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
Rainer Fietkau, MD, of Germany’s University Hospital Erlangen, discusses phase III findings of the CONKO-007 trial, which examined the role of sequential chemotherapy and chemoradiotherapy administered to patients with nonresectable locally advanced pancreatic cancer following standard-of-care chemotherapy (Abstract 4008).
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Sriram Yennu, MD, of The University of Texas MD Anderson Cancer Center, discusses the placebo response in patients with advanced cancer and cancer-related fatigue. His latest findings show that open-labeled placebo was efficacious in reducing cancer-related fatigue and improving quality of life in fatigued patients with advanced cancer at the end of 1 week. The improvement in fatigue was maintained for 4 weeks (Abstract 12006).
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Timothy J. Whelan, MD, of McMaster University and Hamilton Health Sciences, discusses findings from the LUMINA study, which found that women aged 55 or older who had grade 1–2 T1N0 luminal A breast cancer following breast-conserving surgery and were treated with endocrine therapy alone had very low rates of local tumor recurrence at 5 years. These patients, the research suggests, may be able to forgo radiotherapy (Abstract LBA501).
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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
Stephanie Walker, a former nurse and current activist with the Metastatic Breast Cancer Alliance, discusses findings from the BECOME project (Black Experience of Clinical Trials and Opportunities for Meaningful Engagement). They show that, even though Black patients comprise between 4% and 6% of all clinical trial participants, Black women with metastatic breast cancer are willing to consider taking part if steps were taken to increase their awareness, build trust through clear communication with health-care providers, involve people of shared racial/ethnic identity and health experience, and help patients find and access trials (Abstract 1014).