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...
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...
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...
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...
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...
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)...
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...
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...
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 ...
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...
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...
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...
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....
Low-Dose Computed Tomography: A Window Into Early Lung Disease?
Lung health in adults has traditionally been defined as the absence of disease, but it may be time to rethink this paradigm, according to Ravi Kalhan, MD, MS, Director of the Northwestern Asthma and Chronic Obstructive Pulmonary Disease (COPD) Program at Northwestern University Feinberg School of...
Big Data and Vulnerable Populations: Addressing the Gap in Lung Cancer Screening
Recent advances in medical imaging have led to more accurate detection and management of early thoracic diseases such as lung cancer, chronic obstructive pulmonary disease (COPD), and cardiovascular disease—three of the top four leading causes of death in the United States. Unfortunately, if not...
Poziotinib in Previously Treated Patients With NSCLC and HER2 Exon 20 Insertion Mutations
In a cohort of the phase II ZENITH20-2 trial reported in the Journal of Clinical Oncology, Le et al found that the tyrosine kinase inhibitor poziotinib produced responses in previously treated patients with non–small cell lung cancer (NSCLC) and HER2 exon 20 insertion mutations. Study Details In...
Immunomodulatory Effects of Neoadjuvant Nivolumab, Chemotherapy in NSCLC
The immunomodulatory effects of neoadjuvant immune-based treatments for non–small cell lung cancer (NSCLC) are becoming clearer, in part due to data presented by Schmidt et al at the Society for Immunotherapy of Cancer (SITC) 2021 Annual Meeting (Abstract 962). The first integrated analysis of...
Stephanie T. Schmidt, PhD, on NSCLC: The Immunomodulatory Impact of Neoadjuvant Chemotherapy and Immune-Based Treatments
Stephanie T. Schmidt, PhD, of The University of Texas MD Anderson Cancer Center, discusses the first integrated examination of the immunomodulatory effects of neoadjuvant chemotherapy, nivolumab, and nivolumab plus chemotherapy in resected non–small cell lung cancer (Abstract 962).
UKLS Trial Meta-analysis Confirms Mortality Reduction With Low-Dose CT Screening for Lung Cancer
Low-dose lung cancer screening by computed tomography (CT) is associated with a 16% relative reduction in lung cancer mortality over no lung cancer screening of high-risk individuals, based on a meta-analysis conducted by investigators with the United Kingdom Lung Cancer Screening (UKLS) trial.1...
T-DXd Makes Inroads in the Treatment of HER2-Mutant NSCLC
Previously treated patients with HER2-positive non–small cell lung cancer (NSCLC) achieved encouraging response rates and duration of response to the antibody-drug conjugate fam-trastuzumab deruxtecan-nxki (T-DXd) in the phase II DESTINY-Lung01 trial. These results were reported at the European...
Can SBRT to Selected Sites of Limited Progression or Oligoprogression Extend Progression-Free Survival in Advanced Lung Cancer but Not Breast Cancer?
Stereotactic body radiation therapy (SBRT) lengthens progression-free survival for patients with advanced lung cancer who have oligoprogression (ie, tumors that have not been fully responsive to systemic chemotherapy or immunotherapy), according to an interim analysis of the CURB oligoprogression...
Durable Responses in Metastatic NSCLC: Are We Getting Closer to a Cure?
In the United States, the incidence-based mortality related to non–small cell lung cancer (NSCLC) has decreased by approximately 3% each year since 2008 in men; during the same period, the mortality in women decreased by 2% to 4% annually.1 Although multiple factors are likely responsible for the...
2021 State of Lung Cancer Report Finds Survival Has Increased but Remains Significantly Lower for People of Color
The new 2021 State of Lung Cancer report reveals that the 5-year survival rate for lung cancer increased from 14.5% nationally to 23.7%, yet it remains significantly lower among communities of color. The American Lung Association’s fourth annual report also highlights how the toll of lung cancer...
French Study Finds COVID-19 Vaccine Effective in Patients With Lung Cancer
In a new study published by Gounant et al in the Journal of Thoracic Oncology, researchers from France showed that SARS–CoV-2 vaccines are safe and effective in patients with thoracic cancer, most of whom are immunized after two doses. A third shot given to 11% of patients with persistent low...
The Worst Part of Having Cancer Was the Guilt
When I was diagnosed with small cell lung cancer in 1992, at age 38, I remember thinking, “I wish I had breast cancer.” Breast cancer elicits such sympathy from people. A diagnosis of small cell lung cancer mainly gets you stern looks of disapproval and disappointment. There is so much stigma...
