Selection of Patients by EGFR Mutations: A Powerful Predictor, but How Much Does it Really Add?

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Another lung cancer trial that received a good deal of attention at the recent European Society for Medical Oncology (ESMO) conference in Stockholm this past week was conducted by the Spanish Lung Cancer Group and led by Dr. Rafael Rosell, who is chief of medical oncology at Catalan Institute of Oncology in Barcelona and one of the true international greats in the field who has made important contributions for a couple of decades now.

US-Based Erbitux Trial Shows Favorable Survival Trend, But Not Significant Benefit

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Imclone put out a press release yesterday that the previously described, US-based BMS-099 trial of carboplatin-taxane (either taxol (paclitaxel) or taxotere (docetaxel), investigator's discretion) with or without the EGFR monoclonal antibody erbitux (ceteuximab) has failed to demonstrate a statistically significant i

What I Really Do: First Line Advanced NSCLC, Avastin Eligible Patients

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As I described in a recent post introducing the concept of the series, “What I really do”, I wanted to provide a summary of how interpret the evidence I show here, how I really approach real life patients. Some of this will illustrate that the experts don’t agree 100%, and that we all add some interpretation and style to how we manage patients. What I describe isn’t meant to be a dogmatic declaration of what everyone should do, but just the way I apply the evidence from trials of somewhat selected patients in the real world.

Insulin-Like Growth Factor Receptor-1 Inhibitor Continues to Look Favorable in Squamous Cell NSCLC

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One of the abstracts in lung cancer that I noted as being particularly noteworthy before ASCO 2008, but which I haven't managed to mention since, is a trial of a monoclonal antibody known as CP-751,871 that targets and inhibits insulin-like growth factor receptor-1(IGF-1R), a molecule that appears to be involved with cell growth, balance of programmed cell death, and likelihood of metastatic spread (abstract he

A Role for Non-Platinum Doublets in Treating NSCLC?

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Someone recently asked a question about a recommendation she had received about being treated with a first-line combination of gemzar (gemcitabine) and navelbine (vinorelbine), because we have focused so much on doublets of either cisplatin or carboplatin with a newer drug like taxol (paclitaxel), taxotere (docetaxel), gemzar, navelbine, or most recently possibly alimta (pemetrexed). Why don't we pair the partners of the platinums and perhaps do even better?

Refining the Treatment Populations for Erbitux in Lung Cancer: Can We Make the Juice Worth the Squeeze?

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The FLEX trial raises a number of additional points as we struggle to determine how to integrate Erbitux (cetuximab) into the current standards of care. One question is whether we can refine how well we do with Erbitux by using clinical or molecular variables to select better or worse candidates for it. I already mentioned in my prior post that Asian patients (among whom 52% were never-smokers) had a far better survi

Results from FLEX Trial of Chemo +/- Erbitux in Advanced NSCLC Presented

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Within the lung cancer community, the biggest story from the ASCO meeting was the long-awaited plenary session presentation (abstract here) of the FLEX trial of chemo with or without the EGFR monoclonal antibody Erbitux (cetuximab) that we knew was statistically significantly positive for an overall survival benefit as far back as September of last year (see

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