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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

Cancer Commons's curator insight, July 19, 2013 6:06 PM

CBS News | Jul 17, 2013

Cancer Commons's curator insight, July 19, 2013 6:06 PM

CBS News | Jul 17, 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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New 'Tailor-Made' Clinical Trials Look at One Patient at a Time

New 'Tailor-Made' Clinical Trials Look at One Patient at a Time | Lung Cancer Dispatch | Scoop.it

A group of researchers is taking individualized medicine a step further by designing clinical trials focusing on one specific patient at a time. Teams of experts analyze the patient’s tumor to identify genes that are not necessary for the survival of normal cells, but are critical for maintaining the tumor (so-called 'master regulators'). Investigators then look for drugs that block the function of these genes and have already been approved by the FDA (though not necessarily for cancer). The drugs are first tested in a mouse model of the patient’s cancer, then the patient him- or herself. Researchers hope that this tailor-made approach will maximize effectiveness, reduce toxicity, and identify new targets for treatment.

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Medical Xpress | July 15, 2013

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New Clinical Trial Focuses on Cancer Patients Without Known Tumor Mutations

New Clinical Trial Focuses on Cancer Patients Without Known Tumor Mutations | Lung Cancer Dispatch | Scoop.it

Increasingly, targeted therapies are becoming available for patients whose cancers have mutations in certain 'driver' genes that are known to be involved in cancer growth. However, most cancer patients have tumors without these mutations or other changes in their DNA. These patients will be the focus of the new WINTHER clinical trial. The study will compare biopsy samples of the patients’ tumors with healthy tissue samples to see how much they differ. This information, along with examinations of other molecules involved in gene expression called RNA and microRNA, will be used to select the existing cancer treatment most likely to benefit the patient based on a novel scoring system.

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Healio | Jul 12, 2013

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Healio | Jul 12, 2013

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Healio | Jul 12, 2013

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Healio | Jul 12, 2013

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Maintenance Therapy with Alimta Improves Outcomes in Lung Cancer

Patients whose advanced nonsquamous, non-small cell lung cancer (NSCLC) responds to chemotherapy with pemetrexed (Alimta) and cisplatin (Platinol) appear to benefit from continuing Alimta treatment after they have achieved remission (continuation maintenance therapy). Results from the PARAMOUNT clinical trial showed that maintenance treatment with Alimta prolonged time without cancer worsening and increased survival times compared to treatment with a placebo. Continuation maintenance therapy with Alimta may be the preferable treatment choice for patients who do not experience significant toxicity from Alimta.

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Medscape | Jul 11, 2013

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Bone and Brain Metastases Are Common in Lung Cancer, But Avastin May Lower Risk

Lung cancer patients often develop metastases (cancer that has spread) in their bones or brain. A retrospective study of non-small cell lung cancer (NSCLC) patients with metastases revealed that in 39%, the cancer spread affected the bones, and in 30% the spread affected the brain. Bone metastases were more common in elderly patients, were linked to skeletal complications, such as fractures, and were associated with shorter survival (5.5 months vs 9.9 months in patients without bone metastases). Another study found that NSCLC patients who developed new bone metastases were more likely to get brain metastases also. However, patients treated with bevacizumab (Avastin) were less prone to metastases in either the bones (27% vs 43% without Avastin) or the brain (25% vs 33%).

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Cancer Network | Jul 8, 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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mTOR Inhibitors May Be Associated with Kidney Injury

A class of cancer drugs called mTOR inhibitors may produce kidney toxicity in at least some patients. mTOR inhibitors, including rapamycin (sirolimus/Rapamune), temsirolimus (Torisel), everolimus (Afinitor), and ridaforolimus, are used to treat certain forms of breast and kidney cancer, and are under investigation for several other cancers. Researchers described four cases of patients treated with mTOR inhibitors developing severe acute kidney injury. They recommend that doctors carefully monitor kidney function in patients receiving these drugs. However, other experts emphasize that it is unclear whether the mTOR inhibitors were indeed the cause of the kidney injury. In at least one case, the patient was also taking other drugs known to cause kidney toxicity.

