Lung Cancer / Mesothelioma
Over the last several years, chemotherapy after surgery has become the standard strategy for improving survival compared to surgery alone, at least for stage II and IIIA patients who don’t have mediastinal (N2) lymph nodes involved, and it’s often used also for patients with stage IB NSCLC (no lymph nodes, but a larger tumor […]
0 CommentsSmall cell lung cancer (SCLC) has been a very challenging disease for patients and physicians, and unfortunately one in which our improvements in treatment have been few and far between. In fact, a recent educational session at ASCO was titled “Small Cell Lung Cancer: What’s New Since 1978?”. The decreasing frequency of SCLC has […]
5 CommentsI briefly mentioned the potential value of surgery for a solitary brain metastasis, where it is commonly used, in another post. Today I’ll talk more specifically about where the role for surgery has been specifically tested for brain metastases in lung cancer. Aside from possibly removing the only lesion (in certain cases, where it can […]
5 CommentsA novel agent called motexafin gadolinium (MGd), with a marketed name of Xcytrin, has been studied as a potential neuroprotectant as well as radiosensitizer that may allow patients with brain metastases to do better when it as added to whole brain radiation therapy (WBRT) than they would with WBRT alone. It is a molecule […]
2 CommentsBefore turning back to brain metastases, I wanted to cover a topic that has generated some recent questions, and that is the issue of potential interactions of tarceva with food and other drugs. Just as an introduction, the standard dose of single-agent tarceva in lung cancer is 150 mg by mouth daily, and this […]
7 CommentsCarlos, one of the many members here who has several insightful comments and questions, e-mailed me to say that he was having trouble entering a comment in response to a recent post (on Xyotax). We’re trying to fix the problem (and when I say we, I mean the technical guys who are helping me to […]
2 CommentsCelecoxib (Celebrex) has been studied in combination with chemo for NSCLC and has generated enough promising results to raise expectations but also enough negative data to produce disappointment. Dr. Altorki’s trial (abstract here) gave 29 patients with stage IIIA, resectable NSCLC celebrex at 400 mg by mouth twice daily (higher than standard arthritis dosing, but the dose […]
2 Comments We’ll break from brain metastases for a while to talk about another potential avenue of targeted therapy in lung cancer: the cyclo-oxygenase, or COX, pathway.
Cyclo-oxygenase (COX) inhibition has been studied as a potential mechanism for inhibiting cancer over the past few years, and recently some early clinical trial results have looked promising and […]
We’ll cover the general management principles for the more typical situation of patients with multiple brain metastases from lung cancer soon, but today we’ll cover the special situation of the patient who has a brain metastasis identified as the ONLY area of metastatic disease (generally referring to NSCLC, since SCLC has such a high tendency […]
21 CommentsWhile brain metastases are common, some patients seem to be at higher risk than others. As previously noted, SCLC has a very high risk of spread to the brain. For NSCLC subtypes, several studies have shown that patients with non-squamous lung cancers have a greater tendency to develop brain metastases than those with squamous cancers, which […]
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