Number Of Lung Cancer Patients Research Articles

Targeting microRNAs as a promising anti-cancer therapeutic strategy against traffic-related air pollution-mediated lung cancer.

Air pollutants are increasingly emitted into the atmosphere because of the high dependency of humans on fossil-derived fuels. Wind speed and direction assisted high dispersibility and uncontrolled nature of air pollution across geo-/demographical borders, making it one of the major global concerns. Besides climate change, air pollution has been found to be associated with various diseases, such as cancer. Lung cancer, which is the world's most common type of cancer, has been found to be associated with traffic-related air pollution. Research and political efforts have been taken to explore green/renewable energy sources. However, these efforts at the current intensity cannot cope with the increasing need for fossil fuels. More specifically, political tensions such as the Russian-Ukraine war, economic tension (e.g., China-USA economic tensions), and other issues (e.g., pandemic, higher inflation rate, and poverty) significantly hindered phasing out fossil fuels. In this context, an increasing global population will be exposed to traffic-related air pollution, which justifies the current uptrend in the number of lung cancer patients. To combat this health burden, novel treatments with higher efficiency and specificity must be designed. One of the potential "life changer" options is microRNA (miRNA)-based therapy to target the expression of oncogenic genes. That said, this review discusses the association of traffic-related air pollution with lung cancer, the changes in indigenous miRNAs in the body during lung cancer, and the current status of miRNA therapeutics for lung cancer treatment. We believe that the article will significantly appeal to a broad readership of oncologists, environmentalists, and those who work in the field of (bio)energy. It may also gain the policymakers' attention to establish better health policies and regulations about air pollution, for example, by promoting (bio)fuel exploration, production, and consumption.

Drug resistance mechanism and reversal strategy in lung cancer immunotherapy.

Among all malignant tumors, lung cancer has the highest mortality and morbidity rates. The non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) are the most common histological subtypes. Although there are a number of internationally recognized lung cancer therapy regimens, their therapeutic effects remain inadequate. The outlook for individuals with lung carcinoma has ameliorated partly thanks to the intensive study of the tumor microenvironment and immune checkpoint inhibitors. Numerous cancers have been effectively treated with immunotherapy, which has had positive therapeutic results. Global clinical trials have validated that PD-1/PD-L1 inhibitors are effective and safe for treating lung cancer either independently or in combination, and they are gradually being recommended as systemic treatment medications by numerous guidelines. However, the immunotherapy resistance restricts the immunotherapy efficacy due to the formation of tumor immunosuppressive microenvironment and tumor mutations, and immunotherapy is only effective for a small percentage of lung cancer patients. To summarize, while tumor immunotherapy is benefiting an increasing number of lung cancer patients, most of them still develop natural or acquired resistance during immunotherapy. Consequently, a crucial and urgent topic is understanding and tackling drug resistance triggered by immunotherapy in lung cancer treatment. This review will outline the presently recognized mechanisms of immunotherapy resistance and reversal strategies in lung cancer.

Racial disparity and regional variance in healthcare utilization among patients with lung cancer in US hospitals during 2016–2019

BackgroundLung cancer health disparities are related to various patient factors. This study describes regional differences in healthcare utilization and racial characteristics to identify high-risk areas. This study aimed to identify regions and races at greater risk for lung cancer health disparities based on differences in healthcare utilization, measured here by hospital charges and length of stay.MethodsThe National Inpatient Sample of the United States was used to identify patients with lung cancer (n = 92,159, weighted n = 460,795) from 2016 to 2019. We examined the characteristics of the patient sample and the association between the racial and regional variables and healthcare utilization, measured by hospital charges and length of stay. The multivariate sample weighted linear regression model estimated how racial and regional variables are associated with healthcare utilization.ResultsOut of 460,795 patients, 76.4% were white, and 40.2% were from the South. The number of lung cancer patients during the study periods was stable. However, hospital charges were somewhat increased, and the length of stay was decreased during the study period. Sample weighted linear regression results showed that Hispanic & Asian patients were associated with 21.1% and 12.3% higher hospital charges than White patients. Compared with the Northeast, Midwest and South were associated with lower hospital charges, however, the West was associated with higher hospital charges.ConclusionMinority groups and regions are at an increased risk for health inequalities because of differences in healthcare utilization. Further differences in utilization by insurance type may exacerbate the situation for some patients with lung cancer. Hospital managers and policymakers working with these patient populations in identified areas should strive to address these disparities through special prevention programs and targeted financial assistance.

