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Lung Cancer

Alectinib Approved as Adjuvant Treatment for ALK-Positive Non–Small Cell Lung Cancer

On April 18, the U.S. Food and Drug Administration (FDA) approved the tyrosine kinase inhibitor alectinib (Alecensa) for adjuvant treatment after tumor resection in patients with ALK-positive non–small cell lung cancer (NSCLC), as detected by an FDA-approved test. Alectinib is an orally...

Lung Cancer
Issues in Oncology

Professional Societies Introduce New Evidence-Based Guidelines on Testing Immunotherapy Biomarkers in NSCLC

The College of American Pathologists in collaboration with the International Association for the Study of Lung Cancer, the Pulmonary Pathology Society, the Association for Molecular Pathology, and the LUNGevity Foundation have developed evidence-based recommendations on the use of certain...

Breast Cancer
Colorectal Cancer
Lung Cancer
Issues in Oncology

Survival Rates in Patients With Cancer and Intellectual and Developmental Disabilities

Investigators have found a higher rate of mortality among patients with intellectual and developmental disabilities diagnosed with breast cancer, colorectal cancer, or lung cancer, according to a recent study published by Hansford et al in the Canadian Journal of Public Health. Study Methods and...

Lung Cancer

ALK-Positive NSCLC: Adjuvant Alectinib vs Platinum-Based Chemotherapy

As reported in The New England Journal of Medicine by Yi-Long Wu, MD, and colleagues, the phase III ALINA trial has shown significantly improved disease-free survival with adjuvant alectinib vs platinum-based chemotherapy in patients with resected ALK-positive NSCLC. Study Details In the...

Lung Cancer

Atezolizumab/Cabozantinib vs Docetaxel in Previously Treated Metastatic NSCLC

As reported in the Journal of Clinical Oncology by Joel Neal, MD, PhD, and colleagues, the phase III CONTACT-01 trial has shown no significant improvement in overall survival with atezolizumab plus cabozantinib vs docetaxel after checkpoint inhibitor treatment and chemotherapy in patients with...

Lung Cancer
Issues in Oncology

Radon Gas Exposure May Be Linked to Increased Incidence of Lung Cancer in Nonsmokers

Long-term exposure to radon gas may be associated with a rise in nonsmoking lung cancer cases, according to a recent consumer survey conducted on behalf of The Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC–James)....

Lung Cancer

Lung Cancer Screening Eligibility: Effect of Using History vs Pack-Year History of Smoking

In a study reported in the Journal of Clinical Oncology, Potter et al found that use of a smoking history of ≥ 20 years rather than the current 2021 U.S. Preventive Services Task Force (USPSTF) guideline of ≥ 20 pack-years would increase the eligibility of Black individuals for lung cancer...

lung cancer

Akhil G. Pachimatla, MD, on NSCLC: A Link Between Image-Based Measures of Obesity and Metabolic Pathways

Akhil G. Pachimatla, MD, of Roswell Park Comprehensive Cancer Center, discusses study findings showing that, in patients with non–small cell lung cancer (NSCLC), image-based adiposity measures show stronger correlations with gene-expression changes in these tumors than body mass index measures. Dr. Pachimatla explains the clinical implications (Abstract 37).

Lung Cancer
Issues in Oncology

Study Examines Shared Decision-Making Policies and Practices Around Lung Cancer Screening

A Medicare policy requiring shared decision-making between primary care physicians and patients regarding whether to proceed with lung cancer screening may require further examination, according to a recent study published by Kale et al in the Annals of Family Medicine. The findings indicated that...

Lung Cancer

T-DXd in HER2-Overexpressing Unresectable or Metastatic NSCLC

As reported in The Lancet Oncology by Egbert F. Smit, MD, and colleagues, primary analysis in the HER2-overexpressing unresectable or metastatic non–small cell cancer (NSCLC) cohorts of the phase II DESTINY-Lung01 trial show activity of fam-trastuzumab deruxtecan-nxki (T-DXd) in this setting. Prior ...

