EGFR Testing in Squamous Cell Carcinoma of the Lung
Is it true that we don't do EGFR Testing in Squamous Cell Carcinoma of the Lung? True according to NCCN: https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf (slide 17). But I thought we do EGFR testing in all non-small cell lung CA ? (Source: Student Doctor Network)
Source: Student Doctor Network - October 18, 2019 Category: Universities & Medical Training Authors: DrMetal Tags: Hematology / Oncology Source Type: forums
durvalumab after chemoradiation for NSCLC
For stage IIIB lung cancer, if the chemotherapy regimen is paclitaxel plus carboplatin, do MedOncs complete 2 cycles of consolidative paclitaxel plus carboplatin q21 days and then start durvalumab? Or forgo consolidatiive pac/carbo altogether? Any data to support either approach? Thanks. (Source: Student Doctor Network)
Source: Student Doctor Network - April 18, 2019 Category: Universities & Medical Training Authors: seper Tags: Radiation Oncology Source Type: forums
Lung SBRT Reirradiation
I've got a case of an 80yo F with good PS but non-operative candidate with a new stage I NSCLC within 1-2cm of a previously treated early stage NSCLC (50 Gy in 5 fractions in 2013). Original site shows no evidence of recurrence, and the lesion is clearly distinct from the old treatment site and with a spiculated appearance, so fairly convinced this is a new primary instead of a regional recurrence.
The lesion is very peripheral (chest wall adjacent), so I am inclined to do another course...
Lung SBRT Reirradiation (Source: Student Doctor Network)
Source: Student Doctor Network - May 10, 2018 Category: Universities & Medical Training Authors: thaddeus Source Type: forums
CNS Necrosis vs Progression?
Im covering on a patient so I don't know the patient well but he was treated SRS to a high left parietal lesion 16 months ago for NSCLC metastasis. 1.5 months ago developed right hemiparetic symptoms and MRI revealed 1.5 cm nodular enhancing lesion in the area of prior SRS. He was started on steroids and responded well and followed. The enhancing component is now 3.5 cm and he represented to Neurosurgeon with dense right hemiparesis while he was tapering steroids. Surgeon says he could...
CNS Necrosis vs Progression? (Source: Student Doctor Network)
Source: Student Doctor Network - November 7, 2017 Category: Universities & Medical Training Authors: Haybrant Source Type: forums
partial brain
Have a case presently of inpatient with 4-5 symptomatic brain mets (nsclc) lung all superiorly located (in the brain) and decided to go with 300 x10 with lateral opposed partial brain fields. (organizing and starting stereo takes us about a week and difficult for inpts) Haven't seen much literature on partial brain, and wouldnt mind some input on how others are handling this.
It seems like we often have a binary choice between whole brain and stereo, but whole brain has been far from...
partial brain (Source: Student Doctor Network)
Source: Student Doctor Network - October 13, 2017 Category: Universities & Medical Training Authors: nkmiami Source Type: forums
T2?N1? NSCLC Case - any suggestions?
I have a 77 year old male, long time smoker with COPD (FEV1 ~35% of predicted, DLCO 20% of predicted, on O2 prn). Not a surgical candidate. He was diagnosed with what was initially thought to be a ~4 cm peripheral left upper lobe squamous cell. CT C/A/P negative for nodal or distant mets (non contrast).
For whatever reason he had EBUS before PET. All nodes "looked small" so none sampled. Then came PET and a small L hilar ?node? is hot (PET done without IV contrast, so no node was seen...
T2?N1? NSCLC Case - any suggestions? (Source: Student Doctor Network)
Source: Student Doctor Network - July 4, 2017 Category: Universities & Medical Training Authors: BobbyHeenan Source Type: forums
RTOG 0617 Update
Just heard that the high-dose arms of RTOG 0617 are closing immediately. For those of you that don't know, 0617 is a 2 x 2 study in Stage III NSCLC:
1. 60 Gy + carbo-taxol
2. 74 Gy + carbo-taxol
3. 60 Gy + carbo-taxol + C225
4. 74 Gy + carbo-taxol + C225
Arms 2 and 4 are closed immediately because after interim analysis it was determined that it is statistically impossible for there to be a survival benefit. Further randomization will be between arms 1 and 3 only. (Source: Student Doctor Network)
Source: Student Doctor Network - April 1, 2017 Category: Universities & Medical Training Authors: Gfunk6 Source Type: forums
RCT for oligomets
Interesting trial just published showing benefit to local therapy for oligometastatic NSCLC for patients who don't progress on 1st line therapy:
https://www.ncbi.nlm.nih.gov/pubmed/27789196
The most interesting bit is that local therapy actually delayed the development of subsequent new metastatic lesions. Granted it was a post-hoc analysis, but suggests that local treatment can impact natural history in metastatic disease. Abscopal effect? Reducing continued seeding from primary? (Source: Student Doctor Network)
Source: Student Doctor Network - November 3, 2016 Category: Universities & Medical Training Authors: thaddeus Source Type: forums
QUARTZ Phase III Trial: WBRT ineffective, ?worse than best supportive care w/NSCLC brain mets
http://press.thelancet.com/lungcancer.pdf
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30825-X/abstract
Personally I think the study is well done and the results are difficult with which to argue. And probably if we are honest with our American RTOG selves, the dearth of randomized radiation-or-no-radiation trials here has been a travesty. One less (routine) patient and fractionated RT indication for the rad onc department. I will stop routinely...
QUARTZ Phase III Trial: WBRT ineffective, ?worse than best supportive care w/NSCLC brain mets (Source: Student Doctor Network)
Source: Student Doctor Network - September 9, 2016 Category: Universities & Medical Training Authors: scarbrtj Source Type: forums
VivienLauYW, Maria Wong - Mutation and Expression Analysis of PTEN in Non-small Cell
VivienLauYW The University of Hong Kong Medical Sciences Pathology Pharmacology MMedSc
Mutation and Expression Analysis of PTEN in Non-small Cell Lung Cancer From Non-smokers
Abstract
This MMedSc dissertation studied the genetic variations and epigenetic variations of PTEN (phosphatase and tensin homolog deleted on chromosome 10) in relation to Adenocarcinoma (AD) in particular the protein expression level of PTEN in non-smoking non-small cell lung cancer (NSCLC) patient.
PTEN gene is a tumor suppressor gene (TSG) residing at the locus10q23.3. A decrease in PTEN protein level induces the accumulation of lipid phosphoino...
Source: New Media Medicine - December 11, 2014 Category: Universities & Medical Training Authors: VivienLauYW Tags: St George's, University of London Source Type: forums
Re: Minimally invasive thoracic surgery for early stage non-small cell lung cancer
(Source: BMJ Comments)
Source: BMJ Comments - November 12, 2014 Category: Journals (General) Source Type: forums
