Clinical year in review I.

Non-small cell lung cancer

Jean-Paul SCULIERDepartment of Intensive Care & Thoracic Oncology

Institut Jules BordetUniversité Libre de Bruxelles (ULB)

www.pneumocancero.com

No conflict of interest

EPIDEMIOLOGY

SCREENING

NPS to avoid by CT one death by lung cancer in comparison to chest XR : 265

NSS to diagnose one lung cancer by CT : 40

DIAGNOSIS

Thorax 66: 294-300; 2011

TREATMENT

Surgery

Overall survival

Cancer-specific survival

Tumour < 2.1 cm

Chemotherapy for advanced disease

Tyrosine kinase inhibitors

overall mutation

No mutation ?

Mutation No mutation

High copy number

Low copy number

Exon 19 L858R

Oligometastatic disease

62 patients with metastatic sites other than brain or adrenals

PROGNOSIS

PALLIATIVE CARE AND END OF LIFE

Main conclusions1. Antismoking policy has resulted in a significant

decrease in the rate of deaths by lung cancer in Europe.

2. For screening, CT scan detects significantly more lung cancers than chest X-Ray.

3. Single agent switch maintenance chemotherapy is associated with survival advantage.

4. In case of active EGFr mutation in advanced NSCLC, the therapeutic project should include TKI and chemotherapy.

5. More attention should be given to the announce of the diagnosis and the introduction of palliative care.