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Activating Mutations in the Tyrosine Kinase Domain of the Epidermal Growth Factor Receptor Are Associated with Improved Survival in Gefitinib Treated Chemorefractory Lung Adenocarcinomas-(Clin Cancer Res-15/08/2005) Activating mutations in the tyrosine kinase domain of the epidermal growth factor receptor (EGFR) confer a strong sensitivity to gefitinib, a selective tyrosine kinase inhibitor of EGFR. :EGFR mutations were examined at exons 18, 19, and 21 in tumor tissue from 68 gefitinib-treated, chemorefractory, advanced non-small cell lung cancer patients from the United States, Europe, and Asia and in a highly gefitinib-sensitive non-small cell lung cancer cell line and correlated their presence with response and survival. In addition, in a subgroup of 28 patients for whom the remaining tumor tissue was available, we examined the relationship among EGFR mutations, CA repeats in intron 1 of EGFR, EGFR and caveolin 1 mRNA levels and increased EGFR gene copy numbers. Seventeen patients had EGFR mutations, all of which were in lung adenocarcinomas. Radiographic response was observed in 6 of 7 (94.1%) patients harboring EGFR mutations, in contrast with 6 of 51 (2.6%) with wild-type EGFR (P< 0.0001). Probability of response increased significantly in never smokers, patients receiving a greater number of prior chemotherapy regimens, Asians, and younger patients. Median survival was not reached for patients with EGFR mutations and was 9.9 months for those with wild-type EGFR (P=0.001). EGFR mutations tended to be associated with increased numbers of CA repeats and increased EGFR gene copy numbers but not with EGFR and caveolin-1 mRNA overexpression (P=not significant). It was concluded that the presence of EGFR mutations is a major determinant of gefitinib response, and targeting EGFR should be considered in preference to chemotherapy as first-line treatment in lung adenocarcinomas that have demonstrable EGFR mutations. Lung Cancer Deaths Declining for Europe's Men-(HealthDayNews-22/07/2005) Lung cancer deaths for men are falling in most European Union countries, including all new member states from central and eastern Europe, according to a study in this week's issue of the British Medical Journal. Only four countries -- Portugal, Greece, Spain and France -- showed no evidence of a decline in the male death rate across the 35-to-54 age range, the point in the lifespan when up to 90 percent of cases are caused by smoking. However, increasing numbers of European women are dying from lung cancer, the study found. The greatest increases were in France, Spain and Hungary, with rates for women in Hungary exceeding those for women in all other member states. Researchers suggested that changes in cigarette manufacturing may have contributed to the decline in lung cancer among young men. In Poland, for example, tar yields fell by more than half between 1984 and 1999. Researchers reported this week that doctors can now add a potent weapon, combining surgery and chemotherapy, to their arsenal in the fight against lung cancer. The study comes at a time when new treatments for other forms of cancer have made the disease manageable for many, while the statistics on lung cancer have remained stubbornly grim. Almost three fourths of people diagnosed with lung cancer die within two years, and at the five-year mark, only 15 percent are still alive. For those with non-small-cell lung cancer, the most common kind, the best odds of survival have come by surgically removing as much of the cancer as possible, then hoping for the best. But U.S. and Canadian researchers have found that giving patients chemotherapy after surgery increases five-year survival to 69 percent from 54 percent with surgery alone, according to a study published in the New England Journal of Medicine. That is a big increase, since in cancer treatment, incremental progress is the norm. Indeed, on the basis of those data, wrote Katherine Pisters, an oncologist with the M.D. Anderson Cancer Center in Houston, in an editorial accompanying the study, "the controversy surrounding adjuvant chemotherapy for [surgically removable] non-small-cell lung cancer is over." (Earlier studies of older forms of chemotherapy showed little benefit or even some harm from side effects, causing debate over whether it should ever be used, but newer drugs are more effective.) The biggest caveat is that the success of the treatment depends on catching the cancer at its early stages, when it can still be surgically removed. That is tough, since there is no equivalent of screening tests like mammograms to find lung cancer. About 50,000 of the more than 170,000 people diagnosed with lung cancer this year in the United States will find their disease early. But for those people with early-stage non-small-cell lung cancer, the change in treatment will likely begin immediately, based on the strong evidence and the fact that there is no new drug approval needed—the chemotherapy used in the study consisted of two drugs, cisplatin and vinorelbine, that are already being used to treat other cancers. There's likely to be further research to figure out exactly which patients will be most helped by the chemotherapy, how to cut down on unpleasant side effects, and whether this is the best combination of drugs to use. New Lung Cancer Surgery Speeds Healing-(HealthDay News-06/06/2005) A new minimally invasive surgery called thoracoscopic lobectomy can reduce pain and recovery time for patients with early stage lung cancer, according to a Michigan surgeon who is one of the first in the country to use the technique. The procedure involves the removal of a portion of the lungs without spreading open the ribs or cutting large muscles, which occurs in traditional lung cancer surgery. With this new technique, the surgeon makes three small incisions and then inserts a miniature camera through a fourth incision. This 'keyhole' approach allows the surgeon to view the inside of the chest during the operation. According to Dr. Allan Pickens, a thoracic surgeon at the University of Michigan Comprehensive Cancer Center, in Ann Arbor, thoracoscopic lobectomy allows patients to leave the hospital in half the time of conventional lung cancer surgery. Many return to work within two weeks, he said. "It's a way of treating cancer with a less invasive procedure that will get patients back to their regular activities sooner," Pickens said in a prepared statement. Lung cancer cases double in 30 years: Cancer Research UK-(Yahoo News-10/05/2005) Worldwide cases of lung cancer have doubled in the past 30 years, to more than 1.4 million cases diagnosed in 2002, according to research from Cancer Research UK. In contrast, the British research group said in a report there were 600,000 diagnoses made for the cancer -- one of the most lethal forms, with a survival rate of less than one in seven cases -- in 1975. The number of all cases of cancer was also on the rise as the global population ages, with 10.9 million cases diagnosed in 2002 and 6.7 million deaths, it said. In Britain, while the cancer diagnosis rate was up, the death rate was actually falling, it added. "Thanks to research, many more people diagnosed with cancer in 2005 will survive compared to 1975," the organization's medical director John Toy was quoted as saying. FDA Limits Use of Lung Cancer Drug Iressa-(Yahoo News-21/06/2005) People newly diagnosed with lung cancer should not take the lung cancer drug Iressa, according to new limitations placed on the drug by the FDA. Following results of a large study that showed Iressa did not help people with the disease live longer, the FDA says only lung cancer patients already using Iressa whose doctors believe it is helping them should continue to use the drug. New lung cancer patients will only be able to use Iressa as part of strictly controlled clinical trials. Iressa was approved for treating lung cancer in May 2003 under a special FDA program that allows drugs that appear promising to be approved despite absolute proof that they increase survival. Initial studies of Iressa showed that 10 percent of people with lung cancer responded to the drug in terms of slower tumor growth after other available treatments failed. But two studies that were published after Iressa’s approval have shown that the drug didn’t live up to its expectations, and people taking the drug did not live any longer than those taking a placebo. Officials say that since 2003, other drugs, such as Tarceva, have been approved and shown to prolong the lives of difficult-to-treat lung cancer patients. The FDA says it is not considering taking Iressa off the market, and the results of new and ongoing studies of the drug will determine its role in lung cancer treatment. Can Chest X-Rays Find Lung Cancer Early?-(Yahoo News-25/04/2005) When the news that Peter Jennings had lung cancer was reported, many asked why doctors don't use chest X-rays to diagnose lung cancer at an early stage, when it's more treatable. Cancer expert Harold Burstein, MD, assistant professor of medicine at Harvard Medical School in Boston, provided the answer. "Lung cancer is the No. 1 cause of cancer death in the U.S. for both men and women. The vast majority of lung cancer cases are caused by smoking," said Burstein. "Thus, lung cancer simultaneously represents the most devastating cancer in our society, and the most preventable." He says there are good screening tests for many types of cancer, such as Pap smear for cervical cancer, mammogram for breast cancer, and colonoscopy for colorectal cancer. But what about chest X-rays for lung cancer? "The answer is surprisingly complex," he says. Chest X-rays are inadequate for diagnosing lung cancers at an early stage, when they are more treatable. "By the time lung cancers are discovered on chest X-ray, the tumor is often too far advanced to allow the patient to be cured with surgery or radiation therapy. Chest X-rays often miss small, potentially curable lung tumors, as they are too hard to see," says Burstein. In addition, many things seen on a chest X-ray turn out to be benign problems. "If you start getting lots of screening chest X-rays, you end up performing other testing on many patients, which are often unnecessary." In recent years, a lot of attention has been paid to high-tech scans called high resolution, spiral CT scans. The hope was that these CT scans would be able to find smaller, earlier cancers without leading to further unnecessary tests. "A variety of recent studies in the U.S. and Japan have suggested that high-resolution CT scans can often detect lung cancers. In particular, these cancers seem to be small (stage I), suggesting that they may be more likely to be cured with surgery," says Burstein. However, he explains that these were small, early studies that were not able to answer the questions of whether CT scans can actually save lives. Burstein says that a recent analysis of potential lung cancer screening tests shows there is inadequate data to recommend widespread lung cancer screening at this time. The report by the federal Agency for Healthcare Research and Quality and the U.S. Preventive Health Services Task Force says evidence that chest X-rays, CT scans, and other forms of screening can save lives is poor. "In the case of lung cancer, prevention remains the best cure. If you care about someone, try to get them to stop smoking," Burstein says. Procedure Improves Outcomes in Lung Cancer Cases-(HealthDay News-25/01/2005) A combination of intraoperative brachytherapy with sublobar surgical resection improves outcomes for high-risk lung cancer patients, says a new study by researchers at Allegheny General Hospital in Pittsburgh. Intraoperative brachytherapy involves inserting tiny pellets that contain radioactive medication into an area of the lung from which a tumor has been surgically removed. Sublobar resection is a procedure in which only a small part of the lung is removed. This study of 167 patients with stage 1b non-small cell lung cancer found that combining these two treatments reduced local cancer recurrence and improved patients' clinical outcomes.The study was presented at the Society of Thoracic Surgeons annual meeting in Tampa, Fla. "In most cases, early non-small cell lung cancer can be treated successfully with surgery if the cancer has not spread beyond the chest. Unfortunately, some patients with this disease are poor candidates for the ideal surgical intervention, lobectomy, due to poor pulmonary health or other medical issues," principal investigator Dr. Robert Keenan, director of the division of thoracic surgery, said in a prepared statement. Lobectomy is the most common form of lung cancer surgery. It involves removal of an entire lobe of one lung. "Though sublobar resection alone is associated with an increased incidence of post-operative disease recurrence, it is still advocated for high-risk patients in the absence of a good alternative. Our study suggests that adding brachytherapy to the regimen can make a dramatic difference in outcomes," Keenan said. New procedure will improve detection of lung cancer-(Yahoo News-25/08/2004) With the addition of a new procedure that can detect cancer in the lung incredibly early, Southwest Regional Medical Center is hoping to continue making a push to become a premier medical facility in central Arkansas. A fluorescent bronchoscope is a device that will be available at Southwest in September, and patients already are making appointments. Southwest will have the only one in Arkansas and only the second one in a non-teaching facility in the United States. Dr. Chris John of Southwest Pulmonary Associates is overseeing the use of the device, and he is excited about the possibilities it can provide for the people in the area. "Our hope is that we will be able to find those at risk of lung cancer at a much earlier stage," John said. "When most people are diagnosed with the use of a chest X-ray or other device, it is usually much too late to keep the cancer from spreading. With this bronchoscope, areas that would have never been detected before will be found, and treatment can begin much earlier." John said that some cancerous tissue in the lungs are invisible to other devices, especially in the early stages. What the fluorescent bronchoscope does is provide a type of "night vision" into finding metaplasia and dysplasia in people at risk. The scope goes through the body's main airways and shines a fluorescent blue filter into certain tissue areas. Over healthy tissue, the light will bounce back in a greenish color, but over abnormal tissue, green is not allowed to bounce back, and what is left is a reddish, brownish color. What was invisible to other procedures will be routine with the new device. With those early detections, John said, doctors will be able to go in and destroy the cancerous tissue before they ever cause a serious problem. John said he believes it is especially important in Arkansas, where the number of smokers is very high. John said lung cancer is the most common killer of adults because of the malignancy of many diagnoses. The new procedure will be able to pick up 70 percent more cancer than more traditional methods. John was responsible in bringing the bronchoscope to Southwest after seeing it and learning about it at several medical meetings. The procedure has not been used on a widespread basis in the United States, but it has been used successfully in Europe. Only 114 are in use around the world, but John said he believes that the success of the bronchoscope will eventually make it a common procedure. Southwest will begin using the bronchoscope Sept. 10, and John said he is hoping that anyone "at risk" will schedule an appointment. These would include individuals who smoke 20 packs a week and anyone exposed to asbestos. Because it is an evaluation procedure and because it is very rare in the United States, John is unsure about the how one's medical insurance would be involved, but he noted that over the long term, early detection could save a person around $30,000. "It is an outpatient procedure, and it usually takes about 20 minutes," he said. "It could be considered the same as an exercise test that is given to certain patients, and eventually it will be recognized as a screening and preventative procedure." Anyone who is interested in the procedure may contact John at 407-0200. F.D.A. Approves a Pill for Lung Cancer to Be Sold by Genentech and OSI-(Yahoo News-19/11/2004)
The drug is expected to compete most directly with AstraZeneca's Iressa, a similar drug that was approved in 2003. Tarceva's advantage is that in a clinical trial it was shown to prolong lives, by a median of 6.7 months compared to 4.7 months for patients who got a placebo. So far, Iressa has only been shown to shrink tumors. Both drugs, as well as ImClone Systems' colon cancer drug, Erbitux, try to block a particular protein, the epidermal growth factor receptor, that spurs the growth of cancer cells. Such so-called targeted drugs tend to have fewer side effects than conventional chemotherapy. The main side effects of Tarceva are a rash and diarrhea, although there have been infrequent reports of serious or even fatal lung disease in patients taking the drug. Tarceva might also compete with Alimta from Eli Lilly and Taxotere from Aventis, both approved second treatments for lung cancer. Tarceva, a pill taken once a day, will be priced at slightly more than $2,000 wholesale for a month's supply, said Colin Goddard, chief executive of OSI. Patients and doctors have complained recently about the high prices of cancer drugs. Dr. Goddard defended the price of Tarceva, saying it was "set competitively against the other drugs in play." He said the drug was priced at a few hundred dollars more per month than Iressa but less than many other cancer drugs. In another clinical trial, Tarceva was found to extend the lives of patients with pancreatic cancer, which is extremely difficult to treat. The companies plan to apply for approval for that use next year, Dr. Goddard said. Tarceva did not work when tested in combination with chemotherapy as an initial treatment for lung cancer. That would have been a bigger potential market than treatment of patients who fail to respond to chemotherapy. Vivant Medical, Inc. and Rhode Island Hospital Announce Beginning of Clinical Study in Microwave Ablation for the Treatment of Lung Cancer-(PRNewswire-20/09/2004) Vivant Medical and Rhode Island Hospital announced the beginning of a clinicalstudy to determine the effectiveness of microwave ablation for treatment of lung cancer. In the study, Rhode Island Hospital will be using Vivant's VivaWave(TM) Ablation System, which has received FDA 510(k) clearance for coagulation of soft tissue. Damian Dupuy, MD, Director of Minimally Invasive Therapy and Ultrasound at Rhode Island Hospital, will be the principal investigator. Microwave ablation is a new, heat-based treatment used to destroy tumors. Under the lead of Dr. Dupuy, Rhode Island Hospital's staff has already performed procedures in over 50 patients using VivaWave to ablate multiple masses in soft tissues including kidney, liver, bone, and adrenal glands. Due to its consistency, predictability, safety, reduced procedure times, and ability to treat large lesions, the VivaWave system is being developed as a promising and attractive option for patients with lung cancer who are typically not candidates for surgery and may not be able to be treated with current thermal therapy such as radio-frequency ablation. To date, Rhode Island Hospital is the largest user of microwave ablation. Dr. Dupuy, said, "This development is in keeping with Rhode Island Hospital's commitment to providing our patients with the most recent advances in cancer treatment. Our research will result in a greater understanding of cancer and more effective, less traumatic treatment for our patients." Dupuy also noted, "As a large majority of lung cancer patients are not surgical candidates, VivaWave and microwave ablation offers doctors and their patients a much-needed option." "We are pleased with the initiation of this study and look forward to broadening the use of the VivaWave system for the treatment of lung cancer," said Rod Young, Chief Executive Officer at Vivant Medical. "Approximately 174,000 new cases of lung cancer will be diagnosed in 2004, accounting for 13% of all new cancer cases. We believe that the VivaWave has the potential to aid doctors in effectively and safely treating patients with lung cancer who are left with precious few alternatives." Dr. Dupuy was one of the pioneers in the development of radio-frequency ablation, the current industry standard in thermal ablation. Attracted by VivaWave's potential versus radio-frequency ablation, Dr. Dupuy is now a leading expert in microwave ablation. Data Confirm 30% 1-YEAR Survival For Gefitinib In Non-Small Cell Lung Cancer-(Yahoo News-08/09/2004) Final survival data from more than 21,000 non-small cell lung cancer (NSCLC) patients who received gefitinib through AstraZeneca's compassionate use programme (also known as an Expanded Access Programme, EAP) were presented at the European Respiratory Society (ERS) Congress. The one-year survival rate in patients treated with gefitinib on a compassionate basis was reported as 29.9%. Historical data show that patients treated with third- or fourth-line chemotherapy have a one-year survival rate of just 5.5%. This EAP data set represents the largest reporting to date of clinical use of an epidermal growth factor receptor (EGFR) agent. Gefitinib, the most extensively prescribed EGFR agent, has been administered to over 178,000 patients worldwide to date. In 2000, more than 375,000 people were diagnosed with lung cancer and over 345,000 people died from the disease in Europe. Data were presented from 21,064 patients treated with gefitinib. Patients were eligible for treatment who had stage III/IV NSCLC, who had received and failed prior chemotherapy or radiation therapy, or were unable to tolerate chemotherapy. Results showed: 1-year
survival was 29.9% (95% CI, 28.8 - 31.1) Judith Ochs M.D., Senior Director Clinical Research, lead author of the study at AstraZeneca commented: "The results reported in the phase II IDEAL studies showed that ~30% of patients were alive one year after starting treatment, and the results presented today from this large population of patients further support these findings. The IDEAL trials also demonstrated that ~50% of patients gain clinical benefit from treatment with gefitinib and these EAP data give us a valuable insight into what is likely to happen with gefitinib in a typical clinical population with advanced NSCLC." The gefitinib Expanded Access Programme (EAP) was initiated in 2000 to allow those patients with advanced NSCLC and no other treatment options access to the drug before registration. The US programme ran from August 2000 to July 2003 and enrolled over 23,300 advanced (stage III/IV) NSCLC patients who had exhausted all approved treatment options or were unable to tolerate chemotherapy. Lung cancer is the leading cancer killer in the world, causing more deaths each year than breast, prostate and bowel cancer combined. In 2000 there were over 1.2 million people diagnosed with lung cancer worldwide and more than 1 million people died from the disease. NSCLC is the most common form of lung cancer, accounting for 80 percent of all lung cancer cases. Gefitinib has been approved for the treatment of advanced NSCLC in 29 countries, including the US, Japan, Canada, Switzerland and Australia, and is currently undergoing review with many other regulatory authorities worldwide Lung Cancer Different in Nonsmokers-(Reuters Health-18/08/2004) Among individuals who develop lung cancer, there appear to be differences between smokers and nonsmokers in survival rates and in individuals patient characteristics, researchers report. They say the findings indicate that lung cancer in nonsmokers is a specific disease, which has implications for research and clinical trials. Dr. George R. Simon and colleagues from the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Florida, analyzed patient characteristics and survival rates in 132 individuals who never smoked and in 522 current smokers diagnosed with primary lung cancer. They observed that never-smokers were generally older at diagnosis (63.5 years versus 59.4 years) and more often female (78 percent versus 54 percent). Also, never-smokers had better overall survival rates than current smokers, with survival estimates at 5 years of 23 percent versus 16 percent. After adjusting for other risk factors, smoking was an "independent negative prognostic factor," the investigators report in the medical journal Chest. Commenting on these findings, Simon told Reuters Health that lung cancer in smokers is the result of the "carcinogenic properties of chronic tobacco use." In contrast, lung cancer in never-smokers occurs without exposure to the carcinogenic properties of tobacco. Therefore, lung cancer in nonsmokers has a distinct behavior and survival rate. Lung cancer in never-smokers "is a different disease in itself, with its own unique biology, behavior characteristics, and survival," Simon concluded. "Therefore, we assert that laboratory and clinical investigations be specifically designed to further study this distinct disease entity." Dr. Peter J. Mazzone and two colleagues from The Cleveland Clinic Foundation in Ohio concur, noting in an editorial in Chest that this study "further highlights the importance of stratification of patients for smoking history in future clinical trials." Avastin-Tarceva Combo Provides 'One-Two Punch' Against Top Cancer Killer-(AScribe Newswire-28/06/2004) Results of the first clinical trial to combine two new targeted cancer drugs suggest that the combination may provide a powerful "one-two punch" against lung cancer, the nation's leading cancer killer. The work, led by researchers at the Vanderbilt-Ingram Cancer Center in Nashville, Tenn., and The University of Texas M.D. Anderson Cancer Center in Houston, was presented at the 40th annual meeting of the American Society of Clinical Oncology. Tumors were controlled among 85 percent of the 40 patients with advanced non-small cell lung cancer (NSCLC) who entered the Phase I/II trial of a combined regimen of bevacizumab (Avastin TM) and erlotinib (Tarceva TM).The response rate - proportion of patients whose tumors shrank in size by more than half - was about 20 percent, while median survival was 12.5 months. This compares to about 10 percent response and between six and eight months median survival with traditional therapy or erlotinib alone, said Alan Sandler, M.D., associate professor of Medicine and director of the lung cancer clinical program at Vanderbilt-Ingram. The treatment resulted in only mild side effects, including rash and diarrhea, and the drugs did not appear to interact adversely with one another, the investigators report. "The anti-tumor activity was encouraging," said Sandler, who presented the research at the meeting. "These findings suggest not only that combining these two agents is feasible, but that this approach may provide a one-two punch against tumors that should be further examined in larger clinical trials." Lung cancer