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immunotherapy
lung cancer

Matthew A. Gubens, MD, on Non–Small Cell Lung Cancer: New Immunotherapy Strategies in the NCCN Guidelines

Matthew A. Gubens, MD, of the UCSF Helen Diller Family Comprehensive Cancer Center, discusses recent updates to the NCCN Guidelines in non–small cell lung cancer, including the use of pembrolizumab as a single agent or in combination based on PD-L1 status, treatment selection in squamous and nonsquamous patients, and how mutational status affects treatment strategy.

lung cancer
immunotherapy

Stage III Non–Small Cell Lung Cancer: A Look at New Systemic Treatments

Jyoti D. Patel, MD, of the University of Chicago, discusses immunotherapy for locally advanced NSCLC, selecting patients for these treatments, and the potential toxicities of combination therapies.

lung cancer

Susan Y. Wu, MD, on Non–Small Cell Lung Cancer: Using an Online Tool in Treatment

Susan Y. Wu, MD, of the University of California, San Francisco, discusses how patient exposure to treatment guidelines improved smoking cessation counseling and the use of molecular testing, and decreased the use of adjuvant chemotherapy in patients with early-stage disease (Abstract 5).

lung cancer
symptom management

Mark K. Ferguson, MD, on Mitigating Frailty and Sarcopenia to Improve Treatment Outcomes

Mark K. Ferguson, MD, of the University of Chicago Hospital, discusses frailty and loss of muscle tissue, which are common among patients with lung cancer. These conditions are linked with decreased survival as well as increased surgical complications, chemotherapy toxicity, and cost of care.

lung cancer

Jing Zeng, MD, on Non–Small Cell Lung Cancer: Therapeutic Implications of Proper Disease Staging

Jing Zeng, MD, of the University of Washington, discusses upstaging disease from stage III to stage IV, which can occur with repeat PET and/or CT scans for patients with locally advanced NSCLC, and the need for clinicians to stage disease properly to ensure appropriate treatment.

lung cancer
immunotherapy

Ruqin Chen, MB, on Lung Cancer Treated With Immune Checkpoint Inhibitors: Survival Outcomes and Clinical and Molecular Features

Ruqin Chen, MB, of the Mayo Clinic Florida, discusses early study findings that show molecular profiling with NF1, CD79a, and AKT3 could potentially improve prediction of progression-free survival in patients with lung cancer who are receiving immunotherapy.

lung cancer
issues in oncology

Kyle F. Concannon, MD, on Lung Cancer in Homeless Patients: Outcomes and Quality Measures

Kyle F. Concannon, MD, of the University of Washington/Seattle Cancer Care Alliance, discusses study results on the delays in biopsy after radiographic findings among homeless vs housed patients with lung cancer, and the higher rates of missed appointments following diagnosis (Abstract 125).

lung cancer

J. Fletcher Drogos, MD, on Multiple Courses of Stereotactic Body Radiation Therapy: Outcomes in Patients With Lung Cancer

J. Fletcher Drogos, MD, of Rush University, discusses study findings on overall survival and toxicity among patients who undergo multiple radiation treatments for lung cancer.

lung cancer
issues in oncology

Shraddha M. Dalwadi, MD, MBA, on Non–Small Cell Lung Cancer: What Contributes to Disparities in Treating Stage I Disease

Shraddha M. Dalwadi, MD, MBA, of Baylor College of Medicine, discusses the nearly 12% of potentially curable patients with stage I NSCLC who do not receive treatment, the various socioeconomic reasons why, and how some patients may benefit from minimally invasive therapies (Abstract 127).

lung cancer
neuroendocrine tumors

Aaron S. Mansfield, MD, on Treating Rare Thoracic Cancers: Status Update

Aaron S. Mansfield, MD, of the Mayo Clinic, summarizes a session he moderated on rare thoracic cancers such as mesothelioma and thymic epithelial tumors, as well as novel imaging and treatments in neuroendocrine tumors.

lung cancer

Heather A. Wakelee, MD, on Advanced Non–Small Cell Lung Cancer: State-of-the-Art Treatment for EGFR-Positive and ALK-Positive Diseases

Heather A. Wakelee, MD, of Stanford University, discusses the most recent FDA-approved tyrosine kinase inhibitors that target EGFR and ALK mutations, how these agents fit into the treatment landscape, and the rapidly evolving field of TKI resistance.

lung cancer
immunotherapy

Leora Horn, MD, on Small Cell Lung Cancer and Immuno-oncology: Have We Finally Solved the Small Cell Paradox?

