Non-small cell lung cancer - PneumoCancero.com
Transcript of Non-small cell lung cancer - PneumoCancero.com
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.