Artificial Intelligence Can Reliably Diagnosis Specific Types of Lung Cancer

MedicalResearch.com Interview with:

Aristotelis Tsirigos, Ph.D. Associate Professor of Pathology Director, Applied Bioinformatics Laboratories New York University School of Medicine

Dr. Tsirigos

Aristotelis Tsirigos, Ph.D.
Associate Professor of Pathology
Director, Applied Bioinformatics Laboratories
New York University School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Pathologists routinely examine slides made from tumor samples to diagnose cancer types. We studied whether an AI algorithm can achieve the same task with high accuracy. Indeed, we show that such an algorithm can achieve an accuracy of ~97%, slightly better than individual pathologists.

In addition, we demonstrated that AI can be used to predict genes that are mutated in these tumors, a task that pathologists cannot do. Although the accuracy for some genes is as high as 86%, there is still room for improvement. This will come from collecting more training data and also from improvement in the annotations of the slides by expert pathologists.  

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How Common is Overdiagnosis of Lung Cancer with Low Dose CT Screening?

MedicalResearch.com Interview with:
“CT Scan” by frankieleon is licensed under CC BY 2.0Dr. Bruno Heleno MD PhD

Assistant Professor | Professor Auxiliar
NOVA Medical School | Faculdade de Ciências Médicas
Universidade Nova da Lisboa 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The Danish Lung Cancer Screening Trial (DLCST) is a randomized controlled trial which enrolled 4104 participants (aged 50-70 years; current or former smokers; ≥20 pack years; former smokers must have quit <10 years before enrollment) to either 5 rounds of screening for lung cancer with low-dose CT-scans or to no screening.

After 10 years of follow-up, there was a 2.10 percentage points lung cancer absolute risk increase with low-dose CT-screening. Overdiagnosis, i.e. the detection of cancer that would not progress to symptoms or death, was estimated at 67.2% of the screen-detected cancers.

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Minority-Based Lung Cancer Screening Found High Rates of Cancer

MedicalResearch.com Interview with:

Mary Pasquinelli, MS, APRN Doctor of Nursing Practice Candidate (2018) Lung Cancer Screening Program Director Advanced Practice Nurse, Pulmonary and Medical Oncology Department of Medicine Chicago, Il 60612

Mary Pasquinelli

Mary Pasquinelli, MS, APRN
Doctor of Nursing Practice Candidate (2018)
Lung Cancer Screening Program Director
Advanced Practice Nurse
Pulmonary and Medical Oncology
Department of Medicine
Chicago, Il 60612 

MedicalResearch.com: What is the background for this study? What are the main findings?

 Response: We performed a retrospective analysis of our lung cancer-screening program.

Our program included individuals from a predominantly minority inner city population including Federal Qualified Health Centers.

The main findings were that our screening program found a higher rate of positive screens and lung cancer in our initial screens than that compared to the National Lung Screening Trial.

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Coming Soon – More Lung than Breast Cancer in Women

MedicalResearch.com Interview with:
“smoking” by shira gal is licensed under CC BY 2.0Dr. Jose M. Martín-Sánchez
IP of this study
Grupo de Evaluación de Determinantes de Salud y Políticas Sanitarias
Universitat Internacional de Catalunya
Sant Cugat del Vallès
Spain


MedicalResearch.com: What is the background for this study?

Response: Breast cancer has been the first cause of death from cancer among women. However, the mortality rates of breast cancer have been decreased in the last years. This downward trend can be attributed to treatment and screening programs. On the other hand, smoking has been increased among women during the last century and the main cause of lung cancer is smoking behavior. Based on this data, we hypothesized that the lung cancer mortality could outweigh the breast cancer mortality in the next years and the main purpose of this study was to project the mortality rates of lung cancer and breast cancer in women worldwide, based in previous data and using Bayesian methods, in order to identify potential strategies of public health to reduce the impact of lung cancer. Moreover, previous works described the lung and breast cancer mortality or projected one of them in a single country. For example, we have published two articles with data of Spain one of them with the description of lung cancer mortality trend in men and women and other with the projection of lung and breast cancer among women. The information of this study provides an overall point view around the word of this problem of public health.

