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Lung Cancer

Updates of Key Trials in Metastatic Non–Small Cell Lung Cancer: KEYNOTE-024 and AvaALL

IMMUNOTHERAPY AND ANTIANGIOGENESIS were highlighted in a session on metastatic non–small cell lung cancer (NSCLC) at the Best of ASCO New Orleans meeting. Matthew Gubens, MD, MS, presented the selected abstracts from the ASCO Annual Meeting.1 Dr. Gubens is Associate Professor of Thoracic Medical...

lung cancer

ASCO Guideline on Stage IV NSCLC Therapy Updated

An update of the ASCO clinical practice guideline on the systemic treatment of patients with stage IV non–small cell lung cancer (NSCLC) clarifies the role of immunotherapy in this setting. The update, published by Hanna et al in the Journal of Clinical Oncology, also provides new...

lung cancer

Lung Cancer Clinical Trial Eligibility Criteria Increase in Number, Complexity

With the advent of molecular targeted therapies and immunotherapy, eligibility criteria have increased in number and complexity for lung cancer clinical trials, according to an analysis published by Garcia et al in the Journal of Thoracic Oncology. Despite calls to streamline cancer clinical trial...

lung cancer

Fat Intake and Lung Cancer Risk

According to a study reported by Yang et al in the Journal of Clinical Oncology, high dietary intake of total fat and saturated fat was associated with an increased risk of lung cancer, with the association with saturated fat being particularly evident among current smokers. Study Details The...

Lung Cancer

Alectinib: A New Standard for First-Line Therapy of ALK-Rearranged NSCLC?

ANAPLASTIC LYMPHOMA KINASE (ALK) was first identified in anaplastic large cell lymphoma. The ALK gene itself is not oncogenic, but it can become oncogenic by at least three mechanisms: by forming a fusion gene with a number of other partner genes, by copy number gain, or by mutations in the gene....

Lung Cancer

Sacituzumab Govitecan in Metastatic NSCLC

As reported by Rebecca Suk Heist, MD, MPH, of Massachusetts General Hospital, and colleagues in the Journal of Clinical Oncology, the antibody-drug conjugate sacituzumab govitecan showed activity in patients with previously treated metastatic non–small cell lung cancer (NSCLC). Sacituzumab targets ...

lung cancer

FDA Grants Alectinib Priority Review for Initial Treatment of ALK-Positive Lung Cancer

Today, the U.S. Food and Drug Administration (FDA) accepted Genentech’s supplemental New Drug Application (sNDA) and granted Priority Review for alectinib (Alecensa) as a first-line treatment for people with anaplastic lymphoma kinase (ALK)-positive, locally advanced, or metastatic...

lung cancer

Osimertinib Improves Progression-Free Survival for EGFR-Positive NSCLC in the Phase III FLAURA Trial

On July 27, it was announced that the phase III FLAURA trial showed a statistically significant and clinically meaningful progression-free survival benefit with osimertinib (Tagrisso) compared to current first-line standard-of-care treatment (erlotinib [Tarceva] or gefitinib [Iressa]) in previously ...

lung cancer

Tremelimumab in Previously Treated Advanced Malignant Mesothelioma

In the randomized phase IIB DETERMINE trial, the cytotoxic T-lymphocyte–associated protein 4 (CTLA-4) inhibitor tremelimumab did not improve overall survival vs placebo as second- or third-line treatment of relapsed malignant mesothelioma. These findings were reported in The Lancet Oncology...

lung cancer

FDA Grants Durvalumab Breakthrough Therapy Designation for Patients With Locally Advanced Unresectable NSCLC

On July 31, AstraZeneca and MedImmune (AstraZeneca’s global biologics research and development arm) announced that the U.S. Food and Drug Administration (FDA) granted Breakthrough Therapy designation for durvalumab (Imfinzi) for the treatment of patients with locally advanced,...

lung cancer

Initial Progression-Free Survival Results From the MYSTIC Trial in Stage IV NSCLC

On July 27, researchers announced the progression-free survival (PFS) results for the phase III MYSTIC trial, a randomized, open-label, multicenter, global trial of durvalumab (Imfinzi) monotherapy or durvalumab in combination with tremelimumab vs platinum-based standard-of-care chemotherapy in...

lung cancer

Study Finds HER2 Mutations in 3% of Lung Cancers

The Lung Cancer Mutation Consortium at the University of Colorado Cancer Center reported that 24 of 920 patients (3%) with advanced-stage lung cancer in a recent study had mutations in the gene HER2. According to the study, published by Pillai et al in Cancer, 71% of these patients were...

lung cancer

Concurrent Chemotherapy, Proton Therapy May Improve Survival in Patients With Advanced Lung Cancer

For patients with advanced, inoperable stage III lung cancer, concurrent chemotherapy and proton-beam radiotherapy offers improved survival compared to historical data for standard of care, according to a new study from The University of Texas MD Anderson Cancer Center. The research, published by...

lung cancer

Regionalization and Lung Cancer Operative Mortality in Ontario, Canada

In a study reported in the Journal of Clinical Oncology, Bendzsak et al found that centralization of surgery services to high-volume hospitals in Ontario was not independently associated with improved operative mortality rates in lung cancer. In April 2007, a policy was implemented to regionalize...