Genomics-based screening of novel therapeutic targets and biomarkers for lung cancer.

e15093 Background: Since the number of lung cancer patients who show objective response to standard treatments is still limited, development of new anti-cancer agents with minimum risk of side effects and specific cancer biomarkers is urgently required. Methods: We have been screening new therapeutic targets and their companion biomarkers for lung cancer as follows; i) To identify overexpressed genes in lung cancers by the gene expression profile analysis, ii) To verify the candidate genes for their scarce expression in normal tissues, iii) To validate the clinicopathological importance of their protein expression by tissue microarray covering hundreds of lung cancers, and iv) To characterize their function for the growth and/or survival of lung cancer cells by siRNAs. Results: We identified dozens of candidate oncoproteins and selected a lung cancer cell division-associated protein 1 (LCDAP1). Immunohistochemical analysis showed that LCDAP1 was expressed in 171 of 267 (64%) non-small cell lung cancer (NSCLC) tissues but not in normal lung epithelia. LCDAP1 expression was significantly associated with poor prognosis for NSCLC patients. To investigate its function, we screened LCDAP1-binding protein in lung cancer cells and found an interaction of LCDAP1 with a member of 5'-to-3' DNA helicase that was also up-regulated in lung cancer cells. Knockdown of either of LCDAP1 or its binding partner expression with siRNAs significantly inhibited the growth of cancer cells. Conclusions: Our genomics-based screening could be useful to develop diagnostic and prognostic biomarkers as well as therapeutic targets for small molecules, monoclonal antibodies, and nucleic acid drugs against lung cancer.

Abstract 3927: Genome-wide screening and validation of molecular targets and biomarkers for lung cancer

Abstract The number of lung cancer patients who respond well to currently available standard therapies is still small, new molecular targeted therapies with companion diagnostics are eagerly needed. We have been developing new molecular therapies targeting oncoproteins with their cancer biomarkers as follows, i) To identify strongly expressed genes in 120 lung cancers by genome-wide gene expression profile analysis, ii) To verify the candidate genes for their scarce expression in 23 normal organs, iii) To validate the clinicopathological significance of their protein expression by tissue microarray covering about 400 lung cancers (non-small cell lung cancers (NSCLCs) and SCLCs), iv) To examine their importance in the growth and/or invasion of cancer cells by siRNA, small molecule inhibitor, cell permeable peptides targeting their function and/or antibody assays, and v) To analyze the oncogenic function of the target molecules. By this system, we identified 50 oncoproteins and selected a LSERT (lung cancer-specific receptor tyrosine kinase) as a candidate. Immunocytochemical and immunohistochemical analyses confirmed that LSERT protein was expressed in cytoplasm and cytoplasmic membrane of lung cancer cells, but it was hardly expressed in normal lung cells. Strong LSERT expression was associated with poorer prognosis for surgically-treated NSCLC patients, and it was an independent prognostic factor. Exogenous expression of LSERT increased the cell growth and invasion probably through its elevated kinase activity and subsequent phosphorylation of downstream proteins. Inhibition of LSERT expression by siRNAs or treatment with anti-LSERT antibody suppressed the growth of lung cancer cells. Our genome-wide screening might be a useful approach to identify target molecules for developing new therapeutics and diagnostics. LSERT could be a candidate cancer biomarker and therapeutic target for lung cancer. Citation Format: Yataro Daigo, Atsushi Takano, Yusuke Nakamura. Genome-wide screening and validation of molecular targets and biomarkers for lung cancer. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3927.