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Lung Cancer Risk Drops Almost 40% Within 5 Years of Quitting Smoking

MedicalResearch.com Interview with:
Hilary Tindle, MD, MPH

“Used Cigarette Butts” by Indi Samarajiva is licensed under CC BY 2.0Associate Professor of Medicine and theWilliam Anderson Spickard, Jr., MD Chair in Medicine
Founding Director of ViTAL, the Vanderbilt Center for Tobacco, Addiction and Lifestyle
Division of Internal Medicine & Public Health and Vanderbilt Ingram Cancer Center (VICC)

MedicalResearch.com: What is the background for this study?

Response: Lung cancer is the most common cause of cancer related death for men and women ,and cigarette smoking is responsible for almost 9 of our every 10 lung cancers in the US. Lung cancer screening can reduce the risk of death from lung cancer by about 20% or even higher if screening is combined with quitting smoking.

We know that lung cancer risk is lower in people who quit smoking, compared to those who continue to smoke, but it was not clear how quickly this risk drops after quitting. Most prior studies on this subject assessed smoking status (current, former, never) at relatively few timepoints. By asking about smoking more frequently (every couple of years), we can get a better picture of a person’s true exposure to cigarette smoke and take into account periods where someone may have smoked more, less, or even quit altogether. Some people may start and stop multiple times over their lifetime.

Another question was exactly how long the risk of lung cancer stays elevated after quitting smoking. Again, by asking about smoking multiple times over someone’s lifetime, we get a better picture of how long they were truly smoke free.

MedicalResearch.com: What are the main findings?

  •  We analyzed data from the Framingham Heart Study Original and Offspring cohorts (almost 9000 people total) to study the risk of lung cancer after quitting smoking, and to determine if the risk of lung cancer ever goes back to that of someone who has never smoked (termed a “never smoker”). Study participants were followed for a median of almost 30 years, and were asked about smoking every 2-4 years.
  • We focused on heavier smokers, who had smoked more than 21 pack-years. (A “pack-year” is a way to quantify how much someone has been exposed to cigarette smoke. Pack years are the product of years of smoking times the amount smoked. For example, someone who smoked 1 pack of cigarettes per day for 20 years would have 20 pack years. Another person who smoked 2 packs per day for 10 years would also have 20 pack years.) As expected, the risks of lung cancer were highest among current smokers, followed by former smokers, followed by never smokers.
  • Compared to never smokers, former smokers had higher lung cancer risk: about 12 times higher within 10 years since quitting (YSQ), about 7 times higher from 10-15 YSQ, about 6 times higher from 15-25 YSQ, and over 3 times higher even after 25 YSQ.
  • Compared to current smokers, former smokers had lower lung cancer risk: 39% lower within 5 YSQ, which continued to drop over time.
  • Among all former smokers, about 4 in 10 lung cancers occurred after more than 15 YSQ, which is beyond the window of eligibility for current screening guidelines.

In the future, after additional study, guidelines may decide to extend the window of lung cancer screening beyond 15 YSQ. However, additional modeling studies are likely needed before making that determination. For now, anyone who qualifies for lung cancer screening based on age, pack years, and years since quitting, should have it.

MedicalResearch.com: What should readers take away from your report?

Response: If you currently smoke cigarettes, now is a great time to quit. The results of this study show that lung cancer risk drops almost 40% within 5 years since quitting, compared to people who continue to smoke.

If you already quit smoking, congratulations on taking that major step.

Whether you currently smoke, or if you quit smoking within the last 15 years, talk to your doctor to see if you are eligible for lung cancer screening. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

 Response: We would like to see additional research from different groups to determine if the current lung cancer screening guidelines should potentially be altered to include those who quit more than 15 years ago. Again, this is a decision may require additional study, including an understanding of why some former smokers remain at elevated risk of lung cancer. Perhaps studying genetic variation could shed some light on this question.  

MedicalResearch.com: Is there anything else you would like to add?

