Seminars in oncology最新文献_第8页

Military exposures and lung cancer in United States Veterans 美国退伍军人的军事暴露和肺癌

IF 4 3区医学

Seminars in oncology Pub Date : 2022-06-01 DOI: 10.1053/j.seminoncol.2022.06.010

William Grier , Hatoon Abbas , Rediet Regassa Gebeyehu , Ankur Kumar Singh , Jimmy Ruiz , Stella Hines , Fahid Alghanim , Janaki Deepak

{"title":"Military exposures and lung cancer in United States Veterans","authors":"William Grier , Hatoon Abbas , Rediet Regassa Gebeyehu , Ankur Kumar Singh , Jimmy Ruiz , Stella Hines , Fahid Alghanim , Janaki Deepak","doi":"10.1053/j.seminoncol.2022.06.010","DOIUrl":"10.1053/j.seminoncol.2022.06.010","url":null,"abstract":"<div><p>Lung cancer screening begins at age 50, with yearly low dose computed tomography (LDCT) scans until age 80, for patients determined to be high risk due to tobacco smoking. Veterans serving from World War II to the Gulf War are now at the age where LDCT is recommended. This recommendation from the United States Preventative Service Task Force includes patients who have a 20-pack year tobacco history and currently smoke or quit within the last 15 years. This recommendation does not consider additional risk factors such as exposures to lung carcinogens. We discuss unique operational and occupational exposures encountered while serving in the armed forces, which may potentially increase the risk of lung cancers in the Veteran population. The additional risk of lung cancer due to military exposure history is unclear and more work is needed to identify and quantify risk at an individual level. Increasing awareness at the provider level regarding the carcinogenic exposures encountered may allow a larger population of Veterans, not meeting traditional LDCT criteria, to benefit from lung cancer screening.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 3","pages":"Pages 241-246"},"PeriodicalIF":4.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775422000501/pdfft?md5=0cfd7b3b1a14eb31f84cbe6a8489bc49&pid=1-s2.0-S0093775422000501-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40627346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Challenges in initiating a lung cancer screening program: Experiences from two VA medical centers 启动肺癌筛查计划的挑战:来自两个退伍军人医疗中心的经验

IF 4 3区医学

Seminars in oncology Pub Date : 2022-06-01 DOI: 10.1053/j.seminoncol.2022.06.006

Stephen Bujarski , Robert Flowers , Mansour Alkhunaizi , Dave Cuvi , Sneha Sathya , Jennifer Melcher , Farrah Kheradmand , Gregory Holt

{"title":"Challenges in initiating a lung cancer screening program: Experiences from two VA medical centers","authors":"Stephen Bujarski , Robert Flowers , Mansour Alkhunaizi , Dave Cuvi , Sneha Sathya , Jennifer Melcher , Farrah Kheradmand , Gregory Holt","doi":"10.1053/j.seminoncol.2022.06.006","DOIUrl":"10.1053/j.seminoncol.2022.06.006","url":null,"abstract":"<div><p>Establishing a lung cancer screening (LCS) program is an important endeavor that delivers life-saving healthcare to an at-risk population. However, developing a comprehensive LCS program requires critical elements including obtaining institutional level buy-in, hiring necessary personnel, developing appropriate infrastructure and actively engaging primary care providers, subspecialty services, and radiology. The process required to connect such services to deliver an organized LCS program that reaches all eligible candidates must be individualized to each institution's needs and infrastructure. Here we provide detailed experiences from two successful LCS programs, one using a primary care provider-based service and the other using a consult-based service. In each case, we provide the pros and cons of each system. We propose that the decision to setup an ideal LCS program could include a hybrid design that combines aspects of each system.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 3","pages":"Pages 232-240"},"PeriodicalIF":4.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S009377542200046X/pdfft?md5=56ec504d193c057cbf95c5db99dcd01e&pid=1-s2.0-S009377542200046X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9747389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Loss of function STK11 alterations and poor outcomes in non–small-cell lung cancer: Literature and case series of US Veterans 非小细胞肺癌的功能丧失STK11改变和不良预后:美国退伍军人的文献和病例系列

