Introduction to Locally Advanced, Unresectable Stage III NSCLC

When I was a medical student, the question about lung cancer that was always asked on “the Boards” had to do with the difference between stage IIIA and stage IIIB non-small cell lung cancer (NSCLC).  The reason this question was always asked is because patients with stage IIIA NSCLC might be considered for surgery, whereas [...]

Basics of Bronchioloalveolar Carcinoma (BAC)

Bronchioloalveolar carcinoma, or BAC,  is a unique subtype of non-small cell lung cancer (NSCLC) that has unique features in terms of the demographics of who gets it, how it appears on scans, how it often behaves, and potentially in how it responds to treatment.  It is a subset of lung cancer for which most of [...]

Changing Clinical Practice: The Evidence that Convinced Me Many People with Advanced NSCLC Should Have Up Front Molecular Testing

   The question of which patients to test for an EGFR mutation, and when, has become one of the most timely and rapidly changing ones in lung cancer.  The IPASS trial was a landmark study that definitively illustrated that molecular testing overshadows clinical selection for EGFR tyrosine kinase inhibitor (TKI)-based therapy, demonstrating that the 60% of [...]

Case Discussion with Dr. Hanna: Asian Never-Smoking Woman with Stage IIIA N2 NSCLC

Here is the continuation of my conversation with Dr. Nasser Hanna, lung cancer expert at Indiana University and all-around good guy (not part of his official title).  Here we discuss a patient of mine who combines the challenges of managing stage IIIA N2 NSCLC with the issues of how to potentially integrate an EGFR inhibitor [...]

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 [...]

Q&A Session with Dr. Ramalingam on Personalizing Treatment Recommendations for Advanced NSCLC

The second podcast from Dr. Ramalingam’s excellent webinar on Personalizing Treatment for First Line NSCLC is the question and answer session that followed it, which includes many questions about EGFR-based therapy, antiangiogenic agents, and other relevant issues for individualized treatments for patients.
Here is the audio and video versions of the podcast, along with the figures [...]

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Dr. Suresh Ramalingam on Personalizing First Line Therapy for Advanced NSCLC: Podcast Available

I’m very pleased to offer the excellent podcast produced from the recent webinar by Dr. Suresh Ramalingam, a leader in the lung cancer field who heads the Thoracic Oncology Program at Emory University in Atlanta.  He’s also a good friend I’ve known since our fellowship training days, and he was kind and generous enough to [...]

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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 [...]

Molecular Markers from the INTEREST Trial: Chemo and EGFR Inhibitor Therapy Still Remarkably Equivalent

Oncologists often have their own ideas about how effective or ineffective a targeted therapy like an EGFR tyrosine kinase inhibitor (TKI) (Tarceva (erlotinib) or Iressa (gefitinib)) is compared with standard chemotherapy options.   We’ve seen a lot of new information emerge in the field over the last few years, and we now have evidence that [...]

Round Table Case-Based Discussion — Drs. Laskin and Sandler on Molecular Testing in a Never-Smoker

Here is the first podcast of what we plan will be an ongoing series of round table discussions with cancer experts about real case scenarios and how we make decisions in practice.  My guests for the discussion are Drs. Janessa Laskin, medical oncologist from British Columbia Cancer Agency in Vancouver, BC, and Alan Sandler, medical [...]

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