Basic Cancer Info

I'm fortunate to practice at Moffitt, where Dr. Gerold Bepler and Dr. George Simon pioneered a molecularly directed approach to front-line chemotherapy in NSCLC. Data from the phase II clinical trial demonstrated impressive median survival for a platinum-based doublet: 13.3 months. The schema of the MADeIT clinical trial is shown below and I'm happy to say that I am able to put many of my patients on this clinical trial. Dr.

One of my areas of interest is studying gender-related differences in lung cancer. Earlier this year, I wrote a post about interesting data that had come out of the Women’s Health Initiative study. This was the landmark study that established that hormone replacement therapy (HRT) for postmenopausal women did more harm than good. When originally presented in 2002, the investigators noted significantly increased risks of

On March 24, 2009, Dr. West wrote,

My friend and colleague, Dr. Ramiswamy Govindan, is one of the national leaders in lung cancer, and he was kind enough to participate in our NSCLC Patient Education Forum. There, he spoke in some general terms about what patients might expect from chemo/radiation for locally advanced lung cancer (which could include limited SCLC as well as stage III NSCLC), but he also used the occasion to talk about general guidelines about where we've come from and where we're going with cancer treatments.

I missed part of the presentation of the SATURN survival data at the World Lung Conference to hear a very provocative presentation by my cross-town colleague, Dr. Barbara Campling. I know and respect Dr. Campling from her time at the Philadelphia VA, where she took excellent care of veterans with lung cancer for many years. At thoracic tumor board, she could always be counted on to ask about a lung cancer patient’s smoking and smoking cessation history.

For the last several years, we've known that never-smokers are more likely to have a significant and long-lasting response to EGFR inhibitors. Since then, we've learned that EGFR mutation status is quite correlated with smoking status and is the more important, likely driving factor, but all of this work has led to a new focus on never-smokers and smoking history in general.

Imagine that you're a longtime smoker who is well aware of the health risks of smoking, not only in terms of lung cancer but also other cancers, heart disease, and other illnesses. You want to quit smoking, and perhaps you've tried several times, even trying Chantix, the nicotine patch, and other techniques. But in the end, it's been hard to kick the pleasurable sensation of cigarettes. What if you could just remove that?

I just wanted to tell people about a remarkable patient I just saw who is delighted to have had a remarkable response to Tarceva a few years after responding to Iressa. She made my day. In truth, her case was remarkably long before this. She was diagnosed with bronchioloalveolar carcinoma (BAC) all the way back in 1995 (I was finishing med school, no kids -- life was simpler then). She had undergone a left lower lobectomy for localized disease initially, but her cancer recurred in late 1998, confirmed on a bronchoscopy, and she began experiencing a cough then.

“Are we theeeeere yet?” Every parent knows that familiar whining from the back seat of the car. Sometimes, I feel as impatient as the kid in the back of the car. Although EGFR mutation helps with predicting tarceva (erlotinib) response, I want markers for cytotoxic (traditional) chemotherapy now. Unlike the parent in the driver’s seat of the car, I’m not entirely sure where we are, or where we’re going. Sometimes I feel as though I’m driving in the dark. Could molecular markers be the headlights?