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Lung Cancer

Expert Point of View: John Heymach, MD

"TO PUT THESE RESULTS into context, currently we have three approved epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors for EGFR-positive non–small cell lung cancer (NSCLC): gefitinib (Iressa), erlotinib (Tarceva), and afatinib (Gilotrif). Not many studies have compared these drugs ...

Lung Cancer

Dacomitinib Outperforms Gefitinib in EGFR-Positive NSCLC

DACOMITINIB, a second-generation epidermal growth factor receptor (EGFR)-targeted tyrosine kinase inhibitor, outperformed gefitinib (Iressa) as first-line treatment for EGFR-positive advanced non–small cell lung cancer (NSCLC) in the phase III ARCHER 1050 study.1 Dacomitinib improved...

lung cancer

European Commission Expands Use of Ceritinib for First-Line Use in ALK-Positive Advanced NSCLC

On June 29, the European Commission approved expanding the use of ceritinib (Zykadia) to include the first-line treatment of patients with advanced non–small cell lung cancer (NSCLC) whose tumors are anaplastic lymphoma kinase (ALK)–positive. Approval follows a positive opinion granted...

lung cancer

First-Line Nivolumab vs Chemotherapy in Advanced NSCLC With PD-L1 Expression ≥ 5%

As reported by Carbone et al in The New England Journal of Medicine, the phase III CheckMate 026 trial has shown no progression-free survival benefit for first-line nivolumab (Opdivo) vs platinum-based chemotherapy in patients with recurrent or stage IV non–small cell lung cancer with...

lung cancer

FDA Grants Regular Approval to Dabrafenib and Trametinib Combination for Metastatic NSCLC With BRAF V600E Mutation

On June 22, 2017, the U.S. Food and Drug Administration granted regular approvals to dabrafenib (Tafinlar) and trametinib (Mekinist) administered in combination for patients with metastatic non–small cell lung cancer (NSCLC) with BRAF V600E mutation as detected by an FDA-approved test. These ...

lung cancer

Atezolizumab as First-Line or Subsequent Treatment in PD-L1–Selected Advanced NSCLC

In the phase II BIRCH trial, atezolizumab (Tecentriq) was found to produce higher response rates as first-line or subsequent therapy in patients with advanced non–small cell lung cancer (NSCLC) with higher levels of programmed cell death ligand 1 (PD-L1) expression. Study findings were...

Lung Cancer

Expert Point of View: John V. Heymach, MD, PhD

“This is a watershed moment in the treatment of anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC). Often studies show only incremental improvements with a new treatment. This is different. Alectinib [Alecensa] shows a dramatic increase in efficacy that is also accompanied ...

Lung Cancer

Alectinib vs Crizotinib in First-Line Treatment of ALK-Positive NSCLC

In 2011, crizotinib (Xalkori) became the first effective targeted therapy for anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC). Now data from a phase III trial show that alectinib (Alecensa), a second-generation ALK inhibitor, outperformed crizotinib, the current...

lung cancer

Ceritinib vs Chemotherapy in Previously Treated ALK-Rearranged NSCLC

The phase III ASCEND-5 trial has shown a significant improvement in progression-free survival with ceritinib (Zykadia) vs chemotherapy in advanced ALK-rearranged non–small cell lung cancer (NSCLC) previously treated with crizotinib (Xalkori) and chemotherapy. Trial results were reported in...

lung cancer

ASTRO Issues Guideline for Use of Stereotactic Radiation in Early-Stage Lung Cancer

The American Society for Radiation Oncology (ASTRO) has issued a new clinical guideline for the use of stereotactic body radiation therapy (SBRT) in early-stage lung cancer. While SBRT is the current standard of care for peripherally located tumors in patients who cannot undergo surgery, the new...

lung cancer

Sacituzumab Govitecan in Previously Treated Patients With Metastatic NSCLC

As reported by Heist et al in the Journal of Clinical Oncology, the antibody-drug conjugate sacituzumab govitecan showed activity in patients with previously treated metastatic non–small cell lung cancer (NSCLC). Sacituzumab targets Trop-2, present on many solid tumors; govitecan is the...

Lung Cancer

Atezolizumab: Another Therapeutic Option for Patients With Previously Treated Non–Small Cell Lung Cancer

The OAK study—recently reported by Rittmeyer and colleagues and reviewed in this issue of The ASCO Post—is the first study to show patients with previously treated non–small cell lung cancer (NSCLC) treated with a humanized antibody (atezolizumab, Tecentriq) directed against the programmed cell...

