Am Psychol. 2015 Feb-Mar;70(2):198-210. doi: 10.1037/a0036852.

Cancer communication and informatics research across the cancer continuum.

Hesse BW1, Beckjord E2, Rutten LJ3, Fagerlin A4, Cameron LD5.

Author information

• 1Health Communication and Informatics Research Branch, National Cancer Institute.
• 2Biobehavioral Medicine in Oncology Program, University of Pittsburgh.
• 3Population Health Science Program, Department of Health Sciences Research, Mayo Clinic.
• 4Center for Bioethics and Social Sciences in Medicine, University of Michigan.
• 5Health Communications and Interventions Lab and Department of Psychology, University of California, Merced.

Abstract

Over the past decade, dramatic changes brought about by a rapid diffusion of Internet technologies, cellular telephones, mobile devices, personal digital assistants, electronic health records, and data visualization have helped to create a revolution in health communication. To understand the implications of this communication revolution for cancer care, the National Cancer Institute launched an ambitious set of research priorities under its "extraordinary opportunities" program. We present an overview of some of the relevant behavioral research being conducted within the perspective of this extraordinary opportunity in cancer communication research. We begin by tracing the implications of this research for behavioral scientists across the continuum of cancer care from primary prevention (e.g., tobacco control, diet, exercise, sun protection, and immunization against human papilloma virus), to secondary prevention (e.g., screening for polyps, lesions, and early stage neoplasms), to diagnosis and treatment, posttreatment survivorship, and end of life. Along each point of the continuum, we describe a natural evolution of knowledge from studies on the traditional role of media to research on the changing role of new media and informatics, and we carefully highlight the role that psychological research has played in improving communication- and health-related outcomes along the way. We conclude with an appeal to psychologists of many different backgrounds to join with biomedical researchers, engineers, clinical practitioners, and others to accelerate progress against cancer. 

Will suburbanites quickly be paying physicians retainers?

Retainer charges are frequent practice when hiring an lawyer, but could they quickly discover their way to your doctor's workplace?Concierge medicine, as the small business practice is called, is a little, but developing, trend in the medical field.

Radiol Med. 2015 Mar 6. [Epub ahead of print]

Idiopathic interstitial pneumonias: do HRCT criteria established by ATS/ERS/JRS/ALAT in 2011 predict disease progression and prognosis?

Romei C1, Tavanti L, Sbragia P, De Liperi A, Carrozzi L, Aquilini F, Palla A, Falaschi F.

Author information

• 12nd Radiology Unit, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy, chiara.romei@gmail.com.

Abstract

PURPOSE:

The objective of the study was to determine whether HRCT criteria for Usual Interstitial Pneumonia (UIP), possible UIP or no-UIP pattern recommended by ATS/ERS/JRS/ALAT guidelines 2011 are able to predict progression and prognosis of the disease in a group of patients with fibrotic idiopathic interstitial pneumonia (IIP).

MATERIALS AND METHODS:

This was a retrospective study conducted with the approval of the ethics committee. Two radiologists at baseline HRCT distributed 70 patients with fibrotic IIP into three groups on the basis of the 2011 guidelines: UIP pattern (group 1), possible UIP pattern (group 2), inconsistent with UIP pattern (group 3). The different abnormalities (honeycombing, reticulation, ground-glass and traction bronchiectasis), fibrotic score (reticulation + honeycombing) and overall CT score were visually scored at baseline and during the follow-up (total HRCT 178). The mortality rate of the three groups was compared. The baseline abnormalities were then correlated with the mortality rate in the UIP group.

RESULTS:

The inter-observer agreement in the classification of the abnormalities in the three groups was almost perfect (k = 0.92). After consensus, 44 patients were classified into group 1, 13 into group 2 and 13 into group 3. During a mean follow-up of 1386 days, overall CT score, fibrotic score, honeycombing and traction bronchiectasis showed a significant progression in group 1. The mortality rate was significantly higher in group 1 (18 deaths) versus group 2 and 3 (1 death each). In group 1, baseline honeycombing rate higher than 25 %, fibrotic score higher than 30, overall CT score greater than 45 and traction bronchiectasis in more than 4 lobes defined the worst prognosis.