IF 4 3区医学

Seminars in oncology Pub Date : 2022-06-01 DOI: 10.1053/j.seminoncol.2022.06.008

Hafsa Farooq , Harold Bien , Victor Chang , Daniel Becker , Yeun-Hee Park , Susan E. Bates

{"title":"Loss of function STK11 alterations and poor outcomes in non–small-cell lung cancer: Literature and case series of US Veterans","authors":"Hafsa Farooq , Harold Bien , Victor Chang , Daniel Becker , Yeun-Hee Park , Susan E. Bates","doi":"10.1053/j.seminoncol.2022.06.008","DOIUrl":"10.1053/j.seminoncol.2022.06.008","url":null,"abstract":"<div><p>Emerging evidence suggests that STK11 alterations, frequently found in non–small-cell lung cancers, may be prognostic and/or predictive of response to therapy, particularly immunotherapy. STK11 affects multiple important cellular pathways, and mutations lead to tumor growth by creating an immunosuppressive and altered metabolic environment through changes in AMPK, STING, and vascular endothelial growth factor pathways. We illustrate the questions surrounding STK11 genomic alteration in NSCLC with a case series comprising six United States Veterans from a single institution. We discuss the history of STK11, review studies on its clinical impact, and describe putative mechanisms of how loss of STK11 might engender resistance to immunotherapy or other therapies. While the exact impact of STK11 alteration in non–small-cell lung cancer remain to be fully elucidated, future research and ongoing clinical trials will help us better understand its role in cancer development and devise more effective treatment strategies.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 3","pages":"Pages 319-325"},"PeriodicalIF":4.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775422000483/pdfft?md5=d0bdad1db8edbd63244a1de4545aa12c&pid=1-s2.0-S0093775422000483-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40519069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Biomarkers and the microbiome in the detection and treatment of early-stage non-small cell lung cancer 生物标志物和微生物组在早期非小细胞肺癌的检测和治疗中的作用

IF 4 3区医学

Seminars in oncology Pub Date : 2022-06-01 DOI: 10.1053/j.seminoncol.2022.06.011

Mark Klein , Alexa A. Pragman , Christine Wendt

引用次数: 2

Molecular biomarkers and liquid biopsies in lung cancer 肺癌的分子生物标志物和液体活检

IF 4 3区医学

Seminars in oncology Pub Date : 2022-06-01 DOI: 10.1053/j.seminoncol.2022.06.007

Kamya Sankar , Mina Zeinali , Sunitha Nagrath , Nithya Ramnath

{"title":"Molecular biomarkers and liquid biopsies in lung cancer","authors":"Kamya Sankar , Mina Zeinali , Sunitha Nagrath , Nithya Ramnath","doi":"10.1053/j.seminoncol.2022.06.007","DOIUrl":"10.1053/j.seminoncol.2022.06.007","url":null,"abstract":"<div><p>Liquid biopsy refers to the identification of tumor-derived materials in body fluids including in blood circulation. In the age of immunotherapy and targeted therapies used for the treatment of advanced malignancies, molecular analysis of the tumor is considered a crucial step to guide management. In lung cancer, the concept of liquid biopsies is particularly relevant given the invasiveness of tumor biopsies in certain locations, and the potential risks of biopsy in a patient population with significant co-morbidities. Liquid biopsies have many advantages including non-invasiveness, lower cost, potential for genomic testing, ability to monitor tumor evolution through treatment, and the ability to overcome spatial and temporal intertumoral heterogeneity. The potential clinical applications of liquid biopsy are vast and include screening, detection of minimal residual disease and/or early relapse after curative intent treatment, monitoring response to immunotherapy, and identifying mutations that might be targetable or can confer resistance. Herein, we review the potential role of circulating tumor DNA and circulating tumor cells as forms of liquid biopsies and blood biomarkers in non-small cell lung cancer. We discuss the methodologies/platforms available for each, clinical applications, and limitations/challenges in incorporation into clinical practice. We additionally review emerging forms of liquid biopsies including tumor educated platelets, circular RNA, and exosomes.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 3","pages":"Pages 275-284"},"PeriodicalIF":4.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775422000471/pdfft?md5=578251d67cb50f8af9ec14a06a205fb2&pid=1-s2.0-S0093775422000471-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40515813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Treating advanced lung cancer in older Veterans with comorbid conditions and frailty 治疗老年退伍军人合并疾病和虚弱的晚期肺癌

