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Radiotherapy: Novel Lung Cancer Treatment Meets with Success

Radiotherapy: Novel Lung Cancer Treatment Meets with Success | Lung Cancer Dispatch | Scoop.it

"An old idea of retreating lung tumors with radiation is new again, especially with the technological advances seen in radiation oncology over the last decade. 'One of the toughest challenges of lung cancer is what to do for patients when the cancer comes back in an area that’s been treated previously with radiation treatment,' said the lead author. 'With some of the technological advances in radiation treatments that have occurred in the last five to 10 years, we’re beginning to re-look at the issue and ask – can we target the radiation precisely enough and with a high enough dose to knock the cancer back?'

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ScienceDaily  |  May 8, 2014

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Helix BioPharma Corp. Receives U.S. Food and Drug Administration Approval to Initiate a Clinical Trial of L-DOS47 in Combination With Pemetrexed and Carboplatin

Helix BioPharma Corp. Receives U.S. Food and Drug Administration Approval to Initiate a Clinical Trial of L-DOS47 in Combination With Pemetrexed and Carboplatin | Lung Cancer Dispatch | Scoop.it

"Helix BioPharma Corp. (frankfurt:HBP), a biopharmaceutical company developing innovative drug candidates for the prevention and treatment of cancer, today announced that it has received approval from the U.S. Food and Drug Administration ("FDA"), to initiate a Phase I clinical trial with L-DOS47.


"The study is entitled "A Phase I, Open Label, Dose Escalation Study of Immunoconjugate L-DOS47 in Combination with Standard Doublet Therapy of Pemetrexed/Carboplatin in Patients with Stage IV (TNM M1a and M1b) Recurrent or Metastatic Non-Squamous Non-Small Cell Lung Cancer"."


Editor's note: Clinical trials can be a way for some lung cancer patients to access certain treatments they would not otherwise be able to have. Learn more.

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MarketWatch  |  Apr 22, 2014

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Hint of Survival Benefit with Bevacizumab-Pemetrexed Maintenance for NSCLC

Hint of Survival Benefit with Bevacizumab-Pemetrexed Maintenance for NSCLC | Lung Cancer Dispatch | Scoop.it

"Updated data from the phase III AVAPERL trial hint that there might be an overall survival (OS) benefit of using bevacizumab in combination with pemetrexed as maintenance therapy in patients with advanced nonsmall cell lung cancer (NSCLC).

“ 'The AVAPERL study was not powered to detect differences in OS between treatment arms', Fabrice Barlesi, of Aix Marseille University in France, and colleagues observe in the Annals of Oncology.

“ 'The analysis revealed, however, that OS was numerically increased by nearly 4 months in patients treated with maintenance bevacizumab-pemetrexed as compared with bevacizumab alone', the international team of researchers reports."


Editor's Note: Maintenance therapy is "treatment that is given to help keep cancer from coming back after it has disappeared following the initial therapy. It may include treatment with drugs, vaccines, or antibodies that kill cancer cells, and it may be given for a long time," according to the National Cancer Institute. Patients in this study were found to have longer survival times when taking a combination of the drugs bevacizumab and pemetrexed as a maintenance therapy than when taking bevacizumab alone.

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News-Medical.Net  |  Mar 19, 2014

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Local Radiotherapy May Allow Lung Cancer Patients to Stay on Xalkori Longer

Local Radiotherapy May Allow Lung Cancer Patients to Stay on Xalkori Longer | Lung Cancer Dispatch | Scoop.it

Crizotinib (Xalkori) is effective for patients with non-small cell lung cancer (NSCLC) who have a mutation in the ALK gene, but their cancer usually develops resistance to the drug. However, this resistance may affect only part of the cancer, while the majority of the disease still responds to Xalkori. In such cases, localized radiation may be used to destroy the resistant part of the cancer (a technique dubbed 'weeding the garden') while patients continue to take Xalkori. In a small study, patients treated with this method could take Xalkori almost three times longer than those not eligible for the treatment. Longer times on Xalkori were associated with higher rates of 2-year survival. The average time without further relapse after the first radiation treatment was 5.5 months, and patients could be treated multiple times. Similar approaches may be effective with other targeted therapies.

