Confirmed Diagnosis Of Lung Cancer Research Articles

Clinicopathological Profile of Patients with Bronchogenic Carcinoma at a Tertiary Care Center in Western India

Background: Bronchogenic carcinoma is the most common malignancy all over the globe in terms of incidence and mortality, especially in males. Its increasing incidence in nonsmokers and females is also an important concern. Objectives: The objective of this study was to study various demographic, clinical, radiological, and histopathological features of patients with confirmed diagnosis of lung cancer. Patients and Methods: Patients with confirmed histopathological diagnosis of bronchogenic carcinoma attending a tertiary care center in western India were included in the study. Results: A total of 50 patients were studied. Of 50, 45 were male and 5 were female. Average age of the patient was 59.92 years. Forty-six (92%) patients were current or ex-smokers, whereas only 4 patients were never-smokers. Cough (90%) followed by chest pain (62%) was the presenting symptom. Soft-tissue density mass lesion was the most common radiographic finding. Adenocarcinoma (36%) followed closely by squamous cell carcinoma (32%) was the diagnosed histological subtype. Of 50, 9 (18%) patients had evidence of distant metastasis at the time of diagnosis. Conclusions: This study concludes that adenocarcinoma was the most common subtype even in smokers. A high index of suspicion and prompt investigations in a patient with respiratory symptoms should be employed to diagnose patients at an early stage.

Smoking cessation by combined medication and counselling: a feasibility study in lung cancer patients

PurposeSmoking cessation in patients with diagnosed lung cancer has positive effects on cancer therapy and overall prognosis. Despite this, knowledge on smoking cessation in lung cancer patients is sparse.MethodsThis is an observational single centre, 12-week, prospective, single-arm trial at a tertiary lung cancer centre. Responsive patients were enrolled following confirmed lung cancer diagnosis. Smoking cessation intervention included counselling as well as pharmacotherapy. The primary endpoint was the point prevalence abstinence rate at week 12 based on biochemical verification. Secondary endpoints were the abstinence rate at week 26, quality of life and side effects.Results80 patients were enrolled. Mean age was 62.6 ± 7.9 years. Most patients (63%) were treated with chemotherapy or radiochemotherapy. 39 patients used nicotine replacement therapy, 35 varenicline whereas six patients did not use pharmacotherapy. During the study period 13 patients died. Data were available in 72 patients after 12 weeks and 57 patients at week 24. Point prevalence abstinence rates were 37.5% (95% CI 26.4–49.7%) at week 12 and 32.8% (95% CI 21.8–45.4%) at week 26, respectively. Quality of life and side effects were not significantly affected by pharmacotherapy.ConclusionIn conclusion, our results suggest that smoking cessation is feasible in patients with newly diagnosed lung cancer. The observed abstinence rate is comparable to other patient cohorts. Furthermore, pharmacotherapy in addition to cancer therapy was safe and did not show novel side effects in these seriously ill patients. Thus, smoking cessation should be an integral part of lung cancer treatment.Trial registration The study was conducted in accordance with good clinical practice standards (GCP) and approved by the local ethics committee (16/3/14), the European PAS registry (EUPAS8748) and the German BfArM (NIS-Studien-Nr. 5508). All patients provided written informed consent before study enrollment.

Association of Variants in IL6-Related Genes with Lung Cancer Risk in Moroccan Population.

Lung cancer is known to be a complex multifactorial disease, involving both genetic and environmental factors. The study of the different signaling pathways and the identification of the genes involved, will contribute to further understanding the pathogenesis of the disease, thus allowing the development of appropriate targeted treatments. Recently, the link between cancer and inflammation has become more evident and inflammation has been proposed as the seventh hallmark of cancer. Previous studies have suggested that key cytokines involved in inflammation may have an important role in the etiology of lung cancer. The aim of this study was to investigate whether common variants in inflammation-related genes: IL-6, IL6-R, and IL6-ST, influence lung cancer risk in Moroccan population. Single nucleotide polymorphisms (SNPs) in IL-6, IL6-R, and IL6-ST genes were assessed in 120 controls and 120 patients with confirmed lung cancer diagnosis. Genotyping analysis was performed with the TaqMan® allelic discrimination technology. The results were analyzed using SPSS 24.0 software. Among the studied SNPs, we found a significant association for the IL-6 (rs2069840) (OR = 1.63; 95% confidence interval 1.08-2.47; p = 0.01). No significant association was observed for the remaining SNPs of IL-6R (rs2228145) and IL-6ST (rs2228044) genes. Our results suggest the IL-6 (rs2069840) polymorphism may influence the occurrence of lung cancer in Moroccan patients.

