Your AI-Trained Oncology Knowledge Connection!
Approximately one-third of patients with non-small cell lung cancer (NSCLC) present with locally advanced disease, the majority of whom are treated with concurrent chemotherapy and thoracic radiation therapy. Concurrent chemoradiation therapy is superior to sequential chemotherapy followed by thoracic radiation therapy or thoracic radiation therapy alone.
This year's plenary presentations at the American Society of Clinical Oncology annual meeting, held in Chicago on June 1-5, addressed a variety of issues in five major cancer types.
Aranesp (darbepoetin alfa, Amgen) significantly reduced red blood cell (RBC) transfusions and did not affect overall or progression-free survival, compared with placebo, in a randomized, double-blind, phase III trial in 600 patients with previously untreated extensive-stage small-cell lung cancer receiving platinum-based chemotherapy.
Lung cancer remains the leading cause of cancer-related mortality in the United States. The predominant histologic type of lung cancer is Non-Small-Cell lung cancer (NSCLC). Approximately 30% of newly diagnosed patients with NSCLC present with stages I-IIIA disease.
University of Alberta researchers, led by Evangelos Michelakis, MD, have shown that dichloroacetate (DCA), added to the drinking water of nude athymic rats implanted with human lung cancer cells (A549), significantly reduced tumor size, compared with controls, and was associated with increased apoptosis and decreased proliferation.
Although CT screening increases the rates of lung cancer diagnosis and treatment among long-time smokers, data from three studies, individually and combined, show no evidence that such scanning reduces deaths from the disease
Long-term, high-level exposure to bacterial endotoxins in raw cotton fiber and cotton dust was associated with a 40% decrease in lung cancer risk among female Chinese textile workers. The risk of developing lung cancer decreased for workers exposed to greater amounts of endotoxins over many years.
AstraZeneca has initiated a new phase III study of its investigational once-daily oral agent vandetanib (Zactima, ZD6474), known as Study 36.
From 85% to 91% of cancer cases identified by annual CT lung screening in high-risk patients were early stage
Erlotinib (Tarceva) showed activity and was "relatively well tolerated" in chemotherapy-naive elderly patients with stage IIIB/IV non-small-cell lung cancer (NSCLC)
Roche has announced that the international phase III Avastin in Lung study (AVAiL, BO17704) met its primary endpoint of improving progression-free survival in patients with previously untreated advanced non-squamous-cell, non-small-cell lung cancer (NSCLC).
Merck KGaA has opened enrollment in its global phase III clinical study, known as START, assessing the efficacy and safety of Stimuvax (BLP25 liposome vaccine) as a potential treatment for patients with unresectable stage III non-small-cell lung cancer (NSCLC) who have had a response or stable disease after at least two cycles of platinum-based chemotherapy.
Hall of Fame quarterback Troy Aikman (shown talking to the media at Super Bowl XLI) has joined Hall of Fame shortstop Cal Ripken Jr., Emmy-award winning sportscaster Joe Buck, and the Lung Cancer Alliance (lungcanceralliance.org) for the lung cancer awareness campaign "A Face in the Fight."
Almost 40% of patients with newly diagnosed small-cell lung cancer (SCLC) have disease confined to the ipsilateral hemithorax and within a single radiation port, ie, limited-stage disease. The median survival for this group of patients after treatment is approximately 15 months, with one in every four patients surviving 2 years. Current optimal treatment consists of chemotherapy with platinum/etoposide, given concurrently with thoracic radiation. Surgery may represent an option for very early-stage disease, but its added value is uncertain. Prophylactic cranial irradiation (PCI) is used for patients with limited-stage SCLC who have achieved a complete response following initial therapy, as it decreases the risk of brain metastases and provides an overall survival benefit. Newer targeted agents are currently being evaluated in this disease and hold the promise of improving current outcomes seen in patients with early-stage disease.
Almost 40% of patients with newly diagnosed small-cell lung cancer (SCLC) have disease confined to the ipsilateral hemithorax and within a single radiation port, ie, limited-stage disease. The median survival for this group of patients after treatment is approximately 15 months, with one in every four patients surviving 2 years. Current optimal treatment consists of chemotherapy with platinum/etoposide, given concurrently with thoracic radiation. Surgery may represent an option for very early-stage disease, but its added value is uncertain. Prophylactic cranial irradiation (PCI) is used for patients with limited-stage SCLC who have achieved a complete response following initial therapy, as it decreases the risk of brain metastases and provides an overall survival benefit. Newer targeted agents are currently being evaluated in this disease and hold the promise of improving current outcomes seen in patients with early-stage disease.
