Lung Cancer / Mesothelioma
One of the core ideas in the management of stage III, or locally advanced, NSCLC is that unresectable disease that is being treated with curative intent is most effectively treated with a combination of concurrent systemic (”whole body”) therapy and chest radiation to all of the visible cancer. The systemic therapy, which has been […]
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 […]
0 CommentsWhile there have been new agents introduced and rapidly changing standards in advanced NSCLC, another 40% of patients with NSCLC have locally advanced (stage III) NSCLC, many of whom with disease that is not resectable but is potentially curable with agressive chemo and radiation. Last year’s ASCO meeting included results […]
2 CommentsPeople who have been following my comments know that I am often questioning the wisdom of surgery in patients who don’t fit the usual criteria for resection, which is most commonly pursued in stage I and II NSCLC and is often considered an option for some patients with stage IIIA NSCLC. To provide a […]
6 CommentsDespite the fact that a very significant proportion of the “real world” patients have considerable medical problems such as markedly decreased lung function (pretty common with many years of smoking), weight loss (5 or 10% of body weight is usually considered a problem), or otherwise are not able to be very active. The vast majority of clinical […]
0 CommentsAs a follow-up to my last post and an end to this extended discusison of locally advanced NSCLC before moving to other topics, I’ll just cover some more recent work on the topic of chemo followed by chemo and radiation for stage III NSCLC. In that post, I showed that over the past several […]
0 CommentsThe last topic in our discussion of the evolving field of optimal treatment for locally advanced NSCLC is the potential role for induction chemotherapy before radiation, or, more commonly concurrent chemo/radiation (CT/RT). In my recent post, we covered the new findings from ASCO 2007 that our common practice of giving concurrent CT/RT followed by consolidation chemo, most commonly with taxotere, […]
0 CommentsMy last post included studies that demonstrated no additional benefit from giving chemo after concurrent chemo/radiation for locally advanced NSCLC, but it’s important to add a qualifier to that conclusion. The studies that have shown an overall favorable result from two cycles, or about 6-7 weeks, of chemo with radiation have thus far primarily […]
0 Comments Although consolidation taxotere after concurrent chemo and radiation therapy (CT/RT) emerged as the preferred treatment approach for about 2/3 of American oncologists over the last few years, this was predicated on an incomplete story. We received information from an additional two studies this year, and now it’s a big mess.
In the wake of […]
As I described in my last post, there is a strong consensus that overlapping chemotherapy (CT) and radiation therapy (RT) provides greater efficacy, meaning higher survival rates, than a sequential, non-overlapping approach for stage III, unresectable NSCLC. Beyond that, it’s a bit of a mess, with a wide range of choices and no clear […]
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