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Medical Xpress  |  Jan 28, 2014

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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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Selenium Does Not Prevent Lung Cancer Recurrence

Selenium has been suggested to have preventative effects against lung cancer. In a recent clinical trial, patients with stage I non-small cell lung cancer (NSCLC) that had been completely surgically removed were given either selenium supplements or a placebo for 2 years after surgery. Interim results showed that patients receiving selenium were no less likely to have their lung cancer return than those given a placebo. Because there were hints that selenium-treated patients may be indeed more likely to develop new tumors, the study was halted. Final analyses show no harm from taking selenium, but no protection against lung cancer either.

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Journal of Clinical Oncology | Sep 3, 2013

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TRACERx Study Aims to Revolutionize Understanding of Lung Cancer

TRACERx Study Aims to Revolutionize Understanding of Lung Cancer | Lung Cancer Dispatch | Scoop.it

Cancer Research UK recently announced the beginning of a 9-year study that seeks to examine how lung cancers mutate, adapt, and become resistant to treatment. The TRACERx (Tracking Cancer Evolution through Therapy) study will take tumor samples and blood tests from 850 patients across the UK pre-surgery, post-surgery, and, in cases of recurrence, to analyze changes in a tumor’s genetic profile as the disease progresses. The researchers will then compare genetic modifications of tumors between patients and will seek to understand how these mutations affect a patient’s chances of survival. According to Cancer Research UK, the £14 million study constitutes one of the largest single-item funding commitments to lung cancer research.

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Cancer Research UK | Jul 18, 2013

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Cancer Patients Need Support to Adopt Healthy Lifestyles

Cancer Patients Need Support to Adopt Healthy Lifestyles | Lung Cancer Dispatch | Scoop.it

Healthy lifestyles can benefit people with cancer, reducing recurrence and increasing long-term survival. But that knowledge alone is not enough to make cancer patients start exercising, and stop smoking and drinking, researchers report in the British Journal of Cancer. The study included 5,146 adults from the English Longitudinal Study of Ageing, and showed that the 433 who got cancer did not adopt healthier habits after diagnosis. Instead, they smoked and drank as much as those without cancer, and exercised even less. The researchers call for figuring out how to help cancer patients make lifestyle changes that can protect their health.

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British Journal of Cancer│May 22, 2013

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British Journal of Cancer│May 22, 2013

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British Journal of Cancer│May 22, 2013

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Low-Radiation CT Scan Superior for Detecting Lung Cancer Recurrences

Low-Radiation CT Scan Superior for Detecting Lung Cancer Recurrences | Lung Cancer Dispatch | Scoop.it

A new screening method may offer a better way to monitor recurrence after lung cancer surgery. Recurrence is common, but traditional screening methods, including chest x-rays and computed tomography (CT) scans, have significant drawbacks. A new minimal dose CT (MnDCT) scan reduces radiation exposure to no more than that of standard x-rays, but it maintains superior sensitivity. In a recent study, MnDCT detected 94% of cancer recurrences in patients who had received surgery to remove stage I or II lung cancer; x-rays caught only 21%. However, MnDCT has a high rate of false positives (ie, detecting lung cancer when none is actually present), which is of concern because recurrence may call for invasive and potentially dangerous follow-up procedures.

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Medical Xpress | May 6, 2013

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Renewed Radiation Therapy Benefits Some Patients with Recurrent Lung Cancer

About one-third of lung cancer patients treated with radiation therapy and chemotherapy experience recurrence at or near the original site. A study of patients with non-small cell lung cancer (NSCLC) or small-cell lung cancer (SCLC) investigated the use of renewed radiation ("reirradiation" or reRT) for such "locoregional recurrence." ReRT relieved symptoms in 75% of NSCLC patients and conferred long-term survival in some, especially those who had little functional impairment at the time of treatment and had received higher doses of radiation. Some SCLC patients whose returning cancer was small and did not cause symptoms, and whose cancer had not spread outside the chest region, also experienced increased survival from reRT. For all other SCLC patients, reRT produced no meaningful benefits.


