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Fotolyn (Pralatrexate) Chemotherapy Beats Tarceva on Survival as Second Line Therapy in Smokers

July 28, 2010 - 2:50 pm

   It’s been two and a half years since I described a phase IIB trial of Fotolyn (pralatrexate), a relatively new chemotherapy agent, being compared to Tarceva (erlotinib) in current or ex-smokers with previously treated advanced NSCLC.  The new drug, Fotolyn, is described in a prior post, and it has since been approved by the FDA [...]

6 Comments

Post-ASCO Discussion of the BR.19 Trial

July 25, 2010 - 10:04 pm

Here’s the first of a series of posts on key presentations on lung cancer from ASCO 2010, as reviewed by myself and Dr. Nate Pennell of our faculty here several weeks ago.
The first topic we covered was the very interesting if troubling Canadian BR.19 trial of post-operative Iressa (gefitinib) vs. placebo, as summarized by Dr. [...]

3 Comments

Physician Researcher Discredited, Potential Implications for Lung Cancer Research

July 22, 2010 - 11:03 am

Lest we think that media-driven self-immolation is reserved only for people Like Mel Gibson and Lindsey Lohan, this week we saw a little more drama than we prefer to see in the world of medical research, touching quite close to home.  Following a rather stunning article in the low budget but tenacious Cancer Letter (primarily [...]

7 Comments

SAIL Study Reviews Safety of Avastin in Lung Cancer Among >2000 Patients: Few Surprises (Fortunately)

July 20, 2010 - 4:01 pm

This morning, Joe provided a link to a story about the Safety of Avastin in Lung cancer (SAiL) study, which is just being published in Lancet Oncology.  This is not really a new, original study, but rather a post-approval commitment from Roche to generate a registry of real-life experience using the anti-angiogenic agent Avastin (bevacizumab) [...]

3 Comments

The Work We Still Need to Do

July 16, 2010 - 2:59 pm

I just gave a continuing medical education talk to a group of general physicians at an out of town community hospital, and in that process I stepped out of my bubble.  Spending most of my life working with cancer patients, oncologists, and other physicians at my own tertiary hospital, I primarily encounter people who share [...]

14 Comments

Basics of Bronchioloalveolar Carcinoma (BAC)

July 9, 2010 - 3:37 pm

Bronchioloalveolar carcinoma, or BAC,  is a unique subtype of non-small cell lung cancer (NSCLC) that has unique features in terms of the demographics of who gets it, how it appears on scans, how it often behaves, and potentially in how it responds to treatment.  It is a subset of lung cancer for which most of [...]

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NATCH: Good Question, Bad Trial

July 7, 2010 - 10:31 pm

As I mentioned in my last post on the recent results on pre-operative (neoadjuvant) chemotherapy, the results of this work failed to achieve statistical significance but did appear to be associated with a degree of benefit comparable to the magnitude of benefit seen with post-operative (adjuvant)  chemotherapy, but the neoadjuvant trials were smaller and therefore [...]

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ASCO Update on Pre-Operative Chemotherapy

July 6, 2010 - 10:54 pm

Post-operative, also known as adjuvant chemotherapy, is the established method for delivering systemic therapy to improve long-term outcomes beyond what surgery alone can deliver.  An alternative approach, though, is to give treatment prior to surgery.  This gives the potential advantage of treating potential micrometastatic disease at the earliest opportunity, identifying the response to treatment given [...]

3 Comments

Case Discussion with Dr. Nasser Hanna: Managing Extensive Stage Small Cell Lung Cancer

July 4, 2010 - 1:21 pm

Here is the last case I discussed several months ago with Dr. Nasser Hanna, lung cancer expert at Indiana University.  After two cases that included never or light former smokers, which he joked that I saw far more of than he did, we changed direction to cover current issues in managing extensive stage small cell [...]

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Changing Clinical Practice: The Evidence that Convinced Me Many People with Advanced NSCLC Should Have Up Front Molecular Testing

July 2, 2010 - 3:08 pm

   The question of which patients to test for an EGFR mutation, and when, has become one of the most timely and rapidly changing ones in lung cancer.  The IPASS trial was a landmark study that definitively illustrated that molecular testing overshadows clinical selection for EGFR tyrosine kinase inhibitor (TKI)-based therapy, demonstrating that the 60% of [...]

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