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solid tumors
leukemia
lung cancer
lymphoma

FDA Pipeline: Priority Reviews in Solid Tumors and Lymphoma; Plus an sNDA in Acute Myeloid Leukemia

Over the past week, the U.S. Food and Drug Administration (FDA) granted multiple Priority Reviews and accepted a supplemental new drug application: Priority Review for Entrectinib in NTRK Fusion–Positive Solid Tumors and Metastatic, ROS1-Positive NSCLC This week, the FDA accepted new drug...

Lung Cancer

No Survival Benefit With Avelumab vs Docetaxel in Platinum-Treated, Advanced, PD-L1–Positive NSCLC

As reported in The Lancet Oncology by Fabrice Barlesi, MD, and colleagues, the phase III JAVELIN Lung 200 trial has shown no overall survival benefit with avelumab vs docetaxel in patients with platinum pretreated programmed cell death ligand 1 (PD-L1)–positive advanced non–small cell lung cancer ...

lung cancer
issues in oncology

System-Based Intervention to Reduce Racial Disparities in Early-Stage Lung Cancer Treatment

Results from a study published by Cykert et al in Cancer Medicine showed that a pragmatic system-based intervention within cancer treatment centers may eliminate existing disparities in treatment and outcomes for black patients with early-stage lung cancer. “These results show ...

Lung Cancer
Pain Management

Opioid Use Following Thoracoscopic Surgery in Early-Stage Lung Cancer

In a study reported in a research letter in JAMA Oncology, Stephanie Tuminello, MPH, and colleagues found that video-assisted thoracoscopic surgery (VATS) was less likely than open resection to be associated with long-term opioid use in patients undergoing surgery for early-stage lung cancer....

Lung Cancer

Lorlatinib Shows Overall and Intracranial Activity in ALK-Positive NSCLC

IN A GLOBAL phase II study reported in The Lancet Oncology, Benjamin J. Solomon, MBBS, of Peter MacCallum Cancer Centre, Melbourne, and colleagues found that lorlatinib showed high overall and intracranial activity in patients with advanced ALK-positive non–small cell lung cancer (NSCLC) who were...

Lung Cancer

Encourage Lung Cancer Screening to Prevent Early Deaths

Discussions of benefits and harms from screening of high-risk populations for lung cancer have missed the point. The National Lung Screening Trial (NLST) showed an early and statistically significant major benefit in all-cause mortality from computed tomography (CT) screening.1 Those referred for...

lung cancer
issues in oncology

Multiethnic Cohort Study Update on Racial/Ethnic Differences in Lung Cancer Incidence

In an update from the Multiethnic Cohort Study reported in the Journal of the National Cancer Institute, Stram et al found persistent racial/ethnic differences in risk for lung cancer at similar levels of cigarette smoking intensity. A prior report from the study found that African Americans and...

lung cancer

Clonal MET Amplification and Tyrosine Kinase Inhibitor Treatment Outcome in EGFR-Mutant NSCLC

In a Singaporean study reported in the Journal of Clinical Oncology, Lai et al found that tyrosine kinase inhibitor treatment outcome did not differ according to mesenchymal epithelial transition factor (MET)-high vs MET-low status in treatment-naive, EGFR-mutant non–small cell lung cancer...

lung cancer

Genomic Classification of Lung Cancers Diagnosed in Patients From Appalachian Kentucky

Squamous cell carcinoma of the lung represents approximately one-quarter (26.4%) of all lung cancers diagnosed in Appalachian Kentucky, where death from lung cancer is higher than the national average. Researchers sought to characterize genetic alterations specifically found in lung squamous cell...

Lung Cancer

Progress With ALK Inhibitors: When Will We Consider ALK-Positive Lung Cancer a ‘Chronic Disease’?

