I'm very pleased to offer the excellent podcast produced from the recent webinar by Dr. Suresh Ramalingam, a leader in the lung cancer field who heads the Thoracic Oncology Program at Emory University in Atlanta. He's also a good friend I've known since our fellowship training days, and he was kind and generous enough to refuse the honorarium we offered for his participation, instead requesting that it be donated back and used for other GRACE programs. Instead, he was happy to do this entirely out of a commitment to the lung cancer community.

It's been a while since there was anything to discuss about Zactima (vandetanib), an oral targeted therapy being investigated by AstraZeneca that has the potential to inhibit both the epidermal growth factor receptor (EGFR) and the vascular endothelial growth factor (VEGF), key targets of two important pathways in cancer treatment.

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.

Dr. George Simon, medical oncologist and Director of the Thoracic Oncology Program at Fox Chase Cancer Center in Philadelphia, has been kind enough to sit down for an interview with me earlier this year, which was made into a podcast several months ago.

Dr. Alan Sandler is an international leader in the lung cancer world, also identified as among the most down to earth and funniest people in the field (and though that might not sound like much, he travels with an audio clip of a rim shot to play after his jokes). His talks are light-hearted, but he's so highly regarded because he has also been deeply involved in several of the pivotal research activities that have helped shape our current treatments.

This past weekend, I had the unenviable task of debating my friend Dr. Nasser Hanna, from Indiana University and a highly respected leader in lung cancer, about maintenance therapy.

This week I read a fascinating paper in the Journal of Thoracic Oncology by Dr. Nicolas Girard and colleagues at the Centre Hospitalier Universitaire de Besançon in France. I thought this would make a timely post as this seems to be one of the common questions that comes up again and again on the discussion boards.

As more and more oncologists become aware of the importance of testing for at least the EGFR mutation in tumor, and soon, perhaps, in blood, it seems likely that more patients will have their first systemic treatment for advanced non-small cell lung cancer (NSCLC) be an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), usually Tarceva (erlotinib), until Iressa (gefitinib) is re-approved (perhaps).

Patients often ask me, "Why are we only doing four cycles of chemotherapy for my lung cancer?" This is a great question and one for which the answer is a moving target, based on recent data incorporating maintenance therapies. A recently published meta-analysis took another look at this question in NSCLC.