Research paper: http://graphics.tx.ovid.com/ovftpdfs/FPDDNCMCHELLGK00/fs047/ovft/live/gv024/00000421/00000421-900000000-99449.pdf

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American Journal of Clinical Oncology | Jan 24, 2013

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Set of Genes May Predict Benefits from Adjuvant Chemotherapy for Lung Cancer

While adjuvant chemotherapy (ACT) after surgical removal of non-small cell lung cancer (NSCLC) can help prevent cancer recurrence and improve survival, the average benefits are small and the treatment can have serious side effects. A study of patients with adenocarcinoma identified 12 genes that together predicted the likelihood of better (low-risk) or worse (high-risk) long-term outcomes in these patients. Patients with a high-risk "gene signature" benefitted significantly from ACT, while low-risk patients gained no additional benefit, suggesting that the gene set can be used to pinpoint patients for whom ACT treatment would be worth the risk of side effects.

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Clinical Cancer Research | Jan 28, 2013

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Immune Cells May Predict Recurrence of Early-Stage Lung Cancer

Immune Cells May Predict Recurrence of Early-Stage Lung Cancer | Lung Cancer Dispatch | Scoop.it

Currently, stage I (early-stage) lung cancer is usually treated with surgical removal only, but in up to 27% of cases the cancer will return within 5 years. A recent study found that the presence and relative concentration of certain kinds of immune cells in tissue samples from stage I lung cancer patients could predict which patients were at higher risk of the cancer returning after surgery. In the future, testing early-stage lung cancer patients for these immune biomarkers may be used to indicate which patients should be followed more closely after surgery and possibly receive additional treatments with novel immune-based therapies.


Primary source: http://jco.ascopubs.org/cgi/doi/10.1200/JCO.2012.45.2052

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On Cancer | Jan 3, 2013

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Postoperative TKI Treatment Benefits Patients with EGFR Mutations

New research suggests that erlotinib (Tarceva®) and gefitinib (Iressa™) can reduce the risk of recurrence after removal of EGFR-mutant lung cancer tumors. The study followed patients with stage I-III lung cancer who underwent tumor removal. Patients with EGFR-mutant tumors who were treated with either of the two TKI drugs after resection had a lower risk of recurrence or death than patients who did not receive the adjuvant therapy.

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Journal of Thoracic Oncology | Dec 2012

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Postop Opioid Use Tied to NSCLC Recurrence

Postop Opioid Use Tied to NSCLC Recurrence | Lung Cancer Dispatch | Scoop.it

"Non-small cell lung cancer (NSCLC) patients who experienced disease recurrence half a decade after surgery received a significantly higher dose of opioids postoperatively, researchers said here.


"In a retrospective study among patients treated for early-stage NSCLC, recurrence occurred in 26 who received a mean dose of 232 mg of opioids in the 96 hours after surgery compared with 124 mg of opioids administered to the 73 patients in whom there was no recurrence in 5 years (P=0.020), reported Dermot Maher, MD,from Cedars-Sinai Medical Center in Los Angeles, and colleagues."

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MedPage Today  |  May 4, 2014

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Phase II Trial Shows Feasibility of Customized Adjuvant Treatment in NSCLC, but Phase III Trial Canceled Due to Unreliability of ERCC1 Readouts

Phase II Trial Shows Feasibility of Customized Adjuvant Treatment in NSCLC, but Phase III Trial Canceled Due to Unreliability of ERCC1 Readouts | Lung Cancer Dispatch | Scoop.it

"In the phase II Tailored Postsurgical Therapy in Early-Stage NSCLC (TASTE) trial (IFCT-0801), reported in the Journal of Clinical Oncology, Wislez et al examined the feasibility of customized adjuvant treatment based on EGFR mutation status and expression of ERCC1 (excision repair cross-complementation group 1), a predictor of cisplatin response, in patients with non–small cell lung cancer (NSCLC). Although the trial met its primary endpoint of ≥ 80% of patients being able to start adjuvant chemotherapy within 2 months of surgery, a phase III trial of the customized approach was cancelled due to unreliability of ERCC1 immunohistochemical readouts."