IF 4 3区医学

Seminars in oncology Pub Date : 2022-06-01 DOI: 10.1053/j.seminoncol.2022.06.004

Theodore Thomas , Bindiya Patel , Joshua Mitchell , Alison Whitmer , Eric Knoche , Pankaj Gupta

{"title":"Treating advanced lung cancer in older Veterans with comorbid conditions and frailty","authors":"Theodore Thomas , Bindiya Patel , Joshua Mitchell , Alison Whitmer , Eric Knoche , Pankaj Gupta","doi":"10.1053/j.seminoncol.2022.06.004","DOIUrl":"10.1053/j.seminoncol.2022.06.004","url":null,"abstract":"<div><p>Advanced lung cancer is a deadly malignancy that is a common cause of death among Veterans. Significant advancements in lung cancer therapeutics have been made over the past decade and survival outcomes have improved. The Veteran population is older, has more medical comorbidities and frailty compared to the general population. These factors must be accounted for when evaluating patients for treatment and selecting treatment options. This article explores the impact of these important issues in the management of advanced lung cancer. Recent clinical trials leading to the approval of modern therapies will be outlined and treatment outcomes specific to older patients discussed. The impact of key comorbidities that are common in Veterans and their impact on lung cancer treatment will be reviewed. There is no gold standard frailty index for assessment of frailty in patients with advanced lung cancer and the ability to predict tolerability and benefit from systemic therapies. Currently available systemic therapies are associated with higher risk of adverse events and lower potential for clinically meaningful improvement in outcomes. Future research needs to focus on designing better frailty indices and developing novel therapies that are safer and more effective therapies for frail patients, who constitute a considerable proportion of individuals diagnosed with lung cancer.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 3","pages":"Pages 353-361"},"PeriodicalIF":4.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775422000446/pdfft?md5=0487170be9d8ac006471529b86d5b8c6&pid=1-s2.0-S0093775422000446-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40536462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Assessing Outcomes in NSCLC: Radiomic analysis, kinetic analysis and circulating tumor DNA 评估NSCLC的预后:放射组学分析、动力学分析和循环肿瘤DNA

IF 4 3区医学

Seminars in oncology Pub Date : 2022-06-01 DOI: 10.1053/j.seminoncol.2022.06.002

Ashray Maniar , Alexander Z. Wei , Laurent Dercle , Harold H. Bien , Tito Fojo , Susan E. Bates , Lawrence H. Schwartz

引用次数: 1

Controversies and challenges in lung cancer screening 肺癌筛查的争议与挑战

IF 4 3区医学

Seminars in oncology Pub Date : 2022-06-01 DOI: 10.1053/j.seminoncol.2022.07.002

Ravindra Rampariag , Igor Chernyavskiy , Mohammad Al-Ajam , Jun-Chieh J. Tsay

引用次数: 0

Exploring the effects of racial and socioeconomic factors on timeliness of lung cancer diagnosis and treatment in Baltimore Veterans 探讨种族和社会经济因素对巴尔的摩退伍军人肺癌诊断和治疗及时性的影响

IF 4 3区医学

Seminars in oncology Pub Date : 2022-06-01 DOI: 10.1053/j.seminoncol.2022.07.001

Fahid Alghanim , Kevin Z. Li , Max An , Avelino C. Verceles , William R. Grier , Hatoon Abbas , Janaki Deepak

