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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 Bevacizumab to Cisplatin/Etoposide in Extensive-Disease Small Cell Lung Cancer

In an Italian phase III trial reported in the Journal of Clinical Oncology, Marcello Tiseo, MD, of Azienda Ospedaliero-Universitaria, Parma, Italy, and colleagues found that adding first-line bevacizumab (Avastin) to cisplatin/etoposide did not prolong overall survival in patients with...

Lung Cancer

Stage I Lung Cancer: Treatment Advances Have Changed the Game

Read more in the Journal of Oncology Practice (JOP). Visit ASCOPubs.org/journal/jop Patients with stage I lung cancer are achieving excellent local tumor control, thanks to an evolution in radiotherapy and surgical approaches. Jeffrey A. Bogart, MD, Professor and Chair of the Department of...

lung cancer

Cardiac Events After Radiotherapy for Locally Advanced Lung Cancer

An analysis of patients from 4 prospective radiotherapy trials for locally advanced non–small cell lung cancer (NSCLC) conducted at 2 centers in Michigan showed that grade ≥ 3 cardiac events occurred in more than 10% of patients. The study was reported by Dess et al in the Journal of...

lung cancer

AACR 2017: 5-Year Survival Rate for Nivolumab-Treated Advanced Lung Cancer Higher Than Historical Rate in Early-Phase Trial

Treatment with the immune checkpoint inhibitor nivolumab (Opdivo) yielded durable responses in some patients with advanced non–small cell lung cancer (NSCLC), with a 5-year survival rate of 16%, according to data from a phase I clinical trial presented by Brahmer et al at the American...

lung cancer

FDA Grants Osimertinib Full Approval in Metastatic EGFR T790M Mutation–Positive NSCLC

On March 30, 2017, the U.S. Food and Drug Administration (FDA) granted regular approval to osimertinib (Tagrisso) for the treatment of patients with metastatic epidermal growth factor receptor (EGFR) T790M mutation–positive non–small cell lung cancer (NSCLC), as detected by an...

lung cancer

Assessment of Immunohistochemistry Assays for PD-L1 Expression in NSCLC

In a study of four immunohistochemistry programmed cell death ligand 1 (PD-L1) expression assays registered with the U.S. Food and Drug Administration (FDA), scoring was highly concordant for expression in tumor cells but poorly concordant for scoring in immune cells in non–small cell lung...

lung cancer

3-Year Follow-up of Japanese Trial of Alectinib in ALK-Positive NSCLC

Promising 3-year outcomes were found in patients from a Japanese phase I/II study of alectinib (Alecensa) in previously treated patients with ALK-positive non–small cell lung cancer (NSCLC). The findings were reported by Tamura et al in the Journal of Clinical Oncology. Study Details In the ...

Lung Cancer

New First-Line Options for ALK-Positive Lung Cancer on the Horizon

Anaplastic lymphoma kinase (ALK) rearrangements define a subset of non–small cell lung cancer (NSCLC) patients for whom ALK inhibitors are highly effective. In PROFILE 1014, the multitargeted ALK inhibitor crizotinib (Xalkori) was shown to be superior to platinum/pemetrexed (Alimta) chemotherapy...

Lung Cancer

Markedly Improved Progression-Free Survival With First-Line Ceritinib vs Platinum Chemotherapy in ALK-Rearranged NSCLC

In the phase III ASCEND-4 trial reported in The Lancet, Jean-Charles Soria, MD, of Institut Gustave Roussy, and colleagues found that ceritinib (Zykadia) improved progression-free survival vs platinum-based chemotherapy in the first-line treatment of advanced anaplastic lymphoma kinase...

Lung Cancer

Expert Point of View: Heather L. McArthur, MD, MPH

Discussant Heather L. McArthur, MD, MPH, Medical Director of Breast Oncology at Cedars-Sinai Medical Center, Los Angeles, called the plinabulin findings “provocative,” especially considering the substantial impact on durability of response. Specifically with the addition of plinabulin to docetaxel, ...

Lung Cancer

Plinabulin Improves Survival in Subset of Patients With Non–Small Cell Lung Cancer

The investigational small-molecule plinabulin yielded some interesting benefits when added to docetaxel in previously treated patients with stage III/IV non–small cell lung cancer (NSCLC), in a phase II study.1 Although the benefit of the doublet was modest in the overall study population, the...

lung cancer

IASLC Endorses Tobacco Reform Report Outlining Progress Toward Ending Adult Cigarette Smoking

The International Association for the Study of Lung Cancer (IASLC) has endorsed a report released by the Core Team for Tobacco Control that outlines key action items that can be taken immediately to accelerate progress toward ending cigarette smoking in adults. Issuing their Executive Summary ...

