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Richard L. Schilsky, MD, and R. Donald Harvey, PharmD, BCOP, on Advanced Non–Small Cell Lung Cancer: Expanding the Criteria for Clinical Trial Eligibility
Richard L. Schilsky, MD, of ASCO, and R. Donald Harvey, PharmD, BCOP, of Winship Cancer Institute of Emory University, discuss their study findings that expanding the clinical trial eligibility criteria for patients with advanced NSCLC would enable nearly twice as many people to be considered for...
2019 ASCO: Expansion of Clinical Trial Inclusion Criteria in Patients With Advanced NSCLC
A study that examined 10,500 health records of patients with advanced non–small cell lung cancer from ASCO’s CancerLinQ database found that the use of expanded clinical trial inclusion criteria—as proposed by ASCO and Friends of Cancer Research in 2017—would nearly double...
David J. Kwiatkowski, MD, PhD, on Non–Small Cell Lung Cancer: Neoadjuvant Immunotherapy for Resectable Disease
David J. Kwiatkowski, MD, PhD, of Brigham and Women’s Hospital and Dana-Farber Cancer Institute, discusses an interim analysis and biomarker data from a multicenter study showing that 19% of patients with NSCLC had a major pathologic response to preoperative treatment with atezolizumab (Abstract...
Hirotsugu Kenmotsu, MD, on Nonsquamous Non–Small Cell Lung Cancer: Pemetrexed Plus Cisplatin vs Vinorelbine Plus Cisplatin
Hirotsugu Kenmotsu, MD, of Shizuoka Cancer Center, discusses the phase III JIPANG trial findings, which showed that pemetrexed plus cisplatin was not superior to vinorelbine plus cisplatin in terms of recurrence-free survival for patients with completely resected nonsquamous non–small cell lung...
Taofeek Kunle Owonikoko, MD, PhD, on Small Cell Lung Cancer: Tremelimumab and Durvalumab With or Without Radiation
Taofeek Kunle Owonikoko, MD, PhD, of Emory University, discusses the findings of his phase II study, which assessed the efficacy of combined immune checkpoint inhibitors with or without radiation in relapsed small cell lung cancer (Abstract 8515).
Edward B. Garon, MD, on Advanced Non–Small Cell Lung Cancer: KEYNOTE-001 Trial on Pembrolizumab
Edward B. Garon, MD, of the David Geffen School of Medicine at the University of California, Los Angeles, discusses long-term survival data on patients with advanced non–small cell lung cancer treated with pembrolizumab and those with PD-L1 expressed in at least half of their tumor cells (Abstract...
2019 ASCO: KEYNOTE-001: 5-Year Survival Data for Patients With Advanced NSCLC Treated With Pembrolizumab
Five-year data from the phase Ib KEYNOTE-001 trial showed that treatment with pembrolizumab was safe and effective and substantially increased overall survival in patients with advanced non–small cell lung cancer (NSCLC). Specifically, 23.2% of people who had not previously been treated with...
Addition of Bevacizumab to Carboplatin/Pemetrexed in Nonsquamous NSCLC
New research published by Bagley et al in JNCCN—Journal of the National Comprehensive Cancer Network used a large real-world data set to demonstrate a modest but consistent survival benefit associated with adding bevacizumab to carboplatin/pemetrexed in advanced nonsquamous non–small...
FDA Approves the NovoTTF-100L System in Combination With Chemotherapy for Malignant Pleural Mesothelioma
On May 23, the U.S. Food and Drug Administration (FDA) approved the NovoTTF-100L System in combination with pemetrexed plus platinum-based chemotherapy for the first-line treatment of unresectable locally advanced or metastatic malignant pleural mesothelioma. NovoTTF-100L is a noninvasive,...
ACCURE Trial: Improving Racial Disparities in Treatment for Patients With Early-Stage Lung and Breast Cancers
Results from a study published by Cykert et al in The Journal of the National Medical Association show that a pragmatic system-based intervention within cancer treatment centers can nearly eliminate existing disparities in treatment and outcomes for black patients with early-stage...
Long-Term Results With Local Consolidative Therapy vs Maintenance Therapy or Observation in Oligometastatic NSCLC
In long-term follow-up of a phase II study reported in the Journal of Clinical Oncology, Gomez et al confirmed superior outcomes with local consolidative therapy vs maintenance therapy or observation in patients with oligometastatic non–small cell lung cancer (NSCLC). In the open-label,...
Lifetime Risk of Brain Metastases in Elderly Survivors of Breast, Lung, and Skin Cancers
Elderly survivors of breast cancer, lung cancer, and melanoma face risk of brain metastasis later in life, and may require extra surveillance in the years following initial cancer treatment, according to results of a study published by Ascha et al in Cancer Epidemiology, Biomarkers, &...
