Abstract
Early-stage hormone receptor-positive breast cancer is the most common subtype and stage presenting in countries with organized screening programs. Standard clinical and pathologic factors are routinely used to support prognosis and decisions about adjuvant therapies. Hormone receptor and her2 status are essential for decision-making about the use of adjuvant hormonal and anti-her2 therapies respectively. Genomic assays are now commercially available to aid in either further prognostication or in refining the potential benefit of adjuvant chemotherapy. The current genomic assays all generally quantify estrogen receptor and proliferation gene sets (among others) by rna expression, although the specific genes assayed are quite discordant. The present review focuses on the pivotal studies in which each assay attempted to demonstrate clinical utility, with an emphasis on prospective trial data for each assay, if available. Using genomic assays, health care providers will increasingly be able to individualize therapy or de-escalate therapy, optimizing clinic benefit while minimizing toxicities from systemic therapies.
Highlights
In 2019, the Canadian Cancer Statistics Advisory Committee estimated that 29,300 Canadians are diagnosed with lung cancer annually and 21,000 die from it [1]
The only patients with a prospect of cure are those with early stage non-small cell lung cancer (NSCLC) who are amenable to surgical resection with curative intent [2]
Our objective was to quantify the effect of the COVID-19 pandemic on surgical lung cancer care as perceived by practicing thoracic surgeons during the first wave of the pandemic in Canada
Summary
In 2019, the Canadian Cancer Statistics Advisory Committee estimated that 29,300 Canadians are diagnosed with lung cancer annually and 21,000 die from it [1]. In the era of COVID-19, routine lung cancer physiologic and staging assessments are unique in that they are droplet producing and aerosolizing procedures. These include pulmonary function testing (PFT), endobronchial ultrasound, and bronchoscopy [4]. Routine lung cancer physiologic and staging assessments are unique in that they are droplet producing and aerosolizing procedures. Our objective was to quantify the effect of the COVID-19 pandemic on surgical lung cancer care as perceived by practicing thoracic surgeons during the first wave of the pandemic in Canada. Assessing the extent and effects of newly present barriers to standard lung cancer care is essential in forming appropriate mitigation strategies and planning for future pandemic waves
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