is the leading cause of cancer death in the United States, killing more than 157,000 people each year, more than the next four leading cancers (colorectal, breast, prostate and pancreas) combined. About 85 percent of all lung cancers are non-small cell cancers, and nearly half of these patients are diagnosed with advanced disease and receive only chemotherapy or supportive care, the investigators say. Despite newer third-generation chemotherapies, most of these patients become resistant to treatment or develop side effects so severe that they cannot continue treatment. "Less toxic and more effective treatments are clearly needed," Sandler said. The two drugs, both delivered orally, are among newer so-called targeted cancer agents that focus on specific molecular features of cancer cells. Because they potentially target cancer cells while sparing healthy cells, the hope for these new agents is more effective cancer therapy with fewer side effects. Bevacizumab blocks the vascular endothelial growth factor (VEGF), which is involved in making new blood vessels (a process called angiogenesis) that help feed tumor growth and spread. Erlotinib inhibits the epidermal growth factor receptor (EGFr), a key player in delivery of signals that prompt the runaway cell growth that characterizes cancers. Increased activity of the EGFr pathway, as well as increased number of tumor blood vessels resulting from VEGF expression, are associated with poorer outcomes for patients with NSCLC, the investigators note. Other research has suggested that activities of EGFr and VEGF are related - EGFr appears to play a role in angiogenesis, while blocking VEGF appears to interrupt EGFr signaling. As a result, the researchers suspect that a dual blockade of these targets may be synergistic. Interim results from this research were presented at last year's ASCO meeting in Chicago, prompting other investigators across the country to examine this combination in other tumor types as well as combine other targeted agents in clinical trials, Sandler said. At the time the study was launched, it was the first time two drugs that had not yet been approved by the U.S. Food and Drug Administration were combined in a trial. Since that time, bevacizumab has been approved for use in advanced colorectal cancer in combination with chemotherapy. Sponge substance works well with yew derivative to thwart cancer cell proliferation-(Yahoo News-15/06/2004) A drug derived from an ocean-growing sponge teams up to enhance the performance of the yew tree derivative Taxol® (paclitaxel) in preventing the growth of cancer cells, according to research published in the journal Cancer Research. Indeed, discodermolide, a novel drug isolated from the marine sponge Discodermia dissoluta, works with paclitaxel to thwart tumor cell growth--with several times the efficacy that either drug alone exerts on proliferating cancer cells. Studies by Mary Ann Jordan, Ph.D., a scientist at the University of California, Santa Barbara, and an international team of cancer researchers including postdoctoral fellows Stephane Honore, Ph.D., and Kathryn Kamath, Ph.D., demonstrate that the combination of the two drugs inhibited proliferation of human lung cancer cells by 41 percent. Administered alone, either discodermolide or paclitaxel prevented the cancer cell growth by only 9.6 or 16 percent, respectively. The drugs also combined to induce programmed cell death, or apoptosis, in the lung cancer cells. "Our results indicate that Taxol® and discodermolide have the potential to improve cancer patients' responses and reduce undesirable side effects when the two drugs are administered together," Jordan said. The drugs, which stem from naturally occurring sources, work in concert to stabilize the assembly/disassembly process of microtubules in cells. Microtubules--lengthy polymers made up of protein bundles, called tubulin--form long, straw-like cylinders that help shape the skeletal structure within cells and also move cellular components within the cell, including vesicles, granules, organelles like mitochondria, and chromosomes. Their attachment with chromosomes, the DNA genetic material in cells, is critical for cell replication and growth. Microtubules normally exist in a state of dynamic instability, where the polymers grow rapidly--longer or shorter, depending on the need of the cells. In this study, discodermolide and paclitaxel combined to alter the overall microtubule dynamics by 71 percent when administered together. Alone, they each reduced microtubule dynamic instability by 24 percent. By altering the stability dynamics of microtubules, paclitaxel and discodermolide limit cancer cells ability to duplicate DNA and divide. The cells are stuck in a pre-division stage of the cell cycle called G2/M. Cancer cells that are restricted to the pre-division stage of the cell cycle cannot divide and ultimately die, thus reducing proliferation of tumor cells. Both drugs work by binding to the microtubules. Because of their lengthy structure and the number of drug binding sites normally associated with them, microtubules are unique receptors for drugs within cells. Paclitaxel is currently an approved therapeutic for control of cancer growth. Discodermolide is currently under study in phase one clinical studies. Introgen's INGN 241 Combined With Radiation Increases Survival in Animals With Human Lung Cancer-(PR Newswire-28/06/04) Introgen Therapeutics, Inc. announced the publication of new preclinical data from studies evaluating INGN 241 in combination with radiation therapy in an animal model non-small cell lung cancer (NSCLC). INGN 241 currently is in Phase 2 clinical trials in malignant melanoma and has completed Phase 1 - 2 studies in multiple solid tumor indications. The paper, titled "Adenovirus- Mediated mda-7 (IL-24) Gene Therapy Suppresses Angiogenesis and Sensitizes NSCLC Xenograft Tumors to Radiation," reports data from studies conducted by researchers at The University of Texas M. D. Anderson Cancer Center in collaboration with Introgen scientists and is available in the current version of Molecular Therapy. "These data provide the first molecular basis for the inhibition of tumor growth by INGN 241 in combination in radiotherapy," said Sunil Chada, Ph.D., Introgen's director of Research and Development. "The formation of new vessels, a process known as angiogenesis, is essential for tumor growth. In the absence of angiogenesis, cells within the tumor are starved of oxygen and nutrients and die. The importance of angiogenesis in tumor growth has been validated by the recent approval of the first anti-angiogenic cancer therapy. In addition to its anti-angiogenic activity, a substantial body of data demonstrates that the MDA-7 protein has multiple anti-cancer effects, including inducing cell death, stimulating the immune system, reducing cell migration and metastasis and sensitizing cells to the effects of chemotherapy or radiation. Based on these activities, we believe that INGN 241 has enormous potential in treating a variety of cancers." The studies were conducted in the laboratory of Dr. Raymond E. Meyn, professor and chairman of the Department of Experimental Radiation Oncology at The University of Texas M. D. Anderson Cancer Center, and evaluated the combination of INGN 241 and radiation treatment in mice implanted with human NSCLC tumors. Results demonstrated a substantial and prolonged inhibition of tumor growth following the combined treatment. Analysis of tumors revealed a significant reduction in two proteins (bFGF and VEGF) that regulate the formation of new blood vessels essential for tumor growth as well as a reduction in the number of small blood vessels and an increase in apoptosis in tumors treated with the combination regimen compared with either INGN 241 or radiation alone. Additional data show that MDA-7 protein sensitizes the cells that give rise to new blood vessels to the effects of radiation without affecting other normal cells. "In addition to being able to cure some animals with human lung tumors, we found a greater than 300 percent increase in survival after treatment with INGN 241 and radiation combination therapy," said Dr. Meyn. "This treatment regimen kills tumor cells directly and then kills the vasculature feeding tumors without evidence of toxicity. We evaluated the critical molecules involved in angiogenesis and demonstrated that the combination of INGN 241 and radiotherapy significantly suppressed their activity. This data provides an impetus to evaluate INGN 241 in combination with radiotherapy in patients with lung cancer." Postop chemo boosts lung cancer survival Adjuvant therapy significantly improves lifespan in patients with early-stage lung cancer compared to surgery alone-(Yahoo News-05/06/2004) Two "paradigm shifting" studies presented at this year's American Society of Clinical Oncology meeting here show that adjuvant chemotherapy following surgery significantly improves survival in patients with early stage lung cancer compared to surgery alone. In one study, researchers funded by the National Cancer Institute of Canada (NCIC) found that postoperative treatment with the drugs vinorelbine and cisplatin increased the overall survival of patients with early non-small cell lung cancer (NSCLC) by 15% after five years. The other study, conducted by U.S. researchers for the Report of Cancer and Leukemia Group B (CALGB), was halted early after it found that the chemotherapy regimen of paclitaxel and carboplatin improved four-year overall survival by 12% following surgical resection in early-stage disease. "This is the best news for lung cancer patients in a long time," said lead NCIC investigator Dr. Timothy Winton of the University of Alberta in Edmonton. "I think the collective data from these studies is quite telling and compelling as a move towards a change in the standard of care." "These two trials show a large benefit comparable to what we've seen recently in breast cancer and colorectal cancer," said lead CALGB investigator Dr. Gary Strauss of the Rhode Island Hospital and George Brown Medical School in Providence, RI. In the NCIC study, Dr. Winton and colleagues compared the effectiveness of a 16-week regimen of combined neoadjuvant cisplatin and vinorelbine post surgery versus surgery alone (the current standard of care) in 482 patients (age 61 years; 65% male) with stage I or II NSCLC that had been completely removed. The mean survival was found to be significantly longer in the chemotherapy plus surgery group (94 months) than in the group who received surgery alone (73 months). The time it took for a patient's disease to recur was also longer in the chemotherapy plus surgery group. Many did not experience a recurrence during the study period compared to an average time to recurrence of 46.7 months in the surgery alone group. At five years, more patients in the chemotherapy plus surgery group than the surgery alone had survived longer (69% vs. 54%, respectively). "The important, good news for lung cancer patients that came out of this trial is that toxicity to this regimen was limited," said Dr. Winton. "The quality-of-life data that we have show that there was some intrusion in quality of life during the treatment, but that these patients that were treated recovered and had excellent quality of life in the longer term." The commonest non-hematologic toxicities in the study were fatigue (77%), nausea (76%), anorexia (53%), vomiting (46%), sensory neuropathy (45%) and constipation (44%). Two patients died of drug-related toxicities, which were febrile neutropenia and pulmonary fibrosis. In the CALGB study by Dr. Strauss and colleagues, 344 patients with stage IB NSCLC (with tumours at least 3 cm in diameter) who had undergone complete surgical removal of the tumour were randomized to receive adjuvant chemotherapy with paclitaxel and carboplatin or to no further treatment after surgery. The findings showed that overall survival was significantly better for the 173 patients who received the adjuvant chemotherapy. At four years, there was an absolute overall survival benefit of 71% in the chemotherapy group versus 59% in the surgery alone group. Lung cancer mortality at four years was 15% and 26% in the chemotherapy and surgery only groups, respectively. This translated into a 38% reduction in mortality from all causes specifically favouring chemotherapy. At the time of the meeting here, there were 19 lung cancer deaths in the chemotherapy group and 34 deaths from lung cancer in the control group. The researchers noted adjuvant chemotherapy was well tolerated, and there were no chemotherapy-related toxic deaths. "The results of this study represent an important development in the management of patients with early-stage lung cancer," Dr. Strauss said. "The positive results using a carboplatin combination are of particular interest, since many oncologists see carboplatin-based therapy as better tolerated than cisplatin regimens in NSCLC patients." At a press conference here, Dr. Frances Shepherd, Scott Taylor Chair in Lung Cancer Research at Toronto's Princess Margaret Hospital, described Dr. Winton's and Dr. Strauss's studies as "paradigm shifting." Their findings should convince the oncology community that adjuvant chemotherapy for completely resected patients with NSCLC should now be the standard of care, she said. The only current treatment for patients with early stage NSCLC is the surgical removal of the tumour, but patients often experience recurrence of the disease, which often does not respond to treatment. NSCLC is the most common type of lung cancer, accounting for more than 80% of all lung cancer Why lung cancer in women is different from men-(Yahoo News-03/06/2004) Noting that lung cancer is women's number one cancer killer, Loyola medical oncologist Dr. Kathy S. Albain will speak on the molecular differences in lung cancer between men and women at the annual meeting of Women Against Lung Cancer, a Professional Alliance for Education and Research (WALC), at the Hilton New Orleans Riverside Hotel, Two Poydras Street, New Orleans. "Lung cancer takes more women's lives than reproductive cancers and breast cancer combined," said Albain, WALC vice president and professor, division of hematology/oncology, Department of Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, Ill. "We must devote more resources to battling this devastating disease." Albain is calling for more research funding targeted to examining why lung cancer is so deadly and why it affects men and women so differently. "Cigarette smoke damages women's lungs more than men's lungs and lung cancer treatment affects women differently than men," said Albain, director, Breast Research Program; co-director of the multidisciplinary Breast Oncology Center; and director of the Thoracic Oncology Program, Cardinal Bernardin Cancer Center, Loyola University Health System, Maywood, Ill. Albain has been a principal or senior investigator for major national and international research into treating breast and lung cancer. Women Against Lung Cancer was established in 2001 to educate the public and health care professionals about the magnitude of the lung cancer problem in women. WALC supports and encourages research in gender-related differences in the causes, treatments and prevention of lung cancer. WALC also mentors women health care professionals to pursue careers in lung cancer research. The WALC board is composed of leading women oncology health care professionals in the United States and Canada, along with members of women's advocacy groups and the lay public. A new way to kill cancer: SLU research shows viruses can destroy lung, colon tumors-(Yahoo News-15/05/2004) A genetically engineered virus can selectively kill cancerous cells in the lung and colon while leaving healthy cells intact, according to new research published in Cancer Research by William Wold and colleagues at Saint Louis University School of Medicine. The research could lead to a new class of cancer therapies that selectively kill cancer cells. "These engineered viruses kill cancer cells through a mechanism that is completely different from chemotherapy or radiation," said Dr. William Wold, chair of the department of molecular microbiology and immunology at Saint Louis University School of Medicine. "These viruses have the potential to treat many cancers that are resistant to currently available therapeutics. It also may be possible to use these viruses in combination with other therapies to create novel treatment regimens." Dr. Wold and his colleagues Karoly Toth, Konstantin Doronin, Ann E. Tollefson, Mohan Kuppuswamy, Baoling Ying, Jacqueline Spencer, and Maria Thomas have been researching for many years ways to convert the relatively benign "adenovirus" that causes symptoms similar to the common cold in children into an anti-cancer drug that attacks and destroys cancerous cells. Wold's group has developed several new "adenovirus cancer gene therapy vectors," changing these genes so the virus will attack cancer cells. "Some of our vectors are designed to destroy many different types of cancers, others are designed to be specific to colon or lung cancer. In preclinical testing these vectors were highly effective against cancerous tumors and did not harm normal tissues." The new research reported in Cancer Research involves INGN 007 (VRX-007) and INGN 009 (VRX-009), two novel "oncolytic adenoviruses" that have been engineered to kill cancer cells via viral replication. These viruses can be engineered so that they are active in specific types of cancer cells. The data published indicate that both efficiently killed cancer cells in culture. Specifically: · INGN 009, which has been designed to kill cells that carry a mutation common in many colon cancers, efficiently killed cultured colon cancer cells, but not lung cancer cells. · INGN 007 effectively killed both types of cancer cells. In an animal model of colon cancer, injection of either INGN 007 or INGN 009 into tumors suppressed tumor growth more efficiently than a negative control (five-fold and ten-fold suppression, respectively). · INGN 007 also completely suppressed tumor growth in a lung cancer model of disease. Introgen Publishes Data Describing Novel Mechanism of mda-7 Anti-Cancer Activity-(PRNewswire-26/04/2004) Results of a new preclinical study evaluating the mechanisms by which mda-7/IL-24, the active component of Introgen's (Nasdaq: INGN) INGN 241, kills non-small cell lung cancer cells have been published in Molecular Therapy, the official journal of the American Society of Gene Therapy. Data from these studies, which were conducted in collaboration with researchers at The University of Texas M. D. Anderson Cancer Center, Baylor College of Medicine and The University of Texas Medical Branch at Galveston, identify a novel intracellular pathway through which mda-7/IL-24 causes lung cancer cells to undergo apoptosis (programmed cell death). Additionally, these studies highlight the ability of mda-7/IL-24 to exert its anti-cancer effects through a variety of pathways, depending on the gene expression patterns of various types of cancer cells. Dr. Sunil Chada, Ph.D., Introgen's director of research and development, said, "These data identify a unique intracellular signal by which INGN 241 kills cancer cells. Expression of MDA-7 protein inside a cancer cell by treatment with INGN 241 activates a stress response pathway that results in selective apoptosis in cancer cells. These studies demonstrate that INGN 241 can work through multiple pathways to kill cancer cells, without exhibiting toxicity to normal cells. Cancer cells can mutate to develop resistance to chemotherapy and radiation therapy -- MDA-7 is unusual in that it can attack cancer cells via multiple mechanisms and thus may be a good candidate for cancers resistant to conventional therapies. The multiple anti-cancer activities of INGN 241 suggest that this product candidate may have utility in treating a broad array of cancers." In the published study, researchers evaluated the role of MDA-7 protein inside and outside tumor cells. The presence of MDA-7 protein in a specific part of the cancer cell involved in secretion activates a stress response that ultimately leads to cell death. This is a previously unknown mechanism for tumor cell killing. In the lung cancer cells tested, the killing was caused by intracellular MDA-7 since these cells lack MDA-7 receptors on their cell surface. Other tumor cells express specific receptors for MDA-7 on their cell surface and can be killed by both intracellular and extracellular mechanisms that are induced in cancer cells. This study underscores the tumor cell selectivity of the tumor killing mechanisms of INGN 241. Dr. Robert E. Sobol, Introgen's senior vice president of medical and scientific affairs said, "Patients with lung cancer have limited treatment options. The identification of a novel pathway for selectively inducing cell death in lung cancer cells may enable us to develop innovative approaches to therapy. To date, our clinical trials of INGN 241 have shown us that the INGN 241 product candidate has favorable safety and tolerability profiles and have provided data to support continued clinical development in lung cancer and other cancer indications." New Research to Address Pressing Question: Will Early Lung Cancer Detection Lead to Tobacco Cessation?-(Yahoo News-26/04/2004) A new screening technology that could detect lung cancer much earlier than ever before was funded through matching grants of $1.8 million respectively from the American Legacy Foundation and the UK's Medicsight Foundation. Weill Medical College of Cornell University, an international leader in CT screening for lung-cancer detection, will conduct the research. The donation will support a 4,000-patient study whose goal is to demonstrate that CT screening for lung cancer can be effectively linked to smoking-cessation programs to enhance the motivation for people to stop smoking. The study, which will begin in June, will use unique advanced image analysis software. "We want to make screening programs an economic and life-saving reality," says Dr. Claudia Henschke, the study's principal investigator and one of the world's leading authorities on CT screening for lung cancer. "The International Early Lung Cancer Action Program (I-ELCAP) is proving that CT screening is an effective tool for early diagnosis of lung cancer. This newly funded study represents a unique opportunity to understand how to best increase smoking cessation in the context of CT screening. At the same time, we will be incorporating and developing advanced image processing software to make screening as effective as possible." Dr. Henschke directs the Lung Cancer Screening Program at New York-Presbyterian Hospital/Weill Cornell Medical Center, where she is professor of radiology and division chief of chest imaging. The American Legacy Foundation - the only national organization solely focused on tobacco prevention and cessation - and Medicsight Foundation, which provides research funds for medical imaging, share Dr. Henschke's interest in determining if participation in early detection programs would lead more smokers to quit. "The American Legacy Foundation knows that science eventually will find far better ways to detect and treat lung cancer," said Cheryl G. Healton, Dr. P.H, and president and CEO of the Foundation. "The pressing question in the minds of many is whether or not CT screenings for lung cancer will encourage smokers to quit or make them put off this decision even longer. With lung cancer being the leading cause of cancer death in this nation, the Foundation is especially interested in answering this vexing question." "The Medicsight Foundation recognizes the need for teamwork in lung cancer. We know that primarily lung cancer is the result of smoking," Rockefeller says, "but we also know that smokers need help - and teamwork - if they are to succeed in breaking their damaging addiction. When you go it alone, you have a one in 12 chance of stopping smoking. Support can improve that chance." Lung cancer 'different in women-(Yahoo News-13/04/2004) Lung cancer is a different disease in women than it is in men, researchers have said. The female hormone oestrogen is partly to blame, according to a team at Northwestern University, Illinois. Rates of lung cancer in women have increased significantly in recent decades while those for men have remained stable. The research in the Journal of the American Medical Association also noted the effect of more women smoking. Female smokers have a greater chance of developing lung cancer, and a higher risk of developing adenocarcinoma, which is the most common form of the disease. But women also have better survival rates, the researchers said.Numbers of women smoking continue to increase, while rates among men are falling. Between 1990 and 2003 there was a 60% increase in lung cancer cases among women in the US. An estimated 68,500 American women will die from the disease this year. The team at Northwestern University, and colleagues at Memorial Sloan-Kettering Cancer Center, New York, looked at previous research into lung cancer and found evidence that the differences in disease rates and survival could in part be due to oestrogen. Studies have shown lung cancer cells have more oestrogen receptors on their surface than normal lung cells. Other research has indicated a link between oestrogen replacement therapy and adenocarcinoma and an interaction with smoking. Dr Jyoti Patel, an oncologist at the university, said: "Lung cancer appears to be a different disease in women. "Mounting evidence suggests that these differences could be due, in part, to oestrogen. "Genetic, metabolic and hormonal factors all are important to the way women react to carcinogens and lung cancer." The researchers said women reacted better to some targeted therapies and they were now trying to work out why that was. Professor Michael Seckl, professor of cancer medicine at Imperial College London, has researched the role of oestrogen and found a possible link in lung cancer patients. He said the conclusion that the hormone was partly to blame for women's different rates of disease and survival was a "plausible interpretation". Professor Seckl added: "It is hardly surprising - men and women are very different. "The message needs to get out there that lung cancer is not just a male disease. Women do appear to be more at risk of lung cancer." Far more research into lung cancer was needed, he said, as it currently gets only 3% of cancer research money in the UK though it is the form of the disease that kills the most people More US women die from lung cancer-(Yahoo News-14/04/2004) Deaths of American women from lung cancer have shot up 600% in the past 50 years, according to new research. During the same period, the number of lung cancer deaths in men declined. The trend mirrors a dramatic increase in tobacco use by women in the United States during the 20th century. But the findings can not simply be explained by the number of women smoking, said scientists. They also pointed to biological differences that may make women more susceptible to some forms of lung cancer than men. Researcher Dr Jyoti Patel, from North-western University in Chicago, said: "Genetic, metabolic and