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J.R. Jett

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    PRC 02 - Press Conference 2 (ID 197)

    • Event: WCLC 2015
    • Type: Press Conference
    • Track: Other
    • Presentations: 5
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      PRC02.01 - Daily Theme: Lung Cancer Prevention & Screening - Dr. Claudia Henschke, Professor of Radiology and Head of Lung and Cardiac Screening Program at Mount Sinai Medical Center, New York (ID 3619)

      09:45 - 10:45  |  Author(s): C.I. Henschke

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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      PRC02.02 - New Tobacco Declaration from IASLC - Dr. Kenneth Michael Cummings, Chair of Tobacco Control and Smoking Cessation Committee, IASLC (ID 3620)

      09:45 - 10:45  |  Author(s): K.M. Cummings

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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      PRC02.03 - Abstract – Impact of Time to Drug Approval on Potential Years of Life Lost: The Compelling Need for Improved Trial and Regulatory Efficiency - Dr. David Stewart, Head, Division of Medical Oncology, University of Ottawa/The Ottawa Hospital (ID 3621)

      09:45 - 10:45  |  Author(s): D.J. Stewart

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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      PRC02.04 - Abstract – Results From Phase III Trials of Anamorelin in Advanced Non-Small Cell Lung Cancer Patients with Cachexia: ROMANA 1 and 2 - Dr. Amy Abernethy, Director, Center for Learning Health Care, Duke Clinical Research Institute, North Carolina (ID 3622)

      09:45 - 10:45  |  Author(s): A. Abernethy

      • Abstract
      • Presentation

      Abstract not provided

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      PRC02.05 - Abstract – Bevacizumab 15mg/kg Plus Cisplatin-Pemetrexed (CP) vs CP in Malignant Pleural Mesothelioma (MPM): IFCT-GFPC-0701 MAPS Randomized Phase 3 Trial - Dr. Arnaud Scherpereel, Head of the Pulmonary and Thoracic Oncology Department and Professor at the University Hospital (CHU) of Lille, France (ID 3623)

      09:45 - 10:45  |  Author(s): A. Scherpereel

      • Abstract
      • Slides

      Abstract not provided

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    YIS - Young Investigator Session incl. Q & A with Longstanding IASLC Members (ID 238)

    • Event: WCLC 2015
    • Type: Young Investigator Session
    • Track: Other
    • Presentations: 7
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      YIS.01 - Introduction to IALSC: What It Can Do For You (ID 3511)

      07:30 - 11:00  |  Author(s): D.P. Carbone

      • Abstract
      • Presentation
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      Abstract not provided

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      YIS.02 - Planning an Academic Career in Lung Cancer (ID 3512)

      07:30 - 11:00  |  Author(s): H.A. Wakelee

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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      YIS.03 - How to Write a Grant Application for Young Investigators (ID 3513)

      07:30 - 11:00  |  Author(s): S.M. Dubinett

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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      YIS.04 - How to Get Your Paper Published (ID 3514)

      07:30 - 11:00  |  Author(s): A. Adjei

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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      YIS.05 - How to Present Data at a Conference (ID 3515)

      07:30 - 11:00  |  Author(s): T. Mok

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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      YIS.06 - Making the Most of the WCLC: A Guide for First Time Attendees (ID 3516)

      07:30 - 11:00  |  Author(s): S. Novello

      • Abstract
      • Slides

      Abstract not provided

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      YIS.07 - Q & A with Longstanding IASLC Members (ID 3517)

      07:30 - 11:00  |  Author(s): P.A. Bunn, Jr, D. Carney, F. Shepherd, M. Tsuboi

      • Abstract
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      Abstract not provided

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Author of

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    MINI 12 - Biomarkers and Lung Nodule Management (ID 109)

    • Event: WCLC 2015
    • Type: Mini Oral
    • Track: Screening and Early Detection
    • Presentations: 1
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      MINI12.11 - Screening for Lung Cancer with the Early CDT-Lung and Computed Tomography (ID 204)

      16:45 - 18:15  |  Author(s): J.R. Jett

      • Abstract
      • Presentation
      • Slides

      Background:
      Early CDT-Lung, a serum based biomarker consisting of a panel of seven autoantibodies that develop in response to tumor associated antigens, has been shown to detect lung cancer in all stages of disease. We hypothesized that this biomarker when used in combination with a low-dose CT (LDCT) in screening of a high-risk population would increase the detection of early stage lung cancer.

