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.
According to a Wikipedia definition, a presentation is the act of giving something to someone in a formal way. This should not just be a narration of information or data; ideally, a presentation should contain a story, which means that a plot, characters and a narrative point of view need to be included. All of the established types of presentation, i.e., oral abstract presentations, abstract discussions and education symposia, can be created to match this requirement.
In 2013, Japanese researchers launched a nationwide, prospective, observational study for patients with lung cancer and genomic alterations, called Lung Cancer Genomic Screening Project for Individualized Medicine in Japan (LC-SCRUM-Japan). The number of participating institutions has risen greatly over time, and today 241 institutions from almost all regions across the country are part of the project.
Most of the targeted agents currently recommended for the treatment of lung cancer are administered as single agents. However, there is a rationale for combinations, as two drugs might act in an additive or synergistic manner and may control different populations of tumor cells. Tumor heterogeneity plays a major role here, especially in patients who have already developed resistance to their first treatment.
In the setting of a clinical study, sample data are used to make an inference for the entire population. Generally speaking, results from a randomized clinical trial (RCT) will be unlikely to be exactly the same as population parameters, which is the reason for bias involved. In addition, when a RCT were repeated 100 times, results obtained each time would not be identical, which is the reason for uncertainty involved.
A career as a physician scientist can be extremely fulfilling, as it is an opportunity to make a difference in patient care by way of academic excellence. Clinical observations are explored in the translational setting based on experience and prior knowledge; eventually, the insights gained in this way can give rise to clinical innovation.
