Lung cancer in the Indian subcontinent

Vanita Noronha; Rakesh Pinninti; Vijay M. Patil; Amit Joshi; Kumar Prabhash

doi:10.4103/2278-330X.187571

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Review Article

05 (

); 095-103

doi:

10.4103/2278-330X.187571

Lung cancer in the Indian subcontinent

Vanita Noronha¹, Rakesh Pinninti¹, Vijay M. Patil¹, Amit Joshi¹, Kumar Prabhash^1,

1 Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra

*Corresponding author: Dr. Kumar Prabhash. kumarprabhashtmh@gmail.com

Published: 2020-12-28

MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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Abstract

Smoking tobacco, both cigarettes and beedis, is the principal risk factor for causation of lung cancer in Indian men; however, among Indian women, the association with smoking is not strong, suggesting that there could be other risk factors besides smoking. Despite numerous advances in recent years in terms of diagnostic methods, molecular changes, and therapeutic interventions, the outcomes of the lung cancer patients remain poor; hence, a better understanding of the risk factors may impact the preventive measures to be implemented at the community level. There is a lack of comprehensive data on lung cancer in India. In this review, we attempt to collate the available data on lung cancer from India.

Keywords

References

World Health Organization. The Global Burden of Disease: 2004 Update. Geneva: World Health Organization; 2008.
Viswanathan R, Sen Gupta, Iyer PV. Incidence of primary lung cancer in India. Thorax1962;17:73-6.
Available from: http://www.globocan.iarc.fr/old/summary_table_pop-html.asp?selection=89356&title=India&sex=0&type=0&window=1&sort=2&submit=%C2%A0Execute. [Last accessed on 2015 Oct 26].
Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010;127:2893-917.
Jindal SK, Behera D. Clinical spectrum of primary lung cancer - Review of Chandigarh experience of 10 years. Lung India 1990;8:94-8.
Zhong L, Goldberg MS, Parent ME, Hanley JA. Exposure to environmental tobacco smoke and the risk of lung cancer: A meta-analysis. Lung Cancer 2000;27:3-18.
Gupta D, Aggarwal A, Jindal S. Pulmonary effects of passive smoking: The Indian experience. Tob Induc Dis 2002;1:129-36.
Krishnamurthy A, Vijayalakshmi R, Gadigi V, Ranganathan R, Sagar TG. The relevance of "nonsmoking-associated lung cancer" in India: A single-centre experience. Indian J Cancer 2012;49:82-8.
Malik PS, Sharma MC, Mohanti BK, Shukla NK, Deo S, Mohan A, et al. Clinico-pathological profile of lung cancer at AIIMS: A changing paradigm in India.Asian Pac J Cancer Prev 2013;14:489-94.
Available from: http://www.icmr.nic.in/ncrp/pbc.pdf. [Last accessed on 2016 Jan 12].
Available from: http://www.icmr.nic.in/bulletin/English/2010/ICMR%20Bulleti%20February%202010.pdf. [Last accessed on 2016 Jan 12].
Dey A, Biswas D, Saha SK, Kundu S, Kundu S, Sengupta A. Comparison study of clinicoradiological profile of primary lung cancer cases: An Eastern India experience. Indian J Cancer 2012;49:89-95.
Singh N, Aggarwal AN, Gupta D, Behera D, Jindal SK. Unchanging clinico-epidemiological profile of lung cancer in North India over three decades. Cancer Epidemiol 2010;34:101-4.
Sahoo R, Harini VV, Babu VC, Patil Okaly GV, Rao S, Nargund A, et al. Screening for EGFR mutations in lung cancer, a report from India. Lung Cancer 2011;73:316-9.
Chougule A, Prabhash K, Noronha V, Joshi A, Thavamani A, Chandrani P, et al. Frequency of EGFR mutations in 907 lung adenocarcioma patients of Indian ethnicity. PLoS One 2013;8:e76164.
Doval D, Prabhash K, Patil S, Chaturvedi H, Goswami C, Vaid A, et al. Clinical and epidemiological study of EGFR mutations and EML4-ALK fusion genes among Indian patients with adenocarcinoma of the lung. Onco Targets Ther 2015;8:117-23.
Aggarwal S, Patil S, Minhans S, Pungliya M, Soumitra N. A study of EGFR mutation in non-smoker NSCLC: Striking disparity between North and South India patients [Abstract]. J Clin Oncol 2012;30:E18041.
