Ramaswamy Govindan

..Small-cell lung cancer (SCLC) is a histologic subtype of lung cancer with a distinct biology and clinical course. It has been observed that the incidence of SCLC has been decreasing over the last several years...

..Irreversible inhibitors of EGFR and HER2 are novel agents in clinical development that might have the potential to prevent and overcome acquired resistance to first-generation EGFR inhibitors...

..The Cancer and Leukemia Group B conducted a phase II study of gefitinib, an inhibitor of the epidermal growth factor receptor (EGFR) tyrosine kinase, in patients with previously untreated malignant mesothelioma...

..The pCR rate of 22% in this study is similar to that reported with the use of preoperative chemoradiation in other trials. Further follow-up is necessary to assess the impact of maintenance therapy with celecoxib on overall survival...

..The median time to progression was 5.86 months (95% CI 2.50-9.22), and median survival was 10.96 months (95% CI 1.42-20.51) with a 1-year survival rate of 50%. This combination may be important for patients with NSCLC...

..Molecular mechanisms predicting response to cetuximab therapy are currently not well understood. Studies are ongoing to assess the single-agent activity of cetuximab in metastatic NSCLC...

..To evaluate the effect of bexarotene on survival in patients with relapsed non-small-cell lung cancer (NSCLC)...

..However, this combination chemotherapy regimen has an unacceptable rate of febrile neutropenia. This regimen needs to be modified to reduce the incidence of febrile neutropenia...

..The suggested treatment options for patients with metastatic disease and poor PS are single-agent chemotherapy or supportive care...

..The regimen of irinotecan and carboplatin administered once every 3 weeks demonstrates early evidence of activity, and is tolerable and convenient. The main toxicity is hematologic. This study is ongoing and actively accruing patients...

..3%). Complete and partial response rates were 0.7 and 5.6%, respectively, and 40.6% had stable disease. Median survival was 6 months, and estimated 1-year survival was 29.7%. The majority of patients did not receive subsequent CT...

..The radiation dose was 74 Gy given in 37 fractions. Radiation therapy volumes included those of the gross tumor and involved nodes. The volume of lung at or exceeding 20 Gy (V20) was mandated to be <or= 30%...

..We conducted an analysis of Surveillance, Epidemiology, and End Results data to assess whether the presentation and outcomes of NSCLC in younger patients (age < or =40 years) are different from that in older patients (age >40 years)...

..In addition, we studied the correlation between certain genotypes of enzymes involved in irinotecan metabolism with efficacy and toxicity...

..We examined the recent changes in stage distribution in newly diagnosed patients with non-small cell lung cancer (NSCLC) using a national database to assess the impact of recent advances in imaging modalities...

..Cancer and Leukemia Group B conducted a randomized phase II trial to investigate two novel chemotherapy regimens in combination with concurrent thoracic radiation therapy (TRT)...

..There are no reliable markers to predict recurrence in resected Stage I non-small cell lung cancer (NSCLC). A validated clinical model to estimate the risk of recurrence would help select patients for adjuvant therapy...

..Therefore, we conducted a study to evaluate for survival changes in a large national cancer registry database...

..We report the outcomes in elderly patients (70 years or older) with stage I NSCLC after surgical resection...

..This trial focused on optimally combining existing targeted therapies and cytotoxic chemotherapy in the treatment of unselected patients with advanced non-small-cell lung cancer (NSCLC)...

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..Preclinical studies have shown synergism between topoisomerase I and II inhibitors...

..To determine the maximum tolerated dose, dose-limiting toxicity (DLT), and pharmacokinetics of weekly docosahexaenoic acid-paclitaxel (DHA-paclitaxel), a taxane fatty acid conjugate...

..To study the impact of F-fluorodeoxyglucose positron emission tomography (FDG-PET) on stage distribution and survival for patients with newly diagnosed non-small cell lung cancer (NSCLC)...

..Approximately 10% of patients with lung cancer are life long never-smokers. There are only limited data available on the clinical characteristics and outcomes of lung cancer in never-smokers from the Western hemisphere...

..Despite this, many continue to smoke, with estimates ranging from 13% to approximately 60%...

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..1 and 2.9 months, respectively. Toxicities were minimal and included rash and diarrhea. Gefitinib was well tolerated and had interesting activity in previously untreated patients with advanced NSCLC...

..For this review, we have selected presentations that primarily have an impact on clinical practice, and some presentations regarding emerging therapeutic agents...

..Research is also ongoing to define the role of cetuximab in combination with other targeted agents. This review will summarize the results of recently published studies on cetuximab and outline current research with this agent in NSCLC...

..As part of a prospective study of relapse to smoking among previously resected lung cancer patients, we conducted a retrospective survey to examine factors that may contribute to relapse...

..We conducted a single-arm, dose-escalation, phase 1 clinical trial in order to define the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) of bexarotene in combination with docetaxel...

..This phase 1 study evaluated the pharmacokinetic and pharmacodynamic effects of cetuximab on patients with epithelial malignancies...

..Only a small fraction of patients with lung cancer are enrolled in clinical trials. It is critical to understand the barriers to participation in lung cancer clinical trials...

..Although EUS-guided FNA (EUS-FNA) and 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) are both used in the staging of esophageal cancer, the utility of routinely performing both tests is unclear...

..The authors conducted a Phase I trial to evaluate the maximum tolerated dose (MTD), toxicities, and effect of dose sequencing of this combination in patients with advanced malignancies...

..These findings can be used to help determine the role comorbidity information should play in studies of cancer outcomes...

..This review will summarize the results of clinical trials on erlotinib or gefitinib in the first-line treatment of select and unselected patients with NSCLC and describe ongoing studies with these agents in NSCLC...