CONCLUSION:

HRCT classification based on 2011 guidelines showed high accuracy in stratifying fibrotic changes because in our study UIP, possible UIP and inconsistent with UIP pattern seem to be correlated with different disease progression and mortality rate.

"Among currently available screening tests for diseases where death is a common outcome, reductions in disease-specific mortality are uncommon and reductions in all-cause mortality are very rare or non-existent."

Int J Epidemiol. 2015 Feb;44(1):264-77. doi: 10.1093/ije/dyu140. Epub 2015 Jan 15.

Does screening for disease save lives in asymptomatic adults? Systematic review of meta-analyses and randomized trials.

Saquib N1, Saquib J1, Ioannidis JP2.

Author information

• 1Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA and Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, CA, USA.
• 2Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA and Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, CA, USA Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA and Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, CA, USA Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA and Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, CA, USA jioannid@stanford.edu.

Abstract

BACKGROUND:

Several popular screening tests, such as mammography and prostate-specific antigen, have met with wide controversy and/or have lost their endorsement recently. We systematically evaluated evidence from randomized controlled trials (RCTs) as to whether screening decreases mortality from diseases where death is a common outcome.

METHODS:

We searched three sources: United States Preventive Services Task Force (USPSTF), Cochrane Database of Systematic Reviews, and PubMed. We extracted recommendation status, category of evidence and RCT availability onmortality for screening tests for diseases on asymptomatic adults (excluding pregnant women and children) from USPSTF. We identified meta-analyses and individual RCTs on screening and mortality from Cochrane and PubMed.

RESULTS:

We selected 19 diseases (39 tests) out of 50 diseases/disorders for which USPSTF provides screeningevaluation. Screening is recommended for 6 diseases (12 tests) out of the 19. We assessed 9 non-overlapping meta-analyses and 48 individual trials for these 19 diseases. Among the results of the meta-analyses, reductions where the 95% confidence intervals (CIs) excluded the null occurred for four disease-specific mortality estimates (ultrasound for abdominal aortic aneurysm in men; mammography for breast cancer; fecal occult blood test and flexible sigmoidoscopy for colorectal cancer) and for none of the all-cause mortality estimates. Among individual RCTs, reductions in disease-specific and all-causemortality where the 95% CIs excluded the null occurred in 30% and 11% of the estimates, respectively.

CONCLUSIONS:

Among currently available screening tests for diseases where death is a common outcome, reductions in disease-specific mortality are uncommon and reductions in all-cause mortality are very rare or non-existent.

"As many as 15 per cent of Boston toddlers drink coffee every day, new research shows."

Boston Toddlers Drink A Surprising Amount Of Coffee

• Mary Nichols , Design & Trend Contributor
• Mar, 08, 2015, 10:40 AM

"As many as 15 per cent of Boston toddlers drink coffee every day, new research shows."

Ann Oncol. 2015 Feb 26. pii: mdv101. [Epub ahead of print]

Searching for targets for the systemic therapy of mesothelioma.

Stahel RA1, Weder W2, Felley-Bosco E1, Petrausch U1, Curioni-Fontecedro A1, Schmitt-Opitz I2, Peters S3.

Author information

• 1Department of Oncology, University Hospital, Zèrich, Switzerland.
• 2Department of Thoracic Surgery, University Hospital, Zürich, Switzerland.
• 3Department of Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.

Abstract

Malignant mesothelioma is an incurable disease associated with asbestos exposure arising in the pleural cavity and less frequently in the peritoneal cavity. Platinum-based combination chemotherapy with pemetrexed is the established standard of care. Multimodality approaches including surgery and radiotherapy are being investigated. Increasing knowledge about the molecular characteristics of mesothelioma had led to the identification of novel potential targets for systemic therapy. Current evidence suggests pathways activated in response to merlin deficiency, including Pi3K/mTOR and the focal adhesion kinase, as well as immunotherapeutic approaches to be most promising. This review elaborates on the rationale behind targeted approaches that have been and are undergoing exploration in mesothelioma and summarizes available clinical results and ongoing efforts to improve the systemic therapy of mesothelioma.

J Health Polit Policy Law. 2015 Feb 19. pii: 2888381. [Epub ahead of print]

The Little State That Couldn't Could? The Politics of "Single-Payer" Health Coverage in Vermont.

Fox AM1, Blanchet NJ2.

Author information

• 1Rockefeller College.
• 2Results for Development Institute.