IMpower010: Adjuvant Atezolizumab Improves Disease-Free Survival and NSCLC Relapse in Patients Whose Tumors Express PD-L1
Adjuvant immunotherapy with atezolizumab after standard chemotherapy improved disease-free survival and time to locoregional and distant relapse compared with best supportive care in prespecified subgroups of patients with stage II to IIIA non–small cell lung cancer (NSCLC), according to an...
Adjuvant Gefitinib vs Cisplatin/Vinorelbine for Completely Resected EGFR-Mutant Stage II to IIIA NSCLC
In the Japanese phase III IMPACT trial reported in the Journal of Clinical Oncology, Tada et al found that adjuvant gefitinib did not improve disease-free survival vs cisplatin/vinorelbine in patients with completely resected stage II to IIIA EGFR-mutant non–small cell lung cancer (NSCLC). In the...
NSCLC in the United States: Update on Incidence, Prevalence, and Survival
In a study reported in JAMA Oncology, Apar Kishor Ganti, MD, MS, and colleagues found that the incidence of non–small cell lung cancer (NSCLC) has decreased in the United States in recent years. They also found that prevalence has increased, likely in association with more effective treatment and...
Matthew Manning, MD, on Resolving Racial Disparities in the Treatment of Breast and Lung Cancers
Matthew Manning, MD, of Cone Health Cancer Center, discusses findings that showed changes to the way cancer care is delivered may help eliminate racial disparities in survival among patients with early-stage lung and breast cancers. Identifying and addressing obstacles that kept patients from finishing radiation treatments for cancer were associated with improved 5-year survival rates for all patients (Abstract 53).
Study Evaluates Virtual vs In-Person Visits and Access to Lung Cancer Screening
Findings from a novel telemedicine effort to screen patients for lung cancer screening during the COVID-19 pandemic show that virtual single-visit screenings may be just as effective as single-visit screenings done in person, according to a study presented by Magarinos et al at the American College ...
C. Jillian Tsai, MD, PhD, on Using Radiotherapy to Thwart Tumor Growth in Advanced Cancers
C. Jillian Tsai, MD, PhD, of Memorial Sloan Kettering Cancer Center, discusses results from the first randomized trial of stereotactic body radiation therapy (SBRT) to treat oligoprogressive, metastatic lung and breast cancers. The standard of care for patients with these types of tumors is to switch to a different systemic treatment. Adding local therapy such as SBRT may help treat drug-resistant lesions (Abstract LBA3).
Nivolumab for Relapsed Malignant Mesothelioma: Improvements in Progression-Free and Overall Survival
In the phase III CONFIRM trial reported in The Lancet Oncology, Dean A. Fennell, FRCP, PhD, and colleagues found that nivolumab improved progression-free and overall survival vs placebo in patients with relapsed malignant mesothelioma. In October 2020, the combination of nivolumab and ipilimumab...
ACCURE Trial Aims to Eliminate Disparities in Survival in Black and White Patients With Early-Stage Lung and Breast Cancers
A study presented by Manning et al at the 2021 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 53) showed that interventions to help Black patients overcome obstacles to completion of treatment can impact disparities in survival outcomes between Black and White patients...
Having Stage IV Lung Cancer Has Refocused My Life
The first indication I had stage IV lung cancer was a persistent cough during the beginning of the cold-and-flu season in the fall of 2013. I was 35 years old, never smoked, and in otherwise excellent health, so I ignored the cough for several months until I noticed my breathing had also become...
Mobocertinib for Previously Treated Advanced NSCLC With EGFR Exon 20 Insertion Mutations
On September 15, 2021, the kinase inhibitor mobocertinib was granted accelerated approval by the U.S. Food and Drug Administration (FDA) for adults with locally advanced or metastatic non–small cell lung cancer (NSCLC) with EGFR exon 20 insertion mutations, as detected by an FDA-approved test,...
Pretreatment Levels of Circulating Tumor DNA May Predict Long-Term Survival in NSCLC
Pretreatment circulating tumor DNA (ctDNA) levels in patients with non–small cell lung cancer (NSCLC) appear to be a more accurate predictor of long-term survival than classic survival surrogates, according to research presented during the International Association for the Study of Lung Cancer...
POSEIDON Trial: Dual Checkpoint Blockade Plus Chemotherapy Improves Survival in First-Line Metastatic NSCLC
The combination of dual checkpoint inhibition plus chemotherapy could be the new standard of care in first-line metastatic non–small cell lung cancer (NSCLC), according to data presented during the International Association for the Study of Lung Cancer (IASLC) 2021 World Conference on Lung Cancer.1 ...