Response: Yes, we would like to thank the NIH and particularly the NHLBI for supporting the Framingham Heart Study (FHS) and studies like it, and also to all the participants in the FHS for giving their information for decades, to the benefit of all Americans and the world. We consider studies such as the FHS to be “national treasures” in that they provide critical information for doctors and researchers to improve healthcare. The FHS is most often thought of as a cardiovascular dataset, but it also captures information on cancer. In the case of the current study, we re-analyzed information that was already collected, which is one of the efficient and low cost methods of conducting research. 

Citation:

 Hilary A Tindle, Meredith Stevenson Duncan, Robert A Greevy, Ramachandran S Vasan, Suman Kundu, Pierre P Massion, Matthew S Freiberg. Lifetime Smoking History and Risk of Lung Cancer: Results From the Framingham Heart Study. JNCI: Journal of the National Cancer Institute, 2018; DOI: 10.1093/jnci/djy041

 

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More Young Women Than Men Now Get Lung Cancer

MedicalResearch.com Interview with:
“Woman smoking” by Pedro Ribeiro Simões is licensed under CC BY 2.0Ahmedin Jemal, DVM, PHD
Scientific Vice President, Surveillance & Health Services Rsch
American Cancer Society, Inc.
Atlanta, GA 30303

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Historically, lung cancer rates have been higher in men than women at all ages because of the substantially higher cigarette smoking prevalence in men.

However, cigarette smoking prevalences over the past few decades have become similar between young men and women. Consistent with this pattern, we previously reported the convergence of lung cancer rates between young men and young women. In this paper, we examined the lung cancer incidence rates in young women versus young men in the contemporary cohorts.

We found that the historically higher lung cancer incidence rates in young men than in young women have reversed in whites and Hispanics born since the mid-1960s. However, this emerging incidence patterns were not fully explained by sex difference in smoking prevalence as cigarette smoking prevalences among whites and Hispanics were not higher in young women than young men.

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Which Cancers Cost The Most To Treat?

MedicalResearch.com Interview with:

Matthew P. Banegas, PhD, MPH Center for Health Research Kaiser Permanente

Dr. Banegas

Matthew P. Banegas, PhD, MPH
Center for Health Research
Kaiser Permanente

MedicalResearch.com: What is the background for this study?

Response: Despite a large body of research on cancer care costs, we observed a significant evidence gap. Namely, while about one-half of cancer diagnoses in the U.S. occur among people under age 65, it can be difficult to find good data on the costs of care for this population. That’s because most of the current literature on cancer care costs is based on SEER Medicare data, which are limited to Medicare fee-for-service beneficiaries.

At a time of rising costs and an ever-increasing number of new therapies, we felt it was important to improve our understanding of cancer costs for U.S. adults of all ages. We examined medical care costs for the four most common types of cancer in the United States: breast, colorectal, lung, and prostate cancer.

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US vs England: Where Do Lung Cancer Patients Live Longer?

MedicalResearch.com Interview with:

CT scan showing a cancerous tumor in the left lung Wikipedia image

CT scan showing a cancerous tumor in the left lung
Wikipedia image

Cary P. Gross, MD
Department of Internal Medicine
Section of General Internal Medicine
Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center
National Clinician Scholars Program
Yale School of Medicine New Haven, CT 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In both the US and England, lung cancer is a leading cause of cancer deaths, and there is particular concern about access to high quality care among older persons in both countries. However, little is known about how the two nations compare regarding lung cancer care.

We studied over 170,000 patients with lung cancer, and found that patients in the US were more likely to be diagnosed at an early stage (25% in US vs 15% of patients in England).  Our international team also found that patients in the US were more likely to receive treatment for their cancer, and were more likely to survive.

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Combination Inhibitors May Attack More Lung Cancers

MedicalResearch.com Interview with:

Nada Kalaany, PhD Harvard Medical School Boston Children's Hospital  Boston, MA 02115

Dr. Kalaany

Nada Kalaany, PhD
Harvard Medical School
Boston Children’s Hospital
Boston, MA 02115

MedicalResearch.com: What is the background for this study?

