Lung Cancer Update April 2021
With the World Conference on Lung Cancer (WCLC) 2020 completed last January, several new and clinical relevant phase 2 and phase 3 studies on Lung Cancer have been published. We summarised some key data for you.
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With the World Conference on Lung Cancer (WCLC) 2020 completed last January, several new and clinical relevant phase 2 and phase 3 studies on Lung Cancer have been published. We summarised some key data for you.
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Disruption of standard patient care due to the COVID-19 pandemic has been long postulated, and is now supported by a study reported in the Journal of the American College of Cardiology reporting delays in the delivery of essential diagnostic services, particularly for cardiovascular conditions, affecting health outcomes.
While vaccines are starting to become available for the prevention of SARS-Cov-2 infection, it is anticipated that the Coronavirus 2019 (COVID-19) pandemic will continue for at least the next year.
Evidence in recent years has shown that the lower the low-density lipoprotein cholesterol (LDL-C) levels, the lower the risk of future cardiovascular events.
With the San Antonio Breast Cancer Conference (SABCS) 2020 by AACR just completed, several new and clinical relevant phase 2 and phase 3 have been published in the Journal of the American Medical Association, Clinical Cancer Research, New England Journal of Medicine, Journal of Clinical Oncology, and Lancet Oncology. [‘mediPr] provides you with an overview.
Lung cancer is a leading cause of cancer-related death. In East Asian non-small cell lung cancer (NSCLC) patients, epidermal growth factor receptor (EGFR) mutations occur in 40-55% of lung adenocarcinomas.
Somatostatin analogues (SSA) control the hormonal hypersecretion in pancreatic and midgut neuroendocrine tumours (NETs), with antiproliferative, antiangiogenic and proapoptotic effects. Lanreotide autogel is a long-acting SSA that is considered the therapy of choice along with octreotide, in controlling symptoms associated with gastroenteropancreatic (GEP)-NETs.
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Women account for a disproportionate percentage of new human immunodeficiency virus (HIV) infections in sub-Saharan Africa, comprising 59% of 18 million new adult HIV infections in 2017.
Kidney transplants are the best treatment for end-stage renal disease (ESRD), with better survival outcomes than haemodialysis or peritoneal dialysis. However, in Hong Kong as well as much of the rest of the world, there is an increasing gap between the number of patients requiring a transplant and the number of organs available.
Seasonal influenza is common between January to March, and July to August in Hong Kong. Baloxavir marboxil is the first influenza antiviral with a novel mechanism of action to be approved in almost two decades, and was registered for use in Hong Kong in February 2019.
Conventional imaging with computed tomography (CT), magnetic resonance imaging (MRI) and bone scans, are the current standard of care for imaging prostate cancer. Accurate imaging primarily relies on nodal metastases size for detection.
Hepatocellular carcinoma (HCC) accounts for 80% of all liver cancers, and 55% of all HCC cases worldwide are reported from China. In Hong Kong, liver cancer is the fourth most common cancer and the third most common cause of cancer death.
RAS is the most frequently mutated gene family in cancers, with KRAS mutations being involved as a driver in three of the most lethal cancers – lung cancer, colorectal cancer, and pancreatic cancer. Incidence of KRAS mutations vary between ethnicity with Caucasians having a higher incidence than African-Americans or Asians. In non-small lung cancer (NSCLC), the most common KRAS mutation is G12C. In Asia, G12C mutations in particular account for 14.5% of KRAS mutations in the Chinese population. KRAS G12C was identified in 4.3% of lung cancer samples and 2.5% of colorectal cancer samples.
A number of tyrosine kinase inhibitors (TKIs) are now available for the treatment of various types of non-small cell lung cancers (NSCLC), including epidermal growth factor receptor (EGFR)-mutated and anaplastic lymphoma kinase (ALK)-rearranged NSCLC. However, amplification of the MET gene, which codes for the hepatocyte growth factor receptor (HGFR), has been found to be one of the most prominent mechanisms of secondary resistance to EGFR TKIs. Similarly, the MET exon 14 (METex14) mutation has also emerged as a potential tumour driver due to its role in cancer proliferation, and thus also a promising target for NSCLC.
While SARS-CoV2 has been previously reported to exist in lung tissue in a 78-year-old patient who died of unexpected cardiac arrest when ready for discharge after COVID-19 hospitalisation, recently the first evidence of SARS-CoV2 infection in heart muscle cells has been reported in a case from Brazil and which is supported by evidence from other reports.
