US Oncologist Survey: Optimizing Treatment for Advanced Lung CancerThe Assessment GroupApril 5, 2011 56 Pages - SKU: TAG3806104 |
Additional Information
Report ExcerptsAdvanced non-small cell lung cancers make up over three-quarters of all new lung cancer cases in the United States. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. NSCLC can spread throughout the body through the lymph nodes and bloodstream. While there is only one type of small cell lung cancer, there are three types of non-small cell lung cancer. The three types of non-small cell lung cancer are squamous cell carcinoma, large cell carcinoma, and adenocarcinoma. Squamous cell carcinoma occurs in the skin, lungs, head and neck, esophagus, cervix, and anus. Adenocarcinoma is the name of a broad category of cancers. Although commonly associated with lung cancer, adenocarcinoma is a type of cancer that develops in cells lining glandular areas of internal organs, such as the lungs, breasts, colon, prostate, stomach, and pancreas. About forty percent of all lung cancer cases diagnosed today are adenocarcinomas. Large cell carcinoma shows no evidence of squamous or glandular maturation. These tumors are often diagnosed by default. Their diagnosis is made when elements of squamous or glandular differentiation cannot be proven. Large cell carcinoma represents 10-20% of bronchogenic tumors. These tumors lack any specific clinical features to suggest their diagnosis prior to biopsy. They tend to grow rapidly, metastasize early, and are strongly associated with smoking.
Treatment depends on a number of factors, including the type of lung cancer, the size, location, and extent of the tumor, and the general health of the patient. Many different treatments and combinations of treatments may be used to control lung cancer, and/or to improve quality of life by reducing symptoms. Surgery, chemotherapy, and radiation treatment are three common forms of treatment that have been used with varying success for a number of years. Newer combinations of medications now available may provide clinical benefit beyond these three types of treatment. Given the current state of therapy for non-small cell lung cancer, continued clinical studies are needed to find better treatments and the optimal duration of those treatments, especially as they relate to improving survival for patients with this disease.
- Executive Summary
- Chapter 1: Introduction
- Table 1: Treatment Options in Advanced Lung Cancer
- Chapter 2: Respondent Demographics
- Table 2: Eligibility Criteria for Survey Participation
- Figure 2.1 Gender of Survey Respondents
- Figure 2.2 Years since Medical School Graduation
- Figure 2.3 Practice Settings
- Figure 2.4 Practices in NCI Cancer Centers
- Figure 2.5 Geographic Settings
- Figure 2.6 Survey Respondents by State’s Lung Cancer Mortality
- Figure 2.7 Number of Physicians in Practice Groups
- Figure 2.8 Minimal Acceptable Level of Evidence in Determining Treatment Regimen
- Chapter 3: Treatment of a Smoker with Squamous Cell Carcinoma
- Figure 3.1 Laboratory studies to be done on the tumor tissue
- Figure 3.2 First-line chemotherapy regimen
- Figure 3.4 Confidence in treating this patient to an optimal outcome
- Figure 3.5 Next step in management
- Figure 3.6 Subsequent treatment regimen
- Figure 3.7 Treatment at next cancer progression
- Figure 3.8 Factors influencing treatment decisions
- Chapter 4: Treatment of a Light Smoker with Adenocarcinoma
- Figure 4.1 Barriers to an optimal outcome
- Figure 4.2 Confidence in treating patient to an optimal outcome
- Figure 4.3 Laboratory studies to order
- Figure 4.4 First-line chemotherapy regimen
- Figure 4.5 Next step in management
- Figure 4.6 Second-line treatment regimen
- Figure 4.7 Factors influencing treatment decision
- Chapter 5: Treatment of a Never-smoker with Adenocarcinoma
- Figure 5.1 Laboratory studies to order
- Figure 5.2 Confidence in treating patient to an optimal outcome
- Figure 5.3 Next step in management
- Figure 5.4 Whether to wait for results of testing before beginning systemic therapy
- Figure 5.5 First-line chemotherapy regimen
- Figure 5.6 Factors influencing treatment decision
- Chapter 6: Treatment of an EGFR Mutation Positive Adenocarcinoma
- Figure 6.1 First-line chemotherapy regimen
- Figure 6.2 Factors influencing treatment decision
- Figure 6.3 Confidence in treating patient to an optimal outcome
- Figure 6.4 Factors influencing treatment decision
- Figure 6.5 Sequence of treatment choices
- Figure 6.6 Barriers to management of advanced lung cancer
- Chapter 7: Summary
- Appendix A: Survey Instrument
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