Expert Point of View: Nicolas Girard, MD, PhD
Invited discussant Nicolas Girard, MD, PhD, of the Curie Institute, Paris, said, “A major challenge in NSCLC is what happens when osimertinib resistance develops.” “A key takeaway point from this study is that the efficacy is driven by resistance mechanism. The overall response rate was 47% in the ...
Amivantamab/Lazertinib Combination May Overcome Osimertinib Resistance in Patients With EGFR-Positive NSCLC
Combination targeting of epidermal growth factor receptor (EGFR) with amivantamab/lazertinib achieved durable responses in more than one-third of chemotherapy-naive patients with EGFR-mutant non–small cell lung cancer (NSCLC) that had progressed on osimertinib, according to a cohort analysis of the ...
Mechanisms of Acquired Resistance to KRAS G12C Inhibition in Patients With Cancer
In a study reported in The New England Journal of Medicine, Awad et al identified potential mechanisms of acquired resistance to the KRAS G12C inhibitor adagrasib in patients receiving the agent for treatment of KRAS G12C–mutant cancers. As noted by the investigators, clinical trials of the KRAS...
Emerging Reasons for Optimism in Lung Cancer
Despite public smoking cessation initiatives and improved methods for early detection and treatment, lung cancer persists as the leading cause of cancer death in both men and women in the United States. However, over the past decade, smoking cessation efforts, increased screening, and new...
Sotorasib: Subgroup Analysis of Phase II Trial Shows Activity With Breakthrough KRAS Inhibitor in Lung Cancer
The breakthrough KRAS-specific inhibitor sotorasib achieved responses in patients with KRAS G12C–mutated non–small lung cancer (NSCLC) who had experienced disease progression on platinum-based chemotherapy, immunotherapy, or both treatments. The objective response rate was 37.1%, and responses...
Martin Reck, MD, PhD, on NSCLC: Nivolumab, Ipilimumab, and Chemotherapy for Advanced Disease
Martin Reck, MD, PhD, of LungenClinic, discusses a 2-year update of the CheckMate 9LA study, which sought to determine whether nivolumab plus ipilimumab combined with two cycles of chemotherapy is more effective than four cycles of chemotherapy alone as a first-line treatment for patients with stage IV non–small cell lung cancer (Abstract 9000).
Study Evaluates Residential Racial Segregation and NSCLC Treatment and Outcomes
Non–small cell lung cancer (NSCLC) accounts for 80% to 85% of cases of lung cancer; when it is diagnosed early, there is a 5-year survival rate of 50% to 80%. Black patients have a lower overall incidence of NSCLC than White patients but are more likely to be diagnosed at later stages. They also...
Trilaciclib to Reduce Chemotherapy-Induced Bone Marrow Suppression in Extensive-Stage Small Cell Lung Cancer
On February 12, 2021, the cyclin-dependent kinase 4/6 (CDK4/6) inhibitor trilaciclib was approved for use to decrease the incidence of chemotherapy-induced myelosuppression in adult patients when administered prior to a platinum/etoposide–containing regimen or topotecan-containing regimen for...
Pralsetinib in Advanced RET Fusion–Positive NSCLC: ARROW Trial
As reported in The Lancet Oncology by Justin F. Gainor, MD, and colleagues, an interim analysis of the phase I/II ARROW trial has shown that the oral RET inhibitor pralsetinib produced high response rates in previously treated and treatment-naive patients with advanced RET fusion–positive non–small ...
Real-World Survival Outcomes With Targeted Therapy for Intracranial Metastatic Disease
In a retrospective cohort study reported in JAMA Oncology, Erickson et al found that real-world use of targeted therapy after diagnosis of intracranial metastatic disease was associated with improved overall survival vs no use of targeted therapy in patients with HER2-positive breast cancer,...
