Lung Cancer / Mesothelioma
Well, it happened again that the first word came from the financial community (report here), as we learned today that a large trial testing the value of maintenance tarceva (erlotinib), the oral EGFR inhibitor, provides a significant improvement in progression-free survival (PFS). In the following slide, I show the design for two similar trials […]
4 CommentsI just recently wrote a post (here) that describes how I became convinced that under certain circumstances there could be a genuine value in determining whether a particular lung cancer patient has a tumor with an EGFR activating mutation. While these have seemed to predict that these patients are quite likely to respond with […]
0 CommentsThose who have followed my writings over time will know that I haven’t been inclined to adopt a reflexive strategy of ordering molecular testing without good evidence that having this information will improve outcomes. Testing tumors for EGFR mutations is advocated by a vocal minority of lung cancer experts in Boston and New York […]
2 CommentsThough EGFR inhibitors like tarceva can produce some terrific and long-lasting results in many patients, they aren’t toxicity-free. The “targeted therapies” we use just have a very different side effect profile from standard chemo, and the EGFR inhibitors are well known to have skin-related side effects as the leading problem, with loose stools/diarrhea as […]
3 CommentsAn interesting trial presented at ASCO 2008 came out of Japan, asking the question of whether there is an advantage to continuing first line platinum-based doublet chemo for up to six cycles or whether it might be better to give just three cycles and then switch from chemo right to the EGFR […]
0 CommentsOne 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 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 CommentsAnother lung cancer trial that received a good deal of attention at the recent European Society for Medical Oncology (ESMO) conference in Stockholm this past week was conducted by the Spanish Lung Cancer Group and led by Dr. Rafael Rosell, who is chief of medical oncology at Catalan Institute of Oncology in Barcelona and […]
0 CommentsThe 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 […]
0 CommentsI doubt there is a group of lung cancer patients more common but less well studied than the substantial subset of frail and/or very elderly patients with advanced NSCLC. While “elderly” patients, usually defined as age 70, have been evaluated as a subset of the population in larger studies and even been the subject […]
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