hormonal factors are all important to the way women react to carcinogens and lung cancer. This information should impact how we evaluate and screen patients who smoke and how we direct smoking cessation and lung cancer prevention programmes." Lung cancer had now surpassed breast cancer as the leading cause of cancer death among American women, said the researchers. The disease accounted for a fourth of all female cancer deaths in the United States last year. This year, lung cancer was expected to kill 68,500 American women, equal to the number dying from breast and all gynaecological cancers combined. British women more likely to die of cancer-(Yahoo News-04/04/2004) British women are at a much higher risk of dying from cancer than those in many other European countries including Estonia, Slovenia, and Russia, according to research published by the European Institute of Oncology. The cancer mortality rate for women in England and Wales is almost double that of Greece which is at the healthier end of a league table of 37 European countries. Female deaths from lung and bladder cancer in Scotland are the highest in Europe. The study also reveals mortality from lung cancer among women in Scotland is seven times that of Spain. England and Wales rank fifth. The figures will raise further alarm over failure of health services to deal effectively with breast cancer. Scotland, and England and Wales, have the seventh and eighth highest death rates for breast cancer, according to the study. But the study shows death rates from cancer for men are below the European average. The gender gap has been created largely by poor outcomes for women in three main areas of the disease - breast, lung and bladder cancer. Meanwhile, there have been huge improvements in treatment of male cancers, with 96 per cent of men with testicular cancer in the UK now surviving more than five years. The research suggests that while death rates from cancer have been going down across Europe - 90,000 fewer deaths a year than in the late 1980s - there are big differences between countries. Out of 37 countries surveyed, Scotland has the third highest overall cancer death rates for women, just behind Denmark and Hungary. Ireland is fifth while England and Wales are seventh highest. Scotland also tops the league for bladder cancer, with England and Wales in third place. The Scottish death rate is around four times higher than Finland, at the bottom of the league. A report in the International Journal of Cancer says that to reduce death rates, concerted action is needed. "The maintenance, and potential improvement, of favourable trends in cancer mortality in the near future require an integrated strategy focusing on control of tobacco, alcohol abuse and other major risk factors, including avoidance of obesity, taking up of physical activity, favourable changes in diet, increasing daily intake and variety of vegetables and fruit, and avoiding excessive sun and other sources of UV exposure," it says. The report says that in the European Union, total cancer mortality declined by 7 per cent for both sexes over the last five-year period they looked at. It says that the decline is largely due to the drop in tobacco-related cancer mortality in men Concurrent Chemoradiotherapy Provides Good Local-Regional Control and Long-Term Survival in Patients with Stage III Non Small-Cell Lung Cancer-(Yahoo News-18/03/2004) Concurrent chemotherapy with carboplatin/paclitaxel and radiation therapy provides excellent local-regional control (LRC) and encouraging long-term survival in patients with stage III non small-cell lung cancer (NSCLC), according to the findings of new research. In the past decade, the University of Pennsylvania Medical Center, Philadelphia, United States, has offered neoadjuvant chemoradiotherapy to selected stage III NSCLC patients with clinically apparent N2 disease or other features that raised doubts about complete resectability. In the current analysis, Mitchell Machtay, MD, and colleagues present the short-term and long-term outcomes (pathologic response, toxicity, LRC, and survival) of patients treated with neoadjuvant chemoradiotherapy and planned operation for stage IIIA disease. Patients underwent pretreatment evaluation between 1993 and 2000; 87% had complete mediastinoscopy staging, and all were believed to be poor candidates for up-front operation because of bulky extent of disease. Radiotherapy consisted of conventional, 2-dimensionally planned treatment to 45 to 54 Gy in 1.8- to 2-Gy fraction size. Concurrent chemotherapy consisted of etoposide/cisplatin or carboplatin/paclitaxel. Out of 53 patients, 85% were deemed surgical candidates after induction therapy. Twenty-two (42% of the initial cohort) had a major pathologic response to stage 0, I, or II disease. The 5-year actuarial survival was 31%, and improved survival was associated with major pathologic response (48% vs. 24%; P = .027). The overall rate of early death potentially related to therapy was 9%, and was most often seen in patients who underwent right pneumonectomy. Efficacy and mortality in patients receiving etoposide/cisplatin and radiotherapy versus carboplatin/paclitaxel and radiotherapy were similar. However, the latter regimen was associated with less grade 3 or higher acute toxicity requiring interruption or hospitalisation during neoadjuvant treatment (P =.02). LRC was achieved in 83% of all patients (90% of the patients who underwent resection). The first site of treatment failure was brain metastases in 23% of patients. "Our study shows that the resectability rates and LRC for stage IIIA NSCLC treated with neoadjuvant chemoradiotherapy are high," Dr. Machtay and colleagues conclude. "It is disappointing that the overall survival and relapse-free survival have not improved appreciably over the past decade," the researchers note. "This mainly reflects the inadequacy of current therapies to sterilize micrometastatic disease, including brain metastases," they add. Blowing Up Lung Cancer-(ET-20/02/2004) University of Alberta researchers have created "nanoparticle cluster bombs" that carry lung cancer drugs directly to their target. The treatment system has proven effective in treating cancerous cells in a laboratory petri dish and the researchers will conduct tests in live laboratory specimens this year. Clinical trials would follow that. "Based on what we've been able to do so far, we have practical hopes that a new lung delivery platform for lung cancer can be established," researcher Dr. Raimar Loebenberg, a professor of pharmacy, says in a prepared statement. The lung cancer drug, in powder form, is loaded into an inhaler that's similar to the device used by people with asthma. Each grain of the powder contains thousands of nanoparticles. When the powder is inhaled and arrives in the lungs, it dissolves and the nanoparticles are released. "Once the nanoparticles are active in the lung, they have a tremendous advantage over regular drugs, because they are better able to do exactly what we want them to," Warren Finlay, a mechanical engineering professor, says in a prepared statement. The nanoparticles can be designed to escape detection by the immune system and to carry designer drugs that target cancer cells and leave healthy cells alone. "This drug and this delivery system have a lot of potential-there are a lot of different things we can do as we're able to control where and when the nanoparticles release their payload," Finlay says. The research appears in a recent issue of the International Journal of Pharmaceuticals Experimental Vaccine May Stop Lung Cancer-(Yahoo News-13/02/2004) An experimental vaccine wiped out lung cancer in some patients and slowed its spread in others in a small but promising study, researchers say. Three patients injected with the vaccine, GVAX, had no recurrence of lung cancer for more than three years afterward, according to the study of 43 people with the most common form of the disease, non-small cell lung cancer. The findings were published in the Journal of the National Cancer Institute. The research was funded in part by Cell Genesys, a pharmaceutical company that hopes to produce the vaccine. The vaccine, developed by researchers at Baylor University Medical Center in Dallas, is years away from reaching the market, if ever. The researchers hope to apply for Food and Drug Administration approval in three years. "The results are very promising for patients with non-small (cell) lung cancer, which is frequently resistant to chemotherapy," said Dr. John Nemunaitis, a Baylor oncologist who led the study. Non-small cell lung cancer is the nation's leading cause of cancer death, killing more than 150,000 people each year. The disease is related to smoking and is often difficult to treat. Treatment usually involves removal of the tumor, chemotherapy or both. Vaccine studies are a burgeoning area of cancer research. Unlike traditional vaccines, which generally aim to prevent disease, some experimental cancer vaccines are designed to treat or cure existing disease. This study is the first to show complete and long-lasting regression of lung cancer by stimulating the immune system to attack cancer cells, Nemunaitis said. A similar approach has shown promise against skin and renal cell cancer. In the study, each patient was injected in the arm and leg with a vaccine that included cells from his or her tumors. A gene called CM-CSF was placed into the cancer cells to change the surface of the cells to help the body identify them as cancerous. The body's immune cells soon began to recognize, attack and destroy the cancer cells in the lungs. Forty-three lung cancer patients - 10 in the early stage and 33 in the advanced stage - were injected with the vaccine every two weeks for three months. Researchers followed them for three years. The cancer disappeared in three of the advanced-stage patients. Two of those patients previously had chemotherapy, which failed. In the rest of the advanced-stage patients, the disease remained stable and did not spread for almost five months to more than two years. For patients in the early stage, the vaccine did not make much difference against the cancer. "The most exciting thing is in those who responded to the vaccine, it was complete," Nemunaitis said. "It's given us a lot of encouragement." For patients with advanced-stage lung cancer, chemotherapy works no more than 3 percent of the time, and survival is usually eight to nine months. Those whose cancer went into remission with the vaccine were alive at least three years later. And the vaccine has no side effects, Nemunaitis said. Dr. Anwar Khurshid, an oncologist at the Arlington Cancer Center, said the findings will "open a lot of avenues." "I think you'll cure some patients but not everyone. That's what has been proven in other cases," he said. "You need to vaccine earlier or combine with something else to cure more people. Lung Cancer Risk May Be Higher in Female Smokers-(Reuters Health-05/02/2004) Female smokers may be more likely to develop lung cancer than men who smoke a similar amount, new study findings suggest. The investigators found that of nearly 2,500 men and women age 40 and older screened for lung cancer, women had more than twice the risk of being diagnosed with the disease. If further research confirms this higher risk, it will be particularly important to stop girls and young women from taking up the smoking habit, the researchers say. There's not yet a clear reason why women might face a higher lung cancer risk than men, according to the study's lead author, Dr. Claudia Henschke of New York-Presbyterian Hospital/Weill Cornell Medical Center in New York. It's possible, she noted in an interview, that women are less able than men to metabolize, or "clear," the toxins from tobacco smoke, but more research is needed to answer that question. Other possibilities-such as sex differences in the aggressiveness of lung tumors, or underreporting of smoking levels by women-do not appear to explain the findings, according to Henschke. She and colleague Dr. Olli S. Miettnen report their results in the journal Lung Cancer. In the study, 1,202 women and 1,288 men underwent computed tomography (CT) scans to screen for lung cancer. All had smoked for at least 10 "pack-years"-meaning, for example, one pack a day for 10 years, or two packs a day for five years. Follow-up testing confirmed 45 cases of lung cancer among women, and 20 among men. After the researchers factored in participants' age and smoking history, women were more than twice as likely as men to be diagnosed with lung cancer. Some past research has suggested female smokers might be more susceptible to developing lung cancer, but other studies have failed to find such evidence. If further research confirms the current findings, it will be especially important for anti-smoking efforts to reach women and girls, according to Henschke. "The key thing," she said, "is that girls and young women don't start smoking." Drug Shows Little Promise Vs. Lung Cancer-(AP-13/01/2004) A drug that has prolonged the lives of many breast cancer patients has failed to live up to hopes that it might help people with lung cancer, new research has found. In a study outlined in the European journal Annals of Oncology, those treated with Herceptin in combination with two chemotherapy medicines did no better than patients treated with the chemotherapy drugs alone. However, the study, involving about 100 lung cancer patients, gave a hint that a very small fraction of patients with a particular genetic profile may benefit. Herceptin, a standard treatment for spreading breast cancer, belongs to a new set of cancer drugs called targeted therapies, which are intended to arrest cancer by disrupting the internal signals that fuel its unruly growth. Herceptin targets a gene called HER-2 and its protein. In breast cancer it typically delays progression by a few months in the quarter of victims with a particular genetic profile. Scientists were hopeful that Herceptin might benefit lung cancer patients because in many the HER-2 gene is switched on. Also, test tube studies had shown the drug seemed to work better in a chemotherapy combination on lung cancer cells than it did on breast cancer cells. "It was very disappointing therefore to find that the survival times and the time to the disease progressing were very similar - between six and seven months for both," said the study's leader, Dr. Ulrich Gatzemeier, head of thoracic oncology at Grosshansdorf Hospital in Germany. Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, said the findings show that for the large majority of lung cancer patients, Herceptin is not going to be the answer. "Positive or negative, this is important information," he said. "We now know a lot more than we did before this trial was done. This type of information will provide significant guidance to others." "We are perhaps at the end of the beginning of using targeted therapies," said Lichtenfeld, who was not involved with the research. "We're still learning about how these cells work. We are still finding the targets that we have to test. We're going to get there, it's just taking us a longer time." However, the study found that five of the six patients who had extremely high levels of the HER-2 protein responded to the drug better than the other patients did. It was nearly 8 1/2 months before their disease progressed compared with just over six months for the patients with lower HER-2 levels, Gatzemeier said. But experts say the fraction of patients who could benefit is so small that limited resources may better be directed elsewhere. Another targeted drug, Iressa, also has failed to show a benefit as a mainline lung cancer medicine. Lung Cancer Screening Helps Smokers Kick the Habit-(Reuters Health-20/10/2003) Getting screened for lung cancer helps provide many smokers with enough motivation to quit the habit out for good, new research suggests. Researchers based at the Mayo Clinic in Rochester, Minnesota, found that 14 percent of smokers had stopped smoking one year after being screened for lung cancer -- a much higher quitting rate than that typically seen in smokers who are not screened for cancer. Nearly 90 percent of lung cancers are caused by smoking, and smokers whose screening tests showed they had sub-par lung function were more likely to quit than smokers who learned their lungs were less damaged by their habit. The report, which appears in the journal Cancer, suggests that lung cancer screening provides healthcare providers with an opportunity to help smokers realize the impact of their habit, and how to get help, the authors note. "These findings support the use of cancer screening as a teachable moment in which to build on a patient's openness to learn new information and heightened motivation to promote health by providing tobacco dependence intervention," the authors write. During the study, the authors, led by Dr. Lisa Sanderson Cox, screened 901 smokers and 574 former smokers for lung cancer, then asked them one year later if they were still smoking. All former smokers said they had quit within the past 10 years, and both current and former smokers said they had smoked the equivalent of at least one pack per day for 20 years. Study participants received a chest CT scan to get a detailed image of the lungs. Typically, only between 5 and 7 percent of smokers who quit manage to stick it out for a year. However, two times as many butted out for good after being screened for lung cancer. On the other hand, ten percent of former smokers in the study said they had picked up smoking again one year after being screened. This shows "that clinicians promoting smoking abstinence with screening participants must not overlook relapse prevention in former smokers, particularly those in the early period of abstinence," Sanderson Cox and her team write. Ethyol® Protects Against Side Effects of Treatment in Non-Small Cell Lung Cancer-(ET-23/09/2003) According to results published in the International Journal of Radiation, Oncology, Biology and Physics, Ethyol® (amifostine) provides protection against side effects caused by treatment with radiation and chemotherapy, without compromising the effectiveness of therapy in patients with non-small cell lung cancer. Treatment for cancer with radiation and/or chemotherapy is associated with the development of various side effects, depending upon the chemotherapy agents used, the location of radiation, the doses and scheduling of particular regimens as well as the individual patient. Side effects can range from mild to severe, and may even become life threatening. If side effects from treatment become severe enough, the quality of life of a patient becomes impaired, and treatment doses often have to be delayed or reduced, compromising the effectiveness of therapy altogether. Research efforts have become more focused on reducing or mitigating side effects caused by treatment so that doses producing optimal outcomes may be delivered and patient quality of life be maintained. Ethyol is an agent that is approved by the FDA for the prevention or reduction of xerostomia (dry mouth) in patients receiving radiation therapy for cancers of the head and neck, and for the prevention or reduction of renal (kidney) side effects caused by Platinol® (cisplatin) in patients with advanced ovarian or non-small cell lung cancer (NSCLC). Clinical trials have also demonstrated that Ethyol reduces the incidence of side effects of the bladder and gastrointestinal track in patients receiving radiation to the pelvis. Clinical trials are ongoing to evaluate Ethyol in preventing or reducing side effects from various treatments in several types of cancer. Researchers from Greece recently conducted a clinical trial evaluating Ethyol in the treatment of NSCLC. This trial involved 73 patients with advanced NSCLC who were receiving radiation plus chemotherapy (radiochemotherapy) with a platinum compound (Platinol or Paraplatin®). Patients received radiochemotherapy (RCT) plus Ethyol or RCT only (control group) and were directly compared. The incidence of severe esophagitis (inflammation of the esophagus) occurred in only 39% of patients receiving Ethyol, compared with 84.4% in the control group. There was also a significant reduction in side effects to the lungs in the group of patients treated with Ethyol (19.4%), compared to the control group (56.3%). Furthermore, anti-cancer responses to treatment were not compromised with the treatment of Ethyol, with an 88.8% anti-cancer response rate in patients treated with Ethyol and an 82.2% anti-cancer response rate in those treated with RCT alone. The researchers concluded that the addition of Ethyol to radiochemotherapy for treatment of advanced NSCLC reduces the incidence of esophagitis and side effects affecting the lungs without compromising the effectiveness of treatment. Longer follow-up may help determine if a survival benefit can be achieved with the use of Ethyol. Patients with NSCLC who are scheduled to undergo radiochemotherapy may wish to speak with their physician about the risks and benefits of Ethyol. Age No Bar to Chemotherapy for Lung Cancer-(Reuters Health-29/08/2003) Chemotherapy commonly used to treat lung cancer is as effective and is no more toxic for the elderly than for younger patients, researchers report in the medical journal Cancer. In fact, Dr. Thomas A. Hensing told Reuters Health, his group's research matches that of others showing that "age alone should not be used to determine treatment for patients with advanced lung cancer. Elderly patients who are fit and active should be offered standard therapy or encouraged to enroll in ongoing clinical trials for this disease." Advanced lung cancer is increasingly seen in people 70 years old and older, but they are less likely to be considered for the same treatment used in younger individuals. However, research shows that patients who are relatively healthy apart from their cancer survive as long as their younger counterparts, with a comparable quality of life. Hensing, who is currently with Evanston Northwestern Healthcare in Evanston, Illinois, and colleagues analyzed the results of a trial involving 239 patients who had advanced "non-small-cell" lung cancer, nearly a third of whom were aged 70 or above. All the patients were treated with a combination of carboplatin and paclitaxel. Older patients were no more likely to suffer from severe nausea and vomiting, nor did they have more muscle and joint pain. Blood disorders that often accompany chemotherapy, such as low levels of white blood cells, red blood cells and platelets, were no worse in the older patients. When responding to questionnaires asking about their quality of life, the older age group was similar to the younger one. Survival rates after chemotherapy were not affected by age. In light of these findings, the researchers conclude that "in fit, elderly patients, carboplatin/paclitaxel represented a reasonable standard regimen." Nevertheless, Dr. Hensing added, "despite ongoing efforts, elderly patients continue to be underrepresented in clinical trials and we need to work harder to develop strategies that can increase the number of elderly patients in these studies." Study Shows Promising Results for Elderly Patients With Non-Small Cell Lung Cancer Treated With Taxotere(R)-Based Combination Versus Another Standard Therapy-(Market Wire-01/06/2003) Data presented today show that elderly patients with advanced non-small cell lung cancer (NSCLC) who received Taxotere® (docetaxel) Injection Concentrate with a platinum compound had improvement in median survival compared to the combination of vinorelbine and cisplatin, another standard first-line regimen in this patient group. Results of this multinational Phase III study were reported at the 39th annual meeting of the American Society of Clinical Oncology (ASCO). "This study shows that performance status trumps age; the fit elderly patients do as well as younger patients receiving combination platinum-based therapy for advanced non-small cell lung cancer," said the study's discussant Corey Langer, MD, Director, Thoracic and Head & Neck Medical Oncology, Fox Chase Cancer Center. "In this regard, docetaxel partners well with either cisplatin or carboplatin." This analysis of patients over the age of 65, which was part of the largest study reported to date in NSCLC, concludes that age alone should not be a factor in determining whether a patient should receive chemotherapy. "The study findings affirm that Taxotere®/platinum combinations are active first-line treatment options and provide a favorable risk/benefit profile even for older patients greater than 65 years of age with advanced NSCLC," said the study's principal investigator Chandra P. Belani, MD, Professor of Medicine at the University of Pittsburgh School of Medicine, and Co-director of the Lung Cancer Program at the University of Pittsburgh Cancer Institute. "Since more than 50 percent of the newly diagnosed patients are elderly, these more recent data provides hope to those who may not have been offered chemotherapy treatment in the past." The study included 1,218 patients with advanced NSCLC. 