POPULARITY
Dr. Hedy Kindler joins us on the podcast to discuss the latest update to the treatment of pleural mesothelioma guideline. She discusses the latest changes to the updated recommendations across topics including surgery, immunotherapy, chemotherapy, pathology, and germline testing. Dr. Kindler describes the impact of this guideline and the need for ongoing research in the field. Read the full guideline update, “Treatment of Pleural Mesothelioma: ASCO Guideline Update” at www.asco.org/thoracic-cancer-guidelines. TRANSCRIPT This guideline, clinical tools, and resources are available at http://www.asco.org/thoracic-cancer-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology, https://ascopubs.org/doi/10.1200/JCO-24-02425 Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one at asco.org/podcasts. My name is Brittany Harvey and today I'm interviewing Dr. Hedy Kindler from the University of Chicago, lead author on “Treatment of Pleural Mesothelioma: ASCO Guideline Update.” Thank you for being here today, Dr. Kindler. Dr. Hedy Kindler: Thank you so much. Brittany Harvey: Then, before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines in ensuring that the ASCO Conflict of Interest Policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Kindler, who has joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. So then, to jump into the content of this podcast episode, first, Dr. Kindler, can you provide an overview of the purpose and scope of this guideline update on pleural mesothelioma? Dr. Hedy Kindler: The initial ASCO practice guideline on mesothelioma, which we published in 2018, was quite comprehensive, but since that time incredible progress has been made which has truly transformed the management of this disease. So we felt it was really important to update the guideline now, focusing on four key areas: the role of surgery, new systemic treatments, pathologic insights, and germline testing. Brittany Harvey: Great. Thank you for highlighting those key areas of the guideline. And so I'd like to next review the key updated recommendations for our listeners. So starting with what are the new updates for surgery? Dr. Hedy Kindler: So surgery has always been controversial in meso, with significant geographic variation in its use. Now, it's even more controversial. Recent randomized data from the MARS 2 trial, placed in the context of other data we also reviewed in this update, suggest that surgical cytoreduction should not be routinely offered to all patients based solely on anatomic resectability. Surgery should only be offered to highly selected patients with favorable prognostic characteristics. This includes comprehensively staged patients with early-stage epithelioid tumors. Patients should preferably be treated at centers of excellence which have documented low morbidity and mortality, and this should also be done in the context of multimodality therapy and preferably within clinical trials. Brittany Harvey: Understood. I appreciate you reviewing those recommendations for who surgery should be offered to. So following those, what are the main recommendations for immunotherapy for treating pleural mesothelioma? Dr. Hedy Kindler: So for a disease in which for 16 years there was only one FDA-approved regimen, pemetrexed and platinum, the pace of recent changes in systemic therapy has been a welcome change with the FDA approval of doublet immunotherapy in October of 2020 and the approval of chemo immunotherapy just a few months ago in September of 2024. Now that we have choices, we've tried to help clinicians determine the optimal treatment regimen for the individual patient. Doublet immunotherapy with ipilimumab and nivolumab should be offered as a first-line systemic option to any mesothelioma patient. For patients with non-epithelioid histology, doublet immunotherapy is hands down the recommended regimen based on the dramatic improvement in survival from 8.8 to 18.1 months for immunotherapy compared with chemo. For patients with previously untreated epithelioid mesothelioma, either ipilimumab-nivolumab immunotherapy or platinum-pemetrexed chemotherapy are reasonable options. Therapy can be individualized based on the patient's comorbidities, acceptance of differing toxicities. and treatment goals. Chemoimmunotherapy with pembrolizumab, pemetrexed, and carboplatin is a newer treatment option for patients with newly diagnosed pleural mesothelioma. This regimen is noteworthy for its very high objective response rate of 62%. Brittany Harvey: It's great to have those new options to improve outcomes for patients. Beyond the chemoimmunotherapy recommendation that you just described, what are the highlights for chemotherapy recommendations? Dr. Hedy Kindler: So pemetrexed platinum-based chemotherapy with or without bevacizumab