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April 3, 2011, 9:49 AM CT

Target for lung cancer chemoprevention

Target for lung cancer chemoprevention

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Researchers have identified a biomarker for measuring the success of lung cancer chemoprevention, an emerging frontier in the fight against this disease that has long been stymied by a lack of measureable outcomes. These study results were presented at the AACR 102nd Annual Meeting 2011, held April 2-6.

Paul Bunn, M.D., executive director of the International Association for the Study of Lung Cancer and the James Dudley endowed professor of lung cancer research at the University of Colorado Cancer Center at the University of Colorado School of Medicine, said measurements of endobronchial dysplasia, abnormal cell development that can lead to lung cancer, could predict how well a chemoprevention agent is working.

Bunn presented updated results of a study that tested the effect of oral iloprost on the improvement on endobronchial dysplasia in 152 former smokers. As smoking cessation messages take hold and quit rates increase, former smokers are still at greater risk for lung cancer than the general population.

"We told people to quit smoking and they did, but half of our lung cancer cases in the United States are coming from people who are former smokers," he said. "We need to work on ways to repair their lungs through chemoprevention".

Bunn analyzed the effect of iloprost among those who had endobronchial dysplasia at enrollment, and found a significant difference in prevalence of endobronchial dysplasia. Moreover, when they analyzed the effect of iloprost on Ki-67, a measure of cell proliferation, the difference was not significant.........

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April 3, 2011, 9:27 AM CT

New target identified for squamous cell lung cancer

New target identified for squamous cell lung cancer
Researchers at the Dana Farber Cancer Institute have identified a mutation in the DDR2 gene that may indicate which patients with squamous cell lung cancer will respond to dasatinib.

The findings appear in Cancer Discovery, the newest journal of the American Association for Cancer Research, debuting here at the AACR 102nd Annual Meeting 2011, from April 2-6.

As per lead researcher Matthew Meyerson, M.D., Ph.D., professor of pathology at the Dana Farber Cancer Institute, there are currently no targeted therapies for squamous cell lung cancer, which affects approximately 50,000 people annually in the United States. Meyerson estimates that DDR2 mutations would be present in lung cancers from about one to two thousand people a year in the United States.

"As a percentage of the millions of people who get cancer each year it is small, but cancer treatment is going more in the direction of personalized medicine as we learn more and more about the complicated biology of each tumor," he said.

Using standard genetic sequencing techniques, Meyerson and his colleagues identified mutations in the DDR2 kinase gene in about 3 percent of squamous cell lung cancers and cell lines. Furthermore, they observed that tumor cells with these DDR2 mutations responded to therapy with dasatinib. A patient whose cancer carried a DDR2 mutation also showed a clinical response to dasatinib.........

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April 1, 2011, 7:19 AM CT

Soy increases radiation's ability to kill lung cancer cells

Soy increases radiation's ability to kill lung cancer cells
A component in soybeans increases radiation's ability to kill lung cancer cells, as per a research studyreported in the recent issue of the Journal of Thoracic Oncology, the official monthly journal of the International Association for the Study of Lung Cancer.

"To improve radiotherapy for lung cancer cells, we are studying the potential of natural non-toxic components of soybeans, called soy isoflavones, to augment the effect of radiation against the tumor cells and at the same time protect normal lung against radiation injury," said Dr. Gilda Hillman, an associate professor in the Department of Radiation Oncology at Wayne State University's School of Medicine and the Karmanos Cancer Institute in Detroit.

"These natural soy isoflavones can sensitize cancer cells to the effects of radiotherapy, by inhibiting survival mechanisms which cancer cells activate to protect themselves," Hillman said. "At the same time, soy isoflavones can also act as antioxidants in normal tissues, which protect them against unintended damage from the radiotherapy. In a recent study, reported in the Journal of Thoracic Oncology, we demonstrated that soy isoflavones increase killing of cancer cells by radiation via blocking DNA repair mechanisms, which are turned on by the cancer cells to survive the damage caused by radiation".........

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November 5, 2010, 7:36 AM CT

Helical CT scans reduce lung cancer mortality

Helical CT scans reduce lung cancer mortality
In a major newly released study announced recently by the National Cancer Institute, scientists including Brown University biostatistian Constantine Gatsonis and colleagues observed that screening for lung cancer using helical Computerized axial tomography scanning reduced lung cancer deaths by 20 percent in comparison to using chest X-rays.

"The findings we're announcing today offer the first definitive evidence for the effectiveness of helical CT screening smokers for lung cancer " said Gatsonis, a lead biostatistician in the study and director of the American College of Radiology Imaging Network's (ACRIN) Biostatistics and Data Management Center, based at Brown's Center for Statistical Sciences. "This is a major step in the formulation of appropriate screening strategies for this deadly disease".

