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Researchers from multiple organizations, including the American Cancer Society (ACS), studied the smoking trends among men and women over the last 50 years and found that women’s smoking habits in that time have significantly increased their risk of dying from lung cancer and chronic obstructive...
Screening all current and former heavy smokers could prevent over 12,000 lung cancer deaths a year, according to a new study published in Cancer.1 The study, funded by the American Cancer Society, arrived at that number based on data from the National Lung Screening Trial (NLST),2 which found that...
Last fall, a consortium of more than 300 researchers from The Cancer Genome Atlas (TCGA) Research Network published the results of their large-scale genetic analysis of squamous cell lung cancer in the journal Nature.1 The study, the first of its kind, compared the tumor cells from 178 untreated...
Upregulation of BIM (BCL2L11), a proapoptotic member of the BCL2 protein family, is required for induction of apoptosis by EGFR tyrosine kinase inhibitors in EGFR-mutant forms of non–small cell lung cancer (NSCLC). A BIM deletion polymorphism occurs naturally in approximately 13% of East Asian...
Our work on an Internet-based intervention for lung cancer confirmed what many other studies have shown about technologic interventions for health-care consumers—that such interventions can improve quality of life for caregivers and patients.1 We expected this result in part because of the...
The results of a study reported by David H. Gustafson, PhD, Research Professor at the University of Wisconsin-Madison, and colleagues in Cancer suggest that informal caregiver (eg, family member) use of a specifically designed online system to support palliative care reduces symptom distress in...
As recently reported by Gong Yang, MD, MPH, Research Associate Professor at Vanderbilt University School of Medicine, Nashville, and colleagues in the Journal of Clinical Oncology,1 higher prediagnosis consumption of soy food was associated with improved overall survival in Chinese women with lung...
The new guidelines from the College of American Pathologists, International Association for the Study of Lung Cancer, and Association for Molecular Pathology (CAP/IASLC/AMP) are a significant step toward personalized therapy of patients with lung cancer. More than 226,000 new patients per year are...
A new guideline for molecular testing to select lung cancer patients for treatment with epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors has been jointly developed by the College of American Pathologists, International Association for the Study ...
For the treatment of metastases to the liver and the lung, interventional radiologists reported early success with two novel approaches at the Society of Interventional Radiology (SIR) 38th Annual Scientific Meeting, held recently in New Orleans. Cryoablation of Lung Tumors For patients with...
Results of the first of three planned annual screening examinations from the National Lung Screening Trial (NLST) were recently published and physicians may now have more information to share with their patients about the benefits and risks of low-dose computed tomography lung cancer screening.1...
Peregrine Pharmaceuticals recently announced that it has reached agreement with the U.S. Food and Drug Administration (FDA) on a phase III registration trial design of the company’s lead clinical immunotherapeutic candidate bavituximab in second-line non–small cell lung cancer (NSCLC). The trial...
The Dutch-Belgian Randomized Lung Cancer Screening Trial (Dutch acronym: NELSON study) was designed to investigate whether screening for lung cancer by low-dose multidetector computed tomography (CT) in high-risk subjects would lead to a decrease in 10-year lung cancer mortality of at least 25%...
Several meta-analyses conducted in the past have suggested that survival of patients with advanced non–small cell lung cancer (NSCLC) is improved if first-line chemotherapy includes platinum derivatives. Results from a new meta-analysis of randomized clinical trials show that platinum-based...
In a molecular profile analysis of 2,271 cases of non–small cell lung cancer (NSCLC), EGFR was mutated in 12% and KRAS in 32% of cases. HER2 gene amplification was confirmed as a rare event in NSCLC (4%). Coexistence of HER2 gene amplification and EGFR mutation was identified in three cases, while...
The largest-to-date and only prospective Spanish series of 549 patients who underwent surgical resection of lung metastases from colorectal carcinoma demonstrated a good postoperative recovery from the procedure. A further analysis on morbidity, the correlation between imaging studies and...
The FDA has approved erlotinib (Tarceva) for the first-line treatment of patients with metastatic non–small cell lung cancer (NSCLC) whose tumors have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 (L858R) substitution mutations. This indication for erlotinib was approved...
