From the news release:

The U.S. Food and Drug Administration today approved Gilotrif (afatinib) for patients with late stage (metastatic) non-small cell lung cancer (NSCLC) whose tumors express specific types of epidermal growth factor receptor (EGFR) gene mutations, as detected by an FDA-approved test.

Lung cancer is the leading cause of cancer-related death among men and women. According to the National Cancer Institute, an estimated 228,190 Americans will be diagnosed with lung cancer, and 159,480 will die from the disease this year. About 85 percent of lung cancers are NSCLC, making it the most common type of lung cancer. EGFR gene mutations are present in about 10 percent of NSCLC, with the majority of these gene mutations expressing EGFR exon 19 deletions or exon 21 L858R substitution.

Gilotrif is a tyrosine kinase inhibitor that blocks proteins that promote the development of cancerous cells. It is intended for patients whose tumors express the EGFR exon 19 deletions or exon 21 L858R substitution gene mutations. Gilotrif is being approved concurrently with the therascreen EGFR RGQ PCR Kit, a companion diagnostic that helps determine if a patient’s lung cancer cells express the EGFR mutations.

Read the rest — FDA approves new treatment for a type of late-stage lung cancer

Participants receiving this drug had a delay in tumor growth that was over 4 months later than those receiving chemotherapy. The press release notes that there was “no statistically significant difference in overall survival” though.

Hi Doctors, Im a big fan of the site.

I am afraid of what I read online about Propecia. Is there anything natural without harmful side effects that I can do to increase circulation in my scalp, slow down thinning? Do you recommend anything?

The problem with hair loss is not circulatory dependent. The body reduces the blood supply to the scalp as the thinner, sickly hair does not need all of that circulation. Scalp circulation is not the cause of genetic hair loss.

Too many people overreact to the rare sexual side effects of Propecia, but before you draw any conclusions, talk to your doctor and make an informed decision. The odds are in your favor that the side effects won’t occur, but if you’re certain you’re going to have side effects, the power of suggestion is something you should be wary of. There are no all-natural supplements that are proven to regrow or stop genetic hair loss.

Amazing website. I have been on finasteride for the past 12 yrs or so. It has held on to my hair quite well but I have noticed my temple areas and front part of my hairline thinning out recently. The crown is still slightly thick.

I want to know when is a good time to switch to avodart since I have noticed the front part of my scalp thinning out. Should I switch ASAP? I know its not approved for MPB and the risk could be slightly higher etc etc but I know a few of the people who comment on here have switched and are having excellent success even in the temple and hairline which is not very common.

Avodart must be prescribed off label (unless you have prostate issues), so it’s up to your doctor if he is willing to prescribe it to you.

The decision to switch from finasteride to dutasteride (Avodart) is one that you must reach with your prescribing doctor. Some people report better response with Avodart, but you must realize that the risks may be greater for sexual side effects and the possibility of sterility. Unfortunately, the information on this is not clinically available in younger men for treating hair loss, so it is a gamble.

Hey Dr. Rassman,

Since 19 yrs of age, I started taking Propecia daily as prescribed by a doctor. I’ve taken it for 6 years up until last July. I felt that Propecia’s effectiveness had started to wean off and I did not want to take a pill every morning for the rest of my life. Also, I felt that the prolonged usage of this medication might cause health issues when I’m much older and I had already started to dread taking the medication each morning.

Since I stopped taking the medication, I expected to shed massive amounts of hair in about 3-4 months after the medication completely leaves my blood stream and for my DHT levels to get back to normal. Surprisingly, the reverse actually occurred. My hair was getting better each month and I was even able to keep it long at a certain point.

I even noticed an improvement in my libido. On days when I would accidentally overdose on propecia (I used to buy Proscar and cut them up into quarters. Sometimes I’d take half a pill instead of a quarter), I’d have erectile difficulties.

I was wondering if I’m the first person you’ve heard of who’s actually done better off propecia than on it? Was I going bald in the first place? I do however use anti-dandruff shampoo and nizoral daily.

I hope my post helps individuals who’ve started propecia at a young age and are thinking of getting off the medication but are afraid to do so.

This is the first time I’ve heard of someone stopping Propecia after many years and their hair actually getting better. Normally, the story is just the opposite and catch-up hair loss occurs after stopping finasteride.

I have no way to know if you even had genetic hair loss in the first place. If you had early loss when your doctor first prescribed the Propecia, then what you’re describing doesn’t make sense to me, unless perhaps the Nizoral is providing you some benefits. I’m not convinced that Nizoral is a satisfactory treatment for genetic hair loss though, and I would’ve still expected some catch-up loss to occur. Out of curiosity, did you ever go back to your prescribing doctor to get his/her take on your situation?

In any case, I’m glad to hear of your hair growth success… but I would warn readers that as the opposite effect (hair loss) is fairly common after your stop the medication, following in your path may not be in their best long term interest.

Hi Dr. Rassman,

I’ve been on Propecia and Rogaine for 3 years and have been delighted with the results……up until now. Propecia and Rogaine thickened the hair all over my scalp and slowed the regression of my hairline. Unfortunately, it’s becoming apparent that my crown is now thinning, an area that had been strong prior to treatment.

I’m 28 now, and, if possible, I’d like to keep my crown hair for another few years, what are my options?

1) Would upping propecia dosage ever be advisable for a 28 year old?
2) Should I consider Avodart off-limits until it is FDA approved for hair loss?
3) What would you do if you were in this situation?

I’ve a check up with the doctor (who I’m very happy with) that originally prescribed the treatment in a couple of weeks, and will pose the same questions to him. However, your opinion is really important to me, and will help inform any decisions I may have to make. All the best

Upping the dose of Propecia (finasteride) usually does not work in your situation. Rogaine (minoxidil) is fairly effective in the crown and worth trying. Avodart (dutasteride) is an option and some doctors will prescribe it, however, the long term risks of sterility are there (probably remote), and the side effects are more frequent than on Propecia.

Try the minoxidil and give it at least 6 months. Then reassess your situation.

Doctor, how are you. I have been on propecia for 2 years, with fairly good results. hair is about the same, but my question is why do I still shed alot of hairs. I just want your opinion on this from your experiences with propecia and hair restoration field. I mean I know your suppose to shed up to 150 hairs a day, but I feel like I shed more. The hair still looks the same, but why is the shedding so much?

The amount of hair I shed I should be slick bald now, but still have a full head of hair with a bit of thinning like it was 2 years ago when I started propecia. when I wake up theres like 20 hairs on pillow, when I shower I shed so much, when I comb I shed so much, and its been like this even before starting propecia, but still have hair.

are there people that shed more and its still normal? I shed thin weak hairs, to thick hairs, and hair still looks same. As I said with the amount I shed I should be slick bald

We still cycle hair and the thin, weak hairs will eventually be lost. Propecia delays the long term hair loss, but it does not stop it completely. If you have not had your hair bulk analyzed, you should have it done. A baseline of hair bulk will tell you over time what is really happening to you.