Lung Cancer Management最新文献

{"title":"Lung cancer screening: detected nodules, what next?","authors":"Yu Chen, Danai Khemasuwan, Michael J Simoff","doi":"10.2217/lmt-2016-0008","DOIUrl":"10.2217/lmt-2016-0008","url":null,"abstract":"<p><p>Since the success of the NLST study, the incorporation of lung cancer screening programs into current academic programs has been growing. Center for Medicare and Medicaid Services have acknowledged the importance and potential impact of lung cancer screening by making it a reimbursable study. Based on Fleischner Society Guidelines, many nodules will require follow-up imaging. The remainder of those nodules will need tissue to appropriately make the diagnosis. The use of bronchoscopy with transbronchial biopsy has been a standard technique for many years, but as smaller nodules need to be assessed, more advanced tools, such as endobronchial ultrasound and electromagnetic navigation are now improving the yield on the diagnosis of these smaller peripheral nodules. As electromagnetic navigation and peripheral ultrasound are significant changes from practice only 10 years ago, further advancements in the technology, such as bronchoscopic robots and advanced optical imaging tools, that are becoming available, need to be assessed as to their possible incorporation into the evaluation of peripheral nodules. The ceiling to the diagnosis of these small lesions remains at 70-75%; techniques and tools need to be used to improve upon this to maximize the impact of lung cancer screening and minimize the risk to patients.</p>","PeriodicalId":43551,"journal":{"name":"Lung Cancer Management","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310323/pdf/lmt-05-173.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36864624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgery in oligometastatic NSCLC patients in the targeted therapy era.","authors":"Qi Zhang,&nbsp;Yi-Long Wu","doi":"10.2217/lmt-2016-0012","DOIUrl":"https://doi.org/10.2217/lmt-2016-0012","url":null,"abstract":"More than 50% of NSCLC patients present with metastatic disease at first diagnosis, with a median survival of 8-11 months. However, selected patients with oligometastatic disease who receive appropriate local therapy for both the primary lesion and metastases enjoy long-term survival or are even cured. The new (eighth) edition of the tumor, node and metastasis classification of lung cancer suggests that patients with a single metastatic lesion in one distant organ should be placed into a new category, M1b, which will certainly lead to more applications of local therapy in such subpopulations. Moreover, as the applications of targeted therapy increase, surgery will play an evermore critical role in eliminating drug-resistant cancer clones of patients who exhibit mixed responses to tyrosine kinase inhibitors. The lung, brain and adrenal gland are the most common oligometastatic organs, and are reviewed separately.","PeriodicalId":43551,"journal":{"name":"Lung Cancer Management","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/lmt-2016-0012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36864622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigational bronchoscopy at a community hospital: clinical and economic outcomes.","authors":"Susan K Garwood,&nbsp;Pam ClenDening,&nbsp;Nathanael D Hevelone,&nbsp;Kristin L Hood,&nbsp;Sean Pidgeon,&nbsp;Leonard James Wudel","doi":"10.2217/lmt-2016-0015","DOIUrl":"https://doi.org/10.2217/lmt-2016-0015","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the clinical and financial impact of introducing electromagnetic navigation bronchoscopy (ENB) at a community center.</p><p><strong>Methods: </strong>This retrospective, single-arm, single-center study evaluated 90 consecutive patients who had undergone ENB in 2012. Radial probe endobronchial ultrasound was used to localize the lesion after initial ENB. ENB-aided diagnoses, follow-up procedures and treatments, and adverse events were collected through 2 years.</p><p><strong>Results: </strong>ENB was conducted for lung biopsy (86 patients), fiducial placement (five), and/or dye marking (two). ENB-aided diagnostic yield was 82.6% (71/86), including 36 malignant and 35 nonmalignant cases. NSCLC was stage I-II in 84.6%. There were four false negatives. Sensitivity and negative predictive value were 90.0 and 88.6%. Pneumothorax occurred in 6/90 (5/6 with chest tube) and minor bleeding in four. The downstream revenue of new ENB cases was US$363,654.</p><p><strong>Conclusion: </strong>ENB introduction provided high diagnostic yield, early-stage diagnosis, acceptable safety, and was financially justified.