Lung Cancer Management最新文献

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Lung cancer screening guidelines are clear but are they being followed? 肺癌筛查指南很明确，但是否得到了遵守?

IF 2.8 Q4 RESPIRATORY SYSTEM

Lung Cancer Management

Pub Date : 2020-06-22 DOI: 10.2217/lmt-2020-0015

Coral Olazagasti, Carolina Bernabe, Nagashree Seetharamu

Lung cancer is the second most common cause of cancer worldwide and the leading cause of cancer death in the USA [1]. The American Cancer Society (NY, USA) estimated a total of 228,150 new cases of lung cancer with 142,670 deaths from lung cancer in the USA for 2019 [1]. Smoking is the main cause of lung cancer and contributes to 80% of lung cancer deaths in women and 90% in men [2]. Lung cancer is typically diagnosed at advanced stages and carries a high mortality rate, with a 5-year survival rate of only 18% [3]. Randomized controlled trials targeted toward lung cancer screening started in the 1970s when the US National Cancer Institute (NCI; MD, USA) sponsored several clinical trials to evaluate the benefit of adding sputum cytology to annual chest radiography (CXR) [4,5]. However, none of the trials showed a reduction in lung cancer mortality (Supplementary Table 1). Decades later, the NCI initiated the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO), a large randomized controlled trial that aimed to reduce disease-specific cancer mortality by evaluating the use of CXR for screening [6]. The study found that 2% of participants that had a positive radiographic findings were diagnosed with lung cancer within 12 months of the screen, 44% of whom were diagnosed with stage I disease [6]. Pertinent findings that paved the road for future guidelines included the discovery that high incidences of lung cancer were noted in active smokers or those that had quit within 15 years of randomization [6]. In the 2000s, prospective studies were created throughout the world to evaluate the role of low-dose computed tomography (LDCT) for screening. The Lung Screening Study compared LDCT and CXR as screening modalities and revealed that LDCT was twice as effective as CXR in detecting lung cancer [7]. It also showed that 48% of lung cancers detected by LDCT screening were diagnosed at stage I [7]. Inspired by the Lung Screening Study, a large scale study called the National Lung Screening Trial (NLST), which enrolled 53,456 participants, was created. Participants were randomized to LDCT or CXR at a 1:1 ratio. The study demonstrated a 20% relative reduction in mortality in patients screened with LDCT compared with CXR [8]. Results from this trial were updated in 2013 and confirmed the benefit of LDCT for lung cancer screening in specific patient populations [9]. Similar results were showcased from The Dutch–Belgian Randomized Lung Cancer Screening Trial (NELSON) which began in Europe in 2003 [10]. More than 15,000 participants were enrolled and assigned to either computer tomography (CT) screening or to the control group with no screening [10]. The study reported a 41% positive predictive value with screening and 50% of the cancers diagnosed in the screening arm were found at early stages of the disease [10]. During a 10-year follow-up, there was a 26% mortality rate reduction in men and 39% in women [10]. Updated results published in the New E

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引用次数: 1

Understanding sex disparities in lung cancer incidence: are women more at risk? 了解肺癌发病率的性别差异:女性是否更危险?

IF 2.8 Q4 RESPIRATORY SYSTEM

Lung Cancer Management

Pub Date : 2020-06-22 DOI: 10.2217/lmt-2020-0013

Meera V Ragavan, Manali I Patel

Meera V Ragavan*,1 & Manali I Patel2,3,4 1Department of Medicine, Stanford University School of Medicine, Stanford, 94305 CA 94305, USA 2Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA 3Division of Oncology, VA Palo Alto Healthcare System, Palo Alto, CA 94304, USA 4Center for Health Policy/Primary Care Outcomes Research, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA *Author for correspondence: mragavan@stanford.edu

引用次数: 11

Lung cancer management challenges amidst COVID-19 pandemic: hope lives here. COVID-19大流行给肺癌管理带来的挑战：希望就在这里。

IF 0.9 Q4 RESPIRATORY SYSTEM

Lung Cancer Management

Pub Date : 2020-05-01 DOI: 10.2217/lmt-2020-0012

Abhishek Shankar, Deepak Saini, Ruchir Bhandari, Sachidanand Jee Bharati, Sunil Kumar, Geetika Yadav, Tarun Durga, Nalin Goyal

引用次数: 0

Identification of nine key genes by bioinformatics analysis for predicting poor prognosis in smoking-induced lung adenocarcinoma. 通过生物信息学分析鉴定9个预测吸烟诱导肺腺癌不良预后的关键基因。

IF 2.8 Q4 RESPIRATORY SYSTEM

Lung Cancer Management

Pub Date : 2020-04-27 DOI: 10.2217/lmt-2020-0009

Chuanli Ren, Weixiu Sun, Xu Lian, Chongxu Han

Aim: To screen and identify key genes related to the development of smoking-induced lung adenocarcinoma (LUAD).