Leora Horn, MD, of Vanderbilt University Medical Center, discusses the progress made treating extensive-stage small cell lung cancer, improvements in progression-free and overall survival, and the fact that it’s still difficult to determine which patients will benefit most from immunotherapy.

lung cancer

FDA Approves Atezolizumab for Extensive-Stage Small Cell Lung Cancer

On March 18, 2019, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq) in combination with carboplatin and etoposide for the first-line treatment of adult patients with extensive-stage small cell lung cancer. IMpower133 Approval was based on the IMpower133 study, a...

breast cancer
colorectal cancer
lung cancer
pain management

Opioid Use Among Older Survivors of Colorectal, Lung, and Breast Cancers

In a linked Surveillance, Epidemiology, and End Results and Medicare study reported in the Journal of Clinical Oncology, Salz et al found that chronic opioid use varied by cancer among older cancer survivors. By 6 years after diagnosis, survivors were no more likely to be chronic opioid users...

lung cancer

2019 Thoracic Cancers Symposium: Trends in Use of Prophylactic Cranial Irradiation for Extensive-Stage SCLC

A new survey of radiation oncologists points to a sharp decline in the use of prophylactic cranial irradiation for patients with extensive-stage small cell lung cancer (SCLC), indicating a rapid change in standard practice for the disease following the 2017 publication of a major clinical trial by...

lung cancer

2019 Thoracic Cancers Symposium: Effect of Structured Patient Exposure to the NCCN Guidelines for NSCLC

A new clinical trial found that exposing patients to tailored versions of the National Comprehensive Cancer Network (NCCN®) Guidelines for non–small cell lung cancer (NSCLC) may help drive smoking cessation, testing for potential biomarkers and, for early-stage disease, more...

lung cancer

2019 Thoracic Cancers Symposium: Local Consolidative Therapy and Overall Survival in Oligometastatic NSCLC

A new analysis of patients treated with local consolidative therapy for oligometastatic non–small cell lung cancer (NSCLC) found that the intensive treatment approach is associated with improved overall survival. Local consolidative therapy—consisting of radiation therapy or...

lung cancer
immunotherapy

Nivolumab Plus Ipilimumab in Advanced NSCLC: Outcomes by PD-L1 and Tumor Mutational Burden Status

As reported in the Journal of Clinical Oncology by Ready et al, the phase II CheckMate 568 trial has shown that higher tumor mutational burden is associated with response, irrespective of programmed cell death ligand 1 (PD-L1) expression in first-line nivolumab plus low-dose ipilimumab treatment of ...

Lung Cancer

Although Evidence Is Clear That Lung Cancer Screening Saves Lives, Adoption Rates Remain Low

The findings of the National Lung Screening Trial (NLST), reported in 2011, revealed that participants who received low-dose helical computed tomography (CT) scans had a 20% lower risk of dying of lung cancer than participants who received standard chest x-rays. Despite these results,...

