Lung cancer risk and do-it-yourself activities. A neglected risk factor for lung cancer.

BACKGROUND: The aim of this study was to assess the relationship between do-it-yourself activities entailing the exposure to carcinogenic substances and the risk of lung cancer. METHODS: We pooled individual data from different case-control studies conducted in Northwestern Spain which investigated residential radon and lung cancer. Cases had an anatomopathologically confirmed primary lung cancer and controls were selected at the pre-surgery unit with uncomplicated surgeries. Both cases and controls were older than 30 years with no previous cancer history. All participants were interviewed face-to-face using a specific questionnaire. Painting, model building, furniture refinishing and woodworking or home carpentry were the do-it-yourself activities considered risky due to exposure to carcinogenic agents. RESULTS: We included 1528 cases and 1457 controls. Practicing do-it-yourself risk activities was more frequent among cases: 16.0% were exposed to carcinogenic exposures during leisure time, compared to 11.8% for controls. The overall adjusted OR for lung cancer risk among individuals who practiced do-it-yourself risk activities, was 1.77 (95% CI: 1.36-2.31); this was 2.17 (95% CI: 1.51-3.11) when the analysis was restricted to individuals who performed these activities for at least 10 years. These risks were greater when the analyses were carried out exclusively among never-smokers, with the respective ORs being 2.04 (95% CI: 1.38-3.01) and 3.10 (95% CI: 1.78-5.40). CONCLUSION: These results support the hypothesis that do-it-yourself activities involving exposure to certain carcinogens are associated with an increased risk of lung cancer, both in ever and never-smokers.

Ganitumab for the treatment of small-cell lung cancer.

INTRODUCTION: Small-cell lung cancer (SCLC) accounts for 15 - 20% of all lung cancer cases with few advances made in the systemic treatment and outcomes for extensive-stage SCLC. Many strategies have been evaluated over the past 15 years but none of these approaches has resulted in improved survival rates for patients with SCLC. The IGF receptor (IGF-R) pathway represents a potential actionable target in SCLC patients. Indeed, the IGF-R pathway is involved in cancer development and progression and regulates different vital processes including fetal development, growth and metabolism. AREAS COVERED: This review provides an overview of insulin inhibitors and the strategies undertaken in recent years with SCLC. Specifically, the article discusses ganitumab and its applicability to SCLC patients. EXPERT OPINION: At present, there is a lack of therapeutic choices for patients with advanced SCLC. Unfortunately, ganitumab, administered in combination with chemotherapy, demonstrated no clinical activity in patients with SCLC, although it could have utility with other cancers. Furthermore, insulin inhibitors may have some utility in the treatment of SCLC and further studies are required to identify subsets of patients most likely to benefit from their use. The authors also believe that it is important to determine the exact role of the IGF pathway in the pathogenesis and propagation of SCLC.