Lung Cancer / Mesothelioma
We’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 […]
3 CommentsIn a recent issue of the Journal of Clinical Oncology, Dr. Vince Miller and colleagues published the results of an important trial of the EGFR inhibitor tarceva (erlotinib) in the unusual NSCLC subtype bronchioloalveolar carcinoma, or BAC (abstract here). This work was predicated on the observation, also by Dr. Miller and his colleagues at Memorial […]
1 CommentsIt has been noted for many years that Asian women appear to be particularly predisposed to lung cancer despite a low frequency of smoking. Many of the series from resected NSCLC series have never-smoker rates of 30-50%, with the majority of these never-smokers as women. As we’ve struggled to understand and explain risks, hormonal […]
5 CommentsSeveral trials have recently opened up for never-smokers with any lung adenocarcinoma or those with BAC (or adeno/BAC mix, invasive adenocarcinoma with BAC features) with any smoking status. Both of these groups have only recently gained recognition as likely being a distinct clinical entity with a different natural history (clinical behavior outside of treatment) […]
2 CommentsThe 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 […]
0 CommentsAs I’ve described in a prior post, one of the most consistent findings in the work with the EGFR inhibitors Iressa (gefitinib) and Tarceva (erlotinib) is that never-smokers are far more likely to demonstrate a response and survival benefit than patients who do smoke or did smoke. Here, for instance, is the set of […]
5 CommentsMost of the focus on predicting response to EGFR inhibitors has been on identifing molecular markers that are associated with major response to this kind of treatment. But we know that there is a group of patients who get no benefit from these expensive drugs, and in these patients, EGFR inhibitors would just lead […]
8 CommentsIressa was approved by the US FDA in May of 2003 as a third-line therapy, and for the next 18 months it was the only EGFR inhibitor on the market. At the ASCO conference a year later, Frances Shepherd, from the Princess Margaret Hospital in Toronto and chair of the Lung Cancer Committee for […]
0 CommentsIn light of a growing focus on the issue of lung cancer in never-smokers, it makes sense to try to identify potential causes in this population. Among the leading candidates as a cause of lung cancer in never-smokers is secondhand, or environmental tobacco smoke (ETS) exposure. This potential cause was identified more than 25 years […]
2 CommentsMy good friend Heather Wakelee, along with her colleagues at Stanford, just published an important study in the Journal of Clinical Oncology on the incidence of lung cancer among never-smokers, essentially the first and most comprehensive work defining the magnitude of the problem. I’ve mentioned that never-smokers with lung cancer are a particular interest of […]
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