Orlando, 31 maggio 2009
PRESENTATI I RISULTATI DELLO STUDIO NSABP C-08 NELLA TERAPIA ADIUVANTE DEL CARCINOMA DEL COLONIn sessione plenaria presentati questa mattina i dati dello studio NSABP C-08 nella terapia adiuvante del carcinoma del colon: lo studio confrontava il trattamento con FOLFOX 6 per sei mesi vs la stessa chemioterapia con aggiunta di bevacizumab per 12 mesi. Lo studio ha coinvolto 2672 pazienti in stadio II e III di malattia. L’end point primario era la DFS a tre anni. I risultati presentati non dimostrano vantaggi di DFS con l’aggiunta del bevacizumab (p= 0.08; HR=0.87).
A phase III trial comparing mFOLFOX6 to mFOLFOX6 plus bevacizumab in stage II or III carcinoma of the colon: Results of NSABP Protocol C-08.
Author(s): N. Wolmark, G. Yothers, M. J. O’Connell, S. Sharif, J. N. Atkins, T. E. Seay, L. Feherenbacher, S. O’Reilly, C. J. Allegra; Allegheny General Hospital, Pittsburgh, PA; University of Pittsburgh; National Surgical Adjuvant Breast and Bowel Project; National Surgical Adjuvant Breast and Bowel Project, Allegheny General Hospital; Southeast Cancer Control Consortium; Atlanta Cancer Care; Kaiser Permanente, Northern California, Vallejo; All Ireland Clinical Oncology Research Group; University of Florida
Abstract:
Background: The primary aim of this two-arm randomized prospective study was to determine whether mFOLFOX6 plus bevacizumab (mFF6+B) would prolong disease-free survival (DFS) compared to mFOLFOX6 (mFF6) alone. Methods: Between September 2004 and October 2006, 2,672 patients with follow-up (1,338 and 1,334 in respective arms) with stage II (24.9%) or III carcinoma of the colon were randomized to receive either mFF6 (oxaliplatin 85 mg/m2 IV d1, leucovorin 400 mg/m2 IV d1, 5-FU 400 mg/m2 IV bolus d1, and 5-FU 2400 mg/ m2 CI over 46 hrs (d1+2) q14d x 12 cycles) or mFF6+B (same mFF6 regimen + bevacizumab 5 mg/kg IV q 2 wks x 1 yr). The primary end point was DFS. Events were defined as first recurrence, second primary cancer, or death. Results: The median follow-up for patients still alive was 36 months. The hazard ratio (HR: FF6+B vs. mFF6) was 0.89; 95% CI (0.76-1.04); p=0.15. Data censored at intervals disclosed an initial benefit for bevacizumab that diminished over time: The smoothed estimate of the DFS HR over time indicated that bevacizumab significantly reduced the risk of a DFS event during the interval from 0.5 to 1.0 year. There was no evidence that patients receiving bevacizumab had a worse DFS compared to those receiving mFF6 alone following treatment. Conclusions: The addition of bevacizumab to mFF6 did not result in an overall statistically significant prolongation in DFS. There was a transient benefit in DFS during the one-year interval that bevacizumab was utilized. Consideration may be given to clinical trials assessing longer duration of bevacizumab administration. Supported by PHS grants U10CA-12027, -69974, -37377, and -69651 from the NCI and a grant from Genentech, Inc.
IL CONSENSO INFORMATO NEI TRIAL CLINICI
Il tema del consenso informato e’ uno fra i piu’ attuali ma, in base a studi presentati all’ASCO, il gap fra l’informazione posseduta dai pazienti e il consenso, e’ spesso piu’ ampio di quanto i ricercatori credano. “Molti sono convinti che i malati comprendano ed accettino i termini dello studio mentre, di fatto, vi e’ una insufficiente consapevolezza e comunicazione” – afferma Christopher Daugherty dell’Universita’ di Chicago, chair dell’ASCO Ethics Committee. Un’intera sessione dei lavori e’ dedicata a esplorare questo gap, per comprendere come colmarlo, individuare i potenziali ostacoli e le possibili soluzioni per ottenere un vero consenso informato nei trial clinici. I fattori che possono influenzare il livello di comprensione sono numerosi: la scarsa conoscenza medica o il livello culturale medio-basso possono restringere la capacita’ del paziente di comprendere la terminologia utiizzata per descrivere lo studio e i trattamenti. L’eta’ avanzata o la scarsa conoscenza della lingua (in caso di pazienti stranieri) possono ostacolare la comunicazione fra paziente e ricercatori. “Il fatto che i malati firmino il documento di consenso non significa che l’abbiano compreso”, continua Daugherty. Durante la sessione congressuale vengono sperimentate forme interattive di consenso informato concepite per facilitare l’individuazione di ostacoli alla comunicazione e offrire al paziente le migliori opportunita’ di comprendere e aderire al trial in maniera consapevole. Si cerca di definire strategie per facilitare il raggiungimento di questo obiettivo e nello stesso tempo assistere i ricercatori nella comunicazione e nel processo di consenso. Per questo la sessione prevede un forte coinvolgimento del pubblico, con l’analisi condivisa di case studies, l’utilizzo della “interactive keypad response technology” e una discussione.