still plays a role in this disease and should be offered as a first-line treatment option in patients with epithelioid histology. This regimen is not recommended in patients with non-epithelioid disease unless they have medical contraindications to immunotherapy. Pemetrexed maintenance chemotherapy following pemetrexed-platinum chemotherapy is not recommended. Brittany Harvey: Thank you for reviewing those recommendations as well. So then next, what are the important changes regarding pathology? Dr. Hedy Kindler: Well, one fun fact is that we've changed the name of the disease. It's no longer malignant mesothelioma. Now it's just mesothelioma. Since the non-malignant mesothelial entities have been renamed, all mesos are now considered malignant, so there's no need to use the prefix malignant in the disease name. Mesothelioma should be reported as epithelioid, sarcomatoid, or biphasic because these subtypes have a clear prognostic and predictive value. Knowing the subtype helps us decide on whether chemotherapy or immunotherapy is the optimal treatment for a patient, so it must be reported. Additionally, within the epithelioid subtype, histologic features, including nuclear grade, some cytologic features, and architectural patterns should be reported by pathology because they have prognostic significance. Pathologists have recently identified a premalignant entity, mesothelioma in situ, which can be found in patients with long standing pleural effusions and should be considered in the differential diagnosis. In the appropriate clinical setting, additional testing, including BAP1 and MTAP IHC should be performed. Brittany Harvey: Definitely. These pathologic recommendations are important for treatment selection. So in that same vein, in the final section of the recommendations, what are the updated recommendations from the panel regarding germline testing? Dr. Hedy Kindler: This is one of our most important recommendations, that universal germline testing should be offered to all mesothelioma patients. The proportion of patients with mesothelioma who have pathogenic or likely pathogenic germline variants is similar to other diseases in which universal germline genetic testing and counseling are now the standard of care. This is most commonly observed in the tumor suppressor gene BAP1 and this not only affects cancer risk in patients and their family members, but also has key prognostic significance. For example, pleural mesothelioma patients with BAP1 germline mutations who receive platinum-based chemotherapy live significantly longer, 7.9 years compared to 2.4 years for those without these mutations. Thus, we recommend that all patients with mesothelioma should be offered universal germline genetic counseling and/or germline testing. Brittany Harvey: So there were a large amount of new and updated recommendations in this update. So in your view Dr. Kindler, what is the both importance of this update and how will it impact both clinicians and patients with pleural mesothelioma? Dr. Hedy Kindler: Even as we were researching and writing this update, new data kept emerging which we needed to include. So it's clearly a time of great progress in the management of this disease. We've comprehensively reviewed and analyzed the extensive emerging data and provided clinicians with a roadmap for how to incorporate these new advances into their management of this disease. Brittany Harvey: Absolutely, that is key for optimal patient care. So you've just mentioned emerging data and rapid evidence generation, so what future research developments are being monitored for changes in the treatment of pleural mesothelioma? Dr. Hedy Kindler: Despite these recent advances in disease management, mesothelioma continues to be a lethal cancer, and there's clearly a need to develop better treatments. This includes ongoing studies of novel immunotherapeutic agents such as bispecific antibodies, cell therapy using chimeric antigen receptors targeting mesothelioma tumor antigens, and precision medicine approaches to target tumor suppressor genes. Finally, strategies for early cancer detection and prevention are vital for individuals predisposed to develop mesothelioma due to BAP1 and other germline mutations, as well as for those who are occupationally or environmentally exposed to asbestos. Brittany Harvey: Absolutely. We'll look forward to these new updates to continue development in the field. So thank you so much for this mountain of work to update this guideline, and thank you for your time today, Dr. Kindler. Dr. Hedy Kindler: Thank you so much. It's been a pleasure. Thank you for asking me to do this. Brittany Harvey: And thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline update, go to www.asco.org/thoracic-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.
