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Lung Cancer

Sotorasib Achieves Durable Responses in KRAS G12C–Mutated Lung Cancer

Sotorasib, the first KRAS G12C inhibitor approved for the treatment of KRAS G12C–mutated non–small cell lung cancer (NSCLC), continues to demonstrate meaningful and durable efficacy at 2-year follow-up in the phase II CodeBreaK 100 trial. At a median follow-up of 15.3 months, 2-year overall...

Lung Cancer
Genomics/Genetics
Immunotherapy

Patients With Lung Cancer and a Genetic Variant Linked to Autoimmune Disease May Be Especially Responsive to Immunotherapy

A variant of the CTLA-4 gene associated with autoimmune disease was found to be more frequent in patients with non–small cell lung cancer (NSCLC) who experienced an exceptionally high response to anti–PD-1 immunotherapy and a higher rate of immune-related side effects than in a comparable cohort of ...

lung cancer

Alana L. Welm, PhD, on Metastatic Outgrowth in the Lungs: Identifying a New Immune-Mediated Pathway

Alana L. Welm, PhD, of the University of Utah Huntsman Cancer Institute, discusses her findings of a new pathway that regulates the antitumor immune response during metastatic outgrowth. Interfering with a particular isoform of RON kinase may cause metastatic tumors to be swarmed by T cells and killed, suggesting that new approaches to targeting this kinase may be achievable in the near future (Abstract SY32).

Lung Cancer

Rapid Guideline Revises Recommendations for Adjuvant Therapy in Patients With Early-Stage Lung Cancer

A rapid recommendation update to an ASCO guideline offers revised parameters for adjuvant therapy in patients with resected non–small cell lung cancer (NSCLC) who have stage IB to IIIA disease.1,2 The new guidance reflects the findings from two randomized clinical trials that assessed the use of...

Lung Cancer

Anetumab Ravtansine vs Vinorelbine in Relapsed Mesothelin-Positive Advanced Malignant Pleural Mesothelioma

In the phase II ARCS-M trial reported in The Lancet Oncology, Hedy L. Kindler, MD, FASCO, and colleagues found that the antimesothelin antibody–tubulin inhibitor conjugate anetumab ravtansine did not improve progression-free survival vs vinorelbine as second-line treatment for patients with...

Lung Cancer

Collaboration Finds International Disparities in Screening, Treatment, and Outcomes for Patients With Lung Cancer

A consensus reached by a lung cancer clinical community within the International Cancer Benchmarking Partnership (ICBP) presented by Lynch et al at the European Lung Cancer Congress (Abstract 196P) has highlighted international disparities in the management and outcomes of patients with lung cancer ...

Lung Cancer

Registry Study Shows a Real-World Increase in Biomarker Testing Among Patients With Advanced NSCLC

More than half of patients diagnosed with advanced non–small cell lung cancer (NSCLC) undergo biomarker testing, and this figure has increased over the past 5 years, according to real-world data from a Spanish national registry study reported by Calvo de Juan et al at the European Lung Cancer...

Lung Cancer

Guideline-Concordant Surgery and Adjuvant Chemotherapy for Early-Stage NSCLC

In a retrospective cohort study reported in JAMA Oncology, Kenneth L. Kehl, MD, MPH, and colleagues found that only a slight majority of patients with early-stage non–small cell lung cancer (NSCLC) who were enrolled in a U.S. screening study (ALCHEMIST) received guideline-recommended adequate lymph ...

Lung Cancer
Immunotherapy

Adjuvant Pembrolizumab May Improve Disease-Free Survival in Patients With Early-Stage NSCLC

Adjuvant pembrolizumab may improve disease-free survival compared to placebo in patients with early-stage non–small cell lung cancer (NSCLC) following complete resection and adjuvant chemotherapy when indicated, investigators from the PEARLS/KEYNOTE-091 trial reported in a European Society for...

Lung Cancer

Lung Cancer Diagnosis With Low-Dose CT Screening and a Program for Management of Incidentally Detected Lung Nodules

In the prospective observational DELUGE study reported in the Journal of Clinical Oncology, researchers in the Baptist Memorial Health Care Corporation (BMHCC) found that programs for low-dose computed tomography (CT) screening and for management of incidentally detected lung nodules were...

