ELCC 2019: Immunotherapy in Elderly Patients With Advanced NSCLC
Two studies reported at the European Lung Cancer Congress (ELCC) 2019 provided new insights on the efficacy and safety of immunotherapy in elderly patients with advanced non–small cell lung cancer (NSCLC). Although around half of all people newly diagnosed with NSCLC are elderly (Pallis ...
Lung Cancer Organizations Join Forces to Launch GO2 Foundation for Lung Cancer
Two nonprofit organizations serving the lung cancer community—the Bonnie J. Addario Lung Cancer Foundation (ALCF) and Lung Cancer Alliance (LCA)—have announced they are joining forces as the GO2 Foundation for Lung Cancer. With more than 3 decades of combined expertise, a...
AACR and Lung Cancer Initiative at Johnson & Johnson Announce Science Grant Recipients
The American Association for Cancer Research (AACR) and the Lung Cancer Initiative at Johnson & Johnson (LCI) recently announced the inaugural recipients of the AACR–Johnson & Johnson Lung Cancer Innovation Science Grants. The grants represent a new funding opportunity to support research...
FDA Approves Atezolizumab for Extensive-Stage Small Cell Lung Cancer
On March 18, 2019, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq) in combination with carboplatin and etoposide for the first-line treatment of adult patients with extensive-stage small cell lung cancer. Approval was based on the IMpower133 study (ClinicalTrials.gov...
Effect of Increased VA Hospice Care on Use of Aggressive Care and Costs for Veterans With Advanced Lung Cancer
In a study reported in JAMA Oncology, Mor et al found that veterans with advanced lung cancer treated in Veterans Affairs (VA) Medical Centers with high hospice use were more likely to receive concurrent cancer care but less likely to receive aggressive care. Moreover, veterans treated at...
Long-Term Outcomes for Prophylactic Cranial Irradiation vs Observation in Locally Advanced NSCLC
As reported in JAMA Oncology by Sun et al, a long-term update of the phase III NRG Oncology/RTOG 0214 trial has shown that prophylactic cranial irradiation was associated with a reduced incidence of brain metastases and improved disease-free survival—but not overall survival—compared...
AACR 2019: Data Analysis Shows Activity of Pembrolizumab in Pretreated Patients With Advanced Small Cell Lung Cancer
The results of an analysis of pooled data from the phase Ib KEYNOTE-028 trial and the phase II KEYNOTE-158 study of the anti–programmed cell death protein 1 monoclonal antibody pembrolizumab in the treatment of advanced small cell lung cancer has found that the therapy provided antitumor...
Lorlatinib in Advanced NSCLC With ALK Resistance Mutations
In a study reported in the Journal of Clinical Oncology, Shaw et al found that lorlatinib showed greater efficacy in patients with vs without anaplastic lymphoma kinase (ALK) resistance mutations among patients with advanced ALK-positive non–small cell lung cancer (NSCLC) in whom one or more...
Expert Point of View: Siwen Hu-Lieskovan, MD, PhD
DISCUSSANT OF the CheckMate 384 trial, Siwen Hu-Lieskovan, MD, PhD, Director of Solid Tumor Immunotherapy at the Huntsman Cancer Institute, University of Utah, called the short-term safety data “convincing.” However, she noted that the long-term impact of intermittent, lower-minimum concentration...
CheckMate 384 Supports More Convenient Dosing of Nivolumab in Advanced NSCLC
PATIENTS WITH advanced non–small cell lung cancer (NSCLC) may no longer have to come to the clinic every 2 weeks for treatment. According to a descriptive analysis of the phase IIIb/IV CheckMate 384 study, a more convenient dosing option of nivolumab has demonstrated convincing short-term safety...
Ultradeep Next-Generation Sequencing in Patients With Lung Cancer
A new method of determining the sequence of molecules in DNA can be used to detect small fragments of cancerous genetic material in blood samples from patients with lung cancer with a high degree of accuracy, according research published by Li et al in Annals of Oncology. Liquid Biopsies and...
Matthew A. Gubens, MD, on Non–Small Cell Lung Cancer: New Immunotherapy Strategies in the NCCN Guidelines
Matthew A. Gubens, MD, of the UCSF Helen Diller Family Comprehensive Cancer Center, discusses recent updates to the NCCN Guidelines in non–small cell lung cancer, including the use of pembrolizumab as a single agent or in combination based on PD-L1 status, treatment selection in squamous and nonsquamous patients, and how mutational status affects treatment strategy.