</p>","PeriodicalId":43551,"journal":{"name":"Lung Cancer Management","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/lmt-2016-0015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36854070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of immune checkpoint inhibitors in NSCLC according to PD-L1 expression.","authors":"Pedro Aguiar, Luke A Perry, Gilberto L Lopes","doi":"10.2217/lmt-2016-0016","DOIUrl":"10.2217/lmt-2016-0016","url":null,"abstract":"","PeriodicalId":43551,"journal":{"name":"Lung Cancer Management","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322585/pdf/lmt-05-119.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36864618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-line treatment of nonsquamous NSCLC using gemcitabine: a retrospective study of real-life practice.","authors":"Filip Kohutek,&nbsp;Miroslava Stratena,&nbsp;Andrej Rosik,&nbsp;Maria Tamasova,&nbsp;Branislav Bystricky","doi":"10.2217/lmt-2016-0011","DOIUrl":"https://doi.org/10.2217/lmt-2016-0011","url":null,"abstract":"<p><p>We present results of retrospective real-life data of nonsquamous lung cancer patients treated in first-line (platinum-based chemotherapy with gemcitabine without bevacizumab). 56 patients with satisfactory performance status for cytotoxic chemotherapy were treated in 2010-2014. Median progression-free survival was 6.48 months (95% CI: 4.44-9.48), time to progression was 10.19 months (95% CI: 7.59-12.19). Median overall survival was 10.8 months (95% CI: 6.72-14.52). Although our group of patients had higher proportion of elderly patients with somewhat limited performance status, progression-free survival rate was comparable to large registration studies. Overall survival, despite intervening comorbidities and subsequent limited use of second-line treatment was analogous to large gemcitabine/platinum Phase III studies in nonsquamous population. We believe our data represent real-life survival rates of unselected patients with advanced NSCLC of nonsquamous type from mostly rural catchment area.</p>","PeriodicalId":43551,"journal":{"name":"Lung Cancer Management","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/lmt-2016-0011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36854071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting EGFR and ALK in NSCLC: current evidence and future perspective.","authors":"Chiara Bennati, Luca Paglialunga, Biagio Ricciuti, Giulio Metro, Luca Marcomigni, Alessio Gili, Lucio Crinò","doi":"10.2217/lmt-2016-0005","DOIUrl":"10.2217/lmt-2016-0005","url":null,"abstract":"<p><p>The advent of molecular therapy targeting specific driver oncogenes has dramatically changed the prognosis of a subset of NSCLC, dilating survival and improving the quality of life of patients with advanced disease. Two of the major targets for treatment with receptor TKIs are the activated mutated forms of the <i>EGFR</i> and the <i>ALK</i> gene fusions. In advanced NSCLC patients harboring <i>EGFR</i> mutations or <i>ALK</i> rearrangements, the use of TKIs in the first-line setting, have provided unexpected large progression-free survival and overall survival benefits, compared with cytotoxic chemotherapy. However, despite initial responses and durable remissions, the development of resistance inevitably leads to treatment failure. The aim of this review is to discuss the treatment strategy currently used for tumors harboring these two genetic targets and to focus on what will be available in clinical practice in the near future.</p>","PeriodicalId":43551,"journal":{"name":"Lung Cancer Management","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310340/pdf/lmt-05-79.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36864617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptom burden in lung cancer: management updates.","authors":"Rebecca H Lehto","doi":"10.2217/lmt-2016-0001","DOIUrl":"10.2217/lmt-2016-0001","url":null,"abstract":"<p><p>Lung cancer is recognized to carry a high symptom burden with associated lowered quality of life as compared with other cancers. Research has shown that symptom severity can be a prognostic indicator of poorer clinical outcomes and survival post treatment. The purpose of this paper is to review current literature relative to symptom burden associated with diagnosis, medical and/or surgical intervention, assessment and management updates, and emerging initiatives that promote positive outcomes based on updated evidence. Discussion relative to interdisciplinary coordination of supportive services and palliative care initiation is provided.</p>","PeriodicalId":43551,"journal":{"name":"Lung Cancer Management","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310300/pdf/lmt-05-61.