Lung Cancer
Genomics/Genetics
Immunotherapy

Front-Line Toripalimab Plus Chemotherapy Improves Survival in Patients With Advanced NSCLC Without Actionable Mutations

Adding the PD-1 inhibitor toripalimab to chemotherapy significantly improved survival compared with chemotherapy alone in patients with advanced non–small cell lung cancer (NSCLC) without EGFR/ALK mutations, according to research presented by Wang et al during the March 2022 session of the ASCO...

Lung Cancer

Intervention for Racial Disparities in Time to Lung Cancer Surgery: ACCURE Trial

In an analysis from the Accountability for Cancer Care through Undoing Racism and Equity (ACCURE) trial reported in the Journal of Clinical Oncology, Marjory Charlot, MD, MPH, MSc, and colleagues found that the ACCURE intervention reduced the disparity between Black and White patients in time to...

Lung Cancer
Immunotherapy

FDA Approves Neoadjuvant Nivolumab and Platinum Doublet Chemotherapy for Early-Stage NSCLC

On March 4, the U.S. Food and Drug Administration (FDA) approved nivolumab (Opdivo) in combination with platinum-doublet chemotherapy for adult patients with resectable non–small cell lung cancer (NSCLC) in the neoadjuvant setting. This represents the first FDA approval for neoadjuvant therapy for...

Lung Cancer

Esophagus-Sparing vs Standard Palliative Radiation for Patients With Advanced Central NSCLC

As reported in JAMA Oncology by Louie et al, the Canadian phase III PROACTIVE trial showed that esophagus-sparing intensity-modulated radiotherapy (ES-IMRT) did not significantly improve esophageal quality of life vs standard radiotherapy in patients with advanced central non–small cell lung cancer ...

Lung Cancer

Do Diagnostic Delays Impact Overall Survival in Patients With NSCLC?

In a Surveillance, Epidemiology, and End Results (SEER)-Medicare Database analysis reported in JCO Oncology Practice, Romine et al found that longer time from suspicion to histologic diagnosis of non–small cell lung cancer (NSCLC) was associated with better overall survival; however, this effect...

Lung Cancer

Abemaciclib for Previously Treated Patients With p16ink4A-Deficient Mesothelioma

As reported in The Lancet Oncology by Dean A. Fennell, FRCP, and colleagues, a phase II trial (MiST2) showed the activity of abemaciclib in previously treated patients with p16ink4A-deficient malignant mesothelioma. As stated by the investigators, “Genetically stratified therapy for malignant...

Lung Cancer

Incidental Findings on Low-Dose CT Lung Cancer Screening in the NLST and Risk of Respiratory Disease Mortality

In an analysis of data from the National Lung Screening Trial (NLST) reported in Chest, Pinsky et al found that incidental respiratory disease–related findings on low-dose computed tomography (CT) screening were common and associated with an increased risk of mortality from respiratory diseases....

Lung Cancer
Immunotherapy

Updated Efficacy and Safety Data From CheckMate 743: First-Line Nivolumab/Ipilimumab vs Chemotherapy for Unresectable Malignant Pleural Mesothelioma

With a follow-up of at least 3 years, the results from the CheckMate 743 study represent the first long-term survival data in a phase III study evaluating first-line immune checkpoint inhibition in patients with unresectable malignant pleural mesothelioma. Overall, 23% of patients treated with...

Issues in Oncology
Lung Cancer

Importing Oncology Trials From China, or Other Single Foreign Countries, for Consideration of U.S. Regulatory Approvals

In a commentary published in The Lancet Oncology, Harpreet Singh, MD, and Richard Pazdur, MD, both of the Oncology Center of Excellence at the U.S. Food and Drug Administration (FDA), warned against the increasing number of oncology drug development programs based wholly or predominantly on data...

Lung Cancer
COVID-19

Study Finds Patients With Lung Cancer Demonstrated Psychological Resilience in the Face of the COVID-19 Pandemic

Far from being hobbled by fears of COVID-19, patients with lung cancer actually showed less depression and anxiety during the pandemic than their healthy peers, according to results from a new study by Arrato et al published in JNCCN–Journal of the National Comprehensive Cancer Network. Researchers ...

Lung Cancer
Health-Care Policy

CMS Expands Coverage of Lung Cancer Screening With Low-Dose CT

On February 10, the Centers for Medicare & Medicaid Services (CMS) announced a national coverage determination that expands coverage for lung cancer screening with low-dose computed tomography (CT) to improve health outcomes for people with lung cancer. This type of screening is aimed at early...

