Upcoming #LCSM Chat, Thursday, March 27 at 5 pm PT, 8 pm ET: Should All Targeted Rx Lung Cancer Trials be Biomarker-Selective?

ASCO, the American Society for Clinical Oncology, is promoting a new principle that targeted therapies should be used only in targeted patients, as part of a general trend that we need to move away from trials that test new non-chemotherapy agents in a broad population. Meanwhile, we’ve just recently seen a few high profile negative trials in the last few weeks, such as the large phase III METLung trial of “METMAb” or onartuzumab, the monoclonal antibody against the target MET (mesenchymal epithelial transition), combined with Tarceva (erlotinib), and also the MAGE-A3 vaccine in the MAGRIT trial done as adjuvant treatment for resected non-small cell lung cancer.

Increasingly, our negative trials are followed by subset analyses that identify a potential subgroup that may be significant beneficiaries, often offset by larger groups that don’t benefit or are even harmed. As an example, the MAGRIT trial was just reported as negative in the broad population, but the study is still looking at an investigational gene signature that may predict for significant benefit vs. non-benefit with the MAGE-A3 vaccine.

If our large randomized trials, requiring hundreds to thousands of patients and costing millions of dollars and years to conduct, are extremely likely to return as negative and require a more refined population with a prospectively defined target, how should we conduct trials of targeted therapies in lung cancer?  With that in mind, these are the questions we’ll tackle in our upcoming #LCSM chat on Thursday, March 27th, at 8 PM ET, 5 PM PT:

1) Do we need to identify a target before committing people, money, & time to large lung cancer trials? Should we abandon targeted therapy trials in broad populations?

2) Is tissue for testing and molecular testing widely available enough today to limit targeted therapy trials, or will too many potential patients miss out? Will this be a hurdle to access?

3) Will those without any “targetable markers” be left without trial options? Will we exclude too many “molecular marker orphans”?

We need insights from people running trials, who would enroll patients on trials, and those seeking trial options.  We hope you’ll join us for a lively tweet chat, moderated by Dr. H. Jack West, Thursday evening.

Just check out http://www.tchat.io/rooms/lcsm at the appointed hour, or use the twitter client of your choice and follow the hashtag #LCSM. Hope to see you then!

#LCSM Chat Preview March 13 – Stress, Anxiety and Lung Cancer: How Do You Cope?

Patients and caregivers experience considerable stress and anxiety as a result of lung cancer diagnosis and treatment. How do you handle stress? Is it possible to prevent stress or is it ‘just a part of life’?  Some individuals handle stress and anxiety better than others. We want to explore this topic in more detail during this week’s #LCSM chat.

T1: What kinds of stress do lung cancer patients experience due to their cancer diagnosis or treatment?

 T2: What can healthcare providers do to help reduce stress for a lung cancer patient or caregiver?

 T3: What can patients and caregivers do to help reduce stress for themselves and each other?

Our guest for this chat will be Dr. Niki Barr, (@nikibarrphd), a Dallas, Texas, based psychotherapist who specializes in working with cancer patients and their families and teaches them how to “move through the continual challenges of cancer with emotional wellbeing”.

We know this is a very sensitive subject and we don’t expect anyone to share his or her most personal stories in such an open forum.  So we are offering an opportunity for you to submit questions to Dr. Barr in a confidential setting.  If you have a question you’d like answered or addressed during the chat, please email us at lcsmchat@gmail.com.  Only those of us associated with #LCSM Chat will be privy to the contents of the email. We will then forward the questions to Dr. Barr for possible use during the chat. Please note that if we use your question, we won’t use your name. 

 Please join us Thursday, March 13, 7 CT/8 ET, for an in-depth conversation about stress and anxiety associated with a lung cancer diagnosis. 

Thoughts or questions? Email us directly at lcsmchat@gmail.com, leave a note on our blog or send us a direct message on Twitter, @lcsmchat.

#LCSM Chat 27-Feb-14: What do cancer patients want from their doctors and online support groups?

The focus for the next #LCSM Chat at 8 PM Eastern (5 PM Pacific) on Thursday, February 27, 2014 will be “What do cancer patients want from their doctors and online support groups?” The moderator will be Dr. Jack West.

Online cancer support groups can provide a wealth of information and understanding for cancer patients, caregivers, and family members. Many in online forums find expertise and credibility among others who have traveled down the same road. “Expert patients” in these forums can provide an understanding and hope that even the best doctor can’t offer, because they’re living proof you can understand your treatment options, and your treatment can work. And online groups are available 24/7, for free.

However, different patients seek out different levels of information, both in these forums and with their doctors.  Some want to know all the available facts, including survival data in the tables and figures shared among oncologists.  Others prefer to trust their doctors and hope for good results. This leaves doctors wondering if providing a frank discussion of statistics (which might not be encouraging) would inform, confuse, or scare patients.

Also, different patients are comfortable with different levels of self-advocacy.  Some express a strong desire for self-determination of their treatments, while others want a clear recommendation from a trusted oncologist about the a best way to proceed.

Given the diversity in cancer patient needs and wants, our upcoming #LCSM tweetchat on will focus on the following questions:

1) Do the shared experiences of patients provide value and credibility that can’t come from medical professionals?

2) Given the growing movement to give patients their data, should doctors share stats like survival numbers with the patients?  If so, when?

3) Do engaged, empowered patients want a clear recommendation from their doctor, or a presentation of pros and cons so they can choose among the options?

We hope that those of you who use Twitter as a communication tool will join us by following the hashtag #LCSM on Thursday. Feel free to also comment here, before or after the tweet chat.


Upcoming #LCSM chat: What do patients want and need from online networks and their doctors?
by Dr. Jack West on cancergrace.org

ePatients: Engaging Patients in Their Own Care by Medscape

Society for Participatory Medicine

Are physicians ready for the e-patient movement? on KevinMD.com

The ePatient and His/Her Physician: What’s the Way Forward?

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