
Lung Cancer Deaths Not Reduced by Chest X-Rays

RESEARCH REPORT
Anna Azvolinsky
A trial of 154,901 participants between the ages of 55 and 74 sought to address whether performing chest radiographs affects lung cancer incidence and mortality rates from lung cancer. The trial found that chest x-rays did not reduce lung cancer mortality.
• NCI Study: Low-Dose CT Scans Outperforms X-Rays
BAP1 Mutation Linked to Higher Risk of Mesothelioma

RESEARCH REPORT
Ian Ingram
Researchers have discovered that individuals carrying a mutation in the BAP1 gene are at greater risk of developing mesothelioma and uveal melanoma. Members from two families studied developed various malignancies, although mesothelioma predominated. In every affected family member, the researchers found mutations in the BAP1 gene.
ALK-Targeted Therapy for Lung Cancer

REVIEW ARTICLE
Hatim Husain, Charles M. Rudin
Ongoing research into the molecular basis of lung cancer has yielded insight into various critical pathways that are deregulated in lung tumorigenesis, and in particular key driver mutations integral to cancer cell survival and proliferation.
• ALK-Targeted Therapy in NSCLC: Not Quite Ready for Prime Time
• The Future of NSCLC: Molecular Profiles Guiding Treatment Decisions

REVIEW ARTICLES

ALK-Targeted Therapy for Lung Cancer: Ready for Prime Time
Hatim Husain, MD¹, Charles M. Rudin, MD, PhD¹ , June 14, 2011

Ongoing research into the molecular basis of lung cancer has yielded insight into various critical pathways that are deregulated in lung tumorigenesis, and in particular key driver mutations integral to cancer cell survival and proliferation.
• ALK-Targeted Therapy in NSCLC: Not Quite Ready for Prime Time
• The Future of NSCLC: Molecular Profiles Guiding Treatment Decisions

How Long Have I Had My Cancer, Doctor?
Michael V. Patrone¹, Jessica L. Hubbs, MS²,
Janet E. Bailey, BA³, Lawrence B. Marks, MD³ , January 24, 2011

To estimate the “age” of cancers, we reviewed data on the “time to local/regional recurrence” (LRF) following initial surgical resection for three common cancers, then applied a modified version of Collins’ law.
• Influences on the Natural History of Cancers
• Kinetics of Cancer: Implications from Prevention to Prognostication
• Cancer Age: Can We Reliably Estimate and Apply This Knowledge?

Lung Cancer Management in 2010
Apar Kishor Ganti, MD¹, Chao H. Huang, MD², Mark A. Klein, MD³, Sean Keefe, PharmD, BCOP⁴, Michael J. Kelley, MD⁵ , January 21, 2011

Exciting advances in understanding the biology of lung cancer have occurred over the last few years. These advances have led to the design of trials exploring the clinical value of newer treatment approaches.
• Lung Cancer: New Developments Point the Way to Reduced Mortality
• Putting Lung Cancer Clinical Trials Into Perspective

Unanswered Questions: Monoclonal Antibodies in the Treatment of Advanced Non–Small-Cell Lung Cancer
Cesare Gridelli, MD¹, Antonio Rossi, MD¹ , December 17, 2010

Despite the fact that bevacizumab and cetuximab are both in an advanced stage of clinical development for use in treatment for unresectable NSCLC, several unanswered questions regarding these drugs remain.
• Bevacizumab: In Search of the Right Drug for the Right Patient
• Future Directions of Monoclonal Antibody Use in Personalized Therapy

Lung Cancer After 70: Is it a Different Disease?
Daniel J. Lebovic, MD¹, Tariq Mahmood, MD², Alberto Chiappori, MD³ , November 8, 2010

Our knowledge regarding the efficacy and safety of chemotherapy in elderly patients is suboptimal, yet those with advanced NSCLC demonstrate the same response rates and survival benefits as their younger peers.
• Lung Cancer in the Elderly—What’s Age Got to Do With It?
• Youth Has No Age—Cancer Treatment for Older Americans

IMAGE IQ

Pulmonary Mass in 50-Year-Old Male
August 4, 2011

A 50-year-old male complains of episodic flushing and tachycardia over the past few months. X-rays revealed a pulmonary mass.

Mass Found in Lung of 61-Year-Old Male
July 7, 2011

61-year-old male with 3 month history of cough. Mass found in lung and excised. What's the diagnosis?

Carcinoma of the Lung
June 17, 2011

A 63-year-old male with a 50 pack-year smoking history presents with shortness of breath, coughing, and blood-streaked sputum. A chest radiograph shows a large mass in the middle lobe of the right lung that is biopsied.

JOURNAL SCAN

WJSO | Abstract | The prognostic factors of resected non-small cell lung cancer with chest wall invasion: a retrospective study

www.wjso.com - 1/12/12

We retrospectively reviewed the clinical features and surgical outcomes of patients with a surgically resected NSCLC invading chest wall in order to identify prognostic factors that impact long term survival. |We retrospectively reviewed the clinical features and surgical outcomes of patients with a surgically resected NSCLC invading chest wall in order to identify prognostic factors that impact long term survival.