Discussing Lung Cancer ASCO 2023 Highlights, focusing on practice-changing studies with Dr. Charu Aggarwal, Director, Precision Oncology Innovation, Associate Professor of Lung Cancer Excellence at Penn Medicine. Covering three important studies: - ADAURA trial update with increased OS with adjuvant Osimertinib - KEYNOTE 789 - Pemetrexed and platinum with or without pembrolizumab for tyrosine kinase inhibitor (TKI)-resistant, EGFR-mutant - KEYNOTE 671 - Randomized, double-blind, phase 3 study of pembrolizumab or placebo plus platinum-based chemotherapy followed by resection and pembrolizumab or placebo for early stage NSCLC
Landmarks of OncoPharm episode on maintenance pemetrexed in NSCLC. Switch maintenance: https://doi.org/10.1016/s0140-6736(09)61497-5 Continuation maintenance (PARAMOUNT): https://doi.org/10.1016/S1470-2045(12)70063-3
MesoTV Podcast: Conversations Impacting the Mesothelioma Community
Dr. Andreas Rimner of Memorial Sloan Kettering Cancer Center joins us to discuss a clinical trial "Testing the Addition of Targeted Radiation Therapy to Surgery and the Usual Chemotherapy Treatment (Pemetrexed and Cisplatin [or Carboplatin]) for Stage I-IIIA Malignant Pleural Mesothelioma." Dr. Rimner is a radiation oncologist specializing in thoracic cancers. He in interviewed by Mary Hesdorffer, expert nurse practitioner and executive director of the Mesothelioma Applied Research Foundation. Patients who need help with their diagnosis can contact Mary Hesdorffer, NP through the organization's website. The Mesothelioma Applied Research Foundation is the only national nonprofit organization dedicated to eradicating mesothelioma by providing patient services and education; funding peer-reviewed research; and advocating for government funding of mesothelioma research. More information about the organization is available at www.curemeso.org.
Ten years ago a preplanned subgroup analysis changed the NSCLC treatment algorithms. We go back to the beginning with pemetrexed and the studies leading up to the oft-cited Scagliotti that ushered in histology-specific treatment in NSCLC.
Dr. Jack West, Swedish Cancer Institute, raises the question of whether to use immune checkpoint inhibitors as first-line treatment of lung cancer, alone or in combination with chemotherapy.
Dr. Jack West, Swedish Cancer Institute, raises the question of whether to use immune checkpoint inhibitors as first-line treatment of lung cancer, alone or in combination with chemotherapy.
Dr. Jack West, Swedish Cancer Institute, raises the question of whether to use immune checkpoint inhibitors as first-line treatment of lung cancer, alone or in combination with chemotherapy.
Dr. Jack West, Swedish Cancer Institute, defines maintenance therapy in advanced NSCLC and discusses maintenance treatment strategies.
Dr. Jack West, Swedish Cancer Institute, defines maintenance therapy in advanced NSCLC and discusses maintenance treatment strategies.
Dr. Jack West, Swedish Cancer Institute, defines maintenance therapy in advanced NSCLC and discusses maintenance treatment strategies.
Dr. Jack West, Swedish Cancer Institute, reviews the choices for a first-line chemotherapy regimen based on a squamous histology.
Dr. Jack West, Swedish Cancer Institute, reviews the choices for a first-line chemotherapy regimen based on a squamous histology.
Dr. Jack West, Swedish Cancer Institute, reviews the choices for a first-line chemotherapy regimen based on a squamous histology.
Dr. Jack West, Swedish Cancer Institute, addresses the issue of choosing a first-line chemotherapy regimen based on an adenocarcinoma histology.
Dr. Jack West, Swedish Cancer Institute, addresses the issue of choosing a first-line chemotherapy regimen based on an adenocarcinoma histology.
Dr. Jack West, Swedish Cancer Institute, addresses the issue of choosing a first-line chemotherapy regimen based on an adenocarcinoma histology.
Dr. Jack West, Swedish Cancer Institute, discusses the anti-angiogenic agent bevacizumab (Avastin) and the trial evidence of its efficacy for non-squamous NSCLC.
Dr. Jack West, Swedish Cancer Institute, discusses the anti-angiogenic agent bevacizumab (Avastin) and the trial evidence of its efficacy for non-squamous NSCLC.
Dr. Jack West, Swedish Cancer Institute, discusses the anti-angiogenic agent bevacizumab (Avastin) and the trial evidence of its efficacy for non-squamous NSCLC.
