Post-ASCO Discussion of the BR.19 Trial

Here’s the first of a series of posts on key presentations on lung cancer from ASCO 2010, as reviewed by myself and Dr. Nate Pennell of our faculty here several weeks ago.
The first topic we covered was the very interesting if troubling Canadian BR.19 trial of post-operative Iressa (gefitinib) vs. placebo, as summarized by Dr. [...]

Recent Webinar with Dr. Weiss on Potential Use of Post-Operative Tarceva Available

Here’s a podcast from the webinar presentation earlier this month by our beloved Dr. Weiss, covering the open question of whether we should consider giving an EGFR inhibitor like Tarceva (erlotinib) as an adjuvant (post-operative) therapy following potentially curative surgery for early stage NSCLC.  It’s a setting in which there is a good rationale if [...]

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Consolidation Tarceva after Chemo/Radiation for Locally Advanced NSCLC: At Least It Isn’t Significantly Harmful

Perhaps the most unexpected clinical trial result in lung cancer over the past 5 years was the finding in the large Southwest Oncology Group (SWOG) 0023 trial that randomized several hundred patients to maintenance therapy with either the oral EGFR inhibitor  Iressa (gefitinib) or a placebo after chemo/radiation concurrently and then consolidation taxotere (docetaxel).  While [...]

EGFR Inhibitors: Personalization by “Snips”

What we are striving for in cancer care today is personalized medicine. So, if a patient with newly diagnosed NSCLC has an activating epidermal growth factor receptor (EGFR) mutation, we give that patient Tarceva (erlotinib), a tyrosine kinase inhibitor (TKI).  Right?  Well, yes — but it doesn’t always work (the response rate is in the [...]

Iressa vs. Chemo in First Line Treatment of Korean Never-Smokers: The First-SIGNAL Trial

I would consider the recently published IPASS trial that compared Iressa (gefitinib) to standard chemo of carbo/taxol (paclitaxel) to be an extremely influential trial in lung cancer that has essentially ushered in a new era of molecularly-defined guidance of our treatment for many patients with advanced NSCLC, and we can expect that this is [...]

Integrating EGFR Inhibitor Therapy with Chemotherapy: Should We Treat Advanced NSCLC Like a Sprint and Not a Marathon?

Dr. Tony Mok, a friend who lives and works in Hong Kong and is an international leader in lung cancer, has just published not only the IPASS trial in the New England Journal of Medicine but also another trial called FAST-ACT (for First Line Asian Sequential Tarceva and Chemotherapy trial) in the Journal of Clinical [...]

Cetuximab (Erbitux) for Advanced NSCLC: Promising Results, But is it Ready for Prime Time?

There has been quite a lot of discussion recently about the EGFR tyrosine kinase inhibitors (TKIs), erlotinib (Tarceva) and gefitinib (Iressa). Recently however the final results of the FLEX trial were published in The Lancet, bringing attention back to one of the antibodies against EGFR, cetuximab (Erbitux). Dr. West [...]

VeriStrat Test for EGFR Test: Initial Impressions after Sending a Few

  A few weeks ago I described a blood test for predicting survival after getting an oral epidermal growth factor receptor (EGFR) inhibitor that is just becoming commercially available.  This is called the Veristrat test and from company called Biodesix.  As I noted previously, this technique looks at the protein patterns in a patient’s serum and reportedly [...]

Serum Test Being Launched to Test for Likelihood of Benefit from Oral EGFR Inhibitors

   About 18 months ago, I wrote a post about a new technique being developed that looks at the pattern of proteins in the blood of a patient in order to determine whether a patient is likely to do well or poorly after receiving an EGFR tyrosine kinase inhibitor like tarceva (erlotinib) or iressa (gefitinib) [...]

The Shifting Ground in Advanced NSCLC: A Quick Survey of the Experts

   Although there has always been lattitude for individualizing treatment, I think developments in the last few years have added so many options that pretty much any standards we had from a few years ago have eroded. Particularly in a world in which the eligibility for avastin (bevacizumab) has is debatable (with growing experience of [...]