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<recommendedContent xmlns="http://api.mspoke.com">
    <recommendedItem id="20100101_19_3202"
                     title="COLUMN: Should We Screen for Lung Cancer?"
                     score="0.014"
                     href="http://www.medpagetoday.com/Columns/21945?impressionId=1283456797800"
                     
      &lt;center&gt;&lt;embed src=&apos;http://www.medpagetoday.com/mediaplayer-licensed-viral/player-licensed-viral.swf&apos; height=&apos;265&apos; width=&apos;320&apos; allowscriptaccess=&apos;always&apos; allowfullscreen=&apos;true&apos; flashvars=&apos;&amp;file=mp4%3Amedpage%2F21xxx%2F21544_wide.m4v&amp;frontcolor=0x888888&amp;gapro.accountid=UA-3717434-1&amp;gapro.height=241&amp;gapro.trackpercentage=true&amp;gapro.trackstarts=true&amp;gapro.tracktime=true&amp;gapro.visible=true&amp;gapro.width=320&amp;gapro.x=0&amp;gapro.y=0&amp;image=http%3A%2F%2Fwww.medpagetoday.com%2Fupload%2F2010%2F8%2F5%2F21544_wide.jpg&amp;lightcolor=0x333333&amp;logo=http%3A%2F%2Fwww.medpagetoday.com%2Fimages%2F3018-MPTvideologoGB1-29v3.png&amp;plugins=gapro-1%2Cviral-2&amp;screencolor=0xe2eef2&amp;streamer=rtmp%3A%2F%2Fcp39689.edgefcs.net%2Fondemand&amp;viral.allowmenu=true&amp;viral.functions=share%2Cembed&amp;viral.oncomplete=true&amp;viral.onpause=false&amp;logo.link=http://www.medpagetoday.com&amp;logo.file=http://www.medpagetoday.com/images/3018-MPTvideologoGB1-29v3.png&amp;logo.hide=false&amp;logo.position=bottom-right&apos;/&gt;

&lt;/center&gt;&lt;br&gt;&lt;hr&gt;
&lt;p&gt;&lt;strong&gt;Transcript:&lt;/strong&gt;&lt;/p&gt;

&lt;p&gt;Hello. I&apos;m Dr. George Lundberg and this is At Large at &lt;em&gt;MedPage Today&lt;/em&gt;.&lt;/p&gt;
&lt;p&gt;To screen or not to screen? That is NOT the question.&lt;/p&gt;
&lt;p&gt;The question is not whether to screen, it is why, what, where, when, how, and how much, how often, and at what cost for what benefit.&lt;/p&gt;
&lt;p&gt;Patients and physicians must and do screen. The issue is cautious appropriateness. Self-screening by patients is easy, free, and fundamentally harmless. Look at your skin for potential melanomas, be alert to warning symptoms of a stroke, learn the early signs of alcohol dependence, observe your urine for gross blood.&lt;/p&gt;
&lt;p&gt;These are observations that have almost no downsides and could trigger life saving interventions. But when the American Medical Marketing Machine (AMMM) starts screening campaigns, watch out. Both the well intended zeal of the advocacy groups and the ambitious avarice of the suppliers and providers can wreak real havoc, especially when they combine forces.&lt;/p&gt;
&lt;p&gt;Is the benefit to individuals or the public going to be worth the harm to individuals and the costs to whomsoever pays the bills? Case in point: lung cancer.&lt;/p&gt;
&lt;p&gt;The number one cancer killer in America. A really big deal. Caught late; usually kills; caught early; also often kills. How could even earlier change that equation? What are the downsides to screening for it?&lt;/p&gt;
&lt;p&gt;Five investigators at the National Cancer Institute in 2010 &lt;a href=&quot;http://www.annals.org/content/152/8/505.abstract&quot; mce_href=&quot;http://www.annals.org/content/152/8/505.abstract&quot; target=&quot;_blank&quot;&gt;reported in the &lt;em&gt;Annals of Internal Medicine&lt;/em&gt;&lt;/a&gt; the results of a randomized, controlled clinical trial using low dose computed tomography (CT) versus chest x-ray on more than 3,000 current or past 30 pack-year smokers ages 55 to 74 with no history of lung cancer.&lt;/p&gt;
&lt;p&gt;The cumulative risk outcome of a false-positive after one annual screen with CT was 21% and after two, 33%; false positive rates after chest x-ray were 9% and 15% at one and two years.&lt;/p&gt;
&lt;p&gt;Not trivial results, and they often triggered an unnecessary and potentially hazardous invasive procedure, not to mention the hazard of the radiation itself.&lt;/p&gt;
&lt;p&gt;Good things can happen after screening. But so can bad. A false positive means you found something that was not there; a false negative means something was there and you did not find it; a misidentification means you found something that was there but you called it the wrong thing.&lt;/p&gt;
