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Why Don’t We Routinely Use Two Drug Combinations for Previou


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Why Don’t We Routinely Use Two Drug Combinations for Previously Treated Advanced NSCLC?

December 16th, 2012 - by Dr. Jack West

http://blog.lungevity.org/2012/12/16/wh ... ced-nsclc/

Here’s a brief video presentation I just did, which appears on my hospital’s website/blog, discussing why we routinely give single agent treatments rather than doublet combinations to patients who have already received first line therapy for advanced NSCLC.

The basic idea is that as treatment continues for patients on therapy for advanced NSCLC, it becomes only more and more important to balance the anticipated side effects of treatments against the incremental benefit of a more aggressive treatment. Overall, the majority of patients with advanced NSCLC can do well with a combination approach for first line (with the exception of patients with a “driver mutation”, for whom an EGFR or ALK inhibitor alone will generally be quite effective), but after that, we find that combinations confer greater side effects without any accompanying significant improvement in overall survival. The leading alternative is sequential single agent approaches, which may lead to further tumor shrinkage in some patients, and either a minor response or prolonged stable disease in many others; these results often lead to an improvement in survival with minimal cost in terms of side effects.

I hope this video and discussion are helpful for many of you. I’ll be posting more short videos, which I hope will be both educational and engaging, very soon.

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