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LISBON, Portugal-New phase III trials testing novel combinations of platinums and taxanes in patients with small-cell lung cancer (SCLC) are yielding encouraging results, according to two studies presented at the 11th European Cancer Conference (ECCO).
SAN FRANCISCO-Patients with inoperable, locally advanced lung cancer can tolerate up to 80 Gy of conformally delivered radiation therapy, given in 1.6 cGy fractions twice daily, following carboplatin (Paraplatin)/paclitaxel (Taxol) or carboplatin/vinorelbine (Navelbine), according to a phase I study presented at the 43rd Annual Meeting of the American Society for Therapeutic Radiology and Oncology (abstract 35).
The search for effective postoperative adjuvant therapy for patients with resected non-small-cell lung cancer (NSCLC) has been spurred by a high rate of failure after definitive surgery. Except for patients with resected T1, N0, M0 lesions, failure rates exceed 30%. Widespread application of adjuvant therapy has been reined in by a disappointing lack of effectiveness in this setting.
Dr. Movsas has written a thorough, accurate description of the state of the art on postoperative, adjuvant therapy for resected "high risk" non-small-cell lung carcinoma (NSCLC). Management of this common situation indeed remains an "art," since the results of "scientific" randomized trials have been singularly disappointing.
The role of adjuvant therapy following complete resection of node-positive (stage II/IIIA) non-small-cell lung cancer remains controversial. Five-year survival rates in pathologic stage II disease range from 30% to 50% and in resected stage IIIA disease from 10% to 30%. The majority of recurrences following surgery are distant metastases.
Advances in the treatment of lung cancer have been precious and few over the past 40 years, as reflected in the minimal rise in overall survival from this disease since 1960. Significant progress has occurred in staging accuracy, surgical morbidity, radiation delivery, and new chemotherapeutics. And yet, patients with stage II disease have a 5-year survival rate of 50% or less, while patients with stage III disease fare poorly overall.
NEW YORK-In a recent Cancer Care, Inc. survey, 44% of lung cancer patients said they feel they are treated differently than people with other cancers. Even more medical professionals surveyed (77%) said they believe people with lung care are often stigmatized.
SAN FRANCISCO-A weekly regimen of gemcitabine (Gemzar) plus vinorelbine (Navelbine) appears to be equivalent to platinum-containing doublets in untreated or previously treated non-small-cell lung cancer (NSCLC), M.D. Anderson Cancer Center researchers reported at the 37th Annual Meeting of the American Society of Clinical Oncology (ASCO). George R. Blumenschein, Jr., MD, now with the Arlington Cancer Center, Arlington, Texas, presented the results at a poster session (abstract 1371).
SAN FRANCISCO-In stage III non-small-cell lung cancer (NSCLC), an intensive regimen of three-times-daily (TID) radiotherapy and escalating doses of daily cisplatin (Platinol) was found to be feasible and well accepted by patients, according to investigators from the Mayo Clinic, Scottsdale, Arizona. The findings were presented at the 37th Annual Meeting of the American Society of Clinical Oncology (ASCO abstract 1320).
CHICAGO-Intraoperative sentinel lymph node mapping using technetium-99 sulfur colloid is a safe and feasible way of identifying sites of lymph node metastasis in patients with non-small-cell lung cancer (NSCLC). The procedure does not prolong surgical resection, and it is relatively accurate, with an 89% success rate, Michael Liptay, MD, reported at the Second International Chicago Symposium on Malignancies of the Chest and Head & Neck.
According to a study presented at the 11th Annual European Cancer Conference, patients with advanced non-small-cell lung cancer (NSCLC) who received docetaxel (Taxotere) in combination with cisplatin (Platinol) achieved better results than
Fenretinide (N-4-hydroxyphenyl-retinamide, or 4-HPR) is a semisynthetic retinoid that was initially developed as a low-dose chemopreventative agent.[1-3] Unlike other naturally occurring retinoids such as all-trans, 13-cis, and 9-cis retinoic acids, fenretinide does not induce systemic catabolism that interferes with the maintenance of effective plasma levels during long-term use. This characteristic, combined with the agent’s low toxicity and its ability to block aspects of carcinogenesis, provided the rationale for the development of fenretinide in lower doses as a chemoprevention agent for breast, prostate, and bladder cancer.