..This study defines the maximum tolerated dose (MTD) and dose-limiting toxicity of weekly topotecan when administered in combination with docetaxel 25 mg/m(2) given day 1, 8,15 every 28 days...

..To assess the efficacy and toxicity of carboplatin, etoposide, and exisulind as initial therapy for extensive stage small cell lung cancer...

..The objective of this Phase II study was to determine whether trastuzumab would effect responses in patients with nonsmall cell lung carcinoma who had tumors that overexpressed HER-2...

..A survey of ongoing clinical trials in NSCLC in the ClinicalTrials.gov website would help identify areas that require further attention in the future...

..CONCLUSIONS: Our results indicate that gene expression signatures from several datasets can be reconciled. The resulting signature is useful in predicting survival of stage I NSCLC and might be useful in informing treatment decisions...

..This review will summarize available data on the epidemiology, risk factors, molecular genetics, management options, and outcomes of LCINS...

..In this review, we critically examine the published studies on the utility of FDG-PET as a prognostic tool in patients with NSCLC and provide direction for future research...

..In addition, we discuss the role of docetaxel induction therapy before surgery or definitive radiation therapy. Additionally, we address the role of docetaxel in consolidation therapy in patients with locally advanced NSCLC...

..This review summarizes the currently available data on VEGFR TKIs in the treatment of NSCLC...

..We conducted a multicenter phase II study in previously treated patients with NSCLC to evaluate the efficacy of single-agent S-1 in a predominantly non-Asian population...

..The 1 year survival rate is significantly better for BAC patients relative to other histological subtypes of NSCLC. There has not been a marked increase in the incidence of BAC reported to SEER over the past 20 years...

..Cell-cycle and JAK-STAT pathways are significantly altered in lung cancer, along with perturbations in 54 genes that are potentially targetable with currently available drugs...

..We conducted a Surveillance, Epidemiology, and End Results (SEER) database analysis to evaluate the prognostic significance of tumor size in patients with unresected stage III NSCLC...

..We report on selected studies from the developmental therapeutics track (abstracts 2500-2613 and 3000-3108) that may be of interest to the thoracic oncology community...

..Furthermore, molecular predictors of resistance may guide the selection of chemotherapy in this setting...

..Activation of clinical trials is a lengthy process. We studied the procedures and time required to activate lung cancer clinical trials in a US academic center compared with a European center...

..Based on observations like this and those seen in phase I studies with bortezomib, this agent is being studied now in patients with bronchio-alevolar cancer...

..Bladder is not a common site for metastasis of cancer and often goes undiagnosed in the clinical follow up of cancer patients. We reviewed the literature for published reports on metastatic cancer involving bladder...

..Several small molecule antiangiogenic agents are in development. In this article, currently available data from clinical trials of antiangiogenic compounds in advanced non-small cell lung cancer are reviewed...

..In this review, we summarize the existing body of knowledge on lung cancer in never-smokers...

..This review will discuss these issues in detail and outline the strategies that need to be employed to improve the outcomes in patients with locally advanced NSCLC...

..Here, we review published studies of the molecular genetics of lung cancer in never smokers and identify the specific differences from tobacco-associated lung cancer...

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..Supportive care measures help ensure optimal quality of life during difficult psychologic and social situations. Research in the area of supportive care in patients with cancer should be made a priority...

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..To our knowledge, this is the first report on pneumocystis pneumonia following administration of pemetrexed containing regimen...

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..We studied the efficacy of AT-101 in patients with recurrent chemosensitive extensive-stage small cell lung cancer (SCLC)...

..04; P=0.9). (60)Cu-ATSM-PET can be readily performed in patients with NSCLC and the tumor uptake of (60)Cu-ATSM reveals clinically unique information about tumor oxygenation that is predictive of tumor response to therapy...

..The articles in this supplement should be viewed more as meeting reports than as exhaustive and comprehensive review articles...

..This review summarizes the recent advances in second-line therapy for esophageal cancer...

..These results differ from the use of amifostine in non-small cell lung cancer in which there is the observation of esophageal protection...

..Our observations show that EGFR-T790M provides a proliferative advantage with respect to WT EGFR and suggest that the enhanced kinase activity of this mutant is the basis for rare cases of inherited susceptibility to lung cancer...

..It is hoped that their findings will aid in determining the best treatment options for these patients...

..We review the biology of the hedgehog signaling pathway and its potential role in the development of lung cancer...

..The regimen of irinotecan and carboplatin administered once every 3 weeks is tolerable and convenient, with early evidence of activity. The main toxicity is hematologic. This study is ongoing and actively accruing patients...

..Surgical resection alone remains suboptimal for patients with early-stage (I or II) non-small cell lung cancer. Two similar randomized phase II trials were conducted to define an active preoperative regimen in this disease state...

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..There is an urgent need to develop regimens that incorporate chemotherapy agents that can be administered at doses that are systemically active and yet tolerable...

..To determine the prognostic value of celiac lymphadenopathy for patients with esophageal or gastroesophageal junction carcinomas treated with neoadjuvant or definitive chemoradiotherapy...

..To determine the efficacy of cetuximab in patients with recurrent or progressive non-small-cell lung cancer (NSCLC) after receiving at least one prior chemotherapy regimen...

..Additional investigation of bortezomib in NSCLC is warranted in combination with other drugs known to be active, or using different schedules...

..We conducted a phase I study of bexarotene and rosiglitazone to define the MTD of rosiglitazone in this combination regimen...

..A CME activity based on this summary is also available at www.informedicalcme.com/cme...

..We conducted this study to determine whether the preoperative maximum tumor standardized uptake value (SUVmax) was associated with recurrence in patients with resected stage I NSCLC...