Treatment for Carcinoma, Non-Small-Cell Lung

This review does not support the idea that cancer can be cured or that it implies good prognosis after cure. The concept of cure of cancer seems based mostly on the belief that a patient has to bear the terrible suffering (which is hardly credible) of this disease.

The causal factors in lung carcinoma include environmental (including tobacco smoking), genetic (including human hepatitis B virus infection and human papillomavirus infection) and viral factors (including Epstein-Barr virus infection). The causal factors for adenocarcinoma, not squamous cell carcinoma, include smoking (except in adenocarcinoma of the lower respiratory tract); exposure to asbestos; and air pollution. The causal factors for squamous cell carcinoma are environmental (including exposure to arsenic and tobacco smoking) and hereditary (except in the lung). The most significant factor of lung cancer is smoking; if smoking is stopped for at least 5 years, the risk of developing lung cancer drops to 1% per year.

There were only a few (or minority) studies that systematically considered PDE5 inhibitors or TRPV1/2 inhibitors as potential targeted therapy in cancer patients in comparison to drugs targeting the VEGF or EGFR receptor protein complexes. There are a number of studies currently in progress looking in this direction.

Nearly 1/4 of the United States population over the age of 20 suffers from a lung cancer in that year. The incidence of lung cancer increases to nearly 1/3 by the age of 50. Non-smokers are about 10 times more likely to develop lung cancer than smokers. Males and females are equally affected. The number of people with lung cancer has been increasing at a rapid rate (about 6% per year). Cigarette smoking is the main risk factor for lung cancer (70% in non-smokers).

Signs of carcinoma, non-small-cell lung may include weight loss and trouble eating. Other signs and symptoms can include cough, hemoptysis, or shortness of breath. If any of the above signs and symptoms are present, prompt medical referral is necessary.

The incidence of lung cancers among US current smokers (as measured by incidence rates) is approximately 5-fold higher than among US non-smokers (as determined by death rates). The high overall incidence of lung cancer among people with a history of smoking likely reflects both the aging population, and the increased propensity of smokers to develop lung cancer.

Patients with lung cancer must receive standard care, which includes chemotherapy, targeted therapy, radiation, and surgical treatment, when feasible, with or without targeted therapies being the preferred choice. In patients with metastatic disease, surgery may be advisable during a second-line treatment. Chemotherapy was the most common single-agent/single-drug regimen; in the second-line treatment setting, bevacizumab was the most often used single-agent/single-drug regimen.

A substantial proportion of NSCLC patients will not respond to all available treatments. Results from a recent clinical trial of the current trials suggest that a limited number of patients are likely to benefit from the addition of a new investigational targeted cytotoxic agent.

Non-small-cell lung cancer cell metastases occur shortly after primary tumor invasion. Metastases occur sooner in patients who are younger and with high-stage disease. In our small series, prognosis was not significantly different in patients in whom the primary tumor was removed, when metastases were surgically removed only, when metastases were surgically removed combined with adjuvant chemotherapy, or when they received cytotoxic drugs to prevent recurrence. We suggest that chemotherapy should be stopped in those patients after a negative examination of metastases to reduce the likelihood of a recurrence.

There is little evidence about any specific subpopulation of patients who may benefit from clinical trials. As new data on treatment benefit come out, clinicians will want to take into account other patient characteristics and decide who to offer clinical trials.

The findings of this study suggest that this treatment has a more favourable outcome than a placebo. This is in accordance with the clinical practice of treating patients with neuroleptics as monotherapy or in combination with other drugs.