Association Between Clinical Outcomes and Patient Characteristics/Genomic Profiles in Lung Cancer
As reported in JAMA, Singal et al used a clinicogenomic database in routine clinical practice to identify associations between treatment outcomes and patient characteristics or tumor genomic profiles in the setting of non–small cell lung cancer (NSCLC). The study cohort of 4,064 patients...
ESTRO 38: Radical Hemithoracic Therapy in Patients With Mesothelioma
Patients with mesothelioma are twice as likely to survive for 2 years or longer if they are treated with a high dose of radiation to the affected side of the trunk, according to research presented by Minatel et al at ESTRO 38, the annual congress of the European Society for Radiotherapy...
Survey Finds Rates of Physician-Patient Discussions About Lung Cancer Screening Are Declining
A study examining trends in patient-reported physician-patient discussions about lung cancer screening and the association of these discussions with smokers’ attempts to quit and intent to quit has found that discussions about screening have declined since 2012. Moreover, they were not...
Erlotinib Plus Bevacizumab vs Erlotinib Alone in EGFR-Positive, Advanced Nonsquamous NSCLC
In an interim analysis of the phase III NEJ026 trial reported in The Lancet Oncology, Saito et al found that the addition of bevacizumab to erlotinib improved progression-free survival in patients with EGFR-positive, nonsquamous non–small cell lung cancer (NSCLC). In the open-label...
Combined Crowd Innovation and AI in Producing Algorithms for Radiotherapy Targeting
In a study reported in JAMA Oncology, Mak et al found that a crowd innovation contest produced automated artificial intelligence (AI) algorithms “that replicated the skills of a highly trained physician” in segmenting lung tumors for radiotherapy targeting. The investigators also noted...
Deep-Learning Model May Improve Predictions of Survival and Specific Outcomes in Lung Cancer
A study by Xu et al in Clinical Cancer Research evaluating deep-learning networks that analyze time-series computed tomography (CT) images of patients with locally advanced NSCLC has found these networks can integrate imaging scans at multiple time points to improve clinical outcome...
KEYNOTE-042: Pembrolizumab vs Chemotherapy in Previously Untreated Locally Advanced or Metastatic NSCLC With PD-L1 Expression ≥ 1%
As reported in The Lancet by Mok et al, the KEYNOTE-042 trial has shown an improvement in overall survival with pembrolizumab vs standard chemotherapy in previously untreated patients with locally advanced or metastatic non–small cell lung cancer (NSCLC) without a sensitizing EGFR mutation or ...
Five-Fraction SBRT for Centrally Located, Inoperable NSCLC
In the phase I/II NRG Oncology/RTOG 0813 study reported in the Journal of Clinical Oncology, Bezjak et al found that five-fraction stereotactic body radiotherapy (SBRT) was associated with relatively low rates of serious treatment-related toxicity and good outcomes in patients with centrally...
Prophylactic Irradiation of Chest Wall Procedure Sites in Malignant Pleural Mesothelioma
In a phase III trial reported in the Journal of Clinical Oncology, Bayman et al found that prophylactic radiotherapy to the chest wall after diagnostic or therapeutic procedures did not reduce the risk of chest wall metastases in patients with malignant pleural mesothelioma. In the open-label,...
FDA Expands Pembrolizumab Indication for NSCLC in First-Line Setting
Today, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda) for the first-line treatment of patients with stage III non–small cell lung cancer (NSCLC) who are not candidates for surgical resection or definitive chemoradiation, or those with metastatic NSCLC....
ELCC 2019: Does Maintenance Immunotherapy Improve Survival in Patients With Advanced SCLC?
Maintenance immunotherapy did not improve survival in patients with extensive-stage small cell lung cancer (SCLC), according to late-breaking results from the CheckMate 451 study presented today by Owonikoko et al at the European Lung Cancer Congress 2019 (Abstract LBA1_PR). Around 60% to 70% of...
ELCC 2019: Immunotherapy in Elderly Patients With Advanced NSCLC
Two studies reported at the European Lung Cancer Congress (ELCC) 2019 provided new insights on the efficacy and safety of immunotherapy in elderly patients with advanced non–small cell lung cancer (NSCLC). Although around half of all people newly diagnosed with NSCLC are elderly (Pallis ...
Lung Cancer Organizations Join Forces to Launch GO2 Foundation for Lung Cancer
Two nonprofit organizations serving the lung cancer community—the Bonnie J. Addario Lung Cancer Foundation (ALCF) and Lung Cancer Alliance (LCA)—have announced they are joining forces as the GO2 Foundation for Lung Cancer. With more than 3 decades of combined expertise, a...
