Lung Cancer

Malignant pleural mesothelioma (MPM) is a challenging cancer to treat for many reasons, one of which being the difficulty in assessing whether there has been any meaningful change in the volume of a cancer that doesn't tend to appear as a discrete mass, but most commonly as thickening of the pleura, the lining around the lung that is normally a thin, onion skin, but can thicken to be more like an orange rind or even thicker.  We can often see this pattern in some people with lung cancer who happen to have a form of the disease that also primarily appears as pleural-based deposits of ca

Here's a video I just did on the disappointing results of the START trial with Stimuvax, an immunotherapy that was very promising but didn't actually pan out, but why might that have happened, and what does it mean for the future, with other clinical trials with prominent immune-based treatments that have also looked promising in lung cancer?

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What do you think? Are you optimistic about Lucanix and the MAGE-A3 trial?

As a second part of a recent video I did that introduces the concept of a mixed response in lung cancer (or many other cancers) and how we might manage that situation, I wanted to cover the biology of what is presumably occurring.  Here's a video that covers this issue, as well as the implication that we can learn more about this by doing multiple biopsies, more than is considered as the typical standard now.

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The question of whether and how to use blood tests, and particularly serum tumor markers, to monitor the status of a lung cancer has come up often here.  There are a few places where we've covered this in text, but for those of you who would prefer a video format for your information gathering, here's a podcast I just did on that subject for Swedish Medical Center.

[embed]http://www.youtube.com/watch?v=ePzQF6tFNZs[/embed]

Here's a brief video that explains my approach to a so-called "mixed response" to treatment for a lung cancer.  

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There isn't a formal teaching or "best answer" about how to approach this issue, but what I explain here is a common and I think very sensible strategy for a still controversial clinical setting (if I do say so myself).  I'd welcome your comments.

I hope you find it helpful if you or someone you care about faces this situation.

Here's a video I just did in response to my recent spate of molecular marker studies I've sent in the last 4-6 weeks that have come back with quite a few positive results for an EGFR mutation or ALK rearrangement, as well as one patient positive for a ROS1 rearrangement.  For each of these patients, the results have had a major impact in the opportunity for them to receive an oral therapy with a high probability of response, and in a few cases, we've already seen a significant improvement.

We'll kick off our monthly live webinar series, co-sponsored by GRACE along with LUNGevity Foundation, with our annual "Highlights in Lung Cancer" program. This one, featuring the leading developments from 2012, will be by Dr.

Here's a brief video I did for Swedish Medical Center that discusses the issue that a minority of lung cancers might not actually require intervention.

One of the current controversies in the field of lung cancer is whether we should be doing biopsies routinely when a patient develops progression of their disease, particularly in the setting of acquired resistance to a molecularly targeted therapy.  There are some academic oncologists who favor this approach, but I think there's a very good reason why this isn't and shouldn't be the current standard of care.

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