401 patients (33 percent) were age 65 years or older. Patients were randomized to one of three treatment arms. 149 elderly patients received Taxotere®/cisplatin, 118 received Taxotere®/carboplatin and 134 received vinorelbine/cisplatin. The first group received the combination of Taxotere®, 75 mg/m2, and cisplatin, 75 mg/m2, and the treatment was repeated every 21 days. The second group was treated with the combination of Taxotere®, 75mg/m2, and carboplatin, AUC=6 and the treatment was repeated every 21 days. The third group received a combination of vinorelbine, 25 mg/m2/per week, and cisplatin, 100 mg/m2, and the treatment was repeated every 28 days. The median survival of patients over the age of 65 on the Taxotere®/cisplatin arm was improved compared to those who received vinorelbine/cisplatin (12.6 vs. 9.9 months). In addition, one- and 2-year survival rates were 52 percent and 24 percent for the Taxotere®/cisplatin group, compared to 41 percent and 17 percent for the vinorelbine/cisplatin arm.Survival results for the Taxotere®/carboplatin group were similar to those obtained for vinorelbine/cisplatin. Median survival was 9.0 months and one-and two-year survival rates were 38 percent and 19 percent respectively. There was a moderately higher incidence of grade 3-4 asthenia, infection and pulmonary toxicities across all three treatment arms, and diarrhea and sensory neurotoxicity for cisplatin-containing arms, in elderly patients compared with patients younger than 65 years. Elderly patients treated with Taxotere®/cisplatin experienced a higher incidence of grade 1-4 diarrhea (54% vs. 23%) and peripheral edema (36% vs. 18%), but they experienced less vomiting (52% vs. 63%) than elderly patients on the vinorelbine/cisplatin arm. Study Backs Chemotherapy for Lung Cancer-(AP-02/06/2003) A large international study has shown for the first time that offering chemotherapy after surgery can modestly improve the survival of people with early-stage lung cancer. Even though the benefit is small, doctors say the discovery is important, both because lung cancer is such a grim diagnosis and because it is so common. It is the No. 1 cancer killer, diagnosed in 1.2 million people around the world each year, and 85 percent of victims die of the disease. Chemotherapy after surgery is standard for treatment of breast and colon cancer. But until now, there has been no convincing evidence that it changes the course of lung cancer. Doctors do offer chemotherapy to patients, but the treatment is typically intended to ease symptoms rather than delay death. The latest study, suggests lung cancer patients do have another treatment option, if their tumors are found early and can be removed with surgery. A follow-up round of chemotherapy improves their survival by several months. Dr. Thierry Le Chevalier, who directed the study, said the results mean chemotherapy should be a routine option for patients who have surgery for early lung cancer. "The benefit reported could prevent annually around 7,000 deaths worldwide," he said at a meeting in Chicago of the American Society of Clinical Oncology. Several doctors agreed that the results will have a major impact, although some questioned whether the change will be immediately embraced by all specialists. However, Dr. Nassar Hanna of Indiana University noted that several smaller studies have tried and failed to prove that chemotherapy does any good after lung cancer surgery. "I don't think there will be an across-the-board change in practice, although many will be swayed," Hanna said. The study was conducted on patients with non-small-cell lung cancer, by far the most common kind, that was confined to the lungs or had spread only to nearby lymph nodes. About one-third of such patients are considered good candidates for surgery. Many patients cannot have surgery because they are not well enough to tolerate the operation, which typically takes out 20 percent of the lung, or the disease has already spread to the lymph nodes in the neck and opposite side of the chest. Doctors enrolled 1,867 patients at 148 hospitals in 33 countries. They were randomly assigned to get an operation alone or surgery plus chemotherapy. The treatment regimens included the drug cisplatin plus a variety of other standard chemotherapy medicines. After five years, 45 percent of patients getting chemotherapy were still alive, compared with 40 percent of those getting only surgery. Average survival was 51 months for the chemotherapy patients and 44 months for the comparison group. Cisplatin can carry serious side effects, including a drop in white blood cells that leaves patients open to infection. Smoking May Speed Lung Cancer Patients' Death-(Reuters Health-23/05/2003) Smokers who continue to puff away even after a lung cancer diagnosis seem to die more quickly than smokers who quit during cancer treatment, new study findings suggest. The study looked at patients with small cell lung cancer, which accounts for about one quarter of all newly diagnosed lung cancers. Most cases are only identified after the cancer has spread to distant sites such as the brain and liver. Patients typically live for only a matter of months after diagnosis, and few survive two years or more. It is well known that smoking causes cancer, and previous research has suggested that people with cancer who continue to smoke during treatment tend to do more poorly, according to a team led by Dr. Gregory M.M. Videtic of Brigham and Women's Hospital in Boston, Massachusetts. However, the effect of continued smoking on people being treated for small cell lung cancer is less certain, the researchers point out in a report in the Journal of Clinical Oncology. To investigate, Videtic's team reviewed the medical records of 186 people with small cell lung cancer who underwent chemotherapy. The researchers found that the average survival for former smokers was 18 months compared to 13.6 months for those who smoked during their treatment. The researchers ruled out other characteristics, such as age and sex, or differences in treatment, as a cause of the survival difference. "We conclude that (small cell lung cancer) patients who are offered (chemotherapy) as definitive management of their disease are at risk if they continue to smoke while receiving treatment," the authors write. As such, the authors recommend that physicians ask their patients about their smoking status before beginning treatment and make suggestions about how they can kick their habit. FDA OKs Last-Chance Drug for Lung Cancer-(ET-05/05/2003) People with advanced lung cancer who have exhausted standard treatment gained a last-chance therapy, a once-a-day pill called Iressa that shrinks tumors in a fraction of those terminally ill patients. It's a controversial drug: Iressa already is sold in Japan, where the health ministry has linked it to 173 deaths from another pulmonary disorder, interstitial lung disease or ILD. So far, very few users of experimental Iressa in this country appear to get ILD, but it is fatal about a third of the time. But the U.S. Food and Drug Administration said it had enough evidence that Iressa offered some hope for patients already dying of their cancer to approve its sale here even as that side effect and questions about Iressa's overall effectiveness continue to be studied. Iressa treats non-small cell lung cancer, the most common form, but is only to be used as third-line therapy, after the two standard treatments fail, the FDA stressed. One study of 216 advanced patients found 10 percent had their tumors shrink for at least a month while taking Iressa. Nobody yet knows if that translates into longer survival - manufacturer AstraZeneca continues to study that question. But the shrinkage seems to last at least seven months, said FDA oncology chief Dr. Richard Pazdur. Particularly intriguing, the FDA said, is that Iressa seems to work significantly better for women - about 17 percent of women see tumor shrinkage vs. 5 percent of men. Also, it seems to work better for people who never smoked, FDA said, a conundrum because smoking is the main, though not sole, cause of lung cancer. Yet there's a big mystery: Iressa had no effect when more than 2,000 patients with early-stage cancer took it together with regular chemotherapy in two more stringent studies. Why? No one knows, although some scientists think combining regular chemotherapy with Iressa - which works by jamming one of a tumor's internal growth signals - could blunt the new drug's action. Hence, the FDA put a warning label on Iressa stressing it is not for use with other chemotherapies during early lung cancer - and is requiring AstraZeneca to conduct more research to settle the issue. Then there's the question of that rare but often fatal side effect. Of about 28,000 Iressa users in Japan, about 2 percent have come down with ILD. But here, less than half a percent of some 23,000 people given Iressa in a special experimental program got ILD. And in the studies that compared Iressa to a dummy pill in people getting chemotherapy for early lung cancer, both groups came down with ILD equally - about 1 percent, the FDA said. It can be hard to diagnose ILD in lung cancer patients, and other cancer treatments can cause ILD, too, said FDA drug chief Dr. Robert Temple. Even if it turns out that 1 percent of Iressa users gets ILD, that's not a big enough risk to outweigh the drug's potential benefit to these terminally ill patients, he said. That's "an unfortunate decision," said Dr. Peter Lurie of the consumer advocacy group Public Citizen, which had urged the FDA to reject Iressa's sale until questions about the toxicity and true benefit were settled. He questioned if some U.S. deaths thought to be from lung cancer really were Iressa-caused ILD. Conversely, some studies now under way in Japan should help clear up exactly how doctors there classify ILD, to see if it's being overdiagnosed, said AstraZeneca spokeswoman Mary Lynn Carver. Tracking Down Proteins Linked to Lung Cancer-(HealthScoutNews-28/04/2003) A new high-tech method that identifies two proteins involved in lung cancer has been developed by Duke University Medical Center researchers. The technique uses mass spectrometry to detect specific proteins that are over-expressed in cancer cells, blood, urine or any substance that contains proteins. Using this new method, the Duke researchers identified two proteins -- MIF and CyP-A -- whose levels are elevated in lung cancer cells but not in normal cells. The study appears in a recent issue of Cancer Research. The ability to identify these proteins may help lead to development of new drugs aimed at blocking the effects of the proteins. The technology may also help scientists develop a simple blood test using MIF and CyP-A as molecular markers to diagnose lung cancer without having to perform invasive biopsies. "Our technique is a new paradigm for identifying protein targets in cancer, because we are zeroing in on the protein itself rather than searching for a defective gene and then hunting down its relevant proteins," study author Dr. Edward Platz says in a news release. Lung
Cancer Risk Varies Dramatically Among Smokers-(HealthScoutNews-19/03/2003) Consider: A 51-year-old woman who smoked a pack a day for 28 years and then quit has only a 0.8 percent chance of getting lung cancer in the next decade, the study found. Compare her to a 68-year-old man who has smoked two packs a day for 50 years and refuses to stop smoking. If he keeps puffing away, his risk of getting lung cancer in the next decade is 15 percent. The study appears in the Journal of the National Cancer Institute. Bach and his colleagues undertook the study in part because of the increasing interest in using low-dose helical computed tomography scans, commonly called CT scans, to detect lung cancer in its early stages. The problem with CT scans is that the test often detects lung abnormalities that aren't lung cancer, including infections and scarring. This can lead to unnecessary biopsies and needless anxiety, he says. "We thought it would be very important for people to know if they're at the high end or the low end of the risk scale," he says. "That way, they can make a decision with their physician about whether or not these CT scans are for them." Bach and his colleagues used previous data on more than 14,254 men and women aged 50 to 59 who were considered heavy smokers, which was defined as having smoked a pack a day for at least 20 years. The participants were either current smokers or had stopped smoking within six years before enrolling in the study. Another 4,000 participants were men aged 45 to 69 who had been exposed to asbestos, a risk factor of lung cancer, and who were current or former smokers. Study participants were followed for 10 to 20 years. During the follow-up, about 1,110 people were diagnosed with lung cancer. Bach and his colleagues used the data to create a mathematical model to calculate who is most likely to get lung cancer. Researchers then applied the model to a sample of 300 people who had undergone cancer screening at the Mayo Clinic and came up with these sample profiles: · A 51-year-old woman who smoked a pack a day for 28 years and then quit has only a 0.8 percent chance of getting lung cancer in the next decade. · A 52-year-old woman who smoked a pack a day for 35 years and who continues to smoke has a 2.8 percent chance of getting lung cancer in the next decade. · A 58-year-old man who smoked 25 cigarettes a day for 40 years but quit three years ago had a 4.1 percent chance of getting lung cancer in the next decade. · A 56-year-old woman who smoked two packs a day for 44 years and continued to smoke had a 8.4 percent chance of getting lung cancer in the next decade. · A 68-year-old man who smoked two packs a day for 50 years and refused to stop smoking had a 15 percent chance of getting lung cancer in the next decade. His risk would drop to 10.8 percent if he quit. "At the high end, you're talking about one in seven people," he says. Lung cancer is the leading cancer killer of both men and women, according to the American Lung Association. There were an estimated 164,100 new cases of lung cancer and an estimated 156,900 deaths from the disease in the United States in 2000. Even if your risk of getting lung cancer is relatively low, the study should not be read as permission to keep puffing away, says Dr. Jay Brooks, chairman of hematology/oncology at the Ochsner Clinic Foundation in New Orleans. "There is no safe level of exposure to the carcinogens in tobacco smoke," he says. "Quitting is absolutely the No. 1 thing an individual can do to reduce their risk of ever developing cancer." About one-third of cancers in the United States are directly related to cigarette smoke, including lung, throat, sinus, esophagus, pancreas, kidney and cervical cancers, he says. Does Radiation for Breast Cancer Affect Lung Cancer Risk?-(ET-18/03/2003) Women trying to weigh the pros and cons of different treatment options for breast cancer now have another important piece of information. Those who choose breast-conserving surgery (lumpectomy) plus radiation are not at increased risk for developing lung cancer later on, according to a recent study. However, mastectomy plus radiation does seem to increase risk. Lydia Zablotska, MD, PhD, and Alfred Neugut, MD, PhD, both of Columbia University in New York, studied the data on more than 250,000 women who had been treated for early stage breast cancer since 1973. They reported their results in the journal Cancer (Vol. 97, No. 6: 1404-1411). Women with breast cancer that has not spread to distant parts of the body can often choose between mastectomy (surgical removal of the breast) and breast-conserving surgery, such as lumpectomy, followed by radiation therapy. Radiation therapy is not usually required after mastectomy for early stage breast cancers, although it is sometimes used for larger tumors or those that involve nearby lymph nodes. At one time, mastectomy was the preferred treatment for all early breast cancers, but large studies have shown it to be no more effective than lumpectomy plus radiation in terms of survival. Some concerns have been raised, however, about radiation and the development of other cancers later on. Previous studies have shown that women who received radiation along with mastectomy were more likely to develop lung cancer 10 or more years later. This risk was especially high among smokers. Researchers believed this increased risk was due to the lung being exposed to some residual radiation. This idea was supported by the fact that the increased risk was only in the lung on the side of the body that received the radiation. Because lumpectomy and radiation is a relatively newer form of treatment, it was not known if it would increase the risk as well. To determine if there was a risk, the Columbia University researchers went to the National Cancer Institute's SEER database, which contains information from about 10% of all people treated for cancer in the United States, dating back to 1973. Almost 200,000 women in the database had had a mastectomy, and about 65,000 had had a lumpectomy. About 14% of women in the mastectomy group and 75% in the lumpectomy group also received radiation. In the mastectomy group, the risk of lung cancer increased significantly after 10 years in those who also received radiation. The risk of cancer in the lung on the same side as the radiation was more than doubled. In terms of individual risk, the researchers calculated that 1 in 93 women who received a mastectomy plus radiation would develop lung cancer 11 to 20 years after treatment, compared to 1 in 200 for those who received only mastectomy. These findings were consistent with previous studies. In the lumpectomy group, however, those receiving radiation did not have a significantly higher risk of lung cancer compared to those who did not get radiation, even up to 14 years later. (The data did not go back farther because the technique is still relatively new.) The researchers theorized that the remaining breast tissue in lumpectomy patients probably shielded the lungs from receiving much of the radiation. For women with locally advanced cancer, such as those with larger tumors or tumors that have spread to the lymph nodes, the benefit of adding radiation to mastectomy generally outweighs the risk. It's also important to note that the women with the longest follow-up in this study were treated in the 1970s and 1980s, and newer radiation techniques might not pose as much of a risk. Still, the authors cautioned, patients and their doctors should be aware of the risk and should take it into account, both when making treatment decisions and when following up years later. Because the SEER database does not contain information on smoking history, it could not be examined in this study. Still, other studies have found it added to the risk of lung cancer. More research on this subject is needed, stated the authors. Until such research allows guidelines to be developed, women with breast cancer should take this into account as we Combination Chemotherapy May Not Be Best Choice For Elderly Lung Cancer Patients-(ET-06/03/2003) Elderly patients with an advanced form of lung cancer may be better off with single-drug chemotherapy treatment than with a combination of two types of chemotherapy drugs, according to a new study. The research, published in the Journal of the National Cancer Institute (Vol. 95, No. 5: 362-372), compared treatment regimens for patients over age 70 who had advanced non-small-cell lung cancer , or NSCLC. The results could help improve treatment options for hundreds of thousands of patients. The ACS estimates that 171,900 new cases of lung cancer will be diagnosed in the United States in 2003. About 80% of those will be non-small-cell lung cancers. "Since the median age of people diagnosed with lung cancer is 68 to 70, and since there are 170,000 new cases of lung cancer every year, we're talking about a lot of patients," said Dr. Paul Bunn, director of the University of Colorado Cancer Center and president of the American Society of Clinical Oncology, who wrote an editorial accompanying the study. The study, conducted in Italy, compared results for elderly patients given either vinorelbine, or gemcitabine, or a combination of the two drugs. The patients were treated an average of 10-11 weeks. Earlier studies have shown that both vinorelbine and gemcitabine, administered individually, help elderly NSCLC patients survive longer, and have only mild toxic effects. The two-drug combination is often given to elderly patients because it is less toxic than cisplatin-based chemotherapy, a treatment frequently used in younger patients who can better tolerate the side effects. The researchers expected that the combination therapy would be more effective than the single drugs in prolonging patients' lives, but the study results didn't bear that hypothesis out. The combination of the two drugs, they found, did not improve survival by a statistically significant amount. Patients who took just vinorelbine survived an average of 36 weeks; those who took gemcitabine survived an average of 28 weeks; and those on the combination regimen survived an average of 30 weeks. Likewise, patients on all three therapies showed a similar response to treatment, and similar rates of disease progression. They also reported similar quality of life, when questioned in the middle of the chemotherapy cycle. But the researchers did see differences in the toxicity of the three drug regimens. More patients on the combination therapy experienced a drop in blood platelet levels and liver toxicity than did patients who took vinorelbine alone. And the combination drugs more often caused a decline in white blood cell count, as well as vomiting, fatigue, constipation, and cardiac toxicity than the gemcitabine alone. Because of these results, the researchers recommend that elderly patients be offered the single-drug chemotherapy rather than the vinorelbine-gemcitabine combination. The study did not determine which of the individual drugs was more successful. Bunn said the study should also drive home the point that elderly patients can benefit from chemotherapy much the same way younger patients do, and should be given the option of treatment. "For a long time, people have had the general impression that elderly patients with many types of cancers should not be offered therapy," he said. "In point of fact, what that study and others show is that the survival gains and quality of life gains are just as great in the elderly as in younger populations," Bunn said, "so age shouldn't be a determinant of whether patients should be offered treatment." Lung Screens Find Cancer, but at High Cost: Study-(Reuters-27/02/2003) Next-generation X-rays can find early lung tumors while they are still curable, but 98% of people with lumps in their lungs do not turn out to have cancer, US researchers said. They said it will take more research to determine whether it is worth the anguish, money and medical trouble to screen a wide population of smokers for lung cancer. The team at the Mayo Clinic in Rochester, Minnesota, used spiral computed tomography (CT) scans, a type of computer-assisted X-ray that gives doctor a better picture than traditional X-rays, with less exposure to radiation for the patient. The study of 1,520 smokers and other people at high risk of lung cancer showed that two-thirds had nodules--lumps that might be cancerous. Of these, 38 were cancerous, and 60% of them were at the smallest and most curable stage. But 98% of the lumps were benign. So these patients underwent expensive and potentially dangerous surgery only to find they did not have cancer, the researchers report in the journal Radiology. "Surgery costs between $20,000 and $30,000 and carries with it a 2 percent to 4 percent mortality rate," Dr. Stephen Swensen, the radiologist who led the study, said in a statement. Currently, if non-small-cell lung cancer, the most common type, is detected before it spreads, patients have a 50% chance of survival. But only 15% of patients are diagnosed before their cancer has spread. Only 6% of small-cell lung cancer patients live for five years after diagnosis. This makes lung cancer by far the most deadly cancer in the United States. It is expected to kill 157,200 people this year, according to the American Cancer Society. Despite the questions that remain, Swensen said that "CT lung cancer screening may be part of the solution for this major killer." 'Sonic Hedgehog' Holds Clue to Lung Cancer-(HealthScoutNews-05/03/2003) Certain cancer tumors appear to proliferate by hijacking a process that, under normal circumstances, is involved in forming and repairing cells. Blocking this process may stop tumor growth in its tracks, scientists say in a new study. Specifically, the findings may hold promise for small-cell lung cancer (SCLC), the deadliest form of lung cancer that is closely tied to smoking. The authors of the article, appearing in Nature, already have a compound that successfully blocked tumor growth in mice with human cancers. "Knowing what are the key molecules that are causing this process is really exciting," says Myung Shin, associate member of the Fox Chase Cancer Center in Philadelphia. "They demonstrate that this pathway is being turned on in cancer cells and that they can block it." Something seems to go wrong at a very fundamental, molecular level. In certain normal cells, the so-called "embryonic pathways" that repair cells and help them turn over are on all the time. "In adult organisms, the skin, bone marrow and gut all have cells which are constantly growing and turning over and replacing lost cells," says study author Dr. D. Neil Watkins, a research associate with the Kimmel Cancer Center at Johns Hopkins University in Baltimore. That's normal. What is not normal is when these pathways start working on behalf of tumor cells. In other words, they're on when they're not supposed to be. Lung cells represent a case in point. "In a normal adult lung, everything is quiet," Watkins says. There is no hustle and bustle of repairing and replicating activity unless you're a smoker. In people who smoke, injured airways signal repair crews to patch them up so they'll continue to perform the work of breathing. This is still a normal process, as long as the pathway goes back to sleep as soon as the repair is finished. The authors found, however, that when an SCLC tumor is present, a signaling molecule called the "Sonic hedgehog" pathway (after the cartoon character) stays on. The Sonic hedgehog (Shh) pathway is also essential for the formation of the lungs in embryos. "The cells are regenerating and they don't know when to stop. They're bypassing the normal process," Shin explains. The Shh pathway seems to be involved both in repairing lungs and in fueling specific types of cancer. Although it's not clear exactly why this is so, the Nature authors speculate the normal cells involved in repair, called "progenitor" cells, are vulnerable to mutations that cause them to transform into cancer cells. As it turns out, the Shh pathway was also turned on in certain samples of human tissue that had been taken from lung tumors. So this pathway is essentially the Achilles heel of the cancer. "The more interesting -- and, in some ways, more unexpected -- finding is that although SCLC cells harbor many mutations and many abnormal pathways which permit the cell to replicate endlessly, it's still dependent on the pathway for growth," Watkins says. "Although it's a very aggressive malignant tumor, it's extremely vulnerable to having the pathway silenced." Watkins and his team may already have a way to target this Achilles heel. A naturally occurring plant compound called cyclopamine did, in fact, block that pathways in mice so the cells didn't grow. "Mice that have human tumors respond to treatment with this drug," Watkins says. Cyclopamine originally drew interest because it prevented birth defects related to the Shh pathway in sheep. (Study co-author Philip Beachy discovered its ability to block the hedgehog pathway.) "This is not conventional chemotherapy. It does nothing else [to the body]," Watkins says. "It's potentially a very exciting finding because this may be a way of highly specifically treating certain types of cancer without affecting the rest of body." And while the compound seems to work in sheep and mice, it'll be years before it's ready for human cancer patients. Thalidomide-Like Drug Has Potential to Fight Cancer (Reuters Health-03/02/03) British researchers have identified a drug similar to thalidomide that triggers apoptosis, a cell suicide program, in laboratory-grown tumor cells. The drug has the potential to fight a number of different types of cancer, they suggest. The investigators, from St. George's Hospital Medical School in London and the US company Celgene, were assessing the anti-tumor properties of thalidomide itself, along with two groups of molecules similar to thalidomide, dubbed ImiDs (immunomodulatory drugs) and SelCIDs (selective cytokine inhibitory drugs). One of the analogs, SelCID-3, "consistently" reduced tumor cell survival in a variety of types of solid tumor cells but had no effect on non-cancerous cells, the researchers write in the journal Cancer Research. "We were surprised at the ability of this class of drug to kill cancer cells but leave normal cells