Net Guides: Lung Cancer

OncologyLive, January 2011, Volume 12, Issue 1

Useful Online Resources and Clinical Trials for Lung Cancer


ASCO Guidelines Updated

The American Society of Clinical Oncology has posted a full article explaining clinical practice guidelines for the treatment of stage IV non-small cell lung cancer (NSCLC) using chemotherapy. After the introduction, the article begins with a section titled “Guideline Questions,” which contains a list of questions related to treatment decision-making for first-line, second-line, and third-line chemotherapy, as well as molecular analysis. The next sections discuss the methods used to determine updates to the guidelines and the results of those methods. There are the guideline update recommendations themselves and sections discussing future research directions, patient-physician communication, and health disparities.


This Website is part of the CancerCare program, a national nonprofit organization, and is designed to provide information and support to lung cancer patients and their loved ones. In the information section, visitors may find details on lung cancer prevention, types of the disease, symptoms, risk factors, screening and early detection, diagnosis, staging, and treatment. This section also features an FAQ page and a glossary of terms. The site also has a selection of downloadable publications that cover a wide range of topics, including the disease, caregiving, coping, clinical trials, doctor/patient communication, grief and bereavement, financial/insurance information, managing side effects, prevention, treatment advances, and more. Many of these publications— as well as most of the information on the Website—also is available in Spanish. Another resource offered by is its Connect Education Workshop program. Oncology experts lead the workshops, which are interactive educational programs that participants can join via the telephone or live Internet streaming. Previous workshops are available as telephone replays or as podcasts. Other resources on include support groups, a hotline, financial assistance, and a monthly newsletter.


Maintenance therapy for non-small cell lung cancer

Credits: 1.25

Fee: None

Expires: May 12, 2011

This CME activity is based on a 2-part slideshow with audio presentation on maintenance therapy for NSCLC. It was originally presented at the 2010 National Comprehensive Cancer Network 15thAnnual Conference: Clinical Practice Guidelines & Quality Cancer Care. Two experts, Mark G. Kris, MD, of the Memorial Sloan-Kettering Cancer Center, and George R. Simon, MD, of the Fox Chase Cancer Center, discuss various approaches to maintenance therapy for NSCLC. They examine data from a number of trials in order to evaluate and compare the different treatment methods in multiple NSCLC settings. The slides contain notes and charts displaying these data and illustrating the experts’ points. After completing this activity, participants will be able to identify the treatment approaches for patients after initial therapy for advanced NSCLC. Participants also will be able to determine which patients are most likely to benefit from maintenance therapy, and describe the risks and benefits associated with maintenance therapy.


Predictors and impact of second-line chemotherapy for advanced non-small cell lung cancer in the United States: real-world considerations for maintenance therapy

Journal: Journal of Thoracic Oncology

Authors: Gerber DE, Rasco DW, Yan J, Dowell JE, Xie Y

Purpose: Recent studies have demonstrated that including maintenance chemotherapy in the initial treatment of advanced NSCLC has efficacy in some patients. This study was designed to determine the predictors and impact of second-line chemotherapy administration in a contemporary, diverse population of patients with NSCLC. The researchers performed a retrospective analysis of consecutive patients diagnosed with stage IV NSCLC at the University of Texas Southwestern Medical Center’s facilities from 2000 to 2007. Data on demographics, disease, treatments, and outcomes were gathered from hospital tumor registries. The researchers then used univariate analysis and multivariate logistic regression to assess the connection between these variables.

Results:The study included 406 patients who received first-line chemotherapy. Of these patients, 28% were women, 59% were white, and the mean age was 59 years. Second-line chemotherapy was administered to 197 patients. In this group, 67% of patients who had no disease progression after 4 to 6 cycles of first-line chemotherapy had received second-line chemotherapy. The study found that the receipt of second-line chemotherapy was not associated with patient age, gender, race, histology, or year of diagnosis, but was strongly associated with patient insurance type, number of first-line chemotherapy cycles, and receipt of prechemotherapy palliative radiation therapy. The multivariate model confirmed these associations. In both univariate and multivariate analyses, overall survival was associated with the number of first-line chemotherapy cycles and administration of second-line chemotherapy. The authors concluded that markers of socioeconomic status, symptom burden, and response to and tolerance of first-line chemotherapy were associated with the administration of second-line chemotherapy. They also concluded that these factors might help in selecting patients most likely to benefit from maintenance chemotherapy.


Pemetrexed disodium, gemcitabine, and bevacizumab in treating patients with stage IIIB or stage IV non-small cell lung cancer

Study Type: Interventional

Age/Sex Requirements: ≥18 years

Sponsor: Barbara Ann Karmanos Cancer Institute Identifier: NCT00438204

Purpose: This study will test the efficacy of a regimen consisting of the chemotherapy drug gemcitabine, the monoclonal antibody bevacizumab, and the antineoplastic agent pemetrexed disodium in the treatment of patients with stage IIIB or stage IV NSCLC. The primary outcome measure is progression-free survival. Secondary measures include response rate, toxicity, time to treatment failure, and overall survival.


Tarceva (erlotinib)

Tarceva is a drug manufactured by OSI Pharmaceuticals, Inc that inhibits the epidermal growth factor receptor needed by cancer cells to grow and multiply. The drug has been approved as a maintenance therapy for patients with advanced NSCLC whose cancer has not progressed after initial platinum-based chemotherapy. The most common side effects of Tarceva are mild to moderate rash and diarrhea. Less common serious adverse reactions include severe skin reactions, gastrointestinal perforations, liver and kidney problems, and interstitial lung disease-like events. For further information, visit