Effect of Increased VA Hospice Care on Use of Aggressive Care and Costs for Veterans With Advanced Lung Cancer
In a study reported in JAMA Oncology, Mor et al found that veterans with advanced lung cancer treated in Veterans Affairs (VA) Medical Centers with high hospice use were more likely to receive concurrent cancer care but less likely to receive aggressive care. Moreover, veterans treated at...
Long-Term Outcomes for Prophylactic Cranial Irradiation vs Observation in Locally Advanced NSCLC
As reported in JAMA Oncology by Sun et al, a long-term update of the phase III NRG Oncology/RTOG 0214 trial has shown that prophylactic cranial irradiation was associated with a reduced incidence of brain metastases and improved disease-free survival—but not overall survival—compared...
AACR 2019: Data Analysis Shows Activity of Pembrolizumab in Pretreated Patients With Advanced Small Cell Lung Cancer
The results of an analysis of pooled data from the phase Ib KEYNOTE-028 trial and the phase II KEYNOTE-158 study of the anti–programmed cell death protein 1 monoclonal antibody pembrolizumab in the treatment of advanced small cell lung cancer has found that the therapy provided antitumor...
Lorlatinib in Advanced NSCLC With ALK Resistance Mutations
In a study reported in the Journal of Clinical Oncology, Shaw et al found that lorlatinib showed greater efficacy in patients with vs without anaplastic lymphoma kinase (ALK) resistance mutations among patients with advanced ALK-positive non–small cell lung cancer (NSCLC) in whom one or more...
Ultradeep Next-Generation Sequencing in Patients With Lung Cancer
A new method of determining the sequence of molecules in DNA can be used to detect small fragments of cancerous genetic material in blood samples from patients with lung cancer with a high degree of accuracy, according research published by Li et al in Annals of Oncology. Liquid Biopsies and...
Matthew A. Gubens, MD, on Non–Small Cell Lung Cancer: New Immunotherapy Strategies in the NCCN Guidelines
Matthew A. Gubens, MD, of the UCSF Helen Diller Family Comprehensive Cancer Center, discusses recent updates to the NCCN Guidelines in non–small cell lung cancer, including the use of pembrolizumab as a single agent or in combination based on PD-L1 status, treatment selection in squamous and...
Jyoti D. Patel, MD, on Stage III Non–Small Cell Lung Cancer: A Look at New Systemic Treatments
Jyoti D. Patel, MD, of the University of Chicago, discusses immunotherapy for locally advanced NSCLC, selecting patients for these treatments, and the potential toxicities of combination therapies.
Susan Y. Wu, MD, on Non–Small Cell Lung Cancer: Using an Online Tool in Treatment
Susan Y. Wu, MD, of the University of California, San Francisco, discusses how patient exposure to treatment guidelines improved smoking cessation counseling and the use of molecular testing, and decreased the use of adjuvant chemotherapy in patients with early-stage disease (Abstract 5).
Mark K. Ferguson, MD, on Mitigating Frailty and Sarcopenia to Improve Treatment Outcomes
Mark K. Ferguson, MD, of the University of Chicago Hospital, discusses frailty and loss of muscle tissue, which are common among patients with lung cancer. These conditions are linked with decreased survival as well as increased surgical complications, chemotherapy toxicity, and cost of care.
Jing Zeng, MD, on Non–Small Cell Lung Cancer: Therapeutic Implications of Proper Disease Staging
Jing Zeng, MD, of the University of Washington, discusses upstaging disease from stage III to stage IV, which can occur with repeat PET and/or CT scans for patients with locally advanced NSCLC, and the need for clinicians to stage disease properly to ensure appropriate treatment.
Ruqin Chen, MB, on Lung Cancer Treated With Immune Checkpoint Inhibitors: Survival Outcomes and Clinical and Molecular Features
Ruqin Chen, MB, of the Mayo Clinic Florida, discusses early study findings that show molecular profiling with NF1, CD79a, and AKT3 could potentially improve prediction of progression-free survival in patients with lung cancer who are receiving immunotherapy.
Kyle F. Concannon, MD, on Lung Cancer in Homeless Patients: Outcomes and Quality Measures
Kyle F. Concannon, MD, of the University of Washington/Seattle Cancer Care Alliance, discusses study results on the delays in biopsy after radiographic findings among homeless vs housed patients with lung cancer, and the higher rates of missed appointments following diagnosis (Abstract 125).
J. Fletcher Drogos, MD, on Multiple Courses of Stereotactic Body Radiation Therapy: Outcomes in Patients With Lung Cancer
J. Fletcher Drogos, MD, of Rush University, discusses study findings on overall survival and toxicity among patients who undergo multiple radiation treatments for lung cancer.
