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Arguing Against Molecular Testing for EGFR in NSCLC

May 8, 2008 - 10:24 pm

     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 […]

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Biomarkers Predicting Clinical Benefits for BAC Patients Receiving Tarceva

April 30, 2008 - 9:35 pm

   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 […]

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Trial of Tarceva in BAC: New Info on Who Benefits with Tarceva

April 29, 2008 - 3:49 pm

   In a recent issue of the Journal of Clinical Oncology, Dr. Vince Miller and colleagues published the results of an important trial of the EGFR inhibitor tarceva (erlotinib) in the unusual NSCLC subtype bronchioloalveolar carcinoma, or BAC (abstract here).   This work was predicated on the observation, also by Dr. Miller and his colleagues at Memorial […]

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Tarceva vs. Standard Chemo Compared for Marginal Performance Status Patients, by Dr Laskin

March 11, 2008 - 8:18 pm

   One of the issues we struggle the most with, as oncologists, patients, and families, is how to choose a therapy that won’t make someone feel worse. There are so many things to factor into these decisions: what is the baseline function of the person, what comorbidities (other chronic illnesses) might interact or interfere, what side […]

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Results with Chemotherapy in Different Racial Populations

February 16, 2008 - 4:56 pm

   While the differences in anticipated clinical benefits from EGFR tyrosine kinase inhibitors like tarceva and iressa are well known (summarized in prior post), less well appreciated is the potentially significant differences in results with garden variety standard chemotherapy.  These differences are likely to be very relevant as the US has a harder time getting […]

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Racial Differences in Response to EGFR Inhibitors

February 13, 2008 - 9:12 pm

    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.  […]

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Intro to Pharmacogenomics: Trying to Understand Differences in Treatment Outcomes

February 10, 2008 - 10:15 pm

   Infused throughout the website is a constant recognition that “patients are different”, but while we know this intuitively, we’re really not moved to a point of individualizing treatment on the basis of this.  There are many lines of clinical research that are moving in that direction, and one of the key elements is pharmacogenomics, […]

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XL647: Novel Agent As An Alternative or Follow-up After Tarceva

January 13, 2008 - 6:30 pm

   In the Q&A forums recently, members Jianming and Neil introduced us to the  novel agent XL647, in clinical trials now, but I figured it was worth me collecting more background and providing a more thorough background.  XL647 is an oral small molecular that inhibits multiple tyrosine kinases, receptors on cells that trigger cascades of activity […]

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Comparison of Iressa to Single Agent Chemo in First Line treatment for Elderly Advanced NSCLC Patients: The INVITE Trial

September 23, 2007 - 9:17 am

   In addition to a direct comparison of iressa to chemo in the second line setting for advanced NSCLC (see recent post on INTEREST trial), as conducted with the INTEREST trial I described in a recent post, a very similar comparison of Iressa to chemo was also performed in another setting where single-agent chemo is […]

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The INTEREST Trial of Chemo vs. Iressa as Second Line Treatment for Advanced NSCLC

September 19, 2007 - 11:13 pm

   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 […]

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