Lung cancer : journal of the International Association for the Study of Lung Cancer
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Comparative Study Clinical Trial
Single-agent pegylated liposomal doxorubicin (Caelix) in chemotherapy pretreated non-small cell lung cancer patients: a pilot trial.
Polyethylene glycol-coated (pegylated) liposomal doxorubicin (PLD) is a new formulation of doxorubicin with peculiar pharmacokinetic and pharmacodinamic properties, a favorable toxic profile and a demonstrated activity in solid tumors. We tested PLD in locally advanced or metastatic NSCLC patients, progressed after a platinum-based first-line chemotherapy. PLD was administered at the dose of 35 mg/m(2) every 21 days. ⋯ One confirmed partial response was observed (5.8%); five patients (29.4%) had stable disease (including one minor response) and nine (52.9%) had disease progression. Median time to progression was 9.5 weeks, median survival 18.6 weeks. PLD at the doses employed in this study can be safely administered and has shown activity in platinum pretreated NSCLC patients.
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We conducted a computed tomography (CT) screening for lung cancer in a high-risk population. Six hundred and two workers (38-81 years, 97% smokers) with asbestos-related occupational disease were screened using spiral CT and chest radiography. The national cancer registry was checked for possible false negative cases. ⋯ The sensitivity of CT screening was 100%. CT was capable of detecting early lung cancer in asbestos-exposed patients with a lot of confusing pulmonary and pleural pathology. Due to the high number of positive findings attention should be paid to patient compliance and the follow-up protocols and patient selection in future screening programmes.
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The combination of low-dose chemotherapy and thoracic radiotherapy is one of the treatments proposed in an attempt to improve the prognosis of locally advanced non-small cell lung cancer. Chemotherapeutic drugs administered at subtoxic doses act by means of a radiosensitization mechanism. ⋯ However, the optimal dose and timing of such drugs when used concurrently to radiotherapy are unknown. This paper will review the results obtained using new chemotherapeutic drugs as radiosensitizers.
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Among all cancer, lung cancer has the highest rate of mortality in the western world. The persisting grim lung cancer mortality figures argue powerfully for new approaches for controlling this disease such as chemoprevention that has been defined as the use of agents that inhibit or reverse lung carcinogenesis. Carcinogens from cigarette smoke are implicated in about 90% of male and 75-80% of female lung cancer deaths. ⋯ The fact that 85% of heavy smokers will not develop lung cancer points to a variation in individual susceptibility. It also suggests that modulation of susceptibility might be used as a preventive strategy. This review summarizes the outcomes of recent clinical chemoprevention trials and reveals that the chemoprevention approach in lung cancer is still experimental.