Initiative for Early Lung Cancer Research on Treatment: Development of Study Design and Pilot Implementation
Authors: Raja Flores, Emanuela Taioli, David F. Yankelevitz, Betsy J. Becker, Artit Jirapatnakul, Anthony Reeves, Rebecca Schwartz, Rowena Yip, Esther Fevrier, Kathleen Tam, Benjamin Steiger, Claudia I. Henschke, Raja Flores, Andrew Kaufman, Dong-Seok Lee, Daniel Nicastri, Andrea Wolf, Kenneth Rosenzweig, Jorge Gomez, Mary Beth Beasley, Maureen Zakowski, Michael Chung, David Yankelevitz, Claudia Henschke, Rita Futamura, Sydney Kantor, Carly Wallace, Faiz Bhora, Wissam Raad, Andrew Evans, Walter Choi, Zrzu Buyuk, Adie Friedman, Ronald Dreifuss, Stacey Verzosa, Mariya Yakubox, Karina Aloferdova, Patricia Stacey, Simone De Nobrega, Rita Futamura, Sydney Kantor, Carly Wallace, Ardeshir Hakami, Kathleen Tam, Carly Wallace, Harvey Pass, Berne Crawford, Jessica Donnington, Benjamin Cooper, Andre Moreirea, Audrey Sorensen, Leslie Kohman, Robert Dunton, Jason Wallen, Christopher Curtiss, Ernest Scalzetti, Linda Ellinwood, Ralph Aye, Eric Vallieres, Brian Louie, Alex Frivar, Vivek Mehta, Kristin Manning, Maria Chona, Andrew Smith, Clifford P. Connery, Emilo Torres, Dan Cruzer, Bruce Gendron, Sonya Alyea, Daniel Lackaye, Lauren Studer, Raja Flores, Claudia Henschke, Emanuela Taioli, David Yankelevitz, Betsy Becker, Artit Jirapatnakul, Anthony Reeves, Rebecca Schwartz, Rowena Yip, Esther Fevrier, Kathleen Tam, Benjamin Steiger
Journal: Journal of Thoracic Oncology (2018)

IntroductionTo maximize the benefits of computed tomographic screening for lung cancer, optimal treatment for small, early lung cancers is needed. Limiting the extent of surgery spares lung tissue, preserves pulmonary function, and decreases operative time, complications, and morbidities. It also increases the likelihood of resecting future new primary lung cancers. The goal is to assess alternative treatments in a timely manner.MethodsThe focus sessions with patients and physicians separately highlighted the need to consider their perceptions. Literature reviews and analyses of treatment results using large databases were performed to formulate critical questions about long-term treatment outcomes, recurrence, and quality of life of alternative treatments. Based on these analyses, the investigators developed a prospective multi-institutional cohort study, the Initiative for Early Lung Cancer Research for Treatment, to compare treatments for stage I NSCLC. HIPAA compliant institutional review board approval was obtained and we performed a feasibility study of the first 206 surgical patients.ResultsLobectomy was performed in 89 (43.2%) patients, and sublobar resection was performed in 117 (56.7%) patients. Mediastinal lymph node resection was performed in 173 (84.0%) patients, 8 had N1 and 3 N2 lymph node metastases. Patients stated that both the surgeon's opinion (93%) and the patient's own opinion (93%) were extremely important, followed by the patients' view that the chosen procedure would provide the best quality of life (90%).ConclusionsIt was feasible to obtain pre- and postsurgical information from patients and surgeons. We anticipate statistically meaningful results about treatment alternatives in 3 to 5 years.