© 2024 HSP News Service, L.L.C.
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...
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...
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...
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...
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,...
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...
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...
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...
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,...
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.
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.
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.
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...
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...
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....
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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)...
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...
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 ...
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...
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.
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.
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.
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, ...
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...
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...
The addition of anlotinib to immunochemotherapy has achieved the historically longest progression-free survival and overall survival in the first-line setting of extensive-stage small cell lung cancer, according to data presented at the International Association for the Study of Lung Cancer 2023...
A newly published guideline update from ASCO and Ontario Health provides evidence-based recommendations on the use of systemic therapy for small cell lung cancer (SCLC).1 Recommendations cover where novel agents fit in the treatment landscape, the management of disease in older patients with...
On October 16, 2023, pembrolizumab was approved for use with platinum-containing chemotherapy as neoadjuvant treatment and as single-agent adjuvant treatment in patients with resectable (tumors ≥ 4 cm or node-positive) non–small cell lung cancer (NSCLC).1 Supporting Efficacy Data Approval was based ...
In a subgroup analysis from the phase III FLAURA2 trial reported in the Journal of Clinical Oncology, Pasi A. Jänne, MD, PhD, and colleagues found the combination of osimertinib and chemotherapy improved central nervous system (CNS) efficacy vs osimertinib alone in the first-line treatment of...
As reported in the Journal of Clinical Oncology by Tan et al, the phase III CANOPY-1 trial has shown no survival benefits with the addition of canakinumab to first-line pembrolizumab plus chemotherapy in patients with advanced/metastatic non–small cell lung cancer (NSCLC) without EGFR or ALK...
Researchers have found that adopting a Lung Nodule Program may increase early lung cancer detection in patients who are not eligible for lung cancer screening under existing age-eligibility criteria, according to a recent study published by Liao et al in the Journal of Thoracic Oncology. ...
On October 11, 2023, the BRAF inhibitor encorafenib (Braftovi) with the MEK inhibitor binimetinib (Mektovi) was approved for patients with metastatic non–small cell lung cancer (NSCLC) with a BRAF V600E mutation, as detected by a U.S. Food and Drug Administration (FDA)-approved test.1,2 The FDA...
Lung cancer incidence overall has been declining in the United States since 1992—and since 2006–2007 for both men and women by 2.7% annually and 1.1%, respectively—and overall mortality rates have declined in both men and women because of smoking cessation efforts and advances in therapy and early...
Upal Basu Roy, PhD, MPH, Executive Director of Research at the LUNGevity Foundation, in Chicago, shared his thoughts with The ASCO Post on the INCREASE trial’s findings and their potential impact on clinical practice. As Dr. Roy explained, neoadjuvant chemoimmunotherapy remains the current standard ...
The integration of immunotherapy with traditional chemoradiotherapy has significantly increased pathologic complete response rates in patients with non–small cell lung cancer (NSCLC), according to data presented at the International Association for the Study of Lung Cancer 2023 World Conference on...
Datopotamab deruxtecan (Dato-DXd), a TROP-2–directed antibody-drug conjugate, improved progression-free survival by 25% on blinded independent committee review in previously treated patients with advanced or metastatic non–small cell lung cancer (NSCLC), and it was reported to be less toxic than...
The unique public-private partnership that undergirded the Lung-MAP trial for almost a decade may serve as a model for future clinical research that is more rapid, innovative, and inclusive, according to a recent report published by Herbst et al in Clinical Cancer Research. Background The Lung-MAP...