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Clinical Trial Focus: SWOG 0526, Alimta in Advanced BAC

December 10, 2006 - 6:39 pm

   As I mentioned in a previous post, we have very little direct evidence of how chemo performs in advanced BAC, although it is generally perceived to be less effective in BAC than in other types of NSCLC.  The only trials that uniformly treated BAC patients with chemo used taxol (abstract by Scagliotti here, mine […]

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Targeted Therapy for Selected Populations in NSCLC

December 9, 2006 - 4:11 pm

   In my last post, I described the somewhat disappointing results for tarceva compared with chemotherapy in a trial of unselected advanced NSCLC patients with a marginal performance status.  However, EGFR tyrosine kinase inhibitors like iressa and tarceva were developed as targeted therapies, so perhaps they might prove to be more effective if used selectively, in a targeted population.  That […]

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Targeted Therapy in Older and Sicker Patients: A Replacement for Chemo?

December 8, 2006 - 6:21 pm

   The emergence of targeted therapies provides a goal of treating the cancer more selectively, thereby minimizing side effects, while hopefully achieving results as good as or better than standard chemotherapy.  Although this is important in the entire population of cancer patients, this is a particularly welcome benefit in patients who may be reluctant to […]

2 Comments

Does Age Matter? Treating Older Patients with Advanced NSCLC

December 7, 2006 - 2:06 pm

  We know far too little about the best way to treat older patients with NSCLC, that lung cancer, like many other cancers, is a disease highly related to advanced age.  First, how do we define an older, or elderly, population in cancer treatment terms?  Beyond the joke that it increases as the person answering gets older, […]

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The Risk of Overtreating Indolent Bronchioloalveolar Carcinoma

December 6, 2006 - 12:15 am

   Bronchioloalveolar carcinoma, or BAC, is a subtype of lung adenocarcinoma that has a tendency to progress more slowly, stage for stage, than other types of lung cancer.  There are many patients who experience symptomatic and significant progression over months, and rarely patients have a very aggressive and fulminant form of the disease.  However, many […]

25 Comments

Prophylactic Cranial Irradiation for SCLC

December 2, 2006 - 4:12 pm

   Prophylactic cranial irradiation, or PCI, for SCLC, usually limited disease (LD-SCLC), remains a controversial issue, although this is generally recommended for patients with LD-SCLC who have a complete response to treatment (no evidence of disease).   However, the idea of radiating the brain of someone who has no evidence of cancer there and may never […]

14 Comments

Current Standards of Care for Limited Disease SCLC

December 1, 2006 - 4:32 pm

  While SCLC accounts for only about 13% of lung cancer, and only approximately one third of patients with SCLC have limited disease SCLC (LD-SCLC), this remains a high stakes area with the potential for being cured, so it needs to be treated as optimally as possible.  I’m going to give a brief history and highlight […]

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