GRACE :: Lung Cancer

2011 Highlights in Lung Cancer, by Dr. Jared Weiss, Part 1: The EGFR Axis

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Apologies for the long wait since our own Dr. Weiss’s upbeat and thoughtful review of the leading stories about lung cancer in 2011.  Dr. Weiss covered a lot of ground in his presentation that was followed by a Q&A session, so we’ve broken that up into several short pieces that cover a few highlights at a time.  In fact, we’re going to make an effort to have podcasts shorter and easier to digest in the future.  

The first part is on EGFR-based therapies, including the EURTAC trial of the EGFR tyrosine kinase inhibitor (TKI) Tarceva (erlotinib) vs. standard doublet chemo in a European, EGFR mutation-positive patient population, followed by work on EGFR TKI/monoclonal antibody combinations: one being the single arm afatinib/Erbitux (cetuximab) for patients with acquired resistance after a good response to earlier EGFR TKI therapy, and the second being Tarceva with either the c-MET antibody MET-MAb or placebo.  

Here’s the audio and video versions of the podcast, along with the transcript and figures for this portion of the program. 

Dr. Weiss Lung Cancer Highlights 2011 Pt 1 EGFR Axis Audio Podcast

Dr. Weiss Lung Cancer Highlights  2011 Pt 1 EGFR Axis Transcript

Dr. Weiss Lung Cancer Highlights 2011 Pt 1 EGFR Axis Figs

We’ll be putting out more pieces of this every few day or two, so look for the next part very soon.  Thanks to Dr. Weiss, and also to LUNGevity Foundation for partnering with us to make this program possible.

8 Responses to 2011 Highlights in Lung Cancer, by Dr. Jared Weiss, Part 1: The EGFR Axis

  • certain spring says:

    Thank you, Dr Weiss. Could I ask a couple of questions? though I realise that some of them may be answered in future instalments.
    With the MetMab trial, was the overall trial population = patients who had progressed on Tarceva?
    With the afatinib/cetuximab trial, are there any preliminary hypotheses as to why we are seeing such variations in how people are faring? Might the dog actually be chasing the wrong rabbit, ie some patients on the trial might have another kind of acquired resistance, not yet identified, that is driving their progression?
    My inner sub-editor requires me to point out that there’s a glitch on p. 3 of the transcript (“best of conference”). I am looking forward to the next episode!

  • certain spring says:

    Just to add that I think this must be the Phase III MetMab trial to which Dr Weiss refers:

  • Dr West says:

    I’ll ask Dr. Weiss to comment, but I can tell you that in the phase II MetMAb trial, this was an EGFR TKI-naive population, not people who had progressed on Tarceva (erlotinib), except that patients assigned to the Tarceva alone arm could cross over to the combination (and 3 of the approximately 20 who did cross over to the combination did subsequently show a response).

    With the afatinib/cetuximab combination, it’s a little too early to draw conclusions about who is responding and how long. So I don’t think it’s possible to make many hypotheses until we get a clearer signal of who’s doing what. The authors had hypothesized based on lab-based work that the combination would work for patients with a T790M mutation as the mechanisms for acquired resistance, though they didn’t restrict the trial to such patients, and they actually found no clear association of responsiveness to the combination with T790M status.

    -Dr. West

  • Dr West says:

    Also, I see the transcript and heard the passage and don’t think there’s a glitch. Dr. Weiss was saying “best of conference” as you’d speak of a dog as “best of show”. Are you speaking of something else I’m missing?

    -Dr. West

  • certain spring says:

    Thank you, Dr West – that makes sense as this new MetMab trial, cited above, actually excludes anyone who’s been treated with a TKI.
    Clearly I don’t go to enough dog shows! Looking forward to the next instalment.

  • Dr. Weiss says:

    Dr. West captures my thoughts exactly, although I apologize both to him and to certain spring that he had to respond for me–I need to monitor these boards more carefully.

    When we talk about overcoming resistance, we mostly talk about using tarceva until the cancer starts growing again, then trying to do something new to overcome the resistance. But an alternative approach is to address the resistance up front. The basic idea would be to give a drug or combination of drugs that take longer for the cancer to overcome or do something to help knock down resistant cells up front. The metmab trial is an example of this approach.

  • catdander says:

    Dr. Weiss, I caught most of the presentation originally and did not have a chance to comment at that time as I was just arriving to do yoga. Thank you for the overview. Mostly Congratuations Jared on your engagement what a lucky woman she is and I’ll assume you too are as lucky finding her. I’m not sure this fits after a sir name or given name address but Jared Weiss…the song…the song was adorable. Thank you for sharing yourself with us.

  • Dr. Weiss says:

    Thanks–my pleasure. I don’t think that I’m going to quit my day job in favor of lounge singing, though.

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