Cyramza, New Angiogenesis Inhibitor, Approved with Taxotere for Second Line NSCLC: Let's Review Why

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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. 

TITAN Trial: Comparison of Chemo and Tarceva in Patients Who Progressed Early on First Line Chemo for Advanced NSCLC

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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.

Tarceva for Advanced Squamous NSCLC: Recalibrating Expectations

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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.

Second Line NSCLC: Avastin/Tarceva Improves Progression-Free but Not Overall Survival vs. Tarceva

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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.

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.