teddy
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Posts:9
My concern is to find the best lung cancer treatment guidelines available.
1. One site that was recommended by an oncologist was the National Comprehensive Cancer Network (NCCN) as the best of the best cancer center info that is shared publicly. Are there other sites that the oncologists refer to for current guidelines? Are any of those sites shared publicly?
2. In NCCN Guidelines for Patients Non-Small Cell Lung Cancer (Version 1 2015) for ALK gene rearrangement the first-line treatment recommended is Critzotinib regardless performance status. A few weeks ago Critzotinib was approved by the FDA for ROS1 gene rearrangement. Where can I find an update for the recommended first-line treatment for ROS1 gene rearrangement?
Thank you
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Reply # - March 29, 2016, 02:20 PM
Crizotinib is still the
Crizotinib is still the recommended first line treatment for ROS1 rearrangement. In fact it was just last week or 2 FDA approved for ROS1 even though oncologists have been using it successfully for 2 or 3 years. ROS1 is such a rare mutation that it took a long time for the numbers to show how success it is.
NCCN has up to date guidelines. Grace is excellent at helping answer specific questions on the forum as well as pushed information written and video by experts in the field and directed to be understood by the lay person. Our search engine is very helpful.
All best,
Janine
Reply # - March 31, 2016, 08:34 PM
If you want to be up to date,
If you want to be up to date, you need to check recent literature. For example, a recent study suggested Ceretinib could be effective where there was resistance to Crizotinib. Consensus is inherently conservative.
Reply # - March 31, 2016, 09:40 PM
Hi teddy,
Hi teddy,
As Janine stated, the current guideline for first-line treatment of ROS1 lung cancer is Xalkori/crizotinib. If acquired resistance develops there are second generation inhibitors, such as ceritinib, which may be used. You may be interested in Dr. Owonikoko's discussion in this GRACE podcast.
And Dr. Weiss discusses the question of whether to use a second-generation inhibitor as first-line therapy in the latter portion of this podcast, concluding that you may achieve a longer total period of disease control by starting with crizotinib and following up with a second-generation inhibitor if acquired resistance develops.
JimC
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