[heblaj01]

Hope,

Your onc might have an opinion on whether or not the three following prognostic markers may be usefull in your case to choose quickly the best treatment instead of proceeding by trial & error.

The first one called ICAM is a predictor of chemo efficacy:
http://www.docguide.com/news/content...25718800471E9B

Researchers Find Biomarker of Response to Chemotherapy in Non-Small-Cell Lung Cancer: Presented at ASCO

.....June 8, 2006 -- Patients with non-small-cell lung cancer (NSCLC) who have lower baseline levels of soluble intercellular adhesion molecule-1 (ICAM) are more likely to respond to chemotherapy and to have longer progression-free survival, according to findings presented here at the American Society of Clinical Oncology 2006 Annual Meeting (ASCO). "Baseline plasma ICAM is strongly prognostic for survival in advanced NSCLC," said principal investigator Afshin Dowlati, MD, consultant hematologist/oncologist, the Ireland Cancer Center, and assistant professor of medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio. "This biomarker is strongly prognostic for response to chemotherapy." ......




The second marker (Exon 19 ) a mutation of the epidermal growth factor receptor (EGFR) appears to predict high response to EFGR inhibitor drugs such as erlotinib(Tarceva) while patients with Exon 21 do not respond as well.

http://www.docguide.com/news/content.nsf/news/852571020057CCF685257187006FA034?OpenDocument&c=&c ount=10&id=48DDE4A73E09A969852568880078C249

Erlotinib Response in Lung Cancer Patients Highly Dependent on EGFR Mutation Status: Presented at ASCO

......June 8, 2006 -- A small study shows that patients who harbor a particular mutation in the epidermal growth factor receptor (EGFR) known as Exon 19 have a significantly greater survival rate compared with patients who have a mutation of Exon 21.
The clinical importance of this study is that, in time, it may be possible to determine which patients would respond best to erlotinib treatment, and which ones might be better suited to another therapy, since erlotinib treatment would probably produce suboptimal results, according to the researchers.
The study was part of the larger Spanish Lung Cancer Group study (SLADB), which selected only those subjects who were chemotherapy naïve and who had EGFR mutations confirmed by genetic profiling. In all, 22 patients showed mutations to Exon 19 and 18 had mutations of Exon 21. Approximately 70% of the patients were never smokers and 90% had stage IV disease.

Patients underwent a total of 238 doses of erlotinib(Tarceva) 150 mg/day as a single agent (median 6.4 per patient), and though the drug was generally well tolerated, 8 required dose reductions and 7 had dose interruptions......

The third marker is activated nuclear factor (NF)-ĸB :
http://www.her2support.org/vbulletin/showthread.php?t=24632



Finding of a new molecular marker of resistance to chemotherapy in breast cancer
The presence of the activated nuclear factor (NF)-ĸB predicts a response to chemotherapy of 20%, and if the factor is deactivated, response increases up to 91%. This new finding not only predicts chemotherapy response in breast cancer before beginning of treatment, but it also permits to act upon (NF)-ĸB, deactivate it and promote chemotherapy response……….


Your onc should also be able to determine if your are a candidate for one of these two recently reported treatments:

http://www.sciencedaily.com/releases...0601091230.htm
Combination Therapy Shows Promising Results In Patients With Advanced Lung Cancer
......An early phase study pairing an experimental targeted therapy with a common anti-inflammatory produced promising results in patients with advanced lung cancer, researchers at UCLA's Jonsson Cancer Center reported.
Pairing the targeted therapy Tarceva with the anti-inflammatory drug Celebrexincreased response rates in lung cancer patients by about three-fold, said Dr. Karen Reckamp, an assistant professor of hematology/oncology and lead author of the study. ........


http://www.docguide.com/news/content...2568880078C249

Non-Surgical Treatment Gives Lung Cancer Patients Three Years or More

FAIRFAX, VA -- July 117, 2006 -- Fifty-seven percent of lung cancer patients who were treated with thermal ablation survived to three years, two years beyond average life expectancy, according to research in the July issue of the Journal of Vascular and Interventional Radiology (JVIR).

The patients had early-stage, I-II, non-small cell lung cancer (NSCLC). During thermal ablation, an interventional radiologist uses imaging to guide a small needle through the skin into the tumor. Energy is then transmitted to the tip of the needle to "cook" and kill the tumor with heat or "freeze" it with cold.

"Only one-third of patients diagnosed with non-small cell lung cancer are eligible for surgery -- the rest face the reality of having less than 12 months to live," states study author Damian Dupuy, MD, of Rhode Island Hospital. "These new outpatient treatments not only are effective, but allow us to treat patients who historically have no other options. Utilizing imaging and targeted thermal ablation, we can heat and destroy lung tumors, and extend a patients life. As a physician, it's so gratifying to be able to provide a treatment that is so beneficial to patients and so easy for them to undergo."........
Good luck!