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Medscape | Jul 3, 2013

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Medscape | Jul 3, 2013

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Medscape | Jul 3, 2013

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Medscape | Jul 3, 2013

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Blocking a Cell Survival Mechanism May 'Defuse' Lung Cancer

A new study suggests that blocking a cell survival mechanism may render lung cancer tumors less deadly. To provide energy for their rapid multiplication, cancer cells digest some of their own internal parts in a process called autophagy (literally 'self-eating'). Autophagy also clears away old, damaged cell components. When scientists blocked autophagy in a mouse model of non-small cell lung cancer (NSCLC), the cancer cells accumulated defective cell structures and turned from aggressive lung cancer tumors into oncocytomas, a more easily-controlled tumor type that usually does not spread to other parts of the body. Inhibiting autophagy also activated the so-called 'tumor suppressor gene' p53, which halts tumor growth. Autophagy may present a promising target in lung cancer treatment.

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ScienceDaily | Jul 1, 2013

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Stereotactic Body Radiation Therapy Is Safe and Effective in Early-Stage Lung Cancer

Stereotactic body radiation therapy (SBRT), a type of radiotherapy that uses high doses of radiation given over a comparatively small number of sessions, is the treatment of choice for patients with stage I non-small cell lung cancer (NSCLC) who cannot undergo surgery because of other medical problems. However, until now the use of SBRT for these patients was based on limited evidence. A systematic study spanning several institutes found that SBRT (sometimes also called stereotactic ablative radiotherapy or SABR) for stage I NSCLC was safe and effective. Higher radiation doses were associated with better outcomes.

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International Association for the Study of Lung Cancer | Jul 1, 2013

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Two New Books Offer History and Criticism of Cancer Research

Two New Books Offer History and Criticism of Cancer Research | Lung Cancer Dispatch | Scoop.it

Despite billions of dollars invested in cancer research and high-profile anti-cancer government initiatives, millions of people continue to die of cancer every year. In his forthcoming book The Truth in Small Doses, Clifton Leaf blames the cancer research field for being too risk-averse and unreceptive to new ideas. He calls on researchers to explore fundamentally novel approaches, including chemoprevention, i.e., treatments aimed at preventing cancer before it develops in the first place. On the other hand, the cautious research practices decried by Leaf minimize the risk of patients being harmed by unproven, hastily adopted methods. Cautionary examples of such incidents are included in Siddhartha Mukherjee’s The Emperor of All Maladies, a history of cancer and its treatment.

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New Yorker | Jul 1, 2013

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Model of Cancer Drug Resistance Points Way to More Effective Targeted Therapies

Although targeted cancer therapies can be enormously effective, most patients eventually develop resistance to them. Even if only a tiny percentage of the original tumor cells contain mutations that make them resistant to a drug, these cells will survive during treatment with this drug, multiply, and eventually produce new tumors. Researchers have created a mathematical model describing this evolutionary process that closely matches clinical findings in patients. The model predicts that giving two or more targeted therapies at the same time will have a better chance of eradicating resistant cells and preventing relapses, because it is unlikely that any given cell will carry multiple mutations that make it resistant to all the drugs being used. However, the model’s predictions still need to be confirmed with actual clinical data.

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New York Times | Jun 27, 2013

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New York Times | Jun 27, 2013

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New York Times | Jun 27, 2013

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New York Times | Jun 27, 2013

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Targeted Therapies Might Replace Chemotherapy for Cancer Treatment in the Future

Targeted Therapies Might Replace Chemotherapy for Cancer Treatment in the Future | Lung Cancer Dispatch | Scoop.it

Targeted therapies, drugs that are directed at specific molecular abnormalities in a patient’s cancer, may replace chemotherapy as the treatment of choice for many cancers. Because targeted therapies attack specific pathways that are central to the growth of cancer cells, but often not necessary for the survival of healthy tissues, they usually produce fewer side effects than chemotherapy, which damages both cancerous and healthy cells. Studies documenting better outcomes with chemotherapy-free targeted treatment regimens are emerging for numerous cancers, including melanoma, certain forms of leukemia and lymphoma, and a type of sarcoma called gastrointestinal stromal tumor (GIST). Targeted therapies continue to be limited by the development of drug resistance, an issue that researchers are trying to tackle through combination treatments and new drugs targeting resistant tumors.

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Time | Jun 26, 2013

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GeneGame: An App That Lets You Be the Scientist

GeneGame: An App That Lets You Be the Scientist | Lung Cancer Dispatch | Scoop.it

Researchers all over the world have collected vast amounts of data on cancer patients, from genetic information to drug treatment records to cell biopsies, and this information can be very valuable when working to develop new treatments. But the data pool is so vast that finding useful information can take an incredibly long time. Cancer Research UK has now developed a website, called CellSlider, to let the public click through actual microscope slides to identify cancerous cells; it took the public 3 months to analyze as much material as the organization's scientists can cover in 18 months. Building on that success, Cancer Research UK is preparing to launch an app, GeneGame, which will enable patients to analyze data on their smartphones in a fun, interactive setting. The data will then be sent back to scientists to use in their research at a much faster rate, perhaps hastening the development of a cure.