&lt;p&gt;Those are all bad. It is a little like in football; you throw a forward pass; three things can happen, but two of them are bad.&lt;/p&gt;
&lt;p&gt;So, sure, screen; but remember Hippocrates. First, do no harm.&lt;/p&gt;
&lt;p&gt;That&apos;s my opinion. I&apos;m Dr. George Lundberg, At Large for &lt;em&gt;MedPage Today&lt;/em&gt;.&lt;/p&gt;

    </recommendedItem>
    <recommendedItem id="20100101_19_3144"
                     title="ESC: Statins Cleared of Causing Cancer (CME/CE)"
                     score="0.009"
                     href="http://www.medpagetoday.com/MeetingCoverage/ESCCongress/tb/21866?impressionId=1283456797800"
                     
      &lt;p&gt;STOCKHOLM  --  In what may be the final word on the issue, an international team of researchers report that statins neither cause nor prevent cancer.&lt;/p&gt;
&lt;p&gt;The finding comes from a meta-analysis of 25 randomized controlled trials of the lipid-lowering medications, according to Jonathan Emberson, PhD, of the University of Oxford, and colleagues in the international Cholesterol Treatment Trialists&apos; Collaboration.&lt;/p&gt;
&lt;p&gt;In those trials, which included more than 166,000 participants, there were no differences between treatment and control arms in terms of the incidence of cancer or the rate of cancer mortality, Emberson said in a telephone interview.&lt;/p&gt;
&lt;p&gt;He will report the results next week in a presentation at the annual congress of the European Society of Cardiology here.&lt;/p&gt;
&lt;p&gt;&quot;Randomization to statin therapy for at least five years had no effect on the incidence of cancer or of cancer mortality in any group of individuals,&quot; Emberson told &lt;em&gt;MedPage Today&lt;/em&gt;.&lt;/p&gt;
&lt;p&gt;The main goal of the trials was to establish the effect of statins on lipid levels, and especially how changes in lipids affected the risk of major cardiovascular events. But Emberson said the collaborative group planned from the beginning to get data on cancer mortality, based on individual patient-level data from all the studies.&lt;/p&gt;
&lt;p&gt;&quot;Because we have individual patient data, we can really look at particular hypotheses and test them,&quot; he said  --  something that many meta-analyses can&apos;t do.&lt;/p&gt;
&lt;p&gt;The researchers conducting the trials were asked to track cancer, he said, because of observational studies that had suggested that lower cholesterol was linked to a higher risk of cancer. It now seems likely that those results arose from residual confounding or perhaps reverse causality, since it is known that the early stages of cancer can have the effect of lowering cholesterol, he said.&lt;/p&gt;
&lt;p&gt;There have also been observational studies suggesting the opposite effect  --  that statins prevent cancer.&lt;/p&gt;
&lt;p&gt;The 25 studies included 20 in which a statin was compared to placebo, involving 126,753 participants, and five in which higher and lower doses were compared, involving 39,612 participants. All the trials had at least 1,000 participants and lasted at least five years, Emberson said.&lt;/p&gt;
&lt;p&gt;The investigators calculated rate ratios for the effect on cancer incidence and cancer mortality of each 1.0 millimole per liter reduction in low-density lipoprotein cholesterol.&lt;/p&gt;
&lt;p&gt;All told, they reported, 9,954 participants developed cancer and 3,498 died from it.&lt;/p&gt;
&lt;p&gt;But reducing LDL cholesterol with a statin had no effect on the risk of developing cancer or on the risk of cancer death: &lt;ul&gt; &lt;li&gt;In the 20 statin versus control trials, cancer incidence in the treatment arms was 3,502 (or 1.4% a year) versus 3,514 cases in the control arms (also 1.4% a year), for a rate ratio of 0.99.&lt;/li&gt; &lt;li&gt;In those trials, there were 1,289 deaths among those taking statins versus 1,281 in those getting the placebo  --  0.5% a year for both  --  leading to a rate ratio of 1.00.&lt;/li&gt; &lt;li&gt;In the five trials of more versus less statin, cancer incidence was 1,466 versus 1,472 (1.6% a year for both arms) yielding a rate ratio of 1.02, while cancer mortality was 447 deaths versus 481 (0.5% a year for both arms) for a rate ratio of 0.88 and a 95% confidence interval from 0.67 to 1.15. &lt;/li&gt; &lt;li&gt;There was no evidence of any effect of statin therapy on cancer incidence or mortality at any particular site, with increasing years of treatment, or in any particular subgroup.&lt;/li&gt; &lt;/ul&gt;&lt;/p&gt;