The National Lung Screening Trial (NLST) was conducted by a consortium consisting of ACRIN and the Lung Screening Study (LSS). The consortium enrolled more than 53,000 current and former heavy smokers ages 55 to 74 into the NLST at 33 sites across the United States. Starting in August 2002, participants were enrolled during a 20-month period and randomly assigned to receive three annual screens with either low-dose helical CT (often referred to as spiral CT) or standard chest X-ray. A manuscript reporting on the design of the study appeared yesterday on the Web site of the journal Radiology.........

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October 11, 2010, 7:44 AM CT

Erlotinib improves survival as first-line therapy

Erlotinib improves survival as first-line therapy
For patients with advanced lung cancer whose tumors carry EGFR activating mutations, first-line therapy with erlotinib nearly tripled progression-free survival in comparison to a standard chemotherapy combination, show results from the first prospective Phase-III study to report findings in this setting.

The new results from the OPTIMAL trial were reported at the 35th Congress of the European Society for Medical Oncology (ESMO) in Milan, Italy.

"Erlotinib is very effective and well tolerated in advanced NSCLC patients who harbor EGFR activating mutations. It is 2 to 3 times more effective than doublet chemotherapy," said study leader Professor Caicun Zhou of Shanghai Pulmonary Hospital, Tongji University, China.

The OPTIMAL study included 165 patients whose lung cancer carried mutations activating the Epithelial Growth Factor Receptor (EGFR). Participants had not received systemic therapy for their cancer.

Of these patients, 83 were randomly assigned to receive erlotinib 150 mg/day, and 82 patients were assigned to receive a 'doublet' combination chemotherapy of gemcitabine and carboplatin. The primary endpoint of the study was progression-free survival.

In his presentation at the ESMO Congress, Prof Zhou reported that the median progression-free survival in the erlotinib arm was 13.1 months, in comparison to 4.6 months for the chemotherapy arm of the study. The objective response rate with erlotinib was 83%, in comparison to 36% for gemcitabine plus carboplatin. 31 patients in the erlotinib arm are still under study and progression free in comparison to only 1 in the chemotherapy arm.........

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October 8, 2010, 8:07 AM CT

Cheek Swab May Detect Lung Cancer

Cheek Swab May Detect Lung Cancer
Nano-scale disturbances in cheek cells indicate the presence of lung cancer.
Early detection is critical for improving cancer survival rates. Yet, one of the deadliest cancers in the United States, lung cancer, is notoriously difficult to detect in its early stages.

Now, scientists have developed a method to detect lung cancer by merely shining diffuse light on cells swabbed from patients' cheeks.

In a new clinical study, the analysis technique--called partial wave spectroscopic (PWS) microscopy--was able to differentiate individuals with lung cancer from those without, even if the non-malignant patients had been lifetime smokers or suffered from chronic obstructive pulmonary disease (COPD).

The findings-released by a team of engineers and physicians from NorthShore University Health System, Northwestern University and New York University-appear in print in the Oct. 15, 2010, issue of the journal Cancer Research.

"This study is important because it provides the proof of concept that a minimally intrusive, risk-stratification technique may allow us to tailor screening for lung cancer, the leading cause of cancer deaths in Americans," said doctor and researcher Hemant Roy of NorthShore University HealthSystems and the University of Chicago, the main author on the paper. "This represents a major step forward in translating biomedical optics breakthroughs for personalized screening for lung cancer".........

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October 1, 2010, 5:42 AM CT

Half of advanced lung cancer patients receive chemotherapy

Half of advanced lung cancer patients receive chemotherapy
For the first time to date, research reported in the October edition of the Journal of Thoracic Oncology (JTO) sought to determine the use of chemotherapy in a contemporary, diverse non-small cell lung cancer (NSCLC) population encompassing all patient ages. Previous population-based studies have shown that only 20 to 30 percent of advanced patients with lung cancer receive chemotherapy therapy. These studies have previously relied on the Medicare-linked Surveillance, Epidemiology, and End Results (SEER) database, thus excluding the 30 to 35 percent of patients with lung cancer younger than 65 years of age.

