Article and Video CATEGORIES

Cancer Journey

Search By

Dr. Jack West is a medical oncologist and thoracic oncology specialist who is the Founder and previously served as President & CEO, currently a member of the Board of Directors of the Global Resource for Advancing Cancer Education (GRACE)

 

Dr. Julie Brahmer on Second Line Therapy: What Treatment and When?
Author
Howard (Jack) West, MD

The last of our podcasts in 2009 will also close out the series of presentations given at our September NSCLC Patient Education Forum here in Seattle, which was sponsored by OSI Pharmaceuticals and Swedish Cancer Institute (thanks!). The forum covered everything from initial workup to management principles of early stage NSCLC, locally advanced disease, and advanced/metastatic NSCLC. Dr. Brahmer, a friend for many years now who is a medical oncologist and lung cancer expert at Johns Hopkins University in Baltimore, spoke on treatment of patients after the first line setting, integrating thoughts on both patients who have progressed and also the emerging information on maintenance therapy for patients who have stable disease or have shown tumor shrinkage and no progression after the first line setting.

Her presentation is here, including both the video and audio podcast versions, and the accompanying transcript and figures.

[powerpress]

brahmer-second-line-therapy-treatments-and-timing-audio-podcast

brahmer-second-line-therapy-treatments-and-timing-transcript

brahmer-second-line-therapy-treatments-and-timing-figures

I'll also mention that I personally don't agree with Dr. Brahmer's reference to the Fidias trial as simply being "negative" for a survival benefit. She covers this trial and correctly notes that it didn't show a survival benefit, but my take is that the overall survival difference was still 2.6 months in a trial in which nearly half of the patients dropped off before getting to randomization, so I'd really consider it underpowered and with a strong trend toward a survival benefit. For many of our other therapies that have had very marginally positive trials (such as erbitux (cetuximab) and zactima (vandetanib), we would be absolutely thrilled to see a 2.6 month survival benefit and wouldn't question whether that difference is enough.

Still, this just highlights that even the people who have all of the evidence can interpret the meaning differently. She's a great leader in the lung cancer field, and I think that the overall conclusion she imparts, that management after the first line setting is not a color-by-numbers but needs to be very individualized, is very appropriate.

Next Previous link

Previous PostNext Post

Related Content

Image
Bladder Cancer Video Library 2024
Video
Dr. Petros Grivas discusses intravesical treatment for patients with nonmuscle invasive, or early-stage, bladder cancer, the importance of participating in clinical trials for bladder cancer, combination therapy options for patients with metastatic or incurable bladder cancer, and the importance of family history of cancer and discussing that history with your doctor.
Image
Case Based Panel
Video
The panel discusses treatment options for a patient diagnosed with EGFR Exon 19 Deletion NSCLC and examines data from the Laura Trial, a patient with a smoking history and diagnosis of small cell lung cancer, and how the Adriatic Study factors into decisions, and a patient with NSCLC adenocarcinoma, and a EGFR Exon 21 L858R Alteration, and how data from the Flaura 2 Trial can impact treatment decisions.
Image
Terapias Dirigidas de Cancer de Pulmón 2024
Video
La Dra. Estelamari Rodríguez presenta información básica sobre el NSCLC EGFR+ y analiza la importancia de las pruebas de biomarcadores en el cáncer de pulmón y ofrece una descripción general de las opciones de tratamiento para la enfermedad EGFR+.  Para ver la playlist completa, de click aquí.        

Forum Discussions

Hello Linda, my name is Alexandra Beneke, I'm the Outreach Manager for GRACE. Your willingness to share your experiences and knowledge with the cancer community is truly inspiring. Your dedication to...

Hi Bluebird,  Welcome to GRACE.  I'm sorry you're going through this scare and hope it's just inflammation or from an infection you didn't know you had. 

 

A CT would be...

Radiation + Brain Operation has just been discarded due to high risk. They will double Tagrisso dosis and then wait to see if it works, then try traditional Chemo. I would...

Hi and welcome to GRACE.  I'm sorry to know you are entering a new stage.  I'm not about to comment just now but wanted to let you know I see your...

Edit to say, we can't give advice but we can comment with views and facts.  :)

 

My first thought is to ask if she has been seen at a large...

Hi Barbro, Welcome to GRACE. I'm sorry you're worrying about this. We aren't able to give feedback on scan reports. Interpreting scan reports in this setting is not only unethical but...

Recent Comments

JOIN THE CONVERSATION
Tagrix FDA Approval
By mariachristian on
Hi Judy! It is so good to…
By JanineT GRACE … on
Tagrix vs Tagrisso
By Dipakchavan on
Hello Linda, my name is…
By AlexandraGBeneke on