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36864616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liquid biopsy and NSCLC.","authors":"Domenico Trombetta,&nbsp;Angelo Sparaneo,&nbsp;Federico Pio Fabrizio,&nbsp;Lucia Anna Muscarella","doi":"10.2217/lmt-2016-0006","DOIUrl":"https://doi.org/10.2217/lmt-2016-0006","url":null,"abstract":"<p><p>In the era of high-throughput molecular screening and personalized medicine, difficulty in determining whether cancer mutations are truly 'actionable' remains a gray zone in NSCLC. The most important prerequisite to perform such investigations is the tumor tissue retrieval via biopsy at diagnosis and after occurrence of resistance. Blood-based liquid biopsy as circulating tumor cells, circulating tumor DNA and exosomes can offer a fast and non-invasive method to elucidate the genetic heterogeneity of patients, the screening and patient stratification and give a dynamic surveillance for tumor progression and monitor treatments response. Here we prospectively discuss the three main approaches in the blood-biopsy field of lung cancer patients and its clinical applications in patient management. We also outline some of the analytical challenges that remain for liquid biopsy techniques in demonstrating that it could represent a true and actionable picture in lung cancer management for the implementation into clinical routine.</p>","PeriodicalId":43551,"journal":{"name":"Lung Cancer Management","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/lmt-2016-0006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36864620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphnodal micrometastases in NSCLC: where do we stand?","authors":"Andrea Viti,&nbsp;Alberto Terzi,&nbsp;Giuseppe Bogina,&nbsp;Luca Bertolaccini","doi":"10.2217/lmt-2016-0009","DOIUrl":"https://doi.org/10.2217/lmt-2016-0009","url":null,"abstract":"Thoracic Surgery Unit, Sacro Cuore Don Calabria Research Hospital – Cancer Care Center, Via Don Angelo Sempreboni 5, 37024, Negrar Verona, Italy Pathology Service, Sacro Cuore Don Calabria Research Hospital – Cancer Care Center, Negrar Verona, Italy *Author for correspondence: vitimassa@hotmail.it","PeriodicalId":43551,"journal":{"name":"Lung Cancer Management","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/lmt-2016-0009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36865117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent results of immunotherapy and perspectives for advanced NSCLC.","authors":"Denis L Jardim,&nbsp;Debora de Melo Gagliato","doi":"10.2217/lmt-2016-0007","DOIUrl":"https://doi.org/10.2217/lmt-2016-0007","url":null,"abstract":"Centro de Oncologia do Paraná – Oncoville, Curitiba, Brazil *Author for correspondence: Tel.: +55 41 3083 0988; denisjardim@centrodeoncologia.com It is estimated that 224,390 new cases of lung cancer will be diagnosed in 2016 in USA, making it the second most incident cancer for all genders, only behind breast cancer. Additionally, lung cancer will be first cause of cancer death in USA during this year, causing 150,080 estimated deaths [1]. Although lung cancer mortality is slowly decreasing over the last years, data indicate of lung cancer diagnosis and treatment is still an unmet need. One of the key challenges is that approximately 70% of lung cancers are diagnosed in advanced stage, for which curative treatment is not possible [2]. The majority (85%) of lung cancers are classified as NSCLC, while the reaming represents small-cell lung cancers, which is associated with a dismal prognosis [3]. The standard treatment for advanced NSCLC over the last decade is chemotherapy, including platinum-based doublets. These regimens are associated with a response rate (RR) of approximately 20%, and median overall survival (OS) under 12 months [4]. For selected patients, after four to six cycles of platinum-doublets regimens, maintenance therapy either with chemotherapy or EGFR inhibitors is associated with a modest improvement in OS [5]. One of the greatest advances obtained over the last decade for the management of advanced NSCLC is the consolidation of a molecular-based approach. Approximately 70% of NSCLC are nonsquamous, and 40% of them may present with a targetable genetic alteration. Tyrosine kinase inhibitors are available for patients whose tumors harbor EGFR mutations, ALK translocations and, more recently, ROS1 fusions. A matched targeted therapy is associated with an RR of 60–70%, and disease control that frequently surpasses 12 months [6]. Nonetheless, these therapies are not curative; treatment resistance development is almost a rule. In addition, there are no molecularly oriented therapies approved for advanced lung cancers with squamous cell histology. Second-line options for advanced NSCLC were restricted to docetaxel and pemetrexed.","PeriodicalId":43551,"journal":{"name":"Lung Cancer Management","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/lmt-2016-0007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36865121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}