Lung Cancer

The imminent publication of eagerly anticipated new international guidelines promises to transform the complex area of lung cancer staging. The International Association for the Study of Lung Cancer is expected to publish its updated recommendations in 2009. The seventh edition of the guidelines will include tumor, node, and metastasis classification. The original TNM staging of lung cancer proposed in 1973 was based on 2,155 cases from the database of Clifton Mountain, MD, from M.D. Anderson Cancer Center in Houston.

LUGANO, Switzerland-Women may be more vulnerable than men to the cancer-causing effects of smoking, according to a study presented at the 2009 European Multidisciplinary Conference in Thoracic Oncology.

In this issue of ONCOLOGY, Drs. Benjamin Besse and Thierry Le Chevalier have written a clear and concise review of the recent trials of adjuvant (postoperative) and neoadjuvant (preoperative) cisplatin-based chemotherapy for early-stage non–small-cell lung cancer (NSCLC)

Despite aggressive surgical management, 5-year survival rates of non–small-cell lung cancer (NSCLC) patients range from 73% for those with pathologic stage IA to 25% for those with stage IIIA.[1] Clinical or preoperative staging often underestimates the extent of the disease (particularly if positron-emission tomography and mediastinoscopy are not used), and the estimated survival rates for a given clinical stage are much lower than those for the corresponding surgical/pathologic stage.[1]

Besse and Le Chevalier provide us with an excellent and comprehensive review of available literature summarizing the current state of the art relating to both adjuvant and neoadjuvant (or induction) chemotherapy in resectable non–small-cell lung cancer (NSCLC).[1] They review the efficacy of adjuvant and neoadjuvant treatment in randomized clinical trials (RCTs) that employ cisplatin-based chemotherapy in stages I, II, and IIIA NSCLC, as well as meta-analyses of these RCTs.

During investigation of an episode of self-limiting abdominal pain, a 63-year-old Caucasian female never-smoker was found to have an asymptomatic right lower lobe pulmonary mass. A positron-emission tomography/computed tomography (PET/CT) scan revealed the right lower lobe mass to be 25 × 32 mm with a standardized uptake value (SUV) of 10.2, without evidence of hilar or mediastinal lymphadenopathy or of distant metastases.

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]

A single-arm phase II study to evaluate treatment with EC145 in patients with chemotherapy-resistant non-small cell lung cancer who have failed multiple therapy regimens has turned in promising results, according to Endocyte.

Pazopanib reduced tumor volumes in 86% of patients with non-small cell lung cancer when used as a single agent, according to the results of a phase II study. Lead investigator Nasser Altorki, MD, stressed that the most important finding of his group’s work is that the drug can be given safely to patients with early-stage disease without altering their suitability for surgery.

Oncologists who treat non-small-cell lung cancer with bevacizumab (Avastin) should be aware of a phenomenon called “bone flare,” according to researchers from two California-based institutions. 

Early-stage lung cancer patients who exercise regularly have a better quality of life, according to a study conducted at Philadelphia’s Fox Chase Cancer Center.

Genentech, Inc, announced that a phase III study (ATLAS) of erlotinib (Tarceva) in combination with bevacizumab (Avastin) as maintenance therapy following initial treatment with Avastin plus chemotherapy in advanced non–small-cell lung cancer (NSCLC) met its primary endpoint.

Epidermal growth factor receptor (EGFR) inhibitors have emerged as important drugs in cancer therapy, providing a proven survival advantage for some patients with non–small-cell lung cancer, colorectal cancer, head and neck cancer, and pancreas cancer.

Lung cancer is the leading cause of cancer-related mortality. Improved understanding in the molecular biology and genetics of lung cancer has resulted in the identification of individual genes, gene expression profiles, and molecular pathways that may be useful for clinical management decisions.

Hann/Rudin Article Reviewed. Hann and Rudin have provided a comprehensive and thoughtful review of the current management of small-cell lung cancer (SCLC).

Small-cell lung cancer (SCLC) accounts for approximately 15% of the 215,000 new lung cancer diagnoses in the United States annually. With a case-fatality rate greater than 90%, SCLC will be the cause of over 25,000 deaths in 2008 alone.