Scientists performed a retrospective analysis of patients diagnosed with stage IV NSCLC from 2000 to 2007 at the University of Texas Southwestern Medical Center in Dallas, Texas, and Parkland Health and Hospital System, the safety net hospital for Dallas County. Overall, the findings indicate that for patients with advanced non-small cell lung cancer (NSCLC), chemotherapy was administered to approximately half of all patientsmore than twice the rate reported in some earlier studies. In all, 718 patients met criteria, of whom 353 received chemotherapy (49 percent). Age and insurance type were linked to therapy with chemotherapy; specifically, young patients and those with private health insurance were more likely to receive chemotherapy. Furthermore, median survival for the group which received chemotherapy was 9.2 months, compared with 2.3 months for untreated patients.........

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September 1, 2010, 7:05 AM CT

Individualized chemotherapy in lung cancer

Individualized chemotherapy in lung cancer
Chemotherapy is the best broad defense against cancer recurrence after surgical resection. However, it is difficult to predict which patients will benefit from which regimen of anticancer drugs, if at all. Building on existing knowledge, a study reported in the September edition of the Journal of Thoracic Oncology (JTO), analyzed the usefulness of adjuvant chemotherapy for non-small cell lung cancer (NSCLC) based on the histoculture drug response assay (HDRA). After seven years of study, scientists concluded that the use of adjuvant (post-operative) chemotherapy based on results of the in vitro HDRA improved the survival and prognosis of patients with NSCLC who had undergone surgery and whose results of the HDRA assay showed chemosensitivity to the specific drugs used for therapy.

The patients' chemosensitivity to cisplatin, carboplatin, paclitaxel, docetaxel, gemcitabine and irinotecan were examined by the HDRA assay. The patients in the study were then split into two groups: (1) those whose tumors were sensitive to at least two of the HDRA drugs and received two HDRA positive drugs per chemotherapy session (31 patients) and (2) those whose tumors were sensitive to one or none of the HDRA drugs and were treated with a combination of one HDRA positive drug and one HDRA negative or two HDRA negative drugs per chemotherapy session (34 patients).........

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July 23, 2010, 7:03 AM CT

Abnormal cells in blood and lung cancer

Abnormal cells in blood and lung cancer
A novel approach detects genetically abnormal cells in the blood of non-small cell patients with lung cancer that match abnormalities found in tumor cells and increase in number with the severity of the disease, a research team led by researchers at The University of Texas MD Anderson Cancer Center report in the journal Clinical Cancer Research

Patients with lung cancer in the study also had a number of times the number of these circulating abnormal cells than study volunteers in a closely matched control group.

"We suspect additional research will show that these circulating abnormal cells are circulating non-small cell lung cancer cells," said study corresponding author Ruth Katz, M.D., professor in MD Anderson's Department of Pathology. "Blood tests for these circulating tumor cells could be used to diagnose lung cancer earlier, monitor response to treatment and detect residual disease in patients after therapy".

Katz and his colleagues conducted what they believe to be the first study to use a technique called fluorescence in situ hybridization (FISH) to detect abnormal circulating cells that have aberrations found in non-small cell lung cancer. FISH detects and quantifies abnormal cells by using dye-labeled DNA probes of cell chromosomes that cause cells with the targeted genetic abnormalities to light up when viewed under a fluorescent microscope.........

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June 14, 2010, 10:11 PM CT

Predicting success with cancer drugs

Predicting success with cancer drugs
Scientists at the Translational Genomics Research Institute (TGen), the Van Andel Research Institute (VARI) and the Virginia G. Piper Cancer Center at Scottsdale Healthcare have discovered a biomarker that could help in the therapy of patients with an aggressive type of lung cancer.

Using a particular biomarker, scientists might better predict which patients with small cell lung cancer are resistant to existing drug therapies, and which ones could benefit from new therapies tailored to their specific needs, as per a scientific paper published recently in the Journal of Thoracic Oncology.

"There is a need for predictive biomarkers that can aid researchers in designing future clinical trials, to help identify therapys that might be effective for these patients who most likely will be resistance to existing drug therapies, " said Dr. Glen J. Weiss, the paper's senior author and Director of Thoracic Oncology at TGen Clinical Research Services at Scottsdale Healthcare. TCRS is a partnership between TGen and Scottsdale Healthcare that helps bring new therapies quickly to patients at the Virginia G. Piper Cancer Center in Scottsdale.

Nearly 220,000 Americans are diagnosed each year with lung cancer, which is by far the leading cause of cancer death in the U.S., annually killing nearly 160,000 patients.........

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June 7, 2010, 6:50 AM CT

Vandetanib shows clinical benefit for lung cancer

Vandetanib shows clinical benefit for lung cancer
Roy Herbst, M.D., Ph.D., is a professor and chief of the section of MD Anderson's Department of Thoracic/Head and Neck Medical Oncology.
When combined with standard chemotherapy, an international Phase III trial has shown that the oral targeted treatment vandetanib improves progression-free survival for patients with advanced non-small cell lung cancer, as per research from The University of Texas MD Anderson Cancer Center.