&lt;p&gt;The only gap, Emberson said, is that the study only covers five years of treatment and it remains possible that an effect might be seen after longer therapy. But he said that some of the studies now have a decade of data and no evidence of a long-term effect has emerged.&lt;/p&gt;
&lt;p&gt;While statins are widely used, there has been &quot;an ongoing background worry&quot; among physicians that they might cause harm, according to Chris Cannon, MD, of Brigham and Women&apos;s Hospital in Boston.&lt;/p&gt;
&lt;p&gt;That fear has now been laid to rest, he told &lt;em&gt;MedPage Today&lt;/em&gt;.&lt;/p&gt;
&lt;p&gt;&quot;The key message is that statins are safe and there&apos;s no issue of increasing cancer,&quot; he said. &quot;And there&apos;s also no effect of reducing cancer, at least in a five-year time frame.&quot;&lt;/p&gt;
&lt;p&gt;The data, he said, meet the &quot;gold standard&quot; of randomized trials and &quot;trump the many observational analyses that have come out on both sides of the equation.&quot;&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;Emberson said he had no financial conflicts.&lt;/p&gt;
&lt;p&gt;Cannon reported research funding from Accumetrics, AstraZeneca, GlaxoSmithKline, InteKrin Therapeutics, Merck, Takeda; an advisory and ownership relationship with Bristol-Myers Squibb/Sanofi Partnership,  Novartis, and Alnylam; Honorarium for development of independent educational symposium from Pfizer; and clinical advisor and equity in Automedics Medical Systems.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;
    </recommendedItem>
    <recommendedItem id="20100101_19_3070"
                     title="Early Palliative Care Boosts Survival in NSCLC (CME/CE)"
                     score="0.004"
                     href="http://www.medpagetoday.com/HematologyOncology/LungCancer/tb/21753?impressionId=1283456797800"
                     
      Patients with advanced lung cancer lived longer and with a better quality of life when they received early palliative care as opposed to routine care, results of a randomized trial showed.&lt;br&gt;
&lt;br&gt;Early palliative care reduced use of aggressive measures at the end of life by more than a third, cut the prevalence of depression in half, and added nearly three months to the median survival of patients with advanced non-small cell lung cancer (NSCLC), according to an article published in the Aug. 19 issue of the &lt;em&gt;New England Journal of Medicine&lt;/em&gt;.&lt;br&gt;
&lt;br&gt;&quot;Although our findings must be replicated in a variety of care settings and cancer populations, the results nonetheless offer great promise for alleviating distress in patients with metastatic disease and addressing critical concerns regarding the use of healthcare services at the end of life,&quot; Jennifer S. Temel, MD, of Massachusetts General Hospital in Boston, and co-authors wrote in conclusion.&lt;p&gt;&lt;/p&gt;
&lt;p&gt;With its focus on symptom management, psychosocial support, and assistance with decision making, palliative care offers the potential to improve quality of care and reduce use of medical services, the authors wrote in their introduction.&lt;/p&gt;
&lt;p&gt;Historically, palliative care has been offered late in the disease course to patients who are hospitalized in specialized units or as a consultative service for uncontrolled symptoms, they continued.&lt;/p&gt;
&lt;p&gt;Previous studies have suggested that such timing has no effect on quality or delivery of care.&lt;/p&gt;
&lt;p&gt;&quot;To have a meaningful effect on patients&apos; quality of life and end-of-life care, palliative care services must be provided earlier in the course of the disease,&quot; the authors noted.&lt;/p&gt;
&lt;p&gt;In an effort to assess the impact of early palliative care, the investigators conducted a prospective, randomized clinical trial involving 151 patients with metastatic NSCLC. Within eight weeks of diagnosis, the patients were randomized to standard care alone or combined&lt;strong&gt; &lt;/strong&gt;with integrated palliative care.&lt;/p&gt;