Detection and classification of lung cancer computed tomography images using a novel improved deep belief network with Gabor filters

The computer-aided diagnosis (CAD) method plays a considerable role in the automated recognition of medical images, considering the increasing numbers of lung cancer patients. Pulmonary nodules are a type of lung irregularity that can be detected early in the course of a patient's life using CAD-based pulmonary patient diagnosis. For several classification methods of lung CT images, the existing method has a lower performance in early cancer diagnosis and a longer processing time. To improve the performance of the classification method in terms of processing time and accuracy, we propose a novel method to classify lung CT images. In the proposed method of lung cancer classification, we use Gabor filters with an enhanced Deep Belief Network (E-DBN) with multiple classification methods. In this E-DBN, we use two cascaded RBMs, Gaussian-Bernoulli (GB) and Bernoulli–Bernoulli (BB) RBMs. A support vector machine (SVM) gives the best performance parameters of all applied methods. Our proposed model uses a support vector machine with an E-DBN to classify lung CT images and improve performance parameters like accuracy, sensitivity, specificity, F-1 score, false positive rate (FPR), false negative rate (FNR), and ROC curve. The proposed approaches are tested and evaluated using three publicly available datasets: the LIDC-IDRI and LUNA-16 datasets.

Construction of a mortality risk prediction model for elderly people at risk of lobectomy for NSCLC.

An increasing number of lung cancer patients are opting for lobectomy for oncological treatment. However, due to the unique organismal condition of elderly patients, their short-term postoperative mortality is significantly higher than that of non-elderly patients. Therefore, there is a need to develop a personalised predictive tool to assess the risk of postoperative mortality in elderly patients. Information on the diagnosis and survival of 35,411 older patients with confirmed lobectomy NSCLC from 2009 to 2019 was screened from the SEER database. The surgical group was divided into a high-risk mortality population group (≤90 days) and a non-high-risk mortality population group using a 90-day criterion. Survival curves were plotted using the Kaplan-Meier method to compare the differences in overall survival (OS) and lung cancer-specific survival (LCSS) between the two groups. The data set was split into modelling and validation groups in a ratio of 7.5:2.5, and model risk predictors of postoperative death in elderly patients with NSCLC were screened using univariate and multifactorial logistic regression. Columnar plots were constructed for model visualisation, and the area under the subject operating characteristic curve (AUC), DCA decision curve and clinical impact curve were used to assess model predictiveness and clinical utility. Multi-factor logistic regression results showed that sex, age, race, histology and grade were independent predictors of the risk of postoperative death in elderly patients with NSCLC. The above factors were imported into R software to construct a line graph model for predicting the risk of postoperative death in elderly patients with NSCLC. The AUCs of the modelling and validation groups were 0.711 and 0.713 respectively, indicating that the model performed well in terms of predictive performance. The DCA decision curve and clinical impact curve showed that the model had a high net clinical benefit and was of clinical application. The construction and validation of a predictive model for death within 90 days of lobectomy in elderly patients with lung cancer will help the clinic to identify high-risk groups and give timely intervention or adjust treatment decisions.

Impact of previous upper gastrointestinal cancer surgery on complications after lobectomy for lung cancer.

The number of lung cancer patients with a history of other malignancies is increasing. Previous upper gastrointestinal cancer (UGIC) surgery may increase the risk of complications after lung cancer surgery due to malnutrition and susceptibility in patients; therefore, we investigated its short-term outcomes. We retrospectively examined patients with lung cancer who underwent thoracoscopic lobectomy between 2011 and 2021 and collected data regarding postoperative complications and postoperative pulmonary complications ≥ grade II of the Clavien-Dindo classification that developed within 3 months post-surgery. The effect of UGIC surgery on the postoperative complications was evaluated by multivariable analysis using logistic regression. Among the 1,385 included patients, 377 patients had a history of cancer surgery and 65 (4.7%) of them had undergone UGIC surgery. Postoperative and pulmonary complications were observed in 155 (11.2%) and 39 (2.9%) patients, respectively. The frequency of pulmonary complications was significantly higher in patients with previous UGIC surgery (9.2% vs. 2.5%, P=0.003) with no significant difference in all complications (16.9% vs. 10.9%, P=0.137). Multivariable analysis showed that previous UGIC surgery is an independent factor associated with postoperative pulmonary complications (odds ratio =2.923, P=0.029). In contrast, previous surgery for cancer other than UGIC was not associated with postoperative pulmonary complications (the rate was 1.2% after lower gastrointestinal cancer surgery and 3.0% after non-gastrointestinal cancer surgery). Previous UGIC surgery was an independent factor associated with postoperative pulmonary complications after lung cancer surgery.

