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.
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).
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
Apar Kishor Ganti, MD, of the University of Nebraska Medical Center, discusses results from the CALGB 30610 study, which showed a similar clinical benefit for once- and twice-daily radiotherapy administered to patients with limited-stage small cell lung cancer. While both regimens were well tolerated, patients who received radiotherapy once daily had better quality-of-life scores at week 3 and slightly worse scores at week 12. Patients believed the once-daily regimen was more convenient (Abstract 8504).
The ASCO Post Staff
Robert Hugh Jones, MD, PhD, of Cardiff University and Velindre Hospital, discusses results from an updated analysis of the FAKTION trial, which showed improved overall survival with fulvestrant plus capivasertib in women with metastatic estrogen receptor–positive breast cancer whose disease had relapsed or progressed on an aromatase inhibitor. The benefit may be predominantly in patients with PIK3CA/AKT1/PTEN pathway–altered tumors, a topic researchers continue to study in the phase III CAPItello-291 trial (Abstract 1005).
The ASCO Post Staff
Etienne Brain, MD, PhD, of the Institut Curie, discusses phase III findings from the Unicancer ASTER 70s trial, in which patients aged 70 or older with estrogen receptor–positive, HER2-negative breast cancer and a high genomic grade index received adjuvant endocrine therapy with or without chemotherapy. The data did not find a statistically significant overall survival benefit with this treatment after surgery (Abstract 500).
