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Lung Cancer

Continuing Education Information

This CE/CME/CU-accredited supplement is jointly provided by:       To earn credit/contact hours, you must read all the articles in this supplement and then go to https://education.annenberg.net/IASLC Release date: February 25, 2017 Expiration date: February 25, 2018Annenberg Center for Health...

Lung Cancer

Three Assays and Several Laboratory-Developed Tests Highly Concordant Across Platforms in PD-L1 Immunohistochemistry Testing for NSCLC

Programmed cell death ligand 1 (PD-L1) expression assessed by immunohistochemistry in formalin-fixed, paraffin-embedded tumor tissues is currently the main predictive biomarker for the benefit of anti–programmed cell death protein 1 (PD-1) and anti–PD-L1 agents in patients with non–small cell lung ...

Lung Cancer

New Lung Cancer Staging Manual Set to Modify Clinical Practice

A revised tumor classification based on 70,967 evaluable patients with non–small cell lung cancer (NSCLC) and 6,189 patients with small cell lung cancer is now available to lung cancer specialists around the world in the form of the 8th edition of the tumor, node, and metastasis (TNM)...

Lung Cancer

Expert Point of View: Paul Mitchell, MD

“This is a very important systematic review,” commented invited discussant, Paul Mitchell, MD, Associate Professor at the Olivia Newton-John Cancer and Wellness Centre in Melbourne, Australia. “There are theoretical reasons why programmed cell death ligand 1 (PD-L1) inhibitors might cause less...

Lung Cancer

Efficacy, Toxicity on a Par for Different Classes of Immune Checkpoint Inhibitors

The two main classes of immune checkpoint inhibitors used to treat non–small cell lung cancer (NSCLC) have essentially the same efficacy and toxicity profiles, according to a systematic review and meta-analysis of 23 trials with a total of 5,899 patients.1 Results showed that about one-fifth of...

Lung Cancer

Expert Point of View: Leora Horn, MD, MSc

The KEYNOTE-028 results confirm that pembrolizumab ­(Keytruda) is active in extensive-stage small cell lung cancer (SCLC) and lay to rest safety concerns stemming from the higher risk of paraneoplastic syndromes in this disease, according to invited discussant, Leora Horn, MD, MSc, Clinical...

Lung Cancer

Durable Responses Reported With Pembrolizumab in Heavily Pretreated Extensive-Stage Small Cell Lung Cancer

The programmed cell death protein 1 (PD-1) inhibitor pembrolizumab (Keytruda) has shown durable antitumor activity in patients with extensive-stage small cell lung cancer (SCLC) that expresses programmed cell death ligand 1 (PD-L1), according to an update of the KEYNOTE-028 trial.1 “Median overall ...

Lung Cancer

Combination Immunotherapy for Lung Cancer: The Wave of the Future

Increasing experience with immunotherapy for lung cancer in both the lab and the clinic is helping to refine treatment approaches and point the way forward, according to Naiyer Rizvi, MD, Director of both Thoracic Oncology and Immunotherapeutics at Columbia University Medical Center in New York....

Lung Cancer

Ongoing Phase III Clinical Trials of Immunotherapy in Advanced Non–Small Cell Lung Cancer

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on immunotherapy in lung cancer. All of the studies are listed on the National Institutes of Health website at ClinicalTrials.gov. Study Title: A Randomized, Double-Blind, Phase...

Lung Cancer

Managing Toxicities Associated With Immunotherapy for Lung Cancer

Understanding, anticipating, and managing the toxicities associated with immunotherapies for lung cancer are key to steps to safely using and achieving the most benefit from these new agents, according to Beth Eaby-Sandy, MSN, CRNP, OCN, a nurse practitioner at the University of Pennsylvania’s...

Lung Cancer

Expert Point of View: Paul Mitchell, MD

“The progression-free and overall survival curves of CheckMate 057 suggest the presence of two patient populations with respect to nivolumab (Opdivo): a relatively sensitive one and a less sensitive, possibly even resistant, one, according to invited discussant Paul Mitchell, MD, Associate...

Lung Cancer

New Analysis of CheckMate 057: Search Continues for Predictors of Outcome With Nivolumab

Prognostic factors and tumor expression of programmed cell death ligand 1 (PD-L1) predict early mortality among patients with previously treated nonsquamous advanced non–small cell lung cancer (NSCLC) who receive nivolumab instead of docetaxel. But these features are not reliable for excluding...

Lung Cancer

Expert Point of View: Paul Mitchell, MD

“The KEYNOTE-010 updated survival is looking even more impressive with the benefit of pembrolizumab (Keytruda) over docetaxel. Survival at 2 years with pembrolizumab is more than double that with chemotherapy,” commented invited discussant, Paul Mitchell, MD, Associate Professor at the Olivia...

