Lung Cancer Highlights: Early Detection and Long-Term Survival

As one might expect, lung cancer is one of the major focuses at each CHEST conference. The following are highlights from this year’s recently released abstracts and late-breaking studies.

Deepak et al presented the data from their study, Socioeconomic Disparities and the Relationship Between COPD and Lung Cancer. Because smoking is a common risk factor for chronic obstructive pulmonary disease (COPD) and lung cancer is more common in adults with lower socioeconomic status (SES), researchers report that “SES and COPD may result in a late diagnosis of lung cancer, less stage-based appropriate treatment, and a reduced survival.” This study analyzed patients that were diagnosed with lung cancer 2001 to 2005 that were identified in the Surveillance, Epidemiology, and End Results registries. Upon completion of their analysis, researchers concluded that “Contrary to expectations, patients diagnosed with comorbid COPD were diagnosed at earlier stages, which likely altered stage-appropriate treatment and outcomes,” and that “within SES strata, it is likely that patients with COPD had both better primary care and pulmonologist follow-up, which facilitated early stage diagnosis.”

Dhillon et al released the data from their study, Metformin Usage and Not Diabetes Influences the Long-Term Survival of Resected Early Stage Non-small Cell Lung Cancer Patients. According to the research team, previous data have suggested that diabetes influences survival of patients with colorectal, lung, and breast cancer. Additionally, “the anti-cancer effect of metformin, a common oral anti-hyperglycemic drug, further confounds this association.” For these reasons, the study authors sought to examine the influence of diabetes and metformin on the survival of patients undergoing resection of early non-small cell lung cancer (NSCLC). The study authors examined 3393 patients with stage I NSCLC undergoing anatomic resection based on information retrieved from the Tumor Registry of the NCI Designated Comprehensive Cancer Center. Following their analysis of these patients, the authors concluded that “metformin use rather than diabetes improves long-term outcome of patients with stage I lung cancer.”

Rickman et al presented the data from their study, Nashville Early Detection Lung Cancer Project: Establishing a Cohort to Validate Candidate Biomarkers for Early Detection of Lung Cancer, the objective of which was to “validate candidate biomarkers for the detection of lung cancer to develop a high-risk cohort and to determine whether a surveillance program will lead to early diagnosis and improved outcomes.” To date, 1219 subjects have been prescreened, 762 of which were not eligible. However, data have only been collected for 68 subjects (according to the authors 70 subjects are on study and 131 are under review). Although this is a small sample size and accrual is below target, the research team reports that “surrogate tissues are being collected and stored in biorepository for diagnosis and risk assessment of lung cancer,” and“CT has detected nodules in 86% of participants and found 1 nodule resected for presumed cure.” The study authors plan to enroll a cohort of 480 high-risk subjects at 3 sites in a 5-year annual screening trial for lung cancer.

To read more about research highlights at CHEST 2012, please visit the American College of Chest Physicians website.