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Solid Tumors
Issues in Oncology
Geriatric Oncology
Lung Cancer

Chemoradiation in Elderly Patients With Stage III NSCLC Improves Overall Survival

Elderly patients with stage III non–small cell lung cancer (NSCLC) showed improved overall survival when treated with chemoradiation compared with definitive radiation alone, according to findings published by Eric D. Miller, MD, PhD, of The Ohio State University, Columbus, and colleagues in the...

lung cancer
immunotherapy

2018 ASCO: Pembrolizumab Plus Chemotherapy as First-Line Treatment of Metastatic Squamous NSCLC: KEYNOTE-407 Study

Results from KEYNOTE-407, a randomized, double-blind, placebo-controlled, phase III study evaluating pembrolizumab (Keytruda) in combination with carboplatin/paclitaxel or carboplatin/nab-paclitaxel (Abraxane) as first-line treatment for metastatic squamous non–small cell lung cancer...

lung cancer

2018 ASCO: Dacomitinib vs Gefitinib in Advanced NSCLC With EGFR-Activating Mutations

Overall survival (OS) data from the ARCHER 1050 trial evaluating dacomitinib as a first-line treatment for patients with locally advanced or metastatic non–small cell lung cancer (NSCLC) with EGFR-activating mutations compared to gefitinib showed a median OS of 34.1 months for patients...

lung cancer

ASCO 2018: Updated ALEX Trial Results on Alectinib in Treatment-Naive ALK Mutation–Positive NSCLC

Updated results of the global phase III ALEX trial comparing alectinib (Alecensa) with crizotinib (Xalkori) as first-line treatment against ALK-positive non–small cell lung cancer (NSCLC) show a median progression-free survival of 34.8 months in 152 patients treated with alectinib vs 10.9...

lung cancer

Raymond U. Osarogiagbon, MBBS, on NSCLC: A Lymph Node Collection Kit

Raymond U. Osarogiagbon, MBBS, of Baptist Cancer Center, discusses a kit used in non–small cell lung cancer resection that improves staging quality and overall survival without adding to morbidity of curative surgery (Abstract 8502).

lung cancer

Naoki Furuya, MD, PhD, on NSCLC: Results From the NEJ026 Study

Naoki Furuya, MD, PhD, of the St. Marianna University School of Medicine, discusses phase III study findings on a comparison of bevacizumab plus erlotinib to erlotinib in patients with untreated non–small cell lung cancer with activating EGFR mutations (Abstract 9006).

lung cancer

Tony Mok, MD, on NSCLC: Results From the ARCHER 1050 Trial

Tony Mok, MD, of the Chinese University of Hong Kong, discusses study findings on dacomitinib vs gefitinib for first-line treatment of advanced non–small cell lung cancer, a final overall survival analysis.

lung cancer
genomics/genetics

Nathan A. Pennell, MD, PhD, on NSCLC: Lowering Genetic Testing Costs

Nathan A. Pennell, MD, PhD, of the Cleveland Clinic, discusses the economic impact of next generation sequencing vs sequential single-gene testing modalities to detect genomic alterations in newly diagnosed metastatic non–small cell lung cancer (Abstract 9031).

lung cancer
issues in oncology

Danh Pham, MD: Lung Cancer Screening Rates Still Too Low

Danh Pham, MD, of the James Graham Brown Cancer Center, University of Louisville, discusses his findings using a registry on the low rates of screening with low-dose computed tomography, despite its potential to prevent thousands of lung cancer deaths each year (Abstract 6504).

lung cancer
immunotherapy

Gilberto Lopes, MD, MBA, on NSCLC: Results From the KEYNOTE-042 Trial

Gilberto Lopes, MD, MBA, of the Sylvester Comprehensive Cancer Center at the University of Miami, discusses phase III findings on pembrolizumab vs platinum-based chemotherapy as first-line treatment for advanced/metastatic non–small cell lung cancer with a PD-L1 tumor proportion score ≥ to 1% (Abstract LBA4).