Lung Cancer

Expert Point of View: Anne Tsao, MD, and John Heymach, MD, PhD

STUDY DISCUSSANT Anne Tsao, MD, Director of the Mesothelioma Program at The University of Texas MD Anderson Cancer Center in Houston, indicated the response rates seen in the MAPS-2 trial are comparable to those demonstrated in smaller studies of pembrolizumab (Keytruda). She considered the...

Lung Cancer

Checkpoint Inhibitors May Prove to Be Effective in Mesothelioma

CHECKPOINT INHIBITION was effective against malignant pleural mesothelioma in the MAPS-2 study of the French Cooperative Thoracic Intergroup. At the 2017 ASCO Annual Meeting, researchers reported a disease control rate of up to 50% when patients were treated with immunotherapy after relapse in a...

Lung Cancer

Prophylactic Cranial Irradiation vs Observation in Extensive-Disease Small Cell Lung Cancer

A Japanese phase III trial has shown no survival benefit of prophylactic cranial irradiation vs observation in patients with extensive-disease small cell lung cancer who had any response to platinum-based doublet chemotherapy and no brain metastases at baseline. These findings were reported in The...

Lung Cancer

Adding Pravastatin to Chemotherapy in Small Cell Lung Cancer

Following early reports associating favorable outcomes in cancer patients with the use of statins,1,2 further observational studies in this area have provided mixed findings.3 As recently reported in the Journal of Clinical Oncology, and reviewed in this issue of The ASCO Post, Seckl and colleagues ...

Lung Cancer

No Survival Benefit When Pravastatin Is Added to Standard Chemotherapy in Small Cell Lung Cancer

In a UK phase III study (LUNGSTAR) reported in the Journal of Clinical -Oncology, Michael J. Seckl, MD, PhD, of Imperial College London, and colleagues found that adding pravastatin to first-line standard chemotherapy did not improve overall survival in patients with small cell lung cancer...

lung cancer

FDA Approves First Companion Diagnostic Test to Simultaneously Screen for Multiple NSCLC Therapies

On June 22, the U.S. Food and Drug Administration (FDA) granted premarket approval to Thermo Fisher Scientific for the first next-generation sequencing–based test that simultaneously screens tumor samples for biomarkers associated with three FDA-approved therapies for non–small cell...

Lung Cancer

Retreatment With Checkpoint Inhibitors May Be Feasible for Some Patients With NSCLC

INCREASING NUMBERS of patients are being treated with checkpoint inhibitors, and about one-quarter to one-third will develop immune-related adverse events. One question on the minds of oncologists is can these patients be safely re-treated once their adverse events resolve?  One of the first...

Lung Cancer

Expert Point of View: John Heymach, MD

"TO PUT THESE RESULTS into context, currently we have three approved epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors for EGFR-positive non–small cell lung cancer (NSCLC): gefitinib (Iressa), erlotinib (Tarceva), and afatinib (Gilotrif). Not many studies have compared these drugs ...

Lung Cancer

Dacomitinib Outperforms Gefitinib in EGFR-Positive NSCLC

DACOMITINIB, a second-generation epidermal growth factor receptor (EGFR)-targeted tyrosine kinase inhibitor, outperformed gefitinib (Iressa) as first-line treatment for EGFR-positive advanced non–small cell lung cancer (NSCLC) in the phase III ARCHER 1050 study.1 Dacomitinib improved...

lung cancer

European Commission Expands Use of Ceritinib for First-Line Use in ALK-Positive Advanced NSCLC

On June 29, the European Commission approved expanding the use of ceritinib (Zykadia) to include the first-line treatment of patients with advanced non–small cell lung cancer (NSCLC) whose tumors are anaplastic lymphoma kinase (ALK)–positive. Approval follows a positive opinion granted...

lung cancer

First-Line Nivolumab vs Chemotherapy in Advanced NSCLC With PD-L1 Expression ≥ 5%

As reported by Carbone et al in The New England Journal of Medicine, the phase III CheckMate 026 trial has shown no progression-free survival benefit for first-line nivolumab (Opdivo) vs platinum-based chemotherapy in patients with recurrent or stage IV non–small cell lung cancer with...

