Update in lung cancer and oncological disorders 2010

Our plain-English summary of Update in lung cancer and oncological disorders 2010, by B. Halmos, C.A. Powell (American Journal of Respiratory and Critical Care Medicine, 2011).

The study

• Authors: B. Halmos, C.A. Powell
• Journal: American Journal of Respiratory and Critical Care Medicine
• Published: 2011;184(3):297-302
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Summary of the article

This narrative review summarized recent research on lung cancer and mesothelioma, as an update for 2010. The authors noted that lung cancer remains the leading cause of cancer death worldwide, with 157,000 U.S. deaths expected in 2010, and that tobacco smoke accounts for 90% of cases. They described studies of other exposures, including a pooled analysis of 11 case-control studies that found an odds ratio of 1.31 for occupational diesel motor exhaust exposure. They also described genetic susceptibility variants. They reported initial findings of the National Lung Screening Trial, which assigned 54,000 current and former smokers to low-dose CT or chest X-ray screening and showed a 20.3% reduction in lung cancer mortality in the CT arm. Further sections covered a new adenocarcinoma classification, mediastinal staging, mouse models of pathogenesis, treatment of early-stage disease, early palliative care, chemotherapy in the elderly, and therapies targeted to histology, EGFR mutations and ALK translocations. A section on mesothelioma stated that the disease is caused by exposure to amphibole asbestos. It reviewed serum biomarkers tested in 507 subjects (area under the curve 0.87 for soluble mesothelin and 0.85 for megakaryocyte potentiating factor), a trimodality trial with a 42% success rate, and early dendritic cell immunotherapy. The authors concluded that smoking prevention, CT screening and personalized treatment will significantly reduce lung cancer mortality.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This article was a narrative review: an annual update summarizing lung cancer and mesothelioma research published around 2010, with no new data of its own. The authors stated that tobacco smoke accounts for 90% of lung cancer cases. They described early results from the National Lung Screening Trial, which assigned 54,000 current and former smokers aged 55 to 74 to either low-dose chest CT or chest X-ray screening. It showed a 20.3% reduction in lung cancer deaths in the CT group. A short section covered mesothelioma, which the authors stated is caused by exposure to amphibole asbestos. There they described studies by other researchers. One tested two blood markers in 507 subjects. A European phase II trial in early-stage malignant pleural mesothelioma combined chemotherapy, extrapleural pneumonectomy and radiotherapy. Success meant completing the protocol plus progression-free survival at 90 days, meaning being alive without disease progression. The success rate was only 42%. An early trial of dendritic-cell vaccination found the approach safe. The authors said such new treatments had not yet shown clinical benefit, but suggested these strategies would eventually affect clinical practice.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative review (annual research update) of lung cancer and mesothelioma studies published around 2010; no original data
• Who was studied: No study population of its own; the authors reviewed published studies, trials and conference reports on lung cancer and mesothelioma from around 2010
• Exposure: Mainly tobacco smoke for lung cancer. Other exposures discussed include in-home coal and wood use and diesel motor exhaust. For mesothelioma, the authors stated it is caused by exposure to amphibole asbestos. No other fiber types or doses were discussed.
• Main results:
  • The authors stated that tobacco smoke accounts for 90% of lung cancer cases
  • The National Lung Screening Trial (reviewed, not this article's own study) randomly assigned 54,000 current and former smokers aged 55 to 74 years to low-dose helical chest CT or chest X-ray screening
  • In that trial, initial data showed a 20.3% reduction in lung cancer mortality among participants in the CT arm, compared with the chest X-ray arm
  • In a pooled analysis of 11 case-control studies by Olsson and colleagues (reviewed), occupational diesel motor exhaust exposure was associated with lung cancer, with an odds ratio of 1.31 (95% confidence interval, 1.19 to 1.43)
  • Hollevoet and colleagues (reviewed) tested soluble mesothelin and megakaryocyte potentiating factor in 507 subjects. In distinguishing patients with mesothelioma from control subjects, the area under the curve was 0.87 for soluble mesothelin and 0.85 for megakaryocyte potentiating factor.
  • The authors stated that surgery for malignant pleural mesothelioma remains controversial, with lower rates of surgery in the community than in tertiary referral centers
  • The EORTC 08031 phase II trial by Van Schil and colleagues (reviewed) studied early-stage malignant pleural mesothelioma. Treatment was induction chemotherapy, then extrapleural pneumonectomy, then postoperative radiotherapy. The success rate, measured by protocol completion and progression-free survival at 90 days, was only 42%. The authors said this raised concerns about the feasibility of routine trimodal treatment.
  • In a phase I trial by Hegmans and colleagues (reviewed), patients with mesothelioma received chemotherapy followed by dendritic-cell vaccination. The approach was reported to be safe and to induce an immunological response.
  • The authors stated that novel mesothelioma treatment approaches had not yet demonstrated clinical efficacy as measured by outcome
• The authors' conclusion: For mesothelioma, the authors suggested that dendritic cell immunotherapy and immuno-gene delivery strategies will ultimately affect clinical practice

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Lung Cancer, Mesothelioma, Meta-Analysis, Odds Ratio, Chest X-Ray, Adenocarcinoma, Staging, Palliative Care.

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