Lung Cancer / Mesothelioma
To begin with, my overall impression is that the preponderance of evidence on adjuvant (post-operative) chemotherapy supports that it can reduce the recurrence risk and improve the survival at five years, which I’d presume to be pretty close to the “cure rate”. The benefit isn’t uniformly distributed for all patients: higher risk patients, […]
0 CommentsWe’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 […]
15 CommentsAs 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 […]
0 CommentsIn 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 […]
0 CommentsSomeone 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). […]
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 CommentsIn my last post I described the results of the ChEST trial that showed a borderline statistically significant improvement in survival of patients who received cisplatin/gemcitabine chemotherapy for stage IB to IIIA NSCLC prior to surgery. This study was very similar to another neoadjuvant chemotherapy trial, known as SWOG 9900, which also randomized patients […]
0 CommentsIn contrast with post-operative chemotherapy, which has become a standard treatment approach to reduce the probability of recurrence of resected stage II and IIIA NSCLC (still pretty controversial for stage IB), pre-operative chemotherapy (also known as neoadjuvant, or induction chemotherapy) is less well studied and isn’t a typical approach. However, a recent study called ChEST, the […]
0 CommentsOver the past few years, the role of post-operative, also known as adjuvant, chemo has become increasingly accepted as a standard of care. Several trials have shown an improvement in survival at about 5 years that is in the 5-15% range for recipients of chemo. However, the evidence indicates that the people at higher […]
0 CommentsAs a follow-up to my last post on the appeal of developing new regimens for combining with radiation in treatment of locally advanced unresectable NSCLC, I wanted to highlight work being done by the Cancer and Leukemia Group B (CALBG), one of the major cancer cooperative research groups in the US. As I mentioned […]
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