The findings, reported in the Lancet Oncology, mark the first clinical benefit of a small molecule targeted agent and standard chemotherapy in combination for lung cancer. The study was first presented at the 2009 Annual Meeting of the American Society of Clinical Oncology.

"This study shows that an oral tyrosine kinase inhibitor can be combined with chemotherapy safely and effectively to provide systematic benefit to patients with this life-threatening disease," said Roy Herbst, M.D., Ph.D., professor and chief of the section of MD Anderson's Department of Thoracic/Head and Neck Medical Oncology and the study's corresponding author. "Still, we need to build on this research and turn our focus toward better identifying molecular markers involved, with the ultimate goal of personalizing our patient's care."

The treatment is unique in that it's a dual inhibitor and targets the epidermal growth factor receptor (EGFR) and vascular endothelial growth factor receptor (VEGFR). It is the first single agent in lung cancer to target both receptors, said Herbst, the study's international principal investigator.........

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June 6, 2010, 8:48 PM CT

Selenium shows no benefit

Selenium shows no benefit
Selenium, a supplement taken daily by millions in hopes of protection against cancer and a host of other diseases, has proven to be of no benefit in reducing a patient's risk of developing lung cancer - either a recurrence or second primary malignancy, as per results of an international Phase III clinical trial.

Results from the decade-long study, initiated by the Eastern Cooperative Oncology Group, were presented today at the American Society of Clinical Oncology 2010 Annual Meeting by Daniel D. Karp, M.D., professor in the Department of Thoracic/Head and Neck Medical Oncology at The University of Texas MD Anderson Cancer Center.

"Several epidemiological and animal studies have long-suggested a link between deficiency of selenium and cancer development," said Karp, the study's principal investigator. "Interest and research escalated in the late 1990's after a skin cancer and selenium study, published in 1996, found no benefit against the skin cancer, but did suggest an approximate 30 percent reduction of prostate and lung cancers. Our lung cancer research and another major study for the prevention of prostate cancer evolved from that finding".

These large, follow-up clinical studies investigating the naturally occurring mineral, however, have since proven disappointing. In 2009, the National Cancer Institute (NCI) halted SELECT, an international study of more than 35,000 men investigating if either selenium or Vitamin E, alone or in combination, could reduce the risk of prostate cancer. Both supplements failed to show benefit.........

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April 29, 2010, 6:19 AM CT

Best care for the oldest lung cancer patients

Best care for the oldest lung cancer patients
Eventhough more than two fifths of lung cancers are diagnosed in patients over 70, data from clinical trials on the safest and most effective therapys for this age group are scarce. Now Italian oncologists are conducting many trials targeting elderly patients with non-small cell lung cancer (NSCLC), and offer a review of the latest findings - and their recommendations - in the current issue of Therapeutic Advances in Medical Oncology, published by SAGE.

As per Paolo Maione, Antonio Rossi, Cesare Gridelli and his colleagues from S.G. Moscati Hospital in Avellino, Italy, elderly patients have more co-morbidity and don't tend to tolerate toxic medical therapys as well as younger patients. This means that clinical findings from studies on younger populations don't necessarily apply to the majority of elderly patients with NSCLC.

More than half of all cases of advanced NSCLC are diagnosed in patients over 65, and recent Surveillance, Epidemiology and End Results (SEER) Program data from the United States show that patients aged 70 years or older account for 47 percent of all lung cancers. Most prospective clinical data on chemotherapy and molecularly targeted treatment for elderly NSCLC patients come from studies in advanced disease. Unfortunately, by the time most patients from any age group receive a lung cancer diagnosis, the majority already have metastatic disease and a systemic, palliative therapy is their primary therapeutic option.........

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March 22, 2010, 7:45 PM CT

Gene linked to lung cancer in never-smokers

Gene linked to lung cancer in never-smokers
A five-center collaborative study that scanned the genomes of thousands of "never smokers" diagnosed with lung cancer as well as healthy never smokers has found a gene they say could be responsible for a significant number of those cancers.

In the March 22 on line issue of Lancet Oncology, the scientists reported that about 30 percent of patients who never smoked and who developed lung cancer had the same uncommon variant, or allele, residing in a gene known as GPC5. The research was co-led by researchers at the Mayo Clinic campus in Minnesota, Harvard University, University of California at Los Angeles (UCLA), and MD Anderson Cancer Center. Scientists found in laboratory studies that this allele leads to greatly reduced GPC5 expression, in comparison to normal lung tissue. The finding suggests that the gene has an important tumor suppressor-like function and that insufficient function can promote lung cancer development.

