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Chemo Combo Increases Survival, Toxicity in Sensitive Relapsed SCLC

Chemo Combo Increases Survival, Toxicity in Sensitive Relapsed SCLC | Lung Cancer Dispatch | Scoop.it

"Cisplatin, etoposide, and irinotecan outperformed topotecan as second-line chemotherapy in patients with sensitive relapsed small-cell lung cancer (SCLC) in a Japanese trial, though there was substantially increased toxicity with the regimen.


“ 'Topotecan is the only drug approved in the United States and the European Union for relapsed SCLC,' said Koichi Goto, MD, PhD, of the National Cancer Center Hospital East in Chiba, Japan. He presented results of the new trial at the 2014 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago. Sensitive relapse refers to cancers that respond to initial chemotherapy and relapse more than 3 months after completion of that therapy, while refractory cancers do not respond initially or relapse within that 3 month window."


Editor's note: This story is about a clinical trial with volunteer patients to test a new treatment for small cell lung cancer (SCLC). The new treatment is specifically for people with SCLC who were treated with chemotherapy successfully, but whose cancer returned more than 3 months after chemo—this is known as "sensitive relapsed SCLC." The new treatment combines three chemo drugs: cisplatin, etoposide, and irinotecan. In the clinical trial, some patients took the chemo combo and some were treated with the chemo drug topotecan, which is a standard treatment for the condition. Patients who took the new treatment lived longer, but they had more toxic side effects than the patients who took topotecan.

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Cancer Network  |  Jun 23, 2014

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Amrubicin and Cisplatin Inferior to Irinotecan Regimen for Small-Cell Lung Cancer

Amrubicin and Cisplatin Inferior to Irinotecan Regimen for Small-Cell Lung Cancer | Lung Cancer Dispatch | Scoop.it

"A combination of amrubicin and cisplatin was inferior to irinotecan and cisplatin in chemotherapy-naïve patients with extensive disease small-cell lung cancer (SCLC) in a phase III trial conducted in Japan. The irinotecan regimen remains the standard treatment for these patients in that country.


"SCLC accounts for 13% of all new cases of lung cancer, and more than half of those patients present with extensive disease. Though SCLC can be very sensitive to chemotherapy, authors of the new study wrote that “rapid emergence of clinical drug resistance has resulted in poor prognosis, with almost all such patients dead with 2 years of initial diagnosis.” Investigators led by Miyako Satouchi, MD, PhD, of the Hyogo Cancer Center in Akashi, Japan, tested the amrubicin and cisplatin combination against irinotecan and cisplatin in 284 patients; results were published online ahead of print on March 17 in the Journal of Clinical Oncology."

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Cancer Network  |  Apr 23, 2014

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Potential Lung Cancer Vaccine Shows Renewed Promise

Potential Lung Cancer Vaccine Shows Renewed Promise | Lung Cancer Dispatch | Scoop.it

"Researchers at UC Davis have found that the investigational cancer vaccine tecemotide, when administered with the chemotherapeutic cisplatin, boosted immune response and reduced the number of tumors in mice with lung cancer. The study also found that radiation treatments did not significantly impair the immune response. The paper was published on March 10 in the journal Cancer Immunology Research, an American Association for Cancer Research (AACR) publication.


"Though tecemotide, also known as Stimuvax, has shown great potential at times, the recent Phase III trial found no overall survival benefit for patients with non-small cell lung cancer (NSCLC). However, further analysis showed one group of patients, who received concurrent chemotherapy and radiation followed by tecemotide, did benefit from the vaccine. As a result, tecemotide's manufacturer, Merck KGaA, is sponsoring additional post-clinical animal and human studies, so far with good results."


Editor's note: Cancer vaccines are meant to stimulate the immune system to fight cancer. Stimuvax is a cancer vaccine that was found to have no overall survival benefit for patients in a recent clinical trial. But closer analysis of the trial data and the mouse study mentioned above have raised hopes that the vaccine might work with some combination of chemo and radiation treatment.