Lung Cancer

NSCLC: Neoadjuvant Chemoimmunotherapy vs Neoadjuvant Chemotherapy

In a systematic review and meta-analysis reported in JAMA Oncology, Sorin et al found that neoadjuvant chemoimmunotherapy was associated with better outcomes than neoadjuvant chemotherapy in patients with non–small cell lung cancer (NSCLC). Study Details A search of published studies reported...

Lung Cancer

Eligibility for and Prevalence of Lung Cancer Screening in the United States in 2022

In a study reported in a research letter in JAMA Network Open, Henderson et al identified prevalence of lung cancer screening in the United States in 2022 using U.S. Preventive Services Task Force (USPSTF) 2021 and 2013 recommendations for screening eligibility. The USPSTF 2013 guidelines...

Immunotherapy
Lung Cancer

Amivantamab-vmjw in NSCLC With EGFR Exon 20 Insertion Mutations

On March 1, 2024, amivantamab-vmjw (Rybrevant) was approved for use with carboplatin and pemetrexed for first-line treatment of locally advanced or metastatic non–small cell lung cancer (NSCLC) with EGFR exon 20 insertion mutations, as detected by a U.S. Food and Drug Administration (FDA)-approved...

Lung Cancer

Expert Point of View: Luis Paz-Ares, MD, PhD

The findings from RATIONALE-315 were discussed at the ESMO (European Society for Medical Oncology) Virtual Plenary by Luis Paz-Ares, MD, PhD, Head of the Medical Oncology Service at the Hospital Universitario 12 de Octubre, Madrid. He noted that inhibitors of PD-1 and its ligand PD-L1, as...

Lung Cancer

In Resectable Non–Small Cell Lung Cancer, Perioperative Use of Tislelizumab Alone or With Chemotherapy Improved Outcomes

In patients with resectable non–small cell lung cancer (NSCLC), perioperative treatment involving the checkpoint inhibitor tislelizumab led to a statistically significant benefit in event-free survival and a favorable trend for overall survival, investigators for the phase III RATIONALE-315 trial...

Lung Cancer
Issues in Oncology

Racial/Ethnic Differences in Care Intensity at the End of Life for Patients With Lung Cancer

In a study reported in the Journal of Clinical Oncology, Rodriguez et al identified racial/ethnic differences in intensity of end-of-life care among patients in California who died from lung cancer between 2005 and 2018. Study Details The study used data from the California Cancer Registry linked...

Immunotherapy
Lung Cancer

Use of Combination Immunotherapy Before Lung Cancer Surgery

Combination immunotherapy with the anti–PD-L1 monoclonal antibody durvalumab and other novel agents seemed to outperform durvalumab alone in the neoadjuvant setting for early-stage non–small cell lung cancer (NSCLC), according to researchers from The University of Texas MD Anderson Cancer Center,...

Lung Cancer

Repotrectinib for ROS1 Fusion–Positive Advanced NSCLC

On November 15, 2023, repotrectinib (Augtyro) was approved for locally advanced or metastatic ROS1 fusion–positive non–small cell lung cancer (NSCLC).1 This is the first U.S. Food and Drug Administration approval that includes patients with ROS1-positive NSCLC who have previously received a ROS1...

Lung Cancer

Osimertinib With Chemotherapy for EGFR-Mutated NSCLC

On February 16, 2024, osimertinib (Tagrisso) was approved by the U.S. Food and Drug Administraton (FDA) with pemetrexed and platinum-based chemotherapy for patients with locally advanced or metastatic non–small cell lung cancer (NSCLC) with tumors having EGFR exon 19 deletions or exon 21 L858R...

Cardio-oncology
Lung Cancer

Risks of Cardiovascular Disease in Patients Receiving Therapies for Lung Cancer

Managing patients with lung cancer in the current era of an increasing array of systemic treatments has become a complex balancing act of trying to improve outcomes and survival from a cancer perspective while taking the necessary treatment and monitoring steps for cardioprotection. With few...