A real-world, comparative study of FDA-approved diagnostic assays PD-L1 IHC 28-8 and 22C3 in lung cancer and other malignancies

AimsAt the time of analysis, two widely used, drug-specific, tumour-cell programmed death ligand 1 (PD-L1) assays were approved by the US Food and Drug Administration for anti-PD-1 therapies: the Dako...

Environmental tobacco smoke exposure and EGFR and ALK alterations in never smokers' lung cancer. Results from the LCRINS study

Environmental tobacco smoke (ETS) exposure is a main risk factor of lung cancer in never smokers. Epidermal Growth Factor Receptor (EGFR) mutations and ALK translocations are more frequent in never smokers' lung cancer than in ever-smokers. We performed a multicenter case-control study to assess if ETS exposure is associated with the presence of EGFR mutations and its types and if ALK translocations were related with ETS exposure. All patients were never smokers and had confirmed lung cancer diagnosis. ETS exposure during childhood showed a negative association on the probability of EGRF mutation though not significant. Exposure during adulthood, at home or at workplace, did not show any association with EGFR mutation. The mutation type L858R seemed the most associated with a lower probability of EGFR alterations for ETS exposure at home in adult life. There is no apparent association between ETS exposure and ALK translocation. These results might suggest that ETS exposure during childhood or at home in adult life could influence the EGFR mutations profile in lung cancer in never smokers, reducing the probability of presenting EFGR mutation.

PA02.05 Access to Care: Australia

In June 2016, Lung Foundation Australia launched an evidence-based, clear and concise guide, the “Lung Cancer Patient Pathway,” for patients with a confirmed lung cancer diagnosis. The guide is available as a printed resource and online resource supported by a micro-site on Lung Foundation Australia’s website and the Lung Cancer Network Australia website and has been distributed to the majority of dedicated lung cancer treatment centers around Australia. The main aim of producing the Lung Cancer Patient Pathway (LCPP) was to provide newly diagnosed patients with a “one stop” resource that outlines the clinical referral pathways and details the full range of treatment options and supportive care services available to them throughout their lung cancer journey. The LCPP also aims to improve patient health literacy and empower patients with access to evidence based information to support informed decision making and treatment choices, self- management and ultimately, to improve patient outcomes. The LCPP was launched in conjunction with the launch of the Lung Foundation’s Australian Lung Cancer Multi-Disciplinary Team Directory http://lungfoundation.com.au/mdt/. This national directory lists the current (64) dedicated lung cancer multidisciplinary (MDT) services around Australia. It is intended to facilitate referrals of patients to hospitals delivering MDT-based lung cancer management. The creation of this national directory has forged closer relationships between the Lung Foundation and dedicated lung cancer multidisciplinary (MDT) services and provided a mechanism to be able to reach patients at time of diagnosis. Lung Foundation has previously struggled to reach patients early in their cancer journey. Strengthening these relationships with Lung MDT services has led to a systematic distribution of Lung Foundation patient kits including the LCPP info-graph. The Cancer Nurses Society of Australia Winter Congress in May 2016 and Australian Lung Cancer Conference in August 2016 presented opportunities to distribute the printed LCPP in conference delegate bags and at trade exhibitions to more than 550 cancer clinicians and nurses. The Lung Foundation will implement the following strategies to ensure the sustainability of this project: Info-graph will be trialed in Lung Cancer MDTs around Australia, Info-graph will form part of the Lung Cancer Consultative Groups activities, A minimum review period of two years for info-graph and website content, Annual budget allocation for ongoing promotion and dissemination. The Lung Cancer Patient Pathway project has produced a patient centered resource to empower newly diagnosed patients with current, evidence based information so that they can make informed decisions on treatment options and supportive care services and access the right treatment and care at the right time. This project was managed by Glenda Colburn, Director, Lung Cancer National Program, Lung Foundation Australia. The Lung Cancer patient pathway was made possible via unrestricted education grants. Principal sponsor: Bristol-Myers Squibb Supporting Sponsors: AstraZenea, Boehringer Ingelheim, Cancer Australia, Pfizer, Maurice Blackburn Lawyers, MSD.

