Second Line NSCLC: Avastin/Tarceva Improves Progression-Free but Not Overall Survival vs. Tarceva

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 […]

Carbo/Alimta: Poised to Become a Popular First Line Doublet in NSCLC

With 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 […]

Survival Results Presented for European AVAiL Trial of Chemo/Avastin: All Arms with Median Survival Beyond a Year

   Last 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 […]

Iressa vs. Standard Chemo in Asian Never- or Light Ex-Smokers: Results of the IPASS Trial

     The European Society for Medical Oncology (ESMO) Congress, similar to ASCO but based in Europe, has been going on in Stockholm, where the results of a study called the First Line Iressa versus Carboplatin/Paclitaxel in Asia Study (taking some liberties to force it into the acronym ”IPASS”) was presented in the Presidential Symposium by my friend […]

Just another negative trial, or a worrisome trend?

Last week, the preliminary results of interim analysis the ESCAPE (Evaluation of Sorafenib, Carboplatin, And Paclitaxel Efficacy in NSCLC) trial were presented by Dr. Scagliotti at the 1st IASLC (International Association for the Study of Lung Cancer)-ESMO (Eurpean Society for Medical Oncology) Lung Cancer Conference in Geneva, Switzerland. This was a randomized, placebo-controlled, double-blind phase […]

Cavitation of Lung Tumors on Anti-Angiogenic Agents

   Tumor cavitation has been one of the issues we really haven’t discussed but that has been a challenging question as we test more and more anti-angiogenic drugs, which target the tumor blood supply, in the setting of lung cancer.   Since we started testing these agents, we’ve noticed that in addition to sometimes increasing the […]

Can Patients on Blood Thinners Safely Receive Avastin?

   Because the anti-angiogenic drug avastin (bevacizumab) has been associated with some degree of increased risk of bleeding since the beginning of its development in lung cancer, the key trials have historically excluded patients who have been on blood thinners, at least at the standard dose (full dose anti-coagulation, or FDAC).  In fact, though, patients […]

AVAiL Trial Negative for Overall Survival Benefit

   We got some big news in the form of a press release today: avastin (bevacizumab) didn’t produce a survival benefit in the European AVAiL (AVAstin in Lung Cancer) trial of cisplatin/gemcitabine with or without avastin at either a higher dose (15 mg/kg IV every three weeks) or a lower dose (7.5 mg/kg IV every three weeks):

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Use of Avastin (Bevacizumab) in Patients with Brain Metastases

   Since the anti-angiogenic agent avastin (bevacizumab) has been shown to confer a survival benefit in a subset of patients with previously untreated advanced NSCLC (see prior post), we have been struggling with questions of whether the restricted eligibility requirements in the pivotal initial avastin trial were necessary.  Specifically, the trial, called ECOG 4599 (abstract […]

Clinical Trials with Sutent (Sunitinib) in NSCLC

   One of the novel agents being studied in lung cancer is sutent (sunitinib), a multi-targeted oral anti-angiogenic drug that I’ve described in a prior post.  While I’ve mentioned a small study I’m leading at my own institution with this agent in advanced NSCLC patients with bronchioloalvelar carcinoma (BAC) or who have never smoked (information […]