Phase II Trial Finds Atezolizumab of Benefit in Patients With Lung Cancer and Brain Metastases
Patients with non–small cell lung cancer (NSCLC) and brain metastasis derived significant benefit from treatment with the monoclonal antibody atezolizumab plus chemotherapy, according to the multicenter phase II Atezo-Brain trial.1 The study was presented at the International Association for the...
Survey Shows Disparities in Biomarker Testing Among Underserved Patients With Lung Cancer
Recent advances in cancer genomics and targeted therapies have changed the treatment landscape for lung cancer, but disparities in access to precision medicine remain, according to data presented during the International Association for the Study of Lung Cancer (IASLC) 2021 World Conference on Lung ...
Mobocertinib for Platinum-Pretreated Patients With EGFR Exon 20 Insertion–Positive Metastatic NSCLC
In a phase I/II trial reported in JAMA Oncology, Caicun Zhou, PhD, MD, and colleagues found that mobocertinib, a first-in-class oral kinase inhibitor, produced durable responses in platinum-pretreated patients with EGFR exon 20 insertion–positive metastatic non–small cell lung cancer (NSCLC). The...
Second-Line Sotorasib Plus Afatinib for KRAS-Mutant NSCLC
The combination of the KRAS inhibitor sotorasib with afatinib, a pan-ErbB tyrosine kinase inhibitor, was feasible in treating patients with non–small cell lung cancer (NSCLC) and mutated KRAS whose disease had progressed on prior therapies, including KRAS inhibitors alone, according to interim...
Can Inhibition of the Aurora Kinase A Protein Help Overcome Resistance to KRAS Inhibition in Patients With Lung Cancer?
In preclinical models, combining an investigational Aurora kinase A (AURKA) inhibitor with a KRAS inhibitor or a WEE1 inhibitor showed efficacy against lung cancer cells with intrinsic or acquired resistance to KRAS inhibition, according to results presented by Lee et al at the AACR-NCI-EORTC...
FDA Approves Atezolizumab as Adjuvant Treatment for NSCLC
On October 15, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq) for adjuvant treatment following resection and platinum-based chemotherapy in patients with stage II to IIIA non–small cell lung cancer (NSCLC) whose tumors have PD-L1 expression on ≥ 1% of tumor cells, as...
Genomic Profiling of Lung Adenocarcinoma in Never-Smokers vs Smokers
In a study reported in the Journal of Clinical Oncology, Devarakonda et al found that never-smokers with lung adenocarcinoma had a high frequency of RTK/RAS/RAF pathway driver alterations—similar to smokers with lung adenocarcinoma—but also harbored a significantly higher total frequency of...
Neoadjuvant Atezolizumab Under Study in Mesothelioma
Neoadjuvant atezolizumab combined with pemetrexed and cisplatin, with maintenance atezolizumab, proved to be safe and feasible, offering a hint of benefit in patients with resectable pleural mesothelioma, in a small multicenter study presented at the International Association for the Study of Lung...
Expert Point of View: Charles M. Rudin, MD, PhD
Charles M. Rudin, MD, PhD, Hassenfeld Professor and Chief of the Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, commented that although ATLANTIS1 “unfortunately joins the ranks of negative phase III studies in patients with recurrent small cell lung cancer,” there are “some...
Benefits Seen With Lurbinectedin Plus Doxorubicin in Small Cell Lung Cancer—but Primary Endpoint Missed
As a second-line treatment for patients with small cell lung cancer, lurbinectedin plus doxorubicin failed to improve overall survival in the multicenter ATLANTIS trial but did provide other benefits, including better tolerability, researchers reported at the 2021 World Conference on Lung Cancer,...
Expert Point of View: Ichiro Yoshino, MD, PhD
Ichiro Yoshino, MD, PhD, Professor and Chairman of the Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Japan, reviewed the finer details of the IMpower010 exploratory analysis.1 He maintained that atezolizumab’s benefit does, indeed, seem to favor some patient...
IMpower010: Benefits Observed With Atezolizumab Regardless of Stage, Type of Prior Treatment
In an exploratory analysis of the pivotal phase III IMpower010 trial in stage II–IIIA non–small cell lung cancer (NSCLC), continued treatment with the monoclonal antibody atezolizumab after surgery and chemotherapy improved disease-free survival regardless of the type of surgery or chemotherapy...
Study Finds Medicaid Expansion May Be Associated With Decrease in Early Lung Cancer Mortality
Medicare expansion under the Affordable Care Act may have improved outcomes for patients with lung cancer, the leading cause of cancer death in the United States, according to data presented at the 2021 ASCO Quality Care Symposium.1 The National Cancer Database analysis of nearly 12,000 patients...
