UC Davis Comprehensive Cancer Center | Jan 18, 2017
“A national study by researchers at UC Davis Comprehensive Cancer Center has found that a significant number of lung cancer patients are not receiving treatment. Based on data between 1998 and 2012 from the National Cancer Database, 21 percent of patients (190,539) with non-small cell lung cancer (NSCLC) received no specific cancer treatment, such as chemotherapy, radiotherapy or surgery. Many of the untreated patients were women, elderly, minorities, low income and uninsured.”
“In this video, Sancy A Leachman, MD, PhD, discusses the latest developments in the prevention and treatment of melanoma the American Academy of Dermatology Annual Meeting.
“ ‘We finally have a full spectrum of prevention, early treatment and late treatment options for melanoma, which is the first time we’ve had this sort of spectrum of possibilities’ Leachman, professor and chair of the Department of Dermatology at Oregon Health and Science University and director of the melanoma program at Knight Cancer Institute, told Healio.com/Dermatology.
“Melanoma is becoming more like childhood leukemia, Leachman said, in that physicians are ‘whittling away at the number of people dying from the disease and simultaneously, in dermatology we have the opportunity to whittle away the number that ever get there.’
“Among new prevention and treatment options, Leachman discussed applying genetics for various testing and identifying which patients are likely to respond to certain diseases.”
“A drug used to treat advanced breast cancer has had what appears to be unprecedented success in prolonging lives in a clinical trial, researchers reported on Sunday.
“Patients who received the drug — Perjeta, from the Swiss drug maker Roche — had a median survival time nearly 16 months longer than those in the control group.
“That is the longest amount of time for a drug used as an initial treatment for metastatic breast cancer, the researchers said, and it may be one of the longest for the treatment of any cancer.
“Most cancer drugs prolong survival in patients with metastatic disease for a few months at most. Metastasis means the cancer has spread to other parts of the body.
“ ‘We’ve never seen anything like this before,’ said Dr. Sandra M. Swain of the MedStar Washington Hospital Center in Washington, the lead author of the study. ‘It’s really unprecedented to have this survival benefit.’ ”
“The average cost to screen high-risk individuals for developing lung cancer with low-dose computed tomography (LDCT) plus the average cost of curative intent treatment, like surgery, is lower than the average cost to treat advanced stage lung cancer, which quite rarely results in a cure.
“The National Lung Cancer Screening Trial (NLST) has previously shown that LDCT screening of people at high-risk for lung cancer reduces lung cancer mortality by 20%, thus many organizations including the United States Preventative Services Task Force (USPSTF) have recommend LDCT screening for these individuals. It is thought that if lung cancer is detected at an early stage with screening that it can be cured and the consequences of this are a significant reduction in lung cancer mortality, as the 5-year survival rate for early-stage disease is 54%, and a reduction in the need for expensive and toxic treatments for advanced late-stage lung cancer, which seldom results in a cure as reflected by a 5-year survival rate of 4%. However, in the US 8.6 million people meet the high-risk criteria, which could equate to a significant screening cost.
“The Pan-Canadian Early Detection Study prospectively examined the costs for the resources used to screen annually, treat (if necessary), and follow for 2 years 2059 participants who had a 2% or greater risk of developing lung over 3 years as determined by a Web-based lung cancer risk prediction tool.”
The gist: A recent research study examined the effects of particularly aggressive treatment for stage IV non-small cell lung cancer (NSCLC). Aggressive treatment can significantly prolong life for some patients, but for other patients it may not. Aggressive treatment can have bad side effects, so the more certain a doctor can be that it’s the right choice, the better. In this study, researchers were able to pinpoint characteristics of a patient that could be used to identify which patients might benefit from aggressive treatment and which patients might be better off with less-aggressive treatment. Further studies are needed to refine these factors.