Dr. Jack West, Swedish Cancer Institute, identifies the platinum-based chemotherapy doublet as the backbone of first-line treatment for the majority of NSCLC patients.
Dr. Jack West, Swedish Cancer Institute, identifies the platinum-based chemotherapy doublet as the backbone of first-line treatment for the majority of NSCLC patients.
Dr. Jack West, Swedish Cancer Institute, identifies the platinum-based chemotherapy doublet as the backbone of first-line treatment for the majority of NSCLC patients.
Dr. Heather Wakelee, Stanford University Medical Center, lists standard adjuvant chemotherapy regimens, comparing their administration and uses.
Dr. Heather Wakelee, Stanford University Medical Center, lists standard adjuvant chemotherapy regimens, comparing their administration and uses.
Dr. Heather Wakelee, Stanford University Medical Center, lists standard adjuvant chemotherapy regimens, comparing their administration and uses.
Dr. Benjamin Levy, Mount Sinai Health Systems, discusses platinum-based chemotherapy as the standard of care for advanced NSCLC patients without targetable genetic mutations.
Dr. Benjamin Levy, Mount Sinai Health Systems, discusses platinum-based chemotherapy as the standard of care for advanced NSCLC patients without targetable genetic mutations.
Dr. Benjamin Levy, Mount Sinai Health Systems, discusses platinum-based chemotherapy as the standard of care for advanced NSCLC patients without targetable genetic mutations.
Dr. Nasser Hanna, Indiana University Health, lists chemo regiments appropriate for use with radiation in locally advanced NSCLC.
Dr. Nasser Hanna, Indiana University Health, lists chemo regiments appropriate for use with radiation in locally advanced NSCLC.
Dr. Nasser Hanna, Indiana University Health, lists chemo regiments appropriate for use with radiation in locally advanced NSCLC.
Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, evaluates a variety of particular systemic treatment agents for possible use in elderly patients.
Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, evaluates a variety of particular systemic treatment agents for possible use in elderly patients.
Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, evaluates a variety of particular systemic treatment agents for possible use in elderly patients.
Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, discusses the use of single agent vs. doublet chemotherapy in elderly patients.
Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, discusses the use of single agent vs. doublet chemotherapy in elderly patients.
Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, discusses the use of single agent vs. doublet chemotherapy in elderly patients.
Drs. Ben Solomon, Leora Horn, & Jack West discuss highlights of a French randomized trial that demonstrated a significant survival benefit from addition of Avastin (bevacizumab) to cisplatin/Alimta in patients with malignant pleural mesothelioma.
Drs. Ben Solomon, Leora Horn, & Jack West discuss highlights of a French randomized trial that demonstrated a significant survival benefit from addition of Avastin (bevacizumab) to cisplatin/Alimta in patients with malignant pleural mesothelioma.
Drs. Ben Solomon, Leora Horn, & Jack West discuss highlights of a French randomized trial that demonstrated a significant survival benefit from addition of Avastin (bevacizumab) to cisplatin/Alimta in patients with malignant pleural mesothelioma.
The concept of maintenance therapy for advanced lung cancer has emerged over the past few years. Dr. Jack West, medical oncologist, reviews the concepts behind it and treatment options for patients.
The concept of maintenance therapy for advanced lung cancer has emerged over the past few years. Dr. Jack West, medical oncologist, reviews the concepts behind it and treatment options for patients.
The concept of maintenance therapy for advanced lung cancer has emerged over the past few years. Dr. Jack West, medical oncologist, reviews the concepts behind it and treatment options for patients.
Acquired Resistance Forum Video #10: Online advocate and ROS1 patient "Craig In PA" Uthe leads a Q&A with speakers from videos #8 and #9 at the Acquired Resistance in Lung Cancer Patient Forum.
Acquired Resistance Forum Video #10: Online advocate and ROS1 patient "Craig In PA" Uthe leads a Q&A with speakers from videos #8 and #9 at the Acquired Resistance in Lung Cancer Patient Forum.
Acquired Resistance Forum Video #10: Online advocate and ROS1 patient "Craig In PA" Uthe leads a Q&A with speakers from videos #8 and #9 at the Acquired Resistance in Lung Cancer Patient Forum.