Shraddha M. Dalwadi, MD, MBA, on Non–Small Cell Lung Cancer: What Contributes to Disparities in Treating Stage I Disease
Shraddha M. Dalwadi, MD, MBA, of Baylor College of Medicine, discusses the nearly 12% of potentially curable patients with stage I NSCLC who do not receive treatment, the various socioeconomic reasons why, and how some patients may benefit from minimally invasive therapies (Abstract 127).
Aaron S. Mansfield, MD, on Treating Rare Thoracic Cancers: Status Update
Aaron S. Mansfield, MD, of the Mayo Clinic, summarizes a session he moderated on rare thoracic cancers such as mesothelioma and thymic epithelial tumors, as well as novel imaging and treatments in neuroendocrine tumors.
Heather A. Wakelee, MD, on Advanced Non–Small Cell Lung Cancer: State-of-the-Art Treatment for EGFR-Positive and ALK-Positive Diseases
Heather A. Wakelee, MD, of Stanford University, discusses the most recent FDA-approved tyrosine kinase inhibitors that target EGFR and ALK mutations, how these agents fit into the treatment landscape, and the rapidly evolving field of TKI resistance.
Leora Horn, MD, on Small Cell Lung Cancer and Immuno-oncology: Have We Finally Solved the Small Cell Paradox?
Leora Horn, MD, of Vanderbilt University Medical Center, discusses the progress made treating extensive-stage small cell lung cancer, improvements in progression-free and overall survival, and the fact that it’s still difficult to determine which patients will benefit most from immunotherapy.
FDA Approves Atezolizumab for Extensive-Stage Small Cell Lung Cancer
On March 18, 2019, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq) in combination with carboplatin and etoposide for the first-line treatment of adult patients with extensive-stage small cell lung cancer. IMpower133 Approval was based on the IMpower133 study, a...
Opioid Use Among Older Survivors of Colorectal, Lung, and Breast Cancers
In a linked Surveillance, Epidemiology, and End Results and Medicare study reported in the Journal of Clinical Oncology, Salz et al found that chronic opioid use varied by cancer among older cancer survivors. By 6 years after diagnosis, survivors were no more likely to be chronic opioid users...
2019 Thoracic Cancers Symposium: Trends in Use of Prophylactic Cranial Irradiation for Extensive-Stage SCLC
A new survey of radiation oncologists points to a sharp decline in the use of prophylactic cranial irradiation for patients with extensive-stage small cell lung cancer (SCLC), indicating a rapid change in standard practice for the disease following the 2017 publication of a major clinical trial by...
2019 Thoracic Cancers Symposium: Effect of Structured Patient Exposure to the NCCN Guidelines for NSCLC
A new clinical trial found that exposing patients to tailored versions of the National Comprehensive Cancer Network (NCCN®) Guidelines for non–small cell lung cancer (NSCLC) may help drive smoking cessation, testing for potential biomarkers and, for early-stage disease, more...
2019 Thoracic Cancers Symposium: Local Consolidative Therapy and Overall Survival in Oligometastatic NSCLC
A new analysis of patients treated with local consolidative therapy for oligometastatic non–small cell lung cancer (NSCLC) found that the intensive treatment approach is associated with improved overall survival. Local consolidative therapy—consisting of radiation therapy or...
Nivolumab Plus Ipilimumab in Advanced NSCLC: Outcomes by PD-L1 and Tumor Mutational Burden Status
As reported in the Journal of Clinical Oncology by Ready et al, the phase II CheckMate 568 trial has shown that higher tumor mutational burden is associated with response, irrespective of programmed cell death ligand 1 (PD-L1) expression in first-line nivolumab plus low-dose ipilimumab treatment of ...
Edward B. Garon, MD, on Non–Small Cell Lung Cancer: CheckMate 384 Trial on Nivolumab Dosing
Edward B. Garon, MD, of the Olive View–UCLA Medical Center, discusses phase IIIb/IV study findings on reducing the frequency of nivolumab dosing, from 480 mg every 4 weeks to 240 mg every 2 weeks, in patients with previously treated advanced non–small cell lung cancer (Abstract 100).
Nicolas Guibert, MD, PhD, on Non–Small Cell Lung Cancer: Predicting Response to PD-1 Inhibitors With cfDNA
Nicolas Guibert, MD, PhD, of Toulouse University Hospital, discusses a simple algorithm built to predict durable outcomes of patients with advanced non–small cell lung cancer that has been treated with immunotherapy. He notes that early changes in circulating tumor DNA burden may also predict...
