New Biological Insights and Recent Therapeutic Advances in the Management of Lung Cancer: A Clinical Investigator Think Tank
Clinical implications of the RADIANT study of adjuvant erlotinib with or without chemotherapy
1:45 minutes.
TRANSCRIPTION:
DR LOVE: So let’s get into the tricky part here in terms of the EGFR mutation. Corey, could you just give us a little bit more of a flavor for this patient? Was this man out there on the Internet, trying to get information? Was he just asking you what to do? What was his thought about it? DR LANGER: Amazingly incurious gentleman. DR KRIS: Who ordered the test? DR LANGER: We’re starting to do it baseline, basically to have it banked, so when node-positive patients recur, we’re not spending 3 or 4 weeks trying to get the information. We know what to do. And you could argue, “You should rebiopsy at that point,” and we probably would, but if it’s an inaccessible site or a not easily biopsied site or a bone site, we won’t be able to get valid information. So getting back to that, he was EGFR 19-positive. In the absence of Phase III data showing a survival advantage — granted, it was only a subanalysis from RADIANT that even included the mutants — I don’t feel I have sufficient justification. A 20-month improvement in PFS, given the toxicities that you would experience for 2 years and then realization that you could treat them at the time of progression, I don’t feel I would treat them off study. DR LOVE: And did you bring up the issue of an EGFR TKI, or did you just — DR LANGER: I brought it up, but then I dispatched it almost as quickly as I brought it up. DR LOVE: And what did you treat him with? DR LANGER: Taxane/carbo. DR LOVE: Because of the creat and renal dysfunction? DR LANGER: Yes. DR LOVE: Interesting. He’s a 40 pack-year smoker. How long ago did he quit? DR LANGER: He didn’t. DR LOVE: Wow! He’s still smoking? DR LANGER: We had to send him to our smoking cessation program. DR LOVE: And EGFR-positive. |