Standard-dose conformal radiotherapy (60 Gy) is more effective and safer than high-dose radiotherapy (74 Gy) in patients with locally advanced stage III non–small cell lung cancer (NSCLC) undergoing chemotherapy, according to results of the phase III randomized, controlled Radiation Therapy...
Clinical resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor treatment has been observed in lung cancer. The antidiabetic drug metformin has shown significant inhibitory and proapoptotic effects in several cancer models alone and in combination with chemotherapeutic...
The diagnostic test for ALK rearrangement in non–small cell lung cancer (NSCLC) for crizotinib (Xalkori) treatment currently uses biopsy or fine-needle aspiration. Pailler and colleagues assessed whether ALK rearrangement could be detected using circulating tumor cells. They analyzed circulating...
A trial reported by Gerold Bepler, MD, PhD, of Karmanos Cancer Institute, Detroit, and colleagues in Journal of Clinical Oncology assessed whether chemotherapy selected on the basis of in situ ERCC1 and RRM1 protein levels could improve outcomes in patients with advanced non–small cell lung cancer...
This collaborative study with Foundation Medicine (Cambridge, Massachusetts), using very sensitive deep sequencing, partially mitigates some of the anxiety generated by the identification of tumor heterogeneity. While our data in lung cancer confirm that such heterogeneity exists, they also...
In a study reported in Journal of Clinical Oncology, Stéphane Vignot, MD, of Institut National de la Santé et de la Recherche Medicale (INSERM) Unit 981, Paris, and Gustave Roussy Institute, Villejuif, France, and colleagues used next-generation sequencing to identify somatic alterations in...
KRAS mutations have been reported in approximately 30% of lung adenocarcinomas. They occur most frequently in codons 12 and 13 in non–small cell lung cancer (NSCLC), and are most common in cancer in smokers and in nonsquamous NSCLC. Some data suggest that KRAS mutation is associated with poorer...
In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Indication On May 14, 2013, erlotinib (Tarceva) was approved for...
ALK rearrangement has been demonstrated to be a potent oncogenic driver and a promising therapeutic target in non-small cell lung cancer. It defines a distinct molecular subset of NSCLC, in particular adenocarcinoma that can benefit by the treatment of ALK-inhibitors. Development of robust and...
The investigational heat shock protein (Hsp)90 inhibitor ganetespib plus docetaxel extended overall survival compared with docetaxel alone as second-line therapy in patients with advanced non–small cell adenocarcinoma of the lung that had progressed on first-line therapy in the randomized phase II...
Encouraging results were seen in a preliminary study of a second-generation ALK inhibitor in advanced ALK-positive non–small cell lung cancer (NSCLC). The drug—dubbed LDK378—achieved tumor shrinkage in almost all patients enrolled in the study, in all mutational subsets, in crizotinib...
Surveying a population-based and health system–based cohort of patients receiving radiation therapy for incurable lung cancer (defined as stage IV or stage IIIB with malignant effusion at diagnosis) revealed that “64% did not understand that [radiotherapy] was not at all likely to cure them.” These ...
On July 12, 2013, the FDA approved the tyrosine kinase inhibitor afatinib (Gilotrif) for the first-line treatment of patients with metastatic non–small cell lung cancer (NSCLC) whose tumors express epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 (L858R) substitution mutations...
In the phase III PARAMOUNT trial, pemetrexed (Alimta) continuation maintenance therapy significantly reduced the risk of disease progression by 38% compared with placebo after pemetrexed/cisplatin induction in patients with advanced nonsquamous non–small cell lung cancer (NSCLC). Final overall...
EGFR mutation status may not be known at the time treatment is started in patients with advanced non–small cell lung cancer (NSCLC). Further, some data suggest that the efficacy of concurrent treatment with an EGFR tyrosine kinase inhibitor and chemotherapy is reduced because the G1 cell-cycle...
There is ongoing debate about the efficacy of erlotinib (Tarceva) in patients with advanced non-small cell lung cancer (NSCLC) whose tumors have wild-type EGFR. In the TAILOR trial, reported in Lancet Oncology by Garassino and colleagues,1 erlotinib was compared with standard docetaxel as...
A significant proportion of patients with advanced non–small cell lung cancer (NSCLC) have poor performance status, and optimal clinical management of these patients has not been established. In an attempt to help define optimal chemotherapy in such patients, Mauro Zukin, MD, of Instituto Nacional...