Materials & methods: We obtained data from the GEO chip dataset GSE31210. The differentially expressed genes were screened by GEO2R. The protein interaction network of differentially expressed genes was constructed by STRING and Cytoscape. Finally, core genes were screened. The overall survival time of patients with the core genes was analyzed by Kaplan-Meier method. Gene ontology and Kyoto encyclopedia of genes and genomes bioaccumulation was calculated by DAVID.

Results: Functional enrichment analysis indicated that nine key genes were actively involved in the biological process of smoking-related LUAD.

Conclusion: 23 core genes and nine key genes among them were correlated with adverse prognosis of LUAD induced by smoking.

目的:筛选和鉴定与吸烟诱导肺腺癌(LUAD)发生发展相关的关键基因。材料与方法:数据来源于GEO芯片数据集GSE31210。用GEO2R筛选差异表达基因。利用STRING和Cytoscape构建了差异表达基因的蛋白相互作用网络。最后筛选核心基因。采用Kaplan-Meier法分析核心基因患者的总生存时间。通过DAVID计算基因本体和京都基因基因组生物积累百科全书。结果:功能富集分析表明，9个关键基因积极参与吸烟相关性LUAD的生物学过程。结论:23个核心基因和9个关键基因与吸烟所致LUAD不良预后相关。

引用次数: 1

Pretreatment nutritional status and response to checkpoint inhibitors in lung cancer. 肺癌的预处理营养状况和对检查点抑制剂的反应。

IF 2.8 Q4 RESPIRATORY SYSTEM

Lung Cancer Management

Pub Date : 2020-04-24 DOI: 10.2217/lmt-2020-0008

Chung-Shien Lee, Craig E Devoe, Xinhua Zhu, Joanna Stein Fishbein, Nagashree Seetharamu

Background: Checkpoint inhibitors are integral to non-small-cell lung cancer treatment. Existing data suggests that nutritional status may play a role in antitumor immunity.

Materials & methods: This retrospective study of 106 non-small-cell lung cancer patients who started checkpoint inhibitors between 2014 and 2017 at our institution assessed relationship of nutritional parameters to overall survival (OS) and progression-free survival.

Results: Mean age was 68.7 ± 9.2 years and 59.4% patients were male. On multivariate analysis for OS, hypoalbuminemia and significant weight loss were prognostic at p-values of 0.0005 and 0.0052, respectively. We noted a parabolic association between age and OS (p = 0.026, 0.0025).

Conclusion: In our study, some malnutrition parameters were associated with decreased OS. U-shape relationship between age and OS noted here warrants further evaluation.

背景:检查点抑制剂是治疗非小细胞肺癌不可或缺的药物。现有数据表明，营养状况可能在抗肿瘤免疫中发挥作用。材料与方法:这项回顾性研究纳入了2014年至2017年在我院接受检查点抑制剂治疗的106例非小细胞肺癌患者，评估了营养参数与总生存期(OS)和无进展生存期的关系。结果:患者平均年龄68.7±9.2岁，男性占59.4%。在OS的多变量分析中，低白蛋白血症和显著体重减轻是预后因素，p值分别为0.0005和0.0052。我们注意到年龄和OS之间呈抛物线关系(p = 0.026, 0.0025)。结论:在我们的研究中，一些营养不良参数与OS降低有关。年龄与OS之间的u型关系值得进一步研究。

引用次数: 17

Stereotactic ablative body radiotherapy versus conventionally fractionated radiotherapy for early stage large cell neuroendocrine carcinoma of the lung. 立体定向消融体放疗对早期肺大细胞神经内分泌癌的分级放疗比较。

IF 2.8 Q4 RESPIRATORY SYSTEM

Lung Cancer Management

Pub Date : 2020-04-21 DOI: 10.2217/lmt-2020-0004

Rodney E Wegner, Stephen Abel, Athanasios Colonias

Aim: Some patients with early stage large cell neuroendocrine carcinoma (LCNEC) of the lung are not surgical candidates and will be managed with radiotherapy. We used the national cancer database to identify predictors of stereotactic radiotherapy and compare outcomes.