Lung Cancer

Expert Point of View: Ann W. Silk, MD

Ann W. Silk, MD, of Rutgers Cancer Institute of New Jersey, New Brunswick, presented the day’s highlights and commented that the study by Hellmann et al shows the utility, and, in fact, the necessity, of developing a new means of estimating outcomes for patients treated with immunotherapies....

Lung Cancer

Pembrolizumab Affords Long-Term Survival to One-Fourth of Selected Patients With NSCLC, Alternative Statistical Model Suggests

Statistical modeling of long-term survival from the KEYNOTE trials of the programmed cell death protein 1 (PD-1)–inhibitor pembrolizumab ­(Keytruda) estimates that one-quarter of appropriately selected patients with advanced non–small cell lung cancer (NSCLC) may attain long-term survival.1 “In...

lung cancer

Multikinase Inhibitor Treatment Responses in Patients With RET-Rearranged NSCLC

In a report from the Global, Multicenter RET Registry in the Journal of Clinical Oncology, Gautschi et al documented response rates with multikinase RET inhibitors in patients with RET-rearranged non–small cell lung cancer (NSCLC). Study Details The study involved registry data (through...

lung cancer

Thoracic 2017: SBRT Offers Curative Option for Patients With Lung Cancer Aged 80 and Older

Patients in their 80s and 90s who have early-stage lung cancer but cannot undergo an operation can be treated safely and effectively with stereotactic body radiation therapy (SBRT), according to research presented by Cassidy et al at the 2017 Multidisciplinary Thoracic Cancers Symposium (Abstract...

lung cancer

Thoracic 2017: Updated Data Confirm Benefits of Single-Fraction SBRT for NSCLC

New research led by a radiation oncologist at Roswell Park Cancer Institute indicates that less may be more when it comes to some forms of radiation therapy for cancer. In a presentation highlighted in a plenary session (Abstract 4) at the 2017 Multidisciplinary Thoracic Cancers Symposium in San...

lung cancer

Douglas E. Wood, MD, on Lung Cancer Screening

Douglas E. Wood, MD, of the University of Washington, discusses the importance of broad access to and education about lung cancer screening—now approved for people at high risk for the disease—and the need for expanded criteria for screening eligibility.

lung cancer

Charles B. Simone, II, MD, on NSCLC: CTCs as a Biomarker for Early Detection

Charles B. Simone, II, MD, of the University of Maryland Medical Center, discusses results from a large prospective study in locally advanced non–small cell lung cancer, which suggest that circulating tumor cells may be a promising biomarker of progressive or recurrent disease and may help guide early salvage treatment strategies (Abstract 3).

lung cancer

Boris Sepesi, MD, on NSCLC, TILs, and Overall Survival

Boris Sepesi, MD, of The University of Texas MD Anderson Cancer Center, discusses immune cells within tumors and the potential role for checkpoint inhibitor therapy in the neoadjuvant setting of locally advanced lung cancer (Abstract 7).

lung cancer

Zofia Piotrowska, MD, on NSCLC: Resistance Mechanisms

Zofia Piotrowska, MD, of the Massachusetts General Hospital Cancer Center, discusses heterogeneity and variation in resistance mechanisms among EGFR-mutant non–small cell lung cancer patients with at least one postresistance biopsy (Abstract 1).

lung cancer

Zhongxing Liao, MD, on Proton-Beam Radiotherapy for Locally Advanced Disease

Zhongxing Liao, MD, of The University of Texas MD Anderson Cancer Center, discusses the continued improvement in planning, delivery, and patient selection for proton therapy, which can both reduce radiation exposure and increase tumor dose.

lung cancer

Jennifer Ho, MD, on Thoracic Cancers: Reirradiation With IMPT

Jennifer Ho, MD, of The University of Texas MD Anderson Cancer, discusses study results on the use of intensity-modulated proton therapy, which can provide durable local control with minimal toxicity in patients who can have extended survivals; the data also suggest that higher doses may improve outcomes (Abstract 5).

lung cancer

Tracey L. Evans, MD, on NSCLC: Combined-Modality Therapy

Tracey L. Evans, MD, of the University of Pennsylvania, discusses the data supporting use of chemotherapy with radiation in locally advanced non–small cell lung cancer, targeted treatments and immunotherapy, and some of the controversies now debated.

lung cancer

Martin J. Edelman, MD, on NSCLC: Final Results of a CALGB Alliance Trial

Martin J. Edelman, MD, of Fox Chase Cancer Center, discusses study findings from a phase III study of celecoxib in addition to standard chemotherapy for advanced non–small cell lung cancer with COX-2 overexpression (Abstract 2).