{"title":"Exploring the effects of racial and socioeconomic factors on timeliness of lung cancer diagnosis and treatment in Baltimore Veterans","authors":"Fahid Alghanim , Kevin Z. Li , Max An , Avelino C. Verceles , William R. Grier , Hatoon Abbas , Janaki Deepak","doi":"10.1053/j.seminoncol.2022.07.001","DOIUrl":"10.1053/j.seminoncol.2022.07.001","url":null,"abstract":"<div><h3>Objectives</h3><p>To characterize the effect of racial and socioeconomic factors on the timeliness of lung cancer diagnosis and treatment in a single-center Veterans Affair Medical Center (VAMC) pulmonary nodule clinic.</p></div><div><h3>Methods</h3><p>We conducted a single-center retrospective review of all patients seen at the Baltimore VAMC pulmonary nodule clinic between 2013 and 2019 to identify key demographic factors, measures of neighborhood socioeconomic disadvantage, cancer staging and histopathologic information, and time elapsed between diagnosis and treatment. We excluded patients with pulmonary nodules undergoing active surveillance, prior history of lung cancer, metastases of a different primary origin, insufficient followup, or who had received care outside the VHA system.</p></div><div><h3>Results</h3><p>Median times to diagnosis and treatment of lung cancer were 28 and 73 days. There were no statistically significant differences in overall timeliness of diagnosis and treatment when stratified by race or measures of neighborhood socioeconomic disadvantage.</p></div><div><h3>Conclusions</h3><p>The authors found no differences in timeliness of lung cancer care by race and socioeconomic status within the system. Despite general adherence to national standards in timeliness of care, there continues to be a need for improvements in the operational workflows to reduce time to diagnosis and treatment for all Veterans.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 3","pages":"Pages 247-253"},"PeriodicalIF":4.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775422000550/pdfft?md5=bfb9041c676541e5c2399d40393430e8&pid=1-s2.0-S0093775422000550-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40584630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Improving the efficacy of immunotherapy in small cell lung cancer: Leveraging recent scientific discoveries and tumor-specific antigens 提高小细胞肺癌免疫治疗的疗效:利用最新的科学发现和肿瘤特异性抗原

IF 4 3区医学

Seminars in oncology Pub Date : 2022-06-01 DOI: 10.1053/j.seminoncol.2022.06.003

Joseph B. Hiatt , Perrin E. Romine , Daniel Y. Wu

{"title":"Improving the efficacy of immunotherapy in small cell lung cancer: Leveraging recent scientific discoveries and tumor-specific antigens","authors":"Joseph B. Hiatt , Perrin E. Romine , Daniel Y. Wu","doi":"10.1053/j.seminoncol.2022.06.003","DOIUrl":"10.1053/j.seminoncol.2022.06.003","url":null,"abstract":"<div><p>Small cell lung cancer (SCLC) is an aggressive neuroendocrine neoplasm with poor survival outcomes and little change to treatment standards over decades. SCLC is associated with heavy tobacco exposure and a high rate of somatic mutations in tumor cells, leading to hope that immune checkpoint inhibitors would dramatically reshape the treatment landscape of SCLC. Instead, immune checkpoint inhibitors have led to real but modest gains in outcomes, with only a small minority of patients deriving more durable benefit. Furthermore, biomarkers of ICI efficacy that have succeeded in other tumor types have not been validated in SCLC. However, recent research advances have suggested that epigenetic heterogeneity and plasticity play especially key roles in SCLC biology. Leveraging this emerging perspective, a new slate of candidate biomarkers of immune checkpoint inhibitor benefit have been described, and the novel treatment strategies combining rational epigenetic perturbation with immune checkpoint inhibitors are being developed. Finally, other immunotherapy strategies targeting SCLC-specific mechanisms are being tested. Together, these developments may lead to a second generation of much more efficacious immunotherapies in SCLC.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 3","pages":"Pages 344-352"},"PeriodicalIF":4.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775422000434/pdfft?md5=63c4dbba000514f2a6d37c78a0e05a6a&pid=1-s2.0-S0093775422000434-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40609581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0