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Analysis of SWOG Trials Indicates No Survival Difference After 1 Year in Cancer Patients Treated In vs Out of Clinical Trials

Analysis of SWOG Trials Indicates No Survival Difference After 1 Year in Cancer Patients Treated In vs Out of Clinical Trials | Lung Cancer Dispatch | Scoop.it

"In a study reported in the Journal of the National Cancer Institute, Unger et al evaluated whether cancer patients from SWOG clinical trials were similar to nontrial patients in baseline characteristics and survival. They found that, overall, trial participation in standard treatment arms did not influence overall survival after 1 year, suggesting both that findings in clinical trials can be generalized to the wider population and that eligibility requirements might be relaxed to encourage greater clinical trial participation.

"Key Points:

"In good-prognosis patients, there was no significant difference in overall survival between patients treated in vs out of clinical trials.
"In poor-prognosis patients, there was a significant difference in overall survival during the first year after diagnosis (favoring trial participation), but not thereafter."

Editor's note: This study compared outcomes for patients treated in clinical trials with outcomes for patients not enrolled in trials. Learn more about clinical trials here.
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The ASCO Post  |  Mar 20, 2014

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Gene Expression Pattern Predicts Risk in Early Lung Cancer

Gene Expression Pattern Predicts Risk in Early Lung Cancer | Lung Cancer Dispatch | Scoop.it

In a past clinical trial, researchers identified a collection of 15 genes whose expression pattern predicted the relative risk of death in people with early-stage non-small cell lung cancer (NSCLC). Now, a new study has confirmed these findings in a larger, independent group of patients. Early-stage NSCLC patients who were classified into high- or low-risk groups based on testing the expression of the 15 genes differed significantly in their overall 5-year survival. These gene expression patterns may therefore help distinguish patients at higher risk who would benefit from adjuvant chemotherapy (chemotherapy given after tumor removal surgery), from lower-risk patients who could avoid the side effects of chemotherapy. Indeed, the Pervenio test, which looks at the expression of 14 genes, is already used to identify the patient who may benefit from aduvant chemotherapy.

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Medical News Today  |  Dec 9, 2013

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Previously Neglected Lymph Nodes Are Significant in Mesothelioma

To assess cancer stage, that is, how far advanced a cancer is, doctors routinely examine lymph nodes. However, a subset of lymph nodes located between the ribs near the spine, the so-called posterior intercostal lymph nodes, are not usually assessed in cancer staging. In a retrospective study of patients who had undergone surgery for mesothelioma (a type of lung cancer associated with asbestos exposure), researchers found that the cancer had spread to the posterior intercostal lymph nodes in over half of these patients. Patients who had no evidence of cancer in the posterior intercostal lymph nodes lived nearly 2.5 years longer, on average, than those who had. The posterior intercostal lymph nodes appear to be highly significant and should be biopsied routinely in mesothelioma patients.

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Penn Medicine | Oct 28, 2013

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Researchers Identify Genetic Mutations That Occur Across Cancer Types

Researchers Identify Genetic Mutations That Occur Across Cancer Types | Lung Cancer Dispatch | Scoop.it

By analyzing the genetic profiles of thousands of tumors from 12 major cancer types, researchers have identified over 100 genes that are frequently mutated in a variety of cancers. While some mutations were specific for certain cancer types, many occurred in different, apparently unrelated cancers. Most tumors had between two and six mutations in genes that drive cancer, suggesting that a relatively small number of mutations in key genes is enough to produce cancer. Researchers also found that mutations in some genes predicted poorer outcomes, while others were associated with better prognoses. Such analyses may eventually lead to the development of a single, inclusive diagnostic test that assesses all relevant mutations for all cancer types.

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ScienceDaily | Oct 16, 2013

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FDG-PET Distinguishes Low- and High-Risk Lung Cancer Patients After Radiotherapy

FDG-PET Distinguishes Low- and High-Risk Lung Cancer Patients After Radiotherapy | Lung Cancer Dispatch | Scoop.it

Fluorodeoxyglucose-positron emission tomography (FDG-PET) scans may be able to detect early-stage non-small cell lung cancer (NSCLC) patients who are at high risk of treatment failure after stereotactic body radiation therapy (SBRT). A retrospective study examined patients with early-stage NSCLC who were ineligible for or refused surgery and were instead treated with SBRT. Patients with lower FDG-PET readings prior to SBRT treatment survived longer, and those whose FDG-PET readings changed more after SBRT were less likely to experience treatment failure. FDG-PET scans may therefore help identify which patients are at lower or higher risk of recurrence; high-risk patients may opt for additional treatment and/or more frequent surveillance after treatment. FDG-PET has shown similar predictive value in early-stage NSCLC treated with surgery.

