User login
Reduced lung cancer mortality with low-dose computed tomographic screening
The National Lung Screening Trial Research Team of the National Cancer Research Institute has recently reported a large-scale trial showing that screening with low-dose computed tomography (CT) is associated with a significant reduction in lung cancer mortality compared with chest radiography in persons at high risk for lung cancer.1,2
From August 2002 through April 2004, 53,454 persons at high risk for lung cancer were enrolled at 33 US medical centers and randomized to three annual screenings with either low-dose CT (n = 26,722) or singleview posteroanterior chest radiography (n = 26,732). Data on lung cancer cases and deaths were collected through the end of December 2009. Eligible participants were aged between 55 and 74 years, had a history of smoking of at least 30 pack-years and, if former smokers, had quit within the past 15 years. Persons with a previous diagnosis of lung cancer, a chest CT within the preceding 18 months, hemoptysis, or unexplained weight loss of more than 15 lb in the preceding year were excluded from the study. Participants in the two groups were well matched for age at randomization, gender distribution (59% men in each group), and proportion of current smokers (48% in each group). The participants in the trial were younger, had a higher level of education, and were more likely to be former smokers than were respondents to a 2002– 2004 US Census survey of tobacco use who matched the age and smoking history criteria of the trial. ...
* For a full PDF of this article, click on the link to the left of this introduction.
The National Lung Screening Trial Research Team of the National Cancer Research Institute has recently reported a large-scale trial showing that screening with low-dose computed tomography (CT) is associated with a significant reduction in lung cancer mortality compared with chest radiography in persons at high risk for lung cancer.1,2
From August 2002 through April 2004, 53,454 persons at high risk for lung cancer were enrolled at 33 US medical centers and randomized to three annual screenings with either low-dose CT (n = 26,722) or singleview posteroanterior chest radiography (n = 26,732). Data on lung cancer cases and deaths were collected through the end of December 2009. Eligible participants were aged between 55 and 74 years, had a history of smoking of at least 30 pack-years and, if former smokers, had quit within the past 15 years. Persons with a previous diagnosis of lung cancer, a chest CT within the preceding 18 months, hemoptysis, or unexplained weight loss of more than 15 lb in the preceding year were excluded from the study. Participants in the two groups were well matched for age at randomization, gender distribution (59% men in each group), and proportion of current smokers (48% in each group). The participants in the trial were younger, had a higher level of education, and were more likely to be former smokers than were respondents to a 2002– 2004 US Census survey of tobacco use who matched the age and smoking history criteria of the trial. ...
* For a full PDF of this article, click on the link to the left of this introduction.
The National Lung Screening Trial Research Team of the National Cancer Research Institute has recently reported a large-scale trial showing that screening with low-dose computed tomography (CT) is associated with a significant reduction in lung cancer mortality compared with chest radiography in persons at high risk for lung cancer.1,2
From August 2002 through April 2004, 53,454 persons at high risk for lung cancer were enrolled at 33 US medical centers and randomized to three annual screenings with either low-dose CT (n = 26,722) or singleview posteroanterior chest radiography (n = 26,732). Data on lung cancer cases and deaths were collected through the end of December 2009. Eligible participants were aged between 55 and 74 years, had a history of smoking of at least 30 pack-years and, if former smokers, had quit within the past 15 years. Persons with a previous diagnosis of lung cancer, a chest CT within the preceding 18 months, hemoptysis, or unexplained weight loss of more than 15 lb in the preceding year were excluded from the study. Participants in the two groups were well matched for age at randomization, gender distribution (59% men in each group), and proportion of current smokers (48% in each group). The participants in the trial were younger, had a higher level of education, and were more likely to be former smokers than were respondents to a 2002– 2004 US Census survey of tobacco use who matched the age and smoking history criteria of the trial. ...
* For a full PDF of this article, click on the link to the left of this introduction.
Personalized medicine: myth to reality
Ever since the International Human GenomeSequencing Consortium unveiled its “working draft” of the human genome sequence in 2000, the scientific community has eagerly discussed and speculated on the potential of genomic medicine. Patients, clinicians, and scientists were—and still are—excited about the possibilities of targeted therapies such as imatinib (Gleevec) for chronic myeloid leukemias and gastrointestinal stromal tumors and trastuzumab (Herceptin) for HER2/neu-positive breast cancer. There has been significant progress in the development of these and other targeted therapies, and they remain part of an intriguing and promising work in progress. However, for patients with lung cancer and melanoma, both of which are highly refractory diseases, the therapeutic choices other than chemotherapy have been limited and the commensurate outcomes discouraging.