lung cancer
immunotherapy

2018 ASCO: KEYNOTE-042 Trial Compares Pembrolizumab With Chemotherapy as First-Line Treatment of NSCLC With PD-L1 Expression of 1% or More

A large, randomized phase III trial shows that the immunotherapy pembrolizumab (Keytruda) is a more effective initial treatment than chemotherapy (the current standard of care) for the majority of patients with the most common type of lung cancer. People with advanced non–small cell lung...

lung cancer

Geoffrey R. Oxnard, MD, on Lung Cancer: Results From the Circulating Cancer Genome Atlas Study

Geoffrey R. Oxnard, MD, of Dana-Farber Cancer Institute, discusses genome-wide sequencing for early-stage lung cancer detection from plasma cell–free DNA (Abstract LBA8501).

lung cancer
immunotherapy

Robert M. Jotte, MD, PhD, on NSCLC: Results From the IMpower131 Trial

Robert M. Jotte, MD, PhD, of Rocky Mountain Cancer Centers, discusses phase III study findings on atezolizumab plus carboplatin plus paclitaxel or nab-paclitaxel vs carboplatin plus nab-paclitaxel, as first-line therapy in advanced squamous non–small cell lung cancer (Abstract LBA9000).

lung cancer

2018 ASCO: Blood Test Shows Potential as a Detection Tool for Early-Stage Lung Cancer

An initial report from the large, ongoing Circulating Cell-Free Genome Atlas (CCGA) study provides preliminary evidence that a blood test may be able to detect early-stage lung cancer. This is one of the first studies to explore blood tests analyzing free-floating or cell-free DNA as a tool for the ...

lung cancer
immunotherapy

2018 ASCO: IMpower 131 Studies Addition of Atezolizumab to Chemotherapy in Advanced Squamous NSCLC

Initial findings from a randomized phase III clinical trial showed that patients with advanced squamous non–small cell lung cancer (NSCLC) benefit more from initial treatment with the programmed cell death ligand 1 (PD-L1)-targeted immunotherapy atezolizumab (Tecentriq) and chemotherapy than...

lung cancer
symptom management
immunotherapy

Safety of PD-1/PD-L1 Inhibitors in Patients With NSCLC and Preexisting Autoimmune Disorders

In a study reported in the Journal of Clinical Oncology, Leonardi et al found that programmed cell death protein 1 (PD-1)/programmed cell death ligand 1 (PD-L1) inhibitor monotherapy in patients with non–small cell lung cancer (NSCLC) and autoimmune disorders worsened such disorders in a...

Lung Cancer

Valued Mentors and a Link Between Science and Medicine Paved the Road to Oncology for Alice Tsang Shaw, MD, PhD

Lung cancer expert Alice Tsang Shaw, MD, PhD, was born and reared in Gaithersburg, a small suburb located to the northwest of Washington, DC. Both her parents were chemists, and during high school, Dr. Shaw had a keen interest in science, particularly biology, yet the thought of pursuing a career...

lung cancer
issues in oncology

Risk-Prediction Tool Helps Tailor Lung Cancer Screening to Patient Preference and Clinical Benefit

A microsimulation model study found that the benefits of low-dose computed tomography (CT) screening for lung cancer varied substantially across the eligible population, with 3 factors being particularly influential: lung cancer risk, competing risks or life expectancy, and patient...

Lung Cancer

Stage IV Lung Cancer Did Not Stop Me From Climbing Mera Peak

A veteran mountain climber and skier, I’ve been healthy for most of my 61 years, so it was especially shocking to experience a bout of shortness of breath during a moderately intense mountain bike ride with my wife, Jan, in the spring of 2014. A never-smoker, I was used to climbing up high mountain ...

lung cancer

High–Nicotine-Dependent Smokers Less Likely to Quit After Lung Cancer Screening

A new study by Rojewski et al in CHEST investigated the relationships between the degree of nicotine dependence and both the likelihood of successfully quitting smoking and clinical outcomes in a cohort of screened patients. The study found that patients with a higher nicotine dependence...