A Retrospective Review of the Clinical Outcomes of Lung Cancer Patients Referred into the Regional Neuro-Oncology Pathway in 2020 in Merseyside, United Kingdom

Abstract AIMS The aim of this project was to review the outcomes of patients referred via our regional neuro-oncology pathway who received neurosurgery, SRS, whole brain radiotherapy (WBRT), chemotherapy (SACT) or best supportive care (BSC). METHOD All lung cancer patients discussed at our Neuro-Oncology MDT in 2020 were identified. Patient characteristics and outcomes were obtained from the regional lung and neuro-oncology MDT notes and electronic case notes from Clatterbridge Cancer Centre. Overall survival (OS) was calculated from the date of diagnostic scan to death. The date of data cut-off was 15/10/2021. RESULTS Full datasets were available for 100 patients discussed at the Neuro-Oncology MDT. 65 were adenocarcinomas, 4 had ALK or EGFR mutations and 49 were synchronously presenting with brain metastases and lung cancer. At data cut-off 84 deaths had occurred. The median OS in days was calculated for surgery (207), SRS (360), surgery and cavity boost (298), SACT (249), WBRT (102) and BSC (60). A grouped comparison of SRS and surgery versus other interventions or best supportive care found a statistically significant advantage favouring SRS or surgery (Median OS 360 days, p=0.001). When comparing the synchronous versus asynchronous setting, the combined median OS of the neurosurgical, SRS or SACT cohorts was 276 versus 170 days but there was no difference in WBRT or BSC. CONCLUSION This real-world data details the number of lung cancer patients referred to and receiving neurosurgery or SRS via the Merseyside neuro-oncology MDT. This data supports pre-existing evidence that those who receive SRS or neurosurgery have a superior OS.

EP03.01-004 Impact of Covid-19 Pandemic in Lung Cancer Patients in Albania

IntroductionLung cancer is the most common cancer malignancy worldwide. With the spread of the coronavirus disease 2019 (COVID-19) globally, it is important to investigate the impact of Covid-19 in the diagnosis of lung cancer. In Albania, the first case of Covid-19 was reported in Tirana on 8 March 2020MethodsThe aim of this study was to explore how covid -19 pandemic, affected the diagnosis of lung cancer patients.It was retrospective cohort study of newly diagnosed lung cancer patients confirmed by biopsy, according to demographic,clinical, histological characteristics during 2019 and 2020, in the biggest center of lung diseases,in our country.ResultsThe total number of lung cancer patients was 377 (2019) and 172 (2020).Male to female ratio was equal 4:1(2019 m/f:296/41;2020:156/16 ).Median age (2019) was 65,9 years and 63,8 years (2020).60% were NSCLC (2019), 75% NCCL(2020).ConclusionsTabled 1SqmAdncaSmall cellotherTotal2019148796149377202084452815172 Open table in a new tab Keywordslung, cancer, Covid-19 IntroductionLung cancer is the most common cancer malignancy worldwide. With the spread of the coronavirus disease 2019 (COVID-19) globally, it is important to investigate the impact of Covid-19 in the diagnosis of lung cancer. In Albania, the first case of Covid-19 was reported in Tirana on 8 March 2020 Lung cancer is the most common cancer malignancy worldwide. With the spread of the coronavirus disease 2019 (COVID-19) globally, it is important to investigate the impact of Covid-19 in the diagnosis of lung cancer. In Albania, the first case of Covid-19 was reported in Tirana on 8 March 2020 MethodsThe aim of this study was to explore how covid -19 pandemic, affected the diagnosis of lung cancer patients.It was retrospective cohort study of newly diagnosed lung cancer patients confirmed by biopsy, according to demographic,clinical, histological characteristics during 2019 and 2020, in the biggest center of lung diseases,in our country. The aim of this study was to explore how covid -19 pandemic, affected the diagnosis of lung cancer patients.It was retrospective cohort study of newly diagnosed lung cancer patients confirmed by biopsy, according to demographic,clinical, histological characteristics during 2019 and 2020, in the biggest center of lung diseases,in our country. ResultsThe total number of lung cancer patients was 377 (2019) and 172 (2020).Male to female ratio was equal 4:1(2019 m/f:296/41;2020:156/16 ).Median age (2019) was 65,9 years and 63,8 years (2020).60% were NSCLC (2019), 75% NCCL(2020). The total number of lung cancer patients was 377 (2019) and 172 (2020).Male to female ratio was equal 4:1(2019 m/f:296/41;2020:156/16 ).Median age (2019) was 65,9 years and 63,8 years (2020).60% were NSCLC (2019), 75% NCCL(2020). ConclusionsTabled 1SqmAdncaSmall cellotherTotal2019148796149377202084452815172 Open table in a new tab Keywordslung, cancer, Covid-19 lung, cancer, Covid-19

