20 research outputs found
Recommendations for implementing lung cancer screening with low-dose computed tomography in Europe
Lung cancer screening (LCS) with low-dose computed tomography (LDCT) was
demonstrated in the National Lung Screening Trial (NLST) to reduce mortality from the disease.
European mortality data has recently become available from the Nelson randomised controlled
trial, which confirmed lung cancer mortality reductions by 26% in men and 39â61% in women.
Recent studies in Europe and the USA also showed positive results in screening workers exposed to
asbestos. All European experts attending the âInitiative for European Lung Screening (IELS)ââa
large international group of physicians and other experts concerned with lung cancerâagreed that
LDCT-LCS should be implemented in Europe. However, the economic impact of LDCT-LCS and
guidelines for its effective and safe implementation still need to be formulated. To this purpose, the
IELS was asked to prepare recommendations to implement LCS and examine outstanding issues.
A subgroup carried out a comprehensive literature review on LDCT-LCS and presented findings at
a meeting held in Milan in November 2018. The present recommendations reflect that consensus
was reached
Recommendations for implementing lung cancer screening with low-dose computed tomography in Europe
Lung cancer screening (LCS) with low-dose computed tomography (LDCT) was demonstrated in the National Lung Screening Trial (NLST) to reduce mortality from the disease. European mortality data has recently become available from the Nelson randomised controlled trial, which confirmed lung cancer mortality reductions by 26% in men and 39â61% in women. Recent studies in Europe and the USA also showed positive results in screening workers exposed to asbestos. All European experts attending the âInitiative for European Lung Screening (IELS)ââa large international group of physicians and other experts concerned with lung cancerâagreed that LDCT-LCS should be implemented in Europe. However, the economic impact of LDCT-LCS and guidelines for its effective and safe implementation still need to be formulated. To this purpose, the IELS was asked to prepare recommendations to implement LCS and examine outstanding issues. A subgroup carried out a comprehensive literature review on LDCT-LCS and presented findings at a meeting held in Milan in November 2018. The present recommendations reflect that consensus was reached
Immunohistochemistry detection of epidermal growth factor receptor (EGFR) exons 19 and 21 mutations in non-small cell lung cancer (NSCLC) using novel mutation specific antibodies
Page 733s, Abstract 10542info:eu-repo/semantics/publishe
Novel EGFR mutation specific antibodies for NSCLC: Immunohistochemistry as a possible screening method for EGFR mutations
info:eu-repo/semantics/publishe
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Diverse EGFR Exon 20 Insertions and Co-Occurring Molecular Alterations Identified by Comprehensive Genomic Profiling of NSCLC
IntroductionEGFR exon 20 insertions (EGFRex20ins) comprise an uncommon subset of EGFR-activating alterations relatively insensitive to first- and second-generation EGFR tyrosine kinase inhibitors (TKIs). However, recent early clinical data suggests these patients may benefit from newer-generation EGFR-TKIs. Comprehensive genomic profiling (CGP) identifies a broad spectrum of EGFRex20ins and associated co-occurring genomic alterations (GAs) present in NSCLC.MethodsHybrid capture-based CGP was performed prospectively on 14,483 clinically annotated consecutive NSCLC specimens to a mean coverage depth of greater than 650X for 236 or 315 cancer-related genes.ResultsOf 14,483 NSCLC cases, CGP identified 263 (1.8%) cases with EGFRex20ins, representing 12% (263 of 2251) of cases with EGFR mutations. Sixty-four unique EGFRex20ins were identified, most commonly D770_N771>ASVDN (21%) and N771_P772>SVDNP (20%). EGFR amplification occurred in 22% (57 of 263). The most common co-occurring GAs effected tumor protein p53 (TP53) (56%), cyclin dependent kinase inhibitor 2A (CDKN2A) (22%), cyclin dependent kinase inhibitor 2B (CDKN2B) (16%), NK2 homeobox 1 (NKX2-1) (14%) and RB transcriptional corepressor 1 (RB1) (11%); co-occurring GAs in other known lung cancer drivers were rare (5%). Average tumor mutational burden was low (mean 4.3, range 0 to 40.3 mutations/Mb). Clinical outcomes to first- and second-generation EGFR TKIs were obtained for five patients and none responded.ConclusionsIn the largest series of EGFRex20ins NSCLC, diverse EGFRex20ins were detected in 12% of EGFR-mutant NSCLC, a higher frequency than previously reported in smaller single-institution studies. Clinical outcomes showed lack of response to EGFR TKIs. Tumor mutational burden was low, consistent with non-smoking associated NSCLC. Comprehensive sequencing revealed increased proportion and wide variety of EGFRex20ins, representing a population of patients significant enough for focused efforts on effective interventions