Bronchoscopic biopsy for diagnosis of lung cancer in the absence of visible endobronchial abnormalities

Abstract Objective Bronchoscopy has been extensively used in the diagnosis of respiratory diseases, and particularly, malignant diseases. However, endoscopists do not normally perform bronchoscopic biopsy in case lesions are undetected via bronchoscopy. The aim of this study was to evaluate whether performing bronchoscopic biopsy could be established in the diagnosis of lung cancer in case of endobronchial abnormalities undetectable to the naked eye. Methods We retrospectively analyzed 109 cases between January 2008 and December 2012. The inclusion criteria were confirmed lung cancer diagnosis, transbronchial biopsy performed in the absence of visible endobronchial manifestations, brushing, and bronchoalveolar lavage (BAL) according to the images obtained from high-resolution computed tomography (HRCT). Data regarding age, sex, pathology, tumor stage; the method of diagnosis; location of primary lesion (central, peripheral, or intermediate); tumor size, mediastinal lymph node metastasis, and the serum carcinoembryonic antigen (CEA) value were collected. The Pearson chi-square test or Fisher’s exact and McNemar tests were used in the univariate analysis. Results Among the 109 patients, the diagnosis of 37 (33.9%) patients was confirmed through bronchoscopy. Brushing and BAL had higher positive detection rates than biopsy (P = 0.004). There were no differences in the positive detection rates between the sex, pathology, lesion location, tumor size, lymph node metastasis, and the serum CEA value (P > 0.05 for all groups). Conclusion Despite the normal appearance of the endobronchial manifestations, lesions undetectable by bronchoscopy could be indicated. Therefore, we suggest performing bronchoscopic biopsy and that brushing and BAL might increase the positive detection rate of bronchoscopic examination.

The bottleneck effect in lung cancer clinical trials.

Clinical trials provide the most promising way to improve treatment outcomes in cancer. This study examined the rate at which eligible patients with lung cancer, at a National Cancer Institute-designated cancer center in the South, were offered a clinical trial and explored for reasons for ineligibility. We retrospectively reviewed 300 randomly selected lung cancer patients' medical records seen in 2010, to assess clinical trial offers to eligible patients, reasons for not offering an eligible patient a trial, demographic factors associated with eligibility, and reasons for refusal among those offered a trial. Of the 300 patient charts, seven were excluded for lack of confirmed lung cancer diagnosis. Forty-six of the remaining 293 (15.7%) patients were eligible for a clinical trial. Forty-five of the 46 (97.8%) were considered for a trial by their oncologist. Thirty-five of the 45 (77.8%) were offered a trial: 15 agreed (42.9% of those offered, 5.1% of patients reviewed), 11 declined, and 9 were undecided at the end of the review window. Patients with poor Eastern Cooperative Oncology Group (ECOG) performance status levels and small cell (SC) diagnoses were significantly less likely to be eligible for a trial. Results suggest that oncologists at the cancer center are effectively presenting all eligible patients with the option of a clinical trial; however, there is a need to increase the number of approved clinical trials for patients with SC or ECOG score greater than 2.

CYP2D6 genotype and lung cancer risk according to histologic type and tobacco exposure.

Polymorphism for CYP2D6 was determined genetically as part of a hospital-based case-control study. The cases were males with a histologically confirmed lung cancer diagnosis, < 75 years old, and no previous cancer diagnosis. Male controls were matched for age, hospital and residence area. This study includes 301 cases and 310 controls. A DNA bank was established for 547 patients (89.5%), and genotypes for CYP2D6 were differentiated by the Heim and Meyer method for the DNA samples of 249 cases and 271 controls. Among the cases, the frequencies of homozygous for the wild-type (EM), heterozygous (HEM) and homozygous for the mutant alleles (PM) were 62%, 32% and 7%; among the controls: 57%, 37% and 6%. Using EM as the reference, and adjusting for age, hospital and residence, we estimated the odds ratios for the HEM group and the PM group at 0.8 (95% CI [0.5-1.2]) and 1.1 (95% CI [0.5-2.4]) respectively. The PM frequency among the cases of adenocarcinoma was twice as high as among the controls (OR = 1.8, 95% CI [0.7-4.9]). This result was not observed among squamous and small cell carcinoma (OR = 0.7, 95% CI [0.3-1.8]). Twelve different case-control studies on CYP2D6 and lung cancer have so far been performed; the ORs they estimate range from 0.1 to 2.0, with a median value of approximately 0.6. This result lends some support to the hypothesis that belonging to the PM group is associated with a slight protective effect against lung cancer, but does not take into account the possibility that results may vary according to histologic type. In this context, the suggestion of a positive relationship between CYP2D6 and adenocarcinoma seems to us to merit investigation.