Lung Cancer / Mesothelioma
    So I’ve been invited to be on the faculty of a lung cancer conference in Kauai next month (yes, a good gig, but this is the first year that the flights are so expensive that I can’t bring my family to this normally very family-friendly event), and my topic is to argue in a […]
0 Comments  Continuing with the analysis of a publication about tarceva (erlotinib) for patients with advanced BAC that I introduced in the last post, we’ll turn now to the analysis that Dr. Vince Miller and colleagues did on the biomarkers that might predict more or less clinical benefit with an EGFR inhibitor like tarceva (abstract here).  The trial looked at three […]
0 Comments   The issue of population-based differences in response to lung cancer treatments was essentially introduced with the EGFR inhibitors, so it’s appropriate to introduce racial differences overall with this work. Mention of more favorable results with EGFR inhibitors iressa and tarceva emerged with the earliest clinical studies and have since become a well established truism. […]
2 Comments  As I described in my prior post, the marker ERCC1 (excision-repair cross complementing group 1) is a prognostic variable that is associated with a more favorable survival in patients who aren’t treated with chemo after surgery for early stage NSCLC. But this marker also appears to be predictive of resistance to cisplatin and a worse survival […]
0 Comments  Although I’ve described this concept in a few posts over the past year, it’s time for me to dedicate some real discussion to the concept of individualizing treatment with the ERCC1 marker. ERCC1 stands for excision repair cross-complementing group 1, and it helps repair damage to DNA. Now, validated, reliable testing for ERCC1 in […]
6 Comments  In a post several months ago, I described the results of a trial from Japan, designated V-15-32, that directly compared Iressa to Taxotere as a second line therapy. Although overall comparable, the study showed that Japanese patients receiving Iressa had a higher response rate, but despite that had a lower median and one year […]
0 Comments  We’ve discussed various ways of predicting outcomes with EGFR inhibitors like Tarceva or Iressa using clinical variables like smoking status or BAC subtype, as well as molecular markers like EGFR mutations, or EGFR gene amplification or protein expression. These can all be of value, but we know that the clinical markers are quite inexact, […]
7 Comments  The study I was just discussing, the French trial of Iressa at 250 mg daily for advanced BAC (abstract here), provided interesting clinical information, especially when viewed in the context of previous work on EGFR inhibitors in BAC. But in 2007 we’re also interested in the next generation of questions, including trying to identify which patients are […]
0 Comments Celecoxib (Celebrex) has been studied in combination with chemo for NSCLC and has generated enough promising results to raise expectations but also enough negative data to produce disappointment. Dr. Altorki’s trial (abstract here) gave 29 patients with stage IIIA, resectable NSCLC celebrex at 400 mg by mouth twice daily (higher than standard arthritis dosing, but the dose […]
2 Comments  We’ll break from brain metastases for a while to talk about another potential avenue of targeted therapy in lung cancer: the cyclo-oxygenase, or COX, pathway.
 Cyclo-oxygenase (COX) inhibition has been studied as a potential mechanism for inhibiting cancer over the past few years, and recently some early clinical trial results have looked promising and […]
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