Clinical lung cancer
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Clinical lung cancer · Mar 2009
ReviewEmerging data with antiangiogenic therapies in early and advanced non-small-cell lung cancer.
Lung cancer is the leading cause of cancer-related mortality in the United States. Patients treated with adjuvant chemotherapy have a 5-year survival rate of 25% to 70% depending on stage, whereas those with advanced disease have a median survival of approximately 8 months when treated with standard platinum-based therapy. Improvements in our understanding of cancer biology have led to the development of novel agents that more precisely affect the target of interest, allowing for a more rational approach to clinical trial design. ⋯ Studies with bevacizumab in the adjuvant and advanced setting are ongoing in patients with NSCLC. Small-molecule inhibitors targeting the VEGF receptor and the tyrosine kinase receptor have also shown promise when combined with standard chemotherapy, but their role in the treatment of patients with NSCLC remains to be determined. This article reviews clinical trials that have incorporated antiangiogenic agents in the treatment of patients with NSCLC.
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Clinical lung cancer · Mar 2009
Comparative Study Clinical TrialSurgical resection and long-term survival for octogenarians who undergo surgery for non-small-cell lung cancer.
An increasing proportion of newly diagnosed non-small-cell lung cancer (NSCLC) patients are octogenarians. It has been questioned whether older patients benefit from surgical resection of lung cancer to the same extent as younger patients. ⋯ Non-small-cell lung cancer patients < 80 years of age were less likely to undergo potentially curative surgery, but survival for octogenarians who did undergo surgical resection was comparable to younger age groups. Such patients should not be denied potentially curative surgery simply because of age.
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Clinical lung cancer · Nov 2008
An interdisciplinary care approach for integration of palliative care in lung cancer.
Quality of Life (QOL) and symptom concerns are common in lung cancer. This article presents findings from 2 separate pilot studies that utilize an educational model to reduce barriers to pain and fatigue management ("barriers study") and an interdisciplinary palliative care approach to manage QOL concerns for patients with lung cancer ("QOL pilot"). ⋯ Attention to barriers of symptom management, early referral to supportive care services, and coordination of interdisciplinary care are essential to supporting the QOL of patients with lung cancer. The next phase of this research will test QOL/symptom interventions for patients with lung cancer.
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Clinical lung cancer · Jan 2008
ReviewNew options for integrating antiangiogenic therapy and platinum-based first-line chemotherapy for advanced non-small-cell lung cancer.
The essential role of angiogenesis in tumor growth and metastasis is well established. The key mediator of angiogenesis, vascular endothelial growth factor (VEGF), is a rational target for novel therapy. High VEGF levels correlate positively with reduced overall survival (OS) and relapse-free survival. ⋯ Herein, key clinical data from trials of antiangiogenic agents in the first-line treatment of NSCLC are discussed, with a focus on bevacizumab, currently the only approved antiangiogenic agent for the treatment of NSCLC. The optimal integration of these agents into current and future first-line treatment regimens will be discussed, stressing the importance of therapeutic administration until disease progression. The promising activity of antiangiogenic agents in the advanced disease setting, allied with growing understanding of their novel modes of action, holds therapeutic promise for their future application in early-stage disease.