Lung Cancer / Mesothelioma
The general approach to NSCLC is in transition right now, as the line between first and second line therapy are becoming increasingly blurred. A few years ago, the clear standard was that we usually stop first line chemo after four to six cycles, then follow a patient clinically and radiographically until they show evidence […]
6 Comments Warning: this symptom can be a little gross, so the delicate flowers out there should skip this post.
One of the more unusual but quite vexxing symptoms we sometimes see in lung cancer is called bronchorrhea, which is the copious production of watery sputum, specifically at least 100 ml per day. […]
One of the central ideas in medical oncology is that if you have two or more anticancer treatments that are active, you test them together to determine whether it’s safe and whether the combination works better than each individually. We’ve been doing this with chemotherapy combinations for decades, but it’s […]
11 CommentsWith last week’s FDA approval of alimta in the first line setting for NSCLC, we’re likely to see a lot of alimta (pemetrexed) use shift from the second and third line setting to first line. Alimta’s been a very popular choice for previously treated patients, based on issues like the relatively […]
4 CommentsYesterday, as described in a press release, the FDA approved the regimen of cisplatin and alimta as a first line therapy for advanced NSCLC, based on the positive results from a trial called “JMDB” by the sponsor company (Eli Lilly). I described the highlights in a prior post, also recently published (abstract here). It compared cisplatin/gemcitabine to […]
0 CommentsThere are two widely tested epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) — iressa (gefitinib) and tarceva (erlotinib). As discussed in my summary of their history (posts here and here), iressa was the first out of the gates, but it failed to demonstrate a significant survival benefit compared with […]
0 CommentsThe treatment of relapsed SCLC isn’t especially controversial, because this is an area where there aren’t enough breakthroughs. In someone fit enough to perform their own activities of daily living and getting out of the house, the main question is how long it has been since they completed their first line treatment. Although some […]
2 CommentsLast week, updated information on the AVAiL (AVAstin in Lung cancer) trial (see prior post) of cisplatin/gemcitabine with either placebo or a low or higher (full) dose of avastin was presented in a meeting in Stockholm. We had previously heard that this trial was positive for a significant improvement in progression-free survival for both the […]
0 CommentsOver the past several weeks, coincident with the opening of a new large clinical trial and some publicity associated with that, several people have asked me here about a lung cancer vaccine called Lucanix (full name belagenpumatucel-L, so a near guarantee that nobody will call this anything but Lucanix). My initial […]
4 CommentsOne of the topics that frequently occurs in the clinic, and that patients often ask about, is the situation in which there is some suggestion of slight progression. This can take the form of many different situations: a rising tumor marker (see prior post), a slight increase in the uptake on PET (see prior […]
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