As reported by Solomon et al in The Lancet Oncology1 and reviewed in this issue of The ASCO Post, results from a global phase II study of the third-generation ALK inhibitor lorlatinib showed a high overall response rate and high intracranial response rate for patients with advanced ALK-positive...

lung cancer
immunotherapy

Lung-MAP Precision Medicine Trial Expands

The Lung Cancer Master Protocol (Lung-MAP), the first precision medicine trial in lung cancer supported by the National Cancer Institute (NCI), is undergoing a major expansion to include patients with all non–small cell lung cancers (NSCLCs). The trial previously tested treatments for people ...

lung cancer
immunotherapy

Nivolumab or Nivolumab Plus Ipilimumab in Relapsed Malignant Pleural Mesothelioma

In a French phase II trial reported in The Lancet Oncology, Scherpereel et al found evidence of activity with nivolumab or the combination of nivolumab plus ipilimumab in patients with relapsed malignant pleural mesothelioma. Study Details In the open-label, noncomparative trial, 125 patients...

lung cancer
immunotherapy

Avelumab in Previously Treated Advanced Unresectable Mesothelioma

In a phase Ib trial reported in JAMA Oncology, Hassan et al found that the anti–programmed cell death ligand 1 antibody avelumab produced durable responses and a high rate of disease control in some patients with advanced unresectable mesothelioma progressing after platinum and pemetrexed...

lung cancer

FDA Expands Pemetrexed Label With Combination of Pembrolizumab and Platinum Chemotherapy for the First-Line Treatment of Metastatic Nonsquamous NSCLC

Today, the U.S. Food and Drug Administration (FDA) granted approval for a new indication for pemetrexed (Alimta) for injection in combination with pembrolizumab (Keytruda) and platinum chemotherapy for the first-line treatment of patients with metastatic nonsquamous non–small cell...

lung cancer
lymphoma
skin cancer

FDA Pipeline: Updates on Treatments in NSCLC and Lymphomas, Plus New Dosimetry Software

The U.S. Food and Drug Administration (FDA) recently granted the following application, designations, and clearance: sBLA for Atezolizumab Plus Chemotherapy for First-Line Treatment of Metastatic, Nonsquamous NSCLC On January 17, the FDA accepted a supplemental biologics license application...

Immunotherapy
Lung Cancer

PACIFIC Trial of Durvalumab Sets Standard in Stage III Unresectable NSCLC

IMMUNOTHERAPY HAS revolutionized the treatment of lung cancer over the past several years. Although lung cancer is associated with immunosuppression at baseline for most patients, the addition of immune checkpoint inhibitors can overcome that suppression and lead to antitumor immune responses....

health-care policy
lung cancer

Shared Decision-Making and Use of Low-Dose CT Screening for Lung Cancer

In a study reported in a research letter in JAMA Internal Medicine, Goodwin et al found that only a small proportion of Medicare enrollees undergoing low-dose computed tomography (CT) screening for lung cancer had a prescreening shared decision-making session, which is mandated by the Centers for...

lung cancer
immunotherapy

Updated Survival Analysis of KEYNOTE-024: Pembrolizumab vs Platinum-Based Chemotherapy in Previously Untreated, Advanced NSCLC

As reported in the Journal of Clinical Oncology by Reck et al, an updated analysis of the phase III KEYNOTE-024 trial indicates continued overall survival benefit of first-line pembrolizumab vs platinum-based chemotherapy in patients with advanced non–small cell lung cancer (NSCLC) with a...

lung cancer

Transformation of EGFR-Mutant NSCLC to SCLC

In a study reported in the Journal of Clinical Oncology, Marcoux et al provided further evidence that EGFR-mutant non–small cell lung cancer (NSCLC) can undergo transformation to small cell lung cancer (SCLC) and identified factors associated with such transformation. It has been estimated...

Lung Cancer

Lorlatinib in Second- or Third-Line Treatment of ALK-Positive Metastatic Non–Small Cell Lung Cancer

On November 2, 2018, lorlatinib (Lorbrena) was granted accelerated approval for the treatment of patients with ALK-positive metastatic non–small cell lung cancer (NSCLC) whose disease has progressed on crizotinib (Xalkori) and at least one other ALK inhibitor for metastatic disease or whose disease ...

