Lung Cancer

NEW YORK-Resection with intent to cure was possible for all but one of the lung cancers identified in a German screening program using low-dose spiral CT scans. Of the 13 cancers identified, eight were stage I, Stefan Diederich, MD, a staff radiologist at the University of Münster, said at the Second International Conference on Screening for Lung Cancer. The inoperable lesion was stage IIIB. However, it was resected after preoperative chemotherapy. One lesion was small-cell cancer, six were adenocarcinomas, and six were squamous cell carcinomas.

NEW YORK-As the Early Lung Cancer Action Project (ELCAP) continues to focus on lung cancer screening and diagnosis, a consensus has been reached on a number of points affecting the future of the research and variants of its single-arm design.

NEW YORK-The main challenges in the continuing development of low-dose spiral CT screening for lung cancer are “cost, flow, and efficiency,” Stanley H. Fox, PhD, General Electric Med Systems, Milwaukee, said at the Second International Conference on Screening for Lung Cancer.

NEW YORK-The National Cancer Institute (NCI) is designing a randomized controlled trial of low-dose spiral CT lung cancer screening that would enroll 88,000 Americans.

NEW YORK-The cost effectiveness of screening high-risk populations for lung cancer with spiral low-dose CT scans appears to be reasonable, according to two researchers who used somewhat different statistical models and data to arrive at this conclusion. Both researchers presented their results at the Second International Conference on Screening for Lung Cancer.

Although the incidence of non-small-cell lung cancer (NSCLC) is similar to that of other types of cancer, the death rate tends to be higher because lung cancer often is not detected until it is the size of an orange. “There is no reason why

A national study of nearly 11,000 patients confirmed what previous regional studies have suggested: Black Americans are less likely than whites to undergo surgery for early stage non-

As a practicing physician, Dr.Ost’s perspective on the use of photodynamic therapy (PDT) in the treatment of lung cancer is informative and helpful, particularly regarding its application in the multimodality setting. My comments represent the viewpoint of a scientist involved in the clinical use of PDT in an academic tertiary referral institution.

Many readers may find the article by Ost on photodynamic therapy (PDT) for lung cancer to be their introduction to this novel modality. If, for no other reason than this, the article is valuable. For those who address cancer as a systemic problem, first and foremost, the article may offer little to whet the appetite. On the other hand, the review may tempt the intellectual palates of those of us who focus our efforts on solving the sour problems of local cancers, their control, and the cost of aggressive therapies.

Photodynamic therapy (PDT) involves the use of photosensitizing agents that are selectively retained within tumor cells. The agents remain inactive until exposed to light of the proper wavelength. When activated by light, these

NEW YORK-An improved 2-year survival rate was achieved in stage III non-small-cell lung cancer (NSCLC) patients with a combination of paclitaxel (Taxol) and carboplatin (Paraplatin) given concurrently with radiation therapy, according to a report at the Chemotherapy Foundation Symposium XVII.

Docetaxel (Taxotere) was recently approved by the Food and and Drug Administration (FDA) for the treatment of locally advanced or metastatic non–small-cell lung cancer (NSCLC) after failure of prior platinum-based chemotherapy.

NEW YORK-Esophagitis was less frequent and less severe in patients with locally advanced non-small-cell lung cancer (NSCLC) treated with standard chemotherapy and thoracic radiation when amifostine (Ethyol) was added to the regimen, according to a report at the Chemotherapy Foundation Symposium XVII.

NEW YORK-A new prototype machine is producing images that combine CT and scintillation-camera-based PET scans into a single image. In a presentation at the Chemotherapy Foundation Symposium XVII, Hak Choy, MD, professor of radiation oncology, Vanderbilt University, showed images of lung cancer produced by the new device-the GE Millennium VG-code-named “Hawkeye”.