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MedPage Today | Sep 24, 2013

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VeriStrat Test Can Predict Lesser Response to Tarceva

VeriStrat Test Can Predict Lesser Response to Tarceva | Lung Cancer Dispatch | Scoop.it

EGFR inhibitors like erlotinib (Tarceva) can greatly benefit non-small cell lung cancer (NSCLC) patients with mutations in the EGFR gene, but their effectiveness in patients without such mutations is less clear. VeriStrat is a blood test meant to predict how well patients would respond to EGFR-inhibitor treatment. A study designed to evaluate VeriStrat examined patients with advanced NSCLC without EGFR mutations in whom platinum-based chemotherapy had stopped working and who received either different chemotherapy or Tarceva as their second-line treatment. Patients with a VeriStrat result of 'poor' survived longer when treated with chemotherapy than with Tarceva. In contrast, chemotherapy and Tarceva worked equally well for those with a 'good' test result. Good VeriStrat results also predicted longer survival in general.

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ASCO Post | Aug 21, 2013

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Gene Variations May Help Predict Response to Lung Cancer Treatment

Gene Variations May Help Predict Response to Lung Cancer Treatment | Lung Cancer Dispatch | Scoop.it

Researchers have discovered genetic variations that may predict risk of death and help direct treatment for lung cancer patients. The researchers analyzed the DNA of patients with non-small cell lung cancer (NSCLC), looking for variations associated with survival. Four of the variants they identified were located on the same gene, called TNFRSF10B. Patients with these genetic variants had up to a 41% higher chance of death, especially if they were treated with surgery only. In contrast, if these patients received chemotherapy after surgery, their risk of death was not increased. The genetic variants may therefore be useful biomarkers for guiding treatment decisions.

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Medical Xpress | Aug 9, 2013

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Colorado Medicare Will Cover VeriStrat Test for Guiding Lung Cancer Treatment

Colorado’s Medicare provider has announced that it will cover VeriStrat, a test designed to guide decisions about second-line therapies for advanced non-small cell lung cancer (NSCLC). The main second-line therapy options in NSCLC include chemotherapy or the drug erlotinib (Tarceva). While Tarceva can significantly improve outcomes in patients with mutations in the EGFR gene, it also benefits some patients without these mutations. VeriStrat, a rapid blood test, helps predict which of these patients would be more likely to respond to Tarceva and which would be better served by other treatments. Medicare coverage will allow many more patients in Colorado to access this useful tool.

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Fort Mill Times | June 20, 2013

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Blood Levels of Bilirubin Predict Lung Cancer Risk in Smokers

Blood Levels of Bilirubin Predict Lung Cancer Risk in Smokers | Lung Cancer Dispatch | Scoop.it

Smokers with low blood levels of a molecule called bilirubin are at greater risk of developing lung cancer and dying from it, researchers have found. Among 400,000 people, they found that smokers with the lowest levels of bilirubin had a 69% higher rate of lung cancer and were 76% more likely to die from the disease compared to those with the highest bilirubin levels. Among nonsmokers, differences in bilirubin levels did not affect lung cancer risk. It is not clear whether bilirubin has a protective effect against lung cancer or whether low bilirubin is simply a byproduct of other processes involved in lung cancer development. Either way, low bilirubin levels could identify smokers at high risk of lung cancer who are particularly in need of anti-smoking interventions and cancer screening.

Cancer Commons's insight:

American Association for Cancer Research | Apr 7, 2013

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Mutations in EGFR and KRAS Genes Do Not Predict Lung Cancer Outcome by Themselves

Non-small cell lung cancer (NSCLC) patients with mutations in the EGFR gene are likely to benefit from treatment with tyrosine kinase inhibitors (TKIs) like erlotinib (Tarceva) and gefitinib (Iressa), while KRAS mutations predict poor TKI response. A study of patients who were not taking TKIs and had stages I/II/III NSCLC that had been surgically removed found no difference in recurrence or survival between patients with or without EGFR or KRAS mutations. This finding suggests that, while EGFR and KRAS mutations are useful for identifying patients who may benefit from targeted treatments like TKIs, they do not predict overall clinical outcomes by themselves.