Global Registry Analysis of NRG1 Fusion–Positive Lung Cancer
In an analysis from the global eNRGy1 registry for NRG1 fusion–positive lung cancers reported in the Journal of Clinical Oncology, Alexander Drilon, MD, and colleagues found greater than expected heterogeneity in characteristics of disease. Additionally, patients had poor responses to cytotoxic,...
Dual Immune Checkpoint Blockade With Nivolumab and Ipilimumab for Treatment of Malignant Pleural Mesothelioma
In recent years, immune checkpoint inhibitors in the treatment of mesothelioma have been a keen area of investigation for this immunogenic solid tumor. With recent publications, principally findings from CheckMate 743 by Baas et al1 (reviewed in this issue of The ASCO Post), combination immune...
Nivolumab/Ipilimumab Improves Overall Survival vs Chemotherapy in First-Line Treatment for Unresectable Malignant Pleural Mesothelioma
As reported in The Lancet by Paul Baas, MD, of The Netherlands Cancer Institute, Amsterdam, and colleagues, a prespecified interim analysis in the phase III CheckMate 743 trial has shown improved overall survival with first-line nivolumab/ipilimumab vs platinum-based chemotherapy in unresectable...
Selected Poster Presentations From the NCCN 2021 Annual Conference
Although once again, the National Comprehensive Cancer Network® (NCCN®) 2021 Annual Conference could not take place on site in Orlando, researchers presented their work virtually in the form of almost 100 posters. The ASCO Post has summarized some that we found particularly interesting. Many...
Atezolizumab Reduces Risk of Disease Progression in Patients With PD-L1–Expressing Early-Stage NSCLC
Atezolizumab given after chemotherapy to patients with resected stage II to IIIA non–small cell lung cancer (NSCLC) significantly improved disease-free survival compared with best supportive care alone in patients whose tumors expressed PD-L1.1 These results of the global phase III IMpower010 trial ...
Inclusion of Patients With Brain Metastases in Phase III Trials in Advanced Breast Cancer, Lung Cancer, and Melanoma
In a study reported in a research letter in JAMA Oncology, Corbett et al found that the majority of phase III trials investigating systemic therapy in patients with advanced lung cancer, breast cancer, and melanoma over the past 20 years have excluded or restricted enrollment of those with brain...
Expert Point of View: Christine Lovly, MD, PhD
Invited discussant Christine Lovly, MD, PhD, Associate Professor of Medicine, Ingram Associate Professor of Cancer Research, Vanderbilt University Ingram Cancer Center, Nashville, discussed progress in targeted therapies for NSCLC. “We have a tremendous amount of knowledge about driver mutations in ...
More Widespread Biomarker Testing for NSCLC in Oncology Practices and More Testing in Black Patients: An Urgent Priority
Even though next-generation sequencing is recommended by the National Comprehensive Cancer Network (NCCN) for biomarker testing for patients with non–small cell lung cancer (NSCLC), the uptake among community oncology practices is suboptimal, and the uptake is even lower among Black patients with...
Effect of Time to Surgery on Recurrence and Survival in Clinical Stage I NSCLC
In a retrospective cohort study reported in JAMA Network Open, Heiden et al found that increased time from preoperative diagnostic computed tomography imaging and surgical treatment was associated with an increased risk of disease recurrence and poorer overall survival in patients with clinical...
Vamsidhar Velcheti, MD, on NSCLC: Sotorasib in KRAS-Mutated Disease
Vamsidhar Velcheti, MD, of New York University, discusses overall survival and exploratory subgroup analyses from the phase II CodeBreaK 100 trial, which evaluated the use of sotorasib in pretreated KRAS G12C–mutant non–small cell lung cancer (Abstract 9003).
Sotorasib for KRAS G12C–Mutated NSCLC: Overall Survival and Exploratory Subgroup Analyses
Results from the phase II cohort of the CodeBreaK 100 study showed that treatment with the KRAS G12C inhibitor sotorasib achieved a 37.1% objective response rate and a median overall survival of 12.5 months in previously treated patients with KRAS G12C–mutated non–small cell lung cancer (NSCLC)....