&lt;p&gt;General guidelines for palliative care were adapted from the&lt;a href=&quot;http://www.nationalconsensusproject.org&quot; mce_href=&quot;http://www.nationalconsensusproject.org&quot; target=&quot;_blank&quot;&gt; National Consensus Project for Quality Palliative Care&lt;/a&gt;. Principal components included attention to physical and psychosocial symptoms, establishing goals for care, assisting in decision making regarding treatment, and coordinating care on the basis of individual patient needs.&lt;/p&gt;
&lt;p&gt;The primary outcome was the change in quality of life at 12 weeks. Quality of life and mood were assessed at baseline and at 12 weeks by means of the Functional Assessment of Cancer Therapy-Lung (FACT-L) scale and the Hospital Anxiety and Depression Scale.&lt;/p&gt;
&lt;p&gt;Patients assigned to palliative care had better quality of life, reflected in a mean FACT-L score of 98.0 at 12 weeks compared with 91.5 for the control group (&lt;em&gt;P&lt;/em&gt;=0.03).&lt;/p&gt;
&lt;p&gt;Additionally, only 16% of the palliative care group had depressive symptoms versus 38% of the control group (&lt;em&gt;P&lt;/em&gt;=0.01).&lt;/p&gt;
&lt;p&gt;Palliative-care patients were also less likely to receive aggressive care. The authors reported that 33% of patients receiving palliative care had aggressive end-of-life care versus 54% of the standard-care group (&lt;em&gt;P&lt;/em&gt;=0.05).&lt;/p&gt;
&lt;p&gt;Median survival in the patients who received early palliative care was 11.6 months compared with 8.9 months in the control group (&lt;em&gt;P&lt;/em&gt;=0.02).&lt;/p&gt;
&lt;p&gt;Authors of an accompanying editorial said the results show that palliative care is &quot;appropriate and potentially beneficial when it is introduced at the time of diagnosis of a serious or life-limiting illness  --  at the same time as all other appropriate and medical therapies are initiated.&quot;&lt;/p&gt;
&lt;p&gt;Future studies should address the impact of specific components of palliative care to establish evidence to support best practice, according to Amy S. Kelley, MD, and Diane E. Meier, MD, of Mount Sinai School of Medicine in New York City.&lt;/p&gt;
&lt;p&gt;Nonetheless, the results point to the value of a paradigm shift toward earlier implementation of palliative care.&lt;/p&gt;
&lt;p&gt;&quot;Perhaps unsurprisingly, reducing patients&apos; misery may help them live longer,&quot; Kelley and Meier wrote. &quot;We now have both the means and the knowledge to make palliative care an essential and routine component of evidence-based, high-quality care for the management of serious illness.&quot;&lt;/p&gt;
&lt;p&gt;Limitations of the study included single-center design, few minority patients in the study population, the absence of blinding, allowance for control patients to receive early palliative care, and inclusion of patients with missing data based on initial treatment assignment.&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;The study was supported by the American Society of Clinical Oncology, Joanne Hill Monahan Cancer Fund, and Golf Fights Cancer.&lt;/p&gt;&lt;p&gt;Temel reported that she had no relevant disclosures.&lt;/p&gt;&lt;p&gt;Kelley and Meier reported that they had no relevant disclosures.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;

&lt;p&gt;&lt;em&gt;This article was developed in collaboration with ABC News.&lt;/em&gt;&lt;img src=&quot;http://www.medpagetoday.com/upload/2009/10/1/14357_1.jpg&quot; mce_src=&quot;http://www.medpagetoday.com/upload/2009/10/1/14357_1.jpg&quot; alt=&quot;&quot;&gt;&lt;/p&gt;
    </recommendedItem>
    <recommendedItem id="20100101_19_3012"
                     title="No Lung Cancer Hazard With Estrogen (CME/CE)"
                     score="0"
                     href="http://www.medpagetoday.com/OBGYN/HRT/tb/21678?impressionId=1283456797800"
                     
      &lt;p&gt;Unopposed estrogen does not increase lung cancer incidence or mortality in postmenopausal women, according to data from the Women&apos;s Health Initiative (WHI).&lt;/p&gt;