lung cancer

FDA Grants Regular Approval to Dabrafenib and Trametinib Combination for Metastatic NSCLC With BRAF V600E Mutation

On June 22, 2017, the U.S. Food and Drug Administration granted regular approvals to dabrafenib (Tafinlar) and trametinib (Mekinist) administered in combination for patients with metastatic non–small cell lung cancer (NSCLC) with BRAF V600E mutation as detected by an FDA-approved test. These ...

lung cancer

Atezolizumab as First-Line or Subsequent Treatment in PD-L1–Selected Advanced NSCLC

In the phase II BIRCH trial, atezolizumab (Tecentriq) was found to produce higher response rates as first-line or subsequent therapy in patients with advanced non–small cell lung cancer (NSCLC) with higher levels of programmed cell death ligand 1 (PD-L1) expression. Study findings were...

Lung Cancer

Expert Point of View: John V. Heymach, MD, PhD

“This is a watershed moment in the treatment of anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC). Often studies show only incremental improvements with a new treatment. This is different. Alectinib [Alecensa] shows a dramatic increase in efficacy that is also accompanied ...

Lung Cancer

Alectinib vs Crizotinib in First-Line Treatment of ALK-Positive NSCLC

In 2011, crizotinib (Xalkori) became the first effective targeted therapy for anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC). Now data from a phase III trial show that alectinib (Alecensa), a second-generation ALK inhibitor, outperformed crizotinib, the current...

lung cancer

Ceritinib vs Chemotherapy in Previously Treated ALK-Rearranged NSCLC

The phase III ASCEND-5 trial has shown a significant improvement in progression-free survival with ceritinib (Zykadia) vs chemotherapy in advanced ALK-rearranged non–small cell lung cancer (NSCLC) previously treated with crizotinib (Xalkori) and chemotherapy. Trial results were reported in...

lung cancer

ASTRO Issues Guideline for Use of Stereotactic Radiation in Early-Stage Lung Cancer

The American Society for Radiation Oncology (ASTRO) has issued a new clinical guideline for the use of stereotactic body radiation therapy (SBRT) in early-stage lung cancer. While SBRT is the current standard of care for peripherally located tumors in patients who cannot undergo surgery, the new...

lung cancer

Sacituzumab Govitecan in Previously Treated Patients With Metastatic NSCLC

As reported by Heist et al in the Journal of Clinical Oncology, the antibody-drug conjugate sacituzumab govitecan showed activity in patients with previously treated metastatic non–small cell lung cancer (NSCLC). Sacituzumab targets Trop-2, present on many solid tumors; govitecan is the...

Lung Cancer

Atezolizumab: Another Therapeutic Option for Patients With Previously Treated Non–Small Cell Lung Cancer

The OAK study—recently reported by Rittmeyer and colleagues and reviewed in this issue of The ASCO Post—is the first study to show patients with previously treated non–small cell lung cancer (NSCLC) treated with a humanized antibody (atezolizumab, Tecentriq) directed against the programmed cell...

Lung Cancer

Atezolizumab Improves Overall Survival vs Docetaxel in Previously Treated Non–Small Cell Lung Cancer

In the phase III OAK trial reported in The Lancet by Achim Rittmeyer, MD, of Lungenfachklinik Immenhausen, Germany, and colleagues, treatment with the anti–programmed cell death ligand 1 (PD-L1) antibody atezolizumab (Tecentriq) improved overall survival vs docetaxel in previously treated non–small ...

lung cancer
colorectal cancer

David H. Henry, MD, on Advances in Lung Cancer, Colorectal Cancer: Expert Perspective

David H. Henry, MD, of Pennsylvania Oncology Hematology Associates, outlines abstracts focusing on chemotherapy in locally advanced rectal cancer and immune-related toxicity, response to anti–PD-L1 blockade, and epacadostat plus pembrolizumab in lung cancer.

Lung Cancer

Combination Therapy With Pembrolizumab in Metastatic Nonsquamous NSCLC

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs.  On May 10, 2017, pembrolizumab (Keytruda) was granted accelerated...