Acquired Resistance Forum Video #9: Dr. Alice Shaw of Massachusetts General Hospital detailed for patients the so-called "next generation" ALK/ROS1 inhibitors, both those commercially available and those still in development.
Acquired Resistance Forum Video #9: Dr. Alice Shaw of Massachusetts General Hospital detailed for patients the so-called "next generation" ALK/ROS1 inhibitors, both those commercially available and those still in development.
Acquired Resistance Forum Video #9: Dr. Alice Shaw of Massachusetts General Hospital detailed for patients the so-called "next generation" ALK/ROS1 inhibitors, both those commercially available and those still in development.
Acquired Resistance Forum Video #8: Dr. Robert Doebele of the University of Colorado Cancer Center spoke to ALK and ROS1 patients about how and why their cancers become resistant to treatment and what options are available.
Acquired Resistance Forum Video #8: Dr. Robert Doebele of the University of Colorado Cancer Center spoke to ALK and ROS1 patients about how and why their cancers become resistant to treatment and what options are available.
Acquired Resistance Forum Video #8: Dr. Robert Doebele of the University of Colorado Cancer Center spoke to ALK and ROS1 patients about how and why their cancers become resistant to treatment and what options are available.
Thanks to research, Dr. Daniel Morgensztern of the Washington University School of Medicine sees reason to be hopeful in the fight against lung cancer. February 2014
Thanks to research, Dr. Daniel Morgensztern of the Washington University School of Medicine sees reason to be hopeful in the fight against lung cancer. February 2014
Thanks to research, Dr. Daniel Morgensztern of the Washington University School of Medicine sees reason to be hopeful in the fight against lung cancer. February 2014
An analysis of two large studies of EGFR lung cancer patients tried to determine if Gilotrif helped patients live longer.
An analysis of two large studies of EGFR lung cancer patients tried to determine if Gilotrif helped patients live longer.
An analysis of two large studies of EGFR lung cancer patients tried to determine if Gilotrif helped patients live longer.
Medizinische Fakultät - Digitale Hochschulschriften der LMU - Teil 16/19
Lung cancer is the leading cause of cancer deaths worldwide. Despite advances and progresses in surgery, chemotherapy, and radiotherapy over the last decades, the death rate from lung cancer has remained largely unchanged, which is mainly due to metastatic disease and multi drug resistance. Because of the overall poor prognosis, new treatment strategies for lung cancer patients are urgently needed. The aim of this study was to investigate the interactions between pemetrexed and vinorelbine for human adenocarcinoma via various chemotherapy schedules. Vinorelbine and pemetrexed caused a strong dose-dependent cytotoxic effect in both HCC and cisplatin resistant HCC (HCC-res) cells. The IC50 values of vinorelbine against HCC and HCC-res cells were 10.34±1.12 nM and 9.98±2.12 nM, respectively. The IC50 values of Pemetrexed against these cells were 110.77±17.28 nM and 118.89±18.77 nM respectively. The application of different therapy schedules induced a significant time dependent cell growth inhibition on HCC naïve and cisplatin resistant cells. The therapy scheme of cisplatin→pemetrexed→vinorelbine showed the strongest inhibitory effect on both HCC and HCC-res cells. The application of different therapy schedules on HCC and HCC-res cells increased the percentage of cells undergoing apoptosis, except the application of vinorelbine alone. In both HCC and HCC-res cells, cisplatin→pemetrexed→vinorelbine was found the most effective to induce apoptosis. The application of different therapy schedules on HCC and HCC-res cells increased cytoplasma calcium concentration. Only the application of vinorelbine alone failed to increase calcium concentration in HCC cells. The most elevated calcium concentration was found in the cells treated with cisplatin→pemetrexed→vinorelbine in both HCC and HCC-res cells As a conclusion, the sequential application of cisplatin, vinorelbine and pemetrexed has a synergistic effect in cell growth inhibition, apoptosis induction, and calcium concentration elevation in HCC and HCC-res cells. The calcium overload could lead to apoptosis, which was related to the cell growth inhibitory effect of chemotherapeutics in lung cancer cells. It might cast a light to develop chemotherapy schedules for patients, and to overcome cisplatin resistance in lung cancer.