Actress and lung cancer advocate Valerie Harper and her husband Tony Cacciotti joined other lung cancer advocates and supporters recently at the Lung Cancer Foundation of America’s “Day at the Races” at the Del Mar Race Track in Del Mar, California. Ms. Harper is currently fighting lung cancer that ...
LUX-Lung 3 is the sixth, and largest, prospective, randomized trial to evaluate targeted EGFR inhibition vs front-line platinum doublet chemotherapy for patients with EGFR mutations. LUX-Lung 3 distinguishes itself from the previous trials (see Table 1) by using afatinib (Gilotrif), a...
Afatinib (Gilotrif) is an oral selective ErbB family inhibitor that irreversibly blocks signaling from EGFR/ErbB1, HER2/ErbB2, and ErbB4 and has exhibited broad-spectrum activity against EGFR mutations in preclinical studies. A phase II study of afatinib in EGFR-mutation positive lung...
In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Indication On July 12, 2013, afatinib (Gilotrif) was approved for...
Over a decade has passed since the start of the National Lung Cancer Screening Trial and more than 2 years since the first report indicating that this randomized study had demonstrated a significant reduction in lung cancer mortality with low-dose computed tomography (CT) screening.1 That favorable ...
The National Lung Screening Trial found that 3 years of annual screening with low-dose helical computed tomography (CT) reduced lung cancer mortality compared with chest radiography in older persons who were heavy smokers.1 The Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial also...
The prospective phase III PROFILE 1007 study compared the ALK inhibitor crizotinib (Xalkori) to chemotherapy in patients with advanced non–small cell lung cancer (NSCLC) with ALK gene–rearranged tumors refractory to previous chemotherapy. The study showed a clear superiority for crizotinib in terms ...
In a phase III trial reported by Alice T. Shaw, MD, PhD, a thoracic oncologist at Massachusetts General Hospital, Boston, and colleagues in The New England Journal of Medicine, crizotinib (Xalkori) improved progression-free survival compared with standard chemotherapy in previously treated patients ...
Results of the START trial suggest that maintenance therapy with the investigational immunotherapy tecemotide (formerly known as L-BLP25) may have a role in the treatment of patients with unresectable stage III non–small cell lung cancer (NSCLC). Although there was no significant overall survival...
The ALK inhibitor crizotinib (Xalkori) has also shown activity in lung cancers with ROS1 translocations. As recently reported by Mark M. Awad, MD, PhD, of Massachusetts General Hospital, Boston, and colleagues in The New England Journal of Medicine, a mutation conferring resistance to crizotinib...
The recommendation by the U.S. Preventative Services Task Force (USPSTF) for the use of low-dose, computed tomography (CT) to detect early lung cancer in high-risk individuals is a major milestone in the war on cancer. Lung cancer is the leading cause of cancer death across the world. Despite...
The U.S. Preventive Services Task Force recently posted its final evidence report and draft recommendation statement on screening for lung cancer. The Task Force is providing an opportunity for public comment on this draft recommendation statement until August 26. All public comments will be...
I welcomed Matthew Stenger’s Journal Spotlight on the TAILOR trial in the August 15 issue of The ASCO Post (“Docetaxel Superior to Erlotinib in Second-Line Treatment of Advanced Non–Small Cell Lung Cancer With Wild-Type EGFR”). The trial was recently published online in Lancet Oncology,1 and...
Barlesi et al have reported results of a randomized trial comparing bevacizumab (Avastin) vs pemetrexed (Alimta)/bevacizumab as maintenance therapy in patients with stage IV nonsquamous cell non–small cell lung cancer (NSCLC). It is important to consider their observations in relation to data from...
Maintenance therapy is associated with improved survival in non–small cell lung cancer (NSCLC), but few studies have compared active agents in this setting. In a phase III trial (AVAPERL trial) reported in the Journal of Clinical Oncology by Fabrice Barlesi, MD, PhD, of Aix Marseille...
A new study by thoracic surgeons and pathologists at Memorial Sloan-Kettering Cancer Center shows that a specific pattern found in the tumor pathology of some lung cancer patients is a strong predictor of recurrence. Knowing that this feature exists in a tumor’s pathology could be an important...