apparently unaffected," said author Dr. J. Blake Marriott from St. George's Hospital Medical School. Celgene currently markets thalidomide as a treatment for leprosy. The drug is notorious for causing the birth of hundreds of babies with missing limbs in the 1960s after it was used to prevent morning sickness during pregnancy, but is now being explored as a treatment for other conditions. Other British researchers said this week they would begin a large trial of the drug for small cell lung cancer. The St. George's group conducted a second experiment in mice grafted with human pancreatic cancer tissue. They found mice treated daily with SelCID-3 had smaller tumors after 32 days than control mice given a placebo only. Although the work is preliminary, the researchers think the drug has "therapeutic potential against a wide range of solid tumors, including those with mutant p53," which is found in many types of cancers. "The most likely benefits will be when tailor-made combinations of these drugs are used, perhaps in combination with other chemotherapeutic drugs," Marriott added in a statement. The researchers hope that clinical trials with the compound could begin within two years. Vitamin A Cousin May Help Treat Lung Cancer -Study-(Reuters-04/02/03) A cousin of vitamin A may be able to repair some of the genetic damage done by smoking and perhaps even prevent lung cancer, U.S. researchers reported. They hope their research will help them find ways to prevent lung cancer in former smokers, who have a high risk of the disease even years after they quit. "The drug we used acts to reverse a genetic abnormality associated with development of lung cancer," said Dr. Jonathan Kurie of the University of Texas M.D. Anderson Cancer Center, who led the study. They do not believe the drug they used will be a final product -- it causes too many side-effects such as rashes. But their study showed there was hope and pointed researchers down the road toward better compounds. "The work is a proof of concept, suggesting that compounds like this may prove to have a protective effect against development of precancerous lesions," Kurie said.Such lesions can become cancerous tumors. More than 45 million Americans have quit smoking and immediately lowered their risk of lung cancer, but half of all newly diagnosed lung cancer occurs in former smokers. Lung cancer is by far the biggest cancer killer in the United States and the world, expected to kill 157,000 Americans this year. Researchers have been studying antioxidants, compounds that prevent and in some cases reverse genetic damage, as a possible route to preventing or treating a range of cancers. Some of the most common antioxidants are vitamins such as vitamins A. Studies have not shown taking megadoses of these vitamins can help smokers -- and one study showed it may hurt. Taking vitamins at home is probably no solution, either, said Kurie. "You have to take too high a dose and have to be under a doctor's supervision for that," he said. So Kurie's team tried a cousin of vitamin A known as 9-cis-retinoic acid. Writing in the Journal of the National Cancer Institute, Kurie and colleagues said the compound seemed to fix some of the DNA damage seen in former smokers. They focused on the RAR-beta gene. They studied 226 patients who had stopped smoking for at least a year. One-third of them were given 9-cis-retinoic acid, one-third got a related compound called 13-cis-retinoic acid, which has shown promise against other cancers, and a third group got a placebo or dummy pill. Tissue samples taken from their lungs showed clear damage in many of the patients before treatment. Before treatment, 69 percent of the patients had good, working versions of the RAR-beta gene. Afterward, the only real change was seen in those who got 9-cis-retinoic acid -- 76 percent of them had working versions of the gene. Kurie said his team now wants to test related compounds that may be safer. "We are starting to talk to Ligand Pharmaceuticals about Targretin," he said. This drug has a similar mechanism and has shown promise in a range of cancers. "It is probably better tolerated than 9-cis-retinoic acid," Kurie said. His team is also testing Celebrex, a second-generation version of drugs such as ibuprofen and aspirin. Marketed by Pfizer and Pharmacia, Celebrex, and possibly related drugs, may prevent the development of cancer by stopping tumors from growing blood vessels to feed themselves. Thalidomide-Like Drug Has Potential to Fight Cancer (Reuters Health-03/02/03) British researchers have identified a drug similar to thalidomide that triggers apoptosis, a cell suicide program, in laboratory-grown tumor cells. The drug has the potential to fight a number of different types of cancer, they suggest. The investigators, from St. George's Hospital Medical School in London and the US company Celgene, were assessing the anti-tumor properties of thalidomide itself, along with two groups of molecules similar to thalidomide, dubbed ImiDs (immunomodulatory drugs) and SelCIDs (selective cytokine inhibitory drugs). One of the analogs, SelCID-3, "consistently" reduced tumor cell survival in a variety of types of solid tumor cells but had no effect on non-cancerous cells, the researchers write in the journal Cancer Research. "We were surprised at the ability of this class of drug to kill cancer cells but leave normal cells apparently unaffected," said author Dr. J. Blake Marriott from St. George's Hospital Medical School. Celgene currently markets thalidomide as a treatment for leprosy. The drug is notorious for causing the birth of hundreds of babies with missing limbs in the 1960s after it was used to prevent morning sickness during pregnancy, but is now being explored as a treatment for other conditions. Other British researchers said this week they would begin a large trial of the drug for small cell lung cancer. The St. George's group conducted a second experiment in mice grafted with human pancreatic cancer tissue. They found mice treated daily with SelCID-3 had smaller tumors after 32 days than control mice given a placebo only. Although the work is preliminary, the researchers think the drug has "therapeutic potential against a wide range of solid tumors, including those with mutant p53," which is found in many types of cancers. "The most likely benefits will be when tailor-made combinations of these drugs are used, perhaps in combination with other chemotherapeutic drugs," Marriott added in a statement. The researchers hope that clinical trials with the compound could begin within two years. Vitamin A Cousin May Help Treat Lung Cancer -Study-(Reuters-04/02/03) A cousin of vitamin A may be able to repair some of the genetic damage done by smoking and perhaps even prevent lung cancer, U.S. researchers reported. They hope their research will help them find ways to prevent lung cancer in former smokers, who have a high risk of the disease even years after they quit. "The drug we used acts to reverse a genetic abnormality associated with development of lung cancer," said Dr. Jonathan Kurie of the University of Texas M.D. Anderson Cancer Center, who led the study. They do not believe the drug they used will be a final product -- it causes too many side-effects such as rashes. But their study showed there was hope and pointed researchers down the road toward better compounds. "The work is a proof of concept, suggesting that compounds like this may prove to have a protective effect against development of precancerous lesions," Kurie said.Such lesions can become cancerous tumors. More than 45 million Americans have quit smoking and immediately lowered their risk of lung cancer, but half of all newly diagnosed lung cancer occurs in former smokers. Lung cancer is by far the biggest cancer killer in the United States and the world, expected to kill 157,000 Americans this year. Researchers have been studying antioxidants, compounds that prevent and in some cases reverse genetic damage, as a possible route to preventing or treating a range of cancers. Some of the most common antioxidants are vitamins such as vitamins A. Studies have not shown taking megadoses of these vitamins can help smokers -- and one study showed it may hurt. Taking vitamins at home is probably no solution, either, said Kurie. "You have to take too high a dose and have to be under a doctor's supervision for that," he said. So Kurie's team tried a cousin of vitamin A known as 9-cis-retinoic acid. Writing in the Journal of the National Cancer Institute, Kurie and colleagues said the compound seemed to fix some of the DNA damage seen in former smokers. They focused on the RAR-beta gene. They studied 226 patients who had stopped smoking for at least a year. One-third of them were given 9-cis-retinoic acid, one-third got a related compound called 13-cis-retinoic acid, which has shown promise against other cancers, and a third group got a placebo or dummy pill. Tissue samples taken from their lungs showed clear damage in many of the patients before treatment. Before treatment, 69 percent of the patients had good, working versions of the RAR-beta gene. Afterward, the only real change was seen in those who got 9-cis-retinoic acid -- 76 percent of them had working versions of the gene. Kurie said his team now wants to test related compounds that may be safer. "We are starting to talk to Ligand Pharmaceuticals about Targretin," he said. This drug has a similar mechanism and has shown promise in a range of cancers. "It is probably better tolerated than 9-cis-retinoic acid," Kurie said. His team is also testing Celebrex, a second-generation version of drugs such as ibuprofen and aspirin. Marketed by Pfizer and Pharmacia, Celebrex, and possibly related drugs, may prevent the development of cancer by stopping tumors from growing blood vessels to feed themselves. Routine CAT Scans for Lung Cancer? Save Your Breath-(HealthScoutNews-14/01/03) It sounds like a great idea: Go to the doctor's office, spend a few hundred dollars on a CAT scan, and find out if you have lung cancer from smoking. But if you're not suffering from any symptoms, researchers say you should just stay home and save your money. While the scans may save lives, a computer simulation shows that regular scans would be too expensive for American society to bear, says Dr. Parthiv J. Mahadevia, a research scientist who studied the potential use of the technology. False alarms could also lead to unnecessary surgeries for healthy people, he says. "There are negative consequences as well as high costs," says Mahadevia, who works at MEDTAP International in Bethesda, Md. Computed tomography (known as CT or CAT scans) allows doctors to see three-dimensional views of the inside of the body. Scientists improved the technology in the 1990s by developing a type of CAT scan known as helical or spiral. The scans -- which cost as much as $450 each -- can detect tumors smaller than one centimeter, and doctors routinely use them on patients who show signs of lung cancer. But some doctors also advocate their use on smokers who don't otherwise appear to be sick. The U.S. government recently started an eight-year study of the use of the CAT technology to detect lung cancer. The National Cancer Institute is recruiting 50,000 smokers and ex-smokers to determine if regular CAT scans and traditional X-rays would reduce death rates. For now, though, the worth of the scans isn't clear, Mahadevia says. "The question is: What do we do in the interim? How can we guide decision-making?" So he and colleagues designed a computer model to estimate how many lives would be saved if hypothetical groups of 60-year-old smokers and former smokers got annual CAT scans. Out of 100,000 current smokers in the hypothetical scenario, the scans would save an estimated 553 lives. But more than 1,100 people would undergo unnecessary biopsies and other types of surgery that pose risks of their own, according to the study. Using a common measurement of the value of medical tests, the researchers estimate that it would cost U.S. society an estimated $116,000 for each extra year of "high-quality" life for current smokers who would otherwise have died. (Lives defined as "high-quality" would not be hindered by major health problems.) According to the researchers, it's not cost-effective to spend more than $100,000 to add an extra year of "high-quality" life. The results, which are published in the Journal of the American Medical Association, show that CAT scans are best used when a person already shows symptoms of lung cancer, Mahadevia says. "When you know there's something going on, you need to find out what it is," he says. But even a firm diagnosis of lung cancer doesn't guarantee a rosy future, says Dr. Victor Grann, a clinical professor of medicine at Columbia University who wrote an editorial accompanying Mahadevia's study. "The problem with lung cancer patients who smoke is that not only are they prone to get lung cancer once, but they're also at risk to get it again or get other cancers," he says. Also, lung cancer is difficult to detect in its early stages and difficult to treat later on. "The majority of lung cancer patients are in more advanced stages when the disease is picked up, and they end up dying from it," Grann says. However, Grann does say that it may be cost-effective to give the CAT scans to smokers who seem healthy if their level of worry about cancer is so high that it may affect their quality of life. Study Questions Drinking-Lung Cancer Link-(Associated Press-17/12/2002) Light to moderate drinking of alcoholic beverages does not increase the risk of lung cancer, according to a study that involved more than 9,000 people over two generations. The study, appearing in the Journal of the National Cancer Institute, found that people who consume one to two alcoholic drinks a day have no greater chance of developing lung cancer than do nondrinkers. Data from the study was adjusted so that the effects of smoking, known to be the major cause of lung cancer, were statistically eliminated as a factor in the conclusion, the researchers report.Alcohol drinking has been associated with lung cancer in some past studies, but the findings are considered by some experts to be uncertain because drinking and tobacco smoke exposure often go together. The new study attempts to avoid this problem by removing the confounding effects of smoking, the researchers report. Dr. Luc Djousse of Boston University School of Medicine, the first author of the study, said his group used data from the famed Framingham, Mass., study that followed the health of thousands of participants since 1948. The research also includes data from the Framingham Offspring Study, which started in 1971 and involves children of the original study participants. For the lung cancer study, Djousse and his co-authors examined health and survey data from 4,265 subjects in the original Framingham study, and 4,973 from the offspring study. Researchers found 269 cases of lung cancer among the study participants. They were matched by age, gender and smoking history with participants who were not diagnosed with lung cancer. The researchers then compared the drinking habits of the group and concluded that light to moderate alcohol consumption was not a factor in the cancers. Djousse said that only one subcategory - offspring who drank more than two drinks a day - showed an increased risk of lung cancer. The incidence of cancer in this group was double that of the nondrinkers of the same age, smoking history and gender. However, Djousse said the numbers in this subcategory are too small to draw a valid statistical conclusion. Dr. Mary C. Dufour, deputy director of the National Institute on Alcohol Abuse and Alcoholism, said the researchers doing the study make up "a highly respected team using an extensive data base," but that the results do not eliminate alcohol drinking as a risk for lung cancer. Dufour said that the Djousse study analyzed only the effects of one to two drinks a day on lung cancer rates. She said other studies that looked at heavy drinkers - five drinks or more a day - found a direct link between alcohol and lung cancer. "The jury is still out on the heavy drinkers," said Dufour Gene May Help Predict Lung Cancer Patient Survival-(Reuters Health-20/11/2002) Patients with lung cancer are more likely to survive longer if they have high levels of a protein produced by a so-called "repair gene," scientists told a cancer drug meeting. In a study of patients who had undergone surgery for the most common type of lung cancer, known as non-small-cell lung cancer, the investigators found that those with high levels of the protein had the longest survival time. "Currently, every patient with lung cancer gets the same treatment, chemotherapy, and surgery when possible," said Dr. Gerold Bepler, a professor of medicine and oncology at the University of South Florida in Tampa. "However, we can't predict who will respond to chemotherapy and what factors are associated with survival of lung cancer. If this gene turns out to be a reliable predictor, we could tell which patients could do without chemotherapy, and which ones should get it." Most patients with lung cancer have, at best, a limited response to chemotherapy, Bepler noted. The repair gene is known as ERCC1. It works by correcting mistakes made during cell division by removing the defective DNA portion and replacing it with a corrected version. Bepler and colleagues were surprised that high levels of ERCC1 expression were associated with longer survival because the gene has been known to repair damage inflicted on cancer cells that have undergone chemotherapy, so that they become resistant to treatment. He and colleagues studied 51 patients with non-small-cell lung cancer in early to advanced stages. All of the patients' tumors had been surgically removed, and five had also undergone radiation treatment. One patient had received both radiation and chemotherapy. The investigators assessed whether patients had low, intermediate or high levels of ERCC1 expression. Those with low levels had a median survival of approximately 35 months, slightly less than 3 years. The intermediate group had a median survival of approximately 62 months or slightly more than 5 years, and the group with high levels had a median survival of approximately 94 months, or nearly 8 years. Bepler and his investigative team theorized that, following surgical removal of the tumor, patients with high levels of ERCC1 expression benefit because the gene begins to act against the remaining malignant cells. In patients with low levels, the likelihood of this cellular repair is reduced. "This finding could help physicians refine which patients receive chemotherapy," Bepler said. He noted that people with low levels of ERCC1 expression were less likely to develop resistance to chemotherapy drugs, and would therefore benefit from this type of treatment. But patients with high ERCC1 expression levels did not respond well to chemotherapy. The meeting was jointly sponsored by the American Association for Cancer Research, the National Cancer Institute and the European Organization for the Research and Treatment of Cancer. Survival Up Slightly for Some Lung Cancer Patients (Reuters Health-10/10/2002) Survival rates for patients diagnosed with early-stage small cell lung cancer have seen modest improvements over the last 25 years, new study findings show. Small cell lung cancer accounts for about one quarter of all newly diagnosed lung cancers. But most cases are only identified after the cancer has spread to distant sites such as the brain and liver. Patients typically live for only a matter of months after diagnosis, and few survive 2 years or more. In the current investigation, Dr. Bruce E. Johnson of the Dana Farber Cancer Institute in Boston, Massachusetts, and colleagues evaluated the survival of 6,564 patients diagnosed with small cell lung cancer who participated in clinical trials between 1972 and 1992. All of the patients had limited-stage cancer, meaning it had not spread beyond the lung. Half of the patients who participated in the trial between 1972 and 1981 survived for at least 12 months, the authors report in the journal Cancer. Survival improved by roughly 5 months for patients treated between 1982 and 1992, so that half of patients lived for at least 17 months. Johnson and colleagues also analyzed data from the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) cancer registry. Over a similar time period, the SEER data showed that survival for people with limited-stage small cell lung cancer was extended by a median of 6.4 months. The SEER data also showed that the number of patients surviving for 5 years after diagnosis has doubled over the last 25 years, from 5.2% of patients to 12.1%. Currently, the usual treatment for people with this type of lung cancer is a combination of chemotherapy and radiation therapy, Johnson and colleagues note. Further research will be needed, they conclude, to determine the factors--such as better treatment or supportive care--that contributed to the improvement in survival. Function of Key Molecule in Lung Cancer Identified (Reuters-02/10/2002) British scientists have identified a molecule essential for the spread of a serious type of lung cancer, a finding that could lead to the development of new drugs against the disease. Researchers at Hammersmith Hospital in London and Imperial College London said the molecule is abundant in small-cell lung cancer cells and controls signals that allow tumors to grow and spread. Small-cell accounts for about 20% of all lung cancer cases and is particularly difficult to treat because it does not respond to chemotherapy. The tumor grows quickly and is likely to spread to other organs in the body with the result that 97% of patients die within five years of diagnosis. "The function of this molecule was not understood," said Professor Michael Seckl, who headed the Hammersmith team. "We found that it appears to be critical for several different growth factors stimulating the enlargement of tumors. If we can knock that molecule out then we are knocking out the growth signal for a variety of different growth factors." Seckl, whose research is reported in the EMBO (European Molecular Biology Organization) journal, suspects the molecule may also be found in unusually large quantities in other types of cancer. "We've shown that the molecule is important for the growth and the division of the cell," Seckl added. "We would like to identify new therapies that target the cancer in a different way or identify why the cancer has become resistant so you can make the existing therapies work." Scientists had known about the molecule, called PI3KC2 beta, but until now they did not understand how it was involved in the spread of small cell lung cancer. Cancer cells grow when growth factors attach to receptors on the outside of the cell and send signals to the cell nucleus telling it to divide. Many growth factors can be involved so targeting just one with a drug is not likely to be effective. Seckl and his colleagues discovered that the molecule mediates the signals from several growth factors, making it a potential drug target. "Identifying a common single molecule--within each cancer cell--which allows the different growth factors to work in this way is an important step forward," he said. The scientists are hoping that within five to 10 years a treatment targeting this molecule will be available. Cancer Trial to Test Whether CT Scans Save Lives-(HealthScoutNews-18/09/2002) The newest generation of CT scans can spot lung tumors when they are smaller and, presumably, more treatable. But do they save lives? Common sense would dictate a "yes" answer, but research hasn't proven that yet and some small studies have suggested they don't. The federal government intends to find out once and for all, announcing today that it is launching the biggest and most ambitious study yet to learn whether the high-tech scanners will actually cut the death rate from lung cancer. Lung cancer rates "have remained high and have not declined as other cancers have," says John Gohagan, chief of the National Cancer Institute division of cancer prevention and co-director of the National Lung Screening Trial. Although doctors have high hopes for spiral CT scans, right now "we don't have any accepted or proven screening test for lung cancer that we believe will reduce the mortality rate." The National Cancer Institute (NCI), with help from the American Cancer Society, will recruit 50,000 smokers and ex-smokers at 30 leading hospitals nationwide. The cancer-free volunteers will be given either CAT scans or more conventional X-rays each year for three years, and researchers will track their health for eight years. By the study's end, they hope to learn whether CAT scans or X-rays made a better mark on early detection and, especially, death rates. From this, they'll determine whether all smokers and former smokers should have their lungs examined routinely. Much is at stake because of the disease's toll. Were lung cancer a specific cause of death (officially, it's listed along with all other cancers), it would be the nation's third-leading killer. The disease will claim about 160,000 American lives this year, more than cancers of the breast, prostate, colon, and ovary combined. Another 160,000 or so Americans will be diagnosed with the disease this year. The NCI says that 87 percent of these patients smoke or used to smoke, and Gohagan says there are 90 million current or former smokers in this country. Lung cancer is so deadly because it's not usually symptom-specific until it has already done significant damage. A patient often goes to the doctor with a cough, for instance, and an X-ray or CAT scan confirms the presence of a tumor. By that time, the cancer is well established in the lung and perhaps other parts of the body. The trial will have "considerable application for public health policy," Gohagan says, because it will tell whether CT tests should be routine. Spiral computerized tomography has been around for about a decade. It takes X-ray images of the whole chest and assembles them into a three-dimensional model. Whereas conventional X-rays can spot a tumor between one and two centimeters wide, a CAT scan can detect tumors smaller than a centimeter. Whether finding them at a smaller stage will cut the death rate is one aspect of the study. Another is how it affects the patient. The scans also pick up many images that are not cancers, so researchers will look into the incidence of false alarms, whether people are treated unnecessarily, and the "emotional impact of the screening process," says Dr. Denise Aberle, imaging chief at the University of California at Los Angeles and a co-director of the trial. Also, she says, the trial will tell whether such scanning affects smoking behavior. Even if the trial shows that CT scans don't save lives, there will be one upshot, says John Seffrin, chief executive officer of the American Cancer Society. "If it doesn't work, then those addicted [to tobacco] need to know that their only choice is to quit," he says. Breath Test Has Potential for Lung Cancer Detection (Reuters Health-16/09/2002) Tests of breath condensate can identify mutations of a cancer-suppressing gene in