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AstraZeneca unveils successes in treatment of lung cancer

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Re: AstraZeneca unveils successes in treatment of lung cancer

#31

Post by pauln99 »

jncfhnb wrote: post #16
pauln99 wrote: post #13

“Statistically significant and highly clinically meaningful” perhaps, but not so much that they can say what that actually means. My understanding is that of all cancer drugs approved by the FDA between 2000-2016 (around 90 drugs), the median life extension was just over 2 months...

The distribution skews right on these things. Median probably is not the right way to think about it

Maybe I've misunderstood, but for the average person that's even worse news, right?

Two months was from clinical trials where there's no doubt that the "thumb is on the scale" in a host of ways, creating an exaggerated estimate of efficacy that would be realised in the real world.

The reality is closer to no life extension, with the remaining lifespan is spent sicker than you'd have been without the drugs.

Re: AstraZeneca unveils successes in treatment of lung cancer

#32

Post by kkio »

My father has been taking Tagrisso since he was diagnosed with Stage IV lung cancer in January 2022. It’s been able to give him a relatively normal quality of life I don’t think my family would’ve seen otherwise if he’d gone through chemo and radiation.

Just chiming in that I’m super thankful to that these newer treatments are so effective.

That said it’s not cheap and he still has to work to keep his insurance… otherwise it’d be ~10k/mo.

Re: AstraZeneca unveils successes in treatment of lung cancer

#33

Post by losvedir »

ndr wrote: post #18
pauln99 wrote: post #13

“Statistically significant and highly clinically meaningful” perhaps, but not so much that they can say what that actually means. My understanding is that of all cancer drugs approved by the FDA between 2000-2016 (around 90 drugs), the median life extension was just over 2 months...

Sad stats truth: statistical significance does not say much about effect size, and it's misinterpreted by ~half articles. See https://www.nature.com/articles/d41586-019-00857-9 for more

That's why the "highly clinically meaningful" part of the quote is there.

Re: AstraZeneca unveils successes in treatment of lung cancer

#36

Post by latchkey »

Scubabear68 wrote: post #29
latchkey wrote: post #23

My mom died from lung cancer. It was going to happen, life long smoker. Dying from LC is a terrible way to go. Your lungs fill with fluid and you slowly drown in your own fluid. The pain meds make you hallucinate terrible thoughts. I wouldn't wish it on anyone. For the benefit of humanity, I hope this treatment works.

Same with my dad in the 80s. His descent was horrible to witness, in my case at the age of 21. I’ll never know the truth, but I think his doctor took pity on him, dad died very shortly after a push of morphine.

Thanks for sharing and sorry to hear that.

My mom was only 56 (2004) and I got a call from the hospice very early in the morning.

At her request, I had tried to take care of her myself for the couple weeks after her diagnosis, but once the hallucinations started, due to her increasing the pain meds, she started screaming one night and the neighbors called the police thinking I was abusing her.

Thankfully, they called a case worker and I was able to get her into hospice pretty shortly after that and then it was just a couple days more at that point.

It was pretty traumatic. One of those life events you never forget. RIP mom.

Re: AstraZeneca unveils successes in treatment of lung cancer

#37

Post by arrosenberg »

pauln99 wrote: post #13

“Statistically significant and highly clinically meaningful” perhaps, but not so much that they can say what that actually means. My understanding is that of all cancer drugs approved by the FDA between 2000-2016 (around 90 drugs), the median life extension was just over 2 months...

Anecdotal, but Keytruda was approved in 2019 when my dad was diagnosed. He got 4 extra years (3.8 of which were pretty high quality) that I can assure you he would not have gotten without it. The progress on lung cancers specifically has advanced quite a bit in the last 10 years.

Re: AstraZeneca unveils successes in treatment of lung cancer

#38

Post by e40 »

formercoder wrote: post #15

My aunt was diagnosed with stage 4 lung cancer and is only alive because of this drug. It’s a marvel of modern medicine.

My wife was diagnosed in Nov '23. Stage 4. She had a mutation that allowed Tagrisso/osimertinib. There are many mutations, but this one is prevalent in Asian women who have never smoked.

There was a trial published just after her diagnosis that showed progression free survival at 2 years of 57% (chemo+osimertinib) vs 41% (osimertinib).

https://www.nejm.org/doi/full/10.1056/NEJMoa2306434

She's 6 days into the chemo. There are 4 rounds of pemetrexed+carboplatin and then maintenance carboplatin (forever). Every 21 days.

So far, it's been rough, but hopefully her body will adjust and once she's just on carboplatin hopefully her quality of life will be better.

She had few side effects from the osimertinib, but the main one was mouth sores. They're gone now, thankfully.

Another thing people need to know about this: this diagnosis often comes with regular thoracentesis (removal of fluid from the chest). In this case, it's in the lining of her lung, not lung itself.

Advice to anyone in this situation: make all future appointments for thoracentesis, because you don't want to go into the ER/ED to get it done. And, we've stopped allowing residents to practice on her (once it was quite painful).

EDIT:

Forgot to add: carboplatin crosses the blood-brain barrier, as do the cancer cells. The end state for this cancer, even with the above treatments, is usually tumors in the brain.

Re: AstraZeneca unveils successes in treatment of lung cancer

#39

Post by thallada »

1letterunixname wrote: post #6

Hey onco-nosology nerds: Is there a cell-typed unambiguous classification system, research, and clinical treatment protocol nexus attempting to capture and disseminate information on all cancer types in a more precise and organized effort?

NCI has the current treatment guidelines for each cancer and is updated when new treatment options become available: https://www.nccn.org/guidelines/category_1

Unfortunately, these are very clinician-focused and are very hard to understand without a medical background. They also don't usually cover experimental treatments that are still in trials, but in some cases can be extremely helpful. I work on an app at Outcomes4Me (https://outcomes4me.com/) that is trying to convert the NCI guidelines into an algorithm so that we can tell patients in simpler terms what their treatment options are based on their specific diagnosis. We also try to find clinical trials recruiting for their specific diagnosis. We've done this for breast and lung cancer so far.

Re: AstraZeneca unveils successes in treatment of lung cancer

#40

Post by superfunny »

baq wrote: post #14

A friend died of lung cancer. Went from mild cough to funeral in about 5 weeks. 40 yo. 2 pre-teen kids. Started to look after my own health a bit more. This is a very welcome development.

I'm really sorry to hear that - cancer is terrible.
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