Lung Cancer

SABR in Patients With Early NSCLC and Interstitial Lung Disease

In a study reported in JAMA Oncology, David A. Palma, MD, PhD, and colleagues found that stereotactic ablative radiotherapy (SABR) met criteria for efficacy and toxicity in patients with early non–small cell lung cancer (NSCLC) and interstitial lung disease (ILD). As stated by the investigators,...

lung cancer

Neoadjuvant Therapy for EGFR-Positive Lung Adenocarcinoma

This is Part 3 of Optimizing Outcomes for Patients With Locally Advanced and Metastatic NSCLC, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable.   In this video, Drs. Melissa Johnson, Vamsidhar Velcheti, and Helena Yu discuss the neoadjuvant treatment of patients with EGFR-positive lung adenocarcinoma. The patient is a 75-year-old female with a minimal smoking history who was admitted to the hospital for an electrolyte abnormality. Scans show a right upper lobe spiculated mass with right hilar lymphadenopathy, and biopsies confirm a diagnosis of primary lung adenocarcinoma, with a 4R lymph node testing positive as well. Next-generation sequencing is performed showing PALB2, PD-L1 negative, EGFR L861Q, and a low tumor mutation burden.   The faculty discuss next steps for this patient, the optimal neoadjuvant therapy for patients with uncommon EGFR mutations, and whether osimertinib would be appropriate as a treatment option.

lung cancer

Management of Stage IIIA NSCLC in a Former Smoker

This is Part 2 of Optimizing Outcomes for Patients With Locally Advanced and Metastatic NSCLC, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable.   In this video, Drs. Melissa Johnson, Vamsidhar Velcheti, and Helena Yu discuss the management of stage IIIA non–small cell lung cancer (NSCLC) in a former smoker. The patient is a 62-year-old female, a former smoker with a 25 pack-year history, who presents with shortness of breath and cough. Chest CT shows a large right upper lobe mass and an enlarged pretracheal lymph node, both of which are FDG-avid on PET scan. The case goes to multidisciplinary review, and he is ultimately diagnosed with a T4N0 squamous cancer.   The faculty discuss the multidisciplinary management for a patient such as this, the possibility of complete resection, and the role of neoadjuvant immunotherapy plus chemotherapy for stage III NSCLC.

lung cancer

Locally Advanced NSCLC

This is Part 1 of Optimizing Outcomes for Patients With Locally Advanced and Metastatic NSCLC, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable.   In this video, Drs. Melissa Johnson, Vamsidhar Velcheti, and Helena Yu discuss the management of locally advanced non–small cell lung cancer (NSCLC). The patient is a 62-year-old male former smoker with a 45-pack-year history. He has multiple comorbidities and presents with shortness of breath and cough. PET/CT scans show hypermetabolism in a subcarinal node and right lower lobe pulmonary nodule, and right perihilar thickening. Bronchoscopy reveals squamous T2aN2 NSCLC. Next-generation sequencing is performed, showing a PD-L1 expression of 15%; high tumor mutation burden; KIT, FGFR1, PIK3CA and PIK3CA amplification; and the tumor is microsatellite stable.   The faculty discuss how the treatment landscape for locally advanced NSCLC has changed since the approval of nivolumab plus chemotherapy, how to manage dose delays in the neoadjuvant setting, and whether additional adjuvant therapy is appropriate in patients who achieve complete response to neoadjuvant chemotherapy plus immunotherapy.

Lung Cancer
Immunotherapy

Immunotherapy Trials for Metastatic NSCLC: FDA Pooled Analysis

In a U.S. Food and Drug Administration (FDA) pooled analysis reported in The Lancet Oncology, Bernardo Haddock Lobo Goulart, MD, and colleagues found that response rate and progression-free survival were only moderately correlated with overall survival in first-line immunotherapy trials for...

