The historic standard for advanced NSCLC up until a few years ago was for patients to complete 4-6 cycles of platinum-based doublet chemo, and then for patients who were doing well and had responded or demonstrated stable disease to take a break from treatment and be followed until progression. At that point, many patients would re-initiate chemo or targeted therapy with an oral agent like Tarceva (erlotinib).

The third and final part of my conversation with Drs. Tom Hensing from North Shore Health System in Chicago and David Jackman from Dana Farber Cancer Institute in Boston covered a presentation of an Asian never-smoking woman with an advanced lung adenocarcinoma, the demographic picture most closely associated with potentially but not necessarily having an EGFR mutation or ALK rearrangement.

The second part of my conversation with Drs. Tom Hensing from North Shore Health System in Chicago and David Jackman from Dana Farber Cancer Institute in Boston covered a case of a relatively young, generally healthy woman diagnosed with a lung adenocarcinoma that turned out to be stage IV.

Over three and a half years ago, I wrote a post about about early work looking at the possibility that a PET scan done anywhere from three days to a month out from the start of a new systemic therapy (chemo or EGFR inhibitor) for advanced NSCLC could be predictive of a good outcome or not.

The negative trials don't get a lot of discussion, but the ZEPHYR trial, a phase III study that directly compared Zactima (vandetanib), an oral inhibitor of EGFR and angiogenesis, vs. placebo, was one that merits some follow-up after my reporting that it failed to show a survival benefit, which was essentially the only thing we learned about the trial prior to ASCO this year.

Continuing with the webinar discussion I had with Dr. Pennell, here is a summary I did of a randomized phase II trial of the novel agent ARQ-197 combined with the EGFR inhibitor Tarceva (erlotinib): ==================================== Dr. West: We're going to shift gears and move into the metastatic setting, and this is a new agent called ARQ197 that is orally available,

Three months ago, I discussed the press release from Abraxis reporting that the phase III trial of carbo/Abraxane (nanoparticle albumin-bound paclitaxel) vs. carbo/taxol (paclitaxel) showed a significant benefit for higher response rate in the Abraxane arm. Carboplatin was given one day every three weeks, as was taxol, and Abraxane was given every week (no break).

The last of our three cases reviewing management issues in elderly and frail patients with lung cancer, as covered in a recent webinar discussion I had with experts Paul J. Hesketh from Lahey Clinic and Karen Kelly from Kansas University Medical Center, focuses on treatment of advanced/metastatic NSCLC. Drs.

It's only 10 patients, but a brief report in the Journal of Thoracic Oncology that just came out today from a group in Amsterdam has gotten my attention because it suggests that the oral multi-targeted anti-cancer agent Nexavar (sorafenib) may be genuinely effective in patients with advanced NSCLC who have a K-RAS mutation.

I'm very pleased to offer the podcast materials for the recent webinar by Dr. Mark Socinski, medical oncologist and leader of the excellent Thoracic Oncology Program at the University of North Carolina, in Chapel Hill. He's been a long-time leader of the entire field of lung cancer for many years, and he's among the best at synthesizing new information into a cogent perspective.

Here is the audio and video versions of the podcast, along with the figures and transcript that go with the program.

[powerpress]