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Medical Xpress  |  Mar 20, 2014

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New Clinical Trial for SCLC Now Enrolling Patients

New Clinical Trial for SCLC Now Enrolling Patients | Lung Cancer Dispatch | Scoop.it

While medical research has produced significant treatment innovations for many cancer types, so far little has changed for small cell lung cancer (SCLC). Current treatment guidelines recommend chemotherapy with etoposide (Etopophos) and cisplatin (Platinol), drugs than are more than 30 years old. Relapse is common, and survival rates remain low. Now, the new  PINNACLE clinical trial will investigate a new drug against SCLC. Patients with extensive-stage SCLC who have never received any other cancer treatment will be treated with Etopophos and Platinol either by themselves or in combination with the new drug, OMP-59R5. The drug acts by inhibiting NOTCH, a protein involved in cell development and growth that plays a role in various cancers. For more information, call 646-888-4203.

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ScienceDaily | Nov 13, 2013

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Maintenance Therapy with Avastin-Alimta Combination Appears Effective in Advanced NSCLC

Maintenance Therapy with Avastin-Alimta Combination Appears Effective in Advanced NSCLC | Lung Cancer Dispatch | Scoop.it

Maintenance therapy with bevacizumab (Avastin) and pemetrexed (Alimta) showed promising effects in the AVAPERL phase III clinical trial. Patients with advanced non-small cell lung cancer (NSCLC) were first treated with Avastin, Alimta, and cisplatin (Platinol). Those who responded to the treatment were either continued on both Avastin and Alimta or on Avastin only. Patients maintained on both drugs experienced more serious side effects, but went for longer without their cancer progressing (7.4 months on average, compared to 3.7 months for Avastin-only patients). While the study did not examine the benefits of Alimta-only maintenance treatment, the results suggest that the Avastin-Alimta combination is preferable to maintenance on Avastin only.

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Healio | Jul 26, 2013

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Maintenance Therapy with Alimta Improves Outcomes in Lung Cancer

Patients whose advanced nonsquamous, non-small cell lung cancer (NSCLC) responds to chemotherapy with pemetrexed (Alimta) and cisplatin (Platinol) appear to benefit from continuing Alimta treatment after they have achieved remission (continuation maintenance therapy). Results from the PARAMOUNT clinical trial showed that maintenance treatment with Alimta prolonged time without cancer worsening and increased survival times compared to treatment with a placebo. Continuation maintenance therapy with Alimta may be the preferable treatment choice for patients who do not experience significant toxicity from Alimta.

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Medscape | Jul 11, 2013

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Gleevec May Help Preserve Fertility After Chemotherapy

Gleevec May Help Preserve Fertility After Chemotherapy | Lung Cancer Dispatch | Scoop.it

Women who undergo chemotherapy often lose their fertility because the drugs used damage or kill their oocytes—immature egg cells stored in the ovaries. However, a recent study suggests that adding the cancer drug imatinib mesylate (Gleevec) to chemotherapy treatment may protect oocytes. Researchers treated mouse ovaries with the chemotherapy drug cisplatin (Platinol) either by itself or in combination with Gleevec, then implanted them into host mice. The oocytes from Gleevec-treated ovaries still suffered DNA damage from the Platinol exposure, but unlike oocytes treated with just Platinol, they did not die. Previous research suggests that the surviving oocytes could repair the damage over time after chemotherapy treatment ends. These findings offer the hope that Gleevec may help preserve fertility in chemotherapy patients.

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Medical News Today | June 20, 2013

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Medical News Today | June 20, 2013

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Medical News Today | June 20, 2013

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Biomarker Test Does Not Predict Response to Chemotherapy in Lung Cancer

A test for levels of a protein called ERCC1 does not predict how likely non-small cell lung cancer (NSCLC) patients are to benefit from chemotherapy, as was previously believed. NSCLC patients whose cancer can be surgically removed are often treated with chemotherapy after surgery (so-called "adjuvant chemotherapy"). A previous study had suggested that patients with lower levels of ERCC1 were more likely to benefit from such chemotherapy, because higher levels of ERCC1 could counteract the effects of platinum-based chemotherapy drugs like cisplatin (Platinol). However, a follow-up study found no association between ERCC1 test results and chemotherapy benefits. A possible reason is that currently available tests are not selective enough to distinguish the active version of ERCC1 from other versions of ERCC1 or from other proteins.