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BBC | Jul 18, 2013

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BBC | Jul 18, 2013

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BBC | Jul 18, 2013

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BBC | Jul 18, 2013

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RNA Diagnostic Test Improves Diagnosis of Lung Cancer

RNA Diagnostic Test Improves Diagnosis of Lung Cancer | Lung Cancer Dispatch | Scoop.it

The first step towards choosing the best lung cancer treatment is to figure out what specific kind of lung cancer a patient has. Usually, doctors can determine cancer type by surgically removing part of a tumor and examining the appearance of tumor cells under a microscope. But sometimes tumor samples are damaged and difficult to analyze visually, so a second method would be useful to help confirm a diagnosis. Researchers have now developed a new test that can determine which genes are turned on or off in tumor cells, allowing them to distinguish between the most common types of lung cancer (adenocarcinoma, carcinoid, small cell carcinoma, squamous cell carcinoma). Samples of tumors are already routinely collected, and, in an experiment, examining them and analyzing their genetics was found to be a viable predictor of a tumor’s microscopic appearance. Researchers hope that their test will bring more accurate diagnoses to doctors and patients, which in turn could lead to better treatment recommendations and better outcomes.

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Medical Xpress | Jul 16, 2013

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Chemotherapy-Tarceva Combination May Be Effective for Some Lung Cancer Patients

Chemotherapy-Tarceva Combination May Be Effective for Some Lung Cancer Patients | Lung Cancer Dispatch | Scoop.it

Results from the FASTACT clinical trial suggest that interspersing erlotinib (Tarceva) among rounds of chemotherapy improves outcomes in non-small cell lung cancer (NSCLC). Patients with advanced NSCLC received six cycles of gemcitabine (Gemzar) plus carboplatin (Paraplatin) or cisplatin (Platinol), with Tarceva added during the second half of each chemotherapy cycle. This regimen prolonged time without cancer worsening and increased survival compared to patients who had received chemotherapy and placebo, though the benefit was only seen in patients with mutations in the EGFR gene. This approach may be most useful for patients whose EGFR status is unknown, as patients with known EGFR mutations may be even better served by first-line treatment with Tarceva alone.

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Healio | Jul 10, 2013

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FDA Approves Afatinib/Gilotrif for Lung Cancer Treatment

Based on the positive results of a recent clinical trial, the FDA approved afatinib for first-line treatment of patients with late-stage, non-small cell lung cancer (NSCLC) who have a mutation in the EGFR gene. The drug, which will be marketed under the name Gilotrif, is specifically intended for patients with two particular EGFR mutations: exon 19 deletion and exon 21 L858R substitution. The FDA also approved the therascreen EGFR RGQ PCR Kit, a companion diagnostic used to test for EGFR mutations. Afatinib differs from other EGFR inhibitors like erlotinib (Tarceva) and gefitinib (Iressa) in that it irreversibly destroys the EGFR protein, instead of just reversibly blocking it, and also inhibits several other related proteins.

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Food and Drug Administration (FDA) | July 12, 2013

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Afatinib May Be Candidate for First-Line Treatment in Certain Lung Cancers

Results from the LUX-Lung 3 clinical trial show that afatinib appears to be well tolerated and more effective than chemotherapy in patients with advanced non-small cell lung cancer (NSCLC) who have a mutation in the EGFR gene. Afatinib produced higher response rates and longer periods without cancer progression than cisplatin (Platinol) plus pemetrexed (Alimta), suggesting that it could be considered as a first-line therapy in advanced EGFR-mutant NSCLC. Afatinib, which is under priority review for approval by the FDA, may be effective in patients resistant to other EGFR inhibitors like erlotinib (Tarceva) and gefitinib (Iressa). However, no trials so far have directly compared afatinib with Tarceva or Iressa.

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Medscape | Jul 9, 2013

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Laboratory-Developed Tests Need to Be Better Regulated

Diagnostic medical tests, including those used to detect cancers, usually have to be examined by the FDA for safety and accuracy before getting approved. However, tests created by clinical laboratories (so-called laboratory-developed tests or LDTs) are exempt from this requirement. Such tests were originally intended for internal and research use only. However, with the rise of commercial laboratory testing companies, LDTs are reaching the general patient population. Because these tests have not been proven to deliver accurate and meaningful results, they could potentially mislead and harm patients. The FDA has drawn up a draft guidance document outlining better regulation for LDTs, but it is currently stalled in committee.