Lung Cancer
Genomics/Genetics
Issues in Oncology

Could Smoking-Related DNA Changes Reflect Differential Lung Cancer Risks by Race and Ethnicity?

Investigators may have uncovered differential associations between smoking and DNA methylation across various racial and ethnic groups, according to a recent study published by Huang et al in the American Journal of Human Genetics. The findings could lead to the development of new strategies to...

Lung Cancer
Genomics/Genetics

FDA Approves Amivantamab-vmjw for EGFR Exon 20 Insertion–Mutated NSCLC

On March 1, the FDA approved the monoclonal bispecific anti–EGFR-MET antibody amivantamab-vmjw (Rybrevant) in combination with carboplatin and pemetrexed for the first-line treatment of locally advanced or metastatic NSCLC with EGFR exon 20 insertion mutations, as detected by an FDA-approved test....

Lung Cancer
Genomics/Genetics

Gene Signature May Predict Response to Combination Therapy in Patients With NSCLC

Researchers have identified a set of 140 genes that may help predict disease-free survival in patients with non–small cell lung cancer (NSCLC) treated with a combination of immunotherapy and low-dose radiation, according to a recent study published by Altorki et al in Cell Reports Medicine. The...

Lung Cancer

Perioperative Tislelizumab Plus Chemotherapy in Resectable NSCLC

In patients with resectable non–small cell lung cancer (NSCLC), perioperative treatment with the checkpoint inhibitor tislelizumab plus platinum-doublet chemotherapy led to a statistically significant benefit in event-free survival and a favorable trend for overall survival, investigators for the...

Lung Cancer

FDA Approves Osimertinib With Chemotherapy for EGFR-Mutated NSCLC

On February 16, the U.S. Food and Drug Administration (FDA) approved osimertinib (Tagrisso) with platinum-based chemotherapy for patients with locally advanced or metastatic non–small cell lung cancer (NSCLC) whose tumors have EGFR exon 19 deletions or exon 21 L858R mutations, as detected by an...

Lung Cancer

FDA Approves Tepotinib for Metastatic NSCLC

On February 15, the U.S. Food and Drug Administration (FDA) granted traditional approval to the kinase inhibitor tepotinib (Tepmetko) for adult patients with metastatic non–small cell lung cancer (NSCLC) harboring mesenchymal-epithelial transition (MET) exon 14–skipping alterations. The agent is...

Lung Cancer
Immunotherapy

Durvalumab Plus Ceralasertib in Patients With Immunotherapy-Resistant NSCLC

The combination of the anti–PD-L1 antibody durvalumab and the ATR kinase inhibitor ceralasertib may help overcome inherent immune resistance and reinvigorate antitumor activity in patients with advanced non–small cell lung cancer (NSCLC), according to a recent study published by Besse et al in...

Lung Cancer

Osimertinib vs Sequential Gefitinib/Osimertinib in Advanced EGFR-Mutant NSCLC

As reported in the Journal of Clinical Oncology by Jordi Remon, MD, PhD, and colleagues, the final analysis of overall survival in the phase II EORTC APPLE trial showed no significant difference between the strategies of upfront osimertinib vs sequential gefitinib/osimertinib in previously...

Lung Cancer
Issues in Oncology

Osimertinib May Offer Survival Benefit Over Immunotherapy in Some Patients With Unresectable NSCLC

Investigators have found that the targeted therapy osimertinib may be associated with improved progression-free survival when administered after chemotherapy and radiation in patients with non–small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutations, according to a...

Issues in Oncology
Lung Cancer

Sotorasib, the Poster Child for Project Optimus: Truths and Fantasies

In January 2021, two of us wrote in these pages about our field’s pressing need to pivot away from identifying and deploying the maximum tolerated dose (MTD) when it comes to targeted oncology therapies.1 We argued that, instead, one should be looking for the “optimal dose”—the dose that best...

