As the next installment of the podcast series from the GRACE NSCLC Patient Education Forum, I'm pleased to offer a presentation by the Chief of the Thoracic Oncology Division at Swedish Medical Center in Seattle -- my own institution. Dr. Aye has been at the center of the program from the beginning, and whatever success our center has achieved in the field is a reflection on his steady leadership. He was one of the leading reasons I felt I would be happy at Swedish, and nearly seven years later, I can say that he's been one of my favorite aspects of working there.

Over the lasat decade, PET scans have become commonplace in the staging of NSCLC. There's an older post that reviews the concept of PET scans in providing metabolic imaging, as well as a podcast that provides a more complete discussion of PET scanning in oncology, with a focus on lung cancer.

Here's an interview I did a few weeks before ASCO with Dr. Sarita Dubey, medical oncologist at the University of California at San Francisco. This podcast covers a discussion we had about her views on the role of chemotherapy for patients with resected or resectable early stage NSCLC.

Included below is a link to the audio mp3 version, a transcript, a pdf file of figures, and the video version of the podcast (with slides synchronized to the discussion).

In 2007 there was much excitement about the publication of a study by the researchers behind the landmark IALT adjuvant chemotherapy trial, which suggested that patients with early stage NSCLC could be divided into those who benefited greatly from cisplatin-based adjuvant chemotherapy and those who did not.

Post-operative, or adjuvant, chemotherapy is a standard approach for higher risk patients with resected early stage NSCLC, based on several randomized trials that have been presented and published in the last few years that show a survival benefit from chemotherapy. All of the trials that have shown a statistically significant survival benefit have given chemotherapy after surgery, but it’s hard to envision why the same chemotherapy given before surgery wouldn’t be just as good or better.

Over the last 5 years, it’s become standard to consider and often recommend post-operative chemotherapy to patients with higher risk, early stage lung cancer in order to reduce the risk of it recurring and increase the cure rate. In that time, we’ve also seen that there are subgroups of patients who may be harmed by chemo. This may be because their risk of recurrence is not high enough to justify the potentially detrimental effects of adjuvant chemotherapy, or because they are relatively resistant to chemo, or a combination of these issues.

Interview by medical oncologist Dr. Howard (Jack) West with fellow medical oncologist and lung cancer expert Dr. Janessa Laskin from the British Columbia Cancer Agency in Vancouver, BC, Canada on current standards and controversial topics in post-operative (adjuvant) chemotherapy for early stage, resected NSCLC.

[powerpress]

Transcript here: Transcript Laskin on Adjuvant Chemo

This audio interview by medical oncologist Dr. Jack West of radiation oncologist and lung cancer expert Dr. Vivek Mehta covers the current and emerging treatment options for radiation alternatives to treat early stage non-small cell lung cancer (NSCLC).

This is my first post on this wonderful site.

Recently I saw a patient who had undergone surgery for stage II Non-Small Cell Lung Cancer and was receiving chemotherapy with another cancer doctor. He came to me for a second opinion. Among the questions he had was what tests should he get after completing all his treatment.

In Japan, a different chemotherapy approach than cisplatin doublet chemo has been used in the post-operative setting. In contrast to the North American and European approach of 3-4 cycles of platinum-based chemo, in Japan they have studied an oral chemotherapy called UFT, a combination of uracil and tegafur. This combination is in the same family as an old chemo drug called 5-FU that is still used in various settings today, although not commonly in lung cancer.