&lt;p&gt;After eight years of follow-up, women using estrogen had an annual lung cancer incidence of 0.15% compared with 0.13% in the placebo group and lung cancer mortality of 56% and 61%, respectively, Rowan Chlebowski, MD, PhD, of Harbor-UCLA Medical Center in Torrance, Calif., and colleagues reported online in the &lt;em&gt;Journal of the National Cancer Institute&lt;/em&gt;.&lt;/p&gt;
&lt;p&gt;The cancers in the two groups were comparable with respect to number, stage, and grade.&lt;/p&gt;
&lt;p&gt;Those findings contrast with those from a previous WHI analysis showing an increased lung cancer mortality in women taking estrogen-progestin combinations.&lt;/p&gt;
&lt;p&gt;&quot;These findings should be reassuring for women with previous hysterectomy, who use estrogen alone for climacteric symptom management,&quot; the researchers wrote in conclusion&lt;em&gt;.&lt;/em&gt;&lt;/p&gt;
&lt;p&gt;&quot;The difference between combined estrogen plus progestin use and estrogen alone use on death from lung cancer requires further investigation.&quot;&lt;/p&gt;
&lt;p&gt;Two WHI randomized trials were conducted to assess the potential health benefits of hormone therapy (HT) in postmenopausal women. In one trial, women who had had a hysterectomy were randomized to estrogen or placebo for prevention of cardiovascular events. In the second trial, postmenopausal women with an intact uterus were randomized to an estrogen-progestin combination or placebo.&lt;/p&gt;
&lt;p&gt;The trial of unopposed estrogen ended after 7.1 years of follow-up with no evidence of a reduction in coronary heart disease and an increased risk of stroke in women assigned to HT (&lt;em&gt;JAMA&lt;/em&gt; 2004; 291: 1701-1712). The trial comparing combined HT and placebo ended after 5.6 years when results suggested that the risks of HT outweighed the benefits (&lt;em&gt;JAMA&lt;/em&gt; 2002; 288: 321-333).&lt;/p&gt;
&lt;p&gt;A post-hoc analysis of the trial of combined HT showed a significantly higher lung cancer mortality, but not incidence, in the HT arm (&lt;em&gt;Lancet&lt;/em&gt; 2009; 374: 1243-1251). A biologic rationale existed for a hormonal influence on lung cancer because a substantial proportion of the cancers have estrogen and progesterone receptors, the authors wrote in their introduction. Additionally, women with lung cancer have better survival than men do.&lt;/p&gt;
&lt;p&gt;Chlebowski and colleagues reported findings from a similar analysis of the trial of unopposed estrogen.&lt;/p&gt;
&lt;p&gt;The trial involved 10,739 women ages 50 to 79 who received conjugated equine estrogen or matching placebo. Follow-up averaged 7.9 years, extending to the end of the planned follow-up.&lt;/p&gt;
&lt;p&gt;In the estrogen and placebo groups, about half of the participants had never smoked, 38% were former smokers, and the remaining women smoked at enrollment.&lt;/p&gt;
&lt;p&gt;The authors reported that 61 women in the estrogen arm and 54 in the placebo arm had new lung cancer diagnoses during the study, a nonsignificant difference. All but 16 of the cancers were nonsmall-cell lung cancer (NSCLC), and the proportion of NSCLC in the two groups did not differ.&lt;/p&gt;
&lt;p&gt;Among women who developed lung cancer, the malignancy was the cause of death in 34 of 61 participants in the estrogen arm and 33 of 54 women in the placebo arm, another nonsignificant difference.&lt;/p&gt;
&lt;p&gt;All-cause mortality following diagnosis of lung cancer also did not differ between the groups.&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;The WHI was funded by the National Institutes of Health.&lt;/p&gt;&lt;p&gt;Chlebowski disclosed relationships with AstraZeneca, Novartis, Lilly, Amgen, and Pfizer, and co-author Margery Gass disclosed a relationship with Wyeth. The other co-authors had no relevant disclosures.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;
    </recommendedItem>
    <recommendedItem id="20100101_19_2946"
                     title="New ErbB Receptor Inhibitor Active in Several Cancers (CME/CE)"
                     score="-0.004"
                     href="http://www.medpagetoday.com/HematologyOncology/OtherCancers/tb/21590?impressionId=1283456797800"
                     
