Avastin: Glossary of key terms

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1 Avastin: Glossary of key terms Adenocarcinoma Adenoma Adjuvant therapy Angiogenesis Anti-angiogenics Antibody Antigen Avastin (bevacizumab) Benign A form of carcinoma that originates in glandular tissue. To be classified as adenocarcinoma, the cells do not necessarily need to be part of a gland, as long as they have secretory properties. Adenocarcinomas are a common form of non-small cell lung cancer (NSCLC). A collection of benign tumours of gland like structure, originating from a secretory gland. Adenomas can grow from many organs including the colon, adrenal or pituitary glands, etc. Treatment given in addition following the primary treatment, to increase its effectiveness. In cancer treatment, adjuvant therapy usually refers to chemotherapy, hormone therapy, or radiation therapy after surgery to increase the chances of removing all cancer cells. Pronounced an-jee-oh-jen-ah-sis. Blood vessel formation. Tumour angiogenesis is the growth of new blood vessels from nearby body tissue to a tumour. These new blood vessels provide a tumour with nutrients to keep it alive. Therapies that prevent or reverse angiogenesis (blood vessel formation). A large Y-shaped protein used by the immune system to identify and attack foreign substances such as bacteria or viruses. Antibodies recognise specific targets on these substances, called antigens. A substance that is recognised by the body as foreign and causes the immune system to make a specific immune response. Pronounced a-va-stin. Also known by the non-proprietary name of bevacizumab. Avastin is a monoclonal antibody given by infusion during chemotherapy. It is currently approved for the first line treatment of both advanced colorectal cancer and metastatic breast cancer in Europe. Avastin is the first and only anti-angiogenic (prevents blood vessel formation) cancer treatment with consistently-demonstrated overall and/or progression-free survival benefits in four tumour types: colorectal cancer, breast cancer, non-small cell lung cancer (NSCLC) and renal cell cancer. A type of tumour that is not as aggressive as malignant tumours. They are usually slow growing, do not spread to other parts of the body and normally have an outer layer of normal cells. Treatment or removal of these types of tumours is usually curative. Bevacizumab Pronounced be-vac-i-zoo-mab. Bevacizumab is the non-proprietary name for Avastin. Biopsy Bronchoscopy The removal of a small sample of tissue for diagnosis. Examination of the inside of the lung airways, normally using a thin, flexible tube called a bronchoscope. A bronchoscopy is carried out under local anaesthetic and a biopsy is usually taken to test for lung cancer. 1

2 Bronchi Campto (irinotecan) Cancer Carboplatin Chemotherapy Cisplatin Complete remission Computed tomography (CT) scan Curative treatment Docetaxel Efficacy Eloxatin (oxaliplatin) As you breathe in, air is brought down the lungs through the windpipe (trachea) and up through tubes called bronchi. Also known by the non-proprietary name irinotecan. Campto is a chemotherapy drug that is given as a treatment for some types of cancer, including colorectal cancer. A class of diseases or disorders characterised by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis. Cancer may affect people at all ages, but risk tends to increase with age. It is one of the principal causes of death in developed countries. Pronounced car-bo-pla-tin. Carboplatin is a chemotherapy agent used for the treatment of some forms of cancer, mainly ovarian and lung cancer. Treatment with chemicals that have a toxic effect on cancer cells. Most chemotherapy treatments are given intravenously (by a drip). The length of the treatment period may vary, but often lasts for a few months, with rest breaks scheduled to give the body time to regain strength. There are many different types of chemotherapy medicines (over 50 different types) and each has a different effect on cancer cells. They are often given in combination with each other to make the treatment more effective. Sometimes additional medicines are needed to help control side effects. Chemotherapy typically has side effects such as hair loss, nausea, diarrhoea and malnutrition. Pronounced sis-pla-tin. A chemotherapy drug that is used to treat various types of cancer, including lung cancer. A complete disappearance of the signs and symptoms of cancer in response to treatment. A screening method for cancer, sometimes called a computed axial tomography (CAT) scan, or a computerised tomography scan. The CT scanner takes a series of x-rays that build up a three-dimensional picture of the inside of the body. These scans can help to find the exact site and size of the cancer, or to see if it has spread. Treatment for disease that aims to cure the patient or lead to recovery. The non-proprietary name for Taxotere. Efficacy is a word used to indicate the therapeutic effect of a given medication. Eloxatin (pronounced ee-lox-a-tin) is a chemotherapy drug that is given as a treatment for some types of cancer. It is most commonly used to treat colorectal cancer. Also known by the non-proprietary name oxaliplatin. First-line treatment Therapy recommended for the initial treatment of a disease, usually decided on the basis of its efficacy. Fluorouracil (5-FU) Fluorouracil (pronounced floo-ro-you-ro-sill) is a commonly used chemotherapy agent that is used in the treatment of breast and gastrointestinal cancers. 2

