Lung cancer : journal of the International Association for the Study of Lung Cancer
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Circulating tumour cells (CTCs) are reported to be predictive for prognosis and response to treatment in advanced lung cancer. However, the clinical utility of the CTCs detection remains unknown for early stage lung cancer as the number of CTCs is reported as low, providing challenges in identification. We have evaluated diagnostic performance of filtration-based technology using cytomorphologic criteria in patients undergoing surgery for lung cancer. ⋯ The performance of the tested filter-based antibody-independent technology to capture CTCs using standard cytomorphologic criteria provides the potential of a diagnostic blood test for lung cancer.
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A decrease in the size of ground glass nodules may indicate the optimal timing for curative surgery.
Although ground glass nodules (GGNs) are generally considered to grow slowly to a large size, their natural progression remains unclear, and a decrease in tumor size has been reported in a few previous studies. The study aimed to retrospectively review the radiologic and pathological characteristics of resected ground glass nodules (GGNs) followed with chest computed tomography (CT) for at least a year before surgery to clarify the natural progression of GGNs. ⋯ A size reduction was observed in nearly half of the GGNs and suggested the progression to an invasive adenocarcinoma. When a mild collapse of the GGNs is observed, a careful follow-up is necessary to identify a solid component. Tumor size decreases may represent the optimal timing of pulmonary resection for curative treatment.
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Case Reports
BRAF V600E-mutated lung adenocarcinoma with metastases to the brain responding to treatment with vemurafenib.
Somatic BRAF mutations have been reported in 1-4% of non-small cell lung cancer (NSCLC), primarily in adenocarcinomas with the BRAF (V600E) mutation in about 50% of the cases. The role of BRAF mutation in NSCLC and the treatment for tumors with such mutations is still evolving. ⋯ Our patient's visceral disease improved supporting vemurafenib's efficacy in the treatment of metastatic BRAF-mutated NSCLC. The regression of intracranial disease indicated vemurafenib was able to cross the blood-brain barrier and was efficacious in treating brain metastases in this patient with lung cancer.
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The purpose of this study was to investigate the relationship between the level of tobacco smoking and the clinicopathological features of non-small cell lung cancer (NSCLC) patients, individually for adenocarcinoma (Ad) and squamous cell carcinoma (Sq). ⋯ The never-smokers had a significantly better prognosis than ever-smokers among Ad patients, whereas the light-smokers had a significantly worse prognosis than heavy smokers among Sq patients. There may be factors other than tobacco carcinogens that influence the development of Sq in never and/or light smokers.
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Review Meta Analysis
Afatinib in the treatment of EGFR mutation-positive NSCLC--a network meta-analysis.
Epidermal growth factor receptor (EGFR) mutation-positive non-small cell lung cancer (NSCLC) is a specific lung cancer subtype characterized by sensitivity to treatment with EGFR tyrosine kinase inhibitors (TKIs). Two reversible EGFR TKIs (gefitinib, erlotinib) and the irreversible ErbB family blocker afatinib are currently approved for treatment of EGFR mutation-positive NSCLC, but no head-to-head trials have been reported to date. We aimed to assess the relative efficacy of the three drugs by conducting a network meta-analysis (NMA). ⋯ In the absence of direct head-to-head trial data comparing efficacy between the three EGFR TKIs, our analysis suggests that afatinib is a viable treatment alternative to erlotinib or gefitinib in terms of PFS. A direct trial-based comparison of the efficacy of these agents is warranted to clarify their relative benefits.