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Lung Cancer Sex & Gender Difference Slides

This presentation provides an overview of sex and gender differences in lung cancer, including incidence, pathology, risk factors, prevention, diagnosis, staging, prognosis, mutations, and treatment.

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Lung Cancer Sex & Gender Difference Slides

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  1. Lung Cancer

  2. Sex & Gender Difference Slides When in presentation mode, click this button to advance to each sex and gender difference slide.

  3. Introduction Lung Cancer

  4. Lung cancer, also known as carcinoma of the lung or pulmonary carcinoma, is a malignant tumor characterized by uncontrolled cell growth in tissues of the lung.1 • The primary types are small-cell lung carcinoma (SCLC) and non-small-cell lung carcinoma (NSCLC).1 • NSCLC is the most common type accounting for 85% of all lung cancer cases. The most commonly diagnosed, histological subtype of NSCLC is adenonocarcinoma, accounting for approximately one-half of cases.1 Introduction

  5. Incidence Lung Cancer

  6. Approximately 1.8 million patients were diagnosed with lung cancer worldwide in 2012, with an estimated 1.6 million deaths.4 Estimated new cases and deaths from lung cancer (NSCLC and SCLC combined) in the United States in 2014 1-3 • New cases: 224,210; account for 13.5% of all new cancer cases • Deaths: 159,260; account for about 27% of all cancer deaths Incidence

  7. Incidence

  8. Incidence

  9. Mortality Lung Cancer

  10. Mortality

  11. Lung cancer is the leading cause of cancer-related mortality in the United States1 Survival Rate

  12. New Cases and Deaths Each Year

  13. Anatomy Lung Cancer

  14. Anatomy • NSCLC arises from the epithelial cells of the lung of the central bronchi to terminal alveoli. • Squamous cell carcinoma usually starts near a central bronchus.1 • Adenocarcinoma and bronchioloalveolar carcinoma usually originate in peripheral lung tissue.1

  15. Pathology Lung Cancer

  16. Smoking-related lung carcinogenesis is a multistep process. Before becoming invasive, lung epithelium may undergo morphological changes that include the following:1 • Hyperplasia • Metaplasia • Dysplasia • Carcinoma in situ In addition, after resection of a lung cancer, there is a 1% to 2% risk per patient per year that a second lung cancer will occur2 Pathogenesis

  17. Cell Pathology

  18. Risk Factors Lung Cancer

  19. Cigarette, pipe, or cigar smoking.2 • Exposure to second-hand smoke, radon, arsenic, asbestos, chromates, chloromethyl ethers, nickel, polycyclic aromatic hydrocarbons, radon progeny, other agents, and air pollution.2 • Radiation therapy to the breast or chest1,2 Risk Factors

  20. Prevention Lung Cancer

  21. A significant number of patients cured of their smoking-related lung cancer may develop a second malignancy2,3 • None of the phase III trials with agents such as beta carotene, retinol, 13-cis-retinoic acid, [alpha]-tocopherol, N-acetylcysteine, or acetylsalicylic acid have demonstrated beneficial, reproducible results in lung cancer prevention2,3 Prevention

  22. Diagnosis Lung Cancer

  23. USPSTF recommends annual screening for lung cancer with low-dose computed tomography in adults ages 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years.1,2 • Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery.2 Screening

  24. Clinical Features

  25. Diagnosis and Staging

  26. Factors that have correlated with adverse prognosis include: • Presence of pulmonary symptoms • Large tumor size (>3 cm)2 • Nonsquamous histology • Metastases to multiple lymph nodes within a TNM-defined nodal station3 • Vascular invasion4 Patients with good performance status, females, and patients with distant metastases confined to a single site live longer than others.5 Prognostic Factors

  27. Females have a higher incidence adenocarcinomahistology and small cell lung cancer, compare to males 1,2 • Females diagnosed with lung cancer have a better prognosis, with longer overall survival than males, independent of smoking status3-5 • Factors contributing to a better outcome include earlier age and pathological stage at presentation, histology, differentiation state and response to chemotherapy. Sex Difference in Lung Cancer

  28. A higher frequency of mutations in the tumor suppressor protein p53 gene has been observed in females compared to males. • NSCLC is more likely to harbor K-ras, c-erbB-2, or epidermal growth factor receptor mutations in females compared to males.1 • Females exhibit higher gene expression of the cytochrome P4501A1 and gastrin-releasing peptide receptor gene compared to males.1 Mutations and Sex Difference in Lung Cancer

  29. Treatment Lung Cancer

  30. Standard treatment of NSCLC according to TNM staging: • Surgery is the most potentially curative treatment for stages 0, I, II, and III with resectable lesions1 • Locally (T3–T4) and/or regionally (N2–N3) advanced disease are treated with radiation therapy in combination with chemotherapy • Advanced-stage disease is treated with platinum-based chemotherapy. This has been associated with short-term palliation of symptoms and a survival advantage2 Treatment

  31. Molecular Features

  32. Molecular Features

  33. Incidence of Single Driver Mutations in NSCLC

  34. Targeted Therapy

  35. Targeted Therapy

  36. EGFR inhibitors demonstrated a favorable efficacy profile in females • Never-smoking status and Asian ethnicity also were found to be statistically significant clinical predictors of benefit Sex and Targeted Therapy

  37. Conclusion Lung Cancer

  38. The observed sex and gender differences in lung cancer biology and clinical outcome require further study. • These studies will better define fundamental biological processes in females that may result in the development of gender-specific therapeutic strategies Conclusion

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