Lung Cancer

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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.

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.

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).

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).

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.