Vintafolide

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March 21, 2014 at 11:51 am  #1262897    

ssflxl

Here’s some positive news, but again, need to be cautiously optimistic. Look forward to hearing more about this drug.

http://health.yahoo.net/news/s/nm/endocyte-s-drug-meets-goal-in-lung-cancer-study-shares-soar

ssflxl


Non smoker Asian F, St 4 NSCLC – 11/2010, 6 cm LUL mass, met to paraspinal muscle, +EGFR at Exon 21 L858R. Tarceva in 11/2010, rad to lung mass and met. 5/2012 – PET showed inc SUV in primary cancer, new 1.6 cm lesion in left thoracic inlet causing Horner’s syndrome. Cyberknife to lesion – 5/2012. Restarted Tarceva 75mg/day -5/12, reduced to 50mg. 8/12 – PET- thoracic inlet lesion gone. 11/12 PET – inc SUV in primary tumor, ant mammary node, some SUV uptake in a fibrotic area in apex. Biopsy of this showed fibrosis and scant atypical cell. Cyberknife to mammary node, continue Tarceva. PET-10/13 – incr SUV to 14 in left primary tumor and new 1cm nodule in LUL, no new symptom. 12/13 – biopsy of LUL- same Exon 21, L858R – ?no T790M. on Tarceva 75/50. 1/14 PET – not much change. 2/14 – arm pain, cough, sob. CT – inc tumor to 5.5×5.9 with LUL collapse. 2/14 – Carbo/Pem x6. 4/14 PET – dec SUV but new bony lesions. PET in 6/14 – stable. start Pem every 3 wks in 7/14, Pamidronate every 6 wk.

March 21, 2014 at 1:59 pm  #1262903    
Dr West
Dr West

I think both the optimism and the caution are appropriate. It’s a phase II trial, and unfortunately we’ve seen MANY very encouraging phase II trials fail to translate to a real benefit in a larger phase III trial (think MAGE A3 vaccine, Stimuvax, METMAb, tivantinib, and more). At the same time, the endpoint of an improvement in progression-free survival that was touted here is less compelling than an improvement in overall survival. Nevertheless, this is certainly encouraging, and some of the drugs that look promising in phase II studies actually prove to be significantly beneficial in phase III trials as well.

This agent is definitely one to watch.

-Dr. West

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