Immunotherapy Has Given Me Back My Life
Hearing the words “You have cancer” is a devastating blow, especially when the biggest health issues you’ve had to contend with over more than 6 decades are common colds and knee and hip replacements. But in 2017, the symptoms I thought were from a lingering summer cold drove me to seek medical...
Gilberto de Lima Lopes, Jr, MD, MBA, and Oladimeji Akinboro, MD, MPH, on NSCLC: Outcomes of Anti–PD-(L)1 Therapy With or Without Chemotherapy in the First-Line Setting
Gilberto de Lima Lopes, Jr, MD, MBA, of Sylvester Comprehensive Cancer Center at the University of Miami, and Oladimeji Akinboro, MD, MPH, of the U.S. Food and Drug Administration (FDA), discuss a data analysis, which suggests that most subgroups of patients with advanced non–small cell lung cancer with a PD-L1 score of 50% or greater who are receiving FDA-approved chemotherapy/immunotherapy regimens may have overall survival outcomes comparable to or better than immunotherapy-alone regimens (Abstract 9000).
Gilberto de Lima Lopes, Jr, MD, MBA, and Matthew Krebs, PhD, on NSCLC: Updated Results With Amivantamab-vmjw
Gilberto de Lima Lopes, Jr, MD, MBA, of the Sylvester Comprehensive Cancer Center at the University of Miami, and Matthew Krebs, PhD, of The University of Manchester and The Christie NHS Foundation Trust, discuss results from the CHRYSALIS study. The trial showed that the bispecific antibody amivantamab-vmjw demonstrated antitumor activity, even after prior treatment, in patients with non–small cell lung cancer that exhibits the MET exon 14 skipping mutation (Abstract 9008).
Apar Kishor Ganti, MD, on SCLC: Comparing Quality of Life With Once- and Twice-Daily Thoracic Radiotherapy
Apar Kishor Ganti, MD, of the University of Nebraska Medical Center, discusses results from the CALGB 30610 study, which showed a similar clinical benefit for once- and twice-daily radiotherapy administered to patients with limited-stage small cell lung cancer. While both regimens were well tolerated, patients who received radiotherapy once daily had better quality-of-life scores at week 3 and slightly worse scores at week 12. Patients believed the once-daily regimen was more convenient (Abstract 8504).
Real-World Association Between Smoking History and Overall Survival With First-Line Pembrolizumab in Patients With Advanced NSCLC
In a retrospective cohort study reported in JAMA Network Open, Sanjay Popat, FRCP, PhD, and colleagues found that among patients initiating first-line pembrolizumab for EGFR and ALK wild-type advanced non–small cell lung cancer (NSCLC), ever-smokers had significantly better overall survival vs...
Survival With Stereotactic Radiosurgery vs Whole-Brain Radiotherapy in Patients With SCLC and Intracranial Metastatic Disease
In a systematic review and meta-analysis reported in The Lancet Oncology, Gaebe et al found that stereotactic radiosurgery (SRS) was associated with “equitable survival” compared with whole-brain radiotherapy (WBRT) in the first-line treatment of intracranial metastatic disease in patients with...
Intracranial Efficacy of Lorlatinib vs Crizotinib in ALK-Positive Advanced NSCLC
In a post hoc analysis from the phase III CROWN trial reported in the Journal of Clinical Oncology, Benjamin J. Solomon, MBBS, PhD, and colleagues found that progression-free survival and the risk of central nervous system (CNS) progression were improved with lorlatinib vs crizotinib in previously...
Gilberto de Lima Lopes, Jr, MD, MBA, and Karen L. Reckamp, MD, on NSCLC: Overall Survival Results With Ramucirumab Plus Pembrolizumab vs Standard of Care
Gilberto de Lima Lopes, Jr, MD, MBA, of the Sylvester Comprehensive Cancer Center at the University of Miami, and Karen L. Reckamp, MD, of Cedars-Sinai Medical Center, discuss phase II findings from substudy S1800A of the Lung-MAP protocol. The data showed that ramucirumab and pembrolizumab improved overall survival compared with the standard of care for patients with advanced non–small cell lung cancer who were previously treated with immunotherapy and platinum-based chemotherapy (Abstract 9004).
