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Radiation Oncology of Lung Cancer: Why We Fail(ed) in Clinical Research?

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Advances in Radiation Oncology in Lung Cancer

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

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Abstract

Clinical research in radiation oncology of lung cancer can bring important advances in the field of optimized treatment approaches in this disease. However, such a research has been a subject of many controversies, in particular in the light of lack of adequate number and quality of clinical trials which could have changed our standard policies. To address the comprehensive issue of clinical research in radiation oncology of lung cancer, several aspects will be considered: general aspects of clinical research generals, clinical failures, and some of existing, rather controversial issues identified. Finally, some of possible solutions for the current, grossly unfavorable, situation will be discussed.

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References

  • Akerley W, Herndon JE Jr, Lyss AP et al (2005) Induction paclitaxel/carboplatin followed by concurrent chemoradiation therapy for unresectable stage III non-small-cell lung cancer: a limited-access study–CALGB 9534. Clin Lung Cancer 7:47–53

    Article  Google Scholar 

  • Albain KS, Swann RS, Rusch VW et al (2009) Radiotherapy plus chemotherapy with or without surgical resection for stage III non-small-cell lung cancer: a phase III randomised controlled trial. Lancet 374:379–386

    Article  Google Scholar 

  • Alexander BM, Othus M, Caglar HB, Allen AM (2011) Tumor volume is a prognostic factor in non-small-cell lung cancer treated with chemoradiotherapy. Int J Radiat Oncol Biol Phys 79:1381–1387

    Article  Google Scholar 

  • Allen AM, Shochat T, Flex D et al (2018) High-dose radiotherapy as neoadjuvant treatment in non-small-cell lung cancer. Oncology 95:13–19

    Article  Google Scholar 

  • Auperin A (2010) Carcinomes broncho-pulmonaires non à petites cellules localement avancés: évaluation de la chimiothérapie associée à la radiothérapie par les méta-analyses sur données individuelles. Universite Paris XI, Faculte de Medecine Paris-Sud (These)

    Google Scholar 

  • Aupérin A, Le Péchoux C, Rolland E et al (2010) Meta-analysis of concomitant versus sequential radiochemotherapy in locally advanced non-small-cell lung cancer. J Clin Oncol 28:2181–2190

    Article  Google Scholar 

  • Basaki K, Abe Y, Aoki M, Kondo H, Hatayama Y, Nakaji S (2006) Prognostic factors for survival in stage III non-small-cell lung cancer treated with definitive radiation therapy: impact of tumor volume. Int J Radiat Oncol Biol Phys 64:449–454

    Article  Google Scholar 

  • Belani CP, Choy H, Bonomi P et al (2005) Combined chemoradiotherapy regimens of paclitaxel and carboplatin for locally advanced non-small-cell lung cancer: a randomized phase II locally advanced multi-modality protocol. J Clin Oncol 23:5883–5891

    Article  Google Scholar 

  • Bradley JD, Ieumwananonthachai N, Purdy JA et al (2002) Gross tumor volume, critical prognostic factor in patients treated with three-dimensional conformal radiation therapy for non-small-cell lung carcinoma. Int J Radiat Oncol Biol Phys 52:49–57

    Article  Google Scholar 

  • Cerfolio RJ, Bryant AS, Spencer SA, Bartolucci AA (2005) Pulmonary resection after high-dose and low-dose chest irradiation. Ann Thorac Surg 80:1224–1230

    Article  Google Scholar 

  • Clark GM (2008) Prognostic factors versus predictive factors: examples from a clinical trial of erlotinib. Mol Oncol 1:406–412

    Article  Google Scholar 

  • Clark GM, Zborowski DM, Culbertson JL et al (2006) Clinical utility of epidermal growth factor receptor expression for selecting patients with advanced non-small cell lung cancer for treatment with erlotinib. J Thorac Oncol 1:837–846

    Article  Google Scholar 

  • Curran WJ Jr, Scott C, Langer C, Komaki R, Lee JS, Hauser S (2000) Phase III comparison of sequential vs cancer (NSCLC): initial report of radiation therapy oncology group concurrent chemoradiation for pts with unresected stage III non small cell lung (RTOG 9410). Proc Am Soc Clin Oncol 19:484a. (Abstract 1891)

    Google Scholar 

  • Daly BDT, Fernando HC, Ketchedjian A et al (2006) Pneumonectomy after high-dose radiation and concurrent chemotherapy for nonsmall cell lung cancer. Ann Thorac Surg 82:227–231

