Upping the Ante in the Face of Progression

The following is a CancerGRACE article by Dr. Howard (Jack) West. Dr. West is a lung cancer specialist at Swedish Medical Center in Seattle, WA. Dr. West's nonprofit organization, CancerGRACE, provides expert-mediated information on current and emerging cancer management options in order to empower patients, caregivers, and health professionals to become direct partners in cancer care.

Upping the Ante in the Face of Progression

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Today I’m going to veer into the realm of style in cancer management rather than focusing on hard evidence. Sadly, it’s not a rare event to have cancer progress early despite a perfectly good initial therapy. I just saw a patient in my clinic who illustrates what I consider to be a very reasonable treatment idea that doesn’t find its way into the textbook approaches for managing somewhat resistant cancers, but it’s worth discussing the concept of upping the ante with subsequent treatment.
To back up, the textbook answer to what to do in the face of a cancer that is progressing through first line treatment is to move on to second line treatment, though we know that our second line treatments tend to be less effective than earlier ones, and that early progression through good first line therapy represents a high probability that this is a pretty resistant cancer.
The particular patient I saw had been referred by a very good community oncologist for a second opinion after she had just had a scan that demonstrated a mixed response to first line carboplatin/Taxol (paclitaxel) for advanced squamous cell NSCLC, with more progression than response. She’s relatively young, with a very good performance status, and despite the findings of progression, is still looking and feeling very well.While the standard approach for second line treatment for her squamous NSCLC would be either Taxotere (docetaxel) or Tarceva (erlotinib), it’s hard to be extremely optimistic about either of these for her. Taxotere, a cousin of Taxol, could be better than the carbo/Taxol doublet, but I think that’s pretty unlikely.   Tarceva certainly can prolong survival in squamous cell NSCLC, but it doesn’t tend to be a blockbuster in this setting.

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Cryin' in our Corn

Farms.com

Corn: Mid-Session Corn Market Report for 2/10/2011
March corn opened unchanged on the session at 698 and established an early range of 696 1/4 to 704 1/2. Follow-through buying after yesterday's bullish USDA ending stocks news plus strong weekly export sales news helped support the early rally today as the market shook off negative outside markets to move to the highest level since July of 2008. Weekly export sales came in at 1.107 million tonnes for the current marketing year and 104,500 for the next marketing year for a total of 1.212 million tonnes. Cumulative corn sales stand at 61.3% of the USDA forecast for 2010/2011 (current) marketing year versus a 5 year average of 61.8%. Sales of 639,000 metric tonnes are needed each week to reach the USDA forecast. The European Union is proposing to temporarily suspend its import tariffs on feed wheat and barley in order to secure feed due to high prices and tight supply. Keep in mind; world coarse grain supply at the end of the season is expected to be at just 50 days supply, the lowest since 1973. For the US, ending stocks represent just 18 days supply; a record low.
*Disclaimer: The information in the Market Commentaries was obtained from sources believed to be reliable, but we do not guarantee its accuracy. Neither the information nor any opinion expressed therein constitutes a solicitation of the purchase or sale of any futures or options contracts.

Further Market Commentaries can be found at CME Daily Market Commentaries

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WA Legislative CaLL to ACTION

Your calls of support are needed NOW to help get HB 1124 on the Executive Calendar and voted out of the House Ag & Natural Resources Committee (AGNR). Please take the time to call all of the Democratic members on the AGNR Committee and ask them to support moving HB 1124 out of Committee. The testimony that was provided by WCA members on January 18th was very helpful to explain the impacts that Cougars are having on livestock production in the affected 6 County Pilot areas. It is essential that we focus on the Human safety aspect. WCA members in Klickitat County please contact your local law enforcement officers that have been working with you and ask them to call in as well. We also need phone calls from the Glenwood School District. I was told that the Glenwood School was locked down recently due to a cougar near the School grounds. Do not wait to make you phone calls!! This is an urgent issue and one that requires immediate action. The Pilot expires this year and if this bill does not pass the management tool of dogs in the Pilot Counties will go away. As you speak with the Legislative members and their Staff share your concerns of not being able to manage other predators.
CALL NOW DO NOT WAIT!!!!!!!!
House Agriculture & Natural Resources Committee

Blake, Brian (D) Chair MOD F 105 (360) 786-7870
Stanford, Derek (D) V. Chair MOD E 204 (360) 786-7928
Chandler, Bruce (R) * LEG 427B (360) 786-7960
Wilcox, J.T. (R) ** MOD G 106 (360) 786-7912
Buys, Vincent (R) MOD D 204 (360) 786-7854
Dunshee, Hans (D) MOD F 103 (360) 786-7804
Hinkle, Bill (R) MOD G 104 (360) 786-7808
Kretz, Joel (R) LEG 335A (360) 786-7988
Lytton, Kristine (D) MOD B 203 (360) 786-7800
Orcutt, Ed (R) LEG 122F (360) 786-7812
Pettigrew, Eric (D) LEG 434B (360) 786-7838
Rolfes, Christine (D) MOD D 105 (360) 786-7842
Van De Wege, Kevin (D) LEG 434A (360) 786-7916

*Ranking Minority Member **Asst. Ranking Minority Member
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Schedule of Public Hearing: SB 5611, 5631, and 5633 and Work Session.

Agriculture & Rural Economic Development* - 2/10/2011 10:00 a.m.

Senate Full Committee
Senate Hearing Rm 3
J.A. Cherberg Building
Olympia, WA

REVISED ON 2/3/2011 AT 8:17 AM

Public Hearing:
SB 5611 - Regarding the use of designated agricultural lands.
SB 5631 - Concerning miscellaneous provisions regulated by the department of agriculture.
SB 5633 - Exempting agricultural fair premiums from the unclaimed property act.

Work Session: Public comment of proposal to merge the State Conservation Commission into the Department of Agriculture.

Possible executive session on bills heard in committee. Other business.