The AVAPERL trial reveals a significant improvement in progression-free survival with the combination of pemetrexed/bevacizumab compared with bevacizumab alone as maintenance therapy for advanced non- small-cell lung cancer, but the clinically relevant endpoint remains overall survival.
Drs. Nate Pennell, Mary Pinder, and Jack West review the results presented at ASCO 2013 from the PARAMOUNT trial of maintenance therapy with the ECOG 4599 regimen vs. carboplatin/Alimta (pemetrexed)/Avastin (bevacizumab) followed by Alimta/Avastin maint.
Drs. Nate Pennell, Mary Pinder, and Jack West review the results presented at ASCO 2013 from the PARAMOUNT trial of maintenance therapy with the ECOG 4599 regimen vs. carboplatin/Alimta (pemetrexed)/Avastin (bevacizumab) followed by Alimta/Avastin maint.
Drs. Nate Pennell, Mary Pinder, and Jack West review the results presented at ASCO 2013 from the PARAMOUNT trial of maintenance therapy with the ECOG 4599 regimen vs. carboplatin/Alimta (pemetrexed)/Avastin (bevacizumab) followed by Alimta/Avastin maint.
Drs. Nate Pennell, Mary Pinder, and Jack West review the results presented at ASCO 2013 from the PRONOUNCE trial of the ECOG 4599 trial regimen compared with carboplatin/Alimta (pemetrexed) followed by maintenance Alimta.
Drs. Nate Pennell, Mary Pinder, and Jack West review the results presented at ASCO 2013 from the PRONOUNCE trial of the ECOG 4599 trial regimen compared with carboplatin/Alimta (pemetrexed) followed by maintenance Alimta.
Drs. Nate Pennell, Mary Pinder, and Jack West review the results presented at ASCO 2013 from the PRONOUNCE trial of the ECOG 4599 trial regimen compared with carboplatin/Alimta (pemetrexed) followed by maintenance Alimta.
Dr. Natasha Leighl, Princess Margaret Hospital in Toronto, Canada, summarizes evidence from the PARAMOUNT trial, demonstrating a survival benefit for continuation maintenance therapy with Alimta (Pemetrexed) in advanced non-small cell lung cancer.
Dr. Natasha Leighl, Princess Margaret Hospital in Toronto, Canada, summarizes evidence from the PARAMOUNT trial, demonstrating a survival benefit for continuation maintenance therapy with Alimta (Pemetrexed) in advanced non-small cell lung cancer.
Dr. Natasha Leighl, Princess Margaret Hospital in Toronto, Canada, summarizes evidence from the PARAMOUNT trial, demonstrating a survival benefit for continuation maintenance therapy with Alimta (Pemetrexed) in advanced non-small cell lung cancer.
Dr. Natasha Leighl, Princess Margaret Hospital in Toronto, Canada, summarizes evidence from the PARAMOUNT trial, demonstrating a survival benefit for continuation maintenance therapy with Alimta (Pemetrexed) in advanced non-small cell lung cancer.
Dr. Natasha Leighl, Princess Margaret Hospital in Toronto, Canada, summarizes evidence from the PARAMOUNT trial, demonstrating a survival benefit for continuation maintenance therapy with Alimta (Pemetrexed) in advanced non-small cell lung cancer.
Dr. Natasha Leighl, Princess Margaret Hospital in Toronto, Canada, summarizes evidence from the PARAMOUNT trial, demonstrating a survival benefit for continuation maintenance therapy with Alimta (Pemetrexed) in advanced non-small cell lung cancer.
Dr. Phil Bonomi provides his views on the value of maintenance therapy for advanced non-small cell lung cancer and the various alternatives among maintenance therapies compared with a break from treatment.
Dr. Phil Bonomi provides his views on the value of maintenance therapy for advanced non-small cell lung cancer and the various alternatives among maintenance therapies compared with a break from treatment.