    Article  Google Scholar 

  • Dehing-Oberije C, De Ruysscher D, van der Weide H et al (2008) Tumor volume combined with number of positive lymph node stations is a more important prognostic factor than TNM stage for survival of non-small-cell lung cancer patients treated with (chemo)radiotherapy. Int J Radiat Oncol Biol Phys 70:1039–1044

    Article  Google Scholar 

  • Donington JS, Paulus R, Edelman MJ, for the NRG Oncology Lung Group et al (2020) Resection following concurrent chemotherapy and high-dose radiation for stage IIIA non–small cell lung cancer. J Thorac Cardiovasc Surg 160:1331–1345. e1

    Article  Google Scholar 

  • Eaton BR, Pugh SL, Bradley JD et al (2016) Institutional enrollment and survival among NSCLC patients receiving chemoradiation: NRG Oncology Radiation Therapy Oncology Group (RTOG) 0617. J Natl Cancer Inst 108:djw034

    Article  Google Scholar 

  • El Sharouni SY, Kal HB, Battermann JJ (2003) Accelerated regrowth of non-small cell lung tumors after induction chemotherapy. Br J Cancer 89:2184–2189

    Article  Google Scholar 

  • Faivre-Finn C, Snee M, Ashcroft L, for the CONVERT Study Team et al (2017) Concurrent once-daily versus twice-daily chemoradiotherapy in patients with limited-stage small-cell lung cancer (CONVERT): an open-label, phase 3, randomised, superiority trial. Lancet Oncol 18:1116–1125

    Article  Google Scholar 

  • Goldstraw P, Crowley J, Chansky K, Giroux DJ, Groome PA (2007) The IASLC lung cancer staging project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM classification of malignant tumours. J Thorac Oncol 2:706–714

    Article  Google Scholar 

  • Goldstraw P, Chansky K, Crowley J et al (2016) The IASLC lung cancer staging project: proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol 11:39–51

    Article  Google Scholar 

  • Gore EM, Hu C, Sun AY et al (2017) Randomized phase II study comparing prophylactic cranial irradiation alone to prophylactic cranial irradiation and consolidative extracranial irradiation for extensive-disease small cell lung cancer (ED SCLC): NRG Oncology RTOG 0937. J Thorac Oncol 12:1561–1570

    Article  Google Scholar 

  • Grønberg BH, Killingberg KT, Fløtten Ø et al (2021) High-dose versus standard-dose twice-daily thoracic radiotherapy for patients with limited stage small-cell lung cancer: an open-label, randomised, phase 2 trial. Lancet Oncol 22:321–331

    Article  Google Scholar 

  • Horn L, Mansfield AS, SzczÄ™sna A, IM power133 Study Group et al (2018) First-line Atezolizumab plus chemotherapy in extensive-stage small-cell lung cancer. N Engl J Med 379:2220–2229

    Article  Google Scholar 

  • Jeremic B, Shibamoto Y, Acimovic L, Milisavljevic S (1997) Initial versus delayed accelerated hyperfractionated radiation therapy and concurrent chemotherapy in limited small cell lung cancer. J Clin Oncol 15:893–900

    Article  Google Scholar 

  • Jeremic B, Shibamoto Y, Nikolic N, Milicic B, Milisavljevic S, Dagovic A, Aleksandrovic J, Radosavljevic-Asic G (1999) The role of radiation therapy in the combined modality treatment of patients with extensive disease small-cell lung cancer (ED SCLC): a randomized study. J Clin Oncol 17:2092–2099

    Article  Google Scholar 

  • Jeremic B, Casas F, Dubinsky P et al (2016) Surgery in stage IIIA nonsmall cell lung cancer: lack of predictive and prognostic factors identifying any patient subgroup benefiting from it. Clin Lung Cancer 17:107–112

    Article  Google Scholar 

  • Langer CJ, Moughan J, Movsas B et al (2005) Patterns of care survey (PCS) in lung cancer: how well does current U.S. practice with chemotherapy in the non-metastatic setting follow the literature. Lung Cancer 48:93–102

    Article  Google Scholar 

  • Lee P, Bazan JG, Lavori PW et al (2012) Metabolic tumor volume is an independent prognostic factor in patients treated definitively for non–small-cell lung cancer. Clin Lung Cancer 13:52–58

    Article  Google Scholar 

  • Movsas B, Moughan J, Komaki R et al (2003) Radiotherapy patterns of care study in lung carcinoma. J Clin Oncol 21:4553–4559

