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The changing diagnostic pathway for lung cancer patients in Shanghai, China

  • Tao Jiang
    Affiliations
    Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, PR China
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  • Shengxiang Ren
    Affiliations
    Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, PR China
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  • Xuefei Li
    Affiliations
    Department of Lung Cancer and Immunology, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, PR China
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  • Chunxia Su
    Correspondence
    Corresponding author: Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, No. 507, Zheng Min Road, Shanghai, 200433, PR China. Tel.: +86 21 65115006; fax: +86 21 65111298.
    Affiliations
    Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, PR China
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  • Caicun Zhou
    Correspondence
    Corresponding author: Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, No. 507, Zheng Min Road, Shanghai, 200433, PR China. Tel.: +86 21 65115006; fax: +86 21 65111298.
    Affiliations
    Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, PR China
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  • Mary O'Brien
    Affiliations
    Department of Medicine, Royal Marsden NHS Foundation Trust, London, UK
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Published:August 17, 2017DOI:https://doi.org/10.1016/j.ejca.2017.07.036

      Highlights

      • The diagnosis, clinical staging and molecular phenotyping must be quick and efficient for lung cancer patients.
      • A median 4 working days for a new patient from initial respiratory consultation to treatment decision can be achieved.
      • To improve the speed of diagnosis and treatment decision of advanced lung cancer, we need to learn from each other.

      Abstract

      Accumulating evidence suggest that patients with advanced non–small-cell lung cancer (NSCLC) and specific genomic alterations including epidermal growth factor receptor and microtubule-associated protein-like 4 anaplastic lymphoma kinase could significantly benefit from molecular-targeted therapies compared with chemotherapy. Recently, immunotherapy based on programmed cell death 1 (PD-1) and its ligand (PD-L1) blockade prolong survival in patients with advanced NSCLC, especially in those patients with positive expression of PD-L1 and when used in the first-line setting. Therefore, the diagnosis, clinical staging and molecular genotyping must be quick and efficient so that we can make a timely and precise decision for treatment strategy. In our department, it takes a median 4 working days (range 3–6) for a new patient from initial respiratory consultation to treatment decision, whereas in many countries, 14 workdays is considered a reasonable timeline. In this article, we will provide detailed information on the diagnostic pathway for a new patient suspected of having lung cancer to the final treatment decisions in our department.

      Keywords

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