Lung cancer screening and shared decision making in cancer survivors: the long and winding road

Rivera, M. Patricia; Henderson, Louise M.

doi:10.21037/tlcr.2018.12.14

Cited by 8 publications

(4 citation statements)

References 33 publications

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“…Among all cancer types, lung cancer is still the leading cause of cancer-related death (1,2). The main drug treatments for advanced non-small cell lung cancer (NSCLC) include chemotherapy, targeted therapy and immunotherapy.…”

Section: Introductionmentioning

confidence: 99%

Tumor genomics and response to chemotherapy in advanced non-small cell lung cancer with exon 20 insertion epidermal growth factor receptor mutations

Wang¹,

Li²,

Zhou³

et al. 2020

Ann Transl Med

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Background: To characterize the effects of mutation subtypes and concomitant pathogenic mutations on progression-free survival (PFS) and overall survival (OS) in advanced non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) exon 20 insertion (ex20ins) mutations treated with chemotherapy.Methods: We retrospectively found that patients who underwent genomic analysis from January 2017 to December 2019, and 101 patients with advanced EGFR ex20ins NSCLC were found. Binary logistic regression and Cox regression were used to determine how EGFR ex20ins mutation subtypes and concomitant mutations are associated with PFS and OS.Results: A total of 8,348 patients were screened and 101 advanced EGFR ex20ins NSCLC patients were detected. Fifty-five patients who received chemotherapy (n=49) or TKIs (n=6) as first-line treatment were recorded for PFS and OS. PFS and OS were significantly longer in the platinum-based chemotherapy group (median PFS: 7.6 versus 5.6 months; P=0.001; median OS: 19.9 versus 7.4 months; P=0.027) than in the TKI group. Common mutations include Ala767_Val769dupAlaSerVal (A767_V769dupASV), Ser768_ Asp770dupSerValAsp (S768_D770dupSVD) and Ala763_Tyr764insPheGlnGluAla (A763_Y764insFQEA).On binary logistic regression, common mutations (OR =17.04, 95% CI: 1.39-209.56; P=0.027) and number of concomitant mutations ≤1 (OR =34.67, 95% CI: 2.02-595.48; P=0.015) is significantly associated with durable clinical benefit (DCB). On multivariable analysis, common mutations (HR =0.26, 95% CI: 0.0.10-0.63; P=0.003) and the number of concomitant mutations ≤1 (HR =0.33, 95% CI: 0.15-0.73; P=0.006) were significantly associated with longer PFS.Conclusions: Common mutations and the number of concomitant mutations ≤1 correlate with a biomarker that predicts benefit from chemotherapy and confers excellent prognosis for advanced patients with advanced EGFR ex20ins NSCLC. Patients with common mutations and with only one concomitant mutation had the greatest PFS and patients with uncommon mutations, and with over one concomitant mutation had the worst prognosis.

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Section: Introductionmentioning

confidence: 99%

Tumor genomics and response to chemotherapy in advanced non-small cell lung cancer with exon 20 insertion epidermal growth factor receptor mutations

Wang¹,

Li²,

Zhou³

et al. 2020

Ann Transl Med

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“…However, some providers suggested that cancer specialists were better equipped to discuss lung cancer screening with the patients because they would have a better understanding of the survivor’s cancer history and recent health ( 18 ). Several articles have proposed including lung cancer screening in formal head and neck cancer survivorship clinics ( 23 , 24 ). The NCCN and American Society of clinical oncology recommend lung cancer screening for head and neck cancer survivors when clinically indicated.…”

Section: Discussionmentioning

confidence: 99%

Improving lung cancer screening rates among patients with head and neck cancer in a radiation oncology clinic

Soto¹,

Nesbit²,

Ramsey³

et al. 2022

J Thorac Dis

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Background: The United States Preventive Services Task Force (USPSTF) recommends lung cancer screening via annual low dose computed tomography (LDCT) for high risk patients. Despite the strong evidence of a mortality benefit from several randomized clinical trials, rates of lung cancer screening remain low. We plan to assess how screening guidelines are implemented in a radiation oncology clinic for patients with head and neck cancer.Methods: A single institution, retrospective chart review was used to identify patients with head and neck cancer seen in a radiation oncology clinic who were potentially eligible for lung cancer screening under the current USPSTF guidelines. Patients who were potentially screening-eligible were enrolled in a phone survey to assess their knowledge about lung cancer screening and willingness to be screened.Results: Of the 184 patients with head and neck cancer seen in the clinic, 8 (4%) patients were eligible for lung cancer screening under the previous USPSTF recommendations, including 1 (0.5%) patient already being screened. One patient (0.5%) became eligible under the expanded guidelines. All 184 patients had smoking history documented. Of the 87 current or former smokers, there were 24 (28%) who did not have pack-years documented; of the 82 former smokers, there were 8 (10%) who did not have quit date documented. Among the 16 phone survey participants (response rate: 70%) only 6 (38%) were aware there is a way to screen for lung cancer and 12 (75%) patients would be interested in screening if they are found to be eligible.Conclusions: These findings highlight a potential opportunity to increase rates of lung cancer screening among patients with head and neck cancer by both enhancing provider awareness as well as patient education at the community level.

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“…In order to achieve the early detection of screening lung cancer, it is necessary to take actions in the pre-cancerous and diagnoses in early stages. (11) For high risk population whose smoking pack-years over thirty in the past or at present, blood testing was recommended as the assistance for chest imaging examination with minor trauma instead of continual CT scan (11), (12), (13). CT scan showed a low specificity for lung cancer screening.…”

Section: Discussionmentioning

confidence: 99%

The utility of six serum tumor markers in early detection of lung cancer

Jiang

et al. 2019

Preprint

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Background: Lung cancer has become the leading cause of cancer-related death in China. However, most of patients were diagnosed at advanced stage. Thus, novel lung cancer diagnostic tests, which can be used to screen individuals in early stage, are required.Methods: A total of 208 patients involving 161 cases of lung cancer and 47 cases of benign diseases were enrolled. Serum concentration of GTM, CETM, PTM, CTM, ETM and HTM were analyzed by kits according to the manufacturer’s guidelines.Results: The results showed significant difference in serum concentrations of GTM, CETM, PTM, CTM, ETM, and HTM between patients with lung cancer and benign diseases. In addition, when compared with benign diseases, higher levels of those six markers were also observed in patient with SCC and SCLC, but not for ADC. Receiver operating characteristic (ROC) curves were further suggested a high sensitivity and specificity of six markers to identify lung cancer.Conclusion: The serum levels of GTM, CETM, PTM, CTM, ETM and HTM in lung cancer were significantly higher than those of benign diseases. Moreover, these six biomarkers showed a high sensitivity and specificity to identify a patient with malignant. These findings suggested that detection of those six biomarkers in serum might be helpful for differential diagnosis of lung cancer.

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Lung cancer screening and shared decision making in cancer survivors: the long and winding road

Cited by 8 publications

References 33 publications

Tumor genomics and response to chemotherapy in advanced non-small cell lung cancer with exon 20 insertion epidermal growth factor receptor mutations

Tumor genomics and response to chemotherapy in advanced non-small cell lung cancer with exon 20 insertion epidermal growth factor receptor mutations

Improving lung cancer screening rates among patients with head and neck cancer in a radiation oncology clinic

The utility of six serum tumor markers in early detection of lung cancer

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