Lung Cancer / Mesothelioma
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 […]
0 CommentsContinuing 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 […]
3 CommentsI 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 […]
0 CommentsGetting back to the issue of differences in side effects and efficacy of treatments based on differences in individuals and populations, let’s continue the story of how different populations appear to have significant differences in how the do on the same treatment regimen. In a recent prior post I described the SWOG-Japanese research collaboration […]
0 CommentsThe issue of population-based differences in response to lung cancer treatments was essentially introduced with the EGFR inhibitors, so it’s appropriate to introduce racial differences overall with this work. Mention of more favorable results with EGFR inhibitors iressa and tarceva emerged with the earliest clinical studies and have since become a well established truism. […]
2 CommentsInfused throughout the website is a constant recognition that “patients are different”, but while we know this intuitively, we’re really not moved to a point of individualizing treatment on the basis of this. There are many lines of clinical research that are moving in that direction, and one of the key elements is pharmacogenomics, […]
2 CommentsAs I described in my prior post, the marker ERCC1 (excision-repair cross complementing group 1) is a prognostic variable that is associated with a more favorable survival in patients who aren’t treated with chemo after surgery for early stage NSCLC. But this marker also appears to be predictive of resistance to cisplatin and a worse survival […]
0 CommentsAlthough I’ve described this concept in a few posts over the past year, it’s time for me to dedicate some real discussion to the concept of individualizing treatment with the ERCC1 marker. ERCC1 stands for excision repair cross-complementing group 1, and it helps repair damage to DNA. Now, validated, reliable testing for ERCC1 in […]
6 CommentsWe’ve discussed various ways of predicting outcomes with EGFR inhibitors like Tarceva or Iressa using clinical variables like smoking status or BAC subtype, as well as molecular markers like EGFR mutations, or EGFR gene amplification or protein expression. These can all be of value, but we know that the clinical markers are quite inexact, […]
7 Comments One of the central ideas in management of advanced NSCLC is that many two-drug chemo combinations have been compared and show essentially superimposable results, as I described in a prior post.
(click to enlarge)
Perhaps we’re underachieving by using a “one size fits all” approach, getting everyone to a middle ground that falls short of what we might do […]
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