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Chemo Combinations for Advanced NSCLC: A Regimen of Choice, or a Choice of Regimens?

January 16, 2007 - 12:09 am

   We’ve come along way over the past decade.  In the first half of the 1990s, the value of treating metastatic NSCLC was debated and not clear.  A “meta-analysis” that pooled the results from 11 chemotherapy trials, 8 with cisplatin, and nearly 1200 patients demonstrated a modest but convincing improvement in survival compared to supportive care alone […]

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Early Disease Control: More Predictive of Clinical Benefit than Response

January 14, 2007 - 12:08 pm

   In my last post, I described our evolving recognition in the lung cancer field that significant response as the threshold for clinical benefit is too high and that stable disease is likely a relative benefit as well.  An important trial presented by Dr. Lara at UC Davis at ASCO (our biggest cancer meeting) in June, 2006 (abstract here) highlighted not […]

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Treatment of Recurrent SCLC: Evidence for Survival Benefit

January 7, 2007 - 4:31 pm

   As I mentioned in my introduction to the topic, SCLC is typically sensitive to chemo and radiation initially, but it tends to be considerably less responsive after recurrence.  Unfortunately, most SCLC patients, or about 75-80% of patients with LD-SCLC and nearly 100% of patients with ED-SCLC , do subsequently recur.   One key theme is that the longer […]

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The Future of the Field: “Molecular Epidemiology” and SWOG Trial 0424

January 3, 2007 - 4:51 pm

   It’s only been in the past few years that we have begun to appreciate that there may be many different subgroups of patients who fit within the broader lung cancer population.  We now have begun to see differences in the safety and/or activity of certain drugs in never-smokers vs. smokers, patients with adenocarcinomas (and especially […]

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Mediastinal N2 Lymph Nodes after Induction Therapy as a Key Predictor of Outcome

January 1, 2007 - 7:47 pm

     For patients with locally advanced NSCLC, the question of whether to pursue a surgical or a non-surgical approach has a great deal to do with the extent of mediastinal (middle of the chest) lymph node involvement.  The mediastinal nodes are shown here:
 (click to enlarge)
First, at the time of initial staging, patients with bulky (>3 cm) […]

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