L’ADESIONE DEL PAZIENTE ALLE TERAPIE ORALI
L’avvento delle terapie orali ha senza dubbio segnato una svolta positiva con l’opportunita’ di semplificare la vita dei malati. Ma, allo stesso tempo, ha aperto nuovi problemi legati all’aderenza alla terapia. La sessione dell’ASCO “Compliance and cost: bitter pills to swallow in the era of oral cancer treatment” si e’ concentrata soprattutto nel comprendere i possibili ostacoli che il paziente incontra. In genere vengono divisi in tre gruppi: quelli legati al malato, al regime di assunzione e di sistema. I primi riguradano la depressione o altri stati emotivi che possono ostacolarlo nel comprendere come la terapia puo’ essergli d’aiuto nel combattere la patologia. Le difficolta’ legate al regime di assunzione variano a seconda della sua complessita’ e sono connesse agli eventuali effetti collaterali della terapia che possono scoraggiare il paziente fino a spingerlo ad abbandonarla. Le ragioni di sistema sono legate piu’ in generale alla percezione che il malato ha della qualita’ delle cure ricevute. Secondo Aangela De Michele dell’Universita’ della Pennsylvania, chair della sessione: “e’ importante non solo riconoscere le cause della potenziale non-aderenza, ma anche misurarne il livello, i pattern e la correlazione con gli outcomes”. In sessione si discute appunto delle diverse tecniche per misurare l’aderenza ma anche di modalita’ innovative per promuoverla. Viene presentato ad esempio un videogioco, sviluppato dall’equipe della dr.sa Pamela Kato dell’University Medical Centre di Utrecht, pensato per spiegare ai pazienti adolescenti l’importanza di assumere le medicine e seguire lo schema di trattamento. Secondo la De Michele l’aderenza e’ la variabile piu’ significativa della personalizzazione della terapia: “e’ strettamente correlata allo stile di vita, alla visione del mondo, al sistema di valori, al livello culturale. Comprendere i meccanismi che possono minarla rappresenta una delle maggiori sfide della personalized medicine”.
STRESS POST-TRAUMATICO PER CHI DA PICCOLO HA BATTUTO UN TUMORE
Aver lottato contro un tumore da piccoli puo’ lasciare il segno per anni, anche se la battaglia e’ stata vinta. In agguato incubi, pensieri ossessivi e ricorrenti, insonnia. Secondo uno studio presentato all’ASCO, infatti, l’incidenza di stress post-traumatico negli adulti che da bambini hanno sconfitto un cancro e’ quattro volte maggiore rispetto ai fratelli sani. E se, in generale, la presenza di stress post-traumatico e’ bassa nei giovani sopravvissuti a un tumore (circa il 9%), sembra che le difficolta’ di chi incappa nel problema siano sottovalutate dai medici. La ricerca, condotta da Margaret Stuber dell’Universita’ della California a Los Angeles (Usa), ha coinvolto 6.542 adulti che avevano avuto un tumore diagnosticato prima dei 4 anni di età, e 368 fratelli sani. ”La buona notizia – sottolinea la Stuber – e’ che oltre il 90% dei sopravvissuti non soffre di stress post-traumatico, anche se queste persone sono passate attraverso un’esperienza molto difficile. Ma qualcuno può avere delle difficolta’ che perdurano da molto tempo, e che devono essere seguite ed esaminate con attenzione”. Un’attenzione che, secondo la studiosa, ancora scarseggia fra gli oncologi. Secondo lo studio, inoltre, lo stress post-traumatico e’ piu’ comune in chi ha subito da piccolo trattamenti come amputazioni, radiazioni, in chi non e’ sposato, ha una cultura medio-bassa, e’ disoccupato o guadagna meno di 20mila dollari l’anno. Al contrario, i sopravvissuti a un neuroblastoma sono meno vulnerabili a questo problema.