“A large, international analysis of patients with stage IV non-small cell lung cancer (NSCLC) indicates that a patient’s overall survival (OS) rate can be related to factors including the timing of when metastases develop and lymph node involvement, and that aggressive treatment for “low-risk” patients leads to a five-year OS rate of 47.8 percent, according to research presented today at the American Society for Radiation Oncology’s (ASTRO’s) 56th Annual Meeting.
“When lung cancer has spread from an original tumor to other sites of the body, it is classified as metastatic (Stage IV), and the goal of treatment is to slow the cancer down with chemotherapy or radiation, but these treatments are unable to eradicate the cancer and survival is usually in the range of only a few months.
“However, when there are only a few locations of metastatic lung cancer (called oligo-metastatic), some studies suggest that by removing or eradicating each of those cancer deposits with aggressive treatments such as surgery or high-dose, precise radiation called stereotactic ablative radiotherapy or SABR, the cancer may be controlled for a long period of time…
” ‘Our study finds some stage IV NSCLC patients can achieve long-term survival after aggressive treatments; however, it is important to note that the patients in this study are a very select minority of stage IV patients who are younger, more physically fit, with a lower burden and slower pace of disease than the average stage IV patient,’ said lead study author Allison Ashworth, MD, a radiation oncologist who completed the study as part of her training at the London Health Sciences Centre at Western University, in London, Ontario. ‘We hope our study’s results will help determine which stage IV NSCLC patients are most likely to benefit from aggressive treatments, and equally as important, help identify those patients most likely to fail, thus sparing them from futile and potentially harmful treatments. Our research, however, cannot answer the question of whether the longer survival is due to the treatments or simply because these patients have less aggressive disease. We must await the results of randomized clinical trials to answer this question. In the meantime, it is our hope that our study will help cancer specialists in making treatment decisions and in the development of clinical trials. ‘”
Editor’s note: This story reports the results of an unsuccessful clinical trial – a research study with volunteer patients. The goal of the trial was to test a new drug for stage III non-small cell lung cancer (NSCLC). The drug is called tecemotide. Unfortunately, the drug was not successful in treating the patients.
“Bellevue biotech Oncothyreon Inc. said a test of its lung cancer drug in Japan ‘did not meet its primary endpoint of an improvement in overall survival, and no treatment effect was seen.’
“The study of 178 patients in Japan of patients with Stage III non-small cell lung cancer by Merck of Germany of tecemotide, compared with a placebo, saw no treatment effect.
“Merck “has advised Oncothyreon that it will recommend that the investigational treatment in the study be discontinued and that no recruitment of Japanese patients into the Phase 3 program of tecemotide will take place,” the company said in a filing with the Securities and Exchange Commission.”
“The U.S. Food and Drug Administration today approved a new use for Avastin (bevacizumab) to treat patients with persistent, recurrent or late-stage (metastatic) cervical cancer.
“Cervical cancer grows in the tissues of the lower part of the uterus known as the cervix. It commonly occurs when human papillomaviruses (HPV), a virus that spreads through sexual contact, cause cells to become cancerous. Although there are two licensed vaccines available to prevent many types of HPV that can cause cervical cancer, the National Cancer Institute estimates that 12,360 American women will be diagnosed with cervical cancer and 4,020 will die from the disease in 2014.
“Avastin works by interfering with the blood vessels that fuel the development of cancerous cells. The new indication for cervical cancer is approved for use in combination with chemotherapy drugs paclitaxel and cisplatin or in combination with paclitaxel and topotecan.”
“In a study published in BMJ Supportive and Palliative Care and recently posted on the Surviving Mesothelioma website, British researchers say a spinal procedure called cordotomy may relieve the pain of late-stage pleural mesothelioma. Click here to read the study details.
“Scientists at the North Wales Centre for Primary Care Research at Bangor University in the UK conducted a review of the medical literature to find studies on the safety and effectiveness of cordotomy for mesothelioma pain. They found 9 relevant studies through March of 2012 involving a total of 160 pleural mesothelioma patients.”