3 FOLFOX Gemcitabine Gemzar (gemcitabine) An abbreviation for a type of combination chemotherapy that is mainly used to treat colorectal cancer. It includes fluorouracil, leucovorin, and oxaliplatin. The non-proprietary name for the chemotherapy drug Gemzar. Gemzar is a chemotherapy drug that is used to treat breast cancer, non-small cell lung cancer, pancreatic and bladder cancers. Also known by the non-proprietary name gemcitabine. Hazard ratio (HR) The relative likelihood of experiencing a particular risk; for example, a HR of 0.5 indicates that one group of people has half the risk of developing something (e.g. disease or death) compared with another group of people. Large cell carcinoma Lesion A form of non-small cell lung cancer (NSCLC) that is fast-growing and grows near the surface of the lung. An abnormal section of tissue resulting from cancer or other disease. Lobectomy Surgical removal of a lobe of the lung for the treatment of lung cancer. Lobes Lung cancer Lymph nodes Malignant Mesothelioma Mesothelium Metastasis Monotherapy Neoadjuvant therapy The rounded, saclike organs that make up the lungs. The right lung has three lobes and the slightly smaller left lung has two. The malignant transformation and expansion of lung tissue. It has the highest mortality rate of all cancers worldwide. It is caused predominantly by cigarette smoking although many people who do not smoke also develop lung cancer each year. Glands that play a special role in the body s defence against infection. Part of the lymphatic system. A clinical term meaning to be disseminated and accordingly progressively worse. A malignant tumour can invade nearby cells, blood and lymph vessels and metastasise (spread) to other parts of the body. Cancer of the mesothelium that surrounds the lungs. Almost always caused by exposure to asbestos. A thin membrane that lines the chest and abdomen. The mesothelium that surrounds the chest is called the pleura. The spread of cancer from one part of the body to other part(s) from the body, which are not usually in close proximity (to differentiate it from regional disease). A therapy which uses only one drug. Preoperative treatment that is needed to increase the effectiveness of a primary treatment. In cancer treatments, neoadjuvant therapy usually refers to chemotherapy, hormone therapy, or radiation therapy before surgery to increase the chances of removing all cancer cells. 3