Byoung Chul Cho, MD, PhD, on NSCLC: Amivantamab Plus Lazertinib for Treatment of Relapsed Disease
Byoung Chul Cho, MD, PhD, of the Yonsei Cancer Center, discusses study results that showed treatment with the EGFR-MET bispecific antibody amivantamab plus the EGFR inhibitor lazertinib yielded responses in 36% of chemotherapy-naive patients with non–small cell lung cancer whose disease progressed on osimertinib. Genetic biomarkers may be able to identify patients most likely to benefit from the combination regimen (Abstract 9006).
Pasi A. Janne, MD, PhD, on NSCLC: Patritumab Deruxtecan to Target HER3
Pasi A. Janne, MD, PhD, of Dana-Farber Cancer Institute, discusses study findings that show patritumab deruxtecan is effective in patients with EGFR-mutated and inhibitor-resistant non–small cell lung cancer. Dr. Janne also explains why targeting HER3, a mutation expressed in most EGFR-altered cancers, is a beneficial treatment approach (Abstract 9007).
Debora S. Bruno, MD, on NSCLC: Racial Disparities in Biomarker Testing and Clinical Trial Enrollment
Debora S. Bruno, MD, of Seidman Cancer Center at Cleveland Medical Center, discusses study findings that show Black patients with advanced or metastatic non–small cell lung cancer tend to be less likely to undergo biomarker testing or to be treated in clinical trials than White patients. Recommended broad-based testing, says Dr. Bruno, may help ensure equal access to quality care and clinical trials (Abstract 9005).
Serendipity Plays a Role in a Journey to a Noted Career in Surgical Oncology
Over the past 2 decades, the oncologic mantra “early detection leads to cure” has taken on special meaning in lung cancer, persistently a leading cause of cancer death in the United States. “Over a 25-year period, we’ve seen a revolution in early detection, understanding of tumor biology, and...
FDA Approves Sotorasib for KRAS G12C–Mutated NSCLC
On May 28, the U.S. Food and Drug Administration (FDA) approved sotorasib (Lumakras) as the first treatment for adult patients with non–small cell lung cancer (NSCLC) whose tumors have a KRAS G12C genetic mutation and who have received at least one prior systemic therapy. This is the first approved ...
Neoadjuvant Durvalumab With vs Without Stereotactic Body Radiotherapy in Early-Stage NSCLC
In a single-center phase II trial reported in The Lancet Oncology, Nasser K. Altorki, MD, and colleagues found that neoadjuvant durvalumab plus stereotactic body radiotherapy (SBRT) resulted in a markedly higher major pathologic response rate vs durvalumab alone in patients with early-stage...
ORIENT-12 Study: Addition of Sintilimab to Gemcitabine/Platinum in Advanced Squamous NSCLC
Adding sintilimab to a regimen of gemcitabine and platinum demonstrated clinical benefit over gemcitabine and platinum alone as first-line therapy in patients with locally advanced or metastatic squamous non–small cell lung cancer (NSCLC). These results from the ORIENT-12 trial were published by...
EMPOWER-Lung 1 Trial: New Options, No New Answers
The EMPOWER-Lung 1 trial, recently reported in The Lancet and reviewed in this issue of The ASCO Post, showed an improvement in progression-free and overall survival with cemiplimab-rwlc in patients with advanced non–small cell lung cancer (NSCLC) and high PD-L1 expression (tumor proportion score...
First-Line Cemiplimab-rwlc Improves Outcomes vs Platinum-Doublet Chemotherapy in Advanced NSCLC With PD-L1 Expression ≥ 50%
As reported in The Lancet by Ahmet Sezer, MD, of Başkent University, Adana, Turkey, and colleagues, the phase III EMPOWER-Lung 1 trial has shown improved overall and progression-free survival with cemiplimab-rwlc vs platinum doublet chemotherapy among patients with advanced non–small cell lung...
