Ca Lung Biography
(Source google.com)
Treatment of lung cancer refers
to the use of medical therapies, such as surgery, radiation, chemotherapy, and
palliative care, alone or in combination, in an attempt to cure or lessen the
adverse impact of malignant neoplasms originating in lung tissue. Lung cancer is an extremely
heterogeneous family of malignant neoplasms, and well over 50 different
histopathological variants are currently recognized under the most widely used
typing system. Because these variants have differing genetic, biological, and
clinical properties, including response to treatment, correct classification of
lung cancer cases are necessary to assure that lung cancer patients receive
optimum management.
Approximately 98% of lung cancers
are carcinoma, or tumors derived from transformed cells of epithelial lineage.
Currently, nearly four dozen different histopathological variants of lung
carcinoma are recognized. For clinical and treatment purposes, however,
mostoncologists tend to classify lung carcinomas into two major groups, namely
small cell carcinoma (SCLC) and non-small cell lung cancer(NSCLC). This is done
because of differing responses to treatment — NSCLC is comparatively less
sensitive to chemotherapy and/or
radiation, so surgery is the treatment of choice in these tumors. SCLC, in
contrast, usually initially responds well to chemotherapy and/or radiation, but
has usually metastasized widely by the time it is discovered, making surgery
ineffective.
In a 2010 study of patients with
metastatic non–small-cell lung cancer, "early palliative care led to
significant improvements in both quality of life and mood. As compared with
patients receiving standard care, patients receiving early palliative care had
less aggressive care at the end of life but longer survival" which was increased
by approximately 3 months. In recent years, various molecular targeted
therapies have been developed for the treatment of advanced lung cancer.
Gefitinib (Iressa; withdrawn from the U.S. market) is one such drug,
which targets the tyrosine kinase domain of the epidermal growth factor
receptor(EGFR), expressed in many cases of non-small cell lung carcinoma. It
was not shown to increase survival, although females, Asians, nonsmokers, and
those with bronchioloalveolar carcinoma appear to derive the most benefit from
gefitinib. Erlotinib (Tarceva), another EGFR tyrosine kinase inhibitor,
increased survival in non-small cell lung cancer and was approved by the FDA in
2004 for second-line treatment of advanced non-small cell lung carcinoma.
Similar to gefitinib, it also appeared to work best in females, Asians,
nonsmokers, and those with bronchioloalveolar carcinoma, particularly those
with specific mutations in EGFR.
The angiogenesis inhibitor
bevacizumab (Avastin), (in combination with paclitaxel and carboplatin),
improves the survival of patients with advanced non-small cell lung carcinoma.
However, this increases the risk of lung bleeding, particularly in patients
with squamous cell carcinoma.
Crizotinib shows benefit in a
subset of non-small cell lung cancer that is characterized by the EML4-ALK
fusion oncogene, and is approved by the FDA. EML4-ALK is found in some
relatively young, never or light smokers with adenocarcinoma.
Advances in cytotoxic drugs,
pharmacogenetics and targeted drug design show promise. A number of targeted
agents are at the early stages of clinical research, such as cyclo-oxygenase-2
inhibitors, the apoptosis promoter exisulind,] proteasome inhibitors,
bexarotene, the epidermal growth factor receptor inhibitor cetuximab, and vaccines. Sorafenib (marketed as Nexavar for use in
renal and liver cancer) showed promise in a clinical trial matching targeted
treatment to the cancer's genetic profile. Future areas of research include ras
proto-oncogene inhibition, phosphoinositide 3-kinase inhibition, histone
deacetylaseinhibition, and tumor suppressor gene replacement.
Prior to the early part of the
20th century lung cancer was considered a very rare disease, and all malignant
lung tumors were treated identically. Radical surgical resection (i.e.
lobectomy or pneumonectomy)[ was the
only effective intervention available for lung cancer prior to the 1940s, when
the era of modern cytotoxic chemotherapy began. It was not until 1962 that
small cell lung carcinoma (SCLC), then called "oat cell carcinoma"
was recognized for its unique biological behavior, including a much higher
frequency of widespread metastases at presentation, and exquisite sensitivity
to cytotoxic chemotherapy and radiation. Early studies suggested that
patients with small cell lung carcinoma (SCLC) fared better when treated with
chemotherapy and/or radiation than when treated surgically. While this approach
to treating SCLC remains the current standard of care, the role of surgery in
SCLC is being re-examined, with recent studies indicating that surgery may
improve outcomes in some patients with early stage SCLC and combined forms of
SCLC and NSCLC. Squalamine is undergoing trials for treatment of non-small cell
lung cancer . In December 2012, Merck published
the results of its current study. Although the Phase III Trial of L-BLP25
(Stimuvax) did not meet satisfying primary endpoints for patients with
Non-Small Cell Lung Cancer, notable treatment effects have been observed for
L-BLP25 in certain subgroups in the START study.
Ca Lung Lungs Diagram of a Smoker after Smoking Cancer Anatomy And Heart Drawing Images AFter Smoking Wee of a Weed Smoker
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