Abstract

In May 2011, a year after the passage of the Affordable Care Act (ACA), Vermont became the first state to lay the groundwork for a single-payer health care system, known as Green Mountain Care. What can other states learn from the Vermont experience? This article summarizes the findings from interviews with nearly 120 stakeholders as part of a study to inform the design of the health reform legislation. Comparing Vermont's failed effort to adopt single-payer legislation in 1994 to present efforts, we find that Vermont faced similar challenges but greater opportunities in 2010 that enabled reform. A closely contested gubernatorial election and a progressive social movement opened a window of opportunity to advance legislation to design three comprehensive health reform options for legislative consideration. With a unified Democratic government under the leadership of a single-payer proponent, a high-profile policy proposal, and relatively weak opposition, a framework for a single-payer system was adopted by the legislature - though with many details and political battles to be fought in the future. Other states looking to reform their health systems more comprehensively than national reform can learn from Vermont's design and political strategy.

Trends Mol Med. 2015 Mar;21(3):148-153. doi: 10.1016/j.molmed.2015.01.002.

Postmortem disclosure of genetic information to family members: active or passive?

Boers SN1, van Delden JJ2, Knoers NV3, Bredenoord AL2.

Author information

• 1Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Str 6.131, PO Box 85500, 3508 GA Utrecht, The Netherlands. Electronic address: s.n.boers@umcutrecht.nl.
• 2Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Str 6.131, PO Box 85500, 3508 GA Utrecht, The Netherlands.
• 3Department of Medical Genetics, University Medical Center Utrecht, KC04.084.2, PO Box 85090, 3508 GA Utrecht, The Netherlands.

Abstract

Advances in next-generation DNA sequencing (NGS) now make it possible, and affordable, to sequence the entire genome of an individual. Routine clinical application is on the horizon. There is a consensus that some subsets of genetic information should be disclosed to patients, but disclosure to their relatives is less consensual. This issue becomes especially salient after a patient's death, when permission can no longer be sought. There has however been little debate on postmortem disclosure. We identify and explain the arguments in favor of and against disclosure of genetic information to the relatives of a deceased patient. We conclude that there are valid reasons to communicate some subsets of genetic information to family members after death, and we propose a passive postmortem disclosure policy.

Ann Thorac Cardiovasc Surg. 2015 Feb 16. [Epub ahead of print]

Results of Lung Cancer Surgery for Octogenarians.

Hino H1, Murakawa T, Ichinose J, Nagayama K, Nitadori J, Anraku M, Nakajima J.

Author information

• 1Department of Thoracic Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.

Abstract

Purpose: Growing number of elderly lung cancer patients reflecting a lengthening life span has become a serious problem. Purpose of this study was to elucidate the short and long-term outcome of the surgery for octogenarians, and to evaluate the role of lung cancer surgery for this high age group.

Methods: The patients with lung cancer aged 80 years or more who underwent the surgery at our institute from January 1998 through December 2012 were retrospectively analyzed by chart review, and the operative mortality, morbidity and the long-term survival were assessed.

Results: Out of a total of 1107 patients with primary lung cancer who received surgery during the study period, 94 were octogenarians (8.5%). Sixty-nine patients (73.4%) had preoperative co-morbidity including hypertension in 50 (53.2%), coincidence of other malignancy in 35 (37.2%), anti-coagulant therapy in 29 (30.9%). Twenty-six patients (27.7%) had major or minor postoperative morbidity, and one (1.1%) died due to bronchopleural fistula. Overall-5-year survival rate was 57.5%. Univariative and multivariative analysis using Cox proportional hazard model revealed that male gender and non-adenocarcinoma histology were significant risk factors for poor prognosis.

Conclusion: Gender and histology should be taken into account in preoperative evaluation of indication for lung cancer in octogenarians.

Ann Thorac Cardiovasc Surg. 2015 Feb 16. [Epub ahead of print]

Significant Prognostic Factors for Completely Resected pN2 Non-Small Cell Lung Cancerwithout Neoadjuvant Therapy.

Uehara H1, Nakao M, Mun M, Nakagawa K, Nishio M, Ishikawa Y, Okumura S.

Author information

• 1Department of Thoracic Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.

Abstract

Purpose: To identify prognostic factors for pathologic N2 (pN2) non-small cell lung cancer (NSCLC) treated by surgical resection.