patients with lung cancer, a study presented at the Annual Congress of the European Respiratory Society demonstrates. This suggests that the method could one day be used to help identify lung cancer in its early stages, said Dr. Christian Gessner of the University of Leipzig, who presented the research at the meeting. Breath condensate is the mist that issues from the mouth and nose when a person breathes in cold weather. The condensate fluid comes from deep inside the airways and contains water and many different types of molecules. Analysis of the DNA from exhaled breath condensate samples was able to identify mutations in the p53 gene in patients with cancer, Gessner and colleagues found. This gene, when functioning normally, acts to help suppress the development of cancer. The researchers tested breath condensate from 30 healthy volunteers and 13 with biopsy-confirmed non-small-cell lung cancer. To produce the sample, patients blow into a glass chilled by a special machine for about 5 minutes. Gessner's team found mutations of the p53 gene in 4 of the 13 patients (31%). "These are small numbers and it is early days for this method, but still it demonstrates that gene expression analysis in exhaled breath condensate is feasible," Gessner said. A surgical cure for lung cancer may be possible only if the tumour is detected early. Early diagnosis, however, remains a major problem, as symptoms occur mostly in late stages of cancer development. "Finding a mutated gene in breath condensates can be a very early indicator of lung cancers," said Gessner. The gene p53 is mutated in most cells of the patients with non-small-cell lung cancer. Other molecules in breath condensate, such as 8-isoprostane, are already considered promising noninvasive markers of inflammatory respiratory diseases. Human structural genes like beta-actin do exist in a majority of exhaled breath condensate samples, but the significance of this finding is not yet clear. "Further investigations are under way to evaluate expression analysis of tumour suppressor genes or oncogenes in high-risk patients. This may be warranted for screening of follow-up reasons," Gessner concl New Radiotherapy Regimen Ups Lung Cancer Survival (Reuters Health-04/09/2002) Treating lung cancer patients with a higher dose of radiotherapy but giving them weekends off to recover can improve tumor control and increase survival rates, according to the results of a new study. Cancer Research UK scientists said computer models predicted that the new regimen could eradicate 33% of non-small-cell lung tumors compared with 19% under the current "gold standard" treatment system. Continuous hyperfractionated accelerated radiotherapy (CHART)--the present gold standard--gives patients three doses of radiation a day for 12 consecutive days. The new regimen, dubbed CHARTWEL, builds on CHART by giving a higher dose of radiation but one that is still tolerable and that incorporates a break at weekends. Professor Michele Saunders, who led the research at Mount Vernon Hospital, West London, said CHARTWEL was also more practical as radiographers are only allowed to work around 36 hours a week and there is a shortage of staff, especially at weekends."Although CHART has been shown to be more effective than conventional radiotherapy, it is used in fewer than 10 hospitals (in Britain) because we don't have radiographers to staff the machines at weekends." A small clinical study, also published in Clinical Oncology by Saunders' team, shows that combining CHARTWEL and chemotherapy can greatly improve tumor control in non-small-cell lung cancer patients. When patients had a combination of treatments, tumor remission increased from 55% in those who had CHARTWEL alone to 72% who received both CHARTWEL and chemotherapy. Saunders said that while the CHARTWEL radiotherapy and chemotherapy combination might not dramatically improve survival rates, the small improvements seen could translate into substantial gain with thousands of patients surviving 5 years or more per year. "It is clear that there is now a need for randomized clinical trials to take the work forward and, if successful, make the treatment available throughout the country," she added in a statement. New Chemotherapy Promising for Asbestos Lung Cancer (Reuters Health-13/08/2002) The results of a preliminary study suggest that a new chemotherapy combination may be a promising treatment for mesothelioma, British researchers reported. Mesothelioma is a type of lung cancer thought to be triggered by long-term inflammation where asbestos fibers come into contact with the lung surface. It affects 1,700 people in the UK each year and is normally resistant to chemotherapy. But the combination of a new drug called pemeterxed, developed by Eli Lilly, and an existing drug called carboplatin, could be an effective treatment for the hard-to-treat condition, according to Dr. Hilary Calvert from Newcastle General Hospital and colleagues. The researchers administered the two drugs to 27 patients with malignant pleural mesothelioma in a range of doses. They report their results in the Journal of Clinical Oncology. "The drug combination showed remarkable activity in mesothelioma," Calvert said. "Indeed, our study provided the first convincing demonstration that pemeterxed (and) carboplatin could be useful in the treatment of the disease." Of 25 patients who completed the study, 8 showed a partial response, while 70% of patients noticed an improvement in symptoms, often after just two courses of chemotherapy. The median survival time in the study was 451 days, or over 14 months. A handful of patients have survived for 3 years or more. Previously, people diagnosed with mesothelioma could expect to survive for 6 to 8 months, the University of Newcastle researchers said. The chemotherapy was toxic to the blood cell system, causing mainly neutropenia, a drop in infection-fighting white blood cells known as neutrophils. However, this side effect was usually short-lived and "caused few clinical problems," the researchers write. More advanced trials have since been completed, showing an improvement of survival and symptoms, Calvert noted. "Mesothelioma is a serious condition that is difficult to treat so this is an important development," said Dr. Lesley Walker, director of cancer information at Cancer Research UK. "We now need to look closely at the drug's performance in the next stages of clinical trials to see how it compares to other anti-cancer drugs." UA to test selenium use to keep disease at bay (Arizona Daily Star-03/08/2002) What if taking a single, inexpensive pill once a day could stop the most deadly of all cancers - lung cancer - in its tracks? That's the end of the research rainbow now getting under way at the University of Arizona. It may not be known for years if taking a daily dose of the trace mineral selenium can help prevent lung cancer in those at high risk for it - former smokers - but UA researchers have launched the first study to find out. During the next year, some 200 people with a long history of smoking - but who have now quit - will be given selenium or an inactive placebo pill. They will then be tested to see if lung damage that leads to cancer has been stopped or even reversed in those taking the selenium. "We are going to test this on people who are at significant risk for lung cancer - and with 44 million former smokers in this country, what we find out will affect a lot of people," said Dr. Linda Garland, lung cancer specialist at the Arizona Cancer Center, who is heading the UA study. "Anyone who stops smoking drops their risk of developing this cancer significantly, but the truth is that risk still stays much higher than in people who have never smoked, even 10 or 15 years later. It's really tragic," she said, noting that more than half her lung cancer patients are former, not current, smokers. As the biggest cancer killer of both men and women in this country, lung cancer is almost always fatal, because it is usually detected too late to control it. That is why scientists feel compelled to investigate the very real possibility that a simple natural nutrient, taken regularly during those years cancer could be silently developing, may be able to stop that deadly process, or at least slow it enough to give smokers longer lives. Selenium was chosen as the most promising agent to take on this huge challenge after earlier studies found that people with high selenium levels in their blood, due to dietary intake, have a lower risk of certain cancers. The mineral, along with vitamins C and E, is known to have strong antioxidant activity - the ability to combat free radical, oxidizing damage at the cellular level that can trigger the onset of cancer. But what really turned the spotlight on selenium was a landmark UA study conducted for more than a decade during the 1980s and 1990s to see if the mineral could prevent common skin cancers. It did not. However, far from being disappointed in selenium, UA scientists found that those who took it for years did have significantly lower rates of some of the most feared and fatal cancers - colon, prostate and lung - than did people who took placebos. "That one trial has spurred a great number of much larger studies looking at selenium as a chemoprevention agent," Garland said. "Finally, we're going to follow it through on lung cancer." Just launched, the UA selenium-lung cancer study is now recruiting former heavy smokers between 40 and 79 years old, who have quit for at least a year. "We want to have some assurance they won't backslide during the study and start smoking again," Garland said. "We figure a year is a reasonable indication they have really quit." Those who get the active selenium - and no one will know who that is until the study is over - will take a daily dose of 200 micrograms in the form of a brewer's yeast tablet. Even if selenium proves able to repair cellular-level damage in lung tissue in this small, early stage study, it will not be enough to declare the mineral capable of preventing lung cancer, Garland stressed. "What it will mean is there is enough promise with selenium to take it into the big, expensive national trial, to test it on thousands of patients for five years," she said. "So this is the first test, but the big trial will give us the answer." And that is where selenium is now when it comes to battling both colon and prostate cancers. After showing significant effectiveness in early studies, it is now being given to thousands of patients nationwide at high risk for those cancers, with funding from the National Cancer Institute. "At this point in what we know about selenium, we have to say it is still very much an investigational agent, not a proven one," said Dr. David Alberts, director of cancer prevention and control at the Arizona Cancer Center. Alberts is head of a $17 million, five-year study under way nationwide to find out if selenium can prevent colon cancer in high-risk patients. But even though the final results on selenium are not in yet, this nutrient, not widely used and previously known only as an immune system booster, has hit the radar screen among mainstream doctors, who are starting to recommend it to men at risk for prostate cancer. "Actually, there are a number of doctors who are now telling their patients to take it, due to its antioxidant potential," said Dr. Ronald P. Spark, pathologist at Tucson Medical Center. "I'm taking it, because there is prostate cancer in my family. My doctor recommended it. "I think the thinking among doctors is, well, it may not help, but hey, it won't hurt you. That's valid." But doctors caution patients not to overdose on it, because the mineral can be toxic at high levels. Most are recommending a dose of 200 micrograms a day to get the potentially protective effects. Although selenium is found naturally in some foods - liver, kidneys, Brazil nuts, tuna, seafood and whole grains - it is not always easy to get it into the diet. The mineral is also found in vegetables grown in high-selenium soils, but those areas are relatively rare in the United States. That is why clinical trials are using tablet supplements rather than natural food sources to test selenium. Garland, whose patients include smokers, former smokers and lung cancer patients, said she is not ready to tell them to take selenium - despite its promise in the study she is running. "There are a tremendous number of people who have no risk of cancer and are taking selenium, just because of what it might do," she said. "But we have much more to learn about it before we can pronounce it beneficial." Garland pointed to the hype that once surrounded the nutrient beta-carotene, a precursor of vitamin A. Touted widely as a potent cancer-fighter, based on early epidemiologic studies, it failed when finally tested on thousands of smokers in formal clinical trials. "Those studies actually found more cancer in the smokers who took beta-carotene than in those who didn't, and that surprised just about everyone," she said. "There is some evidence that antioxidants may turn into pro-oxidants - that actually promote damage - when carcinogens are already on board. "So we really have to wait for the study results, and until I have them, no, I will not be telling my patients to take selenium." The study is funded by a $389,000 grant from the Arizona Disease Control Research Commission. Alaska Natives Hard-Hit by Quick-Killing Cancers (Reuters-06/08/2002) Alaska's Eskimos, Indians and Aleuts are more likely than American whites to die within five years of being diagnosed with cancer because they are more likely to be stricken by difficult-to-detect, quick-to-kill disease. Lung cancer and other smoking-related cancers are largely to blame, said one of the authors of the study, Dr. Anne Lanier, research director of the Alaska Native Tribal Health Consortium. There is no evidence that Alaska Natives receive inferior cancer diagnosis or treatment, Lanier said. Survival rates for individual types of cancer are not much different here than elsewhere, she said. "Cancer-by-cancer, we do well, and sometimes even better," she told Reuters in an interview. But the prevalence of quick-moving cancers that cannot be detected early, such as lung cancer, reduced overall chances of living five years after a cancer diagnosis, she added. "So overall, we come out with a nasty survival rate," she said. The study, released during the Association of American Indian Physicians' annual conference, was the first comprehensive study of Alaska Native cancer survival rates, tribal health consortium officials said. Alaska Natives diagnosed with cancer between 1984 and 1994 had a five-year survival rate 11.3% lower than that of US whites, according to the study. Only 45.4% of Alaska Natives survived five years after their cancer diagnosis, compared with 56.7% of US whites, the study found. The high prevalence of lung cancer among Alaska Natives--a population with a heavy smoking rate--accounted for much of the difference, Lanier said. Of the 597 Alaska Natives who succumbed to cancer between 1994 and 1998, lung cancer accounted for more than a third of the deaths and was the leading killer, according to another study co-authored by Lanier and released at the conference. Extrapolated to the overall population, the record showed that Alaska Natives were 40% more likely to die from lung cancer during the period than US whites, the study said. Since tobacco was not readily available or widely used in Alaska until World War II, the explosion in lung cancer rates occurred later for Alaska Natives than for whites in the nation as a whole, Lanier said. Decades ago, smoking was encouraged in rural Native villages, she said. The Eskimo Scouts, military personnel who guarded the Alaska coastline during World War II, got free cigarettes in their rations, for example. Lanier said she interviewed elderly cancer patients who were told by their doctors during the 1950s tuberculosis epidemics to switch from smokeless tobacco to cigarettes."In the TB days, they certainly didn't want a lot of people spitting here or there," she said. Cases of lung cancer began to appear much later, since the disease commonly has a latency period of 20 years or more, she said. "We've grown from one case a year to at least 20," she said. Forty-three percent of Alaska Native adults smoke, compared to about 20% for the country as a whole, Lanier said. Alaska health officials can expect a similar explosion in the future of chewing-tobacco-related cancers, said Gretchen Ehrsam, a researcher with the Alaska Native Tribal Health Consortium and a co-author of the cancer-mortality study. Alaska Native youths use smokeless tobacco at a higher rate than the national average, she said, and the latency period for resulting cancers is long. Overall, cancer mortality rates are not declining for Alaska Natives, unlike the US population as a whole, the mortality study found. If rates remain constant, health-care managers can expect a huge increase in cancer cases among Alaska Natives, Ehrsam said. That is because the population, with a current median age of 23, is expected to live far longer than previous generations, she said. In 1950, when cancer was considered rare among Alaska Natives, the life expectancy was 46, she said. "Now Alaska Natives are living to 70, so there's a lot more Natives and they're getting older and they're getting to the age when they get cancer," she said. Screen May Detect High-Risk Lung Cancer (Reuters Health-15/07/2002) Michigan scientists have developed a method of identifying which patients with early-stage lung cancer might benefit most from aggressive treatment. Though the screening, which looks for genetic markers of aggressive cancer in tumor cells, is not yet ready for widespread use, the analysis eventually may help patients with high-risk cancers live longer, according to researcher Dr. David G. Beer. Lung cancer is the number-one cause of cancer deaths in industrialized countries. Most people with so-called non-small-cell lung cancer are not diagnosed until the cancer is already in an advanced stage. Just 8% to 10% of people with this type of lung cancer are still alive 10 years after diagnosis. Even when lung cancer is detected early and is surgically removed, the cancer will return within 5 years in 35% to 50% of patients. Unfortunately, it is not currently possible to identify high-risk patients who would be most likely to benefit from additional therapy besides surgery. That may soon change, according to findings published in the advance online edition of the journal Nature Medicine. Using technology called microarrays, which make it possible to view thousands of genes at once on a single chip, researchers at the University of Michigan at Ann Arbor analyzed tumor samples from 86 patients with early- or late-stage adenocarcinoma, the most common type of non-small-cell lung cancer. Based on this analysis, Beer and colleagues compiled a list of the 50 genes most associated with patient survival. From that list, the researchers developed a "risk profile" to classify the aggressiveness of lung tumors. When Beer's team applied these risk profiles to a sample of early-stage lung cancers from another study, they were able to distinguish between low- and high-risk cancers. "The strategy used in our study involving the developing of a risk index of survival-related gene expression not only provides a means to identify genes involved in aggressive tumor behavior and potentially new targets for therapy, but also allows for independent testing by other researchers," Beer told Reuters Health. There is still a lot that needs to be done, however, before the technique can be put into practice, according to Beer. "I am not sure that the exact type of analyzes we have done in this study will be used in the clinic," he said. He characterized the research as being in the "discovery phase," and said that the most predictive genes still need to be identified. Also, there is a need for "quick, accurate and dependable" methods of analyzing genes in tumor samples, Beer noted. "These are all things that can be done, and I do think they will be," he said. Even if high-risk patients can be identified, Beer said that there is a desperate need for appropriate therapies to treat aggressive lung cancer. "This is where looking at the genes that are associated with aggressive behavior may provide some promise," he said. The Michigan researcher pointed out that one of the genes that the study linked to poor survival was the gene for vascular endothelial growth factor (VEGF), which may influence the growth of blood vessels supplying lung cancer. He noted, "Targeting this gene product as a form of therapy for cancer is an active area of research in the scientific community." Genetic Trait May Triple Smokers Lung Cancer Risk (Reuters Health-09/07/2002) Smokers who inherit a particular genetic trait may have up to three times the risk of getting lung cancer compared with other smokers, according to a report in the British Journal of Cancer. German researchers said that 25% of patients with a common form of lung cancer carry a particular variant of a gene involved in keeping the airways clear. By contrast only 9% of people in the general population carried it. The team studied 117 lung cancer patients--nearly all past or present smokers. They compared these patients with 117 smokers who had undergone lung function tests but had no symptoms of respiratory disease and with another "control" group of 123 healthy individuals from the general population. The study showed that one particular version of the gene coding for surfactant protein B was similar in both control groups--13% in healthy smokers and 9% in the general population. Surfactant is a slippery liquid that helps maintain surface tension in the lungs. Surfactant protein B gene is essential for normal lung function. About 17% of patients with other types of lung cancer had the gene variation compared with 25% in those with squamous cell carcinoma, a common type of cancer that develops in smokers. Dr. Carola Seifart and colleagues at the Philipps University of Marburg said the results indicate that the surfactant protein B gene variation is associated with mechanisms that may enhance susceptibility to lung cancer, especially squamous cell carcinoma. Cancer Research UK, which owns the journal, said scientists were increasingly turning their attention to identifying gene variants. These might not carry a high risk in themselves but in combination with other genes and lifestyle factors could tip the balance as to whether a person is more susceptible to cancer. Venting Stoves Cuts Lung Cancer Rate in China (Reuters Health-05/06/2002) Changing from unvented to vented coal-burning stoves appears to have reduced new cases of lung cancer in one region of China known for high rates of the disease, according to a recent report. In the past, residents of rural Xuanwei County in Yunnan Province typically used unvented indoor firepits or stoves for cooking and heating. Use of these stoves was associated with very high levels of indoor air pollution. During the 1970s, however, most residents changed to stoves with chimneys. Given that high levels of indoor air pollution are a risk factor for lung cancer, Dr. Robert S. Chapman from the US Environmental Protection Agency, Research Triangle Park, North Carolina, and colleagues decided to compare lung cancer rates in Xuanwei before and after the widespread use of vented stoves. The researchers' findings are published in the Journal of the National Cancer Institute. The study included 21,232 farmers born between 1917 and 1951 who were followed from 1976 to 1992. About 81% of subjects changed to vented stoves during their lifetime. Stove improvement was associated with a long-term reduction in lung cancer rates, the authors note. After stove improvement, men and women were 41% and 46% less likely, respectively, to develop lung cancer than before the change. Clear reductions in lung cancer rates were noted 10 years after stove improvements. A direct comparison revealed that vented stoves produced air pollution levels that were less than 35% of those produced by the unvented stoves. "To the best of our knowledge...previous studies have not documented health benefits of stove improvement in households using coal or biomass fuel," the authors write. "We hope that the documentation present in this article will stimulate further development and implementation of appropriate stove improvements and of other strategies to reduce indoor air pollution in developing countries." Outlook Improving for Lung Cancer Patients-Study-(Reuters-03/06/2002) It's still not great, but the outlook for patients with lung cancer is improving, thanks to better treatments and early detection of the first signs of the disease, Finnish scientists said. Lung cancer is the biggest cancer killer, claiming as many as 300,000 lives worldwide each year, but more patients are living longer than they would have 20 years ago. "Survival of lung cancer patients has increased threefold," Dr. Ritta Makitaro, of Oulu University in Finland, told Reuters. Only 4% of people diagnosed with the cancer in Oulu in the 1970s were alive five years afterwards. By the 1990s the number had risen to 12%. Makitaro, whose research was reported in the European Respiratory Journal, believes the figures may be even higher because more effective chemotherapy drugs are now on the market. "It should be even better now since we collected our material in the 1990s," she added. Makitaro and her colleagues compared the results of a five-year study of more than 600 lung cancer patients that was completed in 1997 with a similar survey of 446 patients done two decades earlier. The results showed the tripling of survival was the average for all lung cancers but survival varied according to the different types of tumors. Patients with adenocarcinoma, the most common type of lung cancer in women and in people who have never smoked, had a 19% five-year survival rate. Smoking is the leading cause of lung cancer. But for sufferers with small cell lung cancer, which accounts for about a fifth of cases, survival rates have barely improved during the two decades. Like other cancers, the earlier the illness is diagnosed and treated, the better the chances of defeating it. Patients who have had surgery generally live longer than people whose tumors have not been removed, according to the Finnish research. "Nowadays, the pre-surgical evaluation of patients has improved, so that we can be sure that the right patients are being operated on," said Makitaro. Survival rates for lung cancer are poor because the disease is often not detected until the cancer has spread, which makes it more difficult to treat, and until recently there were few effective drugs for the disease. Makitaro said new medical imaging techniques and fibre optic bronchoscopy are helping doctors detect the disease earlier and surgical techniques and post-operative therapy have also improved. "Finally there is some light at the end of the tunnel..," Makitaro added. Aspirin May Cut Risk of Lung Cancer Risk - Study-(Reuters-25/06/2002) Aspirin, the century-old drug that relieves headaches and helps to prevent heart attacks and strokes, may also cut the risk of