Heterogeneity in Population of NSCLC Patients with Acquired Resistance to EGFR Inhibitors: T790M is Key Predictor

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Over the past several years, probably the biggest development in the field of NSCLC has been the recognition of the importance of molecularly-defined subgroups that help define the clinical patterns of how patients are likely to do with various treatments. We've seen this clearly illustrated with EGFR mutations vs.

Zactima (Vandetanib) Trial vs. Placebo Negative (for Survival): Details from ASCO

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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.

Recent Webinar with Dr. Weiss on Potential Use of Post-Operative Tarceva Available

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Here's a podcast from the webinar presentation earlier this month by our beloved Dr. Weiss, covering the open question of whether we should consider giving an EGFR inhibitor like Tarceva (erlotinib) as an adjuvant (post-operative) therapy following potentially curative surgery for early stage NSCLC. It's a setting in which there is a good rationale if we extrapolate from the setting of metastatic NSCLC, at least for patients with an EGFR mutation, but we've made incorrect presumptions before when we extrapolate.

EGFR Inhibitors: Personalization by "Snips"

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What we are striving for in cancer care today is personalized medicine. So, if a patient with newly diagnosed NSCLC has an activating epidermal growth factor receptor (EGFR) mutation, we give that patient Tarceva (erlotinib), a tyrosine kinase inhibitor (TKI). Right? Well, yes -- but it doesn’t always work (the response rate is in the 70-75% range). Why not? We’re not sure, but it would be nice to learn why we don't see near a 100% response rate among patients with EGFR mutations, so that we can know to recommend other alternatives.

Iressa vs. Chemo in First Line Treatment of Korean Never-Smokers: The First-SIGNAL Trial

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I would consider the recently published IPASS trial that compared Iressa (gefitinib) to standard chemo of carbo/taxol (paclitaxel) to be an extremely influential trial in lung cancer that has essentially ushered in a new era of molecularly-defined guidance of our treatment for many patients with advanced NSCLC, and we can expect that this is how we’ll be approaching a much broader population of lung cancer patients.