Methods: Between 1990 and 2009, 287 patients with pN2 NSCLC underwent curative resection at the CancerInstitute Hospital without preoperative treatment.

Results: The 5-year overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) rates were 46%, 55% and 24%, respectively. The median follow-up time was 80 months. Multivariate analysis identified four independent predictors for poor OS: multiple-zone mediastinal lymph node metastasis (hazard ratio [HR], 1.616; p = 0.003); ipsilateral intrapulmonary metastasis (HR, 1.042; p = 0.002); tumor size >30 mm (HR, 1.013; p = 0.002); and clinical stage N1 or N2 (HR, 1.051; p = 0.030). Multivariate analysis identified three independent predictors for poor RFS: multiple-zone mediastinal lymph node metastasis (HR, 1.457; p = 0.011); ipsilateral intrapulmonary metastasis (HR, 1.040; p = 0.002); and tumor size >30 mm (HR, 1.008; p = 0.032).

Conclusion: Multiple-zone mediastinal lymph node metastasis, ipsilateral intrapulmonary metastasis, and tumor size >30 mm were common independent prognostic factors of OS, CSS, and RFS in pN2 NSCLC.

From U Washington: Sounding Off on Social Media: The Ethics of Patient Storytelling in the Modern Era

Acad Med. 2015 Feb 16. [Epub ahead of print]

Sounding Off on Social Media: The Ethics of Patient Storytelling in the Modern Era.

Wells DM1, Lehavot K, Isaac ML.

Author information

• 1D. M. Wells is a fourth-year medical student, University of Washington School of Medicine, Seattle, Washington. K. Lehavot is research clinical psychologist and assistant professor, VA Puget Sound Health Care System, Seattle Division, and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington. M.L. Isaac is assistant professor, Department of Medicine, University of Washington School of Medicine, Seattle, Washington.

Abstract

Use of social networking programs like Facebook and Twitter, which enable the public sharing of diverse content over the Internet, has risen dramatically in recent years. Although health professionals have faced consequences for clearly unethical online behavior, a relatively unexamined practice among medical students is the disclosure of patient care stories on social media in a manner that is technically compliant with the Health Insurance Portability and Accountability Act, yet is ethically questionable. In this Perspective, the authors review three such cases in which students do not specifically reveal a patient's identity but share details of a personal nature, motivated by a variety of intentions (e.g., a desire to reflect on a meaningful experience, reaching out for social support in the event of a patient's death). Using ethical principles and professional policy recommendations, they discuss aspects of these postings that are potentially problematic. Consequences include the possibility of undermining public trust in the profession, inadvertently identifying patients, and violating expectations of privacy. The authors recommend that medical schools explicitly address these issues across the preclinical and clinical curricula and emphasize that patient-related postings on social media may carry inherent risks both to patients and to the profession.

PLoS One. 2015 Feb 23;10(2):e0118093. doi: 10.1371/journal.pone.0118093. eCollection 2015.

Science vs Conspiracy: Collective Narratives in the Age of Misinformation.

Bessi A1, Coletto M2, Davidescu GA2, Scala A3, Caldarelli G3, Quattrociocchi W4.

Author information

• 1IUSS Institute for Advanced Study, Pavia, Italy; Laboratory of Computational Social Science, Networks Dept IMT Institute for Advanced Studies Lucca, Italy.
• 2Laboratory of Computational Social Science, Networks Dept IMT Institute for Advanced Studies Lucca, Italy.
• 3Laboratory of Computational Social Science, Networks Dept IMT Institute for Advanced Studies Lucca, Italy; ISC-CNR Uos "Sapienza", Roma, Italy.
• 4Laboratory of Computational Social Science, Networks Dept IMT Institute for Advanced Studies Lucca, Italy; Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, USA.