Lung Cancer in the Course of COPD-Emerging Problems Today

Simple SummaryChronic obstructive pulmonary disease (COPD) is a risk factor for lung cancer independent of the influence of tobacco smoke. There are some similarities in immunopathogenesis of both diseases. The participation of inflammatory cells: macrophages, neutrophils and lymphocytes T with CD8 population was presented in both diseases. The emphysematous phenotype of COPD seems to be most often complicated by lung cancer. Some elements of autoimmunity could be involved in the development of emphysema, and its relation with malignant transformation requires further studies. COPD complicates lung cancer diagnosis and treatment, and the patients with coexistence of these both serious diseases need special care.Tobacco smoking remains the main cause of tobacco-dependent diseases like lung cancer, chronic obstructive pulmonary disease (COPD), in addition to cardiovascular diseases and other cancers. Whilst the majority of smokers will not develop either COPD or lung cancer, they are closely related diseases, occurring as co-morbidities at a higher rate than if they were independently triggered by smoking. A patient with COPD has a four- to six-fold greater risk of developing lung cancer independent of smoking exposure, when compared to matched smokers with normal lung function. The 10 year risk is about 8.8% in the COPD group and only 2% in patients with normal lung function. COPD is not a uniform disorder: there are different phenotypes. One of them is manifested by the prevalence of emphysema and this is complicated by malignant processes most often. Here, we present and discuss the clinical problems of COPD in patients with lung cancer and against lung cancer in the course of COPD. There are common pathological pathways in both diseases. These are inflammation with participation of macrophages and neutrophils and proteases. It is known that anticancer immune regulation is distorted towards immunosuppression, while in COPD the elements of autoimmunity are described. Cytotoxic T cells, lymphocytes B and regulatory T cells with the important role of check point molecules are involved in both processes. A growing number of lung cancer patients are treated with immune check point inhibitors (ICIs), and it was found that COPD patients may have benefits from this treatment. Altogether, the data point to the necessity for deeper analysis and intensive research studies to limit the burden of these serious diseases by prevention and by elaboration of specific therapeutic options.

Abstract 5231: Case report: dramatic response to Crizotinib in a patient with synchronous multiple primary lung cancer positive for a novel ARL1-MET fusion

Abstract Background: With the use of high-resolution chest imaging system, an increasing number of lung cancer patients are being diagnosed with multiple primary lung cancer (MPLC). Although surgery is considered as the first choice of treatment for early MPLC, targeted therapy is essential in the management of unresectable MPLC. To date, the driver oncogenes reported in the patients with MPLC are limited, and MET fusion has not yet been reported in MPLC. Case presentation: In this case, we reported a female patient with simultaneous MPLC (sMPLC). A novel ARL1-MET fusion was detected in her right lung tumor tissues using next-generation sequencing (NGS). The patient achieved about 5-month progressive-free survival (PFS) after receiving Crizotinib for the unresectable right lung malignancies. Conclusion: To the best of our knowledge, this case provided the first clinical evidence that the novel ARL1-MET fusion might be an actionable mutation in sMPLC. Citation Format: Qing Ma, Lingping Kong, Diansheng Zhong. Case report: dramatic response to Crizotinib in a patient with synchronous multiple primary lung cancer positive for a novel ARL1-MET fusion [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5231.

Lung Cancer Patients’ Characteristics and Comorbidities Using the Korean National Hospital Discharge In-depth Injury Survey Data