Lung Cancer

KEYNOTE-010 Update Shows ‘Striking’ Durability of Second-Line Pembrolizumab in NSCLC

Pembrolizumab’s benefit in previously treated advanced non–small cell lung cancer (NSCLC) that expresses programmed cell death ligand 1 (PD-L1) is long lasting, persisting even after therapy ends, suggests an update of the KEYNOTE-010 trial.1 Initial results of the randomized phase II/III trial,...

Lung Cancer

Expert Point of View: Michael Boyer, MBBS, PhD

“Taken together, ATLANTIC’s findings show that “durvalumab is active in heavily pretreated patients, and its degree of activity is related to programmed cell death ligand 1 (PD-L1) expression,” commented invited discussant, Michael Boyer, MBBS, PhD, Chief Clinical Officer and Conjoint Chair of...

Lung Cancer

Durvalumab Shows Activity in Heavily Pretreated Patients With Non–Small Cell Lung Cancer

The immune checkpoint inhibitor durvalumab (also known as MEDI4736) is active and achieves durable responses in patients with heavily pretreated advanced non–small cell lung cancer (NSCLC) that does not have any epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK)...

Lung Cancer

Expert Point of View: Michael Boyer, MBBS, PhD

“The OAK subgroup analyses showed the benefit of atezolizumab (Tecentriq) virtually “across the board,” including among patients with programmed cell death ligand 1 (PD-L1)–negative tumors, remarked invited discussant, Michael Boyer, MBBS, PhD, Chief Clinical Officer and Conjoint Chair of Medical...

Lung Cancer

Atezolizumab Benefits Survival vs Docetaxel Across Multiple Subtypes of Non–Small Cell Lung Cancer

A wide range of patients with advanced non–small cell lung cancer (NSCLC) see a survival advantage from second- or third-line atezolizumab (Tecentriq) as compared with docetaxel, according to new data from the OAK trial.1 The main results of the randomized phase III trial, previously reported,...

Lung Cancer

Expert Point of View: Michael Boyer, MBBS, PhD

“This was a very nice analysis using a well-validated group of instruments with high compliance. And this is something that is one of the bugbears of quality-of-life analyses—compliance to completion of the instruments,” commented invited discussant, Michael Boyer, MBBS, PhD, Chief Clinical...

Lung Cancer

Quality-of-Life Data From KEYNOTE-024: First-Line Pembrolizumab vs Chemotherapy in Advanced NSCLC

When used as first-line therapy for advanced non–small cell lung cancer (NSCLC), pembrolizumab (Keytruda) yields better health-related quality of life than platinum-based chemotherapy, suggest new data from the randomized phase III KEYNOTE-024 trial.1 After 15 weeks of treatment, changes in scores ...

Lung Cancer

Expert Point of View: Edward B. Garon, MD

“There are several possible ways to move first-line immunotherapy for non–small cell lung cancer (NSCLC) forward, according to invited discussant Edward B. Garon, MD, Director of Thoracic Oncology at the David Geffen School of Medicine at the University of California, Los Angeles. “We could expand ...

Lung Cancer

Clinical Trials Study the Role of Immunotherapy in the First-Line Setting of Non–Small Cell Lung Cancer

In 2016, the KEYNOTE-024 trial set the bar for first-line immunotherapy in non–small cell lung cancer (NSCLC). Trial results showed that pembrolizumab (Keytruda), an antibody to programmed cell death protein 1 (PD-1), reduced the risk of disease progression or death by 50% and the risk of death by ...

Lung Cancer

Understanding the Role of Immunotherapy for Lung Cancer: A Paradigm Shift for the Better

“Immunotherapy for lung cancer is a paradigm shift. I would never have thought when I started my career taking care of lung cancer patients in the mid 1990s that we’d now be substituting chemotherapy with an antibody immunotherapy in 2017. It’s incredible,” commented Roy S. Herbst, MD, PhD, Chief...

Lung Cancer

Introduction: Immunotherapy for Non–Small Cell Lung Cancer: Advances and Challenges

Lung cancer is the second most commonly diagnosed cancer and the leading cause of cancer-related mortality in the United States, with an estimated 224,390 new cases and 158,080 deaths from the disease in 2016.1 Despite improving survival rates in recent decades, only about 18% of patients are...

lung cancer

Never Smokers Account for Increased Proportion of Non–Small Cell Lung Cancer Cases

In a retrospective study in three U.S. institutions reported in the Journal of the National Cancer Institute, Pelosof et al found that never smokers accounted for an increasing proportion of cases of non–small cell lung cancer (NSCLC) during the period from 1990 to 2013. The study used data...

lung cancer

Gefitinib or Erlotinib vs Chemotherapy in EGFR-Mutant Advanced Non–Small Cell Lung Cancer

In an individual patient data meta-analysis reported in the Journal of the National Cancer Institute, Lee et al found no difference in overall survival for first-line treatment with the first-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors gefitinib (Iressa) or...

lung cancer

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

In an Italian phase III trial reported in the Journal of Clinical Oncology, Tiseo et al found that adding first-line bevacizumab (Avastin) to cisplatin/etoposide did not prolong overall survival in patients with extensive-disease small cell lung cancer. Study Details In the open-label trial, 204...