Ramucirumab/Pembrolizumab vs Standard of Care in Patients With Advanced NSCLC Previously Treated With Immune Checkpoint Inhibitors
In the phase II Lung-MAP substudy S1800A presented at the 2022 ASCO Annual Meeting (Abstract 9004) and simultaneously reported in the Journal of Clinical Oncology, Karen L. Reckamp, MD, and colleagues found that the combination of ramucirumab and pembrolizumab improved overall survival vs...
Adagrasib Improves Outcomes in KRAS-Mutated NSCLC, Phase II Study Shows
Nearly 43% of patients with non–small cell lung cancer (NSCLC) whose lung cancers harbored a specific KRAS mutation responded to the experimental drug adagrasib, and the targeted agent also showed activity against lesions in the brain that metastasized from the lung tumors, according to results of...
Addition of Adebrelimab to Carboplatin/Etoposide in First-Line Treatment of Extensive-Stage SCLC
In a Chinese phase III trial (CAPSTONE-1) reported in The Lancet Oncology, Jie Wang, MD, PhD, and colleagues found that the addition of adebrelimab, a novel anti–PD-L1 antibody, to carboplatin and etoposide significantly improved overall survival as a first-line treatment for patients with...
Neoadjuvant Nivolumab Plus Chemotherapy in Resectable Stage IIIA NSCLC: Overall Survival and Biomarker Analyses
In analyses from a Spanish phase II trial (NADIM) reported in the Journal of Clinical Oncology, Provencio et al found a high rate of 3-year overall survival in patients with operable stage IIIA non–small cell lung cancer (NSCLC) who received neoadjuvant nivolumab plus chemotherapy. Survival was...
Addition of Tiragolumab to Atezolizumab in PD-L1–Positive NSCLC
In a phase II trial (CITYSCAPE) reported in The Lancet Oncology, Byoung Chul Cho, MD, and colleagues found that the addition of tiragolumab, an inhibitor of the immune checkpoint molecule TIGIT, to atezolizumab improved objective response rate and progression-free survival in first-line treatment...
Expert Point of View: David Paul Carbone, MD, PhD
“Progress in lung cancer happens by slow steps punctuated by quantum leaps. In the age of perioperative therapies, we are moving one step closer to curing more patients. Surgery is still the intervention most likely to cure patients with earlier-stage disease, but 50% of cases can recur,” said...
CheckMate 816: Neoadjuvant Nivolumab Plus Chemotherapy Improves Event-Free Survival Over Chemotherapy Alone in Resectable NSCLC
The combination of neoadjuvant nivolumab plus chemotherapy achieved statistically significant and clinically meaningful improvement in event-free survival vs chemotherapy alone (P = .005) in patients with resectable non–small cell lung cancer (NSCLC, stage IB–IIIA), according to the results of the ...
Long-Term Overall Survival in Unresectable Stage III NSCLC With Consolidation Durvalumab in the PACIFIC Trial: Translation to Real-World Outcomes?
Lung cancer mortality rates have declined by more than 50% in men since 1990 and more than 30% in women since 2002. These declines in mortality are largely due to increases in smoking cessation. However, in recent years, clinical treatment advances, such as targeted therapies and immunotherapy,...
5-Year Survival Outcomes With Consolidation Durvalumab After Chemoradiotherapy in Unresectable Stage III NSCLC
As reported in the Journal of Clinical Oncology by David R. Spigel, MD, of Sarah Cannon Research Institute/Tennessee Oncology, and colleagues, long-term follow-up of the phase III PACIFIC trial has shown maintained progression-free and overall survival benefits with consolidation durvalumab (a...
Expert Point of View: Edward B. Garon, MD
Invited discussant of the NeoCOAST trial, Edward B. Garon, MD, Professor of Medicine and Director of the Thoracic Oncology Program at David Geffen School of Medicine at the University of California Los Angeles, praised the study: “NeoCOAST is an impressive study that showed numerical benefit when...
Novel Neoadjuvant Therapy May Boost Response in Resectable NSCLC
Use of multiple immune pathway inhibitors appears to be superior to checkpoint inhibitor therapy alone as neoadjuvant therapy for resectable non–small cell lung cancer (NSCLC), according to the results of the phase II NeoCOAST trial presented at the American Association for Cancer Research (AACR)...
