Search Journal-type in search term and press enter
In Memoriam
Social Media-Follow Southwest Journal of Pulmonary and Critical Care on Facebook and Twitter

News

Last 50 News Postings

 (Click on title to be directed to posting, most recent listed first)

Determining if Drug Price Increases are Justified
Court Overturns CMS' Site-Neutral Payment Policy
Pulmonary Disease Linked to Vaping
CEO Compensation-One Reason Healthcare Costs So Much
Doctor or Money Shortage in California?
FDA Commissioner Gottlieb Resigns
Physicians Generate an Average $2.4 Million a Year Per Hospital
Drug Prices Continue to Rise
New Center for Physician Rights
CMS Decreases Clinic Visit Payments to Hospital-Employed Physicians
   and Expands Decreases in Drug Payments 340B Cuts
Big Pharma Gives Millions to Congress
Gilbert Hospital and Florence Hospital at Anthem Closed
CMS’ Star Ratings Miscalculated
VA Announces Aggressive New Approach to Produce Rapid Improvements
   in VA Medical Centers
Healthcare Payments Under the Budget Deal: Mostly Good News
   for Physicians
Hospitals Plan to Start Their Own Generic Drug Company
Flu Season and Trehalose
MedPAC Votes to Scrap MIPS
CMS Announces New Payment Model
Varenicline (Chantix®) Associated with Increased Cardiovascular Events
Tax Cuts Could Threaten Physicians
Trump Nominates Former Pharmaceutical Executive as HHS Secretary
Arizona Averages Over 25 Opioid Overdoses Per Day
Maryvale Hospital to Close
California Enacts Drug Pricing Transparency Bill
Senate Health Bill Lacks 50 Votes Needed to Proceed
Medi-Cal Blamed for Poor Care in Lawsuit
Senate Republican Leadership Releases Revised ACA Repeal and Replace Bill
Mortality Rate Will Likely Increase Under Senate Healthcare Bill
University of Arizona-Phoenix Receives Full Accreditation
Limited Choice of Obamacare Insurers in Some Parts of the Southwest
Gottlieb, the FDA and Dumbing Down Medicine
Salary Surveys Report Declines in Pulmonologist, Allergist and Nurse 
   Incomes
CDC Releases Ventilator-Associated Events Criteria
Medicare Bundled Payment Initiative Did Not Reduce COPD Readmissions
Younger Smokers Continue to Smoke as Adults: Implications for Raising the
   Smoking Age to 21
Most Drug Overdose Deaths from Nonprescription Opioids
Lawsuits Allege Price Fixing by Generic Drug Makers
Knox Named Phoenix Associate Dean of Faculty Affairs
Rating the VA Hospitals
Garcia Resigns as Arizona University VP
Combination Influenza Therapy with Clarithromycin-Naproxen-Oseltamivir
   Superior to Oseltamivir Alone
VAP Rates Unchanged
ABIM Overhauling MOC
Substitution of Assistants for Nurses Increases Mortality, Decreases Quality
CMS Releases Data on Drug Spending
Trump Proposes Initial Healthcare Agenda
Election Results of Southwest Ballot Measures Affecting Healthcare
Southwest Ballot Measures Affecting Healthcare
ACGME Proposes Dropping the 16 Hour Resident Shift Limit

 

For an excel file with complete news listings click here.

A report from Heartwire described a letter written by Peter Wilmshurst to the AHA asking for full disclosure of conflicts of interest in the MIST trial. Wilmshurst was portrayed in SWJPCC on April 27, 2012 in our Profiles of Medical Courage series. We felt the report of the letter might be of interest to the readership of SWJPCC but there was no good section to pass along the Heartwire article. For this reason, a new Section entitled “News” has been started to report developments outside the usual medical journal purview or from other sources which might interest our readers. We encourage bringing news-worthy articles to our attention and would welcome submission of written reports of such articles.

