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Revisiting KRAS Mutations in Lung Cancer

July 31, 2008 - 9:23 pm

    More than a year ago, I wrote an introductory post about mutations in KRAS, one of the genes that contributes significantly to cancer cell growth and signalling, at least in many cancers.   It’s seen in around 20% of lung cancers, almost always in adenocarcinomas and not squamous NSCLC, and it’s been implicated as being […]

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A Role for Non-Platinum Doublets in Treating NSCLC?

July 29, 2008 - 5:03 am

   Someone recently asked a question about a recommendation she had received about being treated with a first-line combination of gemzar (gemcitabine) and navelbine (vinorelbine), because we have focused so much on doublets of either cisplatin or carboplatin with a newer drug like taxol (paclitaxel), taxotere (docetaxel), gemzar, navelbine, or most recently possibly alimta (pemetrexed).  […]

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New Test to Discriminate Squamous from Non-Squamous Lung Cancer: Great, But Is It Worth $3000?

July 22, 2008 - 9:31 pm

   Rosetta Genomics today issued a press release that described their new test that received regulatory approval in New York state as a method of discriminating whether a lung cancer is squamous or non-squamous cancer.  Rosetta Genomics is based in Israel, and this particular test was developed in collaboration with researchers at Columbia University Medical […]

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Circulating Tumor Cells from Lung Cancer as a Window into the Tumor: Important Proofs of Principle Published in NEJM

July 21, 2008 - 3:37 pm

   In a recent issue of the New England Journal of Medicine, a research group from Massachusetts General Hospital in Boston published some very promising results from their work showing that they can now detect circulating tumor cells (CTCs) from most patients with lung cancer and even detect EGFR mutations and other molecular findings from […]

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Gene Signature Work: The Polish Experience

July 19, 2008 - 9:23 am

   Continuing on the subject from my last post of gene signatures to predict clinical behavior, another ASCO presentation came from Poland (abstract here), with the goal of validating a couple of different kinds of gene signatures that have been presented before. One, from a group in Taiwan, was with just 5 genes and had […]

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Gene Signatures to Predict Benefit from Adjuvant Chemo

July 17, 2008 - 7:11 pm

  I had described earlier this week (prior post here) how the long-term follow up of one of the more important adjuvant chemotherapy trials for early stage resected NSCLC patients showed that there may be long-term adverse effects of chemotherapy.  My last post also suggested that the benefit of pre-operative chemotherapy in another trial appeared […]

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More Work with Neoadjuvant (Pre-Op) Chemotherapy: The SWOG Experience

July 15, 2008 - 5:29 am

   In my last post I described the results of the ChEST trial that showed a borderline statistically significant improvement in survival of patients who received cisplatin/gemcitabine chemotherapy for stage IB to IIIA NSCLC prior to surgery.  This study was very similar to another neoadjuvant chemotherapy trial, known as SWOG 9900, which also randomized patients […]

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Pre-Operative Chemotherapy as an Alternative to Post-Operative Chemo: Evidence of Stage-Dependent Survival Benefit

July 13, 2008 - 8:08 am

  In contrast with post-operative chemotherapy, which has become a standard treatment approach to reduce the probability of recurrence of resected stage II and IIIA NSCLC (still pretty controversial for stage IB), pre-operative chemotherapy (also known as neoadjuvant, or induction chemotherapy) is less well studied and isn’t a typical approach.  However, a recent study called ChEST, the […]

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Long-Term Risk with Adjuvant Chemo

July 11, 2008 - 7:07 pm

   Over the past few years, the role of post-operative, also known as adjuvant, chemo has become increasingly accepted as a standard of care.  Several trials have shown an improvement in survival at about 5 years that is in the 5-15% range for recipients of chemo.  However, the evidence indicates that the people at higher […]

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SCLC with Pleural Effusions: Is there Benefit to Adding Radiation?

July 9, 2008 - 10:32 pm

   In my earliest introductory post about SCLC, I described the typical staging breakdown used clinically, which is essentially divided into limited disease SCLC (LD-SCLC), which is typically treated with chemo and chest radiation together, with curative intent, and extensive disease SCLC (ED-SCLC), which is typically treated with chemo alone and is not considered conventionally curable.  But […]

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