Lung Cancer

New Data Reported From International Studies of Lung Cancer Treatment

At the European Society for Medical Oncology (ESMO) 2018 Congress, important studies were presented for every cancer type. Here, The ASCO Post offers some snapshots of lung cancer studies that may inform approaches to treating this common cancer, which—despite the advances in recent years—remains...

Lung Cancer
Immunotherapy

Durvalumab Improves Overall Survival After Chemoradiotherapy in Unresectable, Stage III NSCLC

AS REPORTED in The New England Journal of Medicine by Scott J. Antonia, MD, PhD, of H. Lee Moffitt Cancer Center and Research Institute, and colleagues, the phase III PACIFIC trial has shown significantly improved overall survival, a coprimary endpoint, with the programmed cell death ligand 1...

Lung Cancer

Priority Review for Atezolizumab in Combination With Chemotherapy for Small Cell Lung Cancer

The U.S. Food and Drug Administration (FDA) accepted a supplemental biologics license application (sBLA) and granted Priority Review for atezolizumab (Tecentriq) in combination with carboplatin and etoposide for the first-line treatment of patients with extensive-stage small cell lung cancer. The...

lung cancer
immunotherapy

ESMO Immuno-Oncology 2018: Second-Line Nivolumab vs Chemotherapy in SCLC

Treatment with nivolumab (Opdivo) did not improve response rates or survival over standard chemotherapy in patients with metastatic small cell lung cancer (SCLC) who relapsed following first-line treatment, according to findings presented by Reck et al at the European Society for Medical...

lung cancer
immunotherapy

ESMO Immuno-Oncology 2018: OAK Trial: Fast Progression in Patients With NSCLC Treated With Atezolizumab vs Chemotherapy

Overall survival (OS) was improved across all subgroups of patients with non–small cell lung cancer (NSCLC) who received atezolizumab (Tecentriq) compared with chemotherapy, including poor prognostic factors that were evaluated in an analysis of data from the OAK trial. Additionally, this...

Lung Cancer

Low-Dose CT Lung Screening: New Developments Support Increased Quality, More Data, Deep Learning

Two years ago, Rick Avila, MS, Chief Executive Officer (CEO) of Accumetra, LLC, was using rolls of Scotch tape as a research tool. The Scotch tape was a phantom, or reference object, and his company was working with computed tomography (CT) lung screening sites around the world to determine the...

lung cancer
immunotherapy

ESMO Immuno-Oncology 2018: MYSTIC: First-Line Durvalumab With or Without Tremelimumab in Metastatic NSCLC

First-line immunotherapy with durvalumab (Imfinzi) or the combination of durvalumab and tremelimumab does not improve overall survival in unselected patients with lung cancer, according to late-breaking results from the MYSTIC trial presented by Rizvi et al at the European Society for Medical...

lung cancer
immunotherapy

ESMO Immuno-Oncology 2018: KEYNOTE-010: Long-Term Treatment With Pembrolizumab in Previously Treated NSCLC

Patients with previously treated, advanced non–small cell lung cancer (NSCLC) who received pembrolizumab (Keytruda) showed significantly longer overall survival (OS) compared to those treated with docetaxel, Herbst et al reported at the ESMO Immuno-Oncology Congress 2018 in Geneva,...

lung cancer

Addition of Veliparib to Cisplatin/Etoposide in Extensive-Stage SCLC

In the phase II ECOG-ACRIN 2511 trial reported in the Journal of Clinical Oncology, Owonikoko et al found that the addition of the poly (ADP ribose) polymerase (PARP) inhibitor veliparib to cisplatin/etoposide was associated with a modest but statistically significant improvement in...

lung cancer

SELECT Trial: Adjuvant Erlotinib in Resected EGFR-Mutant NSCLC

In a phase II trial reported in the Journal of Clinical Oncology, Pennell et al found that adjuvant erlotinib (Tarceva) improved disease-free survival over historical controls in patients with resected EGFR-mutant non­–small cell lung cancer (NSCLC).  In the study, 100 patients with ...

breast cancer
solid tumors
leukemia
lung cancer
lymphoma
multiple myeloma
issues in oncology
immunotherapy

FDA Pipeline: New Priority Reviews, Designations, and Clearances, Plus Statements on Genetic Testing and Class Labeling

The U.S. Food and Drug Administration (FDA) recently issued the following new approvals and designations: Priority Review for Atezolizumab in Combination With Chemotherapy for the Initial Treatment of Extensive-Stage SCLC The FDA accepted a supplemental biologics license application...

