Merck KgAA, the company developing cetuximab/Erbitux, the monoclonal antibody against EGFR, reviewed here) outside of the US, has announced that their pivotal FLEX trial (for First-Line Trial for patients with EGFR-Expressing Advanced NSCLC) is positive, demonstrating a signficant improvement in overall survival, as indicated

Let's move to combinations of velcade with other anti-cancer agents. My friend, Dr.Angela Davies from the University of California at Davis, led a single-arm phase II trial conducted by the Southwest Oncology Group, SWOG 0339, that evaluated the combination of velcade with gemcitabine and carboplatin (abstract here).

The fact is that lung cancer, like many others, is a disease disproportionately affecting older populations, with the median age now in the 69-70 range.

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I recently received a question on the Q&A Forum about the use of cisplatin vs. carboplatin in SCLC. In contrast to the smoldering debate about cisplatin vs. carboplatin in NSCLC that I described in a recent post, there's been very little study and not as much debate about SCLC.

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.

I've recently received some questions about the advantages and disadvantages of maintenance Avastin as a single agent for patients after completion of 6 cycles of first line chemo and avastin together for avastin-eligible patients. While this is generally considered to be a standard of care, many oncologists question whether it should be done. It's worth looking at how that standard came about and the strength of the evidence for it.

Our tendency in oncology is that once we find a new active drug in cancer, we try to add it to our current standard treatment approach and see if we can do better than what our current standard achieves. More is better. And we knew that the epidermal growth factor receptor inhibitors Iressa and Tarceva could lead to significant shrinkage of some lung cancers. So the lung cancer community was relatively optimistic about the clinical trials that compared chemo alone to the same chemo with Iressa or Tarceva.

So far, I've only written a few introductory posts on mesothelioma, but there were some interesting presentations at ASCO 2007 about the topic. One described the results of an expanded access protocol (EAP), which is when a company gives free access to a drug that is not yet commercially available (generally in exchange for participation in a data-collection study).

Over the past few years, sex-based differences in lung cancer have become increasingly recognized as relevant in prognosis overall and potentially in predicting response to treatment, such as EGFR inhibitors and other targeted therapies. At ASCO 2007, a group led by Dr.

As a follow-up to my last post and an end to this extended discusison of locally advanced NSCLC before moving to other topics, I'll just cover some more recent work on the topic of chemo followed by chemo and radiation for stage III NSCLC. In that post, I showed that over the past several years, we hadn't seen the promise of this induction strategy in small trials translate into especially favorable results in larger multicenter trials.