Research paper: http://www.nejm.org/doi/full/10.1056/NEJMoa1214271#t=abstract

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MedPage Today | Mar 20, 2013

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Pomalidomide Can Be Safely Added to Chemotherapy in Small Cell Lung Cancer

In a recent phase I/IIa study, patients with extensive-stage small cell lung cancer (SCLC) that had not previously been treated were given a drug called pomalidomide. The treatment was combined with standard chemotherapy consisting of cisplatin (Platinol) and etoposide (Etopophos/Toposar). Pomalidomide appeared to be safe, with a maximum tolerated dose of 4 mg/day. However, it did not appear to increase the efficacy or decrease the toxicity of the chemotherapy.

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Journal of Thoracic Oncology | Jan 30, 2013

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Necitumumab Plus Chemotherapy Shows Overall Survival Benefit in Patients With Squamous NSCLC

Necitumumab Plus Chemotherapy Shows Overall Survival Benefit in Patients With Squamous NSCLC | Lung Cancer Dispatch | Scoop.it

"A large phase III study investigating necitumumab (IMC-11F8) in combination with gemcitabine and cisplatin as first-line treatment for advanced squamous non–small cell lung cancer show a statistically significant improvement in overall survival of patients with stage IV disease.


"Patients receiving necitumumab plus chemotherapy had a median survival of 11.5 months compared to 9.9 months for patients treated with chemotherapy alone.


"Progression-free survival and disease control rate were also significantly improved."


Editor's note: This story is about a clinical trial that is testing the effectiveness of a new treatment for lung cancer patients. So far, the trial has found that the treatment is promising for people with stage IV squamous non-small cell lung cancer (NSCLC). To learn more about clinical trials, and the risks and advantages for patients who participate in them, click here.

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The ASCO Post  |  May 16, 2014

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Phase II Trial Shows Feasibility of Customized Adjuvant Treatment in NSCLC, but Phase III Trial Canceled Due to Unreliability of ERCC1 Readouts

Phase II Trial Shows Feasibility of Customized Adjuvant Treatment in NSCLC, but Phase III Trial Canceled Due to Unreliability of ERCC1 Readouts | Lung Cancer Dispatch | Scoop.it

"In the phase II Tailored Postsurgical Therapy in Early-Stage NSCLC (TASTE) trial (IFCT-0801), reported in the Journal of Clinical Oncology, Wislez et al examined the feasibility of customized adjuvant treatment based on EGFR mutation status and expression of ERCC1 (excision repair cross-complementation group 1), a predictor of cisplatin response, in patients with non–small cell lung cancer (NSCLC). Although the trial met its primary endpoint of ≥ 80% of patients being able to start adjuvant chemotherapy within 2 months of surgery, a phase III trial of the customized approach was cancelled due to unreliability of ERCC1 immunohistochemical readouts."


Editor's note: This trial tested whether a particular molecular testing method could be used to decide which lung cancer patients might benefit from chemotherapy after surgery to keep the cancer from returning. While the results of the trial were promising, the third phase of the trial was canceled because of some unreliability of the molecular testing method. Another method called Pervenio, already performs a similar function.

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The ASCO Post  |  Mar 31, 2014

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Combination of S-1, Platinol, and Radiation Promising for Lung Cancer

Combination of S-1, Platinol, and Radiation Promising for Lung Cancer | Lung Cancer Dispatch | Scoop.it

Results from a phase II clinical trial suggest that combining the cancer drug S-1 (Teysuno) with the chemotherapy agent cisplatin (Platinol) and radiation therapy may be effective in non-small cell lung cancer (NSCLC). Patients with inoperable, locally advanced NSCLC were treated with S-1, Platinol, and radiation to the chest region. Tumors shrank at least 30% in 36 out of 41 patients. Although some patients experienced low levels of white blood cells, overall the treatment was well tolerated. S-1 is itself a combination of tegafur (a chemotherapy agent), gimeracil (which boosts tegafur levels in the body), and oteracil (which protects the stomach and gut from tegafur toxicity).

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Healio | Nov 8, 2013

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EGFR Antibody Increases Survival in Lung Cancer Trial

EGFR Antibody Increases Survival in Lung Cancer Trial | Lung Cancer Dispatch | Scoop.it

The new cancer drug necitumumab increased survival in the SQUIRE clinical trial, a phase III trial examining squamous non-small cell lung cancer (NSCLC).  Patients with stage IV squamous NSCLC who received necitumumab in addition to the chemotherapy agents cisplatin (Platinol) and gemcitabine (Gemzar) survived longer than those treated with chemotherapy alone. Necitumumab is an antibody (a type of immune system protein) that blocks the function of EGFR, a protein that plays an important role in the survival, spread, and blood supply of tumors.