Lung Cancer

Expert Point of View: Catherine C. Park, MD, FASTRO

DISCUSSANT OF the abstract, Catherine C. Park, MD, FASTRO, Professor and Chair of the Department of Radiation Oncology at the University of California, San Francisco, expressed excitement about this study’s results, which suggest the possibility of curing patients with stage IV disease. “We’re...

Lung Cancer

Local Consolidative Therapy Associated With Survival Benefit for Some With Oligometastatic NSCLC

FOR A SUBSET of patients with stage IV lung cancer, aggressive treatment may improve overall survival, according to data presented at the 2018 Annual Meeting of the American Society for Radiation Oncology (ASTRO).1 The results of the phase II study showed that with long-term follow-up, local...

lung cancer
immunotherapy

FDA Approves Atezolizumab in Combination With Bevacizumab and Chemotherapy for First-Line Treatment of Metastatic, Nonsquamous NSCLC

On December 6, 2018, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq) in combination with bevacizumab (Avastin), paclitaxel, and carboplatin for the first-line treatment of patients with metastatic, nonsquamous non–small cell lung cancer (NSCLC) with no EGFR or...

Solid Tumors
Lung Cancer

Bonnie J. Addario Lung Cancer Foundation Honors Investigators, Clinicians, Caregivers

The Bonnie J. Addario Lung Cancer Foundation (ALCF) recognized outstanding contributors in research, treatment, and caregiving at its Simply the Best Dinner and Gala, which took place recently in San Francisco. The annual event is a celebration of survivors, hope, and determination that brings...

Breast Cancer
Solid Tumors
Lung Cancer

A Diagnosis of Li-Fraumeni Syndrome Has Focused My Life Direction

Despite the fact that I had to have open heart surgery at age 7 to fix a congenital heart defect and then more surgery, chemotherapy, and radiation therapy to treat a diagnosis of rhabdomyosarcoma a year later, I never felt like I was a sick kid. Children don’t have the existential worries about...

Lung Cancer

Pembrolizumab With Chemotherapy for First-Line Treatment of Metastatic Nonsquamous NSCLC

On August 20, 2018, pembrolizumab (Keytruda) in combination with pemetrexed (Alimta) and platinum was granted regular approval as first-line treatment of patients with metastatic nonsquamous non–small cell lung cancer (NSCLC) with no epidermal growth factor receptor (EGFR) or anaplastic lymphoma...

Lung Cancer

Nivolumab for Third-Line Treatment of Metastatic Small Cell Lung Cancer

ON AUGUST 16, 2018, nivolumab (Opdivo) was granted accelerated approval for treatment of patients with metastatic small cell lung cancer (SCLC) with disease progression after platinum-based chemotherapy and at least one other line of therapy.1,2 Supporting Efficacy Data APPROVAL WAS BASED on...

Lung Cancer

Lung Cancer Researcher Melissa Johnson, MD, Benefits From Father’s Perspective as Career Military Officer

Lung cancer researcher Melissa Johnson, MD, is a self-described “military brat,” whose father was a career officer in the Marine Corps, serving for more than 35 years. She was born in Oklahoma City and moved nine times during her childhood. When Dr. Johnson was in high school, her father was...

Lung Cancer

Dacomitinib for Metastatic EGFR-Mutant NSCLC

On September 27, 2018, dacomitinib (Vizimpro) received approval for the first-line treatment of patients with metastatic non–small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) exon 19 deletion or exon 21 L858R substitution mutations, as detected by a test approved by the...