lung cancer

Maximilian Diehn, MD, PhD, on Liquid Biopsies/Cell-Free DNA: Clinical Uses

Maximilian Diehn, MD, PhD, of Stanford School of Medicine, discusses promising clinical applications of circulating tumor DNA in patients with thoracic malignancies: noninvasive detection of resistance mechanisms to targeted agents and treatment response assessment.

lung cancer

Shraddha M. Dalwadi, MBA, on Stage I NSCLC: Racial Disparities in Treatment and Outcome

Shraddha M. Dalwadi, MBA, MD Candidate in the class of 2017 at Texas A&M Health Science Center, discusses findings from a SEER database study that showed African Americans and American Indians with stage I non–small cell lung cancer were less likely to receive definitive treatment and had lower odds for survival (Abstract 9).

lung cancer

Richard J. Cassidy III, MD, on NSCLC and SBRT in Older Patients

Richard J. Cassidy III, MD, of Emory Winship Cancer Institute, discusses results from a multicenter analysis of stereotactic body radiotherapy for early-stage non-small cell lung cancer in patients 80 years and older; the patients tolerated the treatment well and had excellent estimated rates of 5-year cancer-specific survival (Abstract 111).

lung cancer

Kamran Ahmed, MD, on Lung Cancer, Radiation, and Immune Checkpoint Inhibitors

Kamran Ahmed, MD, of the H. Lee Moffitt Cancer Center and Research Institute, discusses results from a small study of pneumonitis in patients who received thoracic radiotherapy within 6 months of anti–PD-1 therapy, anti–PD-L1 therapy, anti–CTLA-4 therapy, or some combination of these drugs (Abstract 10).

lung cancer

Thoracic 2017: Combination of Radiation and Immune Checkpoint Therapy Holds Potential for Lung Cancer

An emerging approach for cancer treatment seeks to combine radiation therapy with immune checkpoint inhibitors to more effectively control tumors in the chest with an acceptable risk of severe treatment-related side effects. About 10% of patients in a retrospective analysis of metastatic lung...

lung cancer

Thoracic 2017: Racial Disparities Persist in Treatment and Survival of Early-Stage Lung Cancer

Analysis of the largest American cancer database indicates that racial disparities persist in the treatment and outcomes of patients diagnosed with stage I non­­–small cell lung cancer (NSCLC). Despite increased availability of potentially curative treatments for early-stage NSCLC,...

lung cancer

Thoracic 2017: Proton Therapy Offers New Treatment Possibility for Recurrent Lung Cancer

A new study offers hope for patients with recurrent lung cancer, who historically have been considered ineligible for curative treatment. In the largest analysis to date of reirradiation using intensity-modulated proton therapy for lung and other thoracic tumors, more than three-fourths of patients ...

lung cancer

Thoracic 2017: Genetic Profile of Treatment-Resistant Lung Cancer More Variable Than Previously Thought

The genetic mutations underlying treatment resistance in non–small cell lung cancer (NSCLC) are more complex and dynamic than previously thought. Analysis of 355 biopsied tumors from patients who acquired resistance to epidermal growth factor receptor (EGFR) inhibitors, the most common form...

lung cancer

Thoracic 2017: Biomarker Test Shows Cancer Recurrence Months Before CT Scans

Results from a prospective clinical trial showed that a blood test looking at specific biomarkers was able to detect recurrences of lung cancer an average of 6 months before conventional imaging methods found evidence of recurrence. In the largest prospective clinical trial to date of circulating...

lung cancer

UK Trial Shows No Survival Benefit in Adding Pravastatin to Standard Chemotherapy in Small Cell Lung Cancer

In the UK phase III LUNGSTAR study reported in the Journal of Clinical Oncology, Seckl et al found that adding pravastatin to first-line standard chemotherapy did not improve overall survival in patients with small cell lung cancer (SCLC). Numerous large prospective cohort and registry studies...

lung cancer
bladder cancer

Study Identifies How Cancer Cells May Develop Resistance to FGFR Inhibitors

A new study by researchers at The Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC– James) has identified a mechanism by which cancer cells develop resistance to a class of drugs called fibroblast growth...

lung cancer

Osimertinib in EGFR Inhibitor–Pretreated T790M-Positive Advanced NSCLC

In the phase II extension component of the phase I/II AURA trial, reported by Yang et al in the Journal of Clinical Oncology, osimertinib (Tagrisso) was found to be highly active in epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor–pretreated T790M-positive advanced...

