Dada la eficacia limitada de la quimio- terapia en el tratamiento de segunda o tercera línea del CPNM, se probó en el ensayo de fase III aleatorizado ULTI- MATE la combinación de quimioterapia y bevacizumab en pacientes con CPNM avanzado de histología no epidermoide que había progresado después de una o dos líneas de tratamiento.
El Lung Cancer Mutation Consortium (LCMC) es un consorcio de varias insti- tuciones para el estudio de las mutacio- nes conductoras del adenocarcinoma de pulmón. La pluralidad de centros cola- boradores permite identificar cifras rela- tivamente elevadas de pacientes con al- teraciones infrecuentes y raras, facilita el análisis de sus características clínicas y sienta las bases para la realización de ensayos de tratamientos dirigidos.
El ensayo de fase IIb LUX-Lung 7 fue una comparación directa del bloqueante de la familia ErbB de segunda generación afatinib y el inhibidor de tirosina cinasa del EGFR reversible de primera generación gefitinib en pacientes con adenocarcinoma de pulmón avanzado (estadio IIIB/IV) EGFR positivo no tratados previamente.
In Caucasian patients, mutations of the EGFR gene occur in 10 % to 15 % of adenocarcinomas of the lung. “These tumours depend on EGFR signalling for growth and survival,” explained Anna Buder, MSc, Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Robert Pirker, MD, Department of Internal Medicine I, Medical University of Vienna, Austria, discussed evidence from clinical trials for the treatment of lung cancer, with a focus on the findings presented at the ASCO 2016 Congress. As Dr. Pirker emphasised, a variety of topics was discussed at the conference, although none of the clinical trial results reported on this year have heralded fundamental changes in clinical practice.
In 2009, the 7th Edition of the TNM classification of malignant tumours was published. The proposals for the revised T, N and M categories will be implemented in the 8th Edition that is expected for late 2016. These proposals have been developed by the Staging and Prognostic Factors Committee of the International Association for the Study of Lung Cancer (IASLC) based on a large prospective database.
According to the principles stated by the World Health Organisation, screening programmes are aimed at timely detection of diseases that represent important health problems and for which there are accepted treatments. Suitable and acceptable tests are required, and the cost of case finding should be economically balanced.
“The 2004 classification had only one type of pre-invasive lesion, called atypical adenomatous hyperplasia”, Dr. Müllauer explained. “This type is still part of the new classification, but a new entity has been added, which is adenocarcinoma in situ.” By definition, atypical adenomatous hyperplasia is a localised, small (≤ 0.5 cm) proliferation of mildly to moderately atypical type II pneumocytes and/or Clara cells that line the alveolar walls.
在 NSCLC 中已经 发现 HER2 （ErbB2）的扩增或超表达，并且在约2%-4%的患者中发生体细胞 HER2 突变。HER2 突变晚期 NSCLC 条件下的化疗反应不佳。类似地，单药pan-HER 抑制剂似乎仅产生有限的获益，且反应罕见而短暂。 这里，双通路抑制代表了潜在的治疗方法。根据临床前数据 和 I 期研究，HER2/EGFR 抑制性 TKI 来那替尼和 mTOR 抑制剂替西罗莫司具有协同作用。
第 8 版 TNM 分类已于近期开始实施。与 2009 年发布的第七版 相比， 对肺癌分期做出了几项重要调整，目的在于改善预测和研究。来自西班牙巴塞罗那塔拉萨 Mútua Terrassa 大学医院胸外科的医学博士 Ramón Rami-Porta 认为，“研究对于可用各种治疗选择进行治疗的小型肿瘤而言尤为重要”。新版本以大量患者为基础，为其稳健性提供了支持。