Abstract

The large availability of user provided contents on online social media facilitates people aggregation around shared beliefs, interests, worldviews and narratives. In spite of the enthusiastic rhetoric about the so called collective intelligence unsubstantiated rumors and conspiracy theories-e.g., chemtrails, reptilians or the Illuminati-are pervasive in online social networks (OSN). In this work we study, on a sample of 1.2 million of individuals, how information related to very distinct narratives-i.e. main stream scientific and conspiracy news-are consumed and shape communities on Facebook. Our results show that polarized communities emerge around distinct types of contents and usual consumers of conspiracy news result to be more focused and self-contained on their specific contents. To test potential biases induced by the continued exposure to unsubstantiated rumors on users' content selection, we conclude our analysis measuring how users respond to 4,709 troll information-i.e. parodistic and sarcastic imitation of conspiracy theories. We find that 77.92% of likes and 80.86% of comments are from users usually interacting with conspiracy stories.

Rev Sci Tech. 2014 Aug;33(2):629-37.

One Health in social networks and social media.

Mekaru SR, Brownstein JS.

Abstract

In the rapidly evolving world of social media, social networks, mobile applications and citizen science, online communities can develop organically and separately from larger or more established organisations. The One Health online community is experiencing expansion from both the bottom up and the top down. In this paper, the authors review social media's strengths and weaknesses, earlier work examining Internet resources for One Health, the current state of One Health in social media (e.g. Facebook, Twitter, YouTube) and online social networking sites (e.g. LinkedIn and ResearchGate), as well as social media in One Health-related citizen science projects. While One Health has a fairly strong presence on websites, its social media presence is more limited and has an uneven geographic distribution. In work following the Stone Mountain Meeting,the One Health Global Network Task Force Report recommended the creation of an online community of practice. Professional social networks as well as the strategic use of social media should be employed in this effort. Finally, One Health-related research projects using volunteers (citizen science) often use social media to enhance their recruitment. Including these researchers in a community of practitioners would take full advantage of their existing social media presence. In conclusion, the interactive nature of social media, combined with increasing global Internet access, provides the One Health community with opportunities to meaningfully expand their community and promote their message.

Better Late Than Never, Doctors Begin to Treat Obesity

Written by Cameron Scott | Published on March 6, 2015

 

More than two decades into an epidemic that affects 1 in 3 Americans, doctors are getting serious about treating obesity.

From the National Law Review: FDA Proposal to Regulate Laboratory Developed Tests Raises Legal Liability Questions for Labs

FDA Proposal to Regulate Laboratory Developed Tests Raises Legal Liability Questions for Labs

"The American Society of Human Genetics contends in its comment to the FDA that legal liability for labs will expand with FDA regulation, subjecting labs to the same tort liability as medical device manufacturers.  It is true that some jurisdictions apply strict liability schemes to manufacturers of medical devices.  However, other courts have expressly rejected the application of strict liability to medical device manufacturers, as they have to prescription drug manufacturers. See, for example, Terrell v. Davol, 2014 U.S. Dist. LEXIS 103695 (E.D. Pa. July 30, 2014), where the court found that Pennsylvania, which already barred strict liability claims against drug manufacturers, also prohibited such claims against device manufacturers."

Losing 30 Minutes of Sleep Linked to Weight Gain and Increased Diabetes Risk

Losing 30 Minutes of Sleep Linked to Weight Gain and Increased Diabetes Risk

A new study found that losing as little as 30 minutes of sleep per day affects the body’s weight and increases one’s risk of diabetes.

"Most people tend to sleep less during weekdays and pay their sleep debt over the weekend. This habit, however, has long-term consequences on weight gain and overall health."

Slippery slope: Facebook Study: A Little Bit Unethical But Worth It?

J Bioeth Inq. 2015 Mar 5. [Epub ahead of print]

Facebook Study: A Little Bit Unethical But Worth It?

Kleinsman J1, Buckley S.

Author information

• 1The Nathaniel Centre, P.O. Box 12243, Thorndon, Wellington, 6144, New Zealand, jkleinsman@nathaniel.org.nz.

Abstract

Human research involving the use social media raises many of the same issues as medical research. The publication of a paper in June 2014 investigating "emotional contagion" received extensive publicity recently because of the methods used. The approach involved manipulating the "News Feeds" of Facebook users, but the participants were not informed of their involvement in the research and had no opportunity to consent or opt out. Some commentators have argued that although it would have been preferable to obtain informed consent, it was not strictly required because the research was unlikely to cause significant harm and was important. This paper argues that the research was unethical because (i) it should have been overseen by an independent ethics committee or review board and (ii) informed consent could and should have been obtained. Regardless of the importance of any research and irrespective of its likelihood to cause harm, the ethical principles that have evolved since the 1940s should be followed in all instances when experimental research is being carried out on human participants.