The role of adjuvant therapy following complete resection of node-positive (stage II/IIIA) non-small-cell lung cancer remains controversial. Five-year survival rates in pathologic stage II disease range from 30% to 50% and in resected stage IIIA disease from 10% to 30%. The majority of recurrences following surgery are distant metastases. This two-part review, which will conclude in the January 2002 issue, analyzes the role of adjuvant therapy in this setting, using an evidence-based approach and focusing primarily on randomized trials and meta-analyses. The key variables in evaluating these studies are elucidated, ranging from the extent of mediastinal, systemic, and "molecular" staging to the quality of the adjuvant treatments administered. Some of the potential flaws inherent in meta-analyses are reviewed. To date, there is no convincing evidence that any therapy consistently improves survival in the adjuvant setting. Postoperative radiotherapy has been associated with a significant improvement in local control, particularly in patients with pathologic N2 disease. Chemotherapy should be offered to patients in appropriate clinical trials, and active phase III trials are reviewed. Future strategies include novel chemotherapy, methods to reduce toxicity, the emerging role of neoadjuvant therapy, and the promise of new biologic agents. [ONCOLOGY 15:1549-1558, 2001]
CHICAGO-Concurrent chemo-radiotherapy and consolidation docetaxel (Taxotere) achieved an unprecedented 3-year survival rate of 40% in patients with stage IIIB non-small-cell lung cancer (NSCLC) in a phase II trial (SWOG 9504).
SAN FRANCISCO-A randomized phase III trial of three chemotherapy regimens in advanced non-small-cell lung cancer (NSCLC) confirmed platinum-containing combinations as the standard treatment, according to a presentation at the 37th Annual Meeting of the American Society of Clinical Oncology (ASCO abstract 1228). The EORTC trial (08975) compared cisplatin (Platinol) and paclitaxel (Taxol) to gemcitabine (Gemzar) with either cisplatin or paclitaxel.
WASHINGTON-Abundant evidence links arsenic in drinking water to an increased risk of bladder and lung cancer and it is stronger than ever, according to a new report from the National Research Council (NRC), the research arm of the National Academy of Sciences.
SAN FRANCISCO-Early results with a regimen of gemcitabine (Gemzar), cisplatin (Platinol), and trastuzumab (Herceptin) in advanced non-small-cell lung cancer (NSCLC) patients overex-pressing HER-2 are encouraging, according to a presentation at the 37th Annual Meeting of the American Society of Clinical Oncology (ASCO abstract 1307).
SAN FRANCISCO-Platinum-based chemotherapy with either gemcitabine (Gemzar) or paclitaxel (Taxol) caused fewer terminations of therapy for progressive disease or adverse events than the reference regimen of platinum with vinorelbine (Navelbine) in advanced non-small-cell lung cancer (NSCLC).
SAN FRANCISCO-Survival of patients with limited-stage small-cell lung cancer (SCLC) has doubled in the past 2 decades, largely because of advances in thoracic radiation, according to an analysis of more than 2 dozen randomized clinical trials and the SEER database. The findings were presented at the 37th Annual Meeting of the American Society of Clinical Oncology (ASCO abstract 1264).
The Southwest Oncology Group (SWOG) is initiating a phase III trial (S0023) that will compare conventional chemoradiotherapy with consolidation docetaxel (Taxotere) followed by maintenance therapy with the investigational agent
EAST LANSING, Michigan-A study of 841 patients age 65 and older newly diagnosed with breast, colon, lung, or prostate cancer found three predictors of pain and fatigue: advanced stage, more comorbid conditions, and lung cancer, compared with breast cancer (the reference), according to researchers from Michigan State University.
SAN FRANCISCO-The biologic marker matrix metalloproteinase-9 (MMP-9) has been identified as an important new predictor of disease recurrence and poor outcome in non-small-cell lung cancer (NSCLC). It also offers some insight into the mechanisms by which NSCLC tumors grow and spread.
Effective radiotherapy for patients with cancer should include maximal tumor cell killing with minimal injury to normal tissue. Radiation doses that can be delivered, without causing severe damage to surrounding normal
SAN FRANCISCO-GVAX, an autologous cancer vaccine, demonstrated antitumor activity in non-small-cell lung cancer (NSCLC) patients in a phase I/II multicenter clinical trial. Interim data were presented at the 37th Annual Meeting of the American Society of Clinical Oncology (ASCO abstract 1019).
NASHVILLE, Tennessee-Irinotecan (Camptosar)/cisplatin (Platinol) combination therapy was significantly more effective and less toxic than standard etoposide (VePesid)/cisplatin in phase II trials, according to Alan B. Sandler, MD. The combination is now being tested in larger clinical studies. These confirmatory studies will use a 21-day cycle of irinotecan/cisplatin rather than the 28-day cycle used in preliminary studies.
