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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...
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...
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,...
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 ...
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...
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...
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...
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...
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...
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...
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...
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.
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)
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...
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...
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...
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...
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....
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...
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...
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...
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 ...
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,...
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...
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...
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,...
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...
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...
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...
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...
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...
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 Medicineby Mok et al, osimertinib (Tagrisso) significantly improved progression-free survival (PFS) vs platinum/pemetrexed (Alimta) among patients with epidermal growth factor receptor (EGFR) T790M–positive non–small...
Study Finds No Predictive Value of ERCC1 Marker for Outcomes With Nonplatinum vs Platinum Therapies in NSCLC
In the UK phase III ERCC1 trial reported in the Journal of Clinical Oncology, Lee et al found that presence of the excision repair cross complementing group 1 (ERCC1) biomarker did not predict better outcome with nonplatinum therapy in patients with non–small cell lung cancer (NSCLC). Study...
Cabozantinib Shows Activity in Advanced RET-Rearranged NSCLC
In a phase II trial reported in The Lancet Oncology, Drilon et al found that cabozantinib (Cabometyx) produced responses in some patients with advanced RET-rearranged non–small cell lung cancer (NSCLC). RET rearrangements are found in 1% to 2% of NSCLCs. In the single-arm study, 25 evaluable ...
Study Finds Cabozantinib Alone or With Erlotinib Improves Outcome 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...
New ALK Inhibitor, Brigatinib, Active in ALK-Rearranged Non–Small Cell Lung Cancer
In a phase I/II study reported in The Lancet Oncology, Gettinger et al found that the anaplastic lymphoma kinase (ALK) inhibitor brigatinib, which showed preclinical activity against ALK mutants resistant to crizotinib (Xalkori) and other ALK inhibitors, was active in patients with ALK-rearranged...
Improved Outcome Reported With Local Consolidative Therapy in Oligometastatic NSCLC Without Progression After First-Line Systemic Therapy
In a phase II trial reported in The Lancet Oncology, Gomez et al found that local consolidative therapy (with or without maintenance therapy) improved progression-free survival in patients with stage IV non–small cell lung cancer (NSCLC) who had up to three metastatic disease lesions and no...
Multiple Genetic Mutational Signatures Associated With Smoking
Scientists have measured the genetic damage caused by smoking in different organs of the body and identified several different mechanisms by which tobacco smoking causes mutations in DNA. Researchers at the Wellcome Trust Sanger Institute, the Los Alamos National Laboratory, and their collaborators ...
Personalized Risk Assessment Tool for Lung Cancer in Never, Light, and Heavy Smokers
Researchers at The University of Texas MD Anderson Cancer Center have developed a new personalized assessment tool that could better predict lung cancer risk in never, light, and heavy smokers using a large Taiwanese prospective cohort study. By incorporating risk factor—in addition to...
Japanese Trial Finds High Levels of Estrogen in Lung Tissue May Be Related to Synchronous Multiple Lung Adenocarcinoma in Postmenopausal Women
Thanks to advances in medical imaging, the detection rate for synchronous multiple lung adenocarcinoma has been on the rise. Cases of synchronous multiple lung adenocarcinoma in Japanese women have been on the rise, despite having a national smoking rate of less than 10% in recent years. This...
FDA Approves Pembrolizumab as First-Line Treatment for PD-L1–Positive Non–Small Cell Lung Cancer
On October 24, 2016, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda) for the treatment of patients with metastatic non–small cell lung cancer (NSCLC) whose tumors express programmed cell death ligand 1 (PD-L1) as determined by an FDA-approved test. This is the...
Osimertinib Shows Activity in Pretreated EGFR Thr790Met–Positive Advanced NSCLC
In a phase II trial reported in The Lancet Oncology, Goss et al found that osimertinib produced a high response rate in EGFR tyrosine kinase inhibitor–pretreated EGFR Thr790Met (T790M)–positive advanced non–small cell lung cancer (NSCLC). Osimertinib is an EGFR tyrosine kinase...
ESMO 2016: Clinical Benefit Demonstrated With Everolimus and Pasireotide LAR Alone or in Combination in Advanced Lung and Thymic Carcinoids
In patients with advanced lung or thymus carcinoid receiving everolimus, pasireotide LAR, or the combination of the two drugs, statistically significant positive impact was seen on proportion of patients’ progression-free rate at 9 months (primary endpoint) in all three arms, more relevant in ...
Atezolizumab Approved for the Treatment of Metastatic NSCLC That Has Progressed During or After Platinum-Containing Therapy
On October 18, 2016, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq) for the treatment of patients with metastatic non–small cell lung cancer (NSCLC) whose disease progressed during or following platinum-containing chemotherapy. Patients with EGFR or ALK genomic...
FDA Modifies the Indication of Erlotinib in Non–Small Cell Lung Cancer to Patients With Specific EGFR Mutations
On October 18, 2016, the U.S. Food and Drug Administration (FDA) modified the indication for erlotinib (Tarceva) in the treatment of non–small cell lung cancer (NSCLC) to limit its use to patients whose tumors have specific epidermal growth factor receptor (EGFR) mutations. The labeling...
Adding Pembrolizumab to Carboplatin/Pemetrexed Seems to Improve Response in Advanced Nonsquamous NSCLC
As reported by Langer et al in The Lancet Oncology, findings in a phase II cohort of the multicohort KEYNOTE-021 study showed that the addition of first-line pembrolizumab (Keytruda) to carboplatin/pemetrexed (Alimta) significantly increased the response rate in patients with advanced nonsquamous...
Martin Reck, MD, PhD, on NSCLC: Results of KEYNOTE-024 (German Language Version) 
Martin Reck, MD, PhD, of the LungenClinic, discusses in German study findings on pembrolizumab vs platinum-based chemotherapy as first-line therapy for advanced non-small cell lung cancer with a PD-L1 tumor proportion score ≥50%. (Abstract LBA8)
ESMO 2016: First-Line Pembrolizumab Plus Chemotherapy Significantly Improves Outcomes in Advanced NSCLC
The addition of the programmed cell death protein 1 (PD-1) antibody pembrolizumab (Keytruda) to standard first-line chemotherapy for treatment-naive advanced non–small cell lung cancer significantly improves response rates and progression-free survival, Langer et al reported at the 2016...
Intensity-Modulated vs 3D Conformal External-Beam Radiation Therapy in Locally Advanced Non–Small Cell Lung Cancer
In a secondary analysis from the NRG Oncology RTOG 0617 trial reported in the Journal of Clinical Oncology, Chun et al found that use of intensity-modulated vs three-dimensional (3D) conformal external-beam radiation therapy was associated with a reduced risk for severe pneumonitis and reduced the...
Luis G. Paz-Ares, MD, PhD, on NSCLC: Results From the LUX-Lung 7 Trial (Spanish Language Version) 
Luis G. Paz-Ares, MD, PhD, of the Hospital Universitario 12 De Octubre, discusses in Spanish overall survival data on afatinib vs gefitinib in patients with EGFR mutation–positive non–small cell lung cancer. (Abstract LBA43)