Lung Cancer

Use of Consolidation Durvalumab and Adjuvant Osimertinib Among Key Recommendations in New ASCO Guideline on Stage III NSCLC Treatment

A new ASCO guideline provides key recommendations for the evaluation and management of stage III non–small cell lung cancer (NSCLC). Recommendations made by the ASCO expert panel cover evaluation and staging of ­NSCLC, neoadjuvant and adjuvant therapies, and the management of unresectable ...

lung cancer

Narjust Duma, MD, on Advanced NSCLC: Reducing Racial Disparities in Outcomes

Narjust Duma, MD, of Dana-Farber Cancer Institute, discusses the many factors that lead to poorer outcomes in lower-income and minority patients with advanced non–small cell lung cancer and the urgent need to address these disparities and physician bias. Women of color and other minority patients are less likely to be offered lung cancer screening; participation in clinical trials; referral to palliative and hospice care services; or genome sequencing of their tumors.

lung cancer

Mirek Fatyga, PhD, on NSCLC: New Data on Stereotactic Body Radiotherapy vs Conventionally Fractionated Radiotherapy

Mirek Fatyga, PhD, of Mayo Clinic Arizona, discusses his findings on overall survival in patients with locally advanced non–small cell lung cancer who are treated with stereotactic body radiotherapy or conventionally fractionated radiotherapy. He notes that a high dose of > 50 Gy to the right-superior portion of the heart likely affects its conduction system. A low dose of < 5 Gy to the inferior segments of the heart may also cause heart damage and toxicity through blood irradiation.  

Lung Cancer
Immunotherapy

Sugemalimab After Concurrent or Sequential Chemoradiation for Unresectable Stage III NSCLC

In an interim analysis of the Chinese phase III GEMSTONE-301 study reported in The Lancet Oncology, Zhou et al found that the PD-L1 inhibitor sugemalimab prolonged progression-free survival vs placebo in patients with locally advanced unresectable stage III non–small cell lung cancer (NSCLC)...

Lung Cancer
Immunotherapy

PACIFIC Trial: 5-Year Survival Outcomes With Durvalumab After Chemoradiotherapy in Stage III NSCLC

As reported in the Journal of Clinical Oncology by Spigel et al, long-term follow-up of the phase III PACIFIC trial has shown maintained progression-free and overall survival benefits with consolidation durvalumab vs placebo after chemoradiotherapy in unresectable stage III non–small cell lung...

lung cancer

Pranshu Mohindra, MD, MBBS, on NSCLC: Benefits of Intensity-Modulated Proton Therapy–Based Reirradiation

Pranshu Mohindra, MD, MBBS, of the University of Maryland School of Medicine and the Maryland Proton Treatment Center, discusses the largest series to date reporting outcomes for patients with non–small cell lung cancer who were treated with intensity-modulated proton therapy–based reirradiation. According to Dr. Mohindra, this approach yields meaningful and durable local control, as well as prolonged survival, and is an important tool in the management of a difficult-to-treat disease.

Lung Cancer
Immunotherapy

Addition of Sugemalimab to Platinum-Based Chemotherapy for Metastatic Squamous or Nonsquamous NSCLC

In the Chinese phase III GEMSTONE-302 trial reported in The Lancet Oncology, Caicun Zhou, MD, and colleagues found that the addition of the PD-L1 inhibitor sugemalimab to platinum-based chemotherapy improved progression-free survival in the first-line treatment of metastatic squamous or nonsquamous ...

Lung Cancer
COVID-19

TERAVOLT Study Identifies Seven Factors That Increase Mortality Risk for Patients With Lung Cancer Infected With COVID-19

The risk of death for patients with SARS–CoV-2 infection and thoracic cancer is based on seven major determinants, according to research published by Alessio Cortellini, MD, in the Journal of Thoracic Oncology. TERAVOLT Data The researchers analyzed data from the Thoracic Cancers International...

Lung Cancer
Immunotherapy

Trastuzumab, Pertuzumab, and Docetaxel for Advanced HER2-Mutant NSCLC

In a French phase II trial (IFCT-1703-R2D2) reported in the Journal of Clinical Oncology, Julien Mazieres, MD, PhD, and colleagues found that the combination of trastuzumab, pertuzumab, and docetaxel produced durable responses in previously treated patients with advanced HER2-mutant non–small cell...