"This is the first gene that has been observed that is specifically linked to lung cancer in people who have never smoked," says the study's lead investigator, Ping Yang, M.D., Ph.D., Mayo Clinic genetic epidemiologist.

"What's more, our findings suggest GPC5 appears to be a critical gene in lung cancer development and genetic variations of this gene may significantly contribute to increased risk of lung cancer," she says. "This is very exciting".........

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February 17, 2010, 7:37 AM CT

Erlotinib marginally cost-effective

Erlotinib marginally cost-effective
Weighing both magnitude of survival benefit and expense, scientists observed that the drug erlotinib, which was found to improve overall survival by 2 months in patients with advanced non-small cell lung cancer, is marginally cost-effective. The results of their economic analysis using clinical trial data were reported in a newly released study published online February 16 in the Journal of the National Cancer Institute

Natasha B. Leighl, M.D., of the University Health Network in Toronto, Canada, and his colleagues performed an analysis of erlotinib therapy in the NCIC Clinical Trials Group BR.21 trial to determine the cost-effectiveness of treating various populations with the drug, a tyrosine kinase inhibitor. The scientists also calculated the incremental cost-effectiveness ratio.

The incremental cost-effectiveness ratio for erlotinib therapy in the trial population was $94,638 (2007 Canadian dollar) per life-year gained (95% confidence interval = $52,359 to $429,148).

As per the researchers, this figure exceeds the threshold historically accepted as cost-effective ($50,000 per quality-adjusted life year). The ratio was in the higher range of cost-effectiveness ratios that high-resource countries may consider acceptable. Thus, it appears to be possible to enhance the cost-effectiveness of this therapy through the clinical and molecular selection of patients for therapy, the authors report.........

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January 22, 2010, 8:24 AM CT

Lung cancer patients who quit smoking

Lung cancer patients who quit smoking
People diagnosed with early stage lung cancer can double their chances of survival over five years if they stop smoking compared with those who continue to smoke, finds a study published on bmj.com today.

This is the first review of studies to measure the effects of continued smoking after diagnosis of lung cancer and suggests that it appears to be worthwhile to offer smoking cessation therapy to patients with early stage lung cancer.

Worldwide, lung cancer is the most usually diagnosed form of cancer. In the UK, it is second only to breast cancer, accounting for around 39,000 new cancer diagnoses annually.

Smoking increases the risk of developing a primary lung cancer; lifelong smokers have a 20-fold increased risk compared with non-smokers. But it is not known whether quitting after a diagnosis of lung cancer has any benefit.

So scientists at the University of Birmingham analysed the results of 10 studies that measured the effect of quitting smoking after diagnosis of lung cancer on prognosis.

Differences in study design and quality were taken into account to minimise bias.

They observed that people who continued to smoke after a diagnosis of early stage lung cancer had a substantially higher risk of death and a greater risk of the tumour returning compared with those who stopped smoking at that time. Data suggested that most of the increased risk of death was due to cancer progression.........

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November 9, 2009, 8:21 AM CT

Predictive value of lung cancer response on PET scan

Predictive value of lung cancer response on PET scan
A rapid decline in metabolic activity on a PET scan after radiation treatment for non-small cell lung cancer is correlated with good local tumor control, as per a research studypresented by scientists at Thomas Jefferson University Hospital at the 51st ASTRO Annual Meeting.

In addition, the scientists also observed that the higher the metabolic activity and tumor size on a PET scan before therapy, the more likely a patient is to die from lung cancer.

"PET scanning is an emerging tool of molecular imaging in lung cancer, in contrast to Computerized axial tomography scans and MRI scans which are anatomic imaging," said Maria Werner-Wasik, associate professor of Radiation Oncology at Jefferson Medical College of Thomas Jefferson University, and the study's main author. "It has become an important tool in the assessment of lung cancer staging and assessment of therapy response".

Dr. Werner-Wasik and his colleagues conducted a retrospective analysis of 50 lung cancer patients who received PET imaging before and after radiation treatment. They analyzed the prognostic factors for tumor local failure. They measured the metabolic activity using the maximum Standardized Uptake Value (mSUV). They also measured the tumor size, or the Metabolic Tumor Volume.

The risk of local failure decreased for each unit decline in mSUV by the first post-therapy scan. When in comparison to the pre-therapy PET scan, the mSUV of the primary tumor declined by 72 percent in the by the first post-therapy scan, 76 percent by the second scan.........

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Lung cancer
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