Editor's note: This trial tested whether a particular molecular testing method could be used to decide which lung cancer patients might benefit from chemotherapy after surgery to keep the cancer from returning. While the results of the trial were promising, the third phase of the trial was canceled because of some unreliability of the molecular testing method. Another method called Pervenio, already performs a similar function.

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The ASCO Post  |  Mar 31, 2014

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Meta-Analysis Shows Survival Benefit of Preoperative Chemotherapy in NSCLC

Meta-Analysis Shows Survival Benefit of Preoperative Chemotherapy in NSCLC | Lung Cancer Dispatch | Scoop.it

"In a systematic review and individual patient meta-analysis reported in The Lancet, the NSCLC Meta-analysis Collaborative Group found that neoadjuvant therapy for non–small cell lung cancer (NSCLC) was associated with a significant 13% reduction in risk of death. Significant benefits in recurrence-free survival and time to distant recurrence were also observed...


"Preoperative chemotherapy was associated with a 13% improvement in overall survival.


"Preoperative chemotherapy was associated with a 15% improvement in recurrence-free survival and a 31% improvement in time to distant recurrence."


Editor's Note: "neoadjuvant therapy" refers to chemotherapy given before tumor removal surgery in the hopes of improving the success of the surgery.

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The ASCO Post  |  Mar 4, 2014

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When Cancer Care Is Too Much of a Good Thing

When Cancer Care Is Too Much of a Good Thing | Lung Cancer Dispatch | Scoop.it

Some routine cancer tests and treatments can do more harm than good. Based on clinical evidence, the American Society of Clinical Oncology highlights cancer care that should be curbed in an annual Top Five List. This year's recommendations include:

  • Not giving antinausea drugs at the beginning of chemotherapies that are only moderately likely to cause nausea;
  • Not treating breast cancers that have spread with combination chemotherapy—unless symptom relief is urgent;
  • Not monitoring for cancer recurrence with advanced imaging technologies—such as positron-emission tomography (PET), computed tomography (CT) and radionuclide bone scans—unless there are symptoms of cancer;
  • Not screening men for prostate cancer unless they are likely to live at least another 10 years; and
  • Not giving people targeted therapies unless their tumor has the specific genetic abnormality that is targeted.
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ASCO Post│Oct 29, 2013

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ASCO Post│Oct 29, 2013

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ASCO Post│Oct 29, 2013

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Two New Trials of Mesothelioma Treatments Begin in the UK

Mesothelioma is a form of lung cancer strongly associated with exposure to asbestos. Even though asbestos has been banned or heavily regulated in most developed nations, due to delayed onset, the number of mesothelioma cases is predicted to climb until around 2020. In the UK, which has the highest mesothelioma incidence worldwide, two new clinical trials are aiming to find treatments for the disease. The Meso2 trial will investigate ganetespib, while the COMMAND trial will examine defactinib. Defactinib specifically targets cancer stem cells, which often survive cancer treatment and cause cancer recurrence. The drug may therefore help prevent relapse after first-line therapy.

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ScienceDaily | Sep 23, 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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Sutent May Hold Off Relapse in SCLC

Small cell lung cancer (SCLC) usually responds well to initial chemotherapy, but frequently relapses within a short time. Maintenance therapy with the drug sunitinib (Sutent) may delay relapse and improve outcomes for SCLC patients, results from a recent phase II clinical trial suggest. Patients with extensive-stage SCLC who had responded to initial chemotherapy were given either Sutent as maintenance therapy or a placebo. Sutent, a tyrosine kinase inhibitor (TKI) that blocks several proteins involved in SCLC, prolonged the time without cancer progression (3.2 months on average, compared to 2.3 months in the placebo-treated patients). Patients receiving Sutent also tended to have longer overall survival (8.9 months vs 6.9 months with placebo), although this finding was not clear enough to determine whether it was due to chance. The survival difference between patient groups may have been smaller because placebo-treated patients whose cancer relapsed were allowed to switch to Sutent, suggesting that Sutent may actually have more definite effects on patient survival.

