As reported in the Journal of Clinical Oncology by David R. Spigel, MD, and colleagues, the phase III RESILIENT Part 2 trial has shown no overall survival benefit with second-line liposomal irinotecan vs topotecan in patients with small cell lung cancer whose disease progressed on or after...
Altering or increasing the dosages of smoking cessation regimens may help patients quit smoking, according to a recent study published by Cinciripini et al in JAMA. The findings indicated that the smoking cessation drug varenicline may be more effective than combined nicotine replacement therapy...
Glecirasib monotherapy demonstrated efficacy in previously treated patients with KRAS G12C–mutated non–small cell lung cancer (NSCLC) according to data presented during the ASCO Plenary Series: April 2024 Session (Abstract 468214). Results of the pivotal Chinese phase II study of glecirasib...
Pasi A. Jänne, MD, PhD, of Dana-Farber Cancer Institute, discusses an exploratory analysis from the FLAURA2 study, which indicates that baseline levels of plasma EGFR mutation may be prognostic and predictive of clinical benefit with osimertinib plus chemotherapy vs osimertinib alone for patients with non–small cell lung cancer (NSCLC).
In a systematic review and meta-analysis reported in JAMA Network Open, Banna et al found that neoadjuvant chemoimmunotherapy was associated with improved event-free survival and pathologic complete response compared with neoadjuvant chemotherapy alone in patients with early-stage non–small cell...
On April 18, the U.S. Food and Drug Administration (FDA) approved the tyrosine kinase inhibitor alectinib (Alecensa) for adjuvant treatment after tumor resection in patients with ALK-positive non–small cell lung cancer (NSCLC), as detected by an FDA-approved test. Alectinib is an orally...
The College of American Pathologists in collaboration with the International Association for the Study of Lung Cancer, the Pulmonary Pathology Society, the Association for Molecular Pathology, and the LUNGevity Foundation have developed evidence-based recommendations on the use of certain...
Investigators have found a higher rate of mortality among patients with intellectual and developmental disabilities diagnosed with breast cancer, colorectal cancer, or lung cancer, according to a recent study published by Hansford et al in the Canadian Journal of Public Health. Study Methods and...
As reported in The New England Journal of Medicine by Yi-Long Wu, MD, and colleagues, the phase III ALINA trial has shown significantly improved disease-free survival with adjuvant alectinib vs platinum-based chemotherapy in patients with resected ALK-positive NSCLC. Study Details In the...
As reported in the Journal of Clinical Oncology by Joel Neal, MD, PhD, and colleagues, the phase III CONTACT-01 trial has shown no significant improvement in overall survival with atezolizumab plus cabozantinib vs docetaxel after checkpoint inhibitor treatment and chemotherapy in patients with...
Long-term exposure to radon gas may be associated with a rise in nonsmoking lung cancer cases, according to a recent consumer survey conducted on behalf of The Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC–James)....
In a study reported in the Journal of Clinical Oncology, Potter et al found that use of a smoking history of ≥ 20 years rather than the current 2021 U.S. Preventive Services Task Force (USPSTF) guideline of ≥ 20 pack-years would increase the eligibility of Black individuals for lung cancer...
Akhil G. Pachimatla, MD, of Roswell Park Comprehensive Cancer Center, discusses study findings showing that, in patients with non–small cell lung cancer (NSCLC), image-based adiposity measures show stronger correlations with gene-expression changes in these tumors than body mass index measures. Dr. Pachimatla explains the clinical implications (Abstract 37).
A Medicare policy requiring shared decision-making between primary care physicians and patients regarding whether to proceed with lung cancer screening may require further examination, according to a recent study published by Kale et al in the Annals of Family Medicine. The findings indicated that...
As reported in The Lancet Oncology by Egbert F. Smit, MD, and colleagues, primary analysis in the HER2-overexpressing unresectable or metastatic non–small cell cancer (NSCLC) cohorts of the phase II DESTINY-Lung01 trial show activity of fam-trastuzumab deruxtecan-nxki (T-DXd) in this setting. Prior ...