Abstract: CRA 10002
Prevalence and predictors of Posttraumatic Stress Disorder in adult survivors of childhood cancer: a report
from the Childhood Cancer Survivor Study M. Stuber, K. Meeske, B. Zebrack, K. Krull, K. Stratton, W Leisenring, L. Robison, L. Zeltzer
TUMORE DEL SENO E CAMBIAMENTI NELLO STILE DI VITA
Al congresso ampio spazio dedicato agli stili di vita e al loro impatto nella prevenzione e nella gestione della malattia. In particolare, uno studio dell’Universita’ di Chicago, ha analizzato il cambiamento di abitudini e l’eventuale ricorso a terapie alternative in donne ad alto rischio di sviluppare tumore del seno. Le persone coinvolte nello studio avevano un’eta’ media di 45 anni, 9 su 10 erano caucasiche, il 30% aveva una mutazione genetica che puo’ essere predittiva di sviluppo del tumore e il 33% era già stata colpita in passato un cancro della mammella o dell’ovaio. Il 48% nel corso della propria vita, ha modificato il proprio stile di vita o fatto ricorso a terapie alternative. I piu’ diffusi comportamenti adottati sono l’esercizio fisico (83%), i massaggi (68%), lo yoga (44%), l’utilizzo della vitamina E (38%) o della medicina chiropratica (36%). I piu’ frequenti “correttivi” adottati in relazione al tumore sono scegliere una dieta meno ricca di grassi (15%), praticare esercizio fisico (11%) o ricorrere alla meditazione (10%). Ma una donna su due non ha mai parlato con il proprio medico dell’opportunita’ di modificare il proprio stile di vita. Il motivo? Il curante non ha mai sollevato l’argomento. Nonostante si trattasse di un gruppo selezionato di donne ad alto rischio.
Un ulteriore studio, presentato all’ASCO, conferma come vi sia una sottovalutazione da parte di medici e pazienti sull’importanza di questi aspetti. La ricerca condotta da ricercatori della californiana Jackson Foundation, ha indagato la modificazione degli stili di vita in seguito alla malattia. Si sono analizzate le differenze nell’indice di massa corporea (BMI), la percentuale di massa grassa, la frequenza con cui veniva svolta attivita’ fisica, l’uso di alcol, tabacco, caffeina e la frequenza dell’autopalpazione. I risultati sono sorprendenti: l’unica modifica significativa e’ risultata la frequenza con cui veniva eseguita l’autopalazione (dal 61% al 72% a un anno dalla diagnosi). Nessun’altra abitudine delle pazienti e’ cambiata nell’arco dei 12 mesi dalla diagnosi.
Abstract: e20583
Lifestyle modifications including complementary and alternative medicine and quality of life among women at high risk for breast cancer
Author(s): D. O. Malaka, R. Lee, R. Lewin, S. Cummings, F. Curlin, A. Bradbury, O. Olopade; University of Chicago, Chicago, IL
Abstract: 9602
Is a diagnosis of invasive breast cancer an effective motivational factor for lifestyle change?
Author(s): R. Ellsworth, N. J. Sann, L. Kvecher, D. L. Ellsworth, C. D. Shriver; Henry M. Jackson Foundation, Windber, PA; Windber Research Institute, Windber, PA; Walter Reed Army Medical Center, Washington, DC
SPECIALE TUMORE DEL POLMONE
Il tumore del polmone resta una delle sfide piu’ difficili quindi ogni progresso per questa neoplasia viene considerate con particolare attenzione. Di seguito gli studi presentati all’ASCO ritenuti fra i piu’ meritevoli di attenzione:
– Pemetrexed extends survival as maintenance therapy: A phase III study reports that maintenance therapy with pemetrexed improves overall survival in nonsquamous forms of advanced nonsmall cell lung cancer (NSCLC).