From Columbia U: FNA, core biopsy, or both for the diagnosis of lung carcinoma: Obtaining sufficient tissue for a specific diagnosis and molecular testing

Cancer Cytopathol. 2015 Feb 24. doi: 10.1002/cncy.21527. [Epub ahead of print]

FNA, core biopsy, or both for the diagnosis of lung carcinoma: Obtaining sufficient tissue for a specific diagnosis and molecular testing.

Coley SM1, Crapanzano JP, Saqi A.

Author information

• 1Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York.

Abstract

BACKGROUND:

Increasingly, minimally invasive procedures are performed to assess lung lesions and stage lungcarcinomas. In cases of advanced-stage lung cancer, the biopsy may provide the only diagnostic tissue. The aim of this study was to determine which method-fine-needle aspiration (FNA), core biopsy (CBx), or both (B)-is optimal for providing sufficient tissue for rendering a specific diagnosis and pursuing molecular studies for guiding tumor-specific treatment.

METHODS:

A search was performed for computed tomography-guided lung FNA, CBx, or B cases with rapid onsite evaluation. Carcinomas were assessed for the adequacy to render a specific diagnosis; this was defined as enough refinement to subtype a primary carcinoma or to assess a metastatic origin morphologically and/or immunohistochemically. In cases of primary lung adenocarcinoma, the capability of each modality to yield sufficient tissue for molecular studies (epidermal growth factor receptor, KRAS, or anaplastic lymphoma kinase) was also assessed.

RESULTS:

There were 210 cases, and 134 represented neoplasms, including 115 carcinomas. For carcinomas, a specific diagnosis was reached in 89% of FNA cases (33 of 37), 98% of CBx cases (43 of 44), and 100% of B cases (34 of 34). For primary lung adenocarcinomas, adequate tissue remained to perform molecular studies in 94% of FNA cases (16 of 17), 100% of CBx cases (19 of 19), and 86% of B cases (19 of 22). No statistical difference was found among the modalities for either reaching a specific diagnosis (p = .07, Fisher exact test) or providing sufficient tissue for molecular studies (p = .30, Fisher exact test).

CONCLUSIONS:

The results suggest that FNA, CBx, and B are comparable for arriving at a specific diagnosis and having sufficient tissue for molecular studies: they specifically attained the diagnostic and prognostic goals of minimally invasive procedures for lung carcinoma.

Eur Respir J. 2015 Mar 5. pii: ERJ-00973-2014. [Epub ahead of print]

No impact of passive smoke on the somatic profile of lung cancers in never-smokers.

Couraud S1, Debieuvre D1, Moreau L1, Dumont P1, Margery J1, Quoix E1, Duvert B1, Cellerin L1, Baize N1, Taviot B1, Coudurier M1,Cadranel J1, Missy P1, Morin F1, Mornex JF1, Zalcman G1, Souquet PJ1; on behalf of the BioCAST/IFCT-1002 study investigators.

Author information

• 1For a list of the authors' affiliations see the Acknowledgements section.

Abstract

EGFR and HER2 mutations and ALK rearrangement are known to be related to lung cancer in never-smokers, while KRAS, BRAF and PIK3CA mutations are typically observed among smokers. There is still debate surrounding whether never-smokers exposed to passive smoke exhibit a "smoker-like" somatic profile compared with unexposed never-smokers. Passive smoke exposure was assessed in the French BioCAST/IFCT-1002 never-smoker lung cancer cohort and routine molecular profiles analyses were compiled. Of the 384 patients recruited into BioCAST, 319 were tested for at least one biomarker and provided data relating to passive smoking. Overall, 219 (66%) reported having been exposed to passive smoking. No significant difference was observed between mutation frequency and passive smoke exposure (EGFR mutation: 46% in never exposed versus 41% in ever exposed; KRAS: 7% versus 7%; ALK: 13% versus 11%; HER2: 4% versus 5%; BRAF: 6% versus 5%; PIK3CA: 4% versus 2%). We observed a nonsignificant trend for a negative association between EGFR mutation and cumulative duration of passive smoke exposure. No association was found for other biomarkers. There is no clear association between passive smoke exposure and somatic profile in lifelong, never-smoker lung cancer.