Materials & methods: We queried national cancer database for T1-2N0 LCNEC treated with radiation. Logistic regression and Cox regression identified predictors of stereotactic ablative body radiotherapy (SABR) and survival, respectively.

Results: We identified 754 patients, with 238 (32%) treated with SABR. Predictors of SABR were distance to facility, no chemotherapy, academic center, T1 and recent year. After propensity matching, median survival was 34.7 months compared with 23.7 months in favor of SABR (p = 0.02).

Conclusion: SABR for LCNEC has increased over time and was associated with improved survival.

目的:一些早期肺大细胞神经内分泌癌(LCNEC)患者不适合手术治疗，需要放疗治疗。我们使用国家癌症数据库来确定立体定向放疗的预测因素并比较结果。材料与方法:我们查询国家癌症数据库中放疗的T1-2N0 LCNEC。Logistic回归和Cox回归分别确定了立体定向消融体放疗(SABR)和生存的预测因子。结果:我们确定了754例患者，其中238例(32%)接受了SABR治疗。SABR的预测因子为离医院距离、未接受化疗、学术中心、T1和最近一年。倾向匹配后，中位生存期为34.7个月，而SABR组为23.7个月(p = 0.02)。结论:LCNEC的SABR随着时间的推移而增加，并与生存率的提高有关。

引用次数: 4

Welcome to Volume 9 of Lung Cancer Management. 欢迎来到《肺癌管理》第九卷。

IF 2.8 Q4 RESPIRATORY SYSTEM

Lung Cancer Management

Pub Date : 2020-03-24 DOI: 10.2217/lmt-2020-0007

Katherine Gordon

引用次数: 1

Switching from first or second generation EGFR-TKI to osimertinib in EGFR mutation-positive NSCLC. EGFR突变阳性NSCLC从第一代或第二代EGFR- tki切换到奥西替尼。

IF 2.8 Q4 RESPIRATORY SYSTEM

Lung Cancer Management

Pub Date : 2020-03-19 DOI: 10.2217/lmt-2020-0005

Fumio Imamura, Takako Inoue, Kei Kunimasa, Aki Kubota, Hanako Kuhara, Motohiro Tamiya, Kazumi Nishino, Madoka Kimura, Kika Kuno, Hayato Kawachi, Toru Kumagai

Aim: We evaluated the efficacy of a novel switch protocol for EGFR-TKIs for EGFR mutation-positive NSCLC.

Materials & methods: Clinical records were collected from the patients who had received one of two sequential combination strategies of EGFR-TKIs: Salvage use of osimertinib for T790M-mediated acquired resistance to an prior EGFR-TKI or switch use of osimertinib where an EGFR-TKI was switched to osimertinib before disease progression.

Results: Progression-free survival of osimertinib and time from the start of treatment until progression to osimertinib was comparable between the salvage use and switch use of osimertinib.

Conclusion: Switch use of osimertinib seemed to produce improved efficacy for patients with activating EGFR mutations, because of the lack of patient selection via T790M.

目的:我们评估了一种新的EGFR- tkis开关方案对EGFR突变阳性NSCLC的疗效。材料与方法:从接受两种EGFR-TKI顺序联合策略之一的患者中收集临床记录:挽救使用奥西替尼治疗t790m介导的对先前EGFR-TKI的获得性耐药，或在疾病进展前将EGFR-TKI转换为奥西替尼。结果:奥西替尼的无进展生存期和从开始治疗到进展到奥西替尼的时间在挽救使用和切换使用奥西替尼之间是相当的。结论:由于缺乏通过T790M对患者的选择，切换使用奥西替尼似乎可以提高EGFR激活突变患者的疗效。

引用次数: 4

Cost analysis of the management of brain metastases in patients with advanced ALK+ NSCLC: alectinib versus crizotinib. 晚期ALK+ NSCLC患者脑转移治疗的成本分析:阿勒替尼与克唑替尼

IF 2.8 Q4 RESPIRATORY SYSTEM

Lung Cancer Management

Pub Date : 2020-03-04 DOI: 10.2217/lmt-2019-0011

Dolores Isla, Bartomeu Massuti, Martín Lázaro, Lucía Ruiz de Alda, Rocio Gordo, Nuria Ortega-Joaquín, Itziar Oyagüez

Aim: To estimate management cost of NSCLC ALK+ patients with and without brain metastasis (BM), and to compare annual costs in patients treated with alectinib or crizotinib.