Lung Cancer

FDA Broadens Ceritinib Indication

On May 26, 2017, the U.S. Food and Drug Administration (FDA) granted regular approval to ceritinib (Zykadia), a kinase inhibitor for patients with metastatic non–small cell lung cancer (NSCLC) whose tumors are anaplastic lymphoma kinase (ALK)-positive as detected by an FDA-approved test. In April...

lung cancer

Arnaud Scherpereel, MD, PhD, on Mesothelioma: Results From the IFCT-1501 MAPS2 Trial (French Language Version)

Arnaud Scherpereel, MD, PhD, of the University Hospital of Lille, discusses in French phase II study findings on second- or third-line nivolumab vs nivolumab plus ipilimumab in malignant pleural mesothelioma patients. (Abstract LBA8507)

lung cancer

Arnaud Scherpereel, MD, PhD, on Mesothelioma: Results From the IFCT-1501 MAPS2 Trial

Arnaud Scherpereel, MD, PhD, of the University Hospital of Lille, discusses phase II study findings on second- or third-line nivolumab vs nivolumab plus ipilimumab in malignant pleural mesothelioma patients. (Abstract LBA8507)

lung cancer

Alice Tsang Shaw, MD, PhD, and Tony Mok, MD, on NSCLC: Results From the ALEX and ARCHER 1050 Trials

Alice Tsang Shaw, MD, PhD, of Massachusetts General Hospital, and Tony Mok, MD, of the Chinese University of Hong Kong, discuss their two ASCO-featured abstracts on non–small cell lung cancer: alectinib vs crizotinib in treatment-naive advanced ALK+ disease, and dacomitinib vs gefitinib for first-line treatment of advanced EGFR+ disease. (Abstracts LBA9008 and LBA9007)

lung cancer

ALEX Trial: Alectinib vs Crizotinib in Untreated Advanced ALK-Positive NSCLC

As reported at the recent ASCO Annual Meeting and in The New England Journal of Medicine by Peters et al, the phase III ALEX trial has shown improvement in progression-free survival with alectinib (Alecensa) vs crizotinib (Xalkori) in the first-line treatment of advanced ALK-positive...

Lung Cancer

Expert Point of View: Trever Bivona, MD, PhD

“The results of this trial are promising but need to be reproduced in the United States and other countries before clear recommendations can be made. There are adjuvant studies such as ALCHEMIST underway to test this strategy in U.S. patients,” said Trever Bivona, MD, PhD, Associate Professor of...

Lung Cancer

Adjuvant Gefitinib Delays Recurrence in EGFR-Positive NSCLC

Adjuvant therapy with gefitinib (Iressa), an epidermal growth factor receptor (EGFR)-targeted agent, was more successful at preventing recurrence than standard-of-care chemotherapy, in a phase III study of patients with EGFR-positive non–small cell lung cancer (NSCLC).1 Gefitinib extended...

lung cancer

Effect of Previous Radiotherapy on Outcome With Pembrolizumab in NSCLC

In a single-site experience reported in The Lancet Oncology by Shaverdian et al, patients with advanced non–small cell lung cancer (NSCLC) in the phase I KEYNOTE-001 trial of pembrolizumab (Keytruda) were found to have better outcomes if they had received prior radiotherapy. Study Details...

lung cancer

ASCO 2017: Research Suggests Possible New Treatment for EGFR-Positive Lung Cancer

Findings from a phase III clinical trial point to a potential new treatment for patients newly diagnosed with advanced, epidermal growth factor receptor (EGFR)-positive non–small cell lung cancer (NSCLC). Compared to the EGFR inhibitor gefitinib (Iressa), one of the standard targeted...

lung cancer

ASCO 2017: Early Research Suggests First Immunotherapy for Mesothelioma on the Horizon

Malignant pleural mesothelioma is a rare cancer, but its incidence has been rising. This cancer is usually associated with asbestos exposure, and patients have a median life expectancy of only 13 to 15 months. All patients relapse despite initial chemotherapy, more than 50% of them within 6 months...

lung cancer

Solange Peters, MD, PhD, on SCLC: Expert Perspective on CheckMate 032

Solange Peters, MD, PhD, of the University of Lausanne, examines the study findings on nivolumab ± ipilimumab in advanced small cell lung cancer, in the first report of a randomized expansion cohort. (Abstract 8503)

lung cancer

Taofeek K. Owonikoko, MD, PhD, on SCLC: Results of the ECOG-ACRIN 2511 Trial

Taofeek K. Owonikoko, MD, PhD, of Emory University, discusses study findings on cisplatin and etoposide in combination with veliparib or placebo for extensive stage small cell lung cancer. (Abstract 8505)

lung cancer

Matthew D. Hellmann, MD, on SCLC: Results From CheckMate 032

Matthew D. Hellmann, MD, of Memorial Sloan Kettering Cancer Center, discusses study findings on nivolumab ± ipilimumab in advanced small cell lung cancer, in the first report of a randomized expansion cohort. (Abstract 8503)

lung cancer

ASCO 2017: ALEX Study: Alectinib Halts Lung Cancer Growth More Than a Year Longer Than Crizotinib

Findings from a phase III clinical trial point to a more effective initial treatment for patients with ALK-positive non–small cell lung cancer (NSCLC). Compared to the current standard of care, crizotinib (Xalkori), the newer ALK inhibitor alectinib (Alecensa) halted cancer growth for a...

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