Podcasts about national lung screening trial

In this JCO Article Insights episode, Davide Soldato summarized finding from the original article published in the September JCO issue: “Mortality Benefit of a Blood-Based Biomarker Panel for Lung Cancer on the Basis of the Prostate, Lung, Colorectal, and Ovarian Cohort”. The summary provides information regarding the ability of a blood-based panel of 4 biomarkers in improving the identification of individuals at risk of developing lethal lung cancer and potential of combined screening strategies to improve trade-off between potential harms and benefit of the screening process. TRANSCRIPT The guest on this podcast episode has no disclosures to declare. Davide Soldato: Welcome to the JCO Article Insights episode for the September issue of the Journal of Clinical Oncology. This is Davide Soldato, your host, and today I will be providing a summary on one article focused on the refinement of screening strategies for lung cancer. The article, titled "Mortality Benefit of a Blood-Based Biomarker Panel for Lung Cancer on the Basis of the Prostate, Lung, Colorectal, and Ovarian Cohort" by Dr. Irajizad and colleagues, investigated the ability of a panel of circulating blood biomarkers in improving the identification of individuals at risk of developing lethal lung cancer. We already know that lung cancer screening based on the use of low dose CT is associated with a reduction in mortality, as already demonstrated by the National Lung Cancer Screening Trial and the NELSON Trial. Furthermore, the US Preventive Task Force has recently recommended an expansion of screening criteria for lung cancer. Currently, based on this recommendation, screening strategies are recommended for individuals 50 years of age and older with a smoking history of at least 20 pack-years and who are current smokers at the moment of the screening time or have quit within the past 15 years. Despite this positive data and this recommendation, the uptake of lung cancer screening in the US is still low, with reported uptake rates below 15%. The risk of false positive results, the unnecessary follow-up procedures, uneven access to lung cancer screening programs, and fear of cancer diagnosis and treatment have all been identified as potential barriers to optimal implementation and uptake of lung cancer screening. And so, in order to overcome some of these barriers, several efforts have been made in the last years to develop lung cancer screening prediction models with the aim of selecting a higher risk population who would derive higher benefit from lung cancer screening.  In the present manuscript, the author builds on their previous work where they developed and tested a clinical prediction model and a blood-based prediction model in the context of the PLCO cohort. The Prostate, Lung, Colon and Ovarian Cancer Screening Trial was a randomized, multicenter trial in the US which aimed to evaluate the impact of early detection procedures on disease-specific mortality for the aforementioned cancers. Two lung cancer screening prediction model had already been developed and tested in the cohort. The PLCOm2012 model is based on several clinical and demographic characteristics, including age, race and ethnicity group, education, BMI, chronic obstructive pulmonary disease, personal history of cancer, family history of lung cancer, smoking status and intensity, duration and quit time. In a previous study, this model demonstrated a higher sensitivity and positive predictive value with no loss in specificity for lung cancer diagnosis compared to the National Lung Screening Trial criteria. Additionally, in the same cohort, the 4MP was a blood-based panel that included the precursor form of surfactant protein B, cancer antigen 125, carcinoembryonic antigen, and cytokeratin-19 fragment. In a previous study, a combination of this blood-based panel and the PLCOm2012 model was associated with a better identification of patients at high risk of developing lung cancer that would consequently benefit from lung cancer screening. In the manuscript that was published in the current issue of the JCO, the authors aim to expand on these previous results and test the ability of the combined 4MP and PLCO model to identify individuals at high risk of developing lung cancer death. The study used prediagnostic sera of 552 individuals that were diagnosed with lung cancer within one year from the blood draw and 2000  non-cases. In the study, the authors assessed the performance of this combined four 4MP and PLCO model at a risk threshold of 1% and 1.7% of developing lung cancer at six years. Among the more than 500 individuals who were diagnosed with lung cancer, 70% died from it and 18% died of other causes, and the median survival times for lung cancer cases was 2.7 years. The combined 4MP and PLCO model had an area under the curve (AUC) of 0.88 for the prediction of lung cancer-specific mortality. The performance of this combined model using both clinical demographic and also a blood-based panel was higher than the ones of the two models considered alone. Furthermore, the model had similar predictive performance for both non small cell lung cancer and small cell lung cancer-related deaths.  Subsequently, the authors compared the performance of the combined 4MP and PLCO model with the 2013 and 2021 US Preventive Task Force criteria and observed that the combined model had improved sensitivity, specificity, and positive predictive value for the prediction of lung cancer-specific mortality compared to both types of criteria. Finally, the authors assessed whether the combined 4MP and PLCO model were able to determine the survival probability among individuals who had a smoking history of at least 10 pack-years. Cases and non-cases were classified as either test positive or negative according to model scores at the 1.7 and 1% risk threshold at six years. For both thresholds, the combined 4MP and PLCO model identified a significantly higher number of lung cancer deaths in test positive individuals compared with test negative ones. So, in conclusion, these studies identify patients who are at higher risk of developing lung cancer-specific mortality using a combination of blood-based biomarkers and clinical demographic characteristics. The combined models showed higher sensitivity and specificity and positive predictive value compared to the standard US Preventive Task Force criteria. The results of this study are important because the identification of individuals at higher risk of lung cancer diagnosis and death offers the opportunity for a more favorable tradeoff between potential harms and benefits of the screening process. And so these results could assist in the design of future screening and intervention studies as well as facilitate the uptake of lung cancer screening, especially for those test-positive patients that have a higher risk of lung cancer death. Application of this model could potentially lead to a higher number of patients diagnosed in earlier stages and thus eligible for curative intent treatment.  That concludes this episode of JCO Article Insights regarding a summary of the article "Mortality Benefit of a Blood-Based Biomarker Panel for Lung Cancer on the Basis of the Prostate, Lung, Colorectal, and Ovarian Cohort" by Dr. Irajizad and colleagues.  This is Davide Soldato. Thank you for your attention and stay tuned for the next episode of JCO Article Insights.  The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experiences, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.      