Lung Cancer

Atezolizumab Improves Overall Survival vs Docetaxel in Previously Treated Non–Small Cell Lung Cancer

In the phase III OAK trial reported in The Lancet by Achim Rittmeyer, MD, of Lungenfachklinik Immenhausen, Germany, and colleagues, treatment with the anti–programmed cell death ligand 1 (PD-L1) antibody atezolizumab (Tecentriq) improved overall survival vs docetaxel in previously treated non–small ...

lung cancer
colorectal cancer

David H. Henry, MD, on Advances in Lung Cancer, Colorectal Cancer: Expert Perspective

David H. Henry, MD, of Pennsylvania Oncology Hematology Associates, outlines abstracts focusing on chemotherapy in locally advanced rectal cancer and immune-related toxicity, response to anti–PD-L1 blockade, and epacadostat plus pembrolizumab in lung cancer.

Lung Cancer

Combination Therapy With Pembrolizumab in Metastatic Nonsquamous NSCLC

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs.  On May 10, 2017, pembrolizumab (Keytruda) was granted accelerated...

Lung Cancer

FDA Broadens Ceritinib Indication

On May 26, 2017, the U.S. Food and Drug Administration (FDA) granted regular approval to ceritinib (Zykadia), a kinase inhibitor for patients with metastatic non–small cell lung cancer (NSCLC) whose tumors are anaplastic lymphoma kinase (ALK)-positive as detected by an FDA-approved test. In April...

lung cancer

Arnaud Scherpereel, MD, PhD, on Mesothelioma: Results From the IFCT-1501 MAPS2 Trial (French Language Version)

Arnaud Scherpereel, MD, PhD, of the University Hospital of Lille, discusses in French phase II study findings on second- or third-line nivolumab vs nivolumab plus ipilimumab in malignant pleural mesothelioma patients. (Abstract LBA8507)

lung cancer

Arnaud Scherpereel, MD, PhD, on Mesothelioma: Results From the IFCT-1501 MAPS2 Trial

Arnaud Scherpereel, MD, PhD, of the University Hospital of Lille, discusses phase II study findings on second- or third-line nivolumab vs nivolumab plus ipilimumab in malignant pleural mesothelioma patients. (Abstract LBA8507)

lung cancer

Alice Tsang Shaw, MD, PhD, and Tony Mok, MD, on NSCLC: Results From the ALEX and ARCHER 1050 Trials

Alice Tsang Shaw, MD, PhD, of Massachusetts General Hospital, and Tony Mok, MD, of the Chinese University of Hong Kong, discuss their two ASCO-featured abstracts on non–small cell lung cancer: alectinib vs crizotinib in treatment-naive advanced ALK+ disease, and dacomitinib vs gefitinib for first-line treatment of advanced EGFR+ disease. (Abstracts LBA9008 and LBA9007)

lung cancer

ALEX Trial: Alectinib vs Crizotinib in Untreated Advanced ALK-Positive NSCLC

As reported at the recent ASCO Annual Meeting and in The New England Journal of Medicine by Peters et al, the phase III ALEX trial has shown improvement in progression-free survival with alectinib (Alecensa) vs crizotinib (Xalkori) in the first-line treatment of advanced ALK-positive...

Lung Cancer

Expert Point of View: Trever Bivona, MD, PhD

“The results of this trial are promising but need to be reproduced in the United States and other countries before clear recommendations can be made. There are adjuvant studies such as ALCHEMIST underway to test this strategy in U.S. patients,” said Trever Bivona, MD, PhD, Associate Professor of...

Lung Cancer

Adjuvant Gefitinib Delays Recurrence in EGFR-Positive NSCLC

Adjuvant therapy with gefitinib (Iressa), an epidermal growth factor receptor (EGFR)-targeted agent, was more successful at preventing recurrence than standard-of-care chemotherapy, in a phase III study of patients with EGFR-positive non–small cell lung cancer (NSCLC).1 Gefitinib extended...

lung cancer

Effect of Previous Radiotherapy on Outcome With Pembrolizumab in NSCLC

In a single-site experience reported in The Lancet Oncology by Shaverdian et al, patients with advanced non–small cell lung cancer (NSCLC) in the phase I KEYNOTE-001 trial of pembrolizumab (Keytruda) were found to have better outcomes if they had received prior radiotherapy. Study Details...

lung cancer

ASCO 2017: Research Suggests Possible New Treatment for EGFR-Positive Lung Cancer

Findings from a phase III clinical trial point to a potential new treatment for patients newly diagnosed with advanced, epidermal growth factor receptor (EGFR)-positive non–small cell lung cancer (NSCLC). Compared to the EGFR inhibitor gefitinib (Iressa), one of the standard targeted...

