Factors associated with time to EGFR TKI treatment in patients with non-squamous metastatic non-small-cell lung cancer.

Aim: Assess factors associated with EGFR TKI initiation among patients with metastatic non-small-cell lung cancer (mNSCLC). Patients & methods: Medicare Part D patients diagnosed with non-squamous mNSCLC and starting an EGFR TKI within 1 year of diagnosis were selected from the Surveillance, Epidemiology and End Results (SEER)-Medicare database. Associations between patient characteristics and time from diagnosis to treatment initiation (time-to-treatment [TTT]) were analyzed. Results: Among the sample (n = 890), the patients who were younger, African-American or from rural communities had significantly longer TTT. Patients who did not receive surgery, who were Asian and those with brain metastases had significantly shorter TTT. Conclusion: Patient demographics and clinical characteristics may affect timeliness of EGFR TKI treatment for mNSCLC. Future research should examine potential barriers to treatment.

This study aimed to identify factors that may affect the time to initiate treatment with a product in the EGFR TKI class of drugs for patients with metastatic non-small-cell lung cancer (mNSCLC). We used an anonymized database that combines health information on cancer patients (SEER) with insurance claims information for Medicare Part D patients. Our study included 890 patients. We found that patients who were younger, African­American or from rural communities had longer times to starting treatment. Patients who did not receive surgery, who were Asian and those with cancer that had spread to the brain had notably shorter times to starting treatment. Further research should examine potential barriers that may contribute to treatment initiation delay.

Small cell lung cancer.

Neuroendocrine tumors account for approximately 20% of lung cancers; most (≈15%) are small cell lung cancer (SCLC). These NCCN Clinical Practice Guidelines in Oncology for SCLC focus on extensive-stage SCLC because it occurs more frequently than limited-stage disease. SCLC is highly sensitive to initial therapy; however, most patients eventually die of recurrent disease. In patients with extensive-stage disease, chemotherapy alone can palliate symptoms and prolong survival in most patients; however, long-term survival is rare. Most cases of SCLC are attributable to cigarette smoking; therefore, smoking cessation should be strongly promoted.

BLP-25 liposomal vaccine: a promising potential therapy in non-small-cell lung cancer.

Despite marginal improvements in survival gained from multimodality treatment, long-term survival rates remain low for lung cancer, which remains the leading cause of cancer-related mortality in North America. BLP25 liposomal (L-BLP25) vaccine (Stimuvax) is a promising liposomal vaccine designed to generate an immune response against MUC1, a glycoprotein expressed on the cell surface of many normal epithelial tissues and over or aberrantly expressed on many carcinoma cells, including non-small-cell lung cancer (NSCLC). MUC1 is potentially a good target for immunotherapy, as evidenced by preclinical data and in Phase I and II clinical trials demonstrating the potential early activity of L-BLP25 with minimal toxicity in NSCLC. A Phase III randomized, placebo-controlled trial of L-BLP25 is currently being conducted in stage III NSCLC patients.