Shi Y, Au JS, Thongprasert S, Srinivasan S, Tsai CM, Khoa MT, et al. A prospective, molecular epidemiology study of EGFR mutations in Asian patients with advanced non-small-cell lung cancer of adenocarcinoma histology (PIONEER). J Thorac Oncol 2014;9:154-62.
Noronha V, Prabhash K, Thavamani A, Chougule A, Purandare N, Joshi A, et al. EGFR mutations in Indian lung cancer patients: Clinical correlation and outcome to EGFR targeted therapy. PLoS One 2013;8:e61561.
Bhatt AD, Pai R, Rebekah G, Nehru GA, Dhananjayan S, Samuel A, et al. Clinicopathologic features of non-small cell lung cancer in India and correlation with epidermal growth factor receptor mutational status. Indian J Cancer 2013;50:94-101.
Noronha V, Joshi A, Gokarn A, Sharma V, Patil V, Janu A, et al. The Importance of Brain Metastasis in EGFR Mutation Positive NSCLC Patients. Chemother Res Pract 2014;2014:856156.
Parikh PM. Awareness about EGFR testing and use of TKIs in advanced lung cancer: A questionnaire-based survey of medical oncologists from India. J Clin Oncol 2013;31. [Abstr. e19116].
Crino L, Kim D, Riely GJ, Janne PA, Blackhall FH, Camidge DR, et al. Initial phase II results with crizotinib in advanced ALK-positive non-small cell lung cancer (NSCLC): Profile 1005. J Clin Oncol 2011;29. [Abstr. 7514].
Shaw AT, Kim DW, Nakagawa K, Seto T, Crinó L, Ahn MJ, et al. Crizotinib versus chemotherapy in advanced ALK-positive lung cancer. N Engl J Med 2013;368:2385-94.
Desai SS, Shah AS, Prabhash K, Jambhekar NA. A year of anaplastic large cell kinase testing for lung carcinoma: Pathological and technical perspectives. Indian J Cancer 2013;50:80-6.
Sharma S, Sharma R, Bhowmik KT. Sequential chemoradiotherapy versus radiotherapy in the management of locally advanced non-small-cell lung cancer. Adv Ther 2003;20:14-9.
Bahl A, Sharma DN, Julka PK, Rath GK. Chemotherapy related toxicity in locally advanced non-small cell lung cancer. J Cancer Res Ther 2006;2:14-6.
Agarwal JP, Hotwani C, Prabhash K, Munshi A, Mira S, Mathew A, et al. Optimizing treatment and analysis of prognostic factors for locally advanced nonsmall cell lung cancer in resource-limited population. Indian J Cancer 2016;53:96-101. [In press].
Agrawal S, Kumar S, Lawrence A, Das MK, Kumar S. Ipsilateral lung dose volume parameters predict radiation pneumonitis in addition to classical dose volume parameters in locally advanced NSCLC treated with combined modality therapy. South Asian J Cancer 2014;3:13-5.
Kundu S, Mathew A, Munshi A, Prabhash K, Pramesh CS, Agarwal JP. Stereotactic body radiotherapy in early stage non-small cell lung cancer: First experience from an Indian Centre. Indian J Cancer 2013;50:227-32.
Rajappa S, Gundeti S, Talluri MR, Digumarti R. Chemotherapy for advanced lung cancer: A 5-year experience. Indian J Cancer 2008;45:20-6.
Rajappa S, Gundeti S, Uppalapati S, Jiwatani S, Abhyankar A, Pal C, et al. Is there a positive effect of participation on a clinical trial for patients with advanced non-small cell lung cancer? Indian J Cancer 2008;45:158-63.
Tiwana MS, Lee HN, Saini S, Verma SK, Gupta M, Gupta M, et al. Outcomes of patients with unresected stage III and stage IV non-small cell lung cancer: A single institution experience. Lung India 2013;30:187-92.
Singh N, Aggarwal AN, Behera D, Jindal SK. Intercycle delays during chemotherapy of non-small cell lung cancer in a health care resource-constrained setting and their effect on overall survival. J Thorac Oncol 2010;5:236-9.
Parikh PM, Prabhash K, Bhattacharyya GS, Sirohi B, Rajappa S, Verma A, et al. Ignore molecular oncology at your peril. Indian J Cancer 2014;51:150-3.
Parikh P, Puri T. Personalized medicine: Lung Cancer leads the way. Indian J Cancer 2013;50:77-9.
Scagliotti GV, Parikh P, von Pawel J, Biesma B, Vansteenkiste J, Manegold C, et al. Phase III study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advanced-stage non-small-cell lung cancer. J Clin Oncol 2008;26:3543-51.