In a systematic review and meta-analysis reported in JAMA Oncology, Sorin et al found that neoadjuvant chemoimmunotherapy was associated with better outcomes than neoadjuvant chemotherapy in patients with non–small cell lung cancer (NSCLC). Study Details A search of published studies reported...
In a study reported in a research letter in JAMA Network Open, Henderson et al identified prevalence of lung cancer screening in the United States in 2022 using U.S. Preventive Services Task Force (USPSTF) 2021 and 2013 recommendations for screening eligibility. The USPSTF 2013 guidelines...
On March 1, 2024, amivantamab-vmjw (Rybrevant) was approved for use with carboplatin and pemetrexed for first-line treatment of locally advanced or metastatic non–small cell lung cancer (NSCLC) with EGFR exon 20 insertion mutations, as detected by a U.S. Food and Drug Administration (FDA)-approved...
The findings from RATIONALE-315 were discussed at the ESMO (European Society for Medical Oncology) Virtual Plenary by Luis Paz-Ares, MD, PhD, Head of the Medical Oncology Service at the Hospital Universitario 12 de Octubre, Madrid. He noted that inhibitors of PD-1 and its ligand PD-L1, as...
In patients with resectable non–small cell lung cancer (NSCLC), perioperative treatment involving the checkpoint inhibitor tislelizumab led to a statistically significant benefit in event-free survival and a favorable trend for overall survival, investigators for the phase III RATIONALE-315 trial...
In a study reported in the Journal of Clinical Oncology, Rodriguez et al identified racial/ethnic differences in intensity of end-of-life care among patients in California who died from lung cancer between 2005 and 2018. Study Details The study used data from the California Cancer Registry linked...
Combination immunotherapy with the anti–PD-L1 monoclonal antibody durvalumab and other novel agents seemed to outperform durvalumab alone in the neoadjuvant setting for early-stage non–small cell lung cancer (NSCLC), according to researchers from The University of Texas MD Anderson Cancer Center,...
On November 15, 2023, repotrectinib (Augtyro) was approved for locally advanced or metastatic ROS1 fusion–positive non–small cell lung cancer (NSCLC).1 This is the first U.S. Food and Drug Administration approval that includes patients with ROS1-positive NSCLC who have previously received a ROS1...
On February 16, 2024, osimertinib (Tagrisso) was approved by the U.S. Food and Drug Administraton (FDA) with pemetrexed and platinum-based chemotherapy for patients with locally advanced or metastatic non–small cell lung cancer (NSCLC) with tumors having EGFR exon 19 deletions or exon 21 L858R...
Managing patients with lung cancer in the current era of an increasing array of systemic treatments has become a complex balancing act of trying to improve outcomes and survival from a cancer perspective while taking the necessary treatment and monitoring steps for cardioprotection. With few...
In a study reported in JAMA Oncology, David A. Palma, MD, PhD, and colleagues found that stereotactic ablative radiotherapy (SABR) met criteria for efficacy and toxicity in patients with early non–small cell lung cancer (NSCLC) and interstitial lung disease (ILD). As stated by the investigators,...
This is Part 3 of Optimizing Outcomes for Patients With Locally Advanced and Metastatic NSCLC, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Melissa Johnson, Vamsidhar Velcheti, and Helena Yu discuss the neoadjuvant treatment of patients with EGFR-positive lung adenocarcinoma. The patient is a 75-year-old female with a minimal smoking history who was admitted to the hospital for an electrolyte abnormality. Scans show a right upper lobe spiculated mass with right hilar lymphadenopathy, and biopsies confirm a diagnosis of primary lung adenocarcinoma, with a 4R lymph node testing positive as well. Next-generation sequencing is performed showing PALB2, PD-L1 negative, EGFR L861Q, and a low tumor mutation burden. The faculty discuss next steps for this patient, the optimal neoadjuvant therapy for patients with uncommon EGFR mutations, and whether osimertinib would be appropriate as a treatment option.
