Targeted therapy for lung cancer.
Thoracic malignancies are a menacing worldwide health problem. To treat lung cancer optimally, care must be prompt, multidisciplinary, and patient-centred. In the entire process, pulmonologists have a key role. Pulmonologists and their professional societies should also enhance lung cancer research and education to provide better treatment options and patient care [1].
To meet that challenge, an action plan [2] was designed by the European Respiratory Society (ERS) Thoracic Oncology Assembly officers in March 2010, which was subsequently approved and strongly welcomed by the ERS Executive Committee. Today the Thoracic Oncology Assembly has almost achieved all of the following.- To create a Task Force for a European initiative for quality management in lung cancer care [3].
- To develop a specific training in thoracic oncology [4]. The HERMES (Harmonised Education in Respiratory Medicine for European Specialists) syllabus for thoracic oncology has been published and the curriculum will be finalised this year.
- To increase the number of meaningful publications in the ERS journals.
- To develop relationships with other European societies, such as the European Society for Medical Oncology, the European Society for Therapeutic Radiology and Oncology, the European Society of Thoracic Surgery, the European society of Radiology, the European Association for Cardio-Thoracic Surgery.
- To promote research in thoracic oncology. With this in mind, the Thoracic Oncology Assembly leaders decided to build an ERS Research Seminar on Targeted Therapy for Lung Cancer. ...
Asthma control in children: Is it important and can we measure it?
The goal of asthma management is to achieve disease control. Poorly controlled asthma is associated with an increased number of days lost from school, exacerbations and days in hospital. Furthermore, children with uncontrolled asthma have more frequent contacts with the health-care system. Recent studies have added new information about the effects of poorly controlled asthma on a range of important, but less studied outcomes, including risk of obesity, daily physical activity, cardiovascular fitness, stress, concentration and focused attention, learning disabilities and risk of depression. (Source: Paediatric Respiratory Reviews)
Severe pulmonary hypertension in lung disease: phenotypes and response to treatment
Pulmonary hypertension (PH) due to lung disease (World Health Organization (WHO) group 3) is common, but severe PH, arbitrarily defined as mean pulmonary artery pressure ≥35 mmHg is reported in only a small proportion. Whether these should be treated as patients in WHO group 1 (i.e. pulmonary arterial hypertension) with PH-targeted therapies is unknown.
We compared the phenotypic characteristics and outcomes of 118 incident patients with severe PH and lung disease with 74 idiopathic pulmonary arterial hypertension (IPAH) patients, all treated with pulmonary vasodilators.
Lung disease patients were older, more hypoxaemic, and had lower gas transfer, worse New York Heart Association functional class and lower 6-min walking distance (6MWD) than IPAH patients. Poorer survival in those ...
Benefit of treatment of latent tuberculosis infection in individual patients
We aimed to develop a decision aid that estimates whether treatment of latent tuberculosis infection (LTBI) is likely to have a net gain in quality-adjusted life-years for an individual.
A Markov model was developed which incorporated personalised estimates for risk of tuberculosis (TB) reactivation, TB death, quality-of-life impairments and treatment side-effects. The net effect of LTBI treatment was quantified in terms of quality-adjusted life-years gained or lost. Analyses were conducted for a representative set of hypothetical patients.
LTBI treatment was estimated to be beneficial when the annual risk of TB reactivation exceeded 13/100 000 to 93/100 000 for females aged 10–75 years and 15/100 000 to 119/100 000 for males aged 10–75 years; the numbers needed to tr...
The burden of severe asthma in childhood and adolescence: results from the paediatric U-BIOPRED cohorts
U-BIOPRED aims to characterise paediatric and adult severe asthma using conventional and innovative systems biology approaches.
A total of 99 school-age children with severe asthma and 81 preschoolers with severe wheeze were compared with 49 school-age children with mild/moderate asthma and 53 preschoolers with mild/moderate wheeze in a cross-sectional study.
Despite high-dose treatment, the severe cohorts had more severe exacerbations compared with the mild/moderate ones (annual medians: school-aged 3.0 versus 1.1, preschool 3.9 versus 1.8; p<0.001). Exhaled tobacco exposure was common in the severe wheeze cohort. Almost all participants in each cohort were atopic and had a normal body mass index. Asthma-related quality of life, as assessed by the Paediatric Asthma Quality of Life Ques...