      Methods:
      A prospective study of 1,600 subjects at high risk for lung cancer was designed. Eligibility criteria included persons 50-75 years of age, current or former smokers of ≥ 20 pack years and < 10 years since quit smoking. Those with a history of lung cancer in first degree relative(s) and any history of smoking were included. Exclusion criteria ware any history of cancer within 10 years (except skin cancer), any use of oxygen, and life expectancy of < 5 years. A direct mail campaign was conducted with study announcements sent to the homes of potentially high-risk individuals, who then contacted us for consideration of participating in this screening study. Those fitting inclusion criteria received the Early CDT-Lung blood test and a LDCT. A nodule of ≥ 3mm was considered as a positive scan. The Early CDT-Lung test was considered positive if any one of the seven autoantibodies was positive. All participants are to have yearly telephone follow-up for two years.

      Results:
      From May 2012 through November 2014, 815 individuals were enrolled and 814 completed the initial blood and LDCT screening tests. The cohort median age was 59 years with 55% female and 45% male gender distribution. The mean smoking history was 44 pack-years. Fifty-four per cent were current smokers while 46% were former smokers. Forty-six per cent of the LDCTs were negative for any lung nodule while 38% were positive. Incidental non-lung cancer findings were identified in 15% of the study group. The Early CDT-Lung biomarker was positive in 60 (7%) of participants, 23 males and 37 females. In those with a positive LDCT (n=313), the biomarker was positive in 25 (8%). As of January 30, 2015, there have been six confirmed lung cancers: two limited stage small cell, two Stage IB adenocarcinoma (ACA), and two Stage IA (one ACA and one squamous cell). The Early CDT-Lung blood test was positive in two of the four Stage IA/B lung cancers and negative in the two small cell cancers.There are 35 Early CDT-Lung biomarker positive individuals whose LDCT had no nodule. These individuals are being followed with yearly LDCT for two years. The study is continuing to accrue with a goal of 1,600. (NCT01700257)

      Conclusion:
      The Early CDT-Lung biomarker was positive in 7% of our high-risk population. The biomarker was positive in two of six lung cancers, specifically in two of four Stage I lung cancers. Accrual to the study and follow-up of 35 biomarker positive but LDCT negative participants continues.

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    MS 23 - Risk Factors: Beyond the Cigarette (ID 41)

    • Event: WCLC 2015
    • Type: Mini Symposium
    • Track: Prevention and Tobacco Control
    • Presentations: 1
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      MS23.03 - Legalization of Marijuana: Implication for Lung Health (ID 1951)

