The BATTLE to Personalize Lung Cancer Prevention through Reverse Migration

Gold, Kathryn A.; Kim, Edward S.; Lee, John; Wistuba, Ignacio I.; Farhangfar, Carol J.; Hong, Waun Ki

doi:10.1158/1940-6207.capr-11-0232

Cited by 44 publications

(46 citation statements)

References 115 publications

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“…1). Particularly, the airway field of injury, because it is widespread in the lung and precedes the development of tumors and premalignant lesions, also provides potential clinical opportunities for early detection and chemoprevention in high-risk smokers and in patients who have survived a cancer of the upper aerodigestive tract (14,16).…”

Section: Introductionmentioning

confidence: 99%

Early Events in the Molecular Pathogenesis of Lung Cancer

Kadara

Scheet

Wistuba

et al. 2016

Cancer Prevention Research

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The majority of cancer-related deaths in the United States and worldwide are attributed to lung cancer. There are more than 90 million smokers in the United States who represent a significant population at elevated risk for lung malignancy. In other epithelial tumors, it has been shown that if neoplastic lesions can be detected and treated at their intraepithelial stage, patient prognosis is significantly improved. Thus, new strategies to detect and treat lung preinvasive lesions are urgently needed in order to decrease the overwhelming public health burden of lung cancer. Limiting these advances is a poor knowledge of the earliest events that underlie lung cancer development and that would constitute markers and targets for early detection and prevention. This review summarizes the state of knowledge of human lung cancer pathogenesis and the molecular pathology of premalignant lung lesions, with a focus on the molecular premalignant field that associates with lung cancer development. Lastly, we highlight new approaches and models to study genome-wide alterations in human lung premalignancy in order to facilitate the discovery of new markers for early detection and prevention of this fatal disease. Cancer Prev Res; 9(7); 518-27. Ó2016 AACR.

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Section: Introductionmentioning

confidence: 99%

Early Events in the Molecular Pathogenesis of Lung Cancer

Kadara

Scheet

Wistuba

et al. 2016

Cancer Prevention Research

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“…This body of work builds a case for future studies of bexarotene plus erlotinib in the unmet medical need population of patients, with wild-type EGFR tumors, with or without KRAS mutations, and supports the use of cyclin D1 levels to stratify or select patients for NSCLC therapy or prevention with the combination. Indeed, our future BATTLE plans include a trial of the combination in preventing new lung cancers in the adjuvant setting (23).…”

Section: Introductionmentioning

confidence: 99%

Cotargeting Cyclin D1 Starts a New Chapter in Lung Cancer Prevention and Therapy

Kim

Lee

Wistuba

2011

Cancer Prevention Research

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Lung cancer has limited effective therapy and no effective prevention. Cytotoxic chemotherapy has not improved when combined with the epidermal growth factor receptor (EGFR) inhibitor erlotinib (standard lung cancer therapy) or with the rexinoid bexarotene. Combining erlotinib and bexarotene, however, to cotarget cyclin D1 via the retinoid X receptor and EGFR was active preclinically in KRAS-driven lung cancer cells derived from transgenic mice and in two clinical studies in lung cancer (including wild-type EGFR tumors, with or without KRAS mutations), as reported in this issue of the journal by Dragnev and colleagues (beginning on page 818). These results, along with closely related clinical results of the BATTLE program, support the promise of this cotargeting approach for lung cancer prevention and therapy and of cyclin D1 as a predictive, personalizing marker for it. Cancer Prev Res; 4(6); 779-82. Ó2011 AACR.

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“…It is expected that the indications will expand in terms of the number of molecular tests needed and in terms of the tumor types from which testing will be required. Clinical trials are ongoing to determine the feasibility of performing sequencing for multiple DNA mutations that may be clinically relevant and of triaging treatment arms on the basis of DNA mutation analysis (19,20). Currently, lung cancer specimens should and do provide sufficient tissue for histologic subtyping and for two molecular assays (EGFR and ALK) that are required for current therapy of advanced lung cancer.…”

Section: Adenocarcinoma: Egfr Mutation and Eml4-alk Translocationmentioning

confidence: 99%

Acquisition and Processing of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Specimens in the Era of Targeted Lung Cancer Chemotherapy

Bulman

Saqi

Powell

2012

Am J Respir Crit Care Med

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Recent advances in therapy for non-small cell lung carcinoma have shown that a personalized approach to treatment has the potential to significantly reduce lung cancer mortality. Concurrently, endoscopic ultrasound transbronchial needle aspiration has emerged as an accurate and sensitive tool for the diagnosis and staging of this disease. As knowledge of the molecular mechanisms that drive lung cancer progression increases, the amount of information that must be derived from a tumor specimen will also increase. Recent clinical studies have demonstrated that small specimens acquired by endoscopic ultrasound transbronchial needle aspiration are sufficient for molecular testing if specimen acquisition and processing are done with these needs in mind. Optimum use of this procedure requires a coordinated effort between the bronchoscopist and the cytopathologist to collect and triage specimens for diagnostic testing. When feasible, rapid onsite evaluation should be performed to assess the specimen for both diagnostic quality and quantity and to allocate the specimen for cell-block and possible immunohistochemistry and molecular studies. It is necessary for pulmonologists and bronchoscopists to understand the rationale for histologic and molecular testing of lung cancer diagnostic specimens and to ensure that specimens are acquired and processed in a fashion that provides information from small cytologic specimens that is sufficient to guide treatment in this era of targeted therapy.Keywords: lung cancer; bronchoscopy; cytology; EGFR; molecular testing Lung cancer remains the leading cause of cancer mortality in the world, with 157,000 deaths expected in the United States in 2010 (1). Despite the large death toll, there are reasons to be cautiously optimistic for a future with fewer lung cancer deaths. Recent advances in clinical and bench research directed toward diagnostics and therapy have led to significant and often dramatic impacts on patient outcomes (2). These developments suggest that a personalized approach to treating lung cancer has the potential to significantly reduce lung cancer mortality. Current standards of care for advanced non-small cell lung carcinoma (NSCLC) treatment assign therapy on the basis of histology and on the basis of epidermal growth factor receptor (EGFR) status for lung adenocarcinoma. This paradigm shift away from homogenous therapy of NSCLC converges with the increased use of bronchoscopic approaches for lung cancer diagnosis and staging, thus enhancing the important role for pulmonary physicians in lung cancer management. It is essential that the bronchoscopist understand the importance of acquiring and processing diagnostic specimens in a manner that provides sufficient information to guide treatment in this era of personalized therapy. This article reviews the rationale for acquiring specific histologic and molecular data from lung cancer biopsies, and recommends multidisciplinary procedures for specimen acquisition and processing that can optimize the yield of pulmonary diagnost...

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The BATTLE to Personalize Lung Cancer Prevention through Reverse Migration

Cited by 44 publications

References 115 publications

Early Events in the Molecular Pathogenesis of Lung Cancer

Early Events in the Molecular Pathogenesis of Lung Cancer

Cotargeting Cyclin D1 Starts a New Chapter in Lung Cancer Prevention and Therapy

Acquisition and Processing of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Specimens in the Era of Targeted Lung Cancer Chemotherapy

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