Maxwell Oluwole Akanbi, MD, PhD, on Lung Cancer: The Effect of Screening on the Incidence of Advanced Disease
2022 ASCO Annual Meeting
Maxwell Oluwole Akanbi, MD, PhD, of McLaren Regional Medical Center, discusses the study he conducted, using the SEER database, to evaluate the impact of lung cancer screening recommendations on low-dose CT scanning. The data suggest that guidelines from the U.S. Preventive Services Task Force led to a more rapid decline in the incidence of advanced disease in the United States, especially among minority populations (Abstract 10506).
Transcript
Disclaimer: This video transcript has not been proofread or edited and may contain errors.
Lung cancer is the leading cause of cancer mortality in the US, and this is because most patients with lung cancer are diagnosed at advanced stages of the disease. Trying to make patients present earlier has been an elusive challenge, until in 2011, when results of the National Lung Cancer Trial were reported. This study showed that low-dose CT scan could improve survival in patients with lung cancer by making earlier diagnosis. Although this has been shown in clinical trials, the government has ruled out lung cancer screening in the general population without also actually knowing whether it is efficacious in the general population.
Our study was to evaluate the effectiveness of lung cancer screening in the US general population. You will use the SEER database, we analyzed data of patient diagnosed with lung cancer from 2004 to 2018. Our goal was to see if the incidence of advanced lung cancer reduced over this time. Our results showed that incidence of advanced lung cancer actually decreased in the US population following the rollout of lung cancer screening. This was particularly significant in minority populations. This is encouraging because there have been concerns that lung cancer screening may not be very effective in this population because they had limited access to screening facilities.
So, while this is encouraging, the work is not yet done. Our end goal is to make sure there's reduction in lung cancer mortality. There are still barriers between screening and mortality, so the next stage of our study will be to see whether this reduction in incidence of advanced lung cancer actually translate to reduction in lung cancer mortality.
Paul G. Richardson, MD, of Dana-Farber Cancer Institute, discusses phase III findings from the DETERMINATION trial, which showed that, for patients with newly diagnosed multiple myeloma, lenalidomide, bortezomib, and dexamethasone (RVd) with or without autologous stem cell transplant (ASCT) and lenalidomide maintenance to disease progression resulted in the longest median progression-free survival reported for each approach, and a highly significant difference in progression-free survival in favor of early transplant. While overall response rates were similar, rates of MRD favored early transplant also, but toxicity was greater and quality of life was transiently but significantly diminished. No overall survival advantage has been observed to date (Abstract LBA4).
The ASCO Post Staff
Eunice S. Wang, MD, of Roswell Park Comprehensive Cancer Center, discusses long-term phase II findings of a trial evaluating crenolanib plus chemotherapy in newly diagnosed adults with FLT3-mutant acute myeloid leukemia. The study showed a composite complete remission rate of 86%. With a median follow-up of 45 months, median overall survival has not been reached. A phase III trial is ongoing (Abstract 7007).
The ASCO Post Staff
Tara B. Sanft, MD, of Yale University, discusses the results of the LEANer study (Lifestyle, Exercise, and Nutrition Early After Diagnosis) in women with breast cancer. It showed that patients with newly diagnosed disease who were just starting chemotherapy could improve physical activity and diet quality. While both groups had high rates of treatment completion, women in the intervention who exercised at or above the recommended levels did better in terms of treatment completion, with fewer dose reductions and delays (Abstract 12007).
The ASCO Post Staff
Stephen M. Ansell, PhD, MD, of Mayo Clinic, discusses updated data from the ECHELON-1 trial, which showed that, when administered to patients with stage III or IV classical Hodgkin lymphoma, the combination of brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine (A+AVD) vs doxorubicin, bleomycin, vinblastine, and dacarbazine resulted in a 41% reduction in the risk of death. These outcomes, says Dr. Ansell, confirm A+AVD as a preferred option for previously untreated disease (Abstract 7503).
The ASCO Post Staff
Richard Finn, MD, of the Geffen School of Medicine at UCLA and the Jonsson Comprehensive Cancer Center, discusses analyses from the PALOMA-2 trial on overall survival with first-line palbociclib plus letrozole vs placebo plus letrozole in women with ER-positive/HER2-negative advanced breast cancer. The study met its primary endpoint of improving progression-free survival but not the secondary endpoint of overall survival. Although patients receiving palbociclib plus letrozole had numerically longer overall survival than those receiving placebo plus letrozole, the results were not statistically significant (Abstract LBA1003).