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Wall Street Journal | Aug 13, 2013

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Chemotherapy-Tarceva Combination May Be Effective for Some Lung Cancer Patients

Chemotherapy-Tarceva Combination May Be Effective for Some Lung Cancer Patients | Lung Cancer Dispatch | Scoop.it

Results from the FASTACT clinical trial suggest that interspersing erlotinib (Tarceva) among rounds of chemotherapy improves outcomes in non-small cell lung cancer (NSCLC). Patients with advanced NSCLC received six cycles of gemcitabine (Gemzar) plus carboplatin (Paraplatin) or cisplatin (Platinol), with Tarceva added during the second half of each chemotherapy cycle. This regimen prolonged time without cancer worsening and increased survival compared to patients who had received chemotherapy and placebo, though the benefit was only seen in patients with mutations in the EGFR gene. This approach may be most useful for patients whose EGFR status is unknown, as patients with known EGFR mutations may be even better served by first-line treatment with Tarceva alone.

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Healio | Jul 10, 2013

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Afatinib May Be Candidate for First-Line Treatment in Certain Lung Cancers

Results from the LUX-Lung 3 clinical trial show that afatinib appears to be well tolerated and more effective than chemotherapy in patients with advanced non-small cell lung cancer (NSCLC) who have a mutation in the EGFR gene. Afatinib produced higher response rates and longer periods without cancer progression than cisplatin (Platinol) plus pemetrexed (Alimta), suggesting that it could be considered as a first-line therapy in advanced EGFR-mutant NSCLC. Afatinib, which is under priority review for approval by the FDA, may be effective in patients resistant to other EGFR inhibitors like erlotinib (Tarceva) and gefitinib (Iressa). However, no trials so far have directly compared afatinib with Tarceva or Iressa.

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Medscape | Jul 9, 2013

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PARP Inhibitors May Offer New Option in Lung Cancer Treatment

PARP Inhibitors May Offer New Option in Lung Cancer Treatment | Lung Cancer Dispatch | Scoop.it

A new class of drugs called PARP inhibitors could help patients with non-small cell lung cancer (NSCLC) who have become resistant to cisplatin (Platinol), a study suggests. Researchers found that Platinol-resistant NSCLC cells contain high levels of a protein called PARP1 in an unusually hyperactive form. PARP1 inhibitors killed these cancer cells and slowed the growth of Platinol-resistant NSCLC tumors implanted into mice. High levels of a protein called PAR predicted greater effectiveness of PARP inhibitors and may be a future biomarker for identifying patients who would benefit from the treatment.

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Medical News Today | Apr 3, 2013

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Small Cell Lung Cancer Patient Treated for 5 Years with Chemotherapy and Lower Airway Clearing

Small cell lung cancer (SCLC) often extends to the bronchi (airway branches that connect the windpipe to the lungs), leading to breathing difficulties. A patient with extensive-stage SCLC received "endobronchial management," in which electrical currents were used to burn off tumor growth and keep the airway clear. He also received standard chemotherapy with cisplatin (Platinol). The patient remained in good condition for 5 years, after which he developed symptoms from cancer spread to the brain and eventually passed away. Adding endobronchial management to chemotherapy may increase survival in SCLC patients, although caution should be used in drawing conclusions from a single case study.

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Pneumologia | Feb 21, 2013

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FoxM1 Gene Expression Correlates with Cisplatin Resistance and Poorer Patient Survival

FoxM1 Gene Expression Correlates with Cisplatin Resistance and Poorer Patient Survival | Lung Cancer Dispatch | Scoop.it

In a study of patients with advanced non-small cell lung cancer (NSCLC), expression of a gene called FoxM1 correlated with poorer progression-free survival and poorer overall survival. FoxM1 expression was also associated with resistance to the drug cisplatin. Cell culture studies showed that FoxM1 inhibition could be a potential strategy to restore sensitivity to cisplatin.

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Lung Cancer | Nov 22, 2012

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