Lung Cancer

Researcher Supported by ASCO’s Conquer Cancer Foundation Earns Spot in Clinical Cancer Advances 2019 for Lung Cancer Study

The work of nine researchers who have previously received funding from Conquer Cancer is featured in ASCO’s Clinical Cancer Advances 2019. Visit CONQUER.ORG/CCA for more details. Immunotherapy At New York University Perlmutter Cancer Center in New York City, Leena Gandhi, MD, PhD, led a large...

lung cancer
immunotherapy

Edward B. Garon, MD, on Non–Small Cell Lung Cancer: CheckMate 384 Trial on Nivolumab Dosing

Edward B. Garon, MD, of the Olive View–UCLA Medical Center, discusses phase IIIb/IV study findings on reducing the frequency of nivolumab dosing, from 480 mg every 4 weeks to 240 mg every 2 weeks, in patients with previously treated advanced non–small cell lung cancer (Abstract 100).

lung cancer
immunotherapy

Nicolas Guibert, MD, PhD, on Non–Small Cell Lung Cancer: Predicting Response to PD-1 Inhibitors With cfDNA

Nicolas Guibert, MD, PhD, of Toulouse University Hospital, discusses a simple algorithm built to predict durable outcomes of patients with advanced non–small cell lung cancer that has been treated with immunotherapy. He notes that early changes in circulating tumor DNA burden may also predict sustained responses to PD-1 inhibitors (Abstract 103).

lung cancer
immunotherapy

2019 ASCO-SITC: Can Plasma Cell–Free DNA Aid in Predicting Response to Checkpoint Inhibitors in NSCLC?

Researchers hypothesized that targeting some genetic alterations in plasma cell–free DNA—along with early monitoring—could be an effective, noninvasive method for predicting response to immune checkpoint inhibitors in advanced non–small cell lung cancer (NSCLC). Findings...

lung cancer
immunotherapy

2019 ASCO-SITC: Efficacy and Safety of Less Frequent Dosing of Second-Line Nivolumab for Non–Small Cell Lung Cancer

Researchers reported similar efficacy and safety with an every-4-week regimen of nivolumab in the second-line setting compared to an every-2-week schedule in patients with non–small cell lung cancer (NSCLC). Edward B. Garon, MD, and colleagues presented the results of an interim analysis of...

lung cancer

Stereotactic Ablative vs Standard Radiotherapy in Inoperable Stage I NSCLC

In the phase III TROG 09.02 CHISEL trial reported in The Lancet Oncology, Ball et al found that stereotactic ablative body radiotherapy improved local disease control vs standard radiotherapy in peripherally located, inoperable stage I non–small cell lung cancer (NSCLC). The open-label trial ...

colorectal cancer
lung cancer
immunotherapy

TAT 2019: Trends in Distribution of Cancer Type in Phase I Trials

The proportion of early-stage drug trials tackling the most common tumor types has declined sharply since the early 1990s, as less common cancers receive increasing attention in trials, according to new research presented by Sato et al at the TAT 2019–International Congress on Targeted...

lung cancer

AACR 2019: Liquid Biopsy–Based Test May Be Reliable in Identifying Treatment for Non–Small Cell Lung Cancer

The number of guideline-recommended biomarkers to be assessed in patients with newly diagnosed, metastatic non–small cell lung cancer (NSCLC) is increasing. These biomarkers include both predictive targets—including EGFR, ALK, ROS1, BRAF, RET, MET, and ERBB2—and prognostic...

Lung Cancer
Immunotherapy

Pembrolizumab in Combination With Chemotherapy in First-Line Treatment of Metastatic Squamous NSCLC

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On October 30, 2018, pembrolizumab in combination with...

solid tumors
leukemia
lung cancer
lymphoma

FDA Pipeline: Priority Reviews in Solid Tumors and Lymphoma; Plus an sNDA in Acute Myeloid Leukemia

Over the past week, the U.S. Food and Drug Administration (FDA) granted multiple Priority Reviews and accepted a supplemental new drug application: Priority Review for Entrectinib in NTRK Fusion–Positive Solid Tumors and Metastatic, ROS1-Positive NSCLC This week, the FDA accepted new drug...