BackgroundThe aim of this study was to assess the incidence of lung cancer and comorbidities in Korea and analyze the lung cancer patient’s characteristics and their comorbidities over the past 12 years. This study also aimed to investigate factors related to death as treatment outcome in discharged lung cancer patients.MethodsThis study analyzed the data obtained from the Korean National Hospital Discharge In-depth Injury Survey from 2006 to 2017. The quantity of discharged lung cancer patients was assessed by year. Comorbidities were limited to those included in the Elixhauser Comorbidity Index (ECI). A Chi-square test was performed to determine statistically significant differences in the distributions of the ECI and ECI scores according to the presence or absence of metastatic cancer. Logistic regression analysis was used to analyze factors related to death as treatment outcome.ResultsFrom 2006 to 2017, the number of discharged male and female patients with lung cancer increased from 31,720 to 42,016 and 10,897 to 18,197, respectively. The increase in the number of lung cancer patients was greater in women than in men (67.0% vs. 32.5%, respectively). The most common associated comorbidities were hypertension, diabetes, and chronic pulmonary disease. The factors related to death as treatment outcome were found to include sex, admission route, number of hospital beds, length of stay, presence or absence of metastatic cancer, and ECI score.ConclusionThe number of lung cancer patients in Korea has increased, and a high proportion of these patients have chronic diseases, which negatively would impact the treatment and outcome of lung cancer patients as well as their quality of life. Thus, the management of chronic diseases needs to be prioritized in patients with lung cancer.

Bone-targeting agent utilization among lung cancer patients with bone metastasis in Taiwan.

e24111 Background: Bone is a common metastatic site among patients with advanced lung cancer. With new treatments available to improve survival of lung cancer and in all likelihood to change the natural history of disease, the diagnosis and management of bone metastasis (BM) may be of increasing clinical relevance. This study aimed to describe the management of BM using bone targeting agents (BTA) among lung cancer patients in Taiwan. Methods: A retrospective cohort of lung cancer patients with BM from 2004 through 2016 was identified using Taiwan National Health Insurance (NHI) data and Taiwan Cancer Registry. Diagnosis codes of International Classification of Disease 9th revision (ICD-9: 198.5) and ICD-10 (C79.51 and C78.03) were used to define BM. Patients were followed from the time of BM diagnosis till death or the end of study period (2017/12/31). We ascertained demographic information and BTA use among these patients. Two classes of BTAs were included: bisphosphonates (zoledronic acid (ZA), pamidronate, and clodronate) and denosumab. Results: A total of 44,800 patients with lung cancer and incident BM diagnosis were identified during the study period. Median age at the time of BM diagnosis was 67 years (25th and 75th percentile: 57-76), with 58.2% male (n = 26,058). The annual number of lung cancer patients with incident BM increased from 2,814 in 2004 to 3,829 in 2016, while the proportion of these patients receiving any BTA during the follow-up ranged from 25.2% to 34.8% annually. Clodronate and pamidronate were the common BTA prescriptions, whereas denosumab became the most frequently prescribed BTA after reimbursement by NHI since 2015. Among patients who initiated BTA after BM diagnosis (n = 10,879), the median time from BM diagnosis to BTA initiation ranged from 31 to 152 days by initial BTA type. More than half of them received more than one dose (56.3%, n = 6,126), with median numbers of doses received as 3, 4, 6 and 6 for ZA, pamidronate, clodronate and denosumab, respectively. Conclusions: A large population of patients with lung cancer were diagnosed with BM every year. However, overall, we observed only a small proportion of eligible patients receiving a BTA and a delayed initiation of BTA, indicating suboptimal treatment for lung cancer patients with BM in Taiwan.[Table: see text]

The outcome and prognostic factors of advanced non-small cell lung cancer patients with do-not-intubation order in intensive care unit.

e24113 Background: The survival of lung cancer patients in critical care has been improved. Increasing number of lung cancer patients have signed predefined do-not-intubation (DNI) order before admission to ICU. These patients may still be transferred to ICU and even receive non-invasive ventilation (NIV) supports. However, there is still lack of prognostic prediction in this cohort. Whether patients will be benefit of ICU care remain unclear. Methods: We retrospectively collected data of patients with advanced lung cancer, having signed DNI order before ICU admission in a tertiary medical center. The clinical characteristics and survival outcomes were discussed. The enrollment duration is between 2014 to 2016. Results: Total 140 patients were included. All patients were diagnosed with stage III or IV non-small cell lung cancer (AJCC 7th edition) and signed DNI. The median age was 73 years old and about two-thirds were male. Most patients had received NIV during ICU course. The median APACHE II score was 14 (SE, 0.66) and the mean P/F ratio was 174.2(+/-104) mmHg. The APACHE II score was significantly lower in 28-day survivors (survivor 12 (+/-0.98) vs non-survivor 15 (+/-0.83), p = 0.019). The P/F ratio of the survivors was higher than non-survivors (survivor 209.6+/-111.4 vs non-survivor 157.9+/-96.7, p = 0.006). Patients with P/F ratio ≥150 had better 28-day survival (p = 0.005). By combining P/F ratio≥150 and APACHE II score < 16, those with high P/F ratio and low APACHE II score during ICU admission had a notable 28-day survival compared with the rest (p < 0.001). These prognostic factors could also be applied for 90-day survival (p = 0.003). The prediction model was significant in those with driver mutations in 90-day survival (p = 0.021) but not in those without driver mutations (p = 0.061). Conclusions: The P/F ratio≥150 and APACHE II score < 16 were the prognostic significance of critically ill lung cancer patients with DNI. The prediction could be applied for 90-day survival in patients with driver mutation. The finding was informative for clinical practice and decision-making.

