Medicine and Health Sciences Commons^™

Lung Cancer Screening: An Evidence-Based Practice Change Project, Robert Bland

Student Scholarly Projects

Practice Problem: Lung cancer is the leading cause of global cancer deaths and is a significant health issue in the US, claiming more than 155,000 lives each year. Lung cancer screening through low dose computed tomography (LDCT) can reduce lung cancer mortality by 20 percent but unfortunately, lung cancer screening is underutilized.

PICOT Question: The PICOT question that guided this project was: in a patient population eligible for LDCT lung screening (P), how does auditing of practice with feedback to the providers (I), compared to not doing the interventions as mentioned above (C), increase LDCT lung cancer screenings in the …

Engaging Patients With Late-Stage Non-Small Cell Lung Cancer In Shared Decision Making About Treatment, Ronald E. Myers, Shailesh M. Advani, Pamela Myers, Preethi Selvan, Gregory Garber, Brooke Worster, Neal Flomenberg, Andrew Chapman, Ralph Zinner

Internal Medicine Faculty Publications

Few treatment decision support interventions (DSIs) are available to engage patients diagnosed with late-stage non-small cell lung cancer (NSCLC) in treatment shared decision making (SDM). We designed a novel DSI that includes care plan cards and a companion patient preference clarification tool to assist in shared decision making. The cards answer common patient questions about treatment options (chemotherapy, chemotherapy plus immunotherapy, targeted therapy, immunotherapy, clinical trial participation, and supportive care). The form elicits patient treatment preference. We then conducted interviews with clinicians and patients to obtain feedback on the DSI. We also trained oncology nurse educators to implement the prototype. …

Diagnosis-To-Surgery Interval And Survival For Different Histologies Of Stage I-Iia Lung Cancer, Lu Zhang, Mei Chin Hsieh, Lior Rennert, Paige Neroda, Xiao Cheng Wu, Chindo Hicks, Jiande Wu, Ronald Gimbel

School of Medicine Faculty Publications

Background: Guidelines on timeliness of lung cancer surgery are inconsistent. Lung cancer histologic subtypes have different prognosis and treatment. It is important to understand the consequences of delayed surgery for each lung cancer histologic subtype. This study aimed to examine the association between diagnosis-to-surgery time interval and survival for early stage lung cancer and selected histologic subtypes. Methods: Patients diagnosed with stage I-IIA lung cancer between 2004 and 2015 receiving definitive surgery and being followed up until Dec. 31, 2018, were identified from Surveillance, Epidemiology, and End Results database. Histologic subtypes included adenocarcinoma, squamous or epidermoid carcinoma, bronchioloalveolar carcinoma, large …

Pembrolizumab Plus Concurrent Chemoradiation Therapy In Patients With Unresectable, Locally Advanced, Stage Iii Non-Small Cell Lung Cancer: The Phase 2 Keynote-799 Nonrandomized Trial., Salma K Jabbour, Ki Hyeong Lee, Nikolaj Frost, Valeriy Breder, Dariusz M Kowalski, Theodore Pollock, Evgeny Levchenko, Noemi Reguart, Alex Martinez-Marti, Baerin Houghton, Jean-Baptiste Paoli, Sufia Safina, Keunchil Park, Takefumi Komiya Md, Amy Sanford, Vishal Boolell, Hong Liu, Ayman Samkari, Steven M Keller, Martin Reck

PCI Publications and Projects

IMPORTANCE: Administration of pembrolizumab plus concurrent chemoradiation therapy (cCRT) may provide treatment benefit to patients with locally advanced, stage III non-small cell lung cancer (NSCLC).

OBJECTIVE: To evaluate treatment outcomes and safety of pembrolizumab plus cCRT in stage III NSCLC.

DESIGN, SETTING, AND PARTICIPANTS: The phase 2, nonrandomized, 2-cohort, open-label KEYNOTE-799 study enrolled patients between November 5, 2018, and July 31, 2020, from 52 academic facilities and community-based institutions across 10 countries. As of October 28, 2020, median (range) follow-up was 18.5 (13.6-23.8) months in cohort A and 13.7 (2.9-23.5) months in cohort B. Of 301 patients screened, 216 eligible …

Role Of Immunotherapy In Stage Iv Large Cell Neuroendocrine Carcinoma Of The Lung., Takefumi Komiya Md, Neema Ravindra, Emily Powell Phd

PCI Publications and Projects

BACKGROUND: Despite approvals of immune checkpoint inhibitors in both small cell and non-small cell lung cancers, the role of immunotherapy in large cell neuroendocrine carcinoma (LCNEC) in lung is undefined.

METHODS: Using the National Cancer Database (NCDB), Stage IV lung LCNEC cases diagnosed from 2014 to 2016 were analyzed. Information regarding cancer treatment was limited to first course of therapy, including surgery for primary lesion, radiation, chemotherapy, and immunotherapy. Survival analysis was performed using Kaplan-Meier curves and Log-rank tests. Cox proportional hazard model was used for multivariate analysis.

RESULTS: Among 661 eligible cases, 37 patients were treated with immunotherapy. No …

Community Health Interventions To Reduce The Burden Of Radon-Related Lung Cancer, Benjamin Weaver

Family Medicine Clerkship Student Projects

Exposure to radon is the second leading cause of lung cancer in the United States. One in seven homes in Vermont has elevated levels of radon, but most patients are unaware of radon as a risk factor for lung cancer or that radon testing and mitigation services are available to them. To promote increased testing and mitigation of radon we screened patients presenting to a Family Medicine practice in Vermont about whether they had had these services done in their home. We also developed a patient education resource for providers to give to patients who had more questions about radon …