Lung Cancer

Researchers in Seoul, Korea, found early-phase contrast-enhanced CT useful for differentiating pulmonary metastases from hepatocellular carcinoma and primary lung cancer. They specifically measured the attenuations of pulmonary nodules on the CT scans.

SAN FRANCISCO-Chemotherapy before surgery for early-stage, non-small-cell lung cancer led to moderately higher survival rates than surgery alone, but not enough to reach statistical significance, according to follow-up analysis of the European NATCH trial. However, the researchers did note that patients were more likely to finish the prescribed chemotherapy course when treatment was given preoperatively.

SAN FRANCISCO-Th e new international standards for lung cancer staging and how they pertain to imaging sent sparks flying during a plenary session at the 2009 World Conference on Lung Cancer.

Despite all of its theoretical advantages, the use of induction chemotherapy is still considered experimental in the management of early-stage resectable NSCLC.

Lung cancer is the most common cancer diagnosed in men and women in the United States, and is the leading cause of cancer death.Over 160,000 individuals died as a result of lung cancer in 2008.[1] This number amounted to more than the number of deaths from colon, breast, and prostate cancers combined. The majority of lung cancer cases are non–small-cell lung cancer (NSCLC), and the poor outcomes are attributed to the high rate of metastases associated with this disease.

The treatment of early-stage non–small-cell lung cancer (NSCLC) has undergone a paradigm shift recently with the addition of systemic therapy to local therapy. The use of cisplatin-based chemotherapy following surgery is now a standard approach for patients with stage II–IIIA disease.

The US Food and Drug Administration has approved pemetrexed (Alimta), the first drug available for maintenance therapy of advanced or metastatic lung cancer. Pemetrexed disrupts metabolic processes that are dependent on the B-vitamin folate, a necessary ingredient for cell replication.

Interim results from an open-label, phase II trial evaluating sunitinib malate (Sutent) showed progression free survival of 9.9 weeks in non–small-cell lung cancer (NSCLC) patients with irradiated brain metastases, which occur in more than one-quarter of all NSCLC patients. These data were presented at the 13th Annual World Conference of Lung Cancer, held July 31–­August 4, 2009, in San Francisco.

ORLANDO-Low-dose CT lung cancer screening carries a high burden of false-positive results after only two rounds of testing, according to research by NIH investigators.

SAN FRANCISCO-Non-small-cell lung cancer patients with irradiated brain metastases responded favorably to treatment with sunitinib malate (Sutent), according to interim results presented at the 2009 World Conference on Lung Cancer.

SAN FRANCISCO-Albumin-bound nab-paclitaxel (Abraxane) with carboplatin showed antitumor activity against squamous and nonsquamous NSCLC, according to research presented at the 2009 World Conference on Lung Cancer (abstracts PD3.4.1 and PD3.3.4).

Performing surgery following concurrent chemotherapy and radiotherapy for patients with stage IIIA (N2) non-small-cell lung cancer does not lead to better overall survival rates than chemotherapy and radiotherapy alone, according to an RTOG trial (The Lancet online, July 27, 2009).

The addition of zoledronic acid (Zometa) increases overall survival in lung cancer patients with bone metastases, according to researchers at Aristotle University of Thessaloniki and G. Papanikolaou Hospital in Greece.

SAN FRANCISCO–Maintenance therapy with erlotinib (Tarceva) in patients with non-small-cell lung cancer following chemotherapy provided a statistically significant improvement in survival, according to results from the SATURN trial.

ORLANDO-Results of a pivotal trial presented at ASCO 2009 boosted the concept of maintenance chemotherapy for advanced non-small-cell lung cancer, but not everyone is ready to wholeheartedly embrace the idea.

AstraZeneca announced the company has submitted a New Drug Application to the FDA for an investigational drug, vandetanib ( Zactima) 100 mg, for use in combination with chemotherapy for the treatment of advanced non–small-cell lung cancer in patients previously treated with one prior anticancer therapy.

Boehringer Ingelheim of Germany has entered into an agreement with the UK’s DxS to provide a companion diagnostic test kit for Boehringer Ingelheim’s compound BIBW 2992 (Tovok) to identify EGFR mutations of in patients with non-small-cell lung cancer.

ORLANDO-Results from an international phase III trial in advanced non-small-cell lung cancer could change the standard of care, according to the lead investigator.

An international, multi-institutional study presented at the 2009 Annual Meeting of the American Society of Clinical Oncology (ASCO), held May 29–June 2 in Orlando, Fla, found that use of pemetrexed (Alimta) as maintenance therapy following standard treatment improves overall survival for patients with advanced non–small-cell lung cancer (NSCLC); the study also further confirmed that this benefit is primarily limited to those with the nonsquamous subtype (abstract CRA8000).

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.