STOCKHOLM-Final analysis of the phase III Avastin in Lung Study (AVAiL), which evaluated bevacizumab (Avastin) as first-line therapy for advanced nonsmall- cell lung cancer, showed that adding bevacizumab to gemcitabine/cisplatin significantly extends progression-free survival, Christian Manegold, MD, of Heidelberg University in Mannheim, Germany, reported at ESMO 2008 (abstract LBA1).

Small-cell lung cancer (SCLC) accounts for approximately 15% of all lung cancers diagnosed in the United States. It is characterized by initial sensitivity to chemotherapy, but a rapid progression to refractory disease and death in a majority of patients.

Lung Cancer is the leading cause of cancer-related death in the United States. Non-small cell lung cancer (NSCLC) accounts for more than 85% of all patients with lung cancer.[1] A third of patients with newly diagnosed NSCLC have locally advanced disease.

mall-cell lung cancer (SCLC) is a distinct clinicopathologic entity that is characterized by neuroendocrine differentiation, early metastatic spread, and initial responsiveness to cytotoxic therapy.

NEW ORLEANS-An in-depth assessment of PET/CT at two German teaching hospitals has shown the fusion imaging technology improves on CT alone and pays dividends clinically and financially for staging non-small-cell lung cancer.

Data presented at the European Society of Medical Oncology (ESMO) meeting in Stockholm show that the IRESSA Pan-ASia Study (IPASS) exceeded its primary objective, demonstrating superior progression-free survival (PFS) for oral gefitinib (Iressa), compared with intravenous carboplatin/paclitaxel chemotherapy (hazard ratio [HR] = 0.74, P < .0001) in the overall population of clinically selected patients with advanced non–small-cell lung cancer (NSCLC) in Asia.

Eli Lilly and Company announced it received approval from the US Food and Drug Administration (FDA) for the use of pemetrexed (Alimta), in combination with cisplatin, in the first-line treatment of locally advanced and metastatic non–small-cell lung cancer (NSCLC), for patients with nonsquamous histology. Pemetrexed is not indicated for treatment of patients with squamous cell NSCLC.

No clear winner has emerged in a head-to-head comparison of whole-body FDG-PET/CT and whole-body 3T MRI for non-small-cell lung (NSCLC) cancer staging. Unenhanced PET/CT proved better for detecting metastatic lymph nodes and soft-tissue involvement, while MR was more sensitive to the presence of brain and liver metastases.

An antibody to the insulin-like growth factor type 1 receptor (IGF-1R), when given with chemotherapy, is active as first-line therapy in advanced non-small-cell lung cancer, especially squamous type, finds the first trial to test an IGF inhibitor in lung cancer. Daniel D. Karp, MD, of M.D. Anderson Cancer Center, reported the trial results at ASCO 2008 (abstract 8015).

CT screening may reduce lung cancer mortality among smokers, but won’t protect them from the other adverse effects of lighting up, according to a modeling study that looked at the long-term efficacy of screening.

CHICAGO-It may be possible to identify non-small-cell lung cancer (NSCLC) patients with a high or low risk of relapse after surgery, according to findings presented at ASCO 2008 (abstract 7501).

CHICAGO-A genetic “fingerprint” detectable in the blood is able to predict with 80% accuracy which asymptomatic smokers will develop lung cancer 2 years later, according to investigators who described the test at ASCO 2008 (abstract 1509).

The anti-inflammatory medication celecoxib (Celebrex) has proven to be safe and reduces a specific proliferation measurement of precancerous lesions in the lung, according to a study from The University of Texas M. D. Anderson Cancer Center. This finding demonstrates the significance of COX-2 inhibition toward preventing lung cancer in individuals at higher risk of developing the disease. The study is the first large randomized trial of celecoxib in lung cancer prevention.

LAS VEGAS-CT multitasks in the lungs, serving as a tool for cancer screening, disease diagnosis, lesion characterization, and lung cancer treatment response. CT can be used more effectively to assess treatment response in lung cancer patients, but clinicians must look beyond current response parameters, Michael McNitt-Gray, PhD, said at the 2008 Stanford International Symposium on Multidetector-Row CT.