Net Guides: Non-Small Cell Lung Cancer

OncologyLive, December 2010, Volume 11, Issue 12

Useful Online Resources and Clinical Trials for Non-Small Cell Lung Cancer


Customization of NSCLC treatment This 97-page slideshow on the treatment of non-small cell lung cancer (NSCLC) was writtenby Professor Zarogoulidis P. Konstantinos of the Lung Tumour Research Section, Aristotle University Pulmonary Clinic, G. Papanikolaou Hospital, Thessaloniki, Greece. The presentation begins with NSCLC statistics, then moves on to define the stages of the disease with the help of colored diagrams. The slideshow goes into detailed descriptions of recommended treatments for each stage and discusses strategies such as chemotherapy, radiotherapy, adjuvant therapy, surgery, and various combination methods. Additional tables and graphs are included in the slideshow and display information such as significant milestones in lung cancer therapy and results from relevant clinical trials. The last informational section of the presentation discusses the management of NSCLC based on prognostic and predictive factors. A short series of questions and answers is provided for physicians to quiz themselves, along with Konstantinos’ conclusions and additional data from NSCLC studies.


NCCN guidelines for pa- tients — NSCLC This new 2010 version of the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology is written specifically for patients so that they can be better informed about available treatment options for NSCLC. After the introduction, the guidelines explain issues for patients to consider and discuss with their oncologist regarding treatment. It then gives a brief overview of lung cancer staging and T, N, and M categories of lung cancer before breaking down each stage using easy-to-understand information in table format. These tables summarize the pretreatment evaluation for each stage, standard treatments used based on the evaluation, and the typical adjuvant treatments used depending on the results of initial treatment. The next sections explain follow-up, recurrence, widespread disease, therapy for recurrence, and principles of pathologic evaluation and treatment. The latter half of the document is the “Discussion version,” which provides more detailed information than the bulleted summaries in the tables and covers a wide range of topics, including diagnostic tests, types of treatment, and clinical trials. A useful glossary of terms appears at the end.


Integrating tumor histology and genetic analysis into the selection of treatment regimens in NSCLC

Credits: 0.75 Fee: None Expires: October 29, 2011

This CME activity is designed to further physicians’ understanding of the use of tumor biomarkers and histology in the treatment of NSCLC. The activity consists of a video/slideshow presented by 3 experts, and may be viewed normally or downloaded in the form of an MP3, a set of slides, or a transcript. On completing this activity, participants should be able to select appropriate treatment strategies based on tumor histology and other patient characteristics. Participants will be able to test for patients’ molecular and genetic tumor profiles, understand the results, and integrate that information into an individualized treatment plan for NSCLC for their patients.


Long-term administration of second-line chemotherapy with S-1 and gemcitabine for platinum-resistant NSCLC: a phase II study

Journal: Journal of Thoracic Oncology Authors: Takiguchi Y, Seto T, Ichinose Y, et al Purpose: S-1 is a recently devel- oped agent that has potential activ- ity against NSCLC. The purpose of this study was to test the efficacy of S-1 in combination with gem- citabine in the second-line treat- ment of platinum-resistant NSCLC. Patients with confirmed NSCLC recurrence after prior treatment with platinum-based chemotherapy were treated with S-1 on days 1 to 14 and gemcitabine on days 8 and 15, repeated every 3 weeks until disease progression.


Study of cetuximab with radiation followed by con- solidation chemotherapy for NSCLC

Study Type: Interventional Age/Sex Requirements: 18 years (None) Sponsor: University of Pittsburgh Identifier: NCT00492206

Purpose: This open-label study will test the use of cetuximab with concurrent thoracic radiotherapy fol- lowed by consolidation chemotherapy with paclitaxel/carboplatin/cetux- imab in the treatment of patients with locally advanced NSCLC. Partici- pants will initially receive radiation and cetuximab, then radiation once daily (Mon—Fri) for 6 to 8 weeks and cetuximab once weekly. Then 4 to 6 weeks after radiation is completed, patients will be treated with pacli- taxel and carboplatin in addition to the weekly cetuximab. Chemotherapy will be administered once every 3 weeks for 9 weeks. The primary outcome measure of this study will be the response rate with cetuximab and concurrent thoracic radiotherapy for patients with locally advanced NSCLC. Secondary measures will include progression-free survival and the safety of the treatment regi- men. Researchers will also conduct correlative science studies on the baseline tumor tissue to evaluate for EGFR mutations and Akt, P-Akt, and MAPKinase.Results: 34 patients were in- cluded in the study. Treatment was administered for a median of 4 courses over a 125-day median period. The overall response rate was 23.5%. Median progression- free and overall survival rates were 6.6 and 19.9 months, respectively. The 1-year survival rate was 58.8%, while the 2-year survival rate was 30.9%. The authors concluded that the relatively high overall response rate met the primary end point, and that the results warranted randomized phase 3 trials of the same regimen.