We are introducing a new feature today on Pulm PEEPs! In our Rapid Fire Journal Club series, we will be reviewing landmark trials in pulmonary and critical care medicine in 10 minutes or less, and sharing a high-yield summary graphic. … Continue reading →

The U.S. Preventive Services Task Force has recently changed the guidelines for lung cancer screening. Listen to two experts who helped establish the first set of screening guidelines. Then hear from a patient advocate living with lung cancer on how the change in screening is a step in the right direction. Guests: Dr. Denise Aberle, LCFA Scientific Advisory Board member David Sturges, LCFA Co-founder and lung cancer survivor Terri Conneran, LCFA Speaker Bureau member   Show Notes | Transcription   Establishing the first set of NLST guidelines The first NCI-sponsored National Lung Screening Trial (NLST) was a trial to compare two ways of lung cancer screening: low dose helical CT versus chest radiography. The NLST was the joint collaboration of ACRIN and the Lung Screening Study. Dr. Denise Aberle served as the national Principal Investigator of the American College of Radiology Imaging Network (ACRIN-NLST) component of the National Lung Screening Trial. Dr. Aberle’s research also centers on lung cancer and oncologic imaging for response assessment; quantitative image analysis, and oncology informatics. LCFA’s co-founder, David Sturges served on the United States Department of Defense’s Congressionally Directed Medical Research Programs’ Integration Panel. He was the sole patient advocate at the table for the groundbreaking National Lung Screening Trial’s Data and Safety Monitoring Board (DSMB). These new lung cancer screening guidelines have two significant changes to the previous criteria in place regarding who qualifies for annually testing: Lowered the age from 55 to 50 so now the Age Range criteria is now Ages 50 - 77. Changed the pack years smoking calculation from using 30 pack years of smoking to using 20 pack years of smoking. Although these improved guidelines may lead to more smokers getting tested for lung cancer earlier, there are many factors that might put you at risk for lung cancer. Many people believe that smoking alone causes lung cancer. But, increasingly, people who have never smoked or who quit smoking many years ago are being diagnosed with lung cancer. Hear from Terri Conneran, member of LCFA’s Speakers Bureau, tell her diagnosis story as one who didn’t meet these criteria. Learn more about her road to her specific diagnosis, which did not follow a direct route. Why is the change in screening guidelines important? Besides the statistic that more than half of new lung cancer patients have never smoked or quit more than 15 years ago are not included in the original CT screening recommendations: These revisions will reduce both racial and sex disparities to enable screening in a higher risk groups and additional percentage of the population who we know are going to get lung cancer. They will provide greater benefits in reducing lung cancer mortality across the United States. When detected early, lung cancer patients have more treatment options and a far greater chance of survival. The 5-year survival rate for those diagnosed before the cancer has spread rises from 18 out of every 100 people to 55 out of every 100. But, the key is being screened for lung cancer early. “The trial lasted from 2002 when we launched to about 2010, and was able over time to identify that low dose CT screening did in fact reduce deaths from lung cancer because of early detection. The name of the game is early detection because that's when the cancer can be treated and is most likely to be curable, meaning to result in long-term survival. And that's exactly what we saw.”  - Dr. Denise Aberle And, even with the new lung cancer screening guidelines, there still is an emphasis on screening people who are either current or former smokers. These guidelines still won’t catch many of the lung cancers in never smoking patients who have a genetic alteration driving their cancer. “While we were talking about smoking and pack-years and all of that, it's true that if you have lungs, you can get lung cancer, right? I mean, you just have to be on top of your health as much as you possibly can. Every breath counts, for sure.” LCFA is a nonprofit dedicated to improving the survivorship of lung cancer patients by funding lung cancer research. Visit lcfamerica.org.