Methods: Management cost/year (€ 2018) in patients with and without BM was estimated with disaggregated resource consumption provided by local oncologists, including medical visits, hospitalizations, diagnostic/laboratory tests, imaging techniques and surgical procedures. The comparison of costs/year with alectinib and crizotinib, considered the cumulative 12-month incidence of BM in ALEX trial (9.4 and 41.4%, respectively).

Results: Management cost was €6173.42/patient-year without BM and €21,637.50/patient-year with BM. With alectinib, average cost/patient was lower than crizotinib (€4948.51/patient-year).

Conclusion: Prevention of BM with alectinib may result in reductions of cost/year in the management of advanced ALK+ NSCLC.

目的:评估伴有和不伴有脑转移(BM)的NSCLC ALK+患者的管理成本，并比较阿勒替尼或克唑替尼治疗患者的年成本。方法:根据当地肿瘤学家提供的分类资源消耗，包括就诊、住院、诊断/实验室检查、成像技术和外科手术，估计有和没有BM的患者的管理成本/年(€2018)。与阿勒替尼和克唑替尼的成本/年比较，考虑了ALEX试验中累积12个月的BM发病率(分别为9.4%和41.4%)。结果:无BM的管理成本为6173.42欧元/患者-年，有BM的管理成本为21637.50欧元/患者-年。使用阿勒替尼，每位患者的平均成本低于克唑替尼(4948.51欧元/患者年)。结论:阿勒替尼预防脑转移可降低晚期ALK+ NSCLC治疗的年成本。

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引用次数: 1

Risk of brain metastases in T1-3N0 NSCLC: a population-based analysis. T1-3N0 NSCLC脑转移风险:基于人群的分析

IF 2.8 Q4 RESPIRATORY SYSTEM

Lung Cancer Management

Pub Date : 2020-02-25 DOI: 10.2217/lmt-2019-0010

Michael T Milano, James E Bates, Justin Budnik, Haoming Qiu, Sara Hardy, Michael A Cummings, Megan A Baumgart, Ronald J Maggiore, Deborah A Mulford, Kenneth Y Usuki

Aim: Several consensus guidelines recommend against routine brain imaging at diagnosis of T1-3N0 non-small cell lung cancer (NSCLC).

Methods: From the Surveillance, Epidemiology and End Results registry, patients with pathologically confirmed T1-3N0 NSCLC were identified. Risks of brain metastases at time of initial diagnosis were analyzed.

Results: Patients selected to not undergo primary NSCLC resection had approximately tenfold greater incidence of brain metastases versus those who did. Younger age, adenocarcinoma histology, higher tumor stage and higher histologic grade were all significantly (p < 0.0001) associated with greater likelihood of presenting with brain metastases.

Conclusion: Given the morbidity and mortality of brain metastases, routine brain screening after NSCLC diagnosis (particularly adenocarcinoma) may be justifiable, though more refined cost-benefit analyses are warranted.

目的:一些一致的指南建议在诊断T1-3N0非小细胞肺癌(NSCLC)时不进行常规脑成像。方法:从监测、流行病学和最终结果登记中，确定病理证实的T1-3N0 NSCLC患者。分析初诊时脑转移的风险。结果:选择不进行原发性非小细胞肺癌切除术的患者的脑转移发生率大约是接受手术的患者的10倍。年龄较小、腺癌组织学、较高的肿瘤分期和较高的组织学分级与出现脑转移的可能性均显著相关(p < 0.0001)。结论:考虑到脑转移的发病率和死亡率，非小细胞肺癌(特别是腺癌)诊断后的常规脑筛查可能是合理的，尽管需要更精确的成本-收益分析。

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引用次数: 6

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