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Innere Medizin 1. März 2008

Congress report: 12th World Conference on Lung Cancer – a step forward in lung cancer treatment. Seo

The present report gives a scope on relevant abstracts presented at the 12th World Conference of Lung Cancer held in Seoul, South Korea, in September 2007. Some data will directly influence the daily routine of thoracic oncologists. The most important is the intention of the International Association for the Study of Lung Cancer IASLC to modify the staging system. For example, T4 tumours with satellite nodules will be reclassified as T3, and nodules in the ipsilateral lung from M1 to T4. In the first-line treatment of stage IIIB/IV patients the combination of cisplatin/pemetrexed was equally effective as the control arm applying cisplatin/gemcitabine with a lower rate of side effects. Interestingly, patients with adenocarcinomas and large cell carcinomas showed a significant survival benefit using the new combination which might be explained by divergent enzymatic activity between the histological subtypes. Gefitinib, applied in the second line setting, showed similar efficacy when compared with docetaxel, even in a non-Asian population. Maybe, the gefitinib story has now to be discussed again. The knowledge on predictive markers for an individualised application of targeted therapies is improving, but at the moment this does not influence our daily practice. The role of smoking in lung cancer was discussed in the presidential session. It was stated that the dramatic increase of adenocarcinomas in relation to other NSCLC subtypes is consistent with the hypothesis that changes in cigarette design and composition were the major factors responsible for this development. The use of filter vents reduced the resistance to draw allowing smokers to take bigger, deeper puffs thus facilitating the delivery of smoke particles deep into the airways. In conclusion one can say that the international effort to improve lung cancer outcome is effective, however, the clinically relevant steps are still small.

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