Tazemetostat for Patients With Relapsed or Refractory BAP1-Inactivated Malignant Pleural Mesothelioma
In a phase II study reported in The Lancet Oncology, Zauderer et al found that the EZH2 inhibitor tazemetostat was active in patients with relapsed or refractory BRCA-associated protein 1 (BAP1)-inactivated malignant pleural mesothelioma. As noted by the investigators, high expression of EZH2 has...
Report Examines Imaging Approach With Potential to Detect Lung Cancer at the Cellular Level
Researchers have found a way to identify lung cancer at the cellular level in real time during a biopsy, which may enable detection of the disease earlier and with more confidence. The findings, published by Kennedy et al in Nature Communications, demonstrated that an imaging agent detected via...
Matthew L. Meyerson, MD, PhD, on Lung Adenocarcinoma: Somatic Mutations, Germline Risk, and Ancestry
Matthew L. Meyerson, MD, PhD, of the Dana-Farber Cancer Institute, discusses study findings that suggest the variation in frequency of EGFR and KRAS mutations in lung cancer may be associated with genetic ancestry in patients from Latin America. The results indicate it may be possible to identify germline alleles underpinning this link. Finding a germline locus or loci may impact the development of lung cancers with these mutations and may improve lung cancer prevention and screening for populations of Latin American origin, as well as others.
Patients With NSCLC Brain Metastases Undergoing Neurosurgical Resection: Comparison of Treatment Regimens
In a German single-institution retrospective cohort study reported in JAMA Network Open, Wasilewski et al found that treatment with immune checkpoint inhibition plus radiotherapy was associated with prolonged overall survival vs platinum-based chemotherapy plus radiotherapy in patients with brain...
Ara Klijian, MD, on Lung Cancer: Operability in Patients With Poor Pulmonary Function
Ara Klijian, MD, of Scripps Health, discusses findings on the safety of AVATS (awake video-assisted thoracic surgery), a procedure that may benefit select patients, including those whose early non–small cell lung cancer was previously deemed inoperable due to poor pulmonary function. Performed under local sedation, AVATS appeared to improve outcomes, reduce hospital stays, increase patient satisfaction, and lower costs.
Beyond Immunotherapy: New Targeted Agents for Advanced NSCLC
The advent of PD-1 and PD-L1 checkpoint inhibitors has changed the treatment landscape of advanced non–small cell lung cancer (NSCLC), but only approximately 20% of patients treated with immunotherapy will be alive at 5 years. According to Melissa L. Johnson, MD, Director, Lung Cancer Research,...
DESTINY-Lung01: Is Trastuzumab Deruxtecan the Answer for HER2-Mutant Lung Cancer?
The human epidermal growth factor (HER) family of receptors are a well-established therapeutic target. Indeed, seminal studies conducted nearly 2 decades ago identified a key association between activating mutations in the kinase domain of the epidermal growth factor receptor (EGFR, also known as...
DESTINY-Lung01: T-DXd Shows Durable Activity in Previously Treated Metastatic HER2-Mutant NSCLC
In a phase II trial (DESTINY-Lung01) reported in The New England Journal of Medicine, Bob T. Li, MD, PhD, MPH, of the Thoracic Oncology and Early Drug Development Service, Memorial Sloan Kettering Cancer Center, New York, and colleagues found that fam-trastuzumab deruxtecan-nxki (T-DXd) showed...
Neoadjuvant Nivolumab and Platinum-Doublet Chemotherapy for Early NSCLC
On March 4, 2022, nivolumab was approved for use with platinum-doublet chemotherapy for resectable non–small cell lung cancer (NSCLC) in the neoadjuvant setting.1 The approval is the first for neoadjuvant therapy for early-stage NSCLC. Supporting Efficacy Data Approval was based on findings from...
2-Year Follow-up Shows Durable Responses With Sotorasib in KRAS G12C–Mutated Non–Small Cell 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 24.9 months, the 2-year overall...
Consolidation Durvalumab Alone or Combined With Oleclumab or Monalizumab for Unresectable Stage III NSCLC
In an interim analysis of the phase II COAST trial reported in the Journal of Clinical Oncology, Roy S. Herbst, MD, PhD, FACP, FASCO, and colleagues found that consolidation durvalumab in combination with the anti-CD73 antibody oleclumab or anti-NKG2A antibody monalizumab both improved objective...