      &lt;p&gt;More than 20% of patients with advanced solid tumors had durable responses or stable disease when treated with an investigational irreversible inhibitor of the ErbB receptor tyrosine kinase family  --  including epidermal growth factor and HER2, results of a phase I clinical trial showed.&lt;/p&gt;
&lt;p&gt;Five of 53 patients had partial responses lasting as long as 34 months, and seven others had stable disease during continuous therapy with BIBW 2992, which the maker plans on naming afatinib.&lt;/p&gt;
&lt;p&gt;The most common treatment-related adverse effects were gastrointestinal events, rash, and fatigue. Dose-limiting toxicity consisted of two cases of grade 3 rash and one of reversible dyspnea secondary to pneumonitis.&lt;/p&gt;
&lt;p&gt;&quot;This study indicates that this agent is well tolerated in patients with advanced cancer, with satisfactory pharmacologic properties,&quot; Timothy A. Yap, MD, of the Institute of Cancer Research in Sutton, England, and colleagues reported online in the &lt;em&gt;Journal of Clinical Oncology&lt;/em&gt;.&lt;/p&gt;
&lt;p&gt;&quot;Importantly, we report durable activity in different tumor types, including multiple patients with non-small cell lung cancer (NSCLC), supporting the development of this small molecule in phase III trials in this disease.&quot;&lt;/p&gt;
&lt;p&gt;Several types of cancer exhibit dysregulation of one or more members of the ErB receptor tyrosine kinase family. Drugs that target EGFR and HER2 have led to clinical benefit, but cancer cells may develop resistance to the agents, the authors wrote in their introduction.&lt;/p&gt;
&lt;p&gt;BIBW 2992 is a highly selective, potent, and irreversible inhibitor of EGFR and HER2 kinases and has demonstrated activity in several preclinical models of cancer. The drug also exhibits inhibitory activity in a variety of EGFR mutants, including mutations known to be resistant to first-generation EGFR tyrosine kinase inhibitors, the authors continued.&lt;/p&gt;
&lt;p&gt;Extending investigation of BIBW 2992 into the clinical arena, investigators conducted a phase I dose-escalation trial in patients with advanced solid tumors. The primary objectives were safety and tolerability, and secondary objectives included pharmacokinetics and tumor response.&lt;/p&gt;
&lt;p&gt;Patients with lung cancer accounted for 16 of the 53 patients, followed by colorectal and esophageal (seven each), and &quot;other&quot; (nine).&lt;/p&gt;
&lt;p&gt;All patients had received at least one prior therapy, and two-thirds had received more than three prior therapies.&lt;/p&gt;
&lt;p&gt;BIBW 2992 doses ranged from 10 to 50 mg/d, including 26 who received 40 mg/d and 13 patients treated with 50 mg/d.&lt;/p&gt;
&lt;p&gt;The authors reported that the drug was generally well tolerated, as no grade 4-5 adverse events occurred. At least one adverse event occurred in 52 of the 53 patients, and 44 patients had a total of 122 treatment-related adverse events. The most common adverse events were gastrointestinal (diarrhea, nausea, vomiting).&lt;/p&gt;
&lt;p&gt;The three cases of dose-limiting toxicity occurred during the first course of treatment with the highest doses. The toxicity resolved upon drug discontinuation.&lt;/p&gt;
&lt;p&gt;The five partial responses included two unconfirmed responses. Four of the five responses involved patients with NSCLC, and the fifth occurred in a patient with esophageal cancer. Three of the patients with NSCLC had response duration of 18, 24, and 34 months, and EGFR mutations were confirmed in two of the three.&lt;/p&gt;
&lt;p&gt;The seven patients with stable disease for at least six months included patients with mesothelioma, breast, colorectal, cervical, and thyroid cancer, and one patient with adenocarcinoma of unknown primary.&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;The study was supported by Boehringer Ingelheim.&lt;/p&gt;&lt;p&gt;Yap had no disclosures. Coauthor James Spicer disclosed relationships with Boehringer Ingelheim, and coauthor Johann S. de Bono disclosed relationships with Boehringer Ingelheim, AstraZeneca, OSI Pharmaceuticals, and Roche. Coauthors inclluded several employees of Boehringer Ingelheim.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;
    </recommendedItem>
</recommendedContent>