While SARS-CoV2 has been previously reported to exist in lung tissue in a 78-year-old patient who died of unexpected cardiac arrest when ready for discharge after COVID-19 hospitalisation, recently the first evidence of SARS-CoV2 infection in heart muscle cells has been reported in a case from Brazil and which is supported by evidence from other reports.
While SARS-CoV2 has been previously reported to exist in lung tissue in a 78-year-old patient who died of unexpected cardiac arrest when ready for discharge after COVID-19 hospitalisation, recently the first evidence of SARS-CoV2 infection in heart muscle cells has been reported in a case from Brazil and which is supported by evidence from other reports.
While SARS-CoV2 has been previously reported to exist in lung tissue in a 78-year-old patient who died of unexpected cardiac arrest when ready for discharge after COVID-19 hospitalisation, recently the first evidence of SARS-CoV2 infection in heart muscle cells has been reported in a case from Brazil and which is supported by evidence from other reports.
Pneumonia is the second leading cause of death in Hong Kong as of 2019, with annually increasing death rates.
Aberrant RET activation has shown to be a clinical driver of tumour growth and proliferation. It is reported that 1-2% of non-small cell lung cancer patients have activating RET fusions. Clinical characteristics of these patients are generally younger (<60 years) with minimal or no smoking history, and frequent presentation with brain metastases at diagnosis of advanced disease. RET mutations are mutually exclusive with other common lung cancer genetic abberations, such as reported for KRAS, EGFR, and ALK.
The development of new targeted therapies for non-small cell lung cancer (NSCLC) in recent years has changed the standard of care for the later stages of NSCLC in specific population groups.
Precision therapies were first approved for cancer in 1998, when trastuzumab was approved for HER2+ breast cancer, opening the door for other targeted therapies such as imatinib for Philadelphia chromosome-positive chronic myelogenous leukaemia.
The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/2019-nCoV) in late 2019 has led to a global pandemic.
Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been used in the treatment of type 2 diabetes mellitus (T2DM) to inhibit renal glucose reabsorption and thereby increase urinary glucose loss.
Human immunodeficiency virus (HIV) has been transformed into a chronic disease to the successful introduction of antiretroviral therapy (ART), and people living with HIV (PWH) now experience morbidity from other chronic conditions, such as kidney, liver, and heart disease.
Infection with the hepatitis C virus (HCV) can lead to chronic hepatitis C infection (CHC) and liver complications such as fibrosis, hepatocellular carcinoma (HCC), cirrhosis, and end-stage liver disease.
Influenza A and B viruses are the cause of 3 to 5 million infection, and 250,000 to 500,00 deaths each year worldwide. Particular groups of the population are at higher risk of infection, including the elderly, immunocompromised, and infants.
Human papillomavirus (HPV) is one of the most common causes of sexually transmitted disease worldwide. HPV is associated with a variety of clinical conditions that can range from cutaneous warts to cervical or anal cancer. Cervical cancer is the third most common cancer in women in the United States, and may constitute up to 25% of all female cancers in developing countries.
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Myelodysplastic syndromes (MDS) are a heterogenous group of clonal haematopoietic disorders that carry a risk of progression to acute myeloid leukaemia (AML). Patients are stratified into risk groups due to the heterogeneity of the disease, which is also exemplified by median overall survival (OS) of 8.8 years for very low risk, and 0.8 years for very high risk patients. Due to symptoms such as anaemia, supportive red blood cell (RBC) transfusions are needed in 80-90% of patients during their disease course, although RBC dependence has been shown to be an adverse prognostic marker.
The incidence of anal cancer has been increasing over the past decade, but currently still constitutes 0.5% of all cancer diagnoses in the United States. When the cancer has metastasised, prognosis remains poor, with relative 5-year survival rates of approximately 30%. The current standard of care for metastatic anal cancer is cisplatin-based chemotherapy combined with 5-fluorouracil (5-FU). However, no randomised clinical trial investigating the optimal chemotherapy regimen for this disease has been conducted. The InterAAct trial was launched to investigate cisplatin plus FU against carboplatin plus paclitaxel in advanced anal cancers, and full results were recently published in the Journal of Clinical Oncology.
This year, ASCO 2020 was held as a virtual conference due to the COVID-19 pandemic. This is a summary of key trials presented at ASCO, focusing primarily on breast cancer, liver cancer, and lung cancer.
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