Lung Cancer

Expert Point of View: Fiona Blackhall, PhD, FRCP

“There has undoubtedly been extremely rapid progress made in establishing effective therapies for anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC) patients in less than a decade,” said Fiona Blackhall, PhD, FRCP, Chair of Thoracic Oncology and medical oncologist at the...

Lung Cancer

ASCEND-4 Study Shows 45% Reduction in Risk of Disease Progression for NSCLC Patients on First-Line Ceritinib

Compared to chemotherapy, the use of first-line ceritinib (Zykadia) resulted in a statistically significant and clinically meaningful improvement in median progression-free survival, with an estimated 45% reduction in disease progression risk, as well as significant improvements in quality of...

lung cancer

Increased Risk of Cardiac Events With High Heart Dose in High-Dose Thoracic Radiotherapy

In a single-center pooled analysis reported in the Journal of Clinical Oncology, Wang et al found that a higher dose of radiation to the heart was associated with an increased risk of cardiac events in patients receiving high-dose radiation therapy for stage III non–small cell lung cancer...

Lung Cancer

Expert Point of View: Michael Boyer, MBBS, PhD

“This drug [durvalumab] clearly shows activity in the third-line and beyond setting, and the higher the programmed cell death ligand 1 (PD-L1) expression, the higher the response rate,” noted Michael Boyer, MBBS, PhD, Chief Clinical Officer and Conjoint Chair of Medical Oncology (Thoracic...

Lung Cancer

Study Finds Durvalumab of Benefit in Advanced and Metastatic Non–Small Cell Lung Cancer

Durvalumab was active and led to long-lasting response in a cohort of heavily pretreated patients with epidermal growth factor receptor/anaplastic lymphoma kinase (EGFR/ALK) wild-type locally advanced and metastatic non–small cell lung cancer (NSCLC), particularly among patients whose tumors...

colorectal cancer
lung cancer

Potential Suboptimal Use of Guideline-Endorsed Genomic Testing in Non–Small Cell Lung and Colorectal Cancers

In a study reported in the Journal of Oncology Practice, Gray et al found that many medical oncologists did not use genomic testing endorsed by guidelines in place in 2012 and 2013 in patients with non–small cell lung cancer (NSCLC) and colorectal cancer. The study involved a survey of U.S....

lung cancer

IASLC Statement on Philip Morris’ New Manifesto Highlights the Importance of Tobacco Control

On February 1, 2017, the International Association for the Study of Lung Cancer (IASLC) issued the following statement: “According to its own public reports, in 2016 Phillip Morris manufactured 800 billion cigarettes. Thus, [IASLC] views with some skepticism Philip Morris’ recent...

lung cancer

Phase III Trial Finds First-Line Ceritinib Improves PFS vs Platinum-Based Chemotherapy in ALK-Rearranged NSCLC

In a phase III trial (ASCEND-4) reported in The Lancet, Soria et al found that ceritinib (Zykadia) improved progression-free survival vs platinum-based chemotherapy in first-line treatment of advanced ALK-rearranged non–small cell lung cancer (NSCLC). Ceritinib is a next-generation selective...

Lung Cancer

Cabozantinib Alone or With Erlotinib in EGFR Wild-Type NSCLC

Treatment with the multikinase inhibitor cabozantinib (Cabometyx) alone or with erlotinib (Tarceva) improved progression-free survival vs erlotinib alone in second- or third-line treatment of advanced nonsquamous epidermal growth factor receptor (EGFR) wild-type non–small cell lung cancer (NSCLC),...

Lung Cancer

Expert Point of View: Tetsuya Mitsudomi, MD

“Osimertinib (Tagrisso) has good penetration of the blood-brain barrier and showed high efficacy in patients with central nervous system (CNS) disease,” noted Tetsuya Mitsudomi, MD, Professor in the Division of Thoracic Surgery at Kindai University Faculty of Medicine in Osaka-Sayama, Japan....

