CT detected indeterminate pulmonary nodules in a chemoprevention trial of fluticasone

Berg, Remco M. van den; Teertstra, Hendrik J.; Zandwijk, Nico van; Visser, Christien; Pasic, Arifa; Sutedja, Tom G.; Baas, Paul; Golding, Richard P.; Postmus, Pieter E.; Smit, Egbert F.

doi:10.1016/j.lungcan.2007.09.007

Cited by 23 publications

(25 citation statements)

References 23 publications

(24 reference statements)

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“…The majority of studies considered RFA (n=25 studies)266 – 290 and SABR (n=14)262 265 291–302. Other publications reported outcomes from conventional radiotherapy (n=3),281 297 303 percutaneous cryotherapy (n=1),276 microwave ablation (n=2)304 305 inhaled corticosteroids (n=2)306 307 and antibiotics (n=1) 308…”

Section: Non-surgical Treatment Without Pathological Confirmation Of mentioning

confidence: 99%

“…Veronesi et al 306 randomised 202 patients to inhaled budesonide 800 µg twice a day or placebo for 12 months and showed no effect on pre-existing nodule size or the development of new nodules. van der Berg et al 307 randomised patients with evidence of bronchial squamous metaplasia/dysplasia and either >20 pack-year history of smoking or previous history of lung or head and neck cancer to inhaled fluticasone. Again no effect was seen on either previously detected nodules or the development of new nodules.…”

Section: Non-surgical Treatment Without Pathological Confirmation Of mentioning

confidence: 99%

See 1 more Smart Citation

British Thoracic Society guidelines for the investigation and management of pulmonary nodules: accredited by NICE

Callister

Baldwin

Akram

et al. 2015

Thorax

707

724

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Section: Non-surgical Treatment Without Pathological Confirmation Of mentioning

confidence: 99%

Section: Non-surgical Treatment Without Pathological Confirmation Of mentioning

confidence: 99%

British Thoracic Society guidelines for the investigation and management of pulmonary nodules: accredited by NICE

Callister

Baldwin

Akram

et al. 2015

Thorax

707

724

View full text Add to dashboard Cite

“…Molecular markers may allow us to select individuals at greater risk, but markers of response to chemoprevention strategies have been most difficult to establish (38, 39). Chemoprevention studies where the evaluation by nodule type was considered revealed a nonsignificant trend toward regression of non-solid and subsolid lesions after budesonide treatment (43, 48, 49). However, resolution of CT-detected nodules was not originally an endpoint in the study protocols, and, therefore, there were only a small number of subjects with nodules.…”

Section: Intermediate Endpoint Biomarkers In Chemoprevention Studiesmentioning

confidence: 99%

Indeterminate Pulmonary Nodules: Risk for Having or for Developing Lung Cancer?

Massion

Walker

2014

Cancer Prevention Research

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This perspective discusses the report by Pinsky and colleagues, which addresses whether noncalcified pulmonary nodules identified on CT screening carry short- and long-term risk for lung cancer. We are facing challenges related to distinguishing a large majority of benign nodules from malignant ones and among those a majority of aggressive from indolent cancers. Key questions in determining individual probabilities of disease, given their history, findings on CT, and upcoming biomarkers of risk, remain most challenging. Reducing the false positives associated with current low-dose computed tomography practices and identification of individuals who need therapy and at what time during tumor surveillance could reduce costs and morbidities associated with unnecessary interventions.

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“…However, a 6-month treatment with high doses of inhaled glucocorticoids does not cause any regression of bronchial dysplasia or secondary markers of carcinogenesis in smokers [206,207,208] and a long-term clinical trial in moderate to severe COPD patients treated for 3 years with inhaled glucocorticoids has not demonstrated a decreased risk of lung cancer [209]. There is an ongoing chemoprevention trial measuring the effect of inhaled fluticasone propionate in high-risk smokers (however, patients with FEV 1 less than 1 litre have been excluded from this study) [206]. The addition of low-dose theophylline to combination therapy may have additional benefits [198].…”

Section: New Potential Pharmacological Therapies For Both Lung Cancermentioning

confidence: 99%

Chronic Obstructive Pulmonary Disease and Lung Cancer: New Molecular Insights

2011

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Both chronic obstructive pulmonary disease (COPD) and lung cancer are major causes of death worldwide. In most cases this reflects cigarette smoke exposure which is able to induce an inflammatory response in the airways of smokers. Indeed, COPD is characterized by lower airway inflammation, and importantly, the presence of COPD is by far the greatest risk factor for lung cancer amongst smokers. Cigarette smoke induces the release of many inflammatory mediators and growth factors including TGF-β, EGFR, IL-1, IL-8 and G-CSF through oxidative stress pathways and this inflammation may persist for decades after smoking cessation. Mucus production is also increased by these inflammatory mediators, further linking airway inflammation to an important mechanism of lung cancer. A greater understanding of the molecular and cellular pathobiology that distinguishes smokers with lung cancer from smokers with and without COPD is needed to unravel the complex molecular interactions between COPD and lung cancer. By understanding the common signalling pathways involved in COPD and lung cancer the hope is that treatments will be developed that not only treat the underlying disease process in COPD, but also reduce the currently high risk of developing lung cancer in these patients.

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CT detected indeterminate pulmonary nodules in a chemoprevention trial of fluticasone

Cited by 23 publications

References 23 publications

British Thoracic Society guidelines for the investigation and management of pulmonary nodules: accredited by NICE

British Thoracic Society guidelines for the investigation and management of pulmonary nodules: accredited by NICE

Indeterminate Pulmonary Nodules: Risk for Having or for Developing Lung Cancer?

Chronic Obstructive Pulmonary Disease and Lung Cancer: New Molecular Insights

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