This is Part 2 of Optimizing Outcomes for Patients With Locally Advanced and Metastatic NSCLC, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Melissa Johnson, Vamsidhar Velcheti, and Helena Yu discuss the management of stage IIIA non–small cell lung cancer (NSCLC) in a former smoker. The patient is a 62-year-old female, a former smoker with a 25 pack-year history, who presents with shortness of breath and cough. Chest CT shows a large right upper lobe mass and an enlarged pretracheal lymph node, both of which are FDG-avid on PET scan. The case goes to multidisciplinary review, and he is ultimately diagnosed with a T4N0 squamous cancer. The faculty discuss the multidisciplinary management for a patient such as this, the possibility of complete resection, and the role of neoadjuvant immunotherapy plus chemotherapy for stage III NSCLC.
This is Part 1 of Optimizing Outcomes for Patients With Locally Advanced and Metastatic NSCLC, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Melissa Johnson, Vamsidhar Velcheti, and Helena Yu discuss the management of locally advanced non–small cell lung cancer (NSCLC). The patient is a 62-year-old male former smoker with a 45-pack-year history. He has multiple comorbidities and presents with shortness of breath and cough. PET/CT scans show hypermetabolism in a subcarinal node and right lower lobe pulmonary nodule, and right perihilar thickening. Bronchoscopy reveals squamous T2aN2 NSCLC. Next-generation sequencing is performed, showing a PD-L1 expression of 15%; high tumor mutation burden; KIT, FGFR1, PIK3CA and PIK3CA amplification; and the tumor is microsatellite stable. The faculty discuss how the treatment landscape for locally advanced NSCLC has changed since the approval of nivolumab plus chemotherapy, how to manage dose delays in the neoadjuvant setting, and whether additional adjuvant therapy is appropriate in patients who achieve complete response to neoadjuvant chemotherapy plus immunotherapy.
In a U.S. Food and Drug Administration (FDA) pooled analysis reported in The Lancet Oncology, Bernardo Haddock Lobo Goulart, MD, and colleagues found that response rate and progression-free survival were only moderately correlated with overall survival in first-line immunotherapy trials for...
Investigators may have uncovered differential associations between smoking and DNA methylation across various racial and ethnic groups, according to a recent study published by Huang et al in the American Journal of Human Genetics. The findings could lead to the development of new strategies to...
On March 1, the FDA approved the monoclonal bispecific anti–EGFR-MET antibody amivantamab-vmjw (Rybrevant) in combination with carboplatin and pemetrexed for the first-line treatment of locally advanced or metastatic NSCLC with EGFR exon 20 insertion mutations, as detected by an FDA-approved test....
Researchers have identified a set of 140 genes that may help predict disease-free survival in patients with non–small cell lung cancer (NSCLC) treated with a combination of immunotherapy and low-dose radiation, according to a recent study published by Altorki et al in Cell Reports Medicine. The...
In patients with resectable non–small cell lung cancer (NSCLC), perioperative treatment with the checkpoint inhibitor tislelizumab plus platinum-doublet chemotherapy led to a statistically significant benefit in event-free survival and a favorable trend for overall survival, investigators for the...
On February 16, the U.S. Food and Drug Administration (FDA) approved osimertinib (Tagrisso) with platinum-based chemotherapy for patients with locally advanced or metastatic non–small cell lung cancer (NSCLC) whose tumors have EGFR exon 19 deletions or exon 21 L858R mutations, as detected by an...
On February 15, the U.S. Food and Drug Administration (FDA) granted traditional approval to the kinase inhibitor tepotinib (Tepmetko) for adult patients with metastatic non–small cell lung cancer (NSCLC) harboring mesenchymal-epithelial transition (MET) exon 14–skipping alterations. The agent is...
The combination of the anti–PD-L1 antibody durvalumab and the ATR kinase inhibitor ceralasertib may help overcome inherent immune resistance and reinvigorate antitumor activity in patients with advanced non–small cell lung cancer (NSCLC), according to a recent study published by Besse et al in...