Lung Cancer

Treatment of Malignant Pleural Mesothelioma: ASCO Clinical Practice Guideline

As reported by Hedy L. Kindler, MD, of the University of Chicago, and colleagues in the Journal of Clinical Oncology, ASCO has released a clinical practice guideline on the treatment of malignant pleural mesothelioma.1 The guideline was based on a systematic literature search and expert panel...

lung cancer
skin cancer
issues in oncology
immunotherapy

Survival in Male vs Female Patients Receiving Immune Checkpoint Inhibitors

In a systematic review and meta-analysis reported in The Lancet Oncology, Conforti et al found a significant difference in overall survival benefit favoring male vs female patients receiving immune checkpoint inhibitor therapy for advanced cancers. Study Details The study involved database...

Colorectal Cancer
Breast Cancer
Hepatobiliary Cancer
Lung Cancer
Kidney Cancer
Prostate Cancer
CNS Cancers
Leukemia

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): 2018 Guidelines Updates

In 1996, the National Comprehensive Cancer Network® (NCCN®) published its first set of Clinical Practice Guidelines in Oncology (NCCN Guidelines®) covering 8 tumor types. Guidelines are now published for more than 60 tumor types and topics. Some of the key updates were presented at NCCN’s 23rd...

lung cancer

NGR-hTNF Combined With Investigator Choice of Therapy in Previously Treated Malignant Pleural Mesothelioma

In the phase III NGR015 trial reported in The Lancet Oncology, Gregorc et al found no benefit of adding NGR-hTNF to best investigator choice of treatment in patients with previously treated malignant pleural mesothelioma. NGR-hTNF consists of human TNFα conjugated to the tumor-targeting ...

lung cancer

2018 ASCO: Upfront, Comprehensive Genetic Testing in Advanced Lung Cancer Is Cost-Effective

An economic model comparing different types of genetic testing in metastatic non–small cell lung cancer (NSCLC) found that using next-generation sequencing to test for all known lung cancer–related gene changes at the time of diagnosis was more cost-effective and faster than testing one ...

lung cancer

2018 ASCO: Majority of Heavy Smokers Not Screened for Lung Cancer, Despite USPSTF Recommendations

An analysis of 1,800 lung cancer screening sites nationwide found that only 1.9% of more than 7 million current and former heavy smokers were screened for lung cancer in 2016, despite U.S. Preventive Services Task Force (USPSTF) and ASCO screening recommendations. Results from this study—the...

palliative care
lung cancer

Racial/Ethnic Disparities in the Quality of End-of-Life Care Among Patients With Lung Cancer

Significant disparities in the quality of end-of-life lung cancer care were found among racial/ethnic minorities, with higher odds of experiencing potentially preventable medical encounters during end of life as compared with non-Hispanic whites. These findings were published by Karanth et al in...

lung cancer

Researchers Identify Most Accurate Risk-Prediction Models for Lung Cancer Screening in Ever-Smokers

Recent lung cancer screening guidelines from the National Comprehensive Cancer Network(®) permit the use of risk models to refer ever-smokers for screening. However, different models select different screening populations and the performance of each model in selecting ever-smokers is...

Lung Cancer

Afatinib in Previously Untreated Metastatic NSCLC With Nonresistant EGFR Mutations

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 January 12, 2018, afatinib (Gilotrif) was approved...

Lung Cancer

Expert Point of View: Roy S. Herbst, MD, PhD

FORMAL DISCUSSANT of the KEYNOTE-189 trial, Roy S. Herbst, MD, PhD, Chief of Medical Oncology at Smilow Cancer Hospital, Yale Cancer Center, New Haven, heartily endorsed the new triplet combination of pembrolizumab, pemetrexed, and a platinum in advanced nonsquamous non– small cell lung cancer...