Response: ​ Non-small cell lung cancer (NSCLC) is the predominant form of lung cancer and the leading cause of cancer death in the US and worldwide. Over a quarter of NSCLC harbors activating mutations in the KRAS oncogene, which despite decades of attempts, has proven to be very difficult to target.

KRAS has previously been demonstrated to directly bind to and activate the pro-proliferative kinase PI3K, which is typically activated by insulin/insulin-like growth factor1 (IGF1) signaling. KRAS-PI3K binding is required for KRAS-driven lung cancer formation and progression. However, whether this interaction is sufficient for lung tumor formation and whether additional input is required from insulin/IGF1 signaling, has remained largely controversial.

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Combination EGFR + TNF Inhibition May Knock Out Most Lung Cancers

MedicalResearch.com Interview with:

Amyn Habib, M.D. Associate Professor, Neurology & Neurotherapeutics UT Southwestern Medical Center

Dr. Amyn Habib

Amyn Habib, M.D.
Associate Professor, Neurology & Neurotherapeutics
UT Southwestern Medical Center

MedicalResearch.com: What is the background for this study?

Response: The epidermal growth factor receptor (EGFR) is expressed in most lung cancers and could play an important role in driving the growth of lung cancer.  Drugs are available that can block the activity of the EGFR. However, EGFR inhibitors are successful in only a small subset of lung cancers that have a mutant form of the EGFR, and do not work in the majority of lung cancers that have the normal form of the EGFR.  Continue reading

FDG-PET Scans of Lung Nodules Should Be Interpreted With Caution

MedicalResearch.com Interview with:

PET Scan Vanderbilt Health

PET Scan Vanderbilt Health

Amelia W. Maiga, MD MPH
Vanderbilt General Surgery Resident
VA Quality Scholar, TVHS

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Positron emission tomography (PET) combined with fludeoxyglucose F18 (FDG) is currently recommended for the noninvasive diagnosis of lung nodules suspicious for lung cancer. Our investigation adds to growing evidence that FDG-PET scans should be interpreted with caution in the diagnosis of lung cancer. Misdiagnosis of lung lesions driven by FDG-PET avidity can lead to unnecessary tests and surgeries for patients, along with potentially additional complications and mortality.

To estimate FDG-PET diagnostic accuracy, we conducted a multi-center retrospective cohort study. The seven cohorts originating from Tennessee, Arizona, Massachusetts and Virginia together comprised 1188 nodules, 81 percent of which were malignant. Smaller nodules were missed by FDG-PET imaging. Surprisingly, negative PET scans were also not reliable indicators of the absence of disease, especially in patients with smaller nodules or who are known to have a high probability of lung cancer prior to the FDG-PET test.

Our study supports a previous meta-analyses that found FDG-PET to be less reliable in regions of the country where fungal lung diseases are endemic. The most common fungal lung diseases in the United States are histoplasmosis, coccidioidomycosis and blastomycosis. All three fungi reside in soils. Histoplasmosis and blastomycosis are common across much of the Mississippi, Ohio and Missouri river valleys and coccidioidomycosis is prevalent in the southwestern U.S. These infections generate inflamed nodules in the lungs (granulomas), which can be mistaken for cancerous lesions by imaging.

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REVEL Trial of Ramucirumab Plus Docetaxel For Fast Progressing NSC Lung Cancer Demonstrates Promise

MedicalResearch.com Interview with:

Martin Reck, MD, PhD Head of the Department of Thoracic Oncology Head of the Clinical Trial Department Department of Thoracic Oncology at the Lung Clinic Grosshansdorf

Dr. Reck

Martin Reck, MD, PhD
Head of the Department of Thoracic Oncology
Head of the Clinical Trial Department
Department of Thoracic Oncology at the Lung Clinic
Grosshansdorf 


MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There is an urgent medical need to improve outcomes in pretreated patients with advanced non-small cell lung cancer (NSCLC), in particular those with fast progressing tumors.

