Genetic Signature Predicted Clinical Outcome in NSCLC

VA I L , C O L O . — The new concept in asthma management is that one size does not fit all. Asthma is a heterogeneous entity, and it is increasingly recognized that most, but not all, asthma patients respond adequately to corticosteroid treatment, Dr. Carolyn M. Kercsmar said at a meeting sponsored by the American Academy of Pediatrics. In fact, there have even been recent, serious calls for abolishing the term “asthma” in favor of “complex wheezing disorders,” to reflect this new understanding that asthma can be very different in different individuals, said Dr. Kercsmar, director of the children’s asthma center at Rainbow Babies and Children’s Hospital, Cleveland. Because many patients are not sensitive to corticosteroids, physicians need to be careful about raising the dose excessively when a patient fails to achieve control, she said. Rather, the prudent approach should be to add another type of drug. Dr. Kercsmar used to attribute much treatment failure to nonadherence to the drug regimen, because it is so common. But the current estimates are that around 30% of patients do not respond to corticosteroid treatment, by any measure. “If you see someone who says they are not doing well, you’ve got to believe them,” she said. She noted four studies in particular that have documented inhaled-corticosteroid insensitivity. One clinical study in a pediatric