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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Evidence of the Impact of Environmental Tobacco Smoke in Never-Smokers: Correlations with EGFR Mutations

It seems obvious: environmental tobacco smoke (ETS)/passive smoke exposure from being around smokers, can be harmful and may cause cancer in never-smokers.  A new paper in the Journal of Clinical Oncology by Lee and colleagues from Korea actually offers some evidence that highlights this, showing that never-smokers in Korea were less likely to have an [...]

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 [...]

The EML4-ALK Mutation Enters the Lung Cancer Clinic

Dr. Pinder previously summarized the early story of the newly identified EML4-ALK mutation in NSCLC, which traces back only a couple of years.  Amazingly, in that short time, treatments targeting this mutation have already been identified and administered to patients who are benefiting from these novel agents at this very moment.   Still, one of the [...]

Looking for Genetic Differences in Never-Smokers who Develop Lung Cancer

Last year I highlighted a research program out of Memorial Sloan-Kettering Cancer Center in NYC that has been trying to identify molecular genetic factors in never-smokers who develop lung cancer that can help provide explanations and even perhaps a better sense of why anyone, including smokers, may be at higher risk for developing lung cancer [...]

Video Presentation on Never-Smokers with Lung Cancer

   Here’s a video presentation on never-smokers with lung cancer, a population that has been a subject of great interest to me for the past several years.   Ten years ago, we really didn’t focus on smoking status as a relevant issue and didn’t break out never-smokers as a group within our lung cancer trials.  Over [...]

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A Non-Scientific Assessment of Better Lung Cancer Outcomes

    This week I happened to see a man in my clinic who I had first met at the time of his diagnosis with metastatic lung cancer more than five years ago. He’s from another part of Washington state, and this was his first time back with me to revisit treatment options. For [...]

Never-smoking Women with Lung Cancer: More Common or More Recognized?

   When I joined GRACE earlier this month, a question was posed by a reader regarding whether there is an increasing frequency of the diagnosis of lung cancer in women who have never smoked. This is a very interesting question that those of us who specialize in lung cancer frequently wonder about.
   We know that [...]

A Case of a 36 Year-Old Never-Smoking Woman with Metastatic Adenocarcinoma of the lung

   With all this recent talk about never-smokers with lung cancer, and the interest in stories of patients with so-called “oligometastatic” cancer (minimal metastatic burden to perhaps a single site), I thought I would describe a recent case in my clinic as an illustration of how I use this information in everyday decision making.
   Mrs. [...]

Screening Trial for Never-Smokers

   One of the principles of screening is that the likelihood of detecting a cancer depends greatly on the risk that a person being screen has for developing that cancer.  Low risk means that it is very likely that any abnormality that is detected is more likely to be unrelated to cancer.  And because of [...]