Research paper: http://graphics.tx.ovid.com/ovftpdfs/FPDDNCOBHDNMDO00/fs047/ovft/live/gv024/00000421/00000421-900000000-99450.pdf

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American Journal of Clinical Oncology | Jan 24, 2013

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DNA Shed by Tumors Shows Promise for Non-Invasive Screening and Prognosis

DNA Shed by Tumors Shows Promise for Non-Invasive Screening and Prognosis | Lung Cancer Dispatch | Scoop.it

"Certain fragments of DNA shed by tumors into the bloodstream can potentially be used to non-invasively screen for early-stage cancers, monitor responses to treatment and help explain why some cancers are resistant to therapies, according to results of an international study led by Johns Hopkins Kimmel Cancer Center investigators.


"Analyzing blood samples from 640 patients with various cancers, the researchers used digital polymerase chain reaction-based technology (a sophisticated method of multiplying and measuring the number DNA molecules) to evaluate how well the DNA fragments predicted the presence of tumors in the patients."

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Medical Xpress  |  Mar 6, 2014

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Medical Xpress  |  Mar 6, 2014

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Medical Xpress  |  Mar 6, 2014

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Genetic Test Can Predict Risk of Death in Lung Cancer

Genetic Test Can Predict Risk of Death in Lung Cancer | Lung Cancer Dispatch | Scoop.it

A new test for non-small cell lung cancer (NSCLC) patients may help guide treatment decisions. The myPlan Lung Cancer test analyzes gene expression in patients with early-stage lung adenocarcinoma, a type of NSCLC, to predict their chances of dying within the next 5 years. A study showed that patients with a high-risk myPlan Lung Cancer score had nearly double the risk of death (35%) than patients with a low-risk score (18%). myPlan Lung Cancer results were better predictors of survival than cancer stage; tumor size; or the patient's age, sex, or smoking status. More accurate risk predictions could help identify early-stage NSCLC patients for whom aggressive treatment after surgery would be advisable despite the possibility of side effects.

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MarketWatch | Oct 29, 2013

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Immune System Marker May Help Diagnose Lung Cancer and Predict Outcomes

Immune System Marker May Help Diagnose Lung Cancer and Predict Outcomes | Lung Cancer Dispatch | Scoop.it

A recent study found that the complement system, a part of the body's immune response, is activated in lung tumors. Levels of C4d, a breakdown product of the complement system, were elevated in tissue and fluid samples from lung cancer patients. C4d elevation was specific for lung cancer and was not observed in patients with non-cancer lung diseases. More advanced lung cancer was associated with higher C4d levels, but even early-stage lung cancer patients had elevated Cd4 levels. Moreover, higher C4d levels in tumor tissue and blood were associated with shorter survival, even after controlling for cancer stage. C4d blood levels fell after surgical removal of lung tumors. C4d may therefore help diagnose lung cancer, predict outcomes, and monitor response to lung cancer treatment.

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Medwire News | Oct 28, 2013

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Blood Biomarkers May Aid Cancer Detection

Blood Biomarkers May Aid Cancer Detection | Lung Cancer Dispatch | Scoop.it

A recent study may point the way to a blood test for detecting lung, prostate, and other cancers. Blood levels of a family of molecules called serum-free fatty acids (FFAs) and their breakdown products were one- to six-times higher in patients with lung or prostate cancer than in cancer-free individuals. Once tumors were surgically removed, FFA levels dropped sharply within 24 hours. Measuring FFA levels may therefore also help determine how successful a cancer surgery was and monitor whether cancer is returning. The only blood test currently available for prostate cancer, the prostate-specific antigen (PSA) test, often detects cancer where there is none, leading to unnecessary biopsies and complications. So far there is no blood test for lung cancer.

Cancer Commons's insight:

ScienceDaily | Oct 15, 2013

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ScienceDaily | Oct 15, 2013

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Married Cancer Patients More Likely to Survive

Married Cancer Patients More Likely to Survive | Lung Cancer Dispatch | Scoop.it

Married people are 20% less likely to die from cancer, a recent study found. Married patients were less likely to be diagnosed with an advanced stage of the disease and more likely to undergo the best treatment plan for their disease state. Moreover, even at the same cancer stage and undergoing the same treatment, married patients were significantly less likely to die. For several cancers, including prostate and colorectal cancer, the effect of marriage on survival was greater than that of chemotherapy. Several factors may explain these findings. Spouses may remind each other to get regular medical check-ups and encourage each other to stick to their cancer treatments. Social support may also alleviate depression, lower stress, and strengthen the immune system.

