＜Update in Lung Cancer＞
Dr Kwun Fong, Prince Charles Hospital and University of Queensland School of Medicine, Australia
非常に駆け足の講演でほとんどついていけませんでしたが、キーワードだけ羅列します。
2000 neoadjuvant chemotherapy
2003 gefitnib into clinical use
2006 ALK rearrangement discovered
2007 BF-navigation system, EBUS-TBNA system
2011 crizotinib for ALK rearrangement into clinical use
2012 The Cancer Genome Atlas consortium
2013 afatinib / NLST CT screening trial
・PLCO trial
・CT screening
NLST: NEJM 2011
eligibility criteria: 55-74y.o., >30 pack-years smokers
cost: $67000 per 1QALY
screening interval review: Lancet Oncol 2016, Kovalchik, Tammemagi et al, NEJM 2013, Tammemagi et al, NEJM 728-736, 2013
LC prediction modelで対象患者を絞り込んで、コストを抑える
DANTE
MILD
DLCST
NELSON
ITALUNG
I-ELCAP
・Lung RADS protocol ( American College of Radiology )
・Pan Canadian Lung Cancer Risk Calculator
https://brocku.ca/lung-cancer-risk-calculator
NEJM 908-917, 2013
BMJ 2014
・volumetrics
Field, Oudkerk et al, Lancet. 2013 Aug 24;382(9893):732-41.
・CAD
・TNM classification 8th edition ( will be updated in 2017?）
Rami-Porta J Thorac Oncol 1618 - 1624, 2014
T: 1-7cmまで1cm刻みで予後が分かれる
diaphragma invasion→T4
N: 変更なし
M: M1a intrathoracic
M1b single station metastasis
M1c multiple station metastasis
・Liquid biopsy
Testoni et al, EMBO ABL1 somatically mutation
Leon et al, Cancer Res 646-650, 1977,
Leon et al, PNAS 2005
Sundrasen et al, Clin Cancer Res 1103 -1110, 2016
CTCとctDNAで結果が乖離する。
・ImmunoCheckpoint inhibitor
review article: Brahmer et al, Semin Oncol 126-132, 2014