Lung Cancer

FDA Approves Lorlatinib for Second- or Third-Line Treatment of ALK-Positive Metastatic NSCLC

On November 2, 2018, the U.S. Food and Drug Administration granted accelerated approval to lorlatinib (Lorbrena) for patients with anaplastic lymphoma kinase (ALK)-positive metastatic non–small cell lung cancer (NSCLC) whose disease has progressed on crizotinib (Xalkori) and at least one other ALK ...

lung cancer

Lorlatinib Shows Overall and Intracranial Activity in ALK-Positive NSCLC

In a global phase II study reported in The Lancet Oncology, Solomon et al found that lorlatinib (Lorbrena) showed high overall and intracranial activity in patients with advanced ALK-positive non–small cell lung cancer (NSCLC) who were treatment-naive or who had received crizotinib (Xalkori)...

Lung Cancer

Lung Cancer Screening: Proven Effective but Still Fighting for Acceptance

In 2010, the long-awaited findings from the National Lung Screening Trial (NLST) revealed that participants who received low-dose helical computed tomography (CT) scans had a 15% to 20% lower risk of dying of lung cancer than participants who received standard chest x-rays. In response, the U.S....

lung cancer

CONVERT Trial: Concurrent Chemoradiotherapy to Treat Elderly Patients With Limited-Stage SCLC

Elderly patients with limited-stage small cell lung cancer (SCLC) showed similar survival and toxicity compared to younger patients when treated with concurrent chemoradiotherapy. These study findings were published by Christodoulou et al in the Journal of Thoracic Oncology. SCLC constitutes ...

Immunotherapy
Lung Cancer

Corticosteroids and Immunotherapy: Guilty or Guilt By Association?

FIRST-LINE TREATMENT options for advanced non–small cell lung cancer (NSCLC) include single- agent immunotherapy for patients with a programmed cell death ligand 1 (PD-L1) tumor proportion score of at least 50% or in combination with chemotherapy in unselected patients.1-3 Single immunotherapy is...

Lung Cancer
Immunotherapy

Corticosteroid Use at Start of PD-1/PD-L1 Inhibitor Therapy Affects Outcomes in NSCLC

IN A STUDY reported in the Journal of Clinical Oncology, Kathryn C. Arbour, MD, of Memorial Sloan Kettering Cancer Center, and colleagues found that baseline treatment with corticosteroids was associated with poorer efficacy of programmed cell death protein 1/programmed cell death ligand 1...

Lung Cancer
Immunotherapy

Atezolizumab Plus Chemotherapy Improves Outcomes in Small Cell Lung Cancer

ATEZOLIZUMAB (TECENTRIQ), an anti–program cell death ligand 1 (PD-L1) antibody, combined with carboplatin/ etoposide as first-line treatment for extensive-stage small-cell lung cancer (SCLC) improved overall and progression-free survival and may represent a new standard of care, according to...

Issues in Oncology
Lung Cancer

Adding the Patient’s Voice to Collaborative Clinical Trial Efforts

THE INTERNATIONAL Association for the Study of Lung Cancer (IASLC) 19th World Conference on Lung Cancer was the largest in its history. One of the key themes of the meeting was to focus on the patient. Here are highlights of presentations from this conference that demonstrate the role of the...

Lung Cancer

Expert Point of View: Fiona Blackhall, MD, PhD

FORMAL STUDY discussant, Fiona Blackhall, MD, PhD, of the University of Manchester, UK, welcomed brigatinib (Alunbrig) as a new first-line option for ALK-positive patients but said, “In the absence of comparisons of next-generation ALK inhibitors, it will take some time to determine if there is...

Lung Cancer

Brigatinib Improves Outcomes Over Crizotinib in ALK-Positive Non–Small Cell Lung Cancer

THE FIRST-LINE USE of brigatinib (Alunbrig) was superior to standard-of-care crizotinib (Xalkori) in patients with advanced anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC), according to the first report of the phase III ALTA-1L trial presented at the International...

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