Syrigos KN, Vansteenkiste J, Parikh P, von Pawel J, Manegold C, Martins RG, et al. Prognostic and predictive factors in a randomized phase III trial comparing cisplatin-pemetrexed versus cisplatin-gemcitabine in advanced non-small-cell lung cancer. Ann Oncol 2010;21:556-61.
Gota V, Kavathiya K, Doshi K, Gurjar M, Damodaran SE, Noronha V, et al. High plasma exposure to pemetrexed leads to severe hyponatremia in patients with advanced non small cell lung cancer receiving pemetrexed-platinum doublet chemotherapy. Cancer Manag Res 2014;6:261-5.
Kumar S, Guleria R, Singh V, Bharti AC, Mohan A, Das BC. Plasma nucleosome levels might predict response to therapy in patients with advanced non-small-cell lung cancer. Clin Lung Cancer 2010;11:36-44.
Lynch TJ, Bondarenko I, Luft A, Serwatowski P, Barlesi F, Chacko R, et al. Ipilimumab in combination with paclitaxel and carboplatin as first-line treatment in stage IIIB/IV non-small-cell lung cancer: Results from a randomized, double-blind, multicenter phase II study. J Clin Oncol 2012;30:2046-54.
Digumarti R, Bapsy PP, Suresh AV, Bhattacharyya GS, Dasappa L, Shan JS, et al. Bavituximab plus paclitaxel and carboplatin for the treatment of advanced non-small-cell lung cancer. Lung Cancer 2014;86:231-6.
Pandey AV, Phillip DS, Noronha V, Joshi A, Janu A, Jambekar N, et al. Maintenance pemetrexed in nonsmall cell lung carcinoma: Outcome analysis from a tertiary care center. Indian J Med Paediatr Oncol 2015;36:238-42.
Prasad N, Bakshi A, Deshmukh C, Hingmire S, Ranade A, Parikh P. Importance of dose intensity in treatment of advanced non-small cell lung cancer in the elderly. South Asian J Cancer 2012;1:9-15.
Parikh PM, Vaid A, Advani SH, Digumarti R, Madhavan J, Nag S, et al. Randomized, double-blind, placebo-controlled phase II study of single-agent oral talactoferrin in patients with locally advanced or metastatic non-small-cell lung cancer that progressed after chemotherapy. J Clin Oncol 2011;29:4129-36.
Digumarti R, Wang Y, Raman G, Doval DC, Advani SH, Julka PK, et al. A randomized, double-blind, placebo-controlled, phase II study of oral talactoferrin in combination with carboplatin and paclitaxel in previously untreated locally advanced or metastatic non-small cell lung cancer. J Thorac Oncol 2011;6:1098-103.
Noronha V, Patil VM, Joshi A, Prabhash K. Efficacy and safety of metronomic administration of paclitaxel for advanced recurrent non-small-cell lung cancer. Indian J Cancer 2013;50:122-7.
Thatcher N, Chang A, Parikh P, Rodrigues Pereira J, Ciuleanu T, von Pawel J, et al. Gefitinib plus best supportive care in previously treated patients with refractory advanced non-small-cell lung cancer: Results from a randomised, placebo-controlled, multicentre study (Iressa Survival Evaluation in Lung Cancer). Lancet 2005;366:1527-37.
Parikh P, Chang AY, Nag S, Digumarti R, Bhattacharyya GS, Doval DC, et al. Clinical experience with gefitinib in Indian patients. J Thorac Oncol 2008;3:380-5.
Puranik AD, Purandare NC, Shah S, Agrawal A, Rangarajan V. Role of FDG PET/CT in assessing response to targeted therapy in metastatic lung cancers: Morphological versus metabolic criteria. Indian J Nucl Med 2015;30:21-5.
Louis RA, Rajendranath R, Ganesan P, Sagar TG, Krishnamurthy A. First report of upfront treatment with gefitinib in comparison with chemotherapy in advanced non-small cell lung cancer patients from South India: Analysis of 120 patients. Indian J Med Paediatr Oncol 2012;33:146-54.
Mallick I, Sharma SC, Behera D. Endobronchial brachytherapy for symptom palliation in non-small cell lung cancer - analysis of symptom response, endoscopic improvement and quality of life. Lung Cancer 2007;55:313-8.
Fernandes MP, Venkatesh S, Sudarshan BG. Early detection of lung cancer using nano-nose - A review. Open Biomed Eng J 2015;9:228-33.