Dr. Phil Bonomi provides his views on the value of maintenance therapy for advanced non-small cell lung cancer and the various alternatives among maintenance therapies compared with a break from treatment.
Dr. Jack West describes the factors that contribute to a recommendation for or against post-operative (adjuvant) chemotherapy for a patient with resected early stage non-small cell lung cancer.
Dr. Mark Socinski from the University of Pittsburgh reviews evidence to support doublet chemo over single agent for marginal performance status (PS2) patients with advanced NSCLC.
Dr. Mark Socinski from the University of Pittsburgh reviews evidence to support doublet chemo over single agent for marginal performance status (PS2) patients with advanced NSCLC.
Dr. Mark Socinski from the University of Pittsburgh reviews the survival benefit and implications from the PARAMOUNT maintenance therapy trial of Alimta (pemetrexed) in advanced NSCLC.
Dr. Mark Socinski from the University of Pittsburgh reviews the survival benefit and implications from the PARAMOUNT maintenance therapy trial of Alimta (pemetrexed) in advanced NSCLC.
Dr. Jared Weiss, Medical Oncologist at UNC-Chapel Hill, reviews lung cancer highlights in 2011, with this podcast focusing on ALK rearrangements and new molecular targets in lung cancer.
Dr. Jared Weiss, Medical Oncologist at UNC-Chapel Hill, reviews lung cancer highlights in 2011, with this podcast focusing on ALK rearrangements and new molecular targets in lung cancer.
Background: Pemetrexed is an antifolate drug approved for maintenance and second-line therapy, and, in combination with cisplatin, for first-line treatment of advanced nonsquamous non-small cell lung cancer. The side-effect profile includes fatigue, hematological and gastrointestinal toxicity, an increase in hepatic enzymes, sensory neuropathy, and pulmonary and cutaneous toxicity in various degrees. Case Report: We present the case of a 58-year-old woman with history of Sharp's syndrome and adenocarcinoma of the lung, who developed toxic epidermal necrolysis after the first cycle of pemetrexed, including erythema, bullae, extensive skin denudation, subsequent systemic inflammation and severe deterioration in general condition. The generalized skin lesions occurred primarily in the previous radiation field and responded to immunosuppressive treatment with prednisone. Conclusion: Although skin toxicity is a well-known side effect of pemetrexed, severe skin reactions after pemetrexed administration are rare. Caution should be applied in cases in which pemetrexed is given subsequent to radiation therapy, especially in patients with pre-existing skin diseases.
Dr. Ross Camidge reviews considerations of who to screen for an ALK rearrangement and additional treatment alternatives for patients with ALK-positive advanced non-small cell lung cancer.
Dr. Ross Camidge reviews considerations of who to screen for an ALK rearrangement and additional treatment alternatives for patients with ALK-positive advanced non-small cell lung cancer.
Case discussion with Drs. Tom Hensing of in Chicago & David Jackman in Boston, discussing practical issues around molecular marker testing & recommended treatments for first line & maintenance therapy for a never-smoker with a lung adenocarcinoma.
Case discussion with Drs. Tom Hensing of in Chicago & David Jackman in Boston, discussing practical issues around molecular marker testing & recommended treatments for first line & maintenance therapy for a never-smoker with a lung adenocarcinoma.
Case discussion with Drs. Tom Hensing of in Chicago and David Jackman in Boston, discussing practical issues around molecular marker testing and recommended treatments for first line and maintenance therapy for an ex-smoker with a lung adenocarcinoma.
Case discussion with Drs. Tom Hensing of in Chicago and David Jackman in Boston, discussing practical issues around molecular marker testing and recommended treatments for first line and maintenance therapy for an ex-smoker with a lung adenocarcinoma.
Case discussion with Drs. Tom Hensing of in Chicago and David Jackman in Boston, discussing practical issues around molecular marker testing and recommended treatments for first line and maintenance therapy for a patient with advanced squamous cell NSCLC.
Case discussion with Drs. Tom Hensing of in Chicago and David Jackman in Boston, discussing practical issues around molecular marker testing and recommended treatments for first line and maintenance therapy for a patient with advanced squamous cell NSCLC.