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Dr. Jack West is a medical oncologist and thoracic oncology specialist, and Executive Director of Employer Services at the City of Hope Comprehensive Cancer Center in Duarte, CA.

Adjuvant Tarceva for Patients with Resected Early Stage EGFR Mutation-Positive NSCLC: Dr. Neal on the SELECT Trial
Fri, 09/21/2012 - 22:13
Author
Howard (Jack) West, MD, Associate Clinical Professor, Medical Oncology, Executive Director, Employer Services, Founder, President and CEO of GRACE

Here is Dr. Neal's summary from the ASCO 2012 Lung Cancer Highlights program of the SELECT Trial, which he led and presented, of adjuvant (post-operative) Tarceva (erlotinib) for patients with resected early stage EGFR mutation-positive NSCLC.   This is a phase II study with only preliminary results, but it demonstrated some important concepts about feasibility and the potential utility of adjuvant Tarceva in this setting.

The video and audio versions of the podcast appear below, along with the transcript and figures.

Dr. Neal ASCO 2012 LC Highlights SELECT Trial Adjuvant Tarceva Audio Podcast

Dr. Neal ASCO 2012 LC Highlights SELECT Trial Adjuvant Tarceva Figs

Dr. Neal ASCO 2012 LC Highlights SELECT Trial Adjuvant Tarceva Transcript

We'll have one more summary piece by Dr. Neal coming up, on the subject of molecular markers being detected for squamous NSCLC, and then close out the podcast series on this program with the question and answer session that followed.  

With regard to the controversial question of whether patients with a detected EGFR mutation should pursue adjuvant Tarceva outside of a clinical trial setting, one lung cancer luminary recently described it as a conflict between your heart and your head.  He noted that while the data aren't there to support it yet, it's understandably tempting.  However, there are also side effect risks to consider for people who might already be cured, and for whom we don't really have an established optimal duration of therapy. Would you want to receive post-operative Tarceva, knowing that it's value isn't clearly defined? Would you favor a fixed duration of treatment or indefinite therapy, understanding that there is a cost in terms of chronic side effects as well as the financial cost of nearly $5000/month? 

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