It may not be the biggest present lung cancer patients could get for the holiday season, but the FDA just yesterday approved Cyramza (ramucirimab), an anti-angiogenic antibody with a mechanism similar to Avastin (bevacizumab) that is already approved for gastric cancer, as a new agent to treat previously treated advanced NSCLC, any histology. This was based on the phase III randomized trial called REVEL that was presented at ASCO 2014, so let's review the evidence that led to this approval.
The annual conference of the American Society of Clinical Oncology in late spring is the biggest event in the cancer world, where more of the big trials are presented than at any other time all year. In the lung cancer world, it’s looking like this one won’t be a blockbuster but will have some promising and interesting findings to dis
TITAN Trial: Comparison of Chemo and Tarceva in Patients Who Progressed Early on First Line Chemo for Advanced NSCLC
One of the trials presented at the Chicago Multidisciplinary Symposium in Thoracic Oncology last month was the TITAN trial, one of a pair of studies conducted in Europe to test the oral EGFR inhibitor Tarceva (erlotinib) in patients with chemotherapy pre-treated advanced NSCLC. The other trial, SATURN, was designed to test Tarceva as a maintenance therapy vs.
This past weekend, I had the unenviable task of debating my friend Dr. Nasser Hanna, from Indiana University and a highly respected leader in lung cancer, about maintenance therapy.
When most oncologists think about the EGFR inhibitor tarceva (erlotinib), they think of the uncommon but very memorable patient who has a spectacular response within a few weeks of starting it, then continues to do well on it for a year or more. These patients are most commonly never-smokers, often Asian, and almost invariably have an adenocarcinoma. In contrast, many oncologists perceive there to be little to no value in giving tarceva to patients with squamous tumors, and many don’t even bother to offer it to these patients.
I just recently wrote a post (here) that describes how I became convinced that under certain circumstances there could be a genuine value in determining whether a particular lung cancer patient has a tumor with an EGFR activating mutation.
One of the central ideas in medical oncology is that if you have two or more anticancer treatments that are active, you test them together to determine whether it's safe and whether the combination works better than each individually. We've been doing this with chemotherapy combinations for decades, but it's only been in the last few years that we have had more than one targeted therapy in lung cancer with enough activity to move ahead with combination work.
Yesterday, as described in a press release, the FDA approved the regimen of cisplatin and alimta as a first line therapy for advanced NSCLC, based on the positive results from a trial called "JMDB" by the sponsor company (Eli Lilly).
There are two widely tested epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) -- iressa (gefitinib) and tarceva (erlotinib).
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.