Genetic Differences in Never-Smoker Lung Cancer

   As I’ve mentioned in some prior posts, there is increasing recognition that lung cancer in never-smokers may be a different disease.  Some of this has been defined by working backward from treatment results, where we’ve seen that never-smokers are consistently among the greatest beneficiaries of EGFR inhibitor therapies like Iressa or Tarceva.  But there […]

Beyond Stage & Tumor Size: More Pathology Variables Associated with Risk of Recurrence after Surgery

   The decision about pursuing post-operative treatment is often difficult and requires carefully weighing the risks of treatment with potentially challenging and even dangerous chemotherapy against the potential to eradicate micrometastases and actually lead some people to be cured who otherwise wouldn’t be.  It’s important to remember that some people are already cured, while others won’t be […]

Making Sense of the “JMDB” Trial

   In my recent post on the JMDB trial that randomized patients between cisplatin/alimta and cisplatin gemcitabine in first line treatment of advanced NSCLC, the take home conclusions were that overall efficacy was very similar, with the cis/alimta arm looking a little better in several side effect parameters, most notably a less significant decline in […]

“JMDB” Trial Indicates Tailored Chemo Approach for Different NSCLC Subtypes May Improve Survival

Biologic and Molecular Correlates of Clinical Benefit in French Trial of Iressa in BAC

   The study I was just discussing, the French trial of Iressa at 250 mg daily for advanced BAC (abstract here), provided interesting clinical information, especially when viewed in the context of previous work on EGFR inhibitors in BAC.  But in 2007 we’re also interested in the next generation of questions, including trying to identify which patients are […]

France Weighs in on EGFR Inhibitor Therapy for BAC; Mucinous vs. Non-Mucinous BAC

   I reviewed a couple of presentations on bronchioloalveolar carcinoma (BAC) at ASCO 2007, including one by Cadranal and colleagues in which patients with advanced BAC received single agent Iressa (abstract here).  This study enrolled 88 eligible previously untreated patients with advanced BAC or adenocarcinoma with BAC features, about 55% women/45% men (typical for BAC trials to […]

The Variability of Bronchioloalveolar Carcinoma (BAC): Non-Mucinous and Mucinous BAC

  One of the themes that we’ve covered in some of the posts introducing the clinical entity of BAC is the variability in its natural history.  In fact, much of what we’ve been learning about BAC has been in the last several years, and we’re still learning more about it all the time.  One of […]

Large Cell Neuroendocrine Carcinomas as a Unique NSCLC Population

  In most of the history of lung cancer management, we have been “lumpers” rather than “splitters”, tossing together many different kinds of lung cancer together and presuming that they all respond similarly and should be treated similarly.  After decades of primarily focusing just on whether a lung cancer was SCLC or NSCLC, with drugs like avastin, it’s […]

Does Tumor Grade Matter in NSCLC?

   Historically, the main task of pathologists in lung cancer has been to divide them into small cell lung cancer and non-small cell lung cancer.  Beyond that, there is now more of an emphasis than there used to be on trying to clarify whether a NSCLC tumor is a squamous cell carcinoma, adenocarcinoma, large cell, […]

Individualizing Treatment Recommendations in Lung Cancer: Who to Treat?

   I’m just coming from a meeting on Targeted Therapies in the Treatment of Lung Cancer, which had the interesting format of dozens of 5-minute presentations just introducing or giving a very brief update of many new therapies.  Some of these, such as the EGFR monoclonal antibody Erbitux (cetixumab), which I spoke on, have been […]