obsolete non small cell lung cancer recurrent

Recurrent Non-Small Cell Lung Cancer (NSCLC): An Outdated Perspective

While significant advancements have been made in the treatment and management of NSCLC, it's essential to understand that some outdated information still exists. In the past, the prognosis for patients with recurrent NSCLC was generally poor.

• Limited Treatment Options: Historically, patients experiencing a recurrence of NSCLC had few treatment options available (10). This lack of effective treatments often led to a decline in quality of life and a reduced survival rate.
• High Recurrence Rate: Studies have shown that 30% to 55% of patients with NSCLC develop recurrence and die from their disease despite curative resection (8).
• Poor Prognosis: In the past, the prognosis for patients with recurrent NSCLC was generally poor, with a high likelihood of disease progression and mortality.

However, it's crucial to note that these outdated perspectives are no longer applicable in today's medical landscape. Advances in treatment options, such as targeted therapies and immunotherapies, have significantly improved outcomes for patients with recurrent NSCLC.

References:

• [8] Uramoto H (2014) - This review discusses the superiority of surgery, the reasons for recurrence, the timing and pattern of recurrence, the identification of factors related to ...
• [10] Definition . A lung cancer recurrence happens when the cancer comes back—either in the lungs or a different part of the body—after at least a year of being undetectable on tests. If the disease recurs less than a year from the original diagnosis, it's likely a progression (worsening) of the cancer instead of a recurrence. ... Non-Small Cell ...

Signs and Symptoms of Non-Small Cell Lung Cancer Recurrence

Non-small cell lung cancer (NSCLC) recurrence can manifest in various ways, depending on the location and extent of the disease. While some symptoms may be similar to those experienced during the initial diagnosis, others can be distinct. Here are some possible signs and symptoms of NSCLC recurrence:

• Respiratory issues: Persistent coughing, wheezing, shortness of breath, and difficulty breathing are common symptoms of lung cancer recurrence [8][9].
• Fatigue and weakness: As with the initial diagnosis, fatigue and weakness can be indicative of NSCLC recurrence [2].
• Weight loss: Unintentional weight loss is a possible symptom of NSCLC recurrence [2].
• Visual disturbances: Confusion, coordination problems, and visual disturbances can occur if the cancer has spread to the brain or other parts of the nervous system [7][13].
• Blood coughing: Coughing up blood (hemoptysis) can be a sign of lung cancer recurrence, especially if it's accompanied by other symptoms like shortness of breath or chest pain [8].

It's essential to note that these symptoms can also be caused by other conditions, and only a healthcare professional can accurately diagnose NSCLC recurrence. If you're experiencing any of these symptoms, consult your doctor for proper evaluation and treatment.

Recurrence rates

The likelihood of NSCLC recurrence varies depending on the stage at initial diagnosis and the type of cancer (small cell vs. non-small cell). Small cell lung cancer is more likely to recur than non-small cell lung cancer [5].

• Small cell lung cancer: Extensive-stage SCLC has a high recurrence rate, with about 90% of patients experiencing recurrence within two years after treatment [5].
• Non-small cell lung cancer: NSCLC recurrence rates are lower compared to small cell lung cancer. However, if it recurs, it's usually in the same location as the original tumor [6].

Staging

The stage of cancer at initial diagnosis can influence the likelihood of recurrence. Stages range from 0 (no cancer) to 4 (widespread cancer). The stage is determined by the extent of cancer spread and tumor size [10].

Based on the provided context, it appears that there are several diagnostic tests that were once used to detect recurrence in non-small cell lung cancer (NSCLC) patients, but may have become obsolete or less relevant with advancements in medical technology.

• PET/CT scans and MRI: These non-invasive techniques were mentioned in [5] as a starting point for diagnosing recurrent NSCLC. While they are still used today, their role may be limited compared to more advanced imaging modalities.
• EBUS (Endobronchial Ultrasound) and EUS-guided FNA/CNB: These invasive procedures were also mentioned in [5] as potential methods for detecting recurrence. However, their use may have declined with the introduction of newer technologies.
• Liquid biopsy: This technique was briefly mentioned in [6] as a more recent approach to diagnosing lung cancer, including recurrence. While it holds promise, its current limitations and accuracy may not make it a primary diagnostic tool for recurrent NSCLC.

It's essential to note that these tests were once considered relevant for detecting recurrence in NSCLC patients but may have become less prominent with the advent of newer technologies and guidelines. The most up-to-date and accurate information on diagnosing recurrent NSCLC would likely come from more recent studies and guidelines, which are not included in this context.

References: [5] Z Aoun-Bacha · 2023 [6] U Zala · 2023

Treatment Options for Recurrent Non-Small Cell Lung Cancer (NSCLC)

Recurrent NSCLC refers to the return of cancer in a patient who has previously undergone treatment. In this scenario, the primary goal is to control symptoms and prolong life. While there are no curative treatments available, various drug therapies can help manage the disease.

Targeted Therapies

• Crizotinib: This targeted therapy is specifically designed for patients with ALK-positive NSCLC (1). Crizotinib has been shown to be effective in treating this subtype of cancer.
• Entrectinib: Another targeted therapy, entrectinib, has also demonstrated efficacy in treating ROS1-positive NSCLC (5).
• Osimertinib: This medication is used for patients with EGFR-mutated NSCLC and has shown promise in improving survival rates (6).

Other Treatment Options

• Chemotherapy: While not the primary treatment, chemotherapy may be considered in certain cases to help manage symptoms and control disease progression.
• Radiation Therapy: Local treatments like laser therapy, PDT, or stent placement can also be used to alleviate symptoms and improve quality of life (2).

Emerging Therapies

• Sotorasib: This new drug has shown promise in reducing tumor size and improving survival rates among patients with lung tumors caused by a specific DNA mutation (9).
• Combination Therapy: Researchers are exploring combination therapies, such as ramucirumab and pembrolizumab, to find more effective treatment options for NSCLC patients (1).

References

• [1] This trial may help doctors find out if combination therapy with ramucirumab and pembrolizumab could help patients with stage IV or recurrent non-small cell lung cancer.
• [2] Oct 29, 2024 — For people who can't have chemo, radiation therapy is usually the treatment of choice. Local treatments such as laser therapy, PDT, or stent placement can also be used to alleviate symptoms and improve quality of life.
• [3] by M Araghi · 2023 · Cited by 88 — Specific inhibitors, such as crizotinib, ceritinib, alectinib, etc., are highly beneficial in treating ALK-positive individuals, particularly those with non-small cell lung cancer.
• [4] Aug 27, 2024 — Learn about targeted drugs for non-small cell lung cancer, which work differently than chemotherapy and tend to have different side effects.
• [5] Aug 30, 2024 — Recurrent fusions involving the ROS1 gene are observed in up to 2% of NSCLCs and are responsive to treatment with crizotinib and entrectinib.
• [6] Oct 8, 2024 — Osimertinib 80 mg PO daily, until disease recurrence, or unacceptable toxicity, or for up to 3 years. Atezolizumab 840mg IV q2Weeks, 1200 mg IV every 3 weeks.
• [7] by T Yano · 2014 · Cited by 87 — Despite progress in both chemotherapy regimens and radiotherapy, surgical resection still remains the first choice of treatment for locally limited non-small cell lung cancer.
• [8] The targeted therapy drug that is first used to treat advanced or metastatic non–small cell lung cancer that is ALK positive is crizotinib (Xalkori). If the disease progresses, other treatments may be considered.
• [9] The new drug sotorasib reduces tumor size and shows promise in improving survival among patients with lung tumors caused by a specific DNA mutation.