Lung Cancer

Immunotherapy Challenges in Lung Cancer: From Patient Selection to Clinical and Financial Toxicity

Immunotherapy has been a major advance in lung cancer, but it is not without its challenges, according to Sanjay Popat, PhD, FRCP, a consultant medical oncologist and reader in cancer medicine at the Royal Marsden Hospital, London, UK. He reviewed some of the challenges pertaining to the use of...

Lung Cancer

Expert Point of View: David R. Gandara, MD

“With the negative results of this phase III trial and the discontinuation of ganetespib development, is this the end for this once promising drug class in non–small cell lung cancer (NSCLC), or is there still an opportunity for heat shock protein (Hsp) inhibitors to make a meaningful impact?”...

Lung Cancer

No Improvement in Overall Survival With Addition of Ganetespib to Docetaxel in Patients With Non–Small Cell Lung Cancer

Despite positive results in the phase II GALAXY-1 study, the addition of ganetespib to docetaxel in the phase III GALAXY-2 study did not improve overall survival or progression-free survival in patients with advanced non–small cell lung cancer (NSCLC), according to data presented by Rathi Pillai,...

Lung Cancer

A Decade of Lessons Learned From EGFR-Targeted Therapy

To summarize the lessons learned from the development of epidermal growth factor receptor (EGFR)-targeted therapy, one only has to go back about 10 years, according to Frances A. Shepherd, MD, Scott Taylor Chair in Lung Cancer Research at Princess Margaret Cancer Centre and Professor of Medicine at ...

Lung Cancer

Expert Point of View: David Planchard, MD, PhD, Luboš Petruželka, MD, PhD, and Clarissa ­Baldotto, MD, MSc

Three invited discussants explored the results of these recent immunotherapy studies in lung cancer as well as their potential clinical implications at the International Association for the Study of Lung Cancer 17th World Conference on Lung Cancer. KEYNOTE-021 trial “Pembrolizumab (Keytruda) is...

Lung Cancer

Immunotherapy Combinations Gain Traction in Lung Cancer

Combining immunotherapies with each other or with other agents such as chemotherapy and growth factor inhibitors holds promise for better tapping their benefit in patients with lung cancer, data from several studies suggest. Results show that strategic combinations can achieve higher response...

lung cancer

ASCO Quality Care 2017: Cost and Survival Analysis Before and After Implementation of Clinical Pathways for Patients With Stage IV NSCLC

In a study reported at the 2017 Quality Care Symposium by Zheng et al (Abstract 3) and published in the Journal of Oncology Practice by Jackman et al, researchers explored the use of clinical pathways to support clinical decision-making and manage resources for patients with late-stage...

issues in oncology
lung cancer

Thomas J. Smith, MD, on Oral Abstract Session B (2017 Quality Care Symposium)

Thomas J. Smith, MD, of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, summarizes two papers for which he was a discussant: reducing overuse of colony-stimulating factors without compromising the safety of patients with lung cancer receiving chemotherapy, and a cost-and-survival analysis before and after implementing Dana-Farber Clinical Pathways for patients with stage IV non–small cell lung cancer (Abstracts 3, 52).

lung cancer

Roy S. Herbst, MD, PhD, on Lung Cancer With Immune Checkpoints: Promising Combinations

Roy S. Herbst, MD, PhD, of the Yale Cancer Center, discusses immunotherapy as a standard of care in lung cancer, critical biomarkers, and scientifically guided combination treatment, which will be the future of lung cancer immunotherapy.

lung cancer

Limo Chen, PhD, on Lung Cancer and CD38: Resistance to Immunotherapy

Limo Chen, PhD, of The University of Texas MD Anderson Cancer Center, discusses co-inhibition of CD38 and PD-L1, which leads to improved antitumor immune response, reducing tumor growth and metastasis. (Abstract 79)

Lung Cancer

Bright Future for Osimertinib in EGFR T790M–Positive Lung Cancer

The AURA3 study—reported by Mok and colleagues and reviewed in this issue of The ASCO Post—confirms the dramatic activity of osimertinib (Tagrisso) in patients with advanced epidermal growth factor receptor (EGFR)-mutant non–small cell lung cancer (NSCLC) and acquired resistance to prior EGFR...

Lung Cancer

Osimertinib Improves Progression-Free Survival vs Platinum/Pemetrexed in EGFR T790M–Positive NSCLC

In the phase III AURA3 trial reported in The New England Journal of Medicine by Tony S. Mok, MD, of the Chinese University of Hong Kong, and colleagues, osimertinib (Tagrisso) significantly improved progression-free survival vs platinum/pemetrexed (Alimta) among patients with epidermal growth...

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