lung cancer

ASCO 2017: Early Research Suggests First Immunotherapy for Mesothelioma on the Horizon

Malignant pleural mesothelioma is a rare cancer, but its incidence has been rising. This cancer is usually associated with asbestos exposure, and patients have a median life expectancy of only 13 to 15 months. All patients relapse despite initial chemotherapy, more than 50% of them within 6 months...

lung cancer

Solange Peters, MD, PhD, on SCLC: Expert Perspective on CheckMate 032

Solange Peters, MD, PhD, of the University of Lausanne, examines the study findings on nivolumab ± ipilimumab in advanced small cell lung cancer, in the first report of a randomized expansion cohort. (Abstract 8503)

lung cancer

Taofeek K. Owonikoko, MD, PhD, on SCLC: Results of the ECOG-ACRIN 2511 Trial

Taofeek K. Owonikoko, MD, PhD, of Emory University, discusses study findings on cisplatin and etoposide in combination with veliparib or placebo for extensive stage small cell lung cancer. (Abstract 8505)

lung cancer

Matthew D. Hellmann, MD, on SCLC: Results From CheckMate 032

Matthew D. Hellmann, MD, of Memorial Sloan Kettering Cancer Center, discusses study findings on nivolumab ± ipilimumab in advanced small cell lung cancer, in the first report of a randomized expansion cohort. (Abstract 8503)

lung cancer

ASCO 2017: ALEX Study: Alectinib Halts Lung Cancer Growth More Than a Year Longer Than Crizotinib

Findings from a phase III clinical trial point to a more effective initial treatment for patients with ALK-positive non–small cell lung cancer (NSCLC). Compared to the current standard of care, crizotinib (Xalkori), the newer ALK inhibitor alectinib (Alecensa) halted cancer growth for a...

lung cancer
cost of care

Daniel A. Goldstein, MD, on Pembrolizumab for Lung Cancer: Saving Costs by Adjusting Dosage

Daniel A. Goldstein, MD, of Emory University and Rabin Medical Center, discusses his study findings that show nearly $1 billion in savings when patients receive personal weight-based doses instead of a predetermined fixed dose for treatment of PD-L1-positive non–small cell lung cancer. (Abstract 9013)

lung cancer

Taofeek K. Owonikoko, MD, PhD, on SCLC: Results of the ECOG-ACRIN 2511 Trial

Taofeek K. Owonikoko, MD, PhD, of Emory University, discusses study findings on cisplatin and etoposide in combination with veliparib or placebo for extensive stage small cell lung cancer. (Abstract 8505)

lung cancer
issues in oncology

ATS 2017: Among All Cancers, Lung Cancer Appears to Put Patients at Greatest Suicide Risk

A lung cancer diagnosis appears to put patients at the greatest risk of suicide when compared to the most common types of non-skin cancers, according to new research presented at the 2017 American Thoracic Society International Conference (Abstract 8321). Researchers analyzed 3,640,229 patients in ...

lung cancer

Japanese Phase III Trial of Alectinib vs Crizotinib in ALK-Positive NSCLC

The Japanese phase III J-ALEX trial has shown improved progression-free survival with alectinib (Alecensa) vs crizotinib (Xalkori) in ALK inhibitor–naive patients with ALK-positive non–small-cell lung cancer (NSCLC). Results were reported by Hida et al in The Lancet. Study Details In...

lung cancer

FDA Broadens Ceritinib Indication to Previously Untreated ALK-Positive Metastatic NSCLC

On May 26, 2017, the U.S. Food and Drug Administration (FDA) granted regular approval to ceritinib (Zykadia) for patients with metastatic non–small cell lung cancer (NSCLC) whose tumors are anaplastic lymphoma kinase (ALK)-positive as detected by an FDA-approved test. In April 2014,...

Lung Cancer

ASCO President, Bruce E. Johnson, MD, FASCO, Participates in Key Research With EGFR Mutation in Lung Cancer

Bruce E. Johnson, MD, FASCO, 2017–2018 ASCO President, was born in St. Peter, Minnesota, and grew up on a rural dairy farm. “Neither of my parents had college degrees, but working on a dairy farm with them gave me a solid work ethic. I was working outside on the farm before I was 10 years old. In...

Survivorship
Lung Cancer

Precision Medicine and My Own Activism Are Keeping Me Alive

In 2009, I was living my dream. My work as a business development manager for a technology company was thriving; I had a satisfying social life; I was active in sports, especially hiking and biking; and I was involved in social justice causes as a volunteer at San Quentin State Prison, helping...