Lung Cancer

Addition of Nivolumab to Chemotherapy in EGFR-Mutant Metastatic NSCLC After Disease Progression on Prior Therapy

As reported in the Journal of Clinical Oncology by Tony Mok, MD, FRCPC, FASCO, and colleagues, final results of the primarily Asian phase III CheckMate 722 trial showed no progression-free survival benefit with the addition of nivolumab to chemotherapy in patients with EGFR-mutant metastatic...

Lung Cancer

Accelerated Hypofractionated Chemoradiation With Adaptive SABR Boost in Locally Advanced, Unresectable NSCLC

In a U.S. single-center radiation dose-expansion study reported in JAMA Oncology, Wu et al found that chemoradiation with adaptively increased stereotactic ablative radiotherapy (SABR) boost doses was safe and effective in patients with locally advanced, unresectable non–small cell lung cancer...

Lung Cancer
Issues in Oncology

Potential Risk Factors for Postoperative Venous Thromboembolism in Lung Cancer Identified

Postoperative pulmonary embolism may be predictive of increased 30-day mortality, reintubation, and readmission rates in patients with lung cancer, according to recent findings presented by Axtell et al at The Society of Thoracic Surgeons (STS) Annual Meeting. Background Patients with lung cancer...

Lung Cancer

Rate of Second Primary Lung Cancers With Lobar vs Sublobar Resection of T1aN0 NSCLC

As reported in the Journal of Clinical Oncology by Thomas E. Stinchcombe, MD, and colleagues, an analysis from the phase III Cancer and Leukemia Group B 140503/Alliance trial has shown high rates of second primary lung cancers with both sublobar and lobar resections for T1aN0 non–small cell lung...

Issues in Oncology
Lung Cancer

Beyond Lung Cancer: Leveraging Machine Learning Techniques to Understand Other Diseases

Although computed tomography (CT) screening has emerged as an essential tool for the early detection of lung diseases, there is still a broad range of potential improvements to be made. According to recent research, understanding the patterns of onset for earlier prediction of disease may be...

Lung Cancer
Skin Cancer
Cost of Care

Undocumented Cost-of-Care Discussions: A Missed Opportunity in Cancer Treatment

A recent study underscored the need for integrating cost-of-care conversations in cancer treatment. Results of the population-based analysis, presented at the 2023 ASCO Quality Care Symposium,1 showed that only about 25% of patients with newly diagnosed advanced non–small cell lung cancer (NSCLC)...

Lung Cancer
Immunotherapy

DXH9 Depletion May Expose Small Cell Lung Cancer Tumors to Immune System Attack

Researchers may have identified a novel genetic mechanism capable of making small cell lung cancer tumors more susceptible to an attack by the immune system, according to a new study published by Murayama et al in Cancer Discovery. The findings could lead to the development of new therapeutics to...

Lung Cancer
Issues in Oncology

Medicaid Expansion May Improve Postsurgical Survival Outcomes in Patients With NSCLC

Investigators have found that Medicaid expansion under the Affordable Care Act may be associated with a reduced risk of early mortality following surgical resection in patients with non–small cell lung cancer (NSCLC), according to a recent study published by Nogueira et al in JAMA Network Open. The ...

Lung Cancer

Repotrectinib in ROS1 Fusion–Positive NSCLC

As reported in The New England Journal of Medicine by Alexander Drilon, MD, and colleagues, the phase I/II TRIDENT-1 trial showed the activity of the next-generation ROS1 tyrosine kinase inhibitor repotrectinib in patients with ROS1 fusion–positive non–small cell lung cancer (NSCLC) with no...