-------------------------------------------------------------------------------------

Entries in cancer (1)

Thursday
Nov032016

Non-Small Cell Lung Cancer: RT Out, Pembrolizumab In, and Vaccine Hope or Hype

Three articles on non-small cell lung cancer (NSCLC) recently appeared which were of interest and might alter therapy. The first on whole brain radiation therapy (WBRT) was presented at the at the European Respiratory Society (ERS) International Congress 2016 and simultaneously published online in the Lancet (1). WBRT and dexamethasone have been the standard of care for patients with NSCLC brain metastases. However, the study of 538 randomized patients concludes that WBRT provides "little additional clinically significant benefit" with brain metastases. Notably, all the patients were unsuitable for surgical resection or stereotactic radiotherapy, owing to widespread metastases. However, patients younger than 60 years did seem to have a survival advantage and might represent an exception.

The second study presented at the European Society for Medical Oncology (ESMO) 2016 Congress reports that the addition of pembrolizumab to first-line treatment with pemetrexed and carboplatin significantly improved objective response rate and progression-free survival in NSCLC (2). The study included 123 treatment-naive NSCLC patients whose tumors did not harbor EGFR or ALK aberrations. Participants were randomly assigned to receive pemetrexed plus carboplatin with or without pembrolizumab. At a median follow-up of 10.6 months, results showed that objective response rate was 55% with pembrolizumab vs 29% with chemotherapy alone (treatment difference, 26%; 95% CI, 9-42; P = .0016). All responses were partial.

Pembrolizumab is a humanized IgG4 monoclonal antibody (mouse antibody grafted to human immunoglublin) which destroys a protective mechanism on cancer cells, allowing the immune system to destroy those cancer cells. It targets the programmed cell death 1 (PD-1) receptor. The drug was initially used in treating metastatic melanoma but is a promising new therapy for advanced cancers, now including lung cancer. Brighton et al. (3) recently reported in the SWJPCC that pembrolizumab can result in drug-induced pneumonitis.

Earlier this spring a Fox News report in Phoenix made some spectacular claims about a Cuban lung cancer vaccine concluding that it “could literally save millions of live” (4-includes a video of the original broadcast). Dr. Santosh Rao from Banner MD Anderson Cancer Center in Phoenix, who apparently has seen studies on the vaccine says that the vaccine does something, and that it extends life. However, he added that "the question will always come up, is it better than some of the new therapies that we have that also help the immune system function better". Banner MD Anderson Cancer Center has been promoting the coverage on social media adding that the vaccine is “potentially groundbreaking". Dr. Doug Campos-Outcalt, Chair of New Department of Family, Community and Preventive Medicine, commented that he was as baffled by the coverage. “Why MD Anderson would hype this alleged breakthrough before it has undergone controlled clinical trials is beyond my understanding,” said Campos-Outcalt. The drug has not been used in the United States but Roswell Park Institute in Buffalo, NY, has applied to do a clinical trial on the vaccine called CIMAVax. If approved, the trial will probably not begin until 2017 and will likely take several years.

Richard A. Robbins, MD

Editor, SWJPCC

References

  1. Mulvenna P, Nankivell M, Barton R, et al. Dexamethasone and supportive care with or without whole brain radiotherapy in treating patients with non-small cell lung cancer with brain metastases unsuitable for resection or stereotactic radiotherapy (QUARTZ): results from a phase 3, non-inferiority, randomised trial. Lancet. 2016 Oct 22;388(10055):2004-14. [CrossRef] [PubMed]
  2. Hoffman J. Adding pembrolizumab to chemo improves efficacy in metastatic NSCLC. Cancer Therapy Advisor. November 1, 2016. Available at: http://www.cancertherapyadvisor.com/lung-cancer/lung-cancer-nsclc-pembrolizumab-chemotherapy-improved-efficacy/article/569669/ (accessed 11/2/16).
  3. Brighton AM, Jain T, Bryce AH, Sista RR, Viggiano RW, Wesselius LJ. November 2016 pulmonary case of the month. Southwest J Pulm Crit Care. 2016:13(5):191-5. [CrossRef]
  4. Lomangino K. FOX, Banner MD Anderson hype Cuba cancer “breakthrough”. Health News Review. March 7, 2016. Available at: http://www.healthnewsreview.org/2016/03/fox-md-anderson-hype-cuba-cancer-breakthrough-rumors/ (accessed 11/2/16).

Cite as: Robbins RA. Non-small cell lung cancer: RT out, pembrolizumab in, and vaccine hope or hype. Southwest J Pulm Crit Care. 2016;13(5):205-6. doi: http://dx.doi.org/10.13175/swjpcc107-16 PDF