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New York Times | Jul 7, 2013

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New York Times | Jul 7, 2013

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New York Times | Jul 7, 2013

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New York Times | Jul 7, 2013

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Cancer Drug Labels Lack Patient-Centric Information

Cancer Drug Labels Lack Patient-Centric Information | Lung Cancer Dispatch | Scoop.it

Unlike many noncancer drugs, the vast majority of cancer drug labels do not include information about the medications’ effects on patient symptoms and quality of life. Such information is especially important given that some new cancer drugs offer only slightly increased survival benefits, making quality of life a crucial factor of a patient’s cost-benefit analysis. Worse symptoms and lower quality of life are also associated with patients not complying with treatment guidelines and with worse prognosis overall. In a recent article, cancer specialist Ethan Basch argues that drug developers should systematically collect information on how their treatments make patients feel and include direct patient input starting early in drug development.

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ScienceDaily | Jul 4, 2013

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Oncologists Should Specialize to Provide the Best Care

Given a growing appreciation of the diversity in cancer diagnoses and the importance of individualized treatment, oncologists (cancer physicians) should focus on the specific cancer types they are most experienced in, argues Rebecca Bechhold. In a recent essay, the oncologist points out that it is becoming increasingly difficult to keep up with all of the many new cancer drugs and their various applications. Practitioners are also bound to be better versed in the management of conditions that they treat frequently. She encourages patients to seek out doctors who specialize in their cancer type, and physicians to be open with patients about which cancer types they have the most expertise in and which they are less familiar with.

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Cancer Network | Jun 30, 2013

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Cancer Network | Jun 30, 2013

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Cancer Network | Jun 30, 2013

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Cancer Network | Jun 30, 2013

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Researchers Decipher Blood Cell Signaling Process that Aids Cancer Spread

Researchers Decipher Blood Cell Signaling Process that Aids Cancer Spread | Lung Cancer Dispatch | Scoop.it

Cancer often spreads throughout the body via the bloodstream. However, once cancer cells have been transported to new locations, they have to find a way through the wall around blood vessels to invade new tissues. Researchers have now discovered that when blood platelets, the cells responsible for blood clotting, are activated, they release a molecule called ATP. ATP then binds to a protein called P2Y2 on the blood vessel wall, causing small openings to appear, which cancer cells can use to escape the blood vessel. Blocking ATP release from blood platelets inhibited cancer spread in mouse models of lung cancer and melanoma. Drugs that inhibit ATP release from platelets or block P2Y2 may therefore be able to curb cancer spread.

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Medical Xpress | Jul 3, 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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Clinical Trial of New Drug to Treat Squamous Cell Lung Cancer Is Enrolling Patients

Clinical Trial of New Drug to Treat Squamous Cell Lung Cancer Is Enrolling Patients | Lung Cancer Dispatch | Scoop.it

A clinical trial examining a new lung cancer drug is enrolling participants at numerous locations throughout the U.S. BMS-936558 (nivolumab) targets PD-1, a protein on the surface of immune cells that suppresses the immune response. By inhibiting PD-1, nivolumab 'unleashes' the immune system so it can continue its attack on tumors. The trial will investigate whether patients with advanced squamous cell carcinoma (SCC) of the lung, a type of non-small cell lung cancer (NSCLC), do better when treated with either nivolumab or the chemotherapy agent docetaxel (Taxotere). To find out more, call 855-216-0126 or visit the trial’s website.

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Exponent Telegram | Jun 30, 2013

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Many Patients with Incurable Lung Cancer Have Inaccurate Expectations of Radiation Therapy

Many Patients with Incurable Lung Cancer Have Inaccurate Expectations of Radiation Therapy | Lung Cancer Dispatch | Scoop.it

Researchers recently performed a survey to evaluate the expectations of patients with incurable lung cancer receiving palliative radiotherapy (ie, therapy not intended to cure their cancer, but instead to relieve their symptoms). The survey revealed that most of the patients held inaccurate beliefs about the aims and potential of their therapy. While a majority of patients accurately believed that radiation therapy could prolong their life and help reduce symptoms from cancer, 64% also expressed the inaccurate belief that radiotherapy had at least some likelihood of curing them. Patients with mistaken beliefs about radiation therapy were also highly likely to have similar misconceptions about chemotherapy. Investigators concluded that treatment providers need to improve communication with patients about the goals and limitations of palliative radiotherapy.

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ASCO Post | Jun 27, 2013

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