Segmentectomy vs Lobectomy in Small-Sized Peripheral NSCLC
In a Japanese phase III trial (JCOG0802/WJOG4607L) reported in The Lancet, Saji et al found that segmentectomy was both noninferior and superior to lobectomy as measured by overall survival in patients with small-sized peripheral non–small cell lung cancer (NSCLC). Study Details In the open-label...
Study Examines Link Between Emphysema and Lung Cancer Risk
Computed tomography (CT)-detected emphysema may be linked to a higher risk of lung cancer, a risk that increases with emphysema severity, according to a new study published by Yang et al in the journal Radiology. Lung cancer is the primary cause of cancer-related death worldwide. However, lung...
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, Paul F. Pinsky, PhD, of the Division of Cancer Prevention, National Cancer Institute, and colleagues found that incidental respiratory disease–related findings on low-dose computed tomography (CT) screening...
Study Reports Adjuvant Pembrolizumab Improves Disease-Free Survival in Early-Stage NSCLC
Adjuvant pembrolizumab improves disease-free survival compared with placebo in patients with early-stage non–small cell lung cancer (NSCLC) following complete resection and adjuvant chemotherapy when indicated. These findings from the PEARLS/KEYNOTE-091 trial were reported in a European Society for ...
CHOICE-01: Toripalimab Plus Chemotherapy Improves Survival in 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 during the 2022 ASCO Monthly Plenary Series.1 At the...
CheckMate 816: Neoadjuvant Nivolumab Plus Chemotherapy in Resectable NSCLC
As reported in The New England Journal of Medicine by Forde et al, the phase III CheckMate 816 trial has shown improved pathologic complete response rate and event-free survival with the addition of nivolumab to platinum-based chemotherapy in the neoadjuvant treatment of resectable non–small cell...
David A. Barbie, MD, on Mesothelioma: Activating the STING Pathway May Promote Antitumor Immunity
David A. Barbie, MD, of Dana-Farber Cancer Institute, discusses his laboratory’s studies, showing that malignant pleural mesothelioma, an inflamed cancer type with marginal response to immune checkpoint blockade, demonstrated high tumor cell STING expression and response to STING agonists in combination with natural killer cell therapies ex vivo. STING is the tumor cell stimulator of interferon genes (Abstract 4168).
Jia Luo, MD, on NSCLC: Clinicopathologic and Molecular Characterization of KRAS G12D–Mutated Disease
Jia Luo, MD, of Dana-Farber Cancer Institute, discusses the emerging class of cancer therapies for allele-specific KRAS inhibitors and the importance of their distinct clinical, genomic, and immunologic features. Because KRAS G12D–mutated non–small cell lung cancer is associated with worse responses to immunotherapy, Dr. Luo believes drug development will need to take these differences into account (Abstract 4117).
Nicolas Girard, MD, PhD, on NSCLC: New Data on Event-Free Survival With Nivolumab Plus Platinum-Doublet Chemotherapy
Nicolas Girard, MD, PhD, of the Institut Curie, discusses findings from the phase III CheckMate 816 trial, which is the first study with an immunotherapy-based combination to demonstrate improved event-free survival and pathologic complete response in the neoadjuvant setting for patients with resectable stage IB to IIIA non–small cell lung cancer. The results may benefit the 30% to 55% of patients whose cancer recurs after surgery (Abstract CT012).
In the Neoadjuvant Setting, Combination Immunotherapy With Durvalumab Is More Effective Than Durvalumab Alone for Early-Stage NSCLC
Combination immunotherapy with the anti–PD-L1 monoclonal antibody durvalumab and other novel agents outperforms durvalumab alone in the neoadjuvant setting for early-stage non–small cell lung cancer (NSCLC), according to research presented by Cascone et al at the American Association for Cancer...
Tina Cascone, MD, PhD, on NSCLC: New Findings From the NeoCOAST Trial on Durvalumab-Based Therapy
Tina Cascone, MD, PhD, of The University of Texas MD Anderson Cancer Center, discusses the findings of the phase II NeoCOAST study, which showed that combination immunotherapy with the anti–PD-L1 monoclonal antibody durvalumab and other novel agents resulted in numerically higher major pathologic response rates than durvalumab alone in the neoadjuvant setting for patients with early-stage resectable non–small cell lung cancer. Translational results also supported combination therapies over single-agent therapy (Abstract CT011).
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...
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 ...
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).
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...
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...
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 ...
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...
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 ...
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...