Lung Cancer

No Survival Benefit With Avelumab vs Docetaxel in Platinum-Treated, Advanced, PD-L1–Positive NSCLC

As reported in The Lancet Oncology by Fabrice Barlesi, MD, and colleagues, the phase III JAVELIN Lung 200 trial has shown no overall survival benefit with avelumab vs docetaxel in patients with platinum pretreated programmed cell death ligand 1 (PD-L1)–positive advanced non–small cell lung cancer ...

lung cancer
issues in oncology

System-Based Intervention to Reduce Racial Disparities in Early-Stage Lung Cancer Treatment

Results from a study published by Cykert et al in Cancer Medicine showed that a pragmatic system-based intervention within cancer treatment centers may eliminate existing disparities in treatment and outcomes for black patients with early-stage lung cancer. “These results show ...

Lung Cancer
Pain Management

Opioid Use Following Thoracoscopic Surgery in Early-Stage Lung Cancer

In a study reported in a research letter in JAMA Oncology, Stephanie Tuminello, MPH, and colleagues found that video-assisted thoracoscopic surgery (VATS) was less likely than open resection to be associated with long-term opioid use in patients undergoing surgery for early-stage lung cancer....

Lung Cancer

Lorlatinib Shows Overall and Intracranial Activity in ALK-Positive NSCLC

IN A GLOBAL phase II study reported in The Lancet Oncology, Benjamin J. Solomon, MBBS, of Peter MacCallum Cancer Centre, Melbourne, and colleagues found that lorlatinib showed high overall and intracranial activity in patients with advanced ALK-positive non–small cell lung cancer (NSCLC) who were...

Lung Cancer

Encourage Lung Cancer Screening to Prevent Early Deaths

Discussions of benefits and harms from screening of high-risk populations for lung cancer have missed the point. The National Lung Screening Trial (NLST) showed an early and statistically significant major benefit in all-cause mortality from computed tomography (CT) screening.1 Those referred for...

lung cancer
issues in oncology

Multiethnic Cohort Study Update on Racial/Ethnic Differences in Lung Cancer Incidence

In an update from the Multiethnic Cohort Study reported in the Journal of the National Cancer Institute, Stram et al found persistent racial/ethnic differences in risk for lung cancer at similar levels of cigarette smoking intensity. A prior report from the study found that African Americans and...

lung cancer

Clonal MET Amplification and Tyrosine Kinase Inhibitor Treatment Outcome in EGFR-Mutant NSCLC

In a Singaporean study reported in the Journal of Clinical Oncology, Lai et al found that tyrosine kinase inhibitor treatment outcome did not differ according to mesenchymal epithelial transition factor (MET)-high vs MET-low status in treatment-naive, EGFR-mutant non–small cell lung cancer...

lung cancer

Genomic Classification of Lung Cancers Diagnosed in Patients From Appalachian Kentucky

Squamous cell carcinoma of the lung represents approximately one-quarter (26.4%) of all lung cancers diagnosed in Appalachian Kentucky, where death from lung cancer is higher than the national average. Researchers sought to characterize genetic alterations specifically found in lung squamous cell...

Lung Cancer

Progress With ALK Inhibitors: When Will We Consider ALK-Positive Lung Cancer a ‘Chronic Disease’?

As reported by Solomon et al in The Lancet Oncology1 and reviewed in this issue of The ASCO Post, results from a global phase II study of the third-generation ALK inhibitor lorlatinib showed a high overall response rate and high intracranial response rate for patients with advanced ALK-positive...

lung cancer
immunotherapy

Lung-MAP Precision Medicine Trial Expands

The Lung Cancer Master Protocol (Lung-MAP), the first precision medicine trial in lung cancer supported by the National Cancer Institute (NCI), is undergoing a major expansion to include patients with all non–small cell lung cancers (NSCLCs). The trial previously tested treatments for people ...

lung cancer
immunotherapy

Nivolumab or Nivolumab Plus Ipilimumab in Relapsed Malignant Pleural Mesothelioma

In a French phase II trial reported in The Lancet Oncology, Scherpereel et al found evidence of activity with nivolumab or the combination of nivolumab plus ipilimumab in patients with relapsed malignant pleural mesothelioma. Study Details In the open-label, noncomparative trial, 125 patients...