developing lung cancer, scientists said. Smoking is the cause of most cases of lung cancer but researchers at New York University School of Medicine have discovered that taking aspirin regularly may have a protective effect against the disease, which is a top cancer killer. "Not smoking is by far the best way to avoid lung cancer, but our study suggests that regular aspirin use could also confer some degree of protection against the disease," said the school's Dr. Arslan Akhmedkhanov. The scientists questioned 14,000 women in New York about their long-term use of aspirin and compared the medical histories of 81 women who developed lung cancer and more than 800 who didn't. Smoking was the biggest factor in the development of the disease but the scientists found women who took aspirin regularly had less than half the normal risk of suffering from non-small lung cancer -- the most common form of the disease. "We need larger-scale research to confirm the results of this study, but it's certainly consistent with other evidence for the health benefits of the drug," said Akhmedkhanov, whose research is published in the British Journal of Cancer. Studies have also shown that aspirin, one of the world's most popular drugs, may also help to protect against prostate cancer and researchers are also conducting studies into its impact on bowel and esophageal cancers. Although scientists do not know how aspirin reduces the risk of cancer, they suspect it could be do with its anti-inflammatory effects. "Aspirin is a remarkable drug with a wide range of health benefits, and this is the latest evidence to suggest that it could be a useful weapon against cancer," said Professor Gordon McVie, director general of the British charity Cancer Research UK which owns the journal. In a separate study in the journal, scientists at the International Agency for Research on Cancer (IARC) said deaths from lung cancer in Britons are due to drop by 20 percent in men and eight percent in women during the next five years but in European countries the rate of the disease, as well as deaths, are expected to remain high. In France, lung cancer deaths are expected to increase by two percent in men and 31 percent in women over the next half decade. Lung cancer rates in Hungary, which are the highest in the world, are also expected to rise. "Health campaigns in the UK have been extremely successful at persuading people, particularly men, to kick the smoking habit, and as a result deaths from lung cancer are starting to come down. But sadly, across Europe the anti-smoking message doesn't seem to be getting across. Among men death rates are remaining high, while women's rates are lower but often going up," said Dr. Paul Brennan, who headed the research team. Growth Blocking Protein May Cut Lung Cancer Risk-(Reuters Health-16/05/2002) A protein that blocks cell growth and induces cell death may play a role in reducing lung cancer risk, federal researchers report. People who had higher levels of the protein, called insulin-like growth factor binding protein-3 (IGFBP-3), were at reduced risk of lung cancer, Dr. Stephanie London, an epidemiologist at the National Institute of Environmental Health Sciences in Research Triangle Park, North Carolina, explained in an interview with Reuters Health. London and colleagues were examining the effect of insulin-like growth factor (IGF-1), a compound that promotes cell growth and has been associated with an increase in cancer risk. They also looked at IGFBP-3, which can blunt IGF-1's effects by binding to it. On its own, IGFBP-3 can also check cell growth and even induce the death of abnormal cells, a process called apoptosis. Based on previous work tested on various forms of cancer, the researchers theorized that people with higher levels of IGF-1 would be more likely to develop cancer, which is caused by the abnormal growth of cells. Similarly, they hypothesized that those who had higher levels of IGFBP-3 would be better able to check the growth of abnormal cells and be less likely to develop cancer. To investigate, the researchers studied more than 18,000 men aged 45 to 64 living in Shanghai, China, during the 1980s. They took blood samples to check the men's levels of the growth factors, and followed their health for more than a decade. The researchers compared growth factor protein levels for the 230 men who developed lung cancer and 740 men who did not. Their findings are published in the Journal of the National Cancer Institute. The researchers did not find any relationship between levels of IGF-1, the cell-growth promoter, and the development of lung cancer. But they did find men who had the highest levels of the growth-halting IGFBP-3 were half as likely to develop lung cancer as men with the lowest levels. And among men who were smokers or had smoked at some point in their lives, the risk reduction was more dramatic. Ever-smokers with the highest IGFBP-3 levels had a 59% lower risk of lung cancer than those with the lowest levels. These findings imply that IGFBP-3 may have some effect on preventing the development of cancer beyond simply blocking IGF-1, London said. "This suggests that the effect of IGFBP-3 is not just because of blocking IGF-1," she said. "It suggests that more-recently discovered effects of IGFBP-3 may be important." New Pill May Improve Lung Cancer-(Associated Press-19/05/2002) A once-a-day pill that slows cancer by jamming its internal growth signals shows encouraging benefits in terminally ill lung cancer patients, quickly easing symptoms for many. Research showed that the drug, called Iressa, can shrink tumors in some patients who have failed all other therapy. But perhaps even more important for these patients, it relieves cancer symptoms in one-third or more of cases. The drug, not yet approved for routine use, is one of the new class of so-called targeted therapies that works by specifically interfering with cancer rather than all fast-growing tissue, as standard chemotherapy does. As a result, it carries far fewer side effects, and patients often can safely take it for months or even years. Many experts doubt that Iressa and drugs like it will actually cure cancer alone, but they say it may help hold the disease in check - especially if given in early stages. "This is a whole new way of treating lung cancer," said Dr. Mark Kris of Memorial Sloan-Kettering Cancer Center in New York City. "People didn't think this would work. It's nothing short of amazing." The data from the study, financed by drug manufacturer AstraZeneca, were made public by Kris at a meeting of the American Society of Clinical Oncology in Orlando. In December, AstraZeneca applied for Food and Drug Administration approval to sell Iressa based on this and a similar study released in November. Meanwhile, two much larger studies are under way to test whether the drug can prolong survival when given as first-line therapy to people newly diagnosed with spreading lung cancer. Kris said the drug is particularly striking for easing symptoms quickly. Most who responded began to feel better within two weeks. The drug relieved their shortness of breath, coughs, poor appetites and other cancer symptoms. All the people studied had already failed to get better after receiving two different regimens of drugs for their spreading lung cancer. Treatment responses of any kind are rare in people with disease this advanced. The volunteers' symptom relief lasted an average of seven months. About one-quarter of the patients enrolled in the study are still alive after 18 months of treatment. Dr. Karen Kelly of the University of Colorado said symptom relief ranged from moderate to dramatic. "The patients felt the improvement was significant to them. It translated to a better quality of life," she said. The drug is one of several in development called epidermal growth factor receptor inhibitors. Others include Tarceva, developed by OSI Pharmaceuticals, Genentech and Roche, and Erbitux from ImClone Systems. All work by interfering with HER-1, a docking post on cancer cells that receives a chemical signal that triggers tumors' out-of-control growth. Long-established cancers may respond to a variety of different signals like this, so experts doubt that blocking just one will be a reliable cure. Kris' study tested two different doses of Iressa on 216 patients. The lower dose worked better. In 12 percent of these patients, tumors shrank by at least half, and 43 percent had improved symptoms. A similar study was conducted in Europe and Japan on people who were somewhat less sick, because they had failed just one course of chemotherapy. Tumors shrank in 19 percent, and 39 percent felt better. "It's for real. I can tell you that," said Dr. Roy Herbst of M. D. Anderson Cancer Center in Houston, a lung cancer specialist who has treated about 100 patients with the drug. "I have seen more than several benefit quite significantly" Herbst is directing a study of 1,024 lung cancer patients. The goal will be to prove that the drug improves survival by at least one-third. "That would be a home run," he said. Results from his study are expected in the fall or winter. Meanwhile, AstraZeneca hopes to win approval of the drug later this year. Studies are also under way to see if Iressa can prevent the development of lung cancer in smokers. The drug is also being studied as a treatment for many other cancers, including breast, prostate and colon. The drug's most frequent side effect is an acne-like rash that is usually easy to control. Drug Helps Treat Asbestos-Related Lung Cancer (Reuters Health-21/05/2002) An experimental drug is the first treatment shown to be effective against a form of lung cancer that is related to asbestos exposure, researchers report. The cancer, called mesothelioma, causes severe, throbbing chest pain--"the really devastating aspect of this disease that just haunts people"--and doctors have had no way to treat it, said study author Dr. Nicholas Vogelzang, director of the University of Chicago Cancer Research Center. Patients generally live about 6 to 9 months after diagnosis. But the new drug, Alimta (pemetrexed), was shown to add an average of 3 months to patients' lives, Vogelzang said at a meeting of the American Society of Clinical Oncology (ASCO). "We now have a treatment that not only treats this disease but also improves symptoms," he said. "This is the first time we've ever documented an improvement in mesothelioma survival." Other experts also were enthusiastic. "This is the first demonstration of a really effective drug for this disease," said ASCO president Dr. Larry Norton, of Memorial Sloan-Kettering Cancer Center in New York. The drug, which is given by infusion, works by blocking three enzymes that promote cancer growth, according to Vogelzang. An estimated 2,500 Americans are diagnosed with mesothelioma annually, Vogelzang said, but that number is expected to rise over the next 20 years. The disease, which affects the lining of the lungs, usually is diagnosed 20 to 40 years after asbestos exposure. In addition to pain, patients also commonly complain of shortness of breath. The study of 448 patients found that those receiving Alimta plus another commonly used cancer drug called cisplatin survived an average of a year, compared with 9 months for those on cisplatin alone. Results also showed that 41% of the tumors shrank in the Alimta group versus 17% of the tumors treated with cisplatin alone. Patients receiving Alimta also reported less pain and a better overall quality of life, Vogelzang said. When patients started to take Alimta, they developed severe side effects, such as low white blood cell counts, severe diarrhea and painful mouth ulcers, and the drug was linked to an initially higher rate of death in this group. The researchers found that the drug was lowering patient's levels of vitamin B12 and folic acid. But when these patients were given supplements of those vitamins, the side effects were diminished, Vogelzang said. Giving these supplements also appeared to boost the effectiveness of the drug, he noted. TXillix Announces Clinical Investigator Agreement With Dr. Harvey Pass-(Yahoo News-31/03/2002) Xillix announced that Dr. Harvey Pass of Wayne State University/Karmanos Cancer Institute, Detroit, MI, has agreed to participate as a Clinical Investigator for the Onco-LIFE(TM) lung cancer clinical trial. Onco-LIFE is Xillix's latest device developed for the improved detection and localization of cancer in the lung and gastrointestinal (GI) tract. Dr. Pass became recognized for clinical and benchwork studies in lung cancer and mesothelioma. He was one of the pioneers of the use of photodynamic therapy for lung cancer, and presently supervises a large, NCI funded lung cancer screening effort in Detroit. Xillix previously announced that Dr. Stephen Lam of the British Columbia Cancer Agency (``BCCA''), Vancouver, Canada will also participate as a Clinical Investigator as well as Medical Advisor for the Onco-LIFE lung cancer clinical trial planned for 2002. Additional Clinical Investigators will be announced as these arrangements are finalized. Xillix LIFE (TM) fluorescence-based medical imaging technology helps physicians diagnose early-stage lung and gastrointestinal (``GI'') cancers. By exposing tissue to light from Xillix's patented fluorescence imaging device, physicians can detect pre-cancerous and cancerous cells. In 1996, clinical studies approved by the U.S. Food and Drug Administration (``FDA'') confirmed that Xillix's first-generation lung device improved physicians' ability to detect lung cancer by 171% compared with conventional white light bronchoscopy alone. Xillix's latest device, Onco-LIFE(TM) is preparing for clinical trials to prove its value in detecting and localizing early lung and GI cancer. This new device leverages Xillix's worldwide experience and innovation. Onco-LIFE is compact, affordable, easy-to-use and incorporates both fluorescence and conventional imaging in a single system that will 'plug and play' with a wide range of endoscopic accessories to maximize global market acceptance.
Cell Pathways Says Drug Combination Kept Tumor-Ridden Rats Alive Longer -(Yahoo News-18/03/2002) Shares of Cell Pathways Inc. (CLPA) surged after the company announced that tests of Aptosyn in combination with Aventis SA's (AVE) Taxotere showed significantly prolonged survival, inhibited tumor growth and metastases, and increased apoptosis in a rat model of human non-small cell lung cancer. Cell Pathways said that the "key preclinical data" showed that Aptosyn, also known as Exisulind, and Taxotere working alone moderately prolonged survival, inhibited tumor growth and metastases and increased apoptosis in tumor tissue compared to control animals. Apoptosis is when cells infected with viruses kill themselves. But when the two drugs were combined, they "produced a statistically significant increase in survival, as well as a reduction in metastases, compared to either agent alone," the biotech concern added. Cell Pathways said the data, published in the March issue of the journal Clinical Cancer Research, "validate the rationale for initiating clinical trials of the combination of Aptosyn and Taxotere" in advanced non-small cell lung cancer, or NSCLC. The ongoing Phase III registration trial of the drug combination is continuing, with the 600-patient enrollment at multiple centers throughout the U.S. expected to be completed during the second half of the year. Dr. Paul Bunn, Clinical Cancer Research's lead investigator, noted in the statement that Taxotere "improves the survival of patients with advanced NSCLC, but five-year survival remains poor and few patients experience a complete remission." But he said the study, in which rats were implanted with human lung tumors, had "significantly prolonged survival" getting both Taxotere and Aptosyn than either drug alone. Dr. Bunn added the findings "were supported by studies of cell cultures and on biopsied tumors from treated animals." The studies found that apoptosis increased in human lung-cancer cells treated with Aptosyn, even with Taxotere doses which normally have no measurable effect on either apoptosis or cell proliferation. In one experiment, no rats had died 80 days after they were implanted with the tumors and began receiving both drugs. In a second study, two groups of rats had a mean survival time of 63.2 days and 65.2 days, respectively, compared with 35.7 days for untreated rats.
Study Ties Lung Cancer, Air Pollution-(Yahoo News-05/03/2002) Long-term exposure to the air pollution in some of America's biggest metropolitan areas significantly raises the risk of dying from lung cancer and is about as dangerous as living with a smoker, a study of a half-million people found. The study echoes previous research and provides the strongest evidence yet of the health dangers of the pollution levels found in many big cities and even some smaller ones, according to the researchers from Brigham Young University and New York University. The risk is from what scientists call combustion-related fine particulate matter - soot emitted by cars and trucks, coal-fired power plants and factories. The study appears in the Journal of the American Medical Association. It involved 500,000 adults who enrolled in 1982 in an American Cancer Society survey on cancer prevention. The researchers examined participants' health records through 1998 and analyzed data on annual air pollution averages in the more than 100 cities in which participants lived. The researchers first took into account other risk factors for heart and lung disease such as cigarettes, diet, weight and occupation. Lung cancer death rates were compared with average pollution levels, as measured in micrograms per cubic meter of air. The researchers found that the number of lung cancer deaths increased 8 percent for every increase of 10 micrograms. Other heart- and lung-related causes of death increased 6 percent for every 10-microgram increase. Allen Dearry, a scientist at the National Institute of Environmental Health Sciences, which funded the study, called it "the best epidemiologic evidence that we have so far that that type of exposure is associated with lung cancer death." "This study is compelling because it involved hundreds of thousands of people in many cities across the United States who were followed for almost two decades," said study co-leader George Thurston, an NYU environmental scientist. Thurston said the lung cancer risks were comparable to those faced by nonsmokers who live with smokers and are exposed long-term to secondhand cigarette smoke. Such risks have been estimated at 16 percent to 24 percent higher than those faced by people living with nonsmokers. In the early 1980s, when the study began, some major cities had air pollution levels of 25 to 30 micrograms per cubic meter, which would confer a more than 20 percent increased risk of lung cancer mortality, said C. Arden Pope III, an environmental epidemiologist at Brigham Young University and a co-leader of the JAMA study. The Environmental Protection Agency set average annual limits at 15 micrograms per cubic meter in 1997, when it tightened its standards to include fine particulate matter - pollutants measuring less than 2.5 micrometers. That is about 1/28th the width of a human hair. That regulation followed another study by Pope linking fine particulate pollution and lung cancer that included many of the same participants as the JAMA study. Pope said the new study doubles the follow-up time and does a better job of taking other risk factors into account, to address criticism from industry groups who challenged the earlier study and sued the EPA over the 1997 regulations. The Supreme Court last year upheld the way the EPA set those standards. Industry challenges to the standards are ongoing, said Jayne Brady, spokeswoman for the Edison Electric Institute, which represents most of the nation's major electric utilities, including operators of many coal-powered plants. Despite those challenges, Brady said, "We are trying to do everything we can to reduce emissions." Thurston said annual fine-particulate pollutant averages have fallen significantly since the early 1980s but as of 1999-2000 were still at or above the EPA limit in such metropolitan areas as New York, Washington, Chicago and Los Angeles. He said the biggest sources of such pollution are coal-burning power plants in the Midwest and East, and diesel trucks and buses in the West. Thurston said the study gives new impetus to efforts in Washington to clean up aging coal-fired power plants. The EPA said the agency will consider the research as part of its continuing review of air quality standards for particulate matter.
Sensitive Scan Catches Lung Cancer Early-(Health Scout News-01/03/2002) A highly sensitive scanning technology can catch lung cancer early, but it's not yet clear whether it can also reduce the death rate from the disease. Doctors at the Mayo Clinic say low-dose, spiral-computed tomography scans (spiral CTs) trounce conventional methods when it comes to finding the first signs of lung cancer. However, the technique has a disturbingly high "false positive" rate, and researchers are still searching for a solid link between spiral CT screening and fewer deaths from lung cancer. The five-year survival rate for lung cancer is less than 15 percent, and early detection of the disease is critical. "There really hasn't been any change in the survival [rate] of lung cancer in the last several decades," says lead investigator Dr. Stephen J. Swensen. "This offers the hope of finding lung cancer earlier, and therefore potentially saving some lives." The findings appear in the American Journal of Respiratory and Critical Care Medicine. In the latest study, the researchers performed a baseline screening of 1,520 people aged 50 or older, all of whom had smoked 20 "pack years" - with one pack year equivalent to one year of smoking 20 cigarettes a day. All of the study participants were at high risk for lung cancer. Each person underwent a spiral CT scan, along with sputum cytology - essentially, an examination of his or her phlegm for cancerous cells. The spiral CT scan identified cancer in 23 cases, while sputum cytology detected only two cases. More than half of the tumors detected by the scans were at the earliest stage of development, and 22 of the patients underwent curative surgery to remove their cancers. However, the scans also identified 2,244 lung nodules in more than 1,000 of the smokers. Seven benign lung nodules were surgically removed, but the researchers estimate that 99 percent of the masses identified were "false positives," meaning they weren't cancerous. In addition, the researchers also calculate a 26 percent "false negative" rate in the baseline scans, referring to abnormalities that might have been missed. Swensen says the high rate of false positives produced by this method could end up doing more harm than good. Not only could it cause stress for people who would think they have lung cancer, it could also lead to the inconvenience and radiation of follow-up scans, and the potential for invasive surgery and any related complications, he says. Dr. Nerinder S. Paul, divisional head of cardiothoracic imaging at the University Health Network and Mount Sinai Hospital in Toronto, says spiral CT scans "are very sensitive at picking up abnormalities. The problem is that not everything that you pick up is going to be a tumor, or even an early tumor. Some of it's going to be old scars or [granulomas from infections or tuberculosis]. All of these things can leave little opacities in the lungs. The technique will pick up all these opacities." The original idea was that a spiral CT could be used to screen high-risk populations, followed by more traditional CT scans to examine abnormalities detected in the first scans. Paul says other centers could then perform biopsies of the abnormalities. One current tactic with a positive result is to put the person on antibiotics, then repeat the spiral CT scan, says Paul. If the abnormality has disappeared, it was probably due to an infection. "If it's still there, depending on what size it is, you either repeat the CT or you do a biopsy or some sort of procedure," he says. In a high-risk population, Paul adds, if doctors don't find any abnormalities on the first spiral CT scan, another one is repeated one year later. However, Swensen says it's still not clear whether using spiral CT scans could ultimately improve the survival rate from lung cancer. "Even though we're able to find lung cancers earlier, we don't know if it's early enough," he says. "It's absolutely unproven that it saves lives." Swensen and his colleagues will continue to scan the same 1,520 participants every year, in hopes of determining whether screening to catch early lung cancers affects their risk of death.
Drug combo may let lung cancer victims live longer-(Times of India Online-11/01/2002) Two drugs, one old and one new, can add months to the lives of patients with advanced small-cell lung cancer when used in combination, researchers reported in New England Journal of Medicine. The new drug is irinotecan, also known as CPT-11 and sold under the brand name Camptosar by Pharmacia. Combined with the drug cisplatin, made by Bristol-Myers Squibb, it allowed nearly 20 percent of patients to survive for two years, compared to only 5.2 per cent of the patients getting an established treatment. In other studies, conventional treatment yields a two-year survival rate of 10 per cent. Small-cell lung cancer accounts for 20 per cent to 25 per cent of lung cancer cases, Dr. Desmond N Carney, of Mater Misericordiae Hospital in Dublin, said in an accompanying editorial. The cancer is so virulent that in most patients the survival time is nine months or less, and 20 years of research trials "have yielded an improvement in survival of only two months," Carney said. In the study, led by Dr. Kazumasa Noda of the Kanagawa Cancer Center in Yokohama, Japan, the patients getting the new treatment lived for an average of 12.8 months compared to a survival rate of 9.4 months for people treated with the older drug combination, etoposide plus cisplatin. Bristol-Myers Squibb sells Etoposide under the brand name VePesid. Carney said the improved results with irinotecan "appear to indicate an advance in treatment." Dr. Alan Sandler of Vanderbilt-Ingram Cancer Center in Nashville, who is leading a US study of the drug, said the results were significant. "For the first time, I can look at patient in the eye and say, 'You have a greater than 50 per cent chance of being alive in a year." In another research paper published in the same issue of the journal, doctors reported finding little difference in the effectiveness of four combinations of drugs for patients suffering from advanced non-small-cell lung cancer, a far more common form of lung cancer. That type of tumor is responsible for one third of all cancer deaths. No matter what the treatment, the average survival time was about eight months, said that team, led by Dr. Joan Schiller of the University of Wisconsin Hospital and Clinics. Lung cancer kills more than a million people worldwide each year and is now the leading cause of death from cancer among both men and women. Smoking causes the vast majority of cases.