Maintenance pemetrexed (Pem) plus best supportive care (BSC) versus placebo (Plac) plus BSC: A randomized phase III study in advanced nonsmall cell lung cancer (NSCLC)
C. P. Belani, T. Brodowicz, T. Ciuleanu, J. H. Kim, M. Krzakowski, E. Laack, Y. L. Wu, P. Peterson, K. Krejcy, C. Zielinski Background: Pemetrexed’s efficacy, favorable tolerability profile and ease of administration provided a strong rationale for evaluation as maintenance therapy in patients (pts) with advanced NSCLC. We present the final analyses for all outcomes, including overall survival (OS), from a phase III study of Pem vs. Plac (Ciuleanu, J Clin Oncol 26, 2008, A 8011) in pts with stage IIIB/IV NSCLC who had not progressed on four cycles of platinum-based chemotherapy. Methods: In this double blind trial, pts were randomized 2:1 to receive Pem (500 mg/m2, day 1) plus BSC or Plac plus BSC in 21-day cycles until disease progression. All pts received vitamin B12, folic acid, and dexamethasone. The final OS analysis was performed using an unadjusted Cox model. Overall α= 0.05 for PFS and OS. Results: In the 663 randomized pts (Pem 441: Plac 222), Pem resulted in significantly better OS (13.4 vs. 10.6 mos [HR 0.79, 95% CI: 0.65-0.95, P = 0.012]). As reported earlier, Pem also had better PFS (P <0.00001) and response (P <0.001) (Table). The improvements in PFS and OS were observed primarily in patients with non-squamous histology (PFS HR = 0.47 and OS HR = 0.70). Treatment by histology interaction for OS was significant (P = 0.038). Drug-related grade 3/4 toxicities were higher for Pem (16% vs 4%; P <0.001); specifically, fatigue (5% vs 0.5%) and neutropenia (2.9% vs. 0%). Grade 3/4 toxicities did not increase significantly in pts who received ≥6 and ≥10 cycles of Pem. There were no Pem-related deaths. Fewer pts in the Pem arm (51.5% vs 67.1%; P <0.001) received systemic post-discontinuation therapy. Conclusions: Pem maintenance therapy is well tolerated and offers superior OS and PFS compared with Plac, making it a new treatment paradigm for patients with advanced NSCLC who respond to initial therapy. This trial further validates that Pem has greater efficacy in patients with non-squamous histology.Disclosures: Chandra Belani,,Consultant or Advisory Role,Eli LillyChandra Belani,,Honoraria,Eli LillyY Wu,,Honoraria,RocheY Wu,,Honoraria,PfizerY Wu,,Honoraria,Eli Lilly and CompanyY Wu,,Honoraria,AstraZenecaP Peterson,,Employment or Leadership Position,Eli Lilly and CompanyP Peterson,,Stock Ownership,Eli Lilly and CompanyK Krejcy,,Employment or Leadership Position,Eli Lilly and CompanyK Krejcy,,Stock Ownership,Eli Lilly and CompanyC Zielinski,,Honoraria,Eli Lilly and CompanyC Zielinski,,Other Remuneration,Eli Lilly and CompanyC Zielinski,,Consultant or Advisory Role,Eli Lilly and Company
– Maintenance therapy with two targeted therapies is superior to one alone: A phase III trial finds that adding erlotinib to bevacizumab-based maintenance therapy in patients with advanced NSCLC delays cancer progression more than maintenance treatment with bevacizumab alone.
A randomized, double blind, placebo controlled, Phase IIIb trial (ATLAS) comparing bevacizumab (B) therapy with or without erlotinib (E) after completion of chemotherapy with B for 1st line treatment of locally advanced, recurrent, or metastatic non small cell lung cancer (NSCLC)
V. A. Miller, P. O’Connor, C. Soh, F. Kabbinavar, for the ATLAS investigators
Background: B when added to chemotherapy, and E alone, each lead to improved survival in the treatment of patients (pts) with NSCLC (Sandler et al, NEJM 2006, 355:2542‐2550; Shepherd et al, NEJM 2005, 353:123‐132). Pre‐clinical and clinical data (Herbst, J Clin Oncol 2007, 25: 4743‐4750) suggest that the combination of B and E may improve the efficacy of NSCLC treatment. This potential was demonstrated in the BETA ( B in combination with E compared with E alone for treatment of advanced NSCLC after failure of standard first‐line chemotherapy) trial, a phase III trial in which progression free survival (PFS) was improved for patients treated with B + E (Hainsworth, Thoracic Oncol 2008, 3(11) Supp. 4:S302). Methods: The ATLAS study was designed to evaluate B + E (150 mg daily) versus B alone, following B + platin‐containing doublet chemotherapy, in pts with stage IIIb/IV NSCLC. Enrolled pts were B‐eligible, including pts with treated brain metastases, and pts anticoagulated with low molecular weight heparin(s). Pts with peripheral and/or extra‐thoracic squamous tumors were also eligible. Pts received 4 cycles of B (15 mg/kg every 3 weeks) with chemotherapy. Pts who had not experienced disease progression (DP) or significant toxicity were then randomized to receive B + E or B + placebo (P). The primary objective of ATLAS was to compare