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Lung Cancer Microscopic Appearance Affects Response to Chemotherapy

Tumor Structure Should Be Considered in Treating NSCLC, Says Report in "The Oncologist"

DURHAM, N.C., Feb. 17 /PRNewswire/ -- A tumor's cellular structure, or histology, improves treatment decisions that may lead to improved outcomes for patients with non-small cell lung cancer (NSCLC), the most common type of lung cancer, according to a paper in the latest issue of "The Oncologist."

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The findings are based on an analysis of recent studies of the chemotherapy drug pemetrexed to treat NSCLC. "The data confirm that histology matters when treating NSCLC," says Professor Giorgio Scagliotti, M.D., of University of Turin, lead author of the new report.

Prof. Scagliotti and colleagues analyzed data from two recent phase III studies of pemetrexed for NSCLC, which accounts for about 90 percent of all lung cancers. They focused on how differences in cancer histology affect the response to treatment with pemetrexed. The histology of a cancer is its microscopic cellular structure and in NSCLC, tumors may be classified as having a "squamous" or "non-squamous" appearance.

Their analysis showed significant differences in response to pemetrexed between these two lung cancer subtypes. Specifically, pemetrexed was more effective than current forms of chemotherapy against cancers with a non-squamous histology. For these patients, pemetrexed led to significant improvements in overall survival and in survival without progressive cancer. In contrast, for patients whose cancers had the squamous histology, outcomes were similar with or without pemetrexed.

The two studies were a "frontline" trial including patients with previously untreated NSCLC and a "second-line" trial including patients with previous chemotherapy. The interaction between cancer histology and response to pemetrexed was similar in both groups of patients. Based on the results of the frontline trial, pemetrexed has been approved for initial treatment of NSCLC in Europe, Canada and the United States, in combination with cisplatin, another chemotherapy drug.

In the past, cancer histology hasn't been considered in selecting treatments for patients with NSCLC. "For more than 25 years medical oncologists have simply looked at the distinction between small-cell and non-small-cell lung cancer in making systemic treatment decisions," says Prof. Scagliotti. "This is because there has previously been no convincing evidence that the available treatments have any differential activity based on the histologic subtype of NSCLC." "On the basis of these studies, tumor histology should be carefully assessed when selecting treatment options for patients with advanced NSCLC," says Prof. Scagliotti.

The article entitled "The Differential Efficacy of Pemetrexed According to NSCLC Histology: A Review of Two Phase III Studies," has been published by "The Oncologist," and is freely available online at:

About AlphaMed Press

AlphaMed Press publishes the internationally renowned journals, "Stem Cells" and "The Oncologist." "Stem Cells," now in its 27th year, is the oldest and one of the world's top-tier peer-reviewed monthly journals in the fast-paced area of stem cells and regenerative medicine. "The Oncologist," in its 14th year, is a premier peer-reviewed monthly journal dedicated to physicians entrusted with the care of cancer patients. View AlphaMed Press journals at

Contact: Dr. Martin J. Murphy, Executive Editor: 919.402.8750,

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