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Maintenance Alimta in Advanced NSCLC Shows Significant Improvement in Progression-Free Survival

May 17, 2008 - 3:05 pm

   Last year, a provocative trial was presented at ASCO that compared early vs. later taxotere as second line therapy.  I described that study here, and it showed a very significant improvement in progression-free survival (PFS) and a near significant improvement in overall survival (OS) for the recipients of taxotere immediately after four cycles of first line […]

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Stable disease is just fine, thank you.

May 10, 2008 - 2:36 pm

At the 1st ESMO-IASLC Lung Cancer Conference in Geneva last week I saw a presentation that I thought would interest this general readership. The study, presented by Dr Grossi, from Italy, is a retrospective review of 61 patients with advanced NSCLC of all subtypes treated with either Tarceva (erlotinib) or Iressa (gefitinib) […]

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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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Use of Avastin (Bevacizumab) in Patients with Brain Metastases

April 20, 2008 - 3:16 pm

   Since the anti-angiogenic agent avastin (bevacizumab) has been shown to confer a survival benefit in a subset of patients with previously untreated advanced NSCLC (see prior post), we have been struggling with questions of whether the restricted eligibility requirements in the pivotal initial avastin trial were necessary.  Specifically, the trial, called ECOG 4599 (abstract […]

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EGFR Vaccine Early Results Published

April 16, 2008 - 3:49 pm

  The epidermal growth factor receptor (EGFR) is a central component of a cell pathway for growth and cell division that is thought to be affected in many cancers, including NSCLC.  EGFR inhibitors have been the focus of clinical trials for several years and are now used for many types of cancer.  Nearly all of […]

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Clinical Trials with Sutent (Sunitinib) in NSCLC

April 4, 2008 - 8:06 pm

   One of the novel agents being studied in lung cancer is sutent (sunitinib), a multi-targeted oral anti-angiogenic drug that I’ve described in a prior post.  While I’ve mentioned a small study I’m leading at my own institution with this agent in advanced NSCLC patients with bronchioloalvelar carcinoma (BAC) or who have never smoked (information […]

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Second Line Treatment in Elderly Patients

April 3, 2008 - 9:25 pm

   Completing the analysis of the randomized trial that compared alimta (pemetrexed) and taxotere (docetaxel) in second line  treatment of NSCLC (abstract here), which showed nearly identical response rates and survival but a more favorable side effect profile with alimta, another retrospective review of results looked at differences between the arms in older vs. younger […]

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Lessons on Who Benefit Most with Second Line and Later Therapies

April 1, 2008 - 9:54 pm

   One very important trial that has changed how we treat previously treated patients with advanced NSCLC has been a trial coded JMEI by Lilly, which sponsored this phase III randomized trial that directly compared second line treatment with alimta (pemetrexed) against the only FDA-approved second line treatment at that time, taxotere (docetaxel).  Essentially identical in activity, […]

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Oral Topotecan in Previously Treated Advanced NSCLC

March 1, 2008 - 8:03 am

   During the entire time I’ve been commenting on the most evidence-based and commonly used agents for previously treated patients, I’ve focused on taxotere, alimta, and tarceva (example in prior post here).  In fact, that overlooks an agent that has actually been tested in a large study and been found to have similar activity to […]

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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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