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[1] World Health Organization. The Global Burden of Disease: 2004 Update. Geneva: World Health Organization; 2008.

[2] Viswanathan R, Sen Gupta, Iyer PV. Incidence of primary lung cancer in India. Thorax1962;17:73-6.

[3] Available from: http://www.globocan.iarc.fr/old/summary_table_pop-html.asp?selection=89356&title=India&sex=0&type=0&window=1&sort=2&submit=%C2%A0Execute. [Last accessed on 2015 Oct 26].

[4] Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010;127:2893-917.

[5] Jindal SK, Behera D. Clinical spectrum of primary lung cancer - Review of Chandigarh experience of 10 years. Lung India 1990;8:94-8.

[6] Zhong L, Goldberg MS, Parent ME, Hanley JA. Exposure to environmental tobacco smoke and the risk of lung cancer: A meta-analysis. Lung Cancer 2000;27:3-18.

[7] Gupta D, Aggarwal A, Jindal S. Pulmonary effects of passive smoking: The Indian experience. Tob Induc Dis 2002;1:129-36.

[8] Krishnamurthy A, Vijayalakshmi R, Gadigi V, Ranganathan R, Sagar TG. The relevance of "nonsmoking-associated lung cancer" in India: A single-centre experience. Indian J Cancer 2012;49:82-8.

[9] Malik PS, Sharma MC, Mohanti BK, Shukla NK, Deo S, Mohan A, et al. Clinico-pathological profile of lung cancer at AIIMS: A changing paradigm in India.Asian Pac J Cancer Prev 2013;14:489-94.

[10] Available from: http://www.icmr.nic.in/ncrp/pbc.pdf. [Last accessed on 2016 Jan 12].

[11] Available from: http://www.icmr.nic.in/bulletin/English/2010/ICMR%20Bulleti%20February%202010.pdf. [Last accessed on 2016 Jan 12].

[12] Dey A, Biswas D, Saha SK, Kundu S, Kundu S, Sengupta A. Comparison study of clinicoradiological profile of primary lung cancer cases: An Eastern India experience. Indian J Cancer 2012;49:89-95.

[13] Singh N, Aggarwal AN, Gupta D, Behera D, Jindal SK. Unchanging clinico-epidemiological profile of lung cancer in North India over three decades. Cancer Epidemiol 2010;34:101-4.

[14] Sahoo R, Harini VV, Babu VC, Patil Okaly GV, Rao S, Nargund A, et al. Screening for EGFR mutations in lung cancer, a report from India. Lung Cancer 2011;73:316-9.

[15] Chougule A, Prabhash K, Noronha V, Joshi A, Thavamani A, Chandrani P, et al. Frequency of EGFR mutations in 907 lung adenocarcioma patients of Indian ethnicity. PLoS One 2013;8:e76164.

[16] Doval D, Prabhash K, Patil S, Chaturvedi H, Goswami C, Vaid A, et al. Clinical and epidemiological study of EGFR mutations and EML4-ALK fusion genes among Indian patients with adenocarcinoma of the lung. Onco Targets Ther 2015;8:117-23.

[17] Aggarwal S, Patil S, Minhans S, Pungliya M, Soumitra N. A study of EGFR mutation in non-smoker NSCLC: Striking disparity between North and South India patients [Abstract]. J Clin Oncol 2012;30:E18041.

[18] Shi Y, Au JS, Thongprasert S, Srinivasan S, Tsai CM, Khoa MT, et al. A prospective, molecular epidemiology study of EGFR mutations in Asian patients with advanced non-small-cell lung cancer of adenocarcinoma histology (PIONEER). J Thorac Oncol 2014;9:154-62.

[19] Noronha V, Prabhash K, Thavamani A, Chougule A, Purandare N, Joshi A, et al. EGFR mutations in Indian lung cancer patients: Clinical correlation and outcome to EGFR targeted therapy. PLoS One 2013;8:e61561.