Lung Cancer
Immunotherapy

Addition of Radiotherapy to Durvalumab Plus Tremelimumab in Patients With Metastatic NSCLC Refractory to PD-1/PD-L1 Inhibitor Therapy

In a phase II trial reported in The Lancet Oncology, Jonathan Schoenfeld, MD, and colleagues found that the addition of low-dose or hypofractionated radiotherapy to durvalumab plus tremelimumab did not improve objective response rates in patients with metastatic non–small cell lung cancer (NSCLC)...

supportive care
lung cancer

Carolyn Presley, MD, on Dementia in Patients Treated for Thoracic Cancer

Carolyn Presley, MD, of The Ohio State University, discusses the differences between “chemo brain,” cognitive aging, and dementia in patients with thoracic cancer who are in treatment; how to test for impairment; and the interventions that can improve cognitive changes in survivors.

lung cancer
genomics/genetics

Julia Rotow, MD, on Patient Selection in Treating Thoracic Cancers: Looking to Driver Mutations and Biomarkers

Julia Rotow, MD, of Dana-Farber Cancer Institute, discusses an education session she conducted on mutations and biomarkers in thoracic cancers, including PD-L1, a continuous variable, with the greatest benefit to treatment being associated with very high levels of PD-L1 tissue polypeptide-specific antigen. Dr. Rotow also discusses STK11 mutations, which may be associated with reduced benefit to immune checkpoint inhibitor therapy, though further study is needed.

Lung Cancer

Cancer Has Made Me a Risk-Taker, and That’s Good

In 2017, I was caring for my brother, who was suffering from respiratory failure due to complications from cerebral palsy, and working full-time as a registered nurse. I was feeling overwhelmed and exhausted all the time. I was also losing weight at an alarming rate—more than 70 pounds in just a...

Lung Cancer
Immunotherapy

Adjuvant Atezolizumab in IMpower010: Moving the Needle in Early-Stage NSCLC

Adjuvant platinum-based chemotherapy for early-stage non–small cell lung cancer (NSCLC) is currently almost an afterthought and is taken for granted as a standard of care for patients with stage II to IIIA NSCLC after resection. The earliest meta-analysis, published in 1995,1 gave the first hint of ...

Immunotherapy
Lung Cancer

Adjuvant Atezolizumab Improves Disease-Free Survival Following Adjuvant Chemotherapy in PD-L1–Positive Resected Stage II–IIIA NSCLC

As reported in The Lancet by ­Enriqueta Felip, MD, of Vall d’Hebron University Hospital, Barcelona, and colleagues, the phase III IMpower010 trial has shown improved disease-free survival with adjuvant atezolizumab vs best supportive care in the predefined population of patients with resected stage ...

Lung Cancer
Immunotherapy

Promise and Need for More Progress in Treatment of Squamous Cell NSCLC

A greater understanding of the mutational landscape in non–small cell lung cancer (NSCLC) has identified key oncogenes, such as EGFR, ALK, ROS, RET, and BRAF, among others. These discoveries, coupled with the availability of specific targeted small-molecule inhibitors, have transformed the...

Lung Cancer
Immunotherapy

T-DXd for Previously Treated Patients With Metastatic HER2-Mutant NSCLC

In the phase II DESTINY-Lung01 trial reported in The New England Journal of Medicine, Bob T. Li, MD, PhD, MPH, and colleagues found that fam-trastuzumab deruxtecan-nxki (T-DXd) showed durable activity in patients with metastatic HER2-mutant non–small cell lung cancer (NSCLC) refractory to standard...

Lung Cancer

Personalized Lung Cancer Risk Assessment Using a Blood-Based Biomarker Panel

In a study reported in the Journal of Clinical Oncology, Fahrmann et al found that a four-component blood-based biomarker panel showed predictive ability for the development of lung cancer. Prediction was improved when the panel was used in conjunction with the Prostate, Lung, Colorectal and...

Lung Cancer
Immunotherapy

Durvalumab/Tremelimumab With or Without Radiotherapy in Resistant NSCLC

In a recent phase II clinical trial, the combination of the PD-L1 inhibitor durvalumab and the CTLA-4 inhibitor tremelimumab curtailed tumor growth in some patients with non–small cell lung cancer (NSCLC) that was resistant to a single immunotherapy agent. The addition of radiation therapy to the...