As reported in the Journal of Clinical Oncology by Jordi Remon, MD, PhD, and colleagues, the final analysis of overall survival in the phase II EORTC APPLE trial showed no significant difference between the strategies of upfront osimertinib vs sequential gefitinib/osimertinib in previously...
Investigators have found that the targeted therapy osimertinib may be associated with improved progression-free survival when administered after chemotherapy and radiation in patients with non–small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutations, according to a...
In January 2021, two of us wrote in these pages about our field’s pressing need to pivot away from identifying and deploying the maximum tolerated dose (MTD) when it comes to targeted oncology therapies.1 We argued that, instead, one should be looking for the “optimal dose”—the dose that best...
As reported in the Journal of Clinical Oncology by Tony Mok, MD, FRCPC, FASCO, and colleagues, final results of the primarily Asian phase III CheckMate 722 trial showed no progression-free survival benefit with the addition of nivolumab to chemotherapy in patients with EGFR-mutant metastatic...
In a U.S. single-center radiation dose-expansion study reported in JAMA Oncology, Wu et al found that chemoradiation with adaptively increased stereotactic ablative radiotherapy (SABR) boost doses was safe and effective in patients with locally advanced, unresectable non–small cell lung cancer...
Postoperative pulmonary embolism may be predictive of increased 30-day mortality, reintubation, and readmission rates in patients with lung cancer, according to recent findings presented by Axtell et al at The Society of Thoracic Surgeons (STS) Annual Meeting. Background Patients with lung cancer...
As reported in the Journal of Clinical Oncology by Thomas E. Stinchcombe, MD, and colleagues, an analysis from the phase III Cancer and Leukemia Group B 140503/Alliance trial has shown high rates of second primary lung cancers with both sublobar and lobar resections for T1aN0 non–small cell lung...
Although computed tomography (CT) screening has emerged as an essential tool for the early detection of lung diseases, there is still a broad range of potential improvements to be made. According to recent research, understanding the patterns of onset for earlier prediction of disease may be...
A recent study underscored the need for integrating cost-of-care conversations in cancer treatment. Results of the population-based analysis, presented at the 2023 ASCO Quality Care Symposium,1 showed that only about 25% of patients with newly diagnosed advanced non–small cell lung cancer (NSCLC)...
Researchers may have identified a novel genetic mechanism capable of making small cell lung cancer tumors more susceptible to an attack by the immune system, according to a new study published by Murayama et al in Cancer Discovery. The findings could lead to the development of new therapeutics to...
Investigators have found that Medicaid expansion under the Affordable Care Act may be associated with a reduced risk of early mortality following surgical resection in patients with non–small cell lung cancer (NSCLC), according to a recent study published by Nogueira et al in JAMA Network Open. The ...
As reported in The New England Journal of Medicine by Alexander Drilon, MD, and colleagues, the phase I/II TRIDENT-1 trial showed the activity of the next-generation ROS1 tyrosine kinase inhibitor repotrectinib in patients with ROS1 fusion–positive non–small cell lung cancer (NSCLC) with no...
This is Part 3 of New Directions in Nonmetastatic Non–Small Cell Lung Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Heather Wakelee, Tina Cascone, and Marina Garassino discuss the management of EGFR-mutated early-stage non–small cell lung cancer (NSCLC). The patient is a 48-year-old woman who is being evaluated for a 3-cm mass in the right lower lobe that was detected on chest x-ray after a car accident. Biopsy confirms adenocarcinoma, and PD-L1 expression is 85%. Her brain MRI is negative. At multidisciplinary tumor board, there is a discussion of whether to start chemotherapy plus immune checkpoint inhibitor therapy immediately vs going straight to surgery given the limited extent of disease. The faculty discuss the importance of testing molecular testing for EGFR and ALK mutations prior to the start of immune checkpoint inhibitor therapy, whether adjuvant osimertinib should be continued for more than 3 years, and the clinical implications of the ADAURA and ALINA trials.