The Phase 3 REVEL study, which included patients with nonsquamous and squamous forms of NSCLC, demonstrated improved overall survival (OS), progression‐free survival (PFS), and objective response rate (ORR) – independent of histology. This analysis confirmed efficacy – with improvement of ORR, PFS and OS – in poor prognosis patients with fast progressing tumors (after 9, 12 or 18 weeks) without additional toxicity or impact on Quality of Life compared to the intent-to-treat (ITT) population results of REVEL.

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Circulating Tumor Cells Linked To Poor Prognosis in Early Stage Lung Cancers

MedicalResearch.com Interview with:

Dr. Sunitha Nagrath, PhD Associate Professor, Chemical Engineering University of Michigan

Dr. Nagrath

Dr. Sunitha Nagrath, PhD
Associate Professor, Chemical Engineering
University of Michigan 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Lung cancer is leading cause of cancer-related mortality, and detecting it in earlier stages is crucial to improving outcomes for patients. The motivation for this study lies in understanding the phenotypic and genetic make-up of lung cancer during its early stages, using a blood sample (blood biopsy). We have done this by employing a microfluidic device to capture cancer cells circulating in the blood that is obtained from the peripheral veins and the pulmonary vein (a vein next to the tumor itself) from patients with early stage lung cancers. The idea behind using blood from the pulmonary vein was to obtain a richer yield of these circulating tumor cells, which are rare in the blood.

Through this study, we found that the pulmonary vein does yield a much higher quantity of circulating tumor cells, and also often harbors these cells in large clusters. We further went on to study the significance of these clusters, and found that these clusters indicated aggressive traits such as resistance to treatment, and could also potentially suggest poorer patient outcomes at long term.

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Lymph Node Staging of Potentially Curable Lung Cancer Needs Improvement

MedicalResearch.com Interview with:

Raymond U. Osarogiagbon, MBBS, FACP Translational Lung Cancer Research Multidisciplinary Thoracic Oncology Program Baptist Centers for Cancer Care Memphis, TN

Dr. Osarogiagbon

Raymond U. Osarogiagbon, MBBS, FACP
Translational Lung Cancer Research
Multidisciplinary Thoracic Oncology Program
Baptist Centers for Cancer Care
Memphis, TN 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Most long-term survivors of lung cancer are among the patients who were fortunate enough to be identified early enough to undergo curative-intent surgery. In the US, 60,000 individuals undergo curative-intent surgery for lung cancer every year. This number is likely to increase over the next few years as lung cancer screening becomes more widely adopted. Unfortunately, fewer than 50% of patients who undergo curative-intent surgery actually survive up to 5 years.

We show that the quality of surgery, especially the quality of pathologic nodal staging is a powerful driver of survival differences between groups of patients. In general, pathologic nodal staging (important as it is stratifying patients into risk groups so those at high risk can be offered additional treatments to increase the chances of cure while those at truly low risk can be left alone without exposure to cost and side-effects of additional treatments) is very poorly done. We show how the percentage of patients whose pathologic staging met sequentially more stringently-define thoroughness of staging metrics falls off sharply, while the survival sequentially increases.

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Radiation Therapy Plus Checkpoint Inhibitors Did Not Increase Adverse Events in Metastatic Lung Cancer

MedicalResearch.com Interview with:

Florence K Keane MD Resident, Radiation Oncology Harvard Radiation Oncology Program Boston, Massachusetts

Dr. Keane

Florence K Keane MD
Resident, Radiation Oncology
Harvard Radiation Oncology Program
Boston, Massachusetts

MedicalResearch.com: What is the background for this study?

Response: Checkpoint inhibitors (CPIs) have recently transformed the management of patients with metastatic lung cancer, demonstrating significant improvements in overall and progression-free survival in both the first-line setting in patients with increased expression of PD-L1 (≥50%) and in patients with previously treated NSCLC who have progressed on chemotherapy. CPIs are also moving into the treatment of patients with localized lung cancer, with the recently published PACIFIC trial demonstrating a significant improvement in progression-free survival in patients with inoperable stage III NSCLC treated with adjuvant durvalumab after definitive chemoradiotherapy.