    Article  Google Scholar 

  • Rami-Porta R, Bolejack V, Giroux DJ, International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee, Advisory Board Members and Participating Institutions et al (2014) The IASLC lung cancer staging project: the new database to inform the eighth edition of the TNM classification of lung cancer. J Thorac Oncol 9:1618–1624

    Article  Google Scholar 

  • Saunders M, Dische S, Barrett A, Harvey A, Griffiths G, Palmar M (1999) Continuous, hyperfractionated, accelerated radiotherapy (CHART) versus conventional radiotherapy in non-small cell lung cancer: mature data from the randomised multicentre trial. CHART steering committee. Radiother Oncol 52:137–148

    Article  Google Scholar 

  • Slotman BJ, Van Tinteren H, Praag JO et al (2015) Use of thoracic radiotherapy for extensive stage small-cell lung cancer: a phase 3 randomised controlled trial. Lancet 385:36–42

    Article  Google Scholar 

  • Socinski MA, Blackstock AW, Bogart JA (2008) Randomized phase II trial of induction chemotherapy followed by concurrent chemotherapy and dose-escalated thoracic conformal radiotherapy (74 Gy) in stage III non-small-cell lung cancer: CALGB 30105. J Clin Oncol 26:2457–2463

    Article  Google Scholar 

  • Sonett JR, Suntharalingam M, Edelman MJ et al (2004) Pulmonary resection after curative intent radiotherapy (>59 Gy) and concurrent chemotherapy in non-small-cell lung cancer. Ann Thorac Surg 78:1200–1205

    Article  Google Scholar 

  • Sorensen JB, Riska H, Ravn J et al (2013) Scandinavian phase III trial of neoadjuvant chemotherapy in NSCLC stages IB-IIIA/T3. J Clin Oncol 31(Suppl; abstr 7504)

    Google Scholar 

  • Suntharalingam M, Paulus R, Edelman MJ et al (2012) Radiation therapy oncology group protocol 02-29: a phase II trial of neoadjuvant therapy with concurrent chemotherapy and full-dose radiation therapy followed by surgical resection and consolidative therapy for locally advanced nonsmall cell carcinoma of the lung. Int J Radiat Oncol 84:456–463

    Article  Google Scholar 

  • Turrisi AT 3rd, Kim K, Blum R (1999) Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide. N Engl J Med 28:265–271

    Article  Google Scholar 

  • van Meerbeeck JP, Kramer GW, van Schil PE et al (2007) Randomized controlled trial of resection versus radiotherapy after induction chemotherapy in stage IIIA-N2 non-small-cell lung cancer. J Natl Cancer Inst 99:442–450

    Article  Google Scholar 

  • Vokes EE, Herndon JE 2nd, Crawford J (2002) Randomized phase II study of cisplatin with gemcitabine or paclitaxel or vinorelbine as induction chemotherapy followed by concomitant chemoradiotherapy for stage IIIB non small-cell lung cancer: cancer and leukemia group B study 9431. J Clin Oncol 20:4191–4198

    Article  Google Scholar 

  • Werner-Wasik M, Swann RS, Bradley J et al (2008) Increasing tumor volume is predictive of poor overall and progression-free survival: secondary analysis of the radiation therapy oncology group 93-11 phase I-II radiation dose-escalation study in patients with inoperable non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 70:385–390

    Article  Google Scholar 

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Authors and Affiliations

  1. School of Medicine, University of Kragujevac, Kragujevac, Serbia

    Branislav Jeremić

  2. BioIRC, Center for Biomedical Engineering, Kragujevac, Serbia

    Nenad Filipović

  3. Department of Thoracic Surgery, University Clinical Center, Kragujevac, Serbia

    Slobodan Milisavljević

  4. Department of Clinical Oncology, Caucasus Medical Center, Tbilisi, Georgia

    Ivane Kiladze

Authors
  1. Branislav Jeremić
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  2. Nenad Filipović
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  3. Slobodan Milisavljević
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  4. Ivane Kiladze
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Corresponding author

Correspondence to Branislav Jeremić .

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Editors and Affiliations

  1. School of Medicine, University of Kragujevac, Kragujevac, Serbia

    Branislav Jeremić

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Jeremić, B., Filipović, N., Milisavljević, S., Kiladze, I. (2021). Radiation Oncology of Lung Cancer: Why We Fail(ed) in Clinical Research?. In: Jeremić, B. (eds) Advances in Radiation Oncology in Lung Cancer. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2021_282

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  • DOI: https://doi.org/10.1007/174_2021_282

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  • Print ISBN: 978-3-031-34846-4

  • Online ISBN: 978-3-031-34847-1

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