Demography and Characteristics of Lung Cancer Patients Evaluated by 18F-FDG PET- CT imaging - Retrospective Analysis in NINMAS

Introduction: Carcinoma of the lung is one of the most common cancer in Bangladesh. Fluorine-18-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) plays an important role in staging and evaluating therapy response. Currently, limited data is available about the demography and characteristics of lung cancer patients in Bangladesh by 18F-FDG PET-CT scan. Objectives: To evaluate the demographic pattern and pattern of findings in lung cancer patients by 18F-FDG PET-CT scan in the National Institute of Nuclear Medicine and Allied Sciences (NINMAS), Dhaka. Materials and Methods: This retrospective study was conducted in the PET-CT division of NINMAS. A total of 53 patients out of 103 patients with lung cancer were enrolled who were referred to NINMAS from October 2020 to December 2021 for either baseline PET CT or for assessment of therapy response. Data were collected in a predesigned format from old documents and analyzed for demographic characteristics, histopathologic, morphologic and metabolic patterns as well as a comparison of the overall number of lung cancer patients with previous years. Results: Among the enrolled 53 lung cancer patients the majority (34%) are in the 6th to 7th decades with 56.6% male and 43.4 % female. Adenocarcinoma (62%) and squamous cell carcinoma (24%) were the most common lung cancer subtypes. The majority of patients (53%) came for a therapeutic response evaluation; among them, 32% had a good response following therapy, 25% with progressive disease and others had mixed response, partial response, and stable disease. Nine percent of the patients came for follow up and among them, recurrence is detected in 20%. Lung cancer patients who came for baseline study, (38%) were upstaged (80%) mainly with 20% remaining in the same stage. Conclusion: The demographic pattern of lung cancer patients observed in this study belonged to 6th & 7th decades having male predominance. Most of the patients were diagnosed with advanced stages of lung cancer. The use of 18FDG PET-CT is crucial for the staging and diagnosis of suspected lung cancer, as well as therapeutic response and follow-up. Bangladesh J. Nuclear Med. 25(1): 22-27, 2022

Organizing the quality assessment in lung cancer care on the example of the Netherlands

Introduction: In the Russian Federation and worldwide lung cancer (RL) is the leading malignancy. In order to improve the availability of modern diagnostic and treatment algorithms for a huge number of lung cancer patients, highly specialized audits of oncological care have been organized in many countries.Purpose: Reviewing the basic principles for organizing specialized national lung cancer care audits based on the example from the Netherlands.Materials and methods: The search for relevant articles was carried out in PubMed, as well as using the Google search engine. The search strings included keywords such as: «audit», «lung cancer», «Dutch», «the Netherlands» and many others.Results: Nowadays, the specialized Dutch audit for lung cancer relies on the sub‑registers devoted to the following topics: 1) medical practice of oncologists‑pulmonologists; 2) the activities of surgeons; 3) the work of radiation oncologists. Wide coverage of different treatment areas and digital integration provide a comprehensive picture of cancer care throughout all aspects of routing patients with RL in the Netherlands Selective sub‑audits are of great scientific and practical importance. Feedback systems, the latest digital technologies and a sufficient level of transparency ensure effective quality control of diagnostics and treatment of patients with lung cancer in the studied countries.Conclusion: Beneficial way to improve quality assurance is based on the use of complex, complementary principles of cognition, including holism, reductionism, induction methods, combinatorial analysis, etc. etc. Regardless of the implemented approaches to quality control, the cancer network should always remain focused on each single patient. The private interests of a particular patient, survival rate, quality of life with have determine the prioritized vector of innovative development of audits of oncological practice.