However, CPIs are associated with unique toxicities as compared to cytotoxic chemotherapy, including pulmonary, endocrine, neurologic, gastrointestinal, and dermatologic adverse events, which may be fatal in some cases. The risk of autoimmune pneumonitis with checkpoint inhibitors is estimated to be on the order of 5%. Many patients with lung cancer will require radiotherapy for palliation of symptoms. Thoracic radiotherapy (TRT) is also a risk factor for pneumonitis, with a dose- and volume-dependent impact on risk. However, it is unknown whether treatment with CPIs and TRT is associated with increased risk of toxicity.

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High Doses of B Vitamins Linked to INCREASED Lung Cancer in Male Smokers

MedicalResearch.com Interview with:

Theodore M. Brasky, PhD Research Assistant Professor The Ohio State University – James Comprehensive Cancer Center Columbus, OH 43201

Dr. Brasky

Theodore M. Brasky, PhD
Research Assistant Professor
The Ohio State University – James Comprehensive Cancer Center
Columbus, OH 43201

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Prior literature has been suggestive of both a protective and harmful effect of certain B vitamins on lung cancer risk. We wanted to examine the association of intakes of vitamins B6, folic acid (B9), and B12 from supplements –which are typically taken at very high doses– and lung cancer risk in a large, prospective study of 77,000 men and women living in Washington State. The study is unique as it was designed specifically to examine associations of dietary supplements with cancer occurrence. We found that men who took high doses of vitamin B6 and B12 from individual supplements over a long period of time (meaning, doses much higher than the US RDA and much greater than what one would receive from taking a multivitamin over the long term) were at nearly 2-fold increased risk of lung cancer compared to men who did not have B6 or B12 intake from any supplemental source. This finding of increased risk appeared to be specific to men who were current smokers. Among them, long term high-dose supplementation was associated with 3-4 fold increases in lung cancer risk. We observed no increased risk for any of the supplements – B6, B12, or folic acid – with lung cancer risk in women or women who smoked.

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Small Cell Lung Cancers Form Chemotherapy-Resistant Circulating Tumor Spheres

MedicalResearch.com Interview with:

Prof. Gerhard Hamilton Department of Obstetrics and Gynecology Medical University of Vienna 

Prof. Hamilton

Prof. Gerhard Hamilton
Department of Obstetrics and Gynecology
Medical University of Vienna

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Small cell lung cancer (SCLC) is a highly aggressive tumor (15 % of all lung cancers) mainly of patients with high tobacco consumption which shows an extremely poor survival (< 5% 2-year survival rate). Unfortunately the
low survival rates of advanced SCLC cases has not improved significantly during the last decades, with platinum drugs/etoposide and topotecan employed for first- and second-line chemotherapy, respectively. All kinds of new chemotherapeutics, targeted drugs and immunotherapies either failed or resulted in prolongation of survival of several months at best. SCLC responds well to first-line therapy but relapses within a short time as chemoradioresistant tumor. The failure of hundreds of registered studies seem to be linked to the lack of knowledge of the mechanism of resistance of SCLCs and proper ways to reverse the refractoriness.

Small cell lung cancer is distinguished by excessive numbers of circulating tumor cells (CTCs) in advanced stages. CTCs contain the founder of metastasis and seem to constitute a highly chemoresistant cell population. Thus, we ware able to establish a panel of permanent CTC lines in vitro for the first time (8 SCLC lines so far from blood samples). Although CTCs were considered to be chemoresistant we detected that they are chemosensitive in vitro in form of single cell suspensions. However, all CTC lines developed spontaneously into large multicellular aggregates, termed tumorospheres, which grow up to 1-2 mm in size and exhibit high chemoradioresistance due to limited drug perfusion as well as content of quiescent and hypoxic cells. Resistance to irradiation seems to be caused by lack of oxygen, such limiting the generation of oxygen radicals. High resistance mediated by the occurrence of tumorospheres easily explains the failure of a large number of drugs – if one is not able to achieve a sufficient concentration of a drug in cancer cells and the cells are quiescent, the respective compounds will not be able to destroy the target cells, regardless of their chemical nature.