Lung Cancer
Immunotherapy

Pembrolizumab Plus Standard Chemotherapy Improves Survival in Newly Diagnosed Metastatic Non–Small Cell Lung Cancer

ADDING THE IMMUNE checkpoint inhibitor pembrolizumab (Keytruda) to standard chemotherapy with pemetrexed (Alimta) and a platinum as first-line therapy was superior to chemotherapy alone in the KEYNOTE-189 trial.1 Induction and maintenance therapies with the new triplet therapy improved overall...

lung cancer
immunotherapy

FDA Accepts sBLA, Grants Priority Review to Atezolizumab for Initial Treatment of Metastatic Nonsquamous NSCLC

The U.S. Food and Drug Administration (FDA) recently accepted a supplemental biologics license application (sBLA) and granted Priority Review for atezolizumab (Tecentriq) in combination with bevacizumab (Avastin), paclitaxel, and carboplatin for the first-line treatment of metastatic nonsquamous...

lung cancer

Disparities Found in Lung Cancer Care, Survival in United States vs England

Despite steady declines in death rates in recent years, lung cancer remains the leading cause of cancer deaths in wealthy countries. In a study published by Andreano et al in the Journal of Thoracic Oncology, Yale researchers collaborated with investigators in Europe to examine lung cancer care and ...

lung cancer
immunotherapy

IL-15 Superagonist Plus Nivolumab in Advanced NSCLC

In a phase Ib trial reported in The Lancet Oncology, Wrangle et al found evidence of activity of the combination of nivolumab (Opdivo) and the interleukin (IL)-15 superagonist ALT-803 in patients with previously treated advanced non–small cell lung cancer (NSCLC). ALT-803 targets the shared...

lung cancer
immunotherapy

FDA Accepts sBLA, Grants Priority Review for Pembrolizumab Plus Pemetrexed and Platinum Chemotherapy in Metastatic Nonsquamous NSCLC

On April 30, the U.S. Food and Drug Administration (FDA) accepted for review a supplemental biologics license application (sBLA) for pembrolizumab (Keytruda) based on results of the phase III KEYNOTE-189 trial. The application seeks approval for pembrolizumab in combination with pemetrexed (Alimta) ...

lung cancer
prostate cancer

By 2030, Prostate and Lung Cancers Are Expected to Be the Most Common Cancer Types Among HIV-Infected Adults

While effective antiretroviral therapy, which suppresses HIV replication and improves immune function, has resulted in increased longevity for people living with HIV and reduced the risk of certain cancers, including Kaposi sarcoma and non-Hodgkin lymphoma, other cancers are expected to become more ...

lung cancer
immunotherapy

Results From the ARCTIC Trial in Third-Line Treatment of NSCLC

AstraZeneca and MedImmune have announced high-level results from the phase III ARCTIC trial in patients with locally advanced or metastatic non–small cell lung cancer (NSCLC) who have received at least two prior treatments. This randomized, open-label, multicenter trial assessed the efficacy...

lung cancer
gastroesophageal cancer

ESTRO 37: Positioning for Radiotherapy and Impact on Survival in Patients With Lung or Esophageal Cancers

Very small differences in the way a patient lies during radiotherapy treatment for lung or esophageal cancer can have an impact on survival, according to research presented at the European Society for Radiotherapy & Oncology (ESTRO) 37 Conference (Abstract OC-0322). These differences of only a...

lung cancer

ESTRO 37: Handgrip Strength Test May Be a Good Indicator of Survival in Patients With NSCLC

A simple test of handgrip strength may be a good indicator of short- and long-term survival in patients with stage I non–small cell lung cancer (NSCLC), according to new findings presented at the European Society for Radiotherapy & Oncology (ESTRO) 37 Conference (Abstract PV0041)....

lung cancer

ESTRO 37: Elderly Patients With NSCLC May Be Less Likely to Benefit From Concurrent Chemoradiotherapy

An analysis of elderly patients with non–small cell lung cancer (NSCLC) treated in a phase II trial of radiotherapy combined with chemotherapy has shown that they were less likely to benefit than younger patients if the two treatments were given at the same time. These findings were presented ...