Lung Cancer

Trends in Population-Level Stage Shift and Mortality Among U.S. Patients With NSCLC: 2006–2016

In a retrospective cohort study reported in JAMA Network Open, Raja Flores, MD, and colleagues found that a population-level shift to earlier-stage diagnosis has been accompanied by a reduction in population-level mortality during recent years in U.S. patients with non–small cell lung cancer...

Lung Cancer

Smoking Cessation After Lung Cancer Diagnosis May Improve Overall Survival

Patients with lung cancer who quit smoking after their diagnosis experienced improvement in their overall survival compared to patients who continued smoking after diagnosis, according to results from a meta-analysis published by Caini et al in the Journal of Thoracic Oncology. Researchers led by...

Lung Cancer

Comparison of Efficiency of USPSTF vs PLCO Criteria in Determining Eligibility for Lung Cancer Screening

In an interim analysis of a prospective cohort study reported in The Lancet Oncology, Tammemägi et al found that the Prostate Lung Colorectal and Ovarian Cancer Screening Trial 2012 risk prediction model (PLCOm2012) may be more efficient than U.S. Preventive Services Task Force 2013 (USPSTF2013)...

Lung Cancer

Postoperative Radiotherapy for Patients With Completely Resected Stage IIIA NSCLC and N2 Involvement

In the European phase III Lung ART trial reported in The Lancet Oncology, Le Pechoux et al found that three-dimensional (3D) conformal postoperative radiotherapy (PORT) did not improve disease-free survival vs no PORT in patients with stage IIIA N2 non–small cell lung cancer (NSCLC) who had...

Lung Cancer
Genomics/Genetics

Expert Point of View: Myung-Ju Ahn, MD, PhD

Myung-Ju Ahn, MD, PhD, Professor in the Department of Hematology and Oncology at Samsung Medical Center, Sungkyunkwan University School of Medicine, South Korea, said the novel regimen of sintilimab, IBI305, and chemotherapy is a promising approach in EGFR-mutated nonsquamous non–small cell lung...

Lung Cancer
Genomics/Genetics

ORIENT-31: Novel Four-Drug Regimen Evaluated in EGFR-Mutated NSCLC

A four-drug combination of the anti–PD-1 antibody sintilimab, the bevacizumab biosimilar IBI305, plus pemetrexed and cisplatin chemotherapy significantly improved progression-free survival compared with chemotherapy alone in patients with advanced nonsquamous non–small cell lung cancer (NSCLC) with ...

Lung Cancer

Addition of First-Line Veliparib to Chemotherapy in Advanced Squamous Cell NSCLC: No Survival Benefit in Current Smokers, but Potential Benefit Among Biomarker-Selected Patients

In a phase III trial reported in the Journal of Clinical Oncology, Suresh S. Ramalingam, MD, of Winship Cancer Institute, Emory University School of Medicine, and colleagues found that the addition of the PARP inhibitor veliparib to platinum-based chemotherapy did not improve overall survival in...

Lung Cancer

I’m Living—and Thriving—With Stage IV Non–Small Cell Lung Cancer

A diagnosis, in 2020, of stage IV adenocarcinoma non–small cell lung cancer (NSCLC) was found accidentally. I was 55 at the time and in the best physical shape of my life. I had spent the previous year and a half on a diet and exercise regimen that had rendered me 35 pounds lighter and feeling...

Lung Cancer

Atezolizumab in Adjuvant Therapy for PD-L1–Positive NSCLC

On October 15, 2021, atezolizumab was approved for adjuvant treatment following resection and platinum-based chemotherapy in patients with stage II to IIIA non–small cell lung cancer (NSCLC) with PD-L1 expression on ≥ 1% of tumor cells, as determined by a U.S. Food and Drug Administration...

Lung Cancer

Update on the Incidence of NSCLC: Focus on Need to Implement Widescale Screening

Recent articles in JAMA Oncology focused on lung cancer and screening strategies. Apar Kishor Ganti, MD, MS, of the University of Nebraska Medical Center, Omaha, and colleagues provided updated data on non–small cell lung cancer (NSCLC) incidence, prevalence, and stage through 2017.1 Sylvia K....

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