WASHINGTON—Three cancer specialists offered a more optimistic view for the future of lung cancer patients during a congressional briefing. Despite the disease’s “dismal” 5-year survival statistics, advances in genetics, a new screening technique, and treatment improvements promise earlier diagnosis and prolonged life for some patients, they said.

Seeking effective drugs for advanced non–small-cell lung cancer (NSCLC), researchers are trying ever more creative combinations, and at the 35th annual meeting of the American Society of Clinical Oncology (ASCO), some investigators suggested that platinums may be “on the way out” as pivotal components of regimens for the disease.

BETHESDA, Md-As ONI went to press, the FDA acted on the recommen-dation of its Oncology Drugs Advisory Committtee (ODAC) to approve Taxotere for injection (docetaxel) for the treat-ment of locally advanced or metastatic non-small-cell lung cancer (NSCLC) after failure of cisplatin-based chemotherapy. The panel voted 12 to 1 for approval and unanimously agreed that data presented by the company showed acceptable safety for Taxotere in NSCLC patients when given at a dose of 75 mg/m² over 1 hour every 3 weeks.

NEW YORK-Two important developments are bringing about a reappraisal of major institutional policy recommendations against lung cancer screening: (1) The amassing of compelling evidence that resection of early lung cancer has a major impact on survival and (2) the emergence of new techniques allowing earlier disease detection.

Studies in the first phase of the Early Lung Cancer Action Project (ELCAP), a joint research study with Weill Cornell Medical Center at New York Presbyterian Hospital and New York University Hospital, show that not only can spiral (“helical”) chest computed tomographic (CT) scans detect four times as many lung cancer tumors as conventional chest x-rays, but also the scans find these tumors when they are significantly smaller. Results of these studies (published in the July 10th issue of the Lancet) show that lung cancer patients have a significantly improved chance for long-term survival if the CT scan (which travels completely around the patient’s torso), is used to detect early-stage tumors.

NEW YORK-Less money is being spent on research for lung cancer than for other common cancers because “people believe that most lung cancer patients are to blame for their disease,” said Betty Layne, director of national planning and policy for the Alliance for Lung Cancer Advocacy, Support, and Education (ALCASE). The group held a teleconference to draw attention to this issue, to inform the public about the disease, and to say that lung cancer patients, like all cancer patients, deserve the best in prevention, early detection, treatment, and support.

BUFFALO, NY-Although adjuvant therapies have made important inroads into improving overall survival for many cancer patients, lung cancer patients have not been so fortunate, Robert J. Ginsberg, MD, said at the Roswell Park Surgical Oncology Symposium.

WASHINGTON-Continuous, hyperfractionated, accelerated radiotherapy, or CHART, has won over official British medicine for the treatment of non-small-cell lung cancer (NSCLC).

Smoking-once a socially accepted behavior-is the leading preventable cause of death and disability in the United States. During the first decades of the 20th century, lung cancer was rare; however, as cigarette smoking became increasingly popular, first among men and later among women, the incidence of lung cancer became epidemic (Figure 1).

NEW YORK-Fewer blacks than whites receive potentially curative surgery for early stage lung cancer, and this disparity is substantially responsible for lower survival rates for black patients, according to researchers at Memorial Sloan-Kettering Cancer Center and the National Cancer Institute.

I enjoyed the review of malignant mesothelioma by Drs. Sean Grondin and David J. Sugarbaker that appeared in the July 1999 issue of oncology. On page 920, the authors mention that mesothelioma will recur locally at sites of pleuroscopy or thoracoscopy. From a radiation therapy standpoint, it is worth bringing to the readers’ attention that a small, prospective trial published by Boutin et al in Chest (108[3]:754-758, 1995) showed that radiotherapy to these sites prevents entry tract metastases. A radiation dose of 21 Gy in three fractions given 10 to 15 days after thoracoscopy decreased the incidence of entry tract metastases from 40% to 0%. This regimen should be considered for patients who will not receive a more definitive surgical procedure and adjuvant radiotherapy.