PFS in pts receiving B + E versus B + placebo. Secondary objectives included the assessment of safety, and overall survival. A data safety monitoring committee (DSMC) monitored safety and efficacy. Results: 1160 patients were enrolled and 768 randomized from May, 2005 to May, 2008. The DSMC recommended stopping the trial at the 2nd planned interim efficacy analysis, because it met the primary endpoint. The median PFS after randomization was 4.8 mos for (B + E) vs. 3.7 mos for (B + P), HR= 0.722 (95% CI: 0.592‐0.881), p = 0.0012. The safety profile for B + E was consistent with known profiles for B and E. Conclusions: E added to B treatment after chemotherapy with B significantly improves the PFS of patients treated in the 1st‐line setting for locally advanced, recurrent, or metastatic NSCLC. Disclosures: Chandra Belani,,Consultant or Advisory Role,Eli LillyChandra Belani,,Honoraria,Eli LillyY Wu,,Honoraria,RocheY Wu,,Honoraria,PfizerY Wu,,Honoraria,Eli Lilly and CompanyY Wu,,Honoraria,AstraZenecaP Peterson,,Employment or Leadership Position,Eli Lilly and CompanyP Peterson,,Stock Ownership,Eli Lilly and CompanyK Krejcy,,Employment or Leadership Position,Eli Lilly and CompanyK Krejcy,,Stock Ownership,Eli Lilly and CompanyC Zielinski,,Honoraria,Eli Lilly and CompanyC Zielinski,,Other Remuneration,Eli Lilly and CompanyC Zielinski,,Consultant or Advisory Role,Eli Lilly and Company
– Menopausal hormone therapy with estrogen and progestin linked to increased risk of death in women with lung cancer: A secondary analysis from the Women’s Health Initiative reports that use of hormone therapy with estrogen plus progestin increases the risk of dying from NSCLC for women with the disease.
Non-small cell lung cancer and estrogen plus progestin use in postmenopausal women in the Women’s Health Initiative randomized clinical trial
R. T. Chlebowski, A. Schwartz , H. Wakelee, G. L. Anderson, M. L. Stefanick, J. E. Manson, J. W. Chien, C. Chen, J. Wactawski-Wende , M. Gass, For the Women’s Health Initiative Investigators
Background: Sex differences in lung cancer outcome suggest a potential hormonal influence; however, observational studies provide mixed findings regarding menopausal hormone therapy (HT) and lung cancer. Methods: Secondary analyses of the WHI randomized, placebo-controlled trial of daily conjugated equine estrogen (CEE, 0.625 mg) plus medroxyprogesterone acetate (MPA, 2.5 mg) in 16,608 multi-ethnic postmenopausal women, aged 50-79 were conducted on lung cancer incidence and mortality. Lung cancers were confirmed by medical record review. Results: Groups were balanced for age, race/ethnicity, and prior HT. Smoking status was also comparable (never 50%, past 40%, current 10% in both groups). Cumulative risk for lung cancer was highest in current (0.51%), compared to past (0.14%) and never (0.04%) smokers. After 5.6 years on trial intervention and 2.4 years additional follow-up (median), small cell lung cancer incidence was comparable between randomization groups (total n=26), aswas subsequent small cell lung cancer mortality. Although a trend for more non-small cell lung cancer (NSCLC) diagnoses in the active hormone group was not significant (p=0.12), an apparent divergence emerged after five years, with more diagnoses in the CEE+MPA group. In addition, mortality after NSCLC diagnosis was significantly higher for the CEE+MPA group (46.3% vs 27.0%, respectively, hazard ratio (HR) 1.59, 95% CI 1.03-2.46, p=0.04). As a result, CEE+MPA group women were more likely to die from NSCLC than those on placebo (p=0.02). Conclusion: Use of CEE + MPA for over 5 years increases a woman’s risk for NSCLC mortality, the leading cause of cancer death in women. These data, together with recent results indicating higher breast cancer risk (Cancer Res 2009;69(2):78s), suggestcancer impact should influence risk-to-benefit consideration for combined HT use. NSCLC outcomes (annualized %) by randomization group. Disclosures: Rowan Chlebowski,,Consultant or Advisory Role,AmgenRowan Chlebowski,,Honoraria,Eli LillyRowan Chlebowski,,Consultant or Advisory Role,WyethRowan Chlebowski,,Consultant or Advisory Role,Eli LillyRowan Chlebowski,,Honoraria,AmgenRowanChlebowski,,Honoraria,AstraZenecaRowan Chlebowski,,Honoraria,WyethRowan Chlebowski,,Honoraria,NovartisRowan Chlebowski,,Consultant or Advisory Role,NovartisRowan Chlebowski,,Research Funding,AmgenRowan Chlebowski,,Consultant or Advisory Role,AstraZenecaChu Chen,,Honoraria,WyethChu Chen,,Honoraria,Wyeth
– Novel therapy that targets two receptors benefits patients with advanced lung cancer: A phase III trial demonstrates that vandetanib, a novel drug that targets two key receptors associated with lung cancer growth, improves progression-free survival in patients with advanced NSCLC.
