Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
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This study explores patient preferences for involvement in lung cancer treatment decisions and the extent of concordance between the views of patients and physicians on decisional roles. The impact of demographic and psychosocial characteristics on the decisional role of patients is also examined. ⋯ The limited concordance between patient preference and perception and between patient and physician perceptions regarding how the treatment decision was made suggests that physicians should more accurately identify patient preferences by directly asking patients at the beginning of each clinical encounter.
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Randomized Controlled Trial
Safety and resource utilization by non-small cell lung cancer histology: results from the randomized phase III study of pemetrexed plus cisplatin versus gemcitabine plus cisplatin in chemonaïve patients with advanced non-small cell lung cancer.
A prespecified analysis of the large, randomized, phase III study in advanced non-small cell lung cancer showed significant improvement in survival for nonsquamous patients treated with pemetrexed/cisplatin versus gemcitabine/cisplatin. Selected grade 3/4 toxicities and resource utilization favored pemetrexed in the overall population, but detailed safety results by histology have not been reported. ⋯ Although previous efficacy analyses showed a significant pemetrexed treatment advantage for nonsquamous patients, results of this analysis indicate that safety and resource utilization do not vary by histology and are consistent with the overall population. The safety and resource utilization of patients treated with pemetrexed/cisplatin are predictable, reproducible, and consistent with the established favorable safety profile of pemetrexed, regardless of histology.
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The Masaoka clinical staging classification is the most widely accepted nowadays and is an excellent predictor for the prognosis of thymoma. Nevertheless, an update of this classification is desirable for it to be suitable for all thymic epithelial tumors including thymic carcinoma and carcinoid. The tumor-node metastasis (TNM) system classification and clinical staging system for thymic epithelial tumors have not been established yet. Until now, four TNM staging systems have been proposed: Yamakawa and Masaoka in 1991 (Y-M system), Tsuchiya et al. in National Cancer Center Hospital of Japan in 1994 (NCCHJ system), the World Health Organization Consensus Committee in 2004 (World Health Organization system), and Bedini et al. in National Cancer Institute of Italy in 2005 (NCII system). ⋯ This TNM staging system is an excellent predictor for the prognosis of thymic epithelial tumors including thymic carcinoma. The N and/or M factors influence the prognosis more than T factor. For the subclassification of the N and/or M factors, large-scale studies including the resectable and unresectable tumors are necessary.
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Malignant mesothelioma (MM) is an aggressive, uniformly fatal tumor usually caused by exposure to asbestos. Soluble mesothelin has been intensively investigated in the serum as a biomarker for this disease. As urine is less complex and less invasive to collect than serum and may be a more acceptable specimen for large-scale screening studies of asbestos-exposed individuals, we determined whether the sensitivity and specificity for MM could be improved by measuring soluble mesothelin in the urine. ⋯ The sensitivity of urinary mesothelin does not warrant the use of urine as a biomarker specimen for MM diagnosis.
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A large group of interacting molecular factors, involved in epithelial-mesenchymal transition, epidermal growth factor receptor (EGFR) signaling, and G1 mitotic phase, are shown to play an important role in cancerogenesis and progression of non-small cell lung cancer (NSCLC). Since success concerning potential correlations, structural and numeric gene aberrations, and biological risk assessment of these molecular factors are still lacking, combined analysis of a multitude of intertwined factors is currently a promising approach. ⋯ The results emphasize that deregulation of controlling factors of the early G1 phase is of significant oncogenic relevance and may represent a potential treatment target in NSCLC.