Stage 4 Lung Cancer: Targeted therapy & Immunotherapy. Which to Start?

Not all lung cancers are of the same type, stage or treated similarly. In a nutshell... A. Targeted therapy For stage 4 lung adenocarcinoma (subset of NSCLC), further testing of EFGR and EML4-ALK mutation are routinely done in Malaysia. ROS1 rearranged mutation driver testing is not routinely done although targetable treatment is available. Those with …

Advanced/ Stage 4 Lung Cancer: Approved Immunotherapy in 2nd Line Treatment (Part 2 of 2)

I will try to play the devil advocate and give a balanced opinion here in regards to second-line immunotherapy treatment for lung cancer. In my first part, I put forward what pharmaceutical representatives often present to oncologists; highlighting positive numbers, glossing over large percentage reduction in risk of death and not mentioning 'hidden' information. The …

Advanced/ Stage 4 Lung Cancer: Approved Immunotherapy in 2nd Line Treatment (Part 1 of 2)

The above are called immune checkpoint inhibitors (nivolumab, pembrolizumab, atezolizumab) that target and bind to PD-1 or PD-L1, denying PD-1 and PD-L1 linkage. PD-1 is receptors on activated T-cells while PD-1 ligand, PD-L1, is present in normal cells (and also in some tumor cells). Linkage of PD-1 and PD-1 ligand (PD-L1) will cause T-cells to …

Living Longer with Advanced/ Stage 4 Renal Cell Cancer ~ 1st Line Treatment (Treatment Naive/ No Previous Treatment)

Brief In Malaysia, renal cell cancer (RCC) or kidney cancer present at stage 4 in 50% of cases. More cases are detected incidentally during imaging (USG, CT scans) than those who present with the classical triad of flank pain, gross hematuria and palpable abdominal mass. Histologically, 80% are of clear cell type and almost all studies and …

Better Practice: Trimodality Treatment, 3x Improvement in Stage 3 Non Small Cell Lung Cancer (NSCLC)

Introduction Every year, there will be a certain treatment that will be the highlight of discussion and presentations in every oncology meetings/ events. Last year, it was immunotherapy durvalumab, which delivered superior results for stage 3 non-small cell lung cancer (NSCLC); adenocarcinoma and squamous irrespective of EGFR status (wild type or mutant) irrespective of PD-L1 …