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October 24, 2014 at 6:55 pm  #1266658    


So much exciting news for those with EGFR or ALK, what about KRAS? Can someone comment on Selumetinib? Is it commonly used in second line state 4 NSCLC? Why or why not? Or only in trials? Can u direct me to any recent promising studies?

October 24, 2014 at 7:54 pm  #1266660    


I apologize for having already asked about Selumetinib in my other post. I see that Jim and Dr. West already responded. I am just worried that if the carbo/alimta doesn’t work my mom will not have any options.
Moderator-feel free to delete this thread.
I look forward to reading all about the immunotherapy conference.

October 25, 2014 at 9:40 am  #1266664    
Dr West
Dr West

No real updates. We’re working on selumetinib in a larger trial, but that will take a few years before we have results from the phase 3 study.

In the meantime, I would caution that being KRAS mutation positive doesn’t mean that conventional therapies are useless. Some trials suggest outcomes a bit worse in the KRAS mutation-positive vs. mutation-negative patients, but many don’t.

Lung cancer investigators certainly appreciate the need for very effective treatments for KRAS mutation-positive patients; unfortunately, even when we’re making progress, that typicallly occurs over several years, and very incrementally. We’ve had some remarkable improvements in targeted therapies over a short time, but that’s really the exception, rather than the rule. It’s not for lack of interest or lack of trying to develop new treatments for KRAS mutation-positive NSCLC.

Good luck.

-Dr. West

October 25, 2014 at 11:57 am  #1266670    
JimC Forum Moderator
JimC Forum Moderator

I would echo Dr. West’s sentiment as a general principle in lung cancer treatment. There is a great deal of interest in targeted therapies, but those treatments benefit only a relatively small segment of the lung cancer patient population and I can understand why many patients may feel left out of this trend.

But as Dr. West said, conventional chemotherapy, radiation therapies and even surgical techniques continue to improve, which can benefit a greater percentage of patients. In addition, the research currently in progress on therapies for such established targets as EGFR and ALK also benefits patients whose cancer does not have those targets, as it has spawned research into many other possible targets.

Forum moderator

Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then:

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