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Study Reports Hair Repigmentation During Immunotherapy For Lung Cancer

MedicalResearch.com Interview with:
Dr. Noelia Rivera MD

Dermatologist
Hospital Universitari Germans Trias i Pujol, Badalona
Universitat Autònoma de Barcelona

MedicalResearch.com: What is the background for this study?

Response: In the last few years some new therapies targeting immune checkpoints have been developed. The programmed death receptor-1 (PD-1) are immune checkpoints that prevent the immune system to act against own tissues. By blocking these mediators it is possible to prevent tumors to escape from the immune system.

About half of the patients receiving these therapies will develop mild to moderate cutaneous adverse events. In the pre-authorization studies for malignant melanoma these include rash, vitiligo, and pruritus. “Rash” has commonly been reported as an adverse event in many oncologic trials evaluating the drugs, without providing further information about the clinical or histological details. Lately, lichenoid eruptions associated to these therapies have been reported and it suggests that an important percentage of these reactions present lichenoid histological features.

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Holes in Cigarette Filters Linked To Increase in Lung Adenocarcinomas

MedicalResearch.com Interview with:
Peter G. Shields, M.D.
Deputy Director, Comprehensive Cancer Center
James Cancer Hospital
Professor, College of Medicine
Julius F. Stone Chair in Cancer Research
The Ohio State University Columbus, OH

MedicalResearch.com: What do we know about the health effects of cigarette filters? 
Response:  The issue is that the design of the filters makes a cigarette even more dangerous, which can be regulated by the FDA. The issue is not about having a filter, but how they are made. And now we are changing the dialogue to the design of virtually all cigarettes. The holes on the filter are likely one reason the cigarettes of today are more dangerous.

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GeneStrat Test Provides Quick Analysis of Genetic Lung Cancer Mutations

MedicalResearch.com Interview with:
Hestia Mellert, PhD

Director, Molecular Product Development
Biodesix: Making Medicine Personal
Boulder, CO

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Identifying specific genetic mutations in non-small cell lung cancer patients helps clinicians choose the best treatment options; specific therapies that target mutations can improve patient outcomes, including reducing the risk of death or lessening the severity of the disease. However, nearly 80% of cancer patients do not have genetic mutation results available at initial oncology consultation; up to 25% of patients begin treatment before receiving their results. These factors hinder physicians’ ability to pursue optimal treatment strategies.

This study found that a blood-based assay, the GeneStrat test, provides results in 72 hours for 94% of patients, which expands testing options, and supports faster treatment decisions by physicians.

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Effect of Centralization on Health Disparities in Lung and Bladder Cancer Surgery

MedicalResearch.com Interview with:

Emanuela Taioli MD PhD Professor, Population Health Science and Policy, and Thoracic Surgery Director, Institute for Translational Epidemiology Director, Center for the Study of Thoracic Diseases Outcome Director, Division of Social Epidemiology Icahn Medical Institute, New York, NY 10029

Dr. Taioli

Emanuela Taioli MD PhD
Professor, Population Health Science and Policy, and Thoracic Surgery
Director, Institute for Translational Epidemiology
Director, Center for the Study of Thoracic Diseases Outcome
Director, Division of Social Epidemiology
Icahn Medical Institute,
New York, NY 10029 

MedicalResearch.com: What is the background for this study?

Response: Extensive literature documenting the relationship between hospital volume and clinical outcomes has resulted in the centralization of cancer care advocating patients to seek cancer surgical procedures at high-volume (HV) hospitals. Lung resection and cystectomy have been specifically recommended for centralization, but improvements in outcomes are not shared equally among racial groups. It has also been reported that black patients more commonly undergo surgery at low-volume and lower-quality hospitals, despite living in close proximity to higher quality hospitals.

We investigated the effects of centralization on HV hospital utilization and surgical outcomes for lung (n = 28,047 White; n = 2,638 Black) and bladder (n = 7,593 White; n = 567 Black) cancer patients over a 15 year time span (1997-2011) in New York State. We hypothesized that centralization has improved utilization of HV hospitals and outcomes for both black and white patients, but significant disparities remain between black and white patients.

