James L. Mulshine, MD | Authors

Shared Decision Making and Screening: An Ongoing Dialogue Informed by Data

March 15, 2015

A state of equipoise now exists for various surgical options in the treatment of early lung cancer, underscoring the need for shared decision making.

Advancing Patient-Centric Genomic Medicine

September 15, 2013

Sorting out the clinical implications of genomic data is going to require extensive or perhaps remarkably extensive clinical correlations; obtaining these clinical data will require the cooperation of our patients.

Lessons From Considering the Cancer Landscape

May 15, 2013

A number of drugs have been approved that result in significant tumor responses. While many of these new drugs are associated with improved clinical outcomes, much more work in this area is essential, as most patients have tumors without such molecular features.

Use of High-Resolution CT Imaging Data in Lung Cancer Drug Development: Measuring Progress

April 30, 2009

Lung cancer is the leading cause of cancer death throughout the United States.[1] Despite massive efforts, tobacco consumption continues to grow, with a large and predictable impact on premature mortality across the globe.[2]

Early Lung Cancer Detection: Approaching the 'Tipping Point'?

November 01, 2006

On October 20, 2006, the International-Early Lung Cancer Action Program (I-ELCAP), an international consortium of leading early lung cancer detection researchers and allied health-care providers including radiologists, thoracic surgeons, pulmonologists, oncologists, statisticians, research nurses, and computer scientists

Developing CT Image-Processing Tools to Accelerate Progress in Lung Cancer Drug Development

November 01, 2006

On April 21, 2005, the Cancer Research and Prevention Foundation (CRPF), in conjunction with academic researchers, federal scientists, lung cancer advocates, and representatives of a number of pharmaceutical and diagnostic imaging companies, participated in a workshop held in Annapolis, Md, on the development of high-resolution spiral computed tomography (CT) imaging tools to assess therapeutic response in lung cancer clinical trials. In this report, we will address developments that led up to that workshop, what was discussed, and recommendations that came out of the meeting.

Current Issues in Lung Cancer Screening

November 01, 2005

In this review we will discuss issues inherent to the lung cancer screening process, including the value of smoking cessation strategies, the challenge with the rapid pace of developments in the field, cost concerns, consideration of biases in trial design (overdiagnosis, for example), overtreatment, and radiation risk. We discuss recommendations from several organizations, such as the US Preventive Services Task Force and the American Cancer Society.

Lung Cancer Screening With Spiral CT: Toward a Working Strategy

May 01, 2004

Given that there is no validated test for early lung cancer detection,the current standard approach to lung cancer detection is to wait forsigns or symptoms to develop. In that setting, newly detected lung canceris generally rapidly fatal resulting in over 157,000 deaths annually.Sole dependence on tobacco control is an insufficient public healthresponse to lung cancer, since most newly diagnosed individuals areeither former smokers or never smokers. Finding a more effective wayto diagnose premetastatic lung cancer would be a crucial step towardan improved lung cancer-related mortality rate. Based on studies ofbreast cancer screening, we know that achieving optimal benefit fromearly cancer detection also involves defining the most effective, efficient,and safest approach to the clinical management of screen-identifiedlung cancer. In this review, we consider how to build on the successesof other cancer screening efforts to detect and manage earlylung cancer. This involves outlining the specific elements for lung cancerthat could make a screening program safe, affordable, and effective.We also explore the current standards of early lung cancer managementand target areas where potential pitfalls and opportunities forimprovement exist.