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. [...]

Is Combining Chemo and an Oral EGFR Inhibitor Helpful, Harmful, or Neither?

A central question since the introduction of the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) like Tarceva (erlotinib) and Iressa (gefitinib) has been how best to use them.  Specifically, one standard way that we integrate new agents in cancer care is to combine them with the treatment that is our current standard of [...]

Can Lower Doses of EGFR Inhibitor Therapy Still be Effective?

   One nagging question that people often ask about, or at least worry about, is whether they are compromising their ability to benefit from an EGFR tyrosine kinase inhibitor (TKI) like Tarceva (erlotinib) or Iressa (gefitinib) if they need to cut down on the dose because of problems with side effects.  Anecdotally, I think just [...]

ASCO Preview on TORCH Trial: Treatment Order Matters

Despite the fact that many of the most anticipated ASCO abstracts are still being withheld until the meeting itself, there is certainly a lot of information in the released abstracts that provide a tantalizing preview and already hint at some important new conclusions.  I’ll try to provide some ongoing thoughts leading into the meeting coming [...]

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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Loading the Dice: Comparative Trials of EGFR Inhibitors in Patients with EGFR Mutations (or, When Bad Trials Happen to Good People)

The IPASS trial that randomized Asian never-smoking or light previously smoking patients with previously untreated advanced NSCLC to either standard chemo or the epidermal growth factor receptor tyrosine kinase inhibitor (EGFR TKI)  inhibitor Iressa (gefitinib) is widely considered among the most important and standard-changing trials of the last few years in the field of lung [...]

Tarceva for Advanced Squamous NSCLC: Recalibrating Expectations

When most oncologists think about the EGFR inhibitor tarceva (erlotinib), they think of the uncommon but very memorable patient who has a spectacular response within a few weeks of starting it, then continues to do well on it for a year or more.   These patients are most commonly never-smokers, often Asian, and almost invariably [...]

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 [...]

More Evidence from Asia on Where EGFR TKIs Fit into NSCLC Treatment

As more and more oncologists become aware of the importance of testing for at least the EGFR mutation in tumor, and soon, perhaps, in blood, it seems likely that more patients will have their first systemic treatment for advanced non-small cell lung cancer (NSCLC) be an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), [...]

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 [...]