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Cost Effectiveness of Lung Cancer Screening Requires Careful Patient Selection

MedicalResearch.com Interview with:
Kevin ten Haaf MSc

Scientific researcher, Public Health
Erasmus Medical Center
Rotterdam

MedicalResearch.com: What is the background for this study?

Response: Lung cancer screening is currently recommended in the United States, for persons aged 55 through 80 who smoked at least 30 pack-years (the average number of cigarettes smoked per day multiplied by the number of years the person has smoked) and who currently smoke or have quit within the last 15 years. Other countries, such as Canada, are investigating the feasibility of implementing lung cancer screening policies.

However, the cost-effectiveness of lung cancer screening in a population-based setting is uncertain. Concerns have been raised on the feasibility of implementing lung cancer screening policies, especially with regards to the potential costs. In this study, the benefits, harms and costs of implementing lung cancer screening in the province of Ontario, Canada were assessed.

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Annual CT Lung Cancer Screening Among Former Smokers Remains Underutilized

MedicalResearch.com Interview with:

Ahmedin Jemal, DVM, PHD Vice President, Surveillance and Health Services Research American Cancer Society, Inc. 250 Williams St. Atlanta, GA 30303

Dr. Ahmedin Jemal

Ahmedin Jemal, DVM, PHD
Vice President, Surveillance and Health Services Research
American Cancer Society, Inc.
250 Williams St.
Atlanta, GA 30303

MedicalResearch.com: What is the background for this study?

Response: In December 2013, the United States Preventive Services Task Force (USPSTF) recommended annual screening for lung cancer with low dose computed tomography (LDCT) for current or former heavy smokers who quit within the past 15 years.

A previous study estimated that only 2-4% of heavy smokers received LDCT for lung cancer screening in 2010 in the United States. We sought to determine whether lung cancer screening among high risk smokers increased in 2015, following the USPSTF recommendation in 2013.

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Comprehensive Lung Cancer Screening Is Complex Task With Many False Positives

MedicalResearch.com Interview with:

Dr-Linda-Kinsinger.jpg

Dr. Linda Kinsinger

Linda Kinsinger, MD, MPH
National Center for Health Promotion and Disease Prevention
U.S. Department of Veterans Affairs
NW Washington DC 20420

MedicalResearch.com: What is the background for this study? 

Response: The U.S. Preventive Services Task Force recommends annual lung cancer screening with low-dose computed tomography (LDCT) for current and former heavy smokers ages 55 to 80.

However, clinicians have questioned the practical aspects of implementing lung cancer screening. VA provides care for 6.7 million Veterans each year, mostly older men – many of whom are current or former smokers – thus the implementation of a lung cancer screening program for VA patients would require substantial resources. In order to understand the feasibility and implications of this for patients and clinical staff, VA implemented a three-year Lung Cancer Screening Demonstration Project (LCSDP) in eight geographically-diverse VA hospitals. Investigators identified 93,033 primary care patients at eight sites who were assessed on screening criteria, of whom 2,106 patients were screened between July 2013 and June 2015.

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Vandetanib Had Antitumor Activity In RET-rearranged NSC Lung Cancer

MedicalResearch.com Interview with:
Dr Kiyotaka Yoh

Department of Thoracic Oncology
National Cancer Center Hospital East
Kashiwa, Japan

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: LURET is multicenter, single-arm, phase II study to evaluate the efficacy and safety of vandetanib as RET inhibitor in patients with advanced RET-rearranged non-small-cell lung cancer (NSCLC). In 2012, RET rearrangements were identified as rare oncogenic alterations for NSCLC.

Among 17 eligible patients included in primary analysis, the objective response rate was 53% (95% CI 28–77), which met the primary endpoint. At the data cutoff, median progression-free survival was 4.7 months (95% CI 2.8–8.5). Overall, vandetanib was tolerated, with an adverse event profile similar to those seen in previous large population studies of vandetanib in patients with unselected NSCLC.

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