Jyoti D. Patel, MD, on Stage III Non–Small Cell Lung Cancer: A Look at New Systemic Treatments
Jyoti D. Patel, MD, of the University of Chicago, discusses immunotherapy for locally advanced NSCLC, selecting patients for these treatments, and the potential toxicities of combination therapies.
Susan Y. Wu, MD, on Non–Small Cell Lung Cancer: Using an Online Tool in Treatment
Susan Y. Wu, MD, of the University of California, San Francisco, discusses how patient exposure to treatment guidelines improved smoking cessation counseling and the use of molecular testing, and decreased the use of adjuvant chemotherapy in patients with early-stage disease (Abstract 5).
Mark K. Ferguson, MD, on Mitigating Frailty and Sarcopenia to Improve Treatment Outcomes
Mark K. Ferguson, MD, of the University of Chicago Hospital, discusses frailty and loss of muscle tissue, which are common among patients with lung cancer. These conditions are linked with decreased survival as well as increased surgical complications, chemotherapy toxicity, and cost of care.
Jing Zeng, MD, on Non–Small Cell Lung Cancer: Therapeutic Implications of Proper Disease Staging
Jing Zeng, MD, of the University of Washington, discusses upstaging disease from stage III to stage IV, which can occur with repeat PET and/or CT scans for patients with locally advanced NSCLC, and the need for clinicians to stage disease properly to ensure appropriate treatment.
Ruqin Chen, MB, on Lung Cancer Treated With Immune Checkpoint Inhibitors: Survival Outcomes and Clinical and Molecular Features
Ruqin Chen, MB, of the Mayo Clinic Florida, discusses early study findings that show molecular profiling with NF1, CD79a, and AKT3 could potentially improve prediction of progression-free survival in patients with lung cancer who are receiving immunotherapy.
Kyle F. Concannon, MD, on Lung Cancer in Homeless Patients: Outcomes and Quality Measures
Kyle F. Concannon, MD, of the University of Washington/Seattle Cancer Care Alliance, discusses study results on the delays in biopsy after radiographic findings among homeless vs housed patients with lung cancer, and the higher rates of missed appointments following diagnosis (Abstract 125).
J. Fletcher Drogos, MD, on Multiple Courses of Stereotactic Body Radiation Therapy: Outcomes in Patients With Lung Cancer
J. Fletcher Drogos, MD, of Rush University, discusses study findings on overall survival and toxicity among patients who undergo multiple radiation treatments for lung cancer.
Shraddha M. Dalwadi, MD, MBA, on Non–Small Cell Lung Cancer: What Contributes to Disparities in Treating Stage I Disease
Shraddha M. Dalwadi, MD, MBA, of Baylor College of Medicine, discusses the nearly 12% of potentially curable patients with stage I NSCLC who do not receive treatment, the various socioeconomic reasons why, and how some patients may benefit from minimally invasive therapies (Abstract 127).
Aaron S. Mansfield, MD, on Treating Rare Thoracic Cancers: Status Update
Aaron S. Mansfield, MD, of the Mayo Clinic, summarizes a session he moderated on rare thoracic cancers such as mesothelioma and thymic epithelial tumors, as well as novel imaging and treatments in neuroendocrine tumors.
Heather A. Wakelee, MD, on Advanced Non–Small Cell Lung Cancer: State-of-the-Art Treatment for EGFR-Positive and ALK-Positive Diseases
Heather A. Wakelee, MD, of Stanford University, discusses the most recent FDA-approved tyrosine kinase inhibitors that target EGFR and ALK mutations, how these agents fit into the treatment landscape, and the rapidly evolving field of TKI resistance.
Leora Horn, MD, on Small Cell Lung Cancer and Immuno-oncology: Have We Finally Solved the Small Cell Paradox?
Leora Horn, MD, of Vanderbilt University Medical Center, discusses the progress made treating extensive-stage small cell lung cancer, improvements in progression-free and overall survival, and the fact that it’s still difficult to determine which patients will benefit most from immunotherapy.
FDA Approves Atezolizumab for Extensive-Stage Small Cell Lung Cancer
On March 18, 2019, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq) in combination with carboplatin and etoposide for the first-line treatment of adult patients with extensive-stage small cell lung cancer. IMpower133 Approval was based on the IMpower133 study, a...
Opioid Use Among Older Survivors of Colorectal, Lung, and Breast Cancers
In a linked Surveillance, Epidemiology, and End Results and Medicare study reported in the Journal of Clinical Oncology, Salz et al found that chronic opioid use varied by cancer among older cancer survivors. By 6 years after diagnosis, survivors were no more likely to be chronic opioid users...
2019 Thoracic Cancers Symposium: Trends in Use of Prophylactic Cranial Irradiation for Extensive-Stage SCLC
A new survey of radiation oncologists points to a sharp decline in the use of prophylactic cranial irradiation for patients with extensive-stage small cell lung cancer (SCLC), indicating a rapid change in standard practice for the disease following the 2017 publication of a major clinical trial by...
2019 Thoracic Cancers Symposium: Effect of Structured Patient Exposure to the NCCN Guidelines for NSCLC
A new clinical trial found that exposing patients to tailored versions of the National Comprehensive Cancer Network (NCCN®) Guidelines for non–small cell lung cancer (NSCLC) may help drive smoking cessation, testing for potential biomarkers and, for early-stage disease, more...
2019 Thoracic Cancers Symposium: Local Consolidative Therapy and Overall Survival in Oligometastatic NSCLC
A new analysis of patients treated with local consolidative therapy for oligometastatic non–small cell lung cancer (NSCLC) found that the intensive treatment approach is associated with improved overall survival. Local consolidative therapy—consisting of radiation therapy or...
Nivolumab Plus Ipilimumab in Advanced NSCLC: Outcomes by PD-L1 and Tumor Mutational Burden Status
As reported in the Journal of Clinical Oncology by Ready et al, the phase II CheckMate 568 trial has shown that higher tumor mutational burden is associated with response, irrespective of programmed cell death ligand 1 (PD-L1) expression in first-line nivolumab plus low-dose ipilimumab treatment of ...
Although Evidence Is Clear That Lung Cancer Screening Saves Lives, Adoption Rates Remain Low
The findings of the National Lung Screening Trial (NLST), reported in 2011, revealed that participants who received low-dose helical computed tomography (CT) scans had a 20% lower risk of dying of lung cancer than participants who received standard chest x-rays. Despite these results,...
Researcher Supported by ASCO’s Conquer Cancer Foundation Earns Spot in Clinical Cancer Advances 2019 for Lung Cancer Study
The work of nine researchers who have previously received funding from Conquer Cancer is featured in ASCO’s Clinical Cancer Advances 2019. Visit CONQUER.ORG/CCA for more details. Immunotherapy At New York University Perlmutter Cancer Center in New York City, Leena Gandhi, MD, PhD, led a large...
Edward B. Garon, MD, on Non–Small Cell Lung Cancer: CheckMate 384 Trial on Nivolumab Dosing
Edward B. Garon, MD, of the Olive View–UCLA Medical Center, discusses phase IIIb/IV study findings on reducing the frequency of nivolumab dosing, from 480 mg every 4 weeks to 240 mg every 2 weeks, in patients with previously treated advanced non–small cell lung cancer (Abstract 100).
Nicolas Guibert, MD, PhD, on Non–Small Cell Lung Cancer: Predicting Response to PD-1 Inhibitors With cfDNA
Nicolas Guibert, MD, PhD, of Toulouse University Hospital, discusses a simple algorithm built to predict durable outcomes of patients with advanced non–small cell lung cancer that has been treated with immunotherapy. He notes that early changes in circulating tumor DNA burden may also predict sustained responses to PD-1 inhibitors (Abstract 103).
2019 ASCO-SITC: Can Plasma Cell–Free DNA Aid in Predicting Response to Checkpoint Inhibitors in NSCLC?
Researchers hypothesized that targeting some genetic alterations in plasma cell–free DNA—along with early monitoring—could be an effective, noninvasive method for predicting response to immune checkpoint inhibitors in advanced non–small cell lung cancer (NSCLC). Findings...
2019 ASCO-SITC: Efficacy and Safety of Less Frequent Dosing of Second-Line Nivolumab for Non–Small Cell Lung Cancer
Researchers reported similar efficacy and safety with an every-4-week regimen of nivolumab in the second-line setting compared to an every-2-week schedule in patients with non–small cell lung cancer (NSCLC). Edward B. Garon, MD, and colleagues presented the results of an interim analysis of...
Stereotactic Ablative vs Standard Radiotherapy in Inoperable Stage I NSCLC
In the phase III TROG 09.02 CHISEL trial reported in The Lancet Oncology, Ball et al found that stereotactic ablative body radiotherapy improved local disease control vs standard radiotherapy in peripherally located, inoperable stage I non–small cell lung cancer (NSCLC). The open-label trial ...
TAT 2019: Trends in Distribution of Cancer Type in Phase I Trials
The proportion of early-stage drug trials tackling the most common tumor types has declined sharply since the early 1990s, as less common cancers receive increasing attention in trials, according to new research presented by Sato et al at the TAT 2019–International Congress on Targeted...
AACR 2019: Liquid Biopsy–Based Test May Be Reliable in Identifying Treatment for Non–Small Cell Lung Cancer
The number of guideline-recommended biomarkers to be assessed in patients with newly diagnosed, metastatic non–small cell lung cancer (NSCLC) is increasing. These biomarkers include both predictive targets—including EGFR, ALK, ROS1, BRAF, RET, MET, and ERBB2—and prognostic...
Pembrolizumab in Combination With Chemotherapy in First-Line Treatment of Metastatic Squamous NSCLC
In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On October 30, 2018, pembrolizumab in combination with...
FDA Pipeline: Priority Reviews in Solid Tumors and Lymphoma; Plus an sNDA in Acute Myeloid Leukemia
Over the past week, the U.S. Food and Drug Administration (FDA) granted multiple Priority Reviews and accepted a supplemental new drug application: Priority Review for Entrectinib in NTRK Fusion–Positive Solid Tumors and Metastatic, ROS1-Positive NSCLC This week, the FDA accepted new drug...
No Survival Benefit With Avelumab vs Docetaxel in Platinum-Treated, Advanced, PD-L1–Positive NSCLC
As reported in The Lancet Oncology by Fabrice Barlesi, MD, and colleagues, the phase III JAVELIN Lung 200 trial has shown no overall survival benefit with avelumab vs docetaxel in patients with platinum pretreated programmed cell death ligand 1 (PD-L1)–positive advanced non–small cell lung cancer ...
System-Based Intervention to Reduce Racial Disparities in Early-Stage Lung Cancer Treatment
Results from a study published by Cykert et al in Cancer Medicine showed that a pragmatic system-based intervention within cancer treatment centers may eliminate existing disparities in treatment and outcomes for black patients with early-stage lung cancer. “These results show ...
Opioid Use Following Thoracoscopic Surgery in Early-Stage Lung Cancer
In a study reported in a research letter in JAMA Oncology, Stephanie Tuminello, MPH, and colleagues found that video-assisted thoracoscopic surgery (VATS) was less likely than open resection to be associated with long-term opioid use in patients undergoing surgery for early-stage lung cancer....
Lorlatinib Shows Overall and Intracranial Activity in ALK-Positive NSCLC
IN A GLOBAL phase II study reported in The Lancet Oncology, Benjamin J. Solomon, MBBS, of Peter MacCallum Cancer Centre, Melbourne, and colleagues found that lorlatinib showed high overall and intracranial activity in patients with advanced ALK-positive non–small cell lung cancer (NSCLC) who were...
Encourage Lung Cancer Screening to Prevent Early Deaths
Discussions of benefits and harms from screening of high-risk populations for lung cancer have missed the point. The National Lung Screening Trial (NLST) showed an early and statistically significant major benefit in all-cause mortality from computed tomography (CT) screening.1 Those referred for...
Multiethnic Cohort Study Update on Racial/Ethnic Differences in Lung Cancer Incidence
In an update from the Multiethnic Cohort Study reported in the Journal of the National Cancer Institute, Stram et al found persistent racial/ethnic differences in risk for lung cancer at similar levels of cigarette smoking intensity. A prior report from the study found that African Americans and...
Clonal MET Amplification and Tyrosine Kinase Inhibitor Treatment Outcome in EGFR-Mutant NSCLC
In a Singaporean study reported in the Journal of Clinical Oncology, Lai et al found that tyrosine kinase inhibitor treatment outcome did not differ according to mesenchymal epithelial transition factor (MET)-high vs MET-low status in treatment-naive, EGFR-mutant non–small cell lung cancer...
Genomic Classification of Lung Cancers Diagnosed in Patients From Appalachian Kentucky
Squamous cell carcinoma of the lung represents approximately one-quarter (26.4%) of all lung cancers diagnosed in Appalachian Kentucky, where death from lung cancer is higher than the national average. Researchers sought to characterize genetic alterations specifically found in lung squamous cell...
Progress With ALK Inhibitors: When Will We Consider ALK-Positive Lung Cancer a ‘Chronic Disease’?
As reported by Solomon et al in The Lancet Oncology1 and reviewed in this issue of The ASCO Post, results from a global phase II study of the third-generation ALK inhibitor lorlatinib showed a high overall response rate and high intracranial response rate for patients with advanced ALK-positive...
Lung-MAP Precision Medicine Trial Expands
The Lung Cancer Master Protocol (Lung-MAP), the first precision medicine trial in lung cancer supported by the National Cancer Institute (NCI), is undergoing a major expansion to include patients with all non–small cell lung cancers (NSCLCs). The trial previously tested treatments for people ...