Astra Zeneca’s Cancer Drug fares well in Trial-(Economic Times-21/10/2001) A new "smart bomb" cancer drug being developed by Astra Zeneca has succeeded in shrinking lung tumours in some seriously ill patients who failed to respond to conventional chemotherapy. The company’s tablet drug, Iressa, is one of a new generation of treatments that aim to knock out cancer cells without damaging healthy tissue. Full results of Phase II trial involving sufferers of non-small cell lung cancer-the leading cause of lung cancer deaths-will be presented in November. In 18.7% of the difficult to treat cases, the tumour was reduced to half its size. In over half the patients, the cancer did not progress for at least two months and in 34% it had not grown after four months.
Canadian scientists devise new test to detect lung cancer-(Times of India Online-24/05/2001) Canadian scientists have devised a new screening test that detects tumours in the earliest stages and has the potential to save millions of people suffering from lung cancer, a report said. The LungAlert test detected 87 per cent lung cancers, considered most lethal of all cancers. This could be the best screening tool to come along in decades, or ever, the scientists were quoted as saying. When lung cancer is detected in the earliest stages, 70 per cent of the patients can be saved through surgery, but only 10 per cent patients survive more than five years if the disease is not caught early enough. Through the current screening method of chest X-rays, by the time a tumour can be detected, the disease is often too advanced to treat as it may have spread to other organs. The LungAlert test works by detecting a type of sugar molecule that is produced when a cancer begins to grow. In the pilot study 75 patients were asked to produce sputum by coughing in a cup. The sample was treated using a test kit, produced a colour reaction, which was read with a colour reader to quantify the results. The LungAlert detected 20 of 23 confirmed cancers and it found 13 of 15 cancers that were classified in stage one or two (of four stages), when they are still treatable. Early detection could become the biggest impact of any treatment (technique) for lung cancer over the last 50 years. In 2000 about 17,000 Canadians and 156,000 Americans died of the malignancy.
Sheep virus offers clues to human lung cancer-(Times of India Online-12/04/2001) The discovery of how a sheep cancer virus attaches to cells may improve our understanding of human lung cancer, as well as lead to a possible new way to deliver gene therapy to the lungs. The virus is called Jaagsiekte sheep retrovirus (JSRV) and it causes a contagious form of lung cancer in sheep similar to human bronchiolo-alveolar carcinoma, a lung cancer that is not linked to smoking. About 25 per cent of all lung cancer cases in the US are bronchiolo-alveolar carcinomas. In a new study, researchers introduced certain genes from JSRV into mouse cells and looked at whether the cells became cancerous. The investigators found that a specific gene that codes for the protein that forms the envelope surrounding JSRV could turn normal cells cancerous without help from any of the other genetic material made by the virus. In a second study, another group found that this envelop protein binds to HYAL2, a protein found on lung cells. Those cells lacking HYAL2 appear to be resistant to infection with JSRV. The next step is to breed mice that have human HYAL2 to use them as models for further study of how JSRV causes cancer. This is an example of how research on an animal cancer virus may provide insights about how a particular human cancer occurs. While some distance in the future, this work might ultimately lead to therapies for this kind of lung cancer. Knowing that JSRV target these HYAL2 receptors in the lungs also opens the possibility of using a weakened virus to deliver desirable genes or other treatments directly to lung cells. Now that we know the entry receptor for the virus, we can make sure the lung expresses adequate levels of the receptor on cells that we want to target for cystic fibrosis or other diseases. The activity of the virus can be modified so that the potential for cancer induction by these vectors is basically eliminated. Genzyme Transgenics, ImmunoGen reach deal-(Cancer Info-06/12/2000) Genzyme Transgenics Corp. and ImmunoGen Inc. said they have reached an agreement to produce a monoclonal antibody as part of a treatment for small-cell lung cancer. The former develops medicines from the milk of specially bred animals, primarily goats, while the latter specializes in developing drugs using monoclonal antibodies that bind to cancer cells. Framingham-based Genzyme Transgenics said it will breed goats whose milk contains the monoclonal antibody, called huN901. After the antibody is purified from the milk, Cambridge-based ImmunoGen said it would couple the antibody with a drug to develop the cancer treatment. Study Questions Value of Chemo for Lung Cancer-(Cancer Info-26/10/2000) Adding chemotherapy to radiation is no more effective than radiation alone in extending survival in certain lung cancer patients who have already had their tumors surgically removed, a new study concludes. The findings add to an ongoing controversy surrounding the value of chemotherapy for non-small cell lung cancer (NSCLC) patients.
In spite of these
findings, some researchers see a "very good future" for chemotherapy for
NSCLC. Newer chemotherapy drugs developed since the earlier study began
are less toxic and have fewer side effects. Whether these newer drugs
will be better tolerated by patients and will extend survival remains
to be seen. NSCLC is the most
common form of lung cancer, accounting for 75 to 80 percent of all cases.
The best chance for a cure is resection, or surgical removal, of the affected
area of the lung. Even if the cancer appears to be completely resected,
the procedure may still leave behind microscopic amounts of cancer cells
that can potentially spread to other parts of the body. For this reason,
chemotherapy, which most commonly consists of the drug cisplatin by itself
or with other drugs, is widely used as a post-operative supplement to
destroy any residual cancer. However some researchers found that only
a few of the many published trials of adjuvant [supplemental] chemotherapy
after curative resection have reported any meaningful survival benefit
from the addition of chemotherapy. The study sought to further elucidate
the role of chemotherapy in a clinical trial of 488 NSCLC patients at
nine cancer centers throughout the United States. The patients all had
either stage II disease, where the cancer has spread to nearby lymph nodes,
or stage III disease, where it has spread to distant nodes, the chest
wall, or the diaphragm near the lung. In either case, they had all already
undergone complete resection prior to entering the study. Once entered
into the study, the patients were divided into two similarly sized groups:
one that received radiotherapy and the drugs etoposide and cisplatin,
and another that received only the radiotherapy. The patients were followed
up for an average of three years and eight months. The average survival
in the two groups was very close - 38 months in the combination group,
compared to 39 months in the radiotherapy-only group. The percentage of
patients in each group who experienced a recurrence of their cancer within
the chest cavity was also very close - 12 percent in the combination group
and 13 percent in the radiotherapy group. In each group, a small percentage
of patients died as a result of the treatment, with a slightly higher
rate in the combination group. The immediate causes of death in these
cases were sepsis (a spread of a microbial infection into the bloodstream),
pneumonitis (inflammation of the lung) and esophagitis (inflammation of
the esophagus). Side effects of treatment, more common in the combination
group, included nausea (20 percent), vomiting (10 percent) and anemia
(13 percent). Researchers have questioned
the findings, emphasizing that close to one-third of the patients in the
combination group did not finish all chemotherapy cycles. Consequently,
the perceived ineffectiveness of chemotherapy may have been due to the
patients not receiving the intended dose. Non-Small-Cell Lung Cancer -- Stalemate or Progress?-(Cancer Info-26/10/2000) Lung cancer is a major
health problem, and each year the overall rate of death from this tobacco-inflicted
disease increases. In a few countries, including the United States, the
death rate has decreased slightly, reflecting changing attitudes toward
cigarette smoking. Non-small-cell lung cancer, which includes adenocarcinoma,
squamous-cell carcinoma, and large-cell carcinoma, accounts for 75 to
80 percent of all new cases of lung cancer; the remainder are due to small-cell
lung cancer. In patients with non-small-cell lung cancer, the possibility
of cure depends mainly on their suitability for surgical resection. Unfortunately,
at the time of diagnosis, only about 30 percent of patients with this
cancer are candidates for curative surgical resection. Another 30 percent
have locally advanced, inoperable disease, and the remaining 40 percent
have confirmed metastatic disease. Most patients die within 12 months
after receiving the diagnosis, because the disease is already advanced
at the time of detection. Even among the patients who undergo curative
resection, recurrent metastatic disease develops within five years in
half. For all these reasons, almost 85 percent of patients with non-small-cell
lung cancer are candidates for chemotherapy alone or in combination with
surgery or radiotherapy. Despite the wide use
of chemotherapy in patients with non-small-cell lung cancer, its value
is controversial. Combinations that include cisplatin and one or two other
agents are the most widely used. In the overall management of non-small-cell
lung cancer, the use of adjuvant chemotherapy may be considered after
curative surgical resection of stage I or II disease, chemotherapy may
be administered preoperatively to patients with locally advanced (stage
III) disease, a combination of chemotherapy and radiotherapy may be recommended
for patients with locally advanced, inoperable (stage IIIB) disease, and
chemotherapy alone may be recommended for metastatic (stage IV) disease.
Only a few of the
many published trials of adjuvant chemotherapy after curative resection
have reported any meaningful survival benefit from the addition of chemotherapy.
Indeed, some studies, including the one by Keller et al., found that chemotherapy
had no effect on survival. The use of adjuvant chemotherapy after curative
resection should not be considered standard care. Over the past decade,
several trials have evaluated the value of neoadjuvant chemotherapy for
locally advanced non-small-cell lung cancer. This approach has several
advantages. A response to chemotherapy may allow an otherwise unresectable
tumor to be removed surgically, the early introduction of chemotherapy
may eradicate micrometastases, and pathological assessment of the resected
specimen after neoadjuvant chemotherapy allows a detailed assessment of
the efficacy of the chemotherapy and provides information about the need
for further chemotherapy after surgery. Many trials have reported rates
of response to preoperative chemotherapy of 40 to 75 percent, rates of
resectability of 60 to 85 percent, and rates of complete pathological
response of 15 percent. On average, the median survival in these trials
was 18 months, and the survival rates at 3 to 5 years ranged from 25 to
30 percent. As compared with radiotherapy alone (median survival, 12 to
14 months), preoperative chemotherapy appears to confer some survival
benefit. However, the patients who were selected for this treatment usually
had an excellent performance status, had no other coexisting medical conditions,
and were relatively young. Because the numbers of patients enrolled in these trials were small (usually less than 60), firm conclusions about the value of neoadjuvant chemotherapy are difficult to make. Other options, such as chemotherapy followed by radiotherapy, instead of surgery, might be equally beneficial. Presently, neoadjuvant chemotherapy should be considered for younger patients with a good performance status, locally advanced disease, and few or no coexisting medical conditions. Almost 30 percent
of patients with newly diagnosed non-small-cell lung cancer have locally
advanced, inoperable disease. The standard care is usually radiotherapy,
and the expected median survival is one year, although a few patients
survive for five years. Since many recurrences after radiotherapy are
both local (within the radiation field) and distant (metastatic), it seems
reasonable to treat not only the primary tumor but also micrometastatic
disease. Many randomized trials with large numbers of patients have compared
radiotherapy alone with chemotherapy plus radiotherapy. Most of these
studies (as well as several meta-analyses that included more than 3000
patients) reported improvements in median and two-year survival with combined
chemotherapy and radiotherapy, but the effects of this approach on long-term
survival and cure rates are less obvious. Patients with advanced
metastatic non-small-cell lung cancer constitute the largest group of
candidates for chemotherapy. Despite its widespread use, the benefits
of chemotherapy in these patients are unclear. The prognosis in this group
is grim: the median survival without cytotoxic treatment is less than
six months, and even with treatment, cures are almost unheard of. Before
chemotherapy is initiated in such patients, its effect on the quality
of life must be considered. In the early 1990s,
debate raged about whether any patient with stage IV non-small-cell lung
cancer should receive chemotherapy. Today, however, in some countries
most patients are offered some kind of chemotherapy. What evidence exists
to support this practice? A 1995 meta-analysis of 52 randomized trials
that included more than 10,000 patients showed that, as compared with
the best supportive care, cisplatin-based chemotherapy was superior in
all major comparisons. Further studies indicated that although the rates
of response to chemotherapy were only 20 to 30 percent, 60 to 70 percent
of patients had decreases in disabling symptoms, such as cough, hemoptysis,
and dyspnea. These data led to a new optimism, but unfortunately they
have not been substantiated in recent large randomized trials. For these
reasons, it is easy to understand the lack of universal acceptance of
the use of chemotherapy for all patients with advanced non-small-cell
lung cancer. Combinations that
include cisplatin are probably superior to the best supportive care in
terms of survival and the quality of life. There is, however, no standard
or best chemotherapy regimen. In randomized trials that compared the old
standards (e.g., cisplatin and etoposide) with newer combinations (e.g.,
paclitaxel, docetaxel, gemcitabine, and vinorelbine), higher response
rates and improved survival rates at one year were frequently observed
with the newer agents, but survival was not always significantly prolonged.
The selection of particular drugs or combinations may be influenced by
their ease of administration, toxicity, the presence or absence of coexisting
medical conditions, and financial costs. All patients should be informed
of the potential benefits, limitations, and adverse effects before embarking
on chemotherapy, and all suitable patients should be encouraged to participate
in clinical trials (including trials of new agents), so that real progress
can be made against non-small-cell lung cancer. Lung cancer is the
most preventable of all common cancers. The elimination of cigarette smoking
remains the best hope for reducing mortality from this disease. For former
smokers and those who continue to smoke, new techniques for the early
detection of the disease, when it is most curable, and methods for preventing
lung cancer are promising developments. Knowledge of the molecular events
during the early stages of lung cancer, such as alteration of the expression
of the fragile histidine triad (FHIT) gene and the presence in sputum
of cells with genetic abnormalities, offers possibilities for early diagnosis.
The use of chemopreventive agents such as orally administered vitamins
has been of limited value, but the development of an aerosolized route
of delivery for these agents, which would allow uniform delivery of the
agent to the entire pulmonary epithelium, may enhance our ability to control
or even reverse early changes associated with lung cancer. Such developments
could benefit patients at risk for lung cancer. Chemicals in broccoli can cut lung cancer risk-(Cancer Info-23/09/2000) New evidence from
a large study in China suggests that chemicals contained in broccoli,
cabbage, or bok choy can help protect people from developing lung cancer.
The study of more than 18,000 men found that people with detectable amounts
of chemicals known as isothiocyanates in their bodies had a 36% lower
chance of developing lung cancer over 10 years than those without the
chemicals. The chemicals are found in broccoli and other so called "cruciferous"
vegetables. Researchers from the
National Institute of Environmental Health Sciences (NIEHS) in North Carolina
along with colleagues in China performed the study in four small communities
in Shanghai. That site is notable because of its population's high smoking
rate and high level of cruciferous vegetable consumption, according to
Dr. Stephanie J. London, an epidemiologist and the study's lead investigator. The researchers recorded
259 cases of lung cancer during the study's follow-up period. The lowered
cancer risk associated with isothiocyanate levels held up even after influences
like smoking were factored out. Patients' genetic
makeup also significantly affected how much protection they got from isothiocyanates.
Those who lacked genes that metabolize the chemicals--about 60% of the
total study population--had more protection than those who carried the
genes. The study is the first to link biological measures of isothiocyanates
with a decrease in cancer risk. Other studies have relied on dietary questionnaires
that give no information as to how much of the chemicals actually are
circulating in subjects' bodies. While the results suggest that eating broccoli and related vegetables can lower cancer risk even for smokers, no one should assume that isothiocyanates would be enough to protect smokers from cancer. Though the chemicals did lower cancer risk by 36% in this study, smoking alone increases lung cancer risk by as much as 10 times. Lung cancer is biggest killer of British women-(Times of India-10/09/2000) Lung cancer has overtaken breast cancer as the biggest killer of British women, according to new figures released on Monday. Data showed a 36% jump in lung cancer in the past 20 years while breast cancer deaths dropped by 5%. While lung cancer
rates have soared women have become more aware of breast cancer and screening
and improvements in treatment have increased survival rates. Statistics
show that more young girls than boys are taking up smoking and older women
find it more difficult than men to quit. Cigarettes are potentially death
in a packet. Doctors
test new vaccine for lung cancer-(Cancer Info-20/07/2000) Anti-angiogenesis drug boosts chemo for lung cancer-(Cancer Info-12/06/2000) Anti-VEGF, an experimental drug that interferes with the blood supply of tumors, has been shown to lengthen the time between initial treatment and relapse for some patients with advanced lung cancer, when used in conjunction with a combination of chemotherapy drugs, the standard treatment for the disease. The new treatment may increase response rates and prolong time to disease progression in patients with non-small cell lung cancer compared to chemotherapy alone when used as a first treatment. The study evaluated 99 patients in a Phase II clinical trial who were receiving their initial treatments for non-small cell lung cancer. All had advanced non-small cell lung cancer (Stage IIIb or Stage IV) and the disease had recurred in some of the patients. One group of patients got a combination of two chemotherapy drugs, carboplatin and paclitaxel (Taxol). A second group got those same drugs along with a low dose of the experimental drug, rhuMAB VEGF, also known as anti-VEGF. A third group got the chemotherapy drugs along with a high dose of the experimental drug. About 40 percent of the patients taking the higher dose of the drug along with chemotherapy responded to the therapy, compared to 31 percent taking chemotherapy alone, and 22 percent taking the lower dose of the experimental drug with the chemotherapy combination. Patients taking the higher dose of anti-VEGF in combination with the chemotherapy went longer before relapse (seven months) compared to those on the chemotherapy combination alone (six months). Patients taking the lower dose of the experimental drug went about four months before relapse. The drug represents substantial progress in the fight against a very tough cancer. However, four patients on the treatment died after developing sudden bleeding. What has caused them may take some time to learn. There can be allergic reactions to the proteins in some of these drugs. And individuals with lung cancer may have serious lung disease in addition to their cancer, going into such a trial. There may be other unknown factors, also. All of those who died of the sudden bleeding were patients with squamous cell tumors, which tend to develop in the larger airways. It now seems unlikely that patients with squamous cell lung cancers in the large airways would be given the drug in the future. Secondhand smoke’s cancer risk: lower than thought? – (TOI-16/02/00) The risk of lung cancer due to secondhand smoke may be substantially lower than previously reported, according to UK researchers. However this does not mean that there is no risk of developing lung cancer due to secondhand smoke, the lead author said. A previous analysis based on 37 studies suggested people who inhaled secondhand smoke had a 24% increase in lung cancer compared with those in a smoke-free environment. However, the analysis only included studies that showed a positive link between passive smoking and lung cancer or those that showed a high risk. Studies showing no association or low risk are unlikely to get published and would not be available to researchers. The evidence suggests that it is the lower estimates that have been left out. The estimate of excess risk falls from 24% to 15% once these studies are taken into account. The authors concluded that the "published estimate of increased risk of lung cancer associated with environmental tobacco smoke needs to be interpreted with caution." A simple way to catch a killer – (TOI-03/02/00) Pilot trials for a simple screening test that detects early stage lung cancer in smokers and ex-smokers show that it can lead to a remarkable fivefold increase in the number of people surviving one of the biggest cancer killers. One of the major obstacles in dealing with lung cancer successfully is that by the time patients get typical symptoms such as coughing, wheezing, etc, the tumour is often too big for surgery. As a result, overall survival rates are so dismal that only one in 10 of the new cases diagnosed this year will be alive five years from now. Most will die in the first year. But if diagnosed in the first stage, the survival rates soar to 70%. This potentially huge increase, coupled with an ability to easily target an identifiable at-risk group, smokers, makes it an ideal disease for screening. But very little has been done so far. In a trial with 1000 men and women who had no symptoms of lung cancer but who had smoked at least a packet of cigarettes every day for 10 years or two packs for five years, volunteers underwent conventional x-rays and low dose computed tomography (CT) scans. 28 tumours less than 10mm in diameter were picked up by the scans and all but one were small enough to be removed surgically. None of the patients needed chemotherapy or radiotherapy thereafter and to date they have shown no signs of recurrence. Why Women Face Much Greater Lung Cancer Risk- (Journal of the National Cancer Institute- 05/01/00) A gene for a protein that fuels lung-cancer growth is more active in women than in men, according to a report by a University of Pittsburgh-led research team, which also discovered that nicotine found in cigarettes induces gene activity. Their report offers the first biological explanation for the greatly increased risk women face versus men in developing lung cancer. If substantiated in future studies, this research could provide a valuable marker for predicting which women are most likely to develop the disease or dangerous pre-cancerous changes. The research team found an increase in the expression of the gene for gastrin-releasing peptide receptor (GRPR), which is found on the surface of cells lining the lung. When stimulated by its hormone, gastrin-releasing peptide, GRPR triggers cell proliferation typically seen in lung cancer. The Pittsburgh-based research team also discovered that nicotine found in cigarettes stimulates expression of the GRPR gene in lung cells. "Our research strongly suggests that women are likely to develop lung cancer after much less smoking exposure than men and much earlier in life, regardless of their smoking history. The take-home message, especially for teenage girls, is that they should stop smoking -- or better yet, never start," said Dr. Sharon Shriver, principal investigator on the study, who is now an instructor of biology at the Penn State University Park Campus. Passive smoking can lead to lung cancer (TOI- 25/10/99) K. Srinath Reddy, one of the experts associated with the World Health Organisation's Tobacco-Free Initiative, said that passive smoking is now known to increase the risk of falling prey to fatal and disabling diseases caused by active smoking. These include cancers of the lung and other organs, besides heart and respiratory ailments. David Ettinger:Hunting early lung cancer-(Medivision, August,1999) Lung cancer will kill almost 159,000 people in the US this year. In most cases, by the time it is diagnosed, it’s too late for effective treatment. One of the deadliest of all cancers, the overall cure rate for all stages of the disease stands at just 14%. The study offers hope of saving thousands of lives, says David S. Ettinger, M.D., Professor of Oncology and Medicine and Associate Director for clinical research at Johns Hopkins. The study used low-dose CAT scan instead of chest X-ray to look at 1000 men and women ages 60 and older who smoked or did smoke. CAT scans were found to be a more accurate diagnostic tool than chest X-ray. This is an expensive test however and the benefits must be weighed against the cost. |