[20] Bhatt AD, Pai R, Rebekah G, Nehru GA, Dhananjayan S, Samuel A, et al. Clinicopathologic features of non-small cell lung cancer in India and correlation with epidermal growth factor receptor mutational status. Indian J Cancer 2013;50:94-101.

[21] Noronha V, Joshi A, Gokarn A, Sharma V, Patil V, Janu A, et al. The Importance of Brain Metastasis in EGFR Mutation Positive NSCLC Patients. Chemother Res Pract 2014;2014:856156.

[22] Parikh PM. Awareness about EGFR testing and use of TKIs in advanced lung cancer: A questionnaire-based survey of medical oncologists from India. J Clin Oncol 2013;31. [Abstr. e19116].

[23] Crino L, Kim D, Riely GJ, Janne PA, Blackhall FH, Camidge DR, et al. Initial phase II results with crizotinib in advanced ALK-positive non-small cell lung cancer (NSCLC): Profile 1005. J Clin Oncol 2011;29. [Abstr. 7514].

[24] Shaw AT, Kim DW, Nakagawa K, Seto T, Crinó L, Ahn MJ, et al. Crizotinib versus chemotherapy in advanced ALK-positive lung cancer. N Engl J Med 2013;368:2385-94.

[25] Desai SS, Shah AS, Prabhash K, Jambhekar NA. A year of anaplastic large cell kinase testing for lung carcinoma: Pathological and technical perspectives. Indian J Cancer 2013;50:80-6.

[26] Sharma S, Sharma R, Bhowmik KT. Sequential chemoradiotherapy versus radiotherapy in the management of locally advanced non-small-cell lung cancer. Adv Ther 2003;20:14-9.

[27] Bahl A, Sharma DN, Julka PK, Rath GK. Chemotherapy related toxicity in locally advanced non-small cell lung cancer. J Cancer Res Ther 2006;2:14-6.

[28] Agarwal JP, Hotwani C, Prabhash K, Munshi A, Mira S, Mathew A, et al. Optimizing treatment and analysis of prognostic factors for locally advanced nonsmall cell lung cancer in resource-limited population. Indian J Cancer 2016;53:96-101. [In press].

[29] Agrawal S, Kumar S, Lawrence A, Das MK, Kumar S. Ipsilateral lung dose volume parameters predict radiation pneumonitis in addition to classical dose volume parameters in locally advanced NSCLC treated with combined modality therapy. South Asian J Cancer 2014;3:13-5.

[30] Kundu S, Mathew A, Munshi A, Prabhash K, Pramesh CS, Agarwal JP. Stereotactic body radiotherapy in early stage non-small cell lung cancer: First experience from an Indian Centre. Indian J Cancer 2013;50:227-32.

[31] Rajappa S, Gundeti S, Talluri MR, Digumarti R. Chemotherapy for advanced lung cancer: A 5-year experience. Indian J Cancer 2008;45:20-6.

[32] Rajappa S, Gundeti S, Uppalapati S, Jiwatani S, Abhyankar A, Pal C, et al. Is there a positive effect of participation on a clinical trial for patients with advanced non-small cell lung cancer? Indian J Cancer 2008;45:158-63.

[33] Tiwana MS, Lee HN, Saini S, Verma SK, Gupta M, Gupta M, et al. Outcomes of patients with unresected stage III and stage IV non-small cell lung cancer: A single institution experience. Lung India 2013;30:187-92.

[34] Singh N, Aggarwal AN, Behera D, Jindal SK. Intercycle delays during chemotherapy of non-small cell lung cancer in a health care resource-constrained setting and their effect on overall survival. J Thorac Oncol 2010;5:236-9.

[35] Parikh PM, Prabhash K, Bhattacharyya GS, Sirohi B, Rajappa S, Verma A, et al. Ignore molecular oncology at your peril. Indian J Cancer 2014;51:150-3.

[36] Parikh P, Puri T. Personalized medicine: Lung Cancer leads the way. Indian J Cancer 2013;50:77-9.

[37] Scagliotti GV, Parikh P, von Pawel J, Biesma B, Vansteenkiste J, Manegold C, et al. Phase III study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advanced-stage non-small-cell lung cancer. J Clin Oncol 2008;26:3543-51.

[38] Syrigos KN, Vansteenkiste J, Parikh P, von Pawel J, Manegold C, Martins RG, et al. Prognostic and predictive factors in a randomized phase III trial comparing cisplatin-pemetrexed versus cisplatin-gemcitabine in advanced non-small-cell lung cancer. Ann Oncol 2010;21:556-61.