The extrinsic factors affecting patient access, referral and treatment of lung cancer in selected oncology public health facilities in KwaZulu-Natal

Patients’ insights into the factors affecting access, referral and treatment of lung cancer in public healthcare facilities, are key to the fight against this disease. On the other hand, the lack of epidemiological information on the actual burden of lung cancer, makes it difficult for public healthcare facilities to be adequately equipped to deal with foreseeable challenges in the oncology units. In order to inform patientcentred interventions and lung cancer control programmes, this study explored extrinsic factors that affect lung cancer patients throughout the cancer care continuum in KwaZulu-Natal. Nineteen patients receiving care in the three public healthcare facilities providing oncology services in KwaZulu-Natal, were interviewed using an interview guide. Following data saturation, thematic analysis was used to develop the themes relating to the extrinsic factors affecting the provision of cancer care. Five themes emerged from the analysis, namely: geographical dynamics affecting patient access to a healthcare facility, lung cancer suspicion index in the diagnostic trail within the different levels of care, decision-making trail for the referral system, equipmentinduced delays and healthcare-patient communication. A number of lung cancer patients utilising oncology services in public healthcare facilities in KwaZulu-Natal, are often met with various extrinsic factors affecting their progression through different stages of cancer care continuum. Therefore, the results of the extrinsic factors explored in this paper through the lung cancer patients’ lenses may be used for designing mitigation plans to reduce delays in lung cancer care in KwaZulu-Natal.

Comparison between Vinorelbine–Carboplatin and Vinorelbine–Cisplatin in Stage III–IV EGFR Mutations-Negative NSCLC

Introduction There are a substantial number of lung cancer patients with negative mutations in Indonesia. This type of cancer is deemed to be the major contributor of lung cancer patient’s death. However, reseaerch related to therapy using vinorelbine combined with platinum-based compounds is still scarce in Indonesia. The aim of this study was to compare the efficacy and tolerability between vinorelbine and carboplatin with vinorelbin and cisplatin in stage III-IV epidermal growth factor receptor (EGFR) mutations-negative non-small cell lung cancer (NSCLC). Methods The participants were divided into two groups—group I(vinorelbine–carboplatin) and group II (vinorelbine–cisplatin). The participants were assessed based on several measurement criteria. Not only Eq-5D was performed, but the body weight and response evaluation criteria for solid tumors (RECIST) were also examined. The participants received chemotherapy for four cycles (1 cycle = 21 days). Results The quality of life was considered stable in 60% of group I and 60% of group II (p = 0.255). In both groups, 46.67% of participants had an increased body weight, while the other 20.00% was stable (p = 1.000). In terms of RECIST evaluation after the second cycle, 80.00% of group I and 86.67% of group II were considered to have a stable disease, with 20% of group I and none of group II had partial response (p = 0.027). However, after the fourth cycle, there were no significant difference between the groups (p = 0.734). Conclusion In EGFR mutation-negative NSCLC patients, the combination of vinorelbine and carboplatin showed comparable outcomes to vinorelbine and cisplatin chemotherapy with no significant differences.

THE SOCIODEMOGRAPHIC PROFILE OF LUNG CANCER

Background: At our tertiary care hospital we receive a large number of lung cancer patients, mostly in poor general conditions; hence we decided to conduct this study to perform a comprehensive evaluation of the demographic profile of lung cancer at our institute, Institute of respiratory disease (IRD), Swai Man Singh Medical (SMS) College and Hospital
 Methods: This study was conducted at Institute of Respiratory Disease (IRD), Swai Mansingh (SMS) Medical Collage, Jaipur after taking necessary permission from Ethical Committee and Research Review Board of SMS Medical College, Jaipur.
 Results: Mean age of the patients was 61.4±6.8; it was higher in male 61.60±6.7. Out of 105 patients majority of patients were (85.7 %) male. Most of the patients (72.4%) were belonged to rural area .In context of education it is indicated that about 36 % of the patients were primary school educated while 25.7 to 26.7 constituted high & middle school respectively followed by graduate & illiterates (5.7 %) respectively
 Conclusion: We concluded that lung cancer was commonly found in elderly male belong to low socio-economic status
 Keywords: Lung cancer, Male, SES