Almost 40% of patients with newly diagnosed small-cell lung cancer (SCLC) have disease confined to the ipsilateral hemithorax and within a single radiation port, ie, limited-stage disease. The median survival for this group of patients after treatment is approximately 15 months, with one in every four patients surviving 2 years. Current optimal treatment consists of chemotherapy with platinum/etoposide, given concurrently with thoracic radiation. Surgery may represent an option for very early-stage disease, but its added value is uncertain. Prophylactic cranial irradiation (PCI) is used for patients with limited-stage SCLC who have achieved a complete response following initial therapy, as it decreases the risk of brain metastases and provides an overall survival benefit. Newer targeted agents are currently being evaluated in this disease and hold the promise of improving current outcomes seen in patients with early-stage disease.
Two embryonic stem cell vaccines proved 60% to 100% effective in preventing lung cancer in mice, John W. Eaton
Early data from a phase I study of the targeted immunoconjugate BB-10901, also known as huN901-DM1 (ImmunoGen), has provided evidence of the drug's safety and clinical activity in patients with small-cell lung cancer (SCLC) and other CD56-positive solid tumors.
Patients with late-stage non-small-cell lung cancer (NSCLC) treated with palliative radiation derive greater value from a longer, less intense course of therapy
The monoclonal antibody bevacizumab (Avastin) is likely to have a variety of uses in cancer treatment but also carries with it risks that require careful monitoring by oncology nursing staff
In early studies, the albumin-bound 130-nm formulation of paclitaxel (nab-paclitaxel, Abraxane) has shown promise in first-line treatment of non-small-cell lung cancer (NSCLC)
Investigators have begun enrolling a select group of non-small-cell lung cancer (NSCLC) patients—those who have never smoked or once smoked lightly—into a phase II trial to determine whether erlotinib (Tarceva), with or without chemotherapy, is effective as first-line treatment.
The Lung Cancer Alliance (LCA) recently launched screenforlungcancer.org, a new website aimed at educating people at risk for lung cancer about the importance of yearly low-dose computed tomography (CT) screening to promote early detection of the disease.
Surgery remains the initial treatment for patients with early-stage non-small-cell lung cancer (NSCLC). Additional therapy is necessary because of high rates of distant and local disease recurrence after surgical resection. Early trials of adjuvant chemotherapy and postoperative radiation were often plagued by small patient sample size, inadequate surgical staging, and ineffective or antiquated treatment. A 1995 meta-analysis found a nonsignificant reduction in risk of death for postoperative cisplatin-based chemotherapy. Since then, a new generation of randomized phase III trials have been conducted, some of which have reported a benefit for chemotherapy in the adjuvant setting. The role of postoperative radiation therapy remains to be defined. It may not be beneficial in early-stage NSCLC but still may have utility in stage IIIA disease. Improvement in survival outcomes from adjuvant treatment are likely to result from the evaluation of novel agents, identification of tumor markers predictive of disease relapse, and definition of factors that determine sensitivity to therapeutic agents. Some of the molecularly targeted agents such as the angiogenesis and epidermal growth factor receptor inhibitors are being incorporated into clinical trials. Preliminary results with gene-expression profiles and lung cancer proteomics have been promising. These techniques may be used to create prediction models to identify patients at risk for disease relapse. Molecular markers such as ERCC1 may determine response to treatment. All of these innovations will hopefully increase cure rates for lung cancer patients by maximizing the efficacy of adjuvant therapy.
Surgery remains the initial treatment for patients with early-stage non-small-cell lung cancer (NSCLC). Additional therapy is necessary because of high rates of distant and local disease recurrence after surgical resection. Early trials of adjuvant chemotherapy and postoperative radiation were often plagued by small patient sample size, inadequate surgical staging, and ineffective or antiquated treatment. A 1995 meta-analysis found a nonsignificant reduction in risk of death for postoperative cisplatin-based chemotherapy. Since then, a new generation of randomized phase III trials have been conducted, some of which have reported a benefit for chemotherapy in the adjuvant setting. The role of postoperative radiation therapy remains to be defined. It may not be beneficial in early-stage NSCLC but still may have utility in stage IIIA disease. Improvement in survival outcomes from adjuvant treatment are likely to result from the evaluation of novel agents, identification of tumor markers predictive of disease relapse, and definition of factors that determine sensitivity to therapeutic agents. Some of the molecularly targeted agents such as the angiogenesis and epidermal growth factor receptor inhibitors are being incorporated into clinical trials. Preliminary results with gene-expression profiles and lung cancer proteomics have been promising. These techniques may be used to create prediction models to identify patients at risk for disease relapse. Molecular markers such as ERCC1 may determine response to treatment. All of these innovations will hopefully increase cure rates for lung cancer patients by maximizing the efficacy of adjuvant therapy.