Vandetanib plus docetaxel versus docetaxel as 2nd-line treatment for patients with advanced non-small-cell lung cancer (NSCLC): A randomized, double-blind phase III trial (ZODIAC)
R. S. Herbst, Y. Sun, S. Korfee, P. Germonpré, N. Saijo, C. Zhou, J. Wang, P. Langmuir, S. J. Kennedy, B. E. Johnson
Background: Vandetanib is a once-daily oral inhibitor of VEGFR, EGFR and RET signaling. Addition of vandetanib to docetaxel (doc) prolonged progression-free survival (PFS) in a randomized phase II study in patients (pts) with previously treated NSCLC (Heymach et al, JCO, 2007). Methods: The primary objective was to determine whether vandetanib 100 mg/day + doc 75 mg/m2 every 21 days (max 6 cycles) prolonged PFS vs placebo + doc. Secondary endpoints included overall survival, objective response rate (ORR), time to deterioration of symptoms (TDS) and safety. Efficacy and safety in females were assessed as a co-primary analysis population. Eligibility criteria included stage IIIB/IV NSCLC, PS 0-1, and previous 1st-line chemotherapy. Results: Between May 06-Apr 08, 1391 pts (mean age, 58 years; 30% female; 25% squamous; 10% brain mets) were randomized to vandetanib + doc (n=694) or placebo + doc (n=697). Baseline characteristics were similar in both arms. Median duration of follow-up was 12.8 months, with 87% patients progressed and 59% dead. Addition of vandetanib to doc showed a statistically significant improvement in PFS vs doc (hazard ratio [HR] 0.79, 97.58% CI 0.70-0.90; P<0.001), and a similar advantage in females (HR 0.79; P=0.024). Significant advantages for vandetanib + doc were also seen for ORR (17% vs 10%, P<0.001) and TDS (HR 0.78, P=0.002; FACT-L Lung Cancer Subscale). Overall survival showed a positive trend for vandetanib + doc that was not statistically significant (HR 0.91, 97.52% CI 0.78-1.07; P=0.196). The adverse event (AE) profile was consistent with that previously observed for vandetanib in NSCLC. Common AEs occurring more frequently in the vandetanib arm included diarrhea (42% vs 33%), rash (42% vs 24%) and neutropenia (32% vs 27%). Nausea (23% vs 32%), vomiting (16% vs 21%) and anemia (10% vs 15%) were less frequent in the vandetanib arm. The incidence of protocol-defined QTc prolongation was <2% in pts receiving vandetanib. Conclusions: The study met its primary objective of PFS prolongation with vandetanib + doc vs doc. Vandetanib is the first oral targeted therapy in phase III trials to show significant evidence of clinical benefit when added to standard chemotherapy in NSCLC.Disclosures: Roy Herbst,,Consultant or Advisory Role,AstraZeneca OncologyRoy Herbst,,Research Funding,AstraZeneca OncologyYan Sun,,Research Funding,WyethPaul Germonpré,,Honoraria,AstraZeneca OncologyNagahiro Saijo,,Stock Ownership,TakedaNagahiro Saijo,,Research Funding,AstraZeneca OncologyNagahiro Saijo,,Research Funding,TakedaNagahiro Saijo,,Research Funding,TaihoNagahiro Saijo,,Research Funding,ChugaiPeter Langmuir,,Employment or Leadership Position,AstraZeneca OncologySarah Kennedy,,Employment or Leadership Position,AstraZeneca OncologyBruce Johnson,,Consultant or Advisory Role,GenZymeBruce Johnson,,Other Remuneration,GenZyme
Fonte ASCO
Supplemento ad AIOM News
Editore Intermedia
Direttore responsabile Mauro Boldrini