      14:15 - 15:45  |  Author(s): J.R. Jett

      • Abstract
      • Presentation
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      Abstract:
      Marijuana is a mixture of dried, shredded leaves, flowers, stems, and seeds from the hemp plant, Cannabis Sativa. Cannabis is a genus of flowering plants that has psychoactive properties. The main active chemical is THC (delta-9-tetrahydrocannabinol). The psychoactive effects are primarily a state of relaxation and euphoria to some degree. Record of cannabis use dates back to the Chinese Emperor Shen Nung in 2727 BC. In the 1500s, Spaniards imported it into the Americas. The amount of THC in marijuana has been steadily increasing and is much stronger now than 30 years ago. The average THC levels have risen from less than 1% in the 1970s to 12% in 2012. (1,2) Uruguay is the first and only country to fully legalize marijuana, but a number of other countries are considering doing so. The Netherlands, especially Amsterdam, is well-known for its tolerance of marijuana use. Medical marijuana use is legal in 23 of the 50 states in the USA. The states of Colorado, Washington, Oregon, Alaska, and District of Columbia have legalized recreational marijuana use. A number of other states have decriminalized the use of marijuana and others are considering approval for recreational use. Most users smoke marijuana in hand-rolled cigarettes called joints, but it can also be smoked in blunts (cigars), bowls, pipes, bongs, or vaporizers. It is also available in oral forms for ingestion. This lecture will be limited to the health effects on the lungs of smoking marijuana. (2,3) Lung Effects: Marijuana smoke contains many of the same toxins and carcinogens as tobacco smoke. (4) In a systematic comparison of smoke from marijuana and tobacco cigarettes consumed under two sets of smoking conditions, there were qualitative similarities and some quantitative differences. Ammonia was 20-fold greater in marijuana. Nitric oxide, hydrogen cyanide, and some aromatic amines were three to five times more than those in tobacco smoke. Selected polycyclic aromatic hydrocarbons were in lower concentration in marijuana. (4) Accurate studies on the health effects of marijuana use are difficult due to the illegal status of its use, variation in its use, and concomitant use of tobacco. (3,5) Bronchoscopic biopsies from subjects who smoke marijuana alone or marijuana and tobacco have been evaluated for histopathologic changes and molecular alterations. Smokers of marijuana alone reported symptoms of cough, sputum, wheeze, and acute episodes of bronchitis. (6) Histologic abnormalities were most frequent in smokers of both marijuana and tobacco. However, smokers of marijuana along did show changes of basal cell hyperplasia, inflammation, and squamous cell metaplasia in a large percentage of the 40 subjects examined. (6) Immunohistochemical analysis of bronchial biopsies from smokers of marijuana only demonstrated increased Ki-67 expression (cell proliferation marker) in 92% and increased EGFR expression in 57%. (7) Marijuana smoking does not appear to cause airflow obstruction. A study with 20 years of follow-up did not observe any significant change in pulmonary function. In a large cross section of US adults, cumulative life-time marijuana use up to 20 joint-years was not associated with airway obstruction. (8) There have been conflicting reports on the association of marijuana smoking and lung cancer. A 40-year cohort study from Sweden evaluated the baseline use of cannabis and cigarette smoking and the risk of lung cancer. They observed a strong dose-response relationship between tobacco use and lung cancer. They also reported a two-fold risk of lung cancer [HR 2.12 (95% CI 1.08-4.14)] in heavy cannabis smokers, even after adjustment for baseline tobacco use. (9) A major weakness of the study was reliance on only baseline self reporting of tobacco and cannabis use. No other data on use of these two agents was obtained throughout the 40 years of the study. A pooled analysis of six case-control studies from the US, Canada, United Kingdom, and New Zealand was performed to study the specific association between cannabis smoking and lung cancer. This included data on 2,159 lung cancers and 2,985 controls. (10) The odds ratio was 0.88 (95% CI 0.63-1.24) for individuals who smoked one or more joint-equivalents of cannabis per day and odds ratio of 0.94 for those who consumed at least 10 joint-years. The results from the pooled analysis provide little evidence for an increased risk of lung cancer among habitual long-term cannabis smokers. In summary, smoking marijuana causes airway inflammation and bronchitis, but to date there is no convincing data that it causes COPD or lung cancer. The level of the evidence is limited by the suboptimal quality of past studies. The current use and dose of inhaled marijuana is changing and therefore measurement of the pulmonary health effects are a moving target. References: http://www.deamuseum.org/ccp/cannabis/history/html (last accessed June 30, 2015) Volkow ND, et al. NEJM 2014; 370:2219-27 Tashkin DP. Annals ATS 2013; 10:239-47 Moir D, et al. Chem Res Toxicol 2008; 21:494-502 Howden ML, et al. Expert Rev Resp Med 2011; 5:87-92 Fligiel SH, et al. Chest 1997; 112:319-26 Barsky SH, et al. J Natl Cancer Inst 1998; 90:1198-1205 Kempker JA, et al. Annals ATS 2015; 12:135-41 Callaghan RC, et al. Cancer Causes Control 2013; 24:1811-1820 Zhang LR, et al. Int J Cancer 2015; 136:894-903

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