lung cancer
immunotherapy

Avelumab in Previously Treated Advanced Unresectable Mesothelioma

In a phase Ib trial reported in JAMA Oncology, Hassan et al found that the anti–programmed cell death ligand 1 antibody avelumab produced durable responses and a high rate of disease control in some patients with advanced unresectable mesothelioma progressing after platinum and pemetrexed...

lung cancer

FDA Expands Pemetrexed Label With Combination of Pembrolizumab and Platinum Chemotherapy for the First-Line Treatment of Metastatic Nonsquamous NSCLC

Today, the U.S. Food and Drug Administration (FDA) granted approval for a new indication for pemetrexed (Alimta) for injection in combination with pembrolizumab (Keytruda) and platinum chemotherapy for the first-line treatment of patients with metastatic nonsquamous non–small cell...

lung cancer
lymphoma
skin cancer

FDA Pipeline: Updates on Treatments in NSCLC and Lymphomas, Plus New Dosimetry Software

The U.S. Food and Drug Administration (FDA) recently granted the following application, designations, and clearance: sBLA for Atezolizumab Plus Chemotherapy for First-Line Treatment of Metastatic, Nonsquamous NSCLC On January 17, the FDA accepted a supplemental biologics license application...

Immunotherapy
Lung Cancer

PACIFIC Trial of Durvalumab Sets Standard in Stage III Unresectable NSCLC

IMMUNOTHERAPY HAS revolutionized the treatment of lung cancer over the past several years. Although lung cancer is associated with immunosuppression at baseline for most patients, the addition of immune checkpoint inhibitors can overcome that suppression and lead to antitumor immune responses....

health-care policy
lung cancer

Shared Decision-Making and Use of Low-Dose CT Screening for Lung Cancer

In a study reported in a research letter in JAMA Internal Medicine, Goodwin et al found that only a small proportion of Medicare enrollees undergoing low-dose computed tomography (CT) screening for lung cancer had a prescreening shared decision-making session, which is mandated by the Centers for...

lung cancer
immunotherapy

Updated Survival Analysis of KEYNOTE-024: Pembrolizumab vs Platinum-Based Chemotherapy in Previously Untreated, Advanced NSCLC

As reported in the Journal of Clinical Oncology by Reck et al, an updated analysis of the phase III KEYNOTE-024 trial indicates continued overall survival benefit of first-line pembrolizumab vs platinum-based chemotherapy in patients with advanced non–small cell lung cancer (NSCLC) with a...

lung cancer

Transformation of EGFR-Mutant NSCLC to SCLC

In a study reported in the Journal of Clinical Oncology, Marcoux et al provided further evidence that EGFR-mutant non–small cell lung cancer (NSCLC) can undergo transformation to small cell lung cancer (SCLC) and identified factors associated with such transformation. It has been estimated...

Lung Cancer

Lorlatinib in Second- or Third-Line Treatment of ALK-Positive Metastatic Non–Small Cell Lung Cancer

On November 2, 2018, lorlatinib (Lorbrena) was granted accelerated approval for the treatment of patients with ALK-positive metastatic non–small cell lung cancer (NSCLC) whose disease has progressed on crizotinib (Xalkori) and at least one other ALK inhibitor for metastatic disease or whose disease ...

Lung Cancer

New Data Reported From International Studies of Lung Cancer Treatment

At the European Society for Medical Oncology (ESMO) 2018 Congress, important studies were presented for every cancer type. Here, The ASCO Post offers some snapshots of lung cancer studies that may inform approaches to treating this common cancer, which—despite the advances in recent years—remains...

Lung Cancer
Immunotherapy

Durvalumab Improves Overall Survival After Chemoradiotherapy in Unresectable, Stage III NSCLC

AS REPORTED in The New England Journal of Medicine by Scott J. Antonia, MD, PhD, of H. Lee Moffitt Cancer Center and Research Institute, and colleagues, the phase III PACIFIC trial has shown significantly improved overall survival, a coprimary endpoint, with the programmed cell death ligand 1...

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