Lung Cancer

Osimertinib in Metastatic EGFR T790M–Mutant NSCLC After EGFR Inhibitor Therapy

On March 30, 2017, osimertinib (Tagrisso) was granted regular approval for the treatment of patients with metastatic epidermal growth factor receptor (EGFR) T790M–mutant non–small cell lung cancer (NSCLC), as detected by a U.S. Food and Drug Administration (FDA)-approved test, who have progressed...

Lung Cancer

The Ongoing Challenges of Lung Cancer Screening

Lung cancer persistently remains the leading cause of cancer death among men and women in the United States. Only about 15% of lung cancers are diagnosed at the localized stage, when clinical intervention could markedly improve patient outcomes. For decades, lung cancer specialists and advocacy...

Hematologic Malignancies
Breast Cancer
Lung Cancer
Kidney Cancer
Sarcoma
Bladder Cancer
Colorectal Cancer
Multiple Myeloma
Genomics/Genetics

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): 2017 Guidelines

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): 2017 Guidelines In 1996, the National Comprehensive Cancer Network® (NCCN®) published its first set of Clinical Practice Guidelines in Oncology®, covering 8 tumor types. Guidelines are now published for more than 60 tumor types and...

Lung Cancer

Lung Cancer: Hope From Science

The following essay by Paul A. Bunn, Jr, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org. I grew up in ...

lung cancer

MEK Inhibitor Selumetinib and Docetaxel in KRAS-Mutant Advanced NSCLC

A phase III trial (SELECT-1) has shown no improvement in progression-free survival with the addition of the MEK inhibitor selumetinib to docetaxel in the second-line treatment of patients with KRAS-mutant non–small cell lung cancer (NSCLC). Trial results were reported by Jänne et al in...

lung cancer

Brigatinib in Advanced Crizotinib-Refractory ALK-Positive NSCLC

As reported by Kim et al in the Journal of Clinical Oncology, the phase II ALTA trial showed that the next-generation oral ALK inhibitor brigatinib produced a high response rate, including intracranial responses, in patients with advanced crizotinib-refractory non–small cell lung cancer...

lung cancer

ASCO 2017: Gefitinib Treatment Can Delay Recurrence of Intermediate-Stage Lung Cancer

The targeted therapy gefitinib (Iressa) appears more effective in preventing recurrence after lung cancer surgery than the standard of care, chemotherapy. In a phase III clinical trial, patients with epidermal growth factor receptor (EGFR)-positive, stage II to IIIA non–small cell lung cancer ...

lung cancer

FDA Approves Pembrolizumab as First-Line Combination Therapy With Pemetrexed and Carboplatin for Metastatic Nonsquamous NSCLC

On May 10, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda), an anti–programmed cell death protein 1 (PD-1) therapy, in combination with pemetrexed (Alimta) and carboplatin for the first-line treatment of metastatic nonsquamous non–small cell lung cancer...

Lung Cancer

Never Smokers Account for Increased Proportion of NSCLC 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. Joan Schiller, MD, of the...

Lung Cancer

Gefitinib or Erlotinib vs Chemotherapy in Advanced NSCLC

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...

lung cancer

ELCC 2017: Prospective Study Shows Concordance of EGFR Mutation Detection Between ctDNA and Tumor Samples

Detection of EGFR mutations in circulating tumor (ct) DNA from plasma samples can be accomplished using the cobas platform, according to findings presented by Kumar et al at the 2017 European Lung Cancer Conference (ELCC) (Abstract 95PD). Assays of ctDNA offer a noninvasive method of finding EGFR...

lung cancer

ELCC 2017: Specific Immune Cell Profiles Potentially Identify Patients With Lung Cancer Responsive to Anti–PD-1 Immunotherapy

An investigation of immune cell subtypes in the tumor microenvironment of patients with lung adenocarcinoma and squamous cell carcinoma (SCC) identified an immune subgroup that associates with prolonged patient survival and may be prognostic of response to nivolumab, according to findings presented ...

lung cancer

ELCC 2017: Ensartinib Demonstrates CNS Activity in ALK-Positive NSCLC

Ensartinib demonstrated intracranial responses in patients with anaplastic lymphoma kinase (ALK)–positive non–small cell lung cancer (NSCLC) and central nervous system (CNS) metastases, according to findings presented by Reckamp et al at the 2017 European Lung Cancer Conference (ELCC)...

lung cancer

ELCC 2017: Development and Validation of Lung Toxicity Prediction Models Aids Effective Use of Radiotherapy in NSCLC

Validation using patient data of an outcome prediction model for the development of dyspnea subsequent to radiotherapy revealed that the prognostic factors in the model did not adequately predict for delta toxicity endpoints, according to results reported by Defraene et al at the 2017 European Lung ...

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