Cancer Commons's insight:

Los Angeles Times | Sep 24, 2013

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Los Angeles Times | Sep 24, 2013

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Los Angeles Times | Sep 24, 2013

Tambre Leighn's curator insight, October 14, 2013 2:35 PM

Great news...but what about those who are not married?  How can we turn these findings into tools to increase survival for more people, even if they are single? 

 

Looks like a lot of opportunity for technology based apps that support accountabilty for regular checkups (Keep a Breast Foundation (http://www.keep-a-breast.org/) has a great, free app that is a self-check reminder) and social media like Facebook and peer to peer organizations such as stupidcancer.com for Young Adults, Imerman Angels for survivors and caregivers to help overcome isolation.

 

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Tumor Size Affects Survival Rate in Advanced Lung Cancer

Tumor Size Affects Survival Rate in Advanced Lung Cancer | Lung Cancer Dispatch | Scoop.it

Current clinical practice does not consider tumor size when assessing advanced lung cancer because tumor size is not presumed to matter as much once the cancer has spread from the original site. However, a recent study found that tumor size was associated with survival rates in advanced non-small cell lung cancer (NSCLC). Patients whose total tumor dimensions were below 7.5 cm (around 3 inches) in diameter had longer life expectancies. These findings suggest that doctors should consider tumor size in advanced NSCLC for prognosis and treatment decisions. Clinical trials may also need to take tumor size into account to avoid biasing their results.

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Medical Xpress | Aug 19, 2013

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Tissue Analysis May Help Predict Risk of Early-Stage Lung Cancer Returning

Tissue Analysis May Help Predict Risk of Early-Stage Lung Cancer Returning | Lung Cancer Dispatch | Scoop.it

The tissue types present in early-stage lung adenocarcinomas, a type of non-small cell lung cancer (NSCLC), may help predict the chances of the cancer returning after surgery. A retrospective study examined outcomes among adenocarcinoma patients whose tumors were 2 cm in diameter or smaller. Patients whose tumors contained 5% or more of a so-called 'micropapillary' tissue structure had a higher risk of the cancer returning if they had just the tumor removed. This difference was not found in patients who underwent lobectomy (removal of an entire subsection of lung). The higher risk of recurrence in patients with 5%-plus micropapillary tissue in their tumor may make them better candidates for the more invasive lobectomy procedure.

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MedPage Today | Aug 7, 2013

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Clinical Trial Seeks to Find People with Mutation That May Confer High Risk for Lung Cancer

Many lung cancer patients have never smoked. Some nonsmokers may be at high risk of developing lung cancer due to inherited genetic mutations. While lung cancer patients often have mutations in their tumor tissue, some also carry genetic mutations in all cells of their body, which were present even before the cancer. The INHERIT EGFR clinical trial by the Dana-Farber Cancer Institute and the Addario Lung Cancer Medical Institute studies a specific mutation in the EGFR gene called T790M. The trial is recruiting patients with the T790M mutation in their tumors who have a high chance of carrying the otherwise very rare mutation in all of their body cells, along with their relatives, who may also carry the mutation. Researchers will investigate whether people with the T790M mutation indeed have a higher risk of developing lung cancer. The findings may help to develop better ways to detect lung cancer sooner or to reduce the risk of developing the disease.

Cancer Commons's insight:

Lung Cancer Foundation | May 14, 2013

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Gene Variations May Predict Outcomes in Non-Small Cell Lung Cancer

Gene Variations May Predict Outcomes in Non-Small Cell Lung Cancer | Lung Cancer Dispatch | Scoop.it

Variations in two genes called CXCR-2 and PAR-1 may predict how a person with non-small cell lung cancer (NSCLC) will fare. A study of over 200 NSCLC patients found that those with certain versions of the genes were likely to experience faster disease progression and shorter survival, especially if patients had squamous cell carcinoma (SCC). Both genes are involved in tumor angiogenesis, that is, the growth of new blood vessels that enable tumors to expand. In the future, testing for these high-risk gene variants may help identify good candidates for anti-angiogenesis treatments like bevacizumab (Avastin).

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Lung Cancer | Mar 30, 2013

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Immune Cell Proteins May Help Determine Prognosis in NSCLC Patients Who Receive Radiation Therapy after Tumor Removal

Radiation therapy is traditionally thought to suppress the immune system. However, it may also stimulate immune cells that can fight against tumor growth. A recent study found that increased levels of the immune cell proteins CD4 and CD8 correlated with improved survival in non-small cell lung cancer (NSCLC) patients who had received radiation therapy after tumor removal. The results suggest that immune cell protein levels could be used to help determine prognosis for patients receiving such "adjuvant therapy."

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Lung Cancer | Feb 5, 2013

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