In the early 2000s, we were excited about targeted therapies such as gefitinib (Iressa), which blocks epidermal growth factor receptor (EGFR)- tyrosine kinase activity in non-small cell lung cancer (NSCLC), but its clinical benefit was still limited. We have since gained a better understanding of lung cancer as a molecularly heterogeneous disease and have adjusted our approach to its treatment, based on new data showing that all lung cancer patients cannot be treated with the same drug regimen and achieve the same outcomes. With those insights, the implications of targeted therapies came into sharper focus in 2004 with the US Food and Drug Administration (FDA) approval of erlotinib (Tarceva) for the 10%–15% of patients with NSCLC (adenocarcinoma) who have the EGFR gene mutation. At around the same time, scientists identified BRAF gene mutations in about 40%– 60% of patients with melanoma, and the quest for therapies for that disease was redirected to the cellular level as well. ...
* For a PDF of the full article, click in the link to the left of this introduction.
Ever since the International Human GenomeSequencing Consortium unveiled its “working draft” of the human genome sequence in 2000, the scientific community has eagerly discussed and speculated on the potential of genomic medicine. Patients, clinicians, and scientists were—and still are—excited about the possibilities of targeted therapies such as imatinib (Gleevec) for chronic myeloid leukemias and gastrointestinal stromal tumors and trastuzumab (Herceptin) for HER2/neu-positive breast cancer. There has been significant progress in the development of these and other targeted therapies, and they remain part of an intriguing and promising work in progress. However, for patients with lung cancer and melanoma, both of which are highly refractory diseases, the therapeutic choices other than chemotherapy have been limited and the commensurate outcomes discouraging.
In the early 2000s, we were excited about targeted therapies such as gefitinib (Iressa), which blocks epidermal growth factor receptor (EGFR)- tyrosine kinase activity in non-small cell lung cancer (NSCLC), but its clinical benefit was still limited. We have since gained a better understanding of lung cancer as a molecularly heterogeneous disease and have adjusted our approach to its treatment, based on new data showing that all lung cancer patients cannot be treated with the same drug regimen and achieve the same outcomes. With those insights, the implications of targeted therapies came into sharper focus in 2004 with the US Food and Drug Administration (FDA) approval of erlotinib (Tarceva) for the 10%–15% of patients with NSCLC (adenocarcinoma) who have the EGFR gene mutation. At around the same time, scientists identified BRAF gene mutations in about 40%– 60% of patients with melanoma, and the quest for therapies for that disease was redirected to the cellular level as well. ...
* For a PDF of the full article, click in the link to the left of this introduction.
Ever since the International Human GenomeSequencing Consortium unveiled its “working draft” of the human genome sequence in 2000, the scientific community has eagerly discussed and speculated on the potential of genomic medicine. Patients, clinicians, and scientists were—and still are—excited about the possibilities of targeted therapies such as imatinib (Gleevec) for chronic myeloid leukemias and gastrointestinal stromal tumors and trastuzumab (Herceptin) for HER2/neu-positive breast cancer. There has been significant progress in the development of these and other targeted therapies, and they remain part of an intriguing and promising work in progress. However, for patients with lung cancer and melanoma, both of which are highly refractory diseases, the therapeutic choices other than chemotherapy have been limited and the commensurate outcomes discouraging.
In the early 2000s, we were excited about targeted therapies such as gefitinib (Iressa), which blocks epidermal growth factor receptor (EGFR)- tyrosine kinase activity in non-small cell lung cancer (NSCLC), but its clinical benefit was still limited. We have since gained a better understanding of lung cancer as a molecularly heterogeneous disease and have adjusted our approach to its treatment, based on new data showing that all lung cancer patients cannot be treated with the same drug regimen and achieve the same outcomes. With those insights, the implications of targeted therapies came into sharper focus in 2004 with the US Food and Drug Administration (FDA) approval of erlotinib (Tarceva) for the 10%–15% of patients with NSCLC (adenocarcinoma) who have the EGFR gene mutation. At around the same time, scientists identified BRAF gene mutations in about 40%– 60% of patients with melanoma, and the quest for therapies for that disease was redirected to the cellular level as well. ...
* For a PDF of the full article, click in the link to the left of this introduction.