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Lung Cancer

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During the past 5 years, real strides have been made in the management of advanced non-small-cell lung cancer (NSCLC). The introduction of newer chemotherapeutic agents and novel treatment regimens is paving the way for marked improvements in both clinical outcomes and quality of life.

Data from North American clinical trials have shown that vinorelbine (Navelbine) is well tolerated when used as a single agent for the treatment of non-small-cell lung cancer, advanced breast cancer, or ovarian cancer. Myelosuppression is the primary dose-limiting toxicity.

The past 5 years have witnessed an evolution in the management of unresectable non-small-cell lung cancer (NSCLC) in the United States. Combined-modality treatment with chemotherapy plus irradiation has become the standard of care for stage III (locally advanced) disease. Most patients with stage IIIB disease and cytology-positive pleural effusion are now considered candidates for chemotherapy, as are those with stage IV disease.

Newer chemotherapy drugs have shown encouraging activity in advanced non-small-cell lung cancer. Based on these improved outcomes, as well as the high rate of distant relapse in patients with locally advanced disease, several recent studies have evaluated the use of systemic therapy in patients with earlier-stage disease.

Two large-scale, randomized, phase III trials have offered new information on the response rates, survival benefits, and safety profile of vinorelbine (Navelbine) in non-small-cell lung cancer (NSCLC). In a multicenter, European trial, the response rate was significantly higher with vinorelbine/cisplatin (Platinol) than with vindesine (Eldisine)/cisplatin (P < .02) or vinorelbine alone (P < .001).

DUBLIN-A new diagnostic strategy using fluorescence bronchoscopy has proven six times more sensitive than white-light bronchoscopy alone in picking up preinvasive lung lesions, Stephen Lam, MD, of the University of British Columbia, reported at the 8th World Conference on Lung Cancer.

DUBLIN-Two metaanalyses have pointed to small but clear-cut survival gains for patients with inoperable locally advanced non-small-cell lung cancer (NSCLC) who receive chemotherapy and radiotherapy. Now, a randomized phase III Japanese study indicates that response rates are higher and survival longer when the two therapeutic modalities are given concurrently rather than sequentially.

DUBLIN-Preliminary results suggest that the use of single-agent topotecan (Hycamtin) as second-line therapy for small-cell lung cancer (SCLC) in patients who failed after an initial response to first-line therapy provides efficacy similar to that of the commonly used regimen of cyclophosphamide, doxorubicin (Adriamycin), and vincristine (CAV).

DUBLIN-Harnessing MIC chemotherapy to radiotherapy is more effective than radiotherapy alone in patients with locally advanced inoperable non-small-cell lung cancer (NSCLC), according to the findings of a multicenter randomized UK trial reported at the 8th World Conference on Lung Cancer.

DUBLIN-The question of whether patients with locally advanced non-small-cell lung cancer (NSCLC) would live longer if they underwent chemotherapy prior to surgical resection would appear to be yes, based on two randomized trials reported in 1994.

DUBLIN-The shift from histologic classification to molecular analysis of bronchial epithelial cells is opening up new prospects for detecting the molecular signature of lung cancer before the disease becomes clinically evident, James L. Mulshine, MD, of the National Cancer Institute, said at the 8th World Conference on Lung Cancer.

BETHESDA, Md-The Food and Drug Administration’s Oncologic Drugs Advisory Committee (ODAC) has recommended approval of QLT Photo-Therapeutics’ Photofrin (porfimer sodium) for use as photodynamic therapy (PDT) of T1 stage endobronchial carcinoma in patients with non-small-cell lung cancer (NSCLC) for whom surgery and radiotherapy are not indicated.

NEW YORK-Today’s treatments for lung cancer are much better tolerated than treatments used 20 years ago, Robert Ginsberg, MD, chief of the Thoracic Service, Memorial Sloan-Kettering Cancer Center, said at an NIH video satellite symposium beamed to 20 selected centers nationwide.

It should be noted that the most common presentation of asymptomatic lung cancer is indeed a solitary pulmonary nodule (SPN), but for most symptomatic lung cancers the nodule is at least 3 cm in diameter at the time of initial diagnosis. The author does a good job of providing documentation to refute one of his critical hypotheses, which indicates that "neoplasm can often be strongly suspected or excluded based on the radiologic characteristics of the single pulmonary nodule."