lung cancer

EGFR-Mutated Early-Stage NSCLC

This is Part 3 of New Directions in Nonmetastatic Non–Small Cell Lung Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable.   In this video, Drs. Heather Wakelee, Tina Cascone, and Marina Garassino discuss the management of EGFR-mutated early-stage non–small cell lung cancer (NSCLC). The patient is a 48-year-old woman who is being evaluated for a 3-cm mass in the right lower lobe that was detected on chest x-ray after a car accident. Biopsy confirms adenocarcinoma, and PD-L1 expression is 85%. Her brain MRI is negative. At multidisciplinary tumor board, there is a discussion of whether to start chemotherapy plus immune checkpoint inhibitor therapy immediately vs going straight to surgery given the limited extent of disease.   The faculty discuss the importance of testing molecular testing for EGFR and ALK mutations prior to the start of immune checkpoint inhibitor therapy, whether adjuvant osimertinib should be continued for more than 3 years, and the clinical implications of the ADAURA and ALINA trials.

lung cancer

PD-L1–Negative Early-Stage NSCLC

This is Part 2 of New Directions in Nonmetastatic Non–Small Cell Lung Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable.   In this video, Drs. Heather Wakelee, Tina Cascone, and Marina Garassino discuss the management of PD-L1–negative early-stage non–small cell lung cancer (NSCLC). The patient is a 75-year-old man who presented to his primary care provider for evaluation of worsening cough and hemoptysis. He was a smoker for 45 years, has an ECOG performance score of 1, has hypertension and COPD, and is relatively active. Chest x-ray reveals a large left lung mass, which biopsy confirms as squamous cell carcinoma. PET and brain MRI are negative, but there is a 4.3-cm lower lobe mass and a level 4L lymph node; endobronchial ultrasound does not confirm disease in any station. The final staging was stage IIA T2bN0. At a multidisciplinary tumor board, the lesion was determined to be resectable. His PD-L1 level is 0%.   In the conversation that follows, the faculty discuss how treatment for early-stage lung cancer differs based on PD-L1 expression; the multidisciplinary management of immune-related adverse events; and perioperative approaches to immunotherapy.

lung cancer

IO Strategies for Resectable NSCLC

This is Part 1 of New Directions in Nonmetastatic Non–Small Cell Lung Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable.   In this video, Drs. Heather Wakelee, Tina Cascone, and Marina Garassino discuss immune checkpoint inhibitor strategies for resectable nonmetastatic non–small cell lung cancer (NSCLC). The patient is an active 68-year-old woman with a 70-pack-year smoking history. On screening computed tomography, she was found to have a 3.7-cm right upper lobe mass, which biopsy confirmed as adenocarcinoma. Further staging revealed uptake in a 10R node on positron-emission tomography, but no other suspicious sites.   In the conversation that follows, the faculty discuss the importance of completing staging prior to resection; how PD-L1 testing informs therapeutic strategies; and the role of neoadjuvant, perioperative, and adjuvant immune checkpoint inhibitor therapy in treating stage II/III NSCLC.

Lung Cancer
Immunotherapy

Real-World Data Show Impact of Immunotherapy in Populations Underrepresented in Lung Cancer Clinical Trials

New research published by Lee et al in JNCCN—Journal of the National Comprehensive Cancer Network found patients treated with first-line immunotherapy for advanced non–small cell lung cancer (NSCLC) had similar results in terms of overall survival, progression-free survival, and treatment duration, ...

Breast Cancer
Lung Cancer

Addition of SBRT to Standard-of-Care Systemic Therapy in Oligoprogressive Disease

In the phase II CURB trial reported in The Lancet, Chiaojung Jillian Tsai, MD, PhD, and colleagues found that the addition of stereotactic body radiotherapy (SBRT) to standard-of-care systemic therapy was associated with improved progression-free survival in the total study population of patients...

Lung Cancer

Antibody-Drug Conjugate Ifinatamab Deruxtecan Shows Robust Activity in Refractory Small Cell Lung Cancer

The antibody-drug conjugate ifinatamab deruxtecan has demonstrated “robust and durable efficacy” in patients with heavily pretreated small cell lung cancer, according to a subset analysis of the DS7300-A-J101 trial presented at the International Association for the Study of Lung Cancer 2023 World...

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