Lung Cancer

Osimertinib Significantly Improves Survival for Patients With Non–Small Cell Lung Cancer

For patients with epidermal growth factor receptor (EGFR) T790M–positive non–small cell lung cancer (NSCLC), osimertinib (Tagrisso) demonstrated clinically superior efficacy over pemetrexed (Alimta) plus a platinum agent, with a 70% reduction in the risk of disease progression, according to the...

lung cancer

Patients With Non–Small Cell Lung Cancer May Benefit From Delayed Adjuvant Chemotherapy

A new Yale study suggested that patients with a common form of lung cancer may still benefit from delayed chemotherapy started up to 4 months after surgery, according to the researchers. The study was published by Salazar et al in JAMA Oncology. Each year, more people die of lung cancer than of...

lung cancer

Older Patients With Lung Cancer Face Significant Treatment Burden

Depending on the type of treatment older patients with lung cancer receive, they can spend an average of 1 in 3 days interacting with the health-care system in the first 60 days after surgery or radiation therapy, according to a study by Yale researchers. These findings were published by Presley in ...

breast cancer
head and neck cancer
lung cancer

Receptor Tyrosine Kinase AXL May Mediate Nuclear Translocation of EGFR

New research from the University of Wisconsin (UW) Carbone Cancer Center has clarified the mechanisms involved in a common growth pathway implicated in many solid tumor types and could lead to better outcomes for patients with head and neck, lung, and triple-negative breast cancer,...

lung cancer

Is Adding Onartuzumab to Erlotinib of Benefit in Advanced Non–Small Cell Lung Cancer?

In a phase III METLung trial reported in the Journal of Clinical Oncology, Spigel et al found that adding the MET inhibitor onartuzumab to erlotinib (Tarceva) was of no benefit in patients with MET-positive advanced non–small cell lung cancer (NSCLC) who had progressed after platinum-based...

Lung Cancer

Osimertinib Shows Activity in Pretreated EGFR Thr790Met–Positive Advanced NSCLC

In a phase II trial reported in The Lancet Oncology, Glenwood Goss, MD, of The Ottawa Hospital Cancer Centre, University of Ottawa, and colleagues found that osimertinib produced a high response rate in EGFR tyrosine kinase inhibitor–pretreated EGFR Thr790Met (T790M)–positive advanced non–small...

lung cancer

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

In the phase III OAK trial reported in The Lancet by Rittmeyer et al, treatment with the anti–programmed cell death ligand 1 (PD-L1) antibody atezolizumab (Tecentriq) improved overall survival vs docetaxel in previously treated non–small cell lung cancer (NSCLC). Results of the trial...

lung cancer

WCLC 2016: Icotinib May Improve Progression-Free Survival vs Whole-Brain Irradiation in Patients With NSCLC With Brain Metastases

Patients whose lung cancer spreads to their brain typically have only 4 to 6 months left to live, but research presented by Chinese doctors suggests that using icotinib increases progression-free survival in these patients compared to whole-brain irradiation and chemotherapy combined. Yi-Long Wu,...

lung cancer

WCLC 2016: First-Line Ceritinib Reduces Risk of Disease Progression in ALK-Positive NSCLC vs Chemotherapy

Patients who received first-line ceritinib experienced a 45% risk reduction for advanced anaplastic lymphoma kinase (ALK)­–positive on–small cell lung cancer (NSCLC) compared to a control group that received chemotherapy, according to research presented at the IASLC 17th World...

lung cancer

WCLC 2016: New Lung Cancer Tumor Staging Manual to Shape Clinical Treatment

A revised tumor classification based on more than 70,000 non­–small cell lung cancer patients and 6,100 small cell lung cancer patients is now available to lung cancer specialists around the world in the form of the 8th edition of the tumor, node, and metastasis (TNM) classification. The...

lung cancer

First-in-Class Rovalpituzumab Tesirine Active in Recurrent Small Cell Lung Cancer

In a phase I study reported in The Lancet Oncology, Rudin et al found that rovalpituzumab tesirine, a first-in-class antibody-drug conjugate directed against delta-like protein 3 (DLL3), produced responses in patients with recurrent small cell lung cancer (SCLC). DLL3 is a target identified in...

lung cancer

WCLC 2016: Phase II LUME-Meso Trial on Oral Nintedanib in Mesothelioma Demonstrates Meaningful Clinical Benefit

The LUME-Meso phase II trial in patients with unresectable malignant pleural mesothelioma met its primary endpoint of progression-free survival. The data, presented at the 17th IASLC World Conference on Lung Cancer (WCLC) in Vienna (Abstract 4191 #OA22.02), showed nintedanib (Ofev) plus...

lung cancer

Promising Activity Seen With First-Line Nivolumab Plus Ipilimumab in Advanced Non–Small Cell Lung Cancer

As reported in The Lancet Oncology by Hellman et al, the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) showed promising activity as first-line treatment in patients in the non–small cell lung cancer (NSCLC) cohort of the phase I CheckMate 012 study. Study Details In the...

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