Lung Cancer
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It has become a common topic of conversation on this site (and in the lung cancer community at large) to discuss mutations in the epidermal growth factor receptor (EGFR). However, since we frequently throw out the terms “deletion 19 mutation”, “L858R”, and “T790M”, I thought would be worthwhile to explain a little bit about [...]
20 CommentsBack when I first started doing this, one of my earliest posts (see here) was on the question of whether EGFR tyrosine kinase inhibitors (TKIs) (see introduction to this work in prior post). My point, which is still true, is that EGFR TKIs aren’t only effective in a narrow population of patients, whether identified based on molecular [...]
1 CommentsOne of the basic concepts of oncology is that you treat patients with different drugs once they’ve shown progression on a treatment, rather than continue that a patient has presumably become resistant to. However, there are some exceptions to this: many or most women with breast cancer continue the antibody herceptin (trastuzumab) even after progression, adding [...]
9 CommentsWe’ve seen clear evidence that patients who have tumors with certain mutations in the EGFR gene are highly likely to respond to oral EGFR inhibitors like tarceva (erlotinib) or iressa (gefitinib) – with response rates that are in the 70% range and often last for many months or even a few years (see prior post). On the [...]
0 CommentsA quick point on the importance of biology over treatment. Years ago, I highlighted the results in the TRIBUTE trial of chemo with placebo or combined with erlotinib (tarceva) at the same time (biomarker study abstract here), which showed that patients with EGFR mutations had a much better survival whether they received an EGFR inhibitor [...]
2 CommentsOne of my good friends in the lung cancer community, Dr. Ed Kim from MD Anderson, was in town tonight and gave a talk that I attended. He’s one of the emerging real leaders in the field, and last week had published in Lancet one of the largest trials in advanced lung cancer, the [...]
3 CommentsThere’s a national trial that is just kicking off throughout North America, called the MARVEL trial, which stands for Marker Validation of Erlotinib in Lung Cancer. The lead investigator is Dr. Alex Adjei, now at Roswell Park Cancer Center in Buffalo and previously of Mayo Clinic, which leads the North Central Cancer Cooperative Group, [...]
0 Comments Actually, it’s some background information and your blood that’s needed.
Memorial Sloan-Kettering is running an important trial that is trying to determine some of the molecular factors that lead some never-smokers to develop lung cancer while other never-smokers don’t. The trial is just a one-time collection of information in a questionnaire, I believe about medical [...]
I just recently wrote a post (here) that describes how I became convinced that under certain circumstances there could be a genuine value in determining whether a particular lung cancer patient has a tumor with an EGFR activating mutation. While these have seemed to predict that these patients are quite likely to respond with [...]
0 CommentsThose who have followed my writings over time will know that I haven’t been inclined to adopt a reflexive strategy of ordering molecular testing without good evidence that having this information will improve outcomes. Testing tumors for EGFR mutations is advocated by a vocal minority of lung cancer experts in Boston and New York [...]
3 Comments
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