Table of Contents
Epidermal Growth Factor Receptor Inhibitors Come of Age
NE Oncology Issue - November 2007 Lesley McKarney An epidermal growth factor receptor inhibitor shows noninferiority to docetaxel for second-line treatment of locally advanced or metastatic non–small cell lung cancer: INTEREST Background Currently approved agents for...
Canadian perspective by Dr. Goss
NE Oncology Issue - November 2007 Like previous trials such as BR.21, the INTEREST study confirms that EGFR TKIs are effective in NSCLC. Perhaps the most surprising result in the INTEREST study is that the biomarkers did not predict response or survival. In the ISEL...
Interim TRUST results confirm BR.21 study findings
NE Oncology Issue - November 2007 Background In the BR.21 phase III placebo-controlled study, erlotinib was well tolerated, significantly improved symptoms, and increased survival in patients with relapsed advanced non–small cell lung cancer (NSCLC).1 In BR.21, 31% of...
Erlotinib has single-agent activity in older patients with advanced or metastatic non–small cell lung cancer
NE Oncology Issue - November 2007 Background Erlotinib is approved for patients with advanced or metastatic non–small cell lung cancer (NSCLC) who have failed at least one prior chemotherapy regimen. It was the first epidermal growth factor receptor (EGFR) inhibitor...
Canadian perspective by Dr. Goss
NE Oncology Issue - November 2007 The TRUST study was a large open-label, non-randomized phase IV study with a final analysis based on more than 5,000 patients with NSCLC. The survival data compare very well with data from the BR.21 trial, which gives us more comfort...
Molecular characterization of EGFR inhibition: EGFR, but not KRAS, mutations are important for EGFR inhibition
NE Oncology Issue - November 2007 Background Retrospective studies have suggested that, in addition to clinical features, patients with tumours containing an epidermal growth factor receptor (EGFR) mutation in different exons, particularly exon 19 and L858R point...
Canadian perspective by Dr. Goss
NE Oncology Issue - November 2007 It should be noted that the above correlates mutational status with response and not survival and confirms the results of a number of trials. Mutational status as a predictor of survival still needs to be definitively evaluated in a...
The New Biology of Non–Small Cell Lung Cancer
NE Oncology Issue - November 2007 Lesley McKarney Pemetrexed plus cisplatin has equivalent efficacy and better safety profile versus gemcitabine plus cisplatin in chemonaïve patients with locally advanced or metastatic non–small cell lung cancer Background Based on an...
Canadian perspective by Dr. Goss
NE Oncology Issue - November 2007 I don’t think there can be any criticism of the design of this study. The cisplatin and gemcitabine were given in standard doses in a standard way in the control arm. There was nothing unusual about the dose of cisplatin and...
Effectiveness of Combined Modality Therapy for Non–Small Cell Lung Cancer
NE Oncology Issue - November 2007 Lesley McKarney Concurrent chemoradiotherapy more effective than sequential chemoradiotherapy or radiotherapy alone in unresectable, locally advanced non–small cell lung cancer In terms of Stage III disease that is unresectable, there...
Contributors
Ronald Louis Burkes, MD, FRCPC
Professor of Medicine, University of Toronto
Medical oncologist, Mount Sinai Hospital/Princess Margaret Hospital/ University Health Network in Toronto
Dr. Burkes was the program director for the medical oncology training program at the University of Toronto from 1996 to 2005 and director of the Clinical Teaching Unit at Princess Margaret Hospital (PMH) from 1999 to 2005. He has won numerous teaching awards including departmental and university-wide awards, the Anderson Award in Program Development and the Hasselback Award for Teaching Excellence at PMH. He has presented at many local, provincial, national, and international meetings.
His research interests include lung and GI malignancies, and he has numerous publications including 57 peer-reviewed, 107 non–peer-reviewed and two book chapters.
Susan F. Dent, BSc., MD, FRCPC
Associate Professor of Medicine, University of Ottawa
Medical oncologist, Ottawa Hospital Cancer Center
Dr. Dent obtained her MD at McMaster University and completed her postgraduate training in internal medicine and medical oncology at the University of Ottawa. Her areas of interest include breast cancer, new drug development, and research ethics. She has a number of peer-reviewed publications and has regularly contributed to non–peer-reviewed Canadian oncology journals. She is a member of the Cancer Care Ontario Breast Disease Site Group Guidelines Committee, the vice chair for the Ontario Cancer Research Ethics Board and a member of the National Cancer Institute of Canada Auditing and Monitoring Committee.
Glenwood Dillon Goss, M.B., B.Ch., FCP(SA), FRCPC
Head of Medical Oncology, Ottawa Hospital Regional Cancer Centre
Director of the lung cancer program, Ottawa Hospital Regional Cancer Centre
Professor of Medicine, University of Ottawa
Dr. Goss graduated from the University of Witwatersrand, Johannesburg, South Africa and completed his post-graduate training at the Royal Marsden Hospital in London, England. He is a member of the National Cancer Institute of Canada Investigational New Drug Executive Committee and Lung Site Executive Committee. His principal areas of research relate to lung cancer and investigation of new drugs. Dr. Goss was a founding member of the Canadian Association of Medical Oncologists (1987) and has served as president.
Vera Hirsh, MD, FRCPC
Chief of the Hematology-Oncology Service, Santa Cabrini Hospital
Associate Professor, Medicine and Oncology, McGill University
Associate Physician, Oncology Service, at the Royal Victoria, Montreal General, and Montreal Chest Hospitals
With a current practice in both hematology and oncology, Dr. Vera Hirsh is an associate professor of medicine and oncology at McGill University. Her research at the Quebec Pulmonary Unit focuses on the treatment of lung cancer, and she continues to chair ongoing international chemotherapy trials. Dr. Hirsh chaired the Quebec Lung Cancer Committee to establish guidelines for the treatment of lung cancer. In addition, she has published abstracts, articles, and book chapters. Dr. Hirsh is a member of advisory boards for many pharmaceutical companies and the Medical Oncology Standing Committee of RTOG.
Jean Maroun, MD, FRCPC, FRCP (London)
Medical oncologist, Ottawa Hospital Regional Cancer Centre
Professor of Medicine, University of Ottawa
Dr. Maroun chairs the Ontario Provincial Gastrointestinal Practice Guidelines Committee. His principal interest lies in clinical research into new drug development and new combinations in the treatment of colorectal cancer. Dr. Maroun has long experience in the management of GI malignancies and his clinical and basic research focus is on thymidylate synthase inhibitors. He is a past president of the Canadian Oncology Societies and the Canadian Association of Medical Oncologists. Dr. Maroun has published extensively in peer-reviewed journals and is involved provincially and nationally in numerous academic and research committees.