Molecular Cancer | Download References | Enhancement of Lung Tumorigenesis in a Gprc5a Knockout Mouse by Chronic Extrinsic Airway Inflammation

www.molecular-cancer.com - 1/12/12

Although cigarette smoking is the principal cause of lung carcinogenesis, chronic obstructive pulmonary disease (COPD), an inflammatory disease of the lung, has been identified as an independent risk factor for lung cancer. Bacterial colonization, particularly with non-typeable Haemophilus influenzae (NTHi), has been implicated as a cause of airway inflammation in COPD besides cigarette smoke. Accordingly, we hypothesized that lung cancer promotion may occur in a chronic inflammatory environment in the ab

Breast Cancer Research | Comments | Hyperinsulinemia enhances c-Myc-mediated mammary tumor development and advances metastatic progression to the lung in a mouse model of Type 2 Diabetes.

breast-cancer-research.com - 1/7/12

Hyperinsulinemia, which is common in early type 2 diabetes (T2D) as a result of the chronically insulin-resistant state, has now been identified as a specific factor which can worsen breast cancer prognosis. In breast cancer, a high rate of mortality persists due to the emergence of pulmonary metastases. |Hyperinsulinemia, which is common in early type 2 diabetes (T2D) as a result of the chronically insulin-resistant state, has now been identified as a specific factor which can worsen breast cancer progno

British Journal of Cancer - Abstract of article: Combined effect of ALK and MEK inhibitors in EML4-ALK-positive non-small-cell lung cancer cells

www.nature.com - 1/12/12

The BJC is owned by Cancer Research UK, a charity dedicated to understanding the causes, prevention and treatment of cancer and to making sure that the best new treatments reach patients in the clinic as quickly as possible. The journal reflects these aims. It was founded more than fifty years ago and, from the start, its far-sighted mission was to encourage communication of the very best cancer research from laboratories and clinics in all countries. The breadth of its coverage, its editorial independenc

Data collection helps to close gap in treatment of lung cancer patients | BMJ

www.bmj.com - 12/6/11

NotesCite this as: BMJ 2011;343:d7941

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MEDLINE

Hypoxia-induced cisplatin resistance is reversible and growth rate independent in lung cancer cells.

pubmed.gov - 9/28/11

Hypoxia frequently occurs in solid tumors and is known to contribute to chemotherapy resistance. However, the mechanisms leading to chemotherapy resistance are not entirely known. We investigated hypoxia-induced resistance to cisplatin in NSCLC cell lines. We show that chronic moderate hypoxia induced resistance to cisplatin in NSCLC cells without involvement of selection pressure. Our data suggest that stabilization of the hypoxia-inducible factor 1 alpha and down-regulation of the pro-apoptotic protein BAX play a role in this process. Furthermore, we provide evidence that hypoxia-induced resistance to cisplatin is not due to the reduced growth rate of cancer cells under hypoxic conditions.

A case of lung cancer with unilateral anhidrosis and contralateral hyperhidrosis as the first clinical manifestation.

pubmed.gov - 8/1/11

18F-fluorothymidine PET/CT as an early predictor of tumor response to treatment with cetuximab in human lung cancer xenografts.

pubmed.gov - 9/1/11

We investigated whether 18F-fluorothymidine-positron-emission tomography/computed tomography (18F-FLT-PET/CT) is useful for the evaluation of the very early response to anti-epidermal growth factor receptor (EGFR) antibody cetuximab therapy in human lung cancer xenografts. A human tumor xenograft model was established with a human non-small cell lung cancer cell line. The mice were randomly assigned to four groups: tumor growth follow-up, exvivo study, PET/CT imaging and non-treated control. Mice were administered saline as control or cetuximab on day 1. An immunohistochemical study with Ki-67 was performed. Tumor volume treated with cetuximab was kept significantly smaller than control after day 8, although there was no difference on day 3. On day 3, 18F-FLT distribution was higher in the tumor than in other tissues, and was significantly decreased by treatment with cetuximab. On PET/CT imaging, 18F-FLT distribution in the tumor was clearly visualized, and the maximum standardized

Mitochondrial and energy metabolism-related properties as novel indicators of lung cancer stem cells.

pubmed.gov - 8/15/11

Energy metabolism is the foundation of survival for all organisms, and mitochondria are the most important energy-supplying organelles in eukaryotic cells. However, the mitochondrial and energy/metabolism-related properties of cancer stem cells (CSCs), the stem cell-like subpopulation in tumor masses, remain unknown. In our study, we compared the masses of mitochondria and mitochondrial DNA (mtDNA), the mitochondrial membrane potential (m), oxygen/glucose consumption, and the concentration of reactive oxygen species (ROS) and ATP between lung CSCs (LCSCs) and non-LCSCs. In addition, the change in features during differentiation was examined. Some mitochondrial and energy metabolism-related properties, such as perinuclear mitochondrial distribution, a lower quantity of mtDNA, higher m, lower oxygen/glucose consumption, and lower intracellular concentrations of ROS and ATP, can be used as indicators of LCSCs.

Inconsistencies in findings from the early lung cancer action project studies of lung cancer screening.

pubmed.gov - 7/6/11

Long-standing guidelines against screening high-risk individuals for lung cancer may change following the publication of the randomized National Lung Screening Trial (NLST), which shows a benefit of computed tomography compared with chest x-ray screening. Guideline panels will likely also seek additional information from nonrandomized studies of computed tomography screening, such as the Early Lung Cancer Action Project (ELCAP). However, for the ELCAP findings to be incorporated into new guidelines, some inconsistencies in the published data should first be resolved. Specifically, some of the reports from ELCAP appear to contradict others in terms of important endpoints, and several findings from ELCAP appear to be statistically improbable or outliers when compared with analyses and studies by other research groups. Clarification of both internal and external inconsistencies is a prerequisite for evaluation of the body of work published by ELCAP investigators.

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