[39] Gota V, Kavathiya K, Doshi K, Gurjar M, Damodaran SE, Noronha V, et al. High plasma exposure to pemetrexed leads to severe hyponatremia in patients with advanced non small cell lung cancer receiving pemetrexed-platinum doublet chemotherapy. Cancer Manag Res 2014;6:261-5.

[40] Kumar S, Guleria R, Singh V, Bharti AC, Mohan A, Das BC. Plasma nucleosome levels might predict response to therapy in patients with advanced non-small-cell lung cancer. Clin Lung Cancer 2010;11:36-44.

[41] Lynch TJ, Bondarenko I, Luft A, Serwatowski P, Barlesi F, Chacko R, et al. Ipilimumab in combination with paclitaxel and carboplatin as first-line treatment in stage IIIB/IV non-small-cell lung cancer: Results from a randomized, double-blind, multicenter phase II study. J Clin Oncol 2012;30:2046-54.

[42] Digumarti R, Bapsy PP, Suresh AV, Bhattacharyya GS, Dasappa L, Shan JS, et al. Bavituximab plus paclitaxel and carboplatin for the treatment of advanced non-small-cell lung cancer. Lung Cancer 2014;86:231-6.

[43] Pandey AV, Phillip DS, Noronha V, Joshi A, Janu A, Jambekar N, et al. Maintenance pemetrexed in nonsmall cell lung carcinoma: Outcome analysis from a tertiary care center. Indian J Med Paediatr Oncol 2015;36:238-42.

[44] Prasad N, Bakshi A, Deshmukh C, Hingmire S, Ranade A, Parikh P. Importance of dose intensity in treatment of advanced non-small cell lung cancer in the elderly. South Asian J Cancer 2012;1:9-15.

[45] Parikh PM, Vaid A, Advani SH, Digumarti R, Madhavan J, Nag S, et al. Randomized, double-blind, placebo-controlled phase II study of single-agent oral talactoferrin in patients with locally advanced or metastatic non-small-cell lung cancer that progressed after chemotherapy. J Clin Oncol 2011;29:4129-36.

[46] Digumarti R, Wang Y, Raman G, Doval DC, Advani SH, Julka PK, et al. A randomized, double-blind, placebo-controlled, phase II study of oral talactoferrin in combination with carboplatin and paclitaxel in previously untreated locally advanced or metastatic non-small cell lung cancer. J Thorac Oncol 2011;6:1098-103.

[47] Noronha V, Patil VM, Joshi A, Prabhash K. Efficacy and safety of metronomic administration of paclitaxel for advanced recurrent non-small-cell lung cancer. Indian J Cancer 2013;50:122-7.

[48] Thatcher N, Chang A, Parikh P, Rodrigues Pereira J, Ciuleanu T, von Pawel J, et al. Gefitinib plus best supportive care in previously treated patients with refractory advanced non-small-cell lung cancer: Results from a randomised, placebo-controlled, multicentre study (Iressa Survival Evaluation in Lung Cancer). Lancet 2005;366:1527-37.

[49] Parikh P, Chang AY, Nag S, Digumarti R, Bhattacharyya GS, Doval DC, et al. Clinical experience with gefitinib in Indian patients. J Thorac Oncol 2008;3:380-5.

[50] Puranik AD, Purandare NC, Shah S, Agrawal A, Rangarajan V. Role of FDG PET/CT in assessing response to targeted therapy in metastatic lung cancers: Morphological versus metabolic criteria. Indian J Nucl Med 2015;30:21-5.

[51] Louis RA, Rajendranath R, Ganesan P, Sagar TG, Krishnamurthy A. First report of upfront treatment with gefitinib in comparison with chemotherapy in advanced non-small cell lung cancer patients from South India: Analysis of 120 patients. Indian J Med Paediatr Oncol 2012;33:146-54.

[52] Mallick I, Sharma SC, Behera D. Endobronchial brachytherapy for symptom palliation in non-small cell lung cancer - analysis of symptom response, endoscopic improvement and quality of life. Lung Cancer 2007;55:313-8.

[53] Fernandes MP, Venkatesh S, Sudarshan BG. Early detection of lung cancer using nano-nose - A review. Open Biomed Eng J 2015;9:228-33.

Lung cancer in the Indian subcontinent

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Abstract

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