4 Nodule Non-small cell lung cancer (NSCLC) Oncologist Oncology Overall survival (OS) Oxaliplatin A small collection of cells or lesion (abnormal tissue change). A term that actually includes a number of distinct types of lung cancer, including squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. It is the most common form of lung cancer. A specialist (doctor or physician) in the study of cancer. The study of cancer. The percentage of people in a study who have survived for a certain period of time. It is usually reported as time since diagnosis or treatment, until they die or are lost to follow up. The non-proprietary name for the chemotherapy agent Elotaxin. Paclitaxel The non-proprietary name for the chemotherapy agent Taxol. Palliative treatment Paraplatin (carboplatin) Pleura Treatment that aims to relieve the symptoms, pain and stress of serious illness. A chemotherapy agent that is most commonly used for the treatment of ovarian and lung cancer. Also known by the non-proprietary name carboplatin. The membranes covering the lungs and the inner surface of the pleural cavity. Pneumonectomy Surgical removal of a whole lung for the treatment of lung cancer. Positron emission tomography (PET) Primary tumour Progression-free survival (PFS) Radiation therapy (radiotherapy) Remission Secondary tumour Second-line treatment A medical imaging technique which produces a 3D image of the body. It is used to diagnose cancer. A tumour that is at the original site at which it first arose. Cancer cells can break away from this primary tumour and spread to other locations. A measure that can be used in a clinical study or trial to help determine whether a new treatment for cancer is effective. It refers to the period by which the disease will be controlled by the treatment till it recurs again or the patient dies of any cause. The use of ionising radiation to treat cancer. It is used as a curative or palliative treatment. It is common to combine radiotherapy with surgery, chemotherapy and/or hormone therapy or use them in a sequential manner. Possible side effects of radiotherapy include damage to the epithelial surfaces (skin, oral or bowel mucosa) and dryness of the salivary glands or tear ducts, depending on site of radiation. A decrease in or disappearance of signs and symptoms of cancer. Cancer that has spread from the organ in which it first appeared to another location. Cancer treatment after a first treatment course has been completed or failed, and the disease is progressing. 4

5 Side effects Small cell lung cancer (SCLC) Squamous cells Staging Taxol (paclitaxel) Taxotere (docetaxel) Thoracoscopy Tumour Vascular endothelial growth factor (VEGF) Unwanted reactions to treatment. Some side effects can be minor and/or temporary. Others can be serious enough to require treatment in hospital, causing a delay in treatment, reduction in dose or switching to a different treatment. The least common type of lung cancer, after non-small cell lung cancer (NSCLC). It tends to start in the larger breathing tubes and grows rapidly, becoming quite large. Flat cells that look like fish scales. The word squamous comes from the Latin word squama meaning the scale of a fish or serpent. The staging of a cancer is important as it indicates to a physician how far the disease has spread. The Tumour, Node, Metastasis (TNM) staging system is the most commonly used for a variety of cancer types, including lung cancer. T = tumour - how far the primary tumour has grown locally. N = nodes - if the cancer has spread to the local lymph nodes. M = metastases - if the cancer has spread to other parts of the body. When a cancer is staged, a number is given to each of these characteristics. For example, in non-small cell lung cancer (NSCLC): Stage 0 = the cancer has only been found in the cells which line the air passages. Stage 1 = the cancer has not spread and the tumour is small. Stage 2 = the cancer is small but that the disease has spread to the lymph nodes. Stage 3 = the cancer has spread away from the lungs to the lymph nodes. Each of these first three stages can be divided into stage A and B depending on where the cancer is located. For example: Stage 3A can mean that there is cancer in lymph nodes away from the affected lung, but still on the same side of the chest Stage 3B could mean that the cancer has spread to lymph nodes on the other side of the chest. Stage 4 = the cancer has spread to another lobe of the lung from where it started, or to another part of the body, for example the liver or bones. Pronounced tax-ol. Also known by the non-proprietary name paclitaxel. Taxol is a chemotherapy agent used to treat many different types of cancer, including breast cancer, non-small cell lung cancer and ovarian cancer. Pronounced tax-oh-tare. Also known by the non-proprietary name docetaxel. Taxotere is a chemotherapy agent that is given as a treatment for many cancers including non-small cell lung cancer (NSCLC). A test using an endoscope to visually examine the pleura, lungs, and middle section of the chest cavity and to obtain tissue for testing purposes. Cells that form a lump or mass. Tumours can be cancerous (made of cancer cells) or benign (not cancerous). Vascular endothelial growth factor (VEGF) initiates the growth of new blood vessels which carry oxygen and nutrients to a tumour, allowing the tumour to grow in size and to metastasise. 5