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What I Really Do: Advanced Lung Cancer in Never-Smokers (LCINS)

August 25, 2008 - 7:33 pm

  We’re recognizing more and more that lung cancer in never-smokers (LCINS) is a distinct disease, with different patterns of who gets it, how the cancer behaves, and it responds  to treatments.  But this recognition is still a work in progress, coming from a background in which the party line has been that NSCLC is […]

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What I Really Do: First Line Treatment for Avastin Ineligible Patients

August 23, 2008 - 8:52 am

   As I mentioned in another post, one of the first branch points in the decision tree about what I recommend as treatment for fit patients with previously untreated advanced NSCLC is the question of eligibility for avastin.   Although I do routinely recommend avastin for eligible patients, they aren’t the majority; instead, I would estimate that population ineligible for avastin due […]

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What I Really Do: First Line Advanced NSCLC, Avastin Eligible Patients

August 22, 2008 - 7:14 pm

   As I described in a recent post introducing the concept of the series, “What I really do”, I wanted to provide a summary of how interpret the evidence I show here, how I really approach real life patients.    Some of this will illustrate that the experts don’t agree 100%, and that we all add […]

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Breath Test for Detecting Lung Cancer Under Study, Looking Promising

August 17, 2008 - 9:05 pm

   Some members had previously asked about a breath test to detect lung cancer, and at the time I was not familiar with this work.  But research has been ongoing with a new test designed by Menssana Research to detect lung cancer (LC) by noting a pattern of volatile organic compounds (VOCs), essentially chemicals in […]

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Actions Speak Louder than Words: When Pathology and the Clinical Picture Don’t Fit

August 13, 2008 - 7:54 pm

   I’ve been involved in a wide range of discussions, both here and in my own clinical, about the fairly common situation of how to approach a situation in which the story on paper and what you see actually happening are incompatible.  For instance, last week I and several of my colleagues participated in a […]

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What follow up should patients have after surgery for early lung cancer?

August 10, 2008 - 8:12 am

   This is my first post on this wonderful site.
   Recently I saw a patient who had undergone surgery for stage II Non-Small Cell Lung Cancer and was receiving chemotherapy with another cancer doctor. He came to me for a second opinion. Among the questions he had was what tests should he get after completing all his […]

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Insulin-Like Growth Factor Receptor-1 Inhibitor Continues to Look Favorable in Squamous Cell NSCLC

August 6, 2008 - 9:19 pm

   One of the abstracts in lung cancer that I noted as being particularly noteworthy before ASCO 2008, but which I haven’t managed to mention since, is a trial of a monoclonal antibody known as CP-751,871 that targets and inhibits insulin-like growth factor receptor-1(IGF-1R), a molecule that appears to be involved with cell growth, balance […]

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Japanese Study Demonstrates Elderly Patients Benefit from Post-Operative Chemo

August 4, 2008 - 8:30 pm

    In Japan, a different chemotherapy approach than cisplatin doublet chemo has been used in the post-operative setting.  In contrast to the North American and European approach of 3-4 cycles of platinum-based chemo, in Japan they have studied an oral chemotherapy called UFT, a combination of uracil and tegafur.  This combination is in the same […]

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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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