FDA Grants Accelerated Approval to Amivantamab-vmjw for Metastatic EGFR Exon 20 Insertion–Mutated NSCLC
On May 21, the U.S. Food and Drug Administration (FDA) granted accelerated approval to amivantamab-vmjw (Rybrevant), a bispecific antibody directed against epidermal growth factor and MET receptors, for adult patients with locally advanced or metastatic non–small cell lung cancer (NSCLC) and...
FDA Pipeline: Applications Accepted for Marginal Zone Lymphoma and Lung Cancer
Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review to zanubrutinib in pretreated patients with marginal zone lymphoma, and accepted a biologics license application for sintilimab injection in combination with pemetrexed and platinum chemotherapy for the first-line...
Heather A. Wakelee, MD, on NSCLC: Atezolizumab vs Best Supportive Care After Chemotherapy
Heather A. Wakelee, MD, of Stanford University Medical Center, discusses the primary disease-free survival results of IMpower010, a phase III study that compared adjuvant atezolizumab vs best supportive care after adjuvant chemotherapy in patients with early-stage resected non–small cell lung cancer (Abstract 8500).
Does Adjuvant Atezolizumab Extend Disease-Free Survival in Patients With Resected Early-Stage NSCLC?
Patients with resected early-stage non–small cell lung cancer (NSCLC) who received the PD-L1 inhibitor atezolizumab following cisplatin-based chemotherapy had a 34% reduction in the risk of disease recurrence compared with best supportive care, according to the results from the phase III IMpower010 ...
Stage IV PD-L1–High Non–Small Cell Lung Cancer: Immunotherapy Alone or With Chemotherapy?
Except in patients with no smoking history, the addition of chemotherapy to immunotherapy does not add benefit as a first-line treatment in patients with stage IV nonsquamous non–small cell lung cancer (NSCLC) and high expression of PD-L1, according to real-world experience. Outcomes from the U.S. ...
Phase II Study of Trilaciclib in Pretreated Patients With Metastatic NSCLC Initiated
PRESERVE 4 (ClinicalTrials.gov identifier: NCT04863248)—a multicenter, randomized, double-blind, placebo-controlled phase II study of trilaciclib administered prior to docetaxel in patients with metastatic non–small cell lung cancer (NSCLC) in the second- and third-line setting who have previously...
ASCO and Ontario Health Publish Joint Update on Guideline for Targeted Therapy in NSCLC With Driver Alterations
ASCO and Ontario Health (Cancer Care Ontario) have jointly published an update1 to the 2017 ASCO guideline2 regarding systemic therapy recommendations for stage IV non–small cell lung cancer (NSCLC) with driver alterations. Guideline Co-Chair Nasser H. Hanna, MD, of the Indiana University Simon...
Cemiplimab-rwlc for First-Line Treatment of NSCLC With High PD-L1 Expression
On February 22, 2021, cemiplimab-rwlc was approved for first-line treatment of patients with advanced non–small cell lung cancer (NSCLC; locally advanced who are not candidates for surgical resection or definitive chemoradiation therapy or metastatic) whose tumors have high PD-L1 expression (tumor...
Expert Point of View: Jhanelle E. Gray, MD
Formal discussant of the CheckMate 816 trial, Jhanelle E. Gray, MD, of Moffitt Cancer Center, Tampa, said that both neoadjuvant and adjuvant therapies have been shown to improve overall survival and relapse-free survival in non–small cell lung cancer (NSCLC). “Overall, neoadjuvant outcomes compare...
CheckMate 816: Neoadjuvant Nivolumab Plus Chemotherapy Boosts Pathologic Complete Response in Resectable NSCLC
Neoadjuvant chemotherapy with nivolumab plus platinum-doublet chemotherapy significantly improved pathologic complete response rates compared with chemotherapy alone in patients with resectable stage IB to IIIA non–small cell lung cancer (NSCLC), according to the results of the CheckMate 816 study...