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MedPage Today | June 5, 2013

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Standard-Dose Radiation Therapy Safer and More Effective Than High-Dose Therapy in Stage III NSCLC

Standard-dose radiation therapy gives better results compared to high-dose radiation in patients with locally advanced stage III non-small cell lung cancer (NSCLC), a recent clinical trial showed. Patients treated with 60 Gy of radiation had longer median survival (28.7 vs 19.5 months) and higher 18-month survival rates (66.9% vs 53.9%) compared to those receiving 74 Gy of radiation. Standard-dose therapy resulted in less cancer spread, lower rates of recurrence, and fewer severe side effects and treatment-related deaths than high-dose radiation. All patients also received chemotherapy with or without cetuximab (Erbitux) in addition to radiation; a future analysis will look at whether Erbitux helped survival.

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ASCO Post | May 17, 2013

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PET Scans May Identify High-Risk, Early-Stage Lung Cancer Patients

Stage Ia non-small cell lung cancer (NSCLC) is commonly treated with surgery alone. However, the cancer frequently recurs, and only 67% of stage Ia NSCLC patients survive for 5 years or more. Adjuvant chemotherapy (chemotherapy given as a secondary treatment in addition to surgery) may increase survival, but also has severe toxic side effects. Therefore, it is important to identify stage Ia patients with high risk of recurrence, for whom the benefits of adjuvant chemotherapy would outweigh the drawbacks. A retrospective analysis of stage Ia NSCLC patients found that those with positive results from a scanning technique called a fluorodeoxyglucose PET (positron emission tomography) scan (FDG-PET) had significantly lower rates of survival. Patients with positive FDG-PET results may, therefore, be good candidates for adjuvant chemotherapy.

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MedPage Today | Apr 10, 2013

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Variations in Certain Genes May Predict Clinical Outcomes in Early-Stage Lung Cancer

Early-stage non-small cell lung cancer (NSCLC) is usually treated with surgical removal of the tumor. However, in up to 50% of patients, the cancer will return within 5 years. A study of genetic variations that affect the function of microRNAs (small molecules involved in gene expression) found that several of them, including variations in the FAS, FZD4, SP1, and DROSHA genes, were associated with higher or lower probabilities of cancer recurrence and survival. Tests for such microRNA-related genetic variations may eventually help identify high-risk, early-stage NSCLC patients who would benefit from additional treatment after surgery.

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Cancer Research | Feb 1, 2013

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Overexpression of IGF1R and EGFR Genes May Worsen Lung Cancer Prognosis

The roles of the genes IGF1R and EGFR in lung cancer were examined in patients with non-small cell lung cancer (NSCLC) who had their primary tumor surgically removed. Patients whose tumors had increased expression of both IGFR1R and EGFR were more likely to experience recurrence of the cancer after a shorter amount of time and had shorter survival times after surgery. This finding suggests that concurrent overexpression of IGF1R and EGFR is a negative prognosis factor in NSCLC and may indicate patients who are more likely to benefit from novel treatments with IGF1R inhibitors.


Research paper: http://link.springer.com/article/10.1007/s00280-012-2056-y/fulltext.html

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Cancer Chemotherapy and Pharmacology | Jan 12, 2013

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Beta-blockers May Improve Survival after Radiotherapy for NSCLC Patients

A retrospective study of patients with non-small cell lung cancer (NSCLC) who had received radiotherapy found that those who had been taking beta-blockers survived 22% longer than those who did not.  The patients, who had been taking the beta-blockers for conditions other than cancer, also had lower rates of cancer recurrence and metastasis (cancer spread to other parts of the body). Further studies are required to confirm any possible beneficial effects of beta-blockers on lung cancer survival.


Primary source: http://annonc.oxfordjournals.org/content/early/2013/01/01/annonc.mds616.full

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Cancer Network | Jan 11, 2013

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