I just arrived today at the American Society for Clinical Oncology (ASCO) Annual Meeting, the largest cancer conference of the year, in Chicago this time. There are something in the range of 25,000 - 30,000 people who attend from all over the world, and a lot of the blockbuster results that change treatment practice are saved to be presented here. You’ll almost certainly see some leads on the news about various cancer trials, since there are press releases that come after the results are reported. We’ll have to see how much on the lung cancer front is newsworthy.
Fortunately, you won’t have to rely on the big news channels to tell you the highlights in the lung cancer arena. I’ll give a glimpse of some of the highlights as the information comes in over the next several days (ends 6/5), and then over the next few weeks I’ll be able to go into many of these stories in more depth, likely with some of the slides and figures as I can get them. I hope to have plenty to talk about!
posted by Dr. West @ 9:10 pm link to this post
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June 2nd, 2007 at 12:00 pm
greetings Dr. West!!!!
I am very very excited to hear the latest news on lung cancer this year, I can’t hardly wait for your posts
Hope all is well there in the windy city!
Karen
June 2nd, 2007 at 8:44 pm
Hi Doctor West! Glad you’ll be giving us the scoop and enjoy our fair city by the lake!
Welthy
June 2nd, 2007 at 9:54 pm
I’ll try very hard to post info tomorrow (6/3). These days are so long I need to get some sleep before the rush starts all too early tomorrow.
June 2nd, 2007 at 10:56 pm
For those who want to browse in advance of Dr. West’s posts, each day’s abstracts are posted at this site at the end of the work day. http://www.asco.org/portal/site/ASCO/menuitem.34d60f5624ba07fd506fe310ee37a01d/?vgnextoid=76f8201eb61a7010VgnVCM100000ed730ad1RCRD
You just have to be slightly imaginative in combining search terms. For instance, a search for erlotinib nsclc (just click on ASCO 2007 conference, not all of the conferences) produces a variety of interesting information about Tarceva (with more to be added each day). These are only the papers that have been presented so far, and it seems it also omits summaries of some of the panels that do not involve a simple paper.
I just spent a couple of hours looking. I think I see no magic bullets (no surprise there), but some modest (and sometimes slightly-more-than-modest) improvements, particularly in second-line (and beyond) treatments. The lingo can be a little thick for us laypeople, but you can usually get the general idea.
June 2nd, 2007 at 11:02 pm
One other thing worthy of note (and this actually made some news stories). Shark cartilage seems to have struck out as a complementary NSCLC treatment (people who took it with chemotherapy did slightly worse than those who just did chemotherapy, though the difference was not statistically signficant). Flaxseed may have gotten a better review (so said the New York Times story, though I couldn’t find that abstract), and there was some evidence that ginseng helps with chemotherapy side effects.
June 3rd, 2007 at 8:10 am
Dear Dr.West,
you gave me a comprehensive answer to my question “What to do after Iressa fails for an EGFR mutation positive patient?” on August 8, 2006, saying also in the bottom that “we don’t know right now”. Having asked in advance and arriving now to the instant when Iressa does not probably work for my wife any more (after 19 moths of working) I wonder if anything new emerged since that time. Also some recommendation concerning management of edema of locoregional arm, which has currently (two days ago) developed would be appreciated. I found that arm lymphedema and swollen arm is associated with VEGFR http://www.fasebj.org/cgi/reprint/16/9/922.pdf. Therefore I would like to think about avastin combined with alimta. Would that be a sound idea or you can advise some better option for such a case?
My wife Blanka (52):
Dx July 2005 NSCLC stage IV, adenocarcinoma with tumor in the apical segment of upper right lung lobe 38 mm diameter, with bone mets
and cancer found in supraclavicular lymph node
Paklitaxel/Carboplatina 4 rounds
EGFR mutations found on exon 19 del745-750insK, therefore:
Iressa, Bonefos, Ocober 2005 -
stable, , having rash improving from 2 crutches and severe pains to
doing 20 km a day skiing or biking.
May 2007 swollen right lymph node and right arm about 1 inch on the arm periphery
For complete information I add ultrasound of thyroid 15.07.2005:
Right fold homogenous, ventrodorsal size 14 mm
At the bottom edge paratracheally a pair of spherical, hypoechogenic ganglia of the size of 9-10mm (0.4 inch)
Left fold in its upper part with two hypo-anechogenic foci of the size of 4 a 3 mm (0.15 and 0.12 inch). In the bottom part inhomogeneous focus 13 x 8 mm (0.51 to 0.31 inch).
Bothside supraclavicularly and laterally at carotid vessel multiplex morbid lymfadenopathy more to the left, the biggest set of ganglia in longitudinal axis up to 25mm (1 inch).
Conclusion:
*Morbid focus in the bottom part of the left fold of thyroid 13 x 8 mm (0.51 to 0.31 inch).
Two small hypoechogenic foci in the upper part of the left fold of thyroid
*Two spherical hypoechogenic ganglia 10mm (0.4 inch) at the bottom edge of R fold of thyroid
*Multiplex morbid lymfadenopathy in v supraclavicular parts bothside , more in the left
Thank you for your attention
Jara Pridal
June 3rd, 2007 at 8:22 pm
Neil,
Thank you for your suggestions for people to get some sense of what’s at the conference.
Jara,
Unfortunately, there haven’t been any breakthroughs with this in the last year. Much of the attention has been on trying to use irreversible EGFR inhibitors like HKI-272, which have shown a suggestion based on lab models that they may be beneficial in EGFR TKI-resistant cells, but we haven’t seen any results in actual human lung cancer patients yet.
Arm edema would most often be from a blood clot, potentially related to an IV/portacath on that side, or from decreased lypmhatic drainage due to swollen lymph nodes in the region that aren’t draining properly. It makes sense to check with her doctor.
In the future, please post questions unrelated to the post as a question in the forum section.
-Dr. West
June 4th, 2007 at 2:30 am
Thank you, Dr. West. My appology to join this post, I assumed my question a little related, since today (Monday June 4 11:30 AM) there is at ASCO the lecture Vincent A. Miller, MD : Treatment strategies for EGFR TKI-Sensitive NSCLC upon treatment Failure (M23).
Next time I post my question to the proper section.
Jara Pridal
Czech Republic
June 4th, 2007 at 7:59 pm
No problem. Dr. Miller is indeed one of the leaders in our struggle to figure out options for this setting. Some time in the next few weeks I’ll report an update on what emerges from ASCO in this regard.
-Dr. West