Last year, a provocative trial was presented at ASCO that compared early vs. later taxotere as second line therapy. I described that study here, and it showed a very significant improvement in progression-free survival (PFS) and a near significant improvement in overall survival (OS) for the recipients of taxotere immediately after four cycles of first line chemo for advanced NSCLC.

Although it’s only a leak from a “reliable source”, news came yesterday (link here) about a new lung cancer development from a financial source (yet another example of us learning oncology from Wall Streeters). Specifically, we heard that the BMS-099 that I described in a prior post is actually demonstrating a significant benefit in overall survival (OS).

During the entire time I've been commenting on the most evidence-based and commonly used agents for previously treated patients, I've focused on taxotere, alimta, and tarceva (example in prior post here). In fact, that overlooks an agent that has actually been tested in a large study and been found to have similar activity to taxotere, but it remains pretty much an afterthought.

I'll get back to the storyline of our growing understanding of the differences of individuals based on pharmacogenomics very soon. But I wanted to give people some breaking news that just came out.

Although I've previously written about the question about optimal duration of therapy for first-line chemotherapy in advanced NSCLC (post here), these conclusions have been based on a limited number of trials. One study randomized patients to three or six cycles of rather old chemo and found no significant differences (abstract here).

In addition to a direct comparison of iressa to chemo in the second line setting for advanced NSCLC (see recent post on INTEREST trial), as conducted with the INTEREST trial I described in a recent post, a very similar comparison of Iressa to chemo was also performed in another setting where single-agent chemo is also the treatment of choice. Specifically, the INVITE trial evaluated iressa vs.

In a post several months ago, I described the results of a trial from Japan, designated V-15-32, that directly compared Iressa to Taxotere as a second line therapy. Although overall comparable, the study showed that Japanese patients receiving Iressa had a higher response rate, but despite that had a lower median and one year survival.

The question of whether to use cisplatin or carboplatin in our "platinum-based chemotherapy doublets" that are the most common treatment for the first-line treatment of NSCLC has been a smoldering debate in lung cancer for more than a decade. Although at this point carboplatin is by far and away more commonly used than the generally less tolerable cisplatin, whether these are completely identical in their efficacy isn't entirely clear. Nobody questions that they're very close.

It's a little sad that you can get more cancer information from the business websites than from the medical ones, but if you checked a story on Forbes.com today you learned that Bristol-Myers Squibb (BMS) provided a press release that one of their important Erbitux (cetuximab) trials didn't meet its primary endpoint of improved progression-free

I had previously mentioned in prior posts that there have been a few studies in advanced NSCLC that indicate that about 4 cycles provides as much treatment benefit as continuing first-line chemo until progression. I also noted that the ECOG 4599 trial (abstract here) gave up to 6 cycles of chemo (with carbo/taxol) and avastin, followed by avastin alone as a maintenance therapy until progression of the cancer.