Clinical lung cancer
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Clinical lung cancer · Jan 2008
ReviewIntegrating epidermal growth factor receptor-targeted therapies into platinum-based chemotherapy regimens for newly diagnosed non-small-cell lung cancer.
Cytotoxic chemotherapy treatment for patients with advanced non-small-cell lung cancer (NSCLC) has reached a plateau, but further improvements are expected with integration of targeted therapies. Epidermal growth factor receptor (EGFR)-directed therapies are of particular interest because the EGFR is frequently expressed in tumors and associated with poorer outcome. Thus, blockade of the EGFR should improve outcome. ⋯ In contrast, MoAbs in combination with platinum-based first-line chemotherapy showed promising efficacy in phase II trials. Two phase III trials with chemotherapy with or without cetuximab have been performed in patients with advanced NSCLC. Other EGFR-directed MoAbs and TKIs are in earlier stages of clinical development.
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Novel therapies have been added to the treatment arsenal of physicians treating lung cancer in recent years. Most promising are agents that target the major pathways involved in cancer evolution, mostly proliferation and angiogenesis. Some of these treatments have been shown to synergize with traditional chemotherapy and radiation therapy. ⋯ This can refer not only to molecules that autonomously inhibit several pathways but also to combinations of therapies that, by targeting more than one pathway, act in concert to inhibit the malignant growth. In this review, we present the background and current status of multitargeted treatments in the management of patients with lung cancer, mostly non-small-cell lung cancer (NSCLC). Novel agents in clinical use and important ongoing clinical trials are reviewed.
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Clinical lung cancer · Nov 2007
Pulmonary function tests as a predictor of quantitative and qualitative outcomes after thoracic surgery for lung cancer.
Pulmonary function tests are used to select patients with non-small-cell lung cancer (NSCLC) suitable for thoracic surgery. We studied the impact of pulmonary function tests on both quantitative (morbidity, mortality, and overall survival [OS]) and qualitative (quality of life [QOL]) outcomes of patients undergoing thoracic surgery for NSCLC. ⋯ Pulmonary function tests allow a relatively good prediction of postoperative quantitative outcomes such as postoperative morbidity and mortality as well as OS after thoracic surgery for NSCLC. However, pulmonary function tests remain poorly correlated to postoperative qualitative outcomes, making QOL a separate and essential assessment of the health status of patients with resected NSCLC.
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Clinical lung cancer · Sep 2007
Meta Analysis Comparative StudySafety of irinotecan/cisplatin versus etoposide/cisplatin for patients with extensive-stage small-cell lung cancer: a metaanalysis.
The objective of this study was to evaluate the safety of patients with extensive small-cell lung cancer treated with irinotecan/cisplatin (IP) versus etoposide/cisplatin (EP). ⋯ Current clinical studies might confirm that fewer patients receiving IP experienced grade 3/4 leukopenia, grade 3 anemia, grade 3/4 thrombocytopenia, and grade 3/4 neutropenia, compared with patients receiving EP, but more experienced grade 3 vomiting/nausea and grade 3/4 diarrhea. There was no significant difference between the group receiving IP and the group receiving EP with regard to infection. Although there is convincing evidence to confirm the results mentioned herein, they still need to be confirmed by large-sample, multicenter, randomized, controlled trials.
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Clinical lung cancer · Sep 2007
Randomized Controlled TrialPrognostic factors in stage III non-small-cell lung cancer.
The aim of this study is to present an analysis investigating the association of patient characteristics with overall survival (OS) in individuals with stage III non-small-cell lung cancer (NSCLC). ⋯ This analysis suggests that FEV(1) > 2 L and higher pretreatment Hb values are associated with improved OS in patients with stage III NSCLC. These factors can be useful in predicting for more favorable outcomes in patients with stage III NSCLC and provide additional information when designing future studies.