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Survey Sheds Light on Common Clinical Practice for Incompletely Resected Lung Cancer

"A landmark survey of more than 700 specialists provides crucial real-world insight into the treatments most oncologists choose for lung cancer patients whose tumour has been incompletely resected, an expert from the European Society for Medical Oncology (ESMO) says.

"Jean Yves Douillard, from the ICO Institut de Cancerologie de l'Ouest René Gauducheau, France, Chair of the ESMO Educational Committee, was commenting on a paper published in the journal Lung Cancer. In the study, researchers led by Raffaele Califano of The Christie NHS Foundation Trust, Manchester, UK, surveyed 768 oncologists from 41 European countries about the treatments they offered patients who had 'R1 resected' non-small-cell lung cancer."

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Medical Xpress  |  Jun 10, 2014

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Survival Rates after Lung Cancer Surgery Essentially Unchanged Since 1950s

Survival Rates after Lung Cancer Surgery Essentially Unchanged Since 1950s | Lung Cancer Dispatch | Scoop.it

Despite advances in cancer research, the survival rates of lung cancer patients after surgery have not changed significantly in the last 60 years, highlighting the need for better therapies. After specialist chest surgery, patients have a 5-year survival rate of 25% and a 10-year survival rate of 15%; survival rates are lower in patients whose cancer is inoperable or who are too weak to receive surgery. However, lung cancer patients are now much more likely to be treated by a chest specialist surgeon than they were in the 1950s. Nevertheless, referral rates to chest specialist units for lung cancer patients can and should still be improved. These concerns, along with other challenges facing lung cancer research, are discussed in a new book on the history of lung cancer.

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Medical Xpress  |  Nov 20, 2013

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Trial Investigating Iressa After Lung Cancer Surgery Terminated Early

A clinical trial investigating whether the cancer drug gefinitib (Iressa) can improve outcomes after lung cancer surgery has been ended early. The trial followed patients who were given either Iressa or a placebo after receiving surgery to completely remove their non-small cell lung cancer (NSCLC). When two other studies showed no benefit of Iressa in similar disease situations, the trial was terminated. Due to the early termination of the trial, no firm conclusions can be drawn from the results. However, analysis of the already collected data suggests that Iressa likely did not improve survival, or delay cancer recurrence in this patient population, and may have indeed been harmful.

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CancerNetwork | Sep 2, 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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New Tool Helps Remove Tumors Completely

New Tool Helps Remove  Tumors  Completely | Lung Cancer Dispatch | Scoop.it

Lumpectomies can save breasts but surgeons often have difficulty finding the tumor edges—and this means women often need follow-up surgeries to get the rest of the breast cancer. Now, a new device helps tell surgeons right away if they got all of the tumor. Called MarginProbe, the device uses radio waves to detect tumor edges in tissue that has been removed. In a trial of 600 lumpectomies, women were more likely to avoid second surgeries with the device than without it (69% vs 58%). Ultimately, the device may be customized to work on other types of cancers.

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The Wall Street Journal│Jul 8, 2013

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The Wall Street Journal│Jul 8, 2013

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The Wall Street Journal│Jul 8, 2013

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The Wall Street Journal│Jul 8, 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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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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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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Major Lung Resection Safer than Ever, Especially at the Busiest Hospitals

Major Lung Resection Safer than Ever, Especially at the Busiest Hospitals | Lung Cancer Dispatch | Scoop.it

"Major lung surgery has become progressively safer over the last few decades, although higher death rates at low-volume hospitals and an unexpected increase in mortality at 90 days compared to 30 days were observed. The study further suggests that choosing a center that performs major lung surgery regularly can have a strong impact on survival."

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ScienceDaily  |  Apr 29, 2014

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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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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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'iKnife' Could Revolutionize Cancer Surgery

'iKnife' Could Revolutionize Cancer Surgery | Lung Cancer Dispatch | Scoop.it

A new surgical tool–dubbed the 'iKnife'–has the potential to change the way surgeons operate on cancer patients. Typically, surgeons use knives that vaporize tumors during procedures, which produces a strong-smelling smoke. Under standard protocol the surgeon must send tissue to the lab to be analyzed to determine whether or not it is cancerous, waiting on the results while the patient lies on the operating table for close to 30 minutes. The 'iKnife' eliminates the lab work, analyzing the smoke on its own to distinguish cancerous tissue from healthy tissue; it can tell doctors if the tissue is cancerous almost instantaneously. In a recent study, the knife correctly detected cancer in all 91 patients. Researchers believe the knife will lower tumor recurrence rates and enable more accurate procedures.

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CBS News | Jul 17, 2013

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CBS News | Jul 17, 2013

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CBS News | Jul 17, 2013

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CBS News | Jul 17, 2013

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Radiation and Chemotherapy Before Surgery Best Option in Patients with Stage IIIA(N2) NSCLC

Disagreement persists about the best treatment for non-small cell lung cancer (NSCLC) patients with stage IIIA(N2) disease, that is, cancer that has spread to lymph nodes just outside the lung. A recent study compared the outcomes of different treatments. Patients who had received neoadjuvant chemoradiotherapy (chemotherapy and radiation administered before surgery) followed by lobectomy (removal of the lung subsection containing the cancer) had higher 5-year survival rates than patients treated with:

  • neoadjuvant chemoradiotherapy and pneumonectomy (removal of the whole lung containing the cancer);
  • either lobectomy or pneumonectomy plus adjuvant therapy (chemotherapy and/or radiation administered after surgery);
  • concurrent chemoradiotherapy (chemotherapy and radiation delivered at the same time, without surgery).

These findings suggest that neoadjuvant chemoradiotherapy followed by lobectomy is the preferable treatment for stage IIIA(N2) NSCLC.

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Journal of Thoracic Oncology | Jul 1, 2013

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Local Tumor Removal Followed by TKI Treatment May Be Effective in Lung Cancer Patients Resistant to TKIs

Many non-small cell lung cancer (NSCLC) patients who receive EGFR-tyrosine kinase inhibitors (TKIs) like erlotinib (Tarceva) and gefitinib (Iressa) develop drug resistance. Some of these patients may also have a small number of metastases ("oligometastatic disease"), which can be destroyed with local therapy. Local therapy methods include surgical removal, radiation, or electrical current produced by high-frequency radio waves known as radiofrequency ablation. A recent study explored the use of local therapy, followed by renewed treatment with EGFR-TKIs, in patients with oligometastatic NSCLC who had become resistant to EGFR-TKIs. The treatment was well tolerated and effective, especially for patients in whom local therapy had removed all known tumors.


Research paper: http://journals.lww.com/jto/Abstract/2013/03000/Local_Therapy_with_Continued_EGFR_Tyrosine_Kinase.14.aspx

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International Association for the Study of Lung Cancer | Feb 23, 2013

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Lobectomy Linked to Better Outcomes in Lung Cancer than Wedge Resection

Small, early-stage lung cancers can be removed using either wedge resection (removal of a small, wedge-shaped piece of lung that contains the cancer and a margin of healthy tissue around the cancer) or lobectomy (removal of the entire subsection, or lobe, of the lung that contains the cancer). A study of patients with non-small cell lung cancer (NSCLC) that was less than 2 cm in diameter and had not spread to the lymph nodes (stage T1N0) showed that those who received lobectomy were more likely to remain cancer-free and had higher survival rates compared to those who received wedge resection. The study authors recommend lobectomy as the preferred treatment for small NSCLC tumors, with wedge resection reserved for patients whose lung function would be decreased too much by lobectomy.

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Minerva Chirurgica | Dec 2012

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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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