lung cancer
immunotherapy

FDA Accepts sBLA, Grants Priority Review for Nivolumab in Previously Treated Patients With SCLC

On April 18, the U.S. Food and Drug Administration (FDA) accepted for Priority Review a supplemental biologics license application (sBLA) for nivolumab (Opdivo) to treat patients with small cell lung cancer (SCLC) whose disease has progressed after two or more prior lines of therapy. ...

lung cancer

FDA Approves Osimertinib for First-Line Treatment of Metastatic NSCLC With Most Common EGFR Mutations

On April 18, the U.S. Food and Drug Administration (FDA) approved osimertinib (Tagrisso) for the first-line treatment of patients with metastatic non–small cell lung cancer (NSCLC) whose tumors have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 L858R mutations, as...

lung cancer
immunotherapy

Pembrolizumab Monotherapy in NSCLC Meets Primary Endpoint in Phase III KEYNOTE-042 Study

On April 9, the phase III KEYNOTE-042 trial evaluating pembrolizumab (Keytruda) as monotherapy for the first-line treatment of locally advanced or metastatic non–small cell lung cancer (NSCLC, including nonsquamous or squamous histologies) met its primary endpoint of overall survival (OS). An ...

lung cancer

Crizotinib in East Asian Patients With ROS1-Positive Advanced NSCLC

In a phase II study reported in the Journal of Clinical Oncology, Wu et al found that crizotinib (Xalkori) was highly active in East Asian patients with ROS1-positive advanced non­–small cell lung cancer (NSCLC). Study Details In the study, 127 patients from 37 sites in China, Japan,...

lung cancer
immunotherapy

AACR 2018: Pilot Study of Neoadjuvant Nivolumab in Resectable NSCLC

In a pilot study reported at the 2018 American Association for Cancer Research (AACR) Annual Meeting (Abstract CT079) and in The New England Journal of Medicine by Forde et al, neoadjuvant nivolumab therapy was found to be feasible and active in patients with resectable non–small cell lung...

lung cancer

AACR 2018: New Liquid Biopsy–Based Cancer Model Reveals Data on Chemoresistance in SCLC

Small cell lung cancer (SCLC) accounts for 14% of all lung cancers and is often rapidly resistant to chemotherapy, resulting in poor clinical outcomes. Treatment has changed little for decades, but a study at The University of Texas MD Anderson Cancer Center offers a potential explanation for...

lung cancer
immunotherapy

AACR 2018: KEYNOTE-189: Addition of Pembrolizumab to Chemotherapy in Metastatic NSCLC

As reported at the American Association for Cancer Research (AACR) Meeting (Abstract CT075) in the The New England Journal of Medicine by Gandhi et al, the first interim analysis of the phase III KEYNOTE-189 trial has shown significant improvement in overall and progression-free survival with the...

lung cancer
immunotherapy

AACR 2018: CheckMate 227: Nivolumab/Ipilimumab vs Chemotherapy in NSCLC With High Tumor Mutational Burden Analysis

As reported at the 2018 American Association for Cancer Research (AACR) Meeting (Abstract CT077) and in The New England Journal of Medicine by Hellmann et al, an analysis from the phase III CheckMate 227 trial has shown that the combination of nivolumab (Opdivo) plus ipilimumab (Yervoy)...

Solid Tumors
Lung Cancer
Issues in Oncology

Enormous Cost of Failure to Screen Heavy Smokers for Lung Nodules

In 2011 the American College of Radiology Imaging Network (ACRIN) group published its publicly funded study of three annual screening chest computed tomography (CT) scans among heavy smokers aged 55 to 74.1 The results remain the first and only screening study for any cancer demonstrating a...

solid tumors
lung cancer

AACR 2018: Selective Inhibitor Shows Early Promise in Patients With RET-Altered Cancers

BLU-667, a next-generation inhibitor that selectively targets the oncogenic receptor tyrosine kinase RET, was well tolerated and had broad clinical benefit in patients with advanced cancer that had progressed on previous therapies, including multikinase inhibitor therapy. Proof-of-concept data from ...

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