Inside-Out Leadership: Human Leadership and Mental Health with Dr. Alison Van Dyke Dr. Alison Van Dyke joined the Data Quality, Analysis, and Interpretation Branch of the Surveillance Research Program (SRP) as Director of the SEER-linked Virtual Tissue Repository (VTR) Pilot Studies. For the VTR Pilot Studies, SRP works with SEER registries to obtain custom annotations of detailed treatment data for pancreas and female breast cancer cases which may have biospecimens available. The goal is to match unusual survival cases with more typical survival controls. Dr. Van Dyke also directs the Residual Tissue Repositories (RTRs). Operated by the SEER registries in Hawaii, Iowa, and Los Angeles, the RTRs collect tissue being discarded by hospital laboratories once the minimum requirement for retaining diagnostic tissue blocks, as set forth by the College of American Pathologists (CAP), has been met.Prior to joining SRP, Dr. Van Dyke earned her MD/PhD from Wayne State University School of Medicine in 2011 with graduate training in cancer biology. Under the mentorship of Dr. Ann Schwartz, her doctoral research focused on the role of inflammation in non-small cell lung cancer among women and included SEER data. She completed postgraduate medical residency training in anatomic pathology at Yale-New Haven Hospital and surgical subspecialty training in thoracic pathology at the University of Pittsburgh Medical Center. In addition to being board certified in Anatomic Pathology by the American Board of Pathology, she is a Fellow of the CAP and serves as the SEER Liaison to the CAP Cancer Committee, which determines what and how tumor information will be reported in pathology reports.Dr. Van Dyke completed a postdoctoral fellowship in the Infections and Immunoepidemiology Branch of the Division of Cancer Epidemiology & Genetics (DCEG). Working with Drs. Jill Koshiol and Eric Engels in DCEG, Dr. Van Dyke's postdoctoral research focused on the incorporation of surgical pathology in epidemiologic research. She utilized data from the NCI Cancer Cohort Consortium to investigate the epidemiology of biliary tract cancers. She was also the first researcher to use the digital slide collection from the National Lung Screening Trial to investigate the relationships between lung scarring characteristics and lung cancer development. In addition, she established pathology tissue collection and evaluation methods for Dr. Koshiol’s Chile Biliary Longitudinal Study (Chile BiLS). She is completing a NAACCR project examining biliary tract cancer incidence trends in the United States.In this episode we discuss her path to being a MD/PhD, some of the projects she is working on currently at the NCI, the lessons she learned from living with Bipolar Disorder, and her experience as a woman in STEM. Questions we posed include: What it means to you to be a physician-scientist and why you chose this path? How does balancing these two professional identities affect your leadership philosophy? What things outside of medical school, research, and residency have you done that most impacted your leadership development? What are some Challenges/barriers that you faced? Why do you still think there is still such a stigma surrounding mental health? What needs to be emphasized during the training of young medical and scientific leaders in order to improve the culture? Do you have any personal stories where you felt that you were discriminated against by your peers for your gender?What message do you want to send to our listeners that may feel discriminated against based on their gender, race, etc? What are your favorite books? What advice do you have for medical trainees?

This week, we discuss long-term results from an extended analysis of the National Lung Screening Trial, and Dr. James Mulshine of Rush University offers his thoughts on these findings. We also review a report on radioactive iodine treatment for hyperthyroidism and long-term risk of death from solid cancers.Coverage of stories discussed this week on ascopost.com:Extended Follow-up From the National Lung Screening Trial ReportedDoes Radioactive Iodine Treatment for Hyperthyroidism Increase the Risk of Cancer Mortality?

Een combinatie van een drietal biomarkers (voor hart-en vaatziekten, COPD en longkanker) zullen de voorspelling van longkanker en mortaliteit verbeteren. Deze resultaten presenteerde dr. Anton Schreuder, arts-onderzoeker (Radboudumc, Nijmegen) tijdens het IASLC 19th World Conference on Lung Cancer in Toronto, Canada. Schreuder trok deze conclusie na computeranalyse van 6.000 CT-scans uit de National Lung Screening Trial.Referentie1. Schreuder A, et al. WCLC 2018; abstr MA20.09.

Lung cancer is the third most common type of cancer in both men and women. More men and women die every year from lung cancer than from any other form of cancer.  In 2011, the National Lung Screening Trial showed a 20 percent decrease in lung cancer deaths in heavy smokers who received a low-dose lung screening exam. This screening helps to find lung cancer at an early stage so treatment options are more successful.Learn more from Matthew Graczyk, MD, thoracic surgeon at the Virginia Piper Cancer Institute, about the importance of early lung screening.

Summary of the April 7, 2015 issue, including articles on lumbar spinal stenosis, imaging strategies for patients with stable chest pain, performance of Lung-RADS in the National Lung Screening Trial, firearm-related hospitalization, and efficacy of commercial weight-loss programs, as well as recommendations from 8 health professional organizations and the American Bar Association on preventing firearm-related injury and death.

Reginald Munden, M.D., sees a light at the end of the tunnel with the release of the findings of the National Lung Screening Trial.

The New England Journal of Medicine recently published the results of the National Lung Screening Trial led by the National Cancer Institute with MD Anderson Cancer Center a main participant. This first-of-its-kind study found computed tomography (CT) scans detect lung cancer at an earlier, more curable stage compared to traditional X-rays resulting in 20% fewer deaths. Reggie Munden, M.D., Professor in the Department of Diagnostic Radiology and Therese Bevers, M.D., Professor in the Department of Clinical Cancer Prevention, discuss this breakthrough that has lead to the first screening for lung cancer.