Accuracy of Lung Cancer Risk Model in Diverse Populations
A commonly used risk prediction model does not accurately identify high-risk Black patients with lung cancer who could gain life-saving benefit from early screening—paving the way for improving screenings and guidelines. These findings were published in a research letter by Shusted et al in JAMA...
FDA Pipeline: Priority Reviews of Treatments for Bladder and Lung Cancers
Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review designation to treatments for surgically resected, high-risk, muscle-invasive urothelial carcinoma and epidermal growth factor receptor exon 20 insertion mutation–positive metastatic non–small cell lung cancer (NSCLC)....
First-Line Immune Checkpoint Inhibitor Monotherapy vs Chemoimmunotherapy in Advanced NSCLC According to KRAS Variant Status
In a study reported in a research letter in JAMA Oncology, Sun et al found that first-line immune checkpoint inhibitor monotherapy was associated with better overall survival among patients with advanced non–small cell lung cancer (NSCLC) with PD-L1 expression ≥ 50% and KRAS variant vs KRAS...
Five-Year Efficacy Outcomes With Pembrolizumab vs Chemotherapy in Metastatic NSCLC With PD-L1 Tumor Proportion Score of at Least 50%
As reported by Martin Reck, MD, PhD, and colleagues in the Journal of Clinical Oncology, the 5-year follow-up of the pivotal phase III KEYNOTE-024 trial shows maintained overall survival benefit in patients treated with pembrolizumab vs chemotherapy—despite substantial crossover to the...
Contralateral Esophagus-Sparing Radiotherapy Technique Reduces Rates of Esophagitis in Patients With Lung Cancer Receiving High-Dose Chemoradiation
In a small, single-institution phase I trial reported in JAMA Oncology, Kamran et al found that the use of a contralateral esophagus-sparing radiotherapy technique in patients receiving high-dose chemoradiation for locally advanced lung cancer was associated with no cases of grade ≥ 3 esophagitis,...
Safety of Stereotactic Body Radiotherapy for Patients With Multiple Metastases
In the phase I NRG-BR001 trial reported in JAMA Oncology, Chmura et al found that stereotactic body radiotherapy (SBRT) could be used safely to treat multiple metastases in patients with breast, lung, and prostate cancers. Study Details The trial was conducted within a consortium of North...
Transmission of Cancer to Infants From Mothers With Cervical Cancer During Vaginal Delivery
In a brief report in The New England Journal of Medicine, Ayumu Arakawa, MD, of the Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, and colleagues described identification of lung cancer in two boys that likely resulted from transmission of maternal cervical cancer tumor...
Nivolumab/Ipilimumab Plus Two Cycles of Histology-Based Chemotherapy: Another Option in First-Line Metastatic NSCLC
Introduction of immunotherapy has revealed a paradigm shift in the management of patients with metastatic non–small cell lung cancer (NSCLC) that does not harbor a therapeutically targetable driver mutation. Over the past 5 years, several trials have informed treatment decisions, based on disease...
First-Line Nivolumab/Ipilimumab Plus Chemotherapy Improves Overall Survival vs Chemotherapy in Stage IV or Recurrent NSCLC
As reported in The Lancet Oncology by Luis Paz-Ares, MD, of the Universidad Complutense & CiberOnc, Madrid, and colleagues, the phase III CheckMate 9LA trial has shown improved overall survival with first-line nivolumab/ipilimumab plus two cycles of chemotherapy vs four cycles of chemotherapy...
Patient Knowledge and Expectations Regarding Genomic Testing Results
As reported in JCO Oncology Practice by Roth et al, many participants in a biomarker-driven master protocol trial (Lung Cancer Master Protocol [Lung-MAP]; SWOG S1400GEN) did not display correct knowledge or expectations about using the results of genomic testing. Study Details Lung-MAP is a...
