Adding EGFR Inhibitor Therapy to Radiation or Chemo/Radiation for Locally Advanced NSCLC

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We've recently received a series of questions on the question of whether it makes sense to give an oral EGFR inhibitor like Tarceva (erlotinib) or Iressa (gefitinib) concurrently with radiation. This is really a poorly studied question, but a paper just published in the Journal of Thoracic Oncology describes a clinical trial that helps to address this question.

Who is Defining the Standard of Care? Clinical Trial vs. Real World Patients with Lung Cancer

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The rate of our progress in lung cancer and other settings in medicine reaches a bottleneck in the slow rate at which clinical trials are completed. Nevertheless, only about 3% of patients with cancer in the US participate in clinical trials, and the number is even a little lower for people with lung cancer.

Lung Cancer FAQ: I've just been diagnosed with advanced NSCLC. What treatment should I be starting with??

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The initial or "first line" management of advanced NSCLC has evolved quite a bit over the past 10 years, in that time moving from a much more uniform approach of very similar treatment for just about everyone to a revised approach that is far more individualized. First, we assess key issues like the subtype of NSCLC, focusing largely on whether it is squamous cell or non-squamous NSCLC, because treatment tends to diverge very early based on this factor.

Advanced NSCLC in the Frail/Elderly: Podcast of Discussion with Drs. Hesketh and Kelly

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The last of our three cases reviewing management issues in elderly and frail patients with lung cancer, as covered in a recent webinar discussion I had with experts Paul J. Hesketh from Lahey Clinic and Karen Kelly from Kansas University Medical Center, focuses on treatment of advanced/metastatic NSCLC. Drs.

Locally Advanced NSCLC in the Frail/Elderly: Podcast of Case Discussion with Drs. Hesketh and Kelly

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Here is the second of three cases covering issues in managing elderly and frail patients with lung cancer that I discussed with experts Paul J. Hesketh from Lahey Clinic and Karen Kelly from Kansas University Medical Center. Both major experts in lung cancer, they have a lot of experience and have been leaders in publishing on the understudied population of elderly and poor performance status patients with lung cancer. This particular case covers treatment options for a patient with unresectable stage III non-small cell lung cancer (NSCLC).

Adjuvant Therapy in the Elderly and/or Frail: Podcast of Discussion with Drs. Hesketh and Kelly

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Several weeks ago I had the opportunity to discuss several difficult cases with experts Drs. Paul Hesketh from the Lahey Clinic outside of Boston and Karen Kelly from Kansas University Medical Center in Kansas City, KS. These scenarios raise questions about how best to manage lung cancer issues in elderly and/or frail patients, starting with a 78 year-old woman who presented to me for discussion of the pros and cons of post-operative therapy, which also touch on other factors of administering chemotherapy to more marginal patients in general, regardless of the setting.

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