1361P - Long-term effects of inhaled budesonide on screening-detected lung nodules

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Aetiology, Epidemiology, Screening and Prevention
Basic Scientific Principles
Presenter Giulia Veronesi
Citation Annals of Oncology (2014) 25 (suppl_4): iv478-iv480. 10.1093/annonc/mdu351
Authors G. Veronesi1, M. Lazzeroni2, E. Szabo3, P. Brown4, A. De Censi5, A. Guerrieri-Gonzaga2, M. Bellomi6, D. Radice7, M.C. Grimaldi6, L. Spaggiari1, B. Bonanni8
  • 1Thoracic Surgery, Istituto Europeo di Oncologia, 20141 - Milan/IT
  • 2Division Of Cancer Prevention And Genetics, Istituto Europeo di Oncologia, Milan/IT
  • 3Division Of Cancer Prevention, NCI, Washington, DC/US
  • 4Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, 77030 - Houston/US
  • 5Medical Oncology, Ospedali Galliera, IT-16125 - Genova/IT
  • 6Division Of Radiology, Istituto Europeo di Oncologia, Milan/IT
  • 7Division Of Epidemiology And Biostatistics, Istituto Europeo di Oncologia, 20141 - Milan/IT
  • 8Division Of Cancer Prevention And Genetics, European Institute of Oncology, 20141 - Milan/IT



After treatment with inhaled budesonide for 1 year, non-solid and partially solid lung nodules detected by low-dose computed tomography (LDCT) and not immediately suspicious for lung cancer, tended to regress in a randomized phase IIb, placebo-controlled trial, nested in the COSMOS lung cancer screening study. Because some of these nodules may be slow-growing adenocarcinoma precursors, we evaluated long-term outcomes by annual LDCT.


We analyzed the evolution of target trial nodules detected by LDCT in the budesonide and placebo arms up to five years after randomization. The numbers and characteristics of lung cancers diagnosed during follow up were also analyzed.


The mean diameter of non-solid nodules reduced significantly (2.42 mm reduction in five years) in the budesonide arm; there was no significant size change in the placebo arm. The mean diameter of partially solid lesions also decreased significantly, but only by 0.69 mm. The size of solid nodules did not change. Neither the number of new lesions nor number of lung cancers differed in the two arms.


Inhaled budesonide given for one year significantly decreased the size of non-solid nodules detected by screening LDCT after five years. This is of potential importance since some of these nodules may progress slowly to adenocarcinoma, however further studies are required to assess clinical implications.


All authors have declared no conflicts of interest.