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
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).
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
Gilberto de Lima Lopes, Jr, MD, MBA, of the Sylvester Comprehensive Cancer Center at the University of Miami, and Karen L. Reckamp, MD, of Cedars-Sinai Medical Center, discuss phase II findings from substudy S1800A of the Lung-MAP protocol. The data showed that ramucirumab and pembrolizumab improved overall survival compared with the standard of care for patients with advanced non–small cell lung cancer who were previously treated with immunotherapy and platinum-based chemotherapy (Abstract 9004).
The ASCO Post Staff
Nancy Davidson, MD, of the Fred Hutchinson Cancer Research Center, reviews results from four abstracts about the importance of long-term follow-up in studies of adjuvant endocrine therapy for hormone receptor–positive breast cancer. Because the natural history of hormone receptor–positive breast cancer is long, an effort is underway to improve selection of patients by clinical parameters or biomarkers, refine the endocrine therapy background, and administer more effective combinations of endocrine therapy with other agents.
The ASCO Post Staff
Pamela L. Kunz, MD, of the Yale University School of Medicine, discusses new findings from the ECOG-ACRIN E2211 trial, which showed the longest progression-free survival and highest response rates with temozolomide plus capecitabine reported to date for patients with pancreatic neuroendocrine tumors. The presence of a deficiency of MGMT, the drug-resistance gene, was associated with greater odds of an objective response (Abstract 4004).
