Analysis of Cardiac Data Among Patients Treated With Osimertinib
As reported in the Journal of Clinical Oncology by Michael S. Ewer, MD, JD, PhD, and colleagues, an analysis of data from clinical trials of osimertinib suggests the absence of a “causal relationship” between osimertinib and cardiac failure. Study Details The study involved a post hoc assessment of ...
FDA Pipeline: Two Reviews in NSCLC, Plus Prescribing Information Update for Darolutamide
Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review to lorlatinib in ALK-positive non–small cell lung cancer (NSCLC) and Breakthrough Therapy designation to the combination of tiragolumab plus atezolizumab in NSCLC with high PD-L1 expression. The FDA also updated the...
Invasive Diagnostic Procedure Complication Rates After Lung Cancer Screening
In a study reported in a research letter in JAMA Network Open, Zhao et al found that the rate of complications from invasive diagnostic procedures after low-dose computed tomography (CT) lung cancer screening in the community setting was lower than a prior estimate—but still higher than reported in ...
Does Anticancer Therapy Impact Unplanned Hospital Care in Patients With NSCLC?
In a single-institution study reported in JCO Oncology Practice, Shah and Neal found that only a small proportion of unplanned hospital encounters were related to anticancer therapy among patients with non–small cell lung cancer (NSCLC), with almost one-quarter of such encounters being considered...
Adjuvant Gefitinib vs Vinorelbine/Cisplatin in Stage II–IIIA EGFR-Mutant NSCLC: Final Overall Survival Analysis
As reported in the Journal of Clinical Oncology by Zhong et al, the final overall survival results of the phase III CTONG1104 trial indicated no significant advantage of adjuvant gefitinib vs vinorelbine/cisplatin in patients with EGFR-mutant stage II–IIIA (N1–2) non–small cell lung cancer ...
Nivolumab Indication in Small Cell Lung Cancer Withdrawn in U.S. Market
On December 29, Bristol Myers Squibb issued the following statement on nivolumab’s small cell lung cancer (SCLC) indication in the United States. In 2018, nivolumab was granted accelerated approval by the U.S. Food and Drug Administration (FDA) for the treatment of patients with SCLC whose disease...
Left Anterior Descending Coronary Artery Radiation Exposure, Cardiac Events, and Mortality in NSCLC
In a retrospective cohort analysis reported in JAMA Oncology, Atkins et al identified a volume (V, percent) of exposure of the left anterior descending (LAD) coronary artery to a radiation dose (V15 Gy ≥10%) that is an independent risk factor for major adverse cardiac events and all-cause mortality ...
Effect of the COVID-19 Pandemic on Lung Cancer Screening
Reporting on how deferred care worsened outcomes for patients with lung cancer when the COVID-19 pandemic first surged in the spring of 2020, Robert M. Van Haren, MD, MSPH, FACS, and colleagues explained that they have identified a framework that could help people with serious health conditions...
FDA Approves Adjuvant Osimertinib for EGFR-Mutated NSCLC
On December 18, the U.S. Food and Drug Administration (FDA) approved osimertinib (Tagrisso) for adjuvant therapy after tumor resection in patients with non–small cell lung cancer (NSCLC) whose tumors have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 L858R mutations, as...
Association of Out-of-Pocket Costs for Tyrosine Kinase Inhibitors With Outcomes in Patients With EGFR- and ALK-Positive Advanced NSCLC
In a single-institution study reported in JCO Oncology Practice, Bernardo H.L. Goulart, MD, and colleagues found that higher out-of-pocket costs for tyrosine kinase inhibitors (TKIs) were associated with reduced adherence to and increased discontinuation of TKI therapy—as well as poorer overall...
ESMO Immuno-Oncology 2020: Sintilimab vs Docetaxel for Advanced Squamous NSCLC
Sintilimab provided superior clinical benefit compared to docetaxel in patients with previously treated, advanced and/or metastatic squamous non–small cell lung cancer (NSCLC), according to phase III study findings presented by Shi et al at the European Society for Medical Oncology (ESMO)...
Updated Results of CASPIAN Trial: Addition of Durvalumab With or Without Tremelimumab to Chemotherapy in Extensive-Stage SCLC
As reported in The Lancet Oncology by Goldman et al, updated results from the phase III CASPIAN trial showed maintained improvement in overall survival with first-line durvalumab plus platinum/etoposide vs platinum/etoposide in patients with extensive-stage small cell lung cancer (SCLC). However,...
ESMO Immuno-Oncology 2020: Does Pleural Effusion Affect Survival in Patients Treated With Immunotherapy for NSCLC?
Patients with non–small cell lung cancer (NSCLC) who have pleural effusion, especially those requiring pleural evacuation, experienced poorer survival when treated with immune checkpoint inhibitors, according to findings presented by Epaillard et al at the European Society for Medical Oncology...
The Lung Microbiome May Affect Lung Cancer Pathogenesis and Prognosis
Enrichment of the lungs with oral commensal microbes was associated with advanced-stage disease, worse prognosis, and tumor progression in patients with lung cancer, according to results from a study published in Cancer Discovery, a journal of the American Association for Cancer Research.1 “The...
Expert Point of View: Joel W. Neal, MD, PhD
Invited discussant of the abstract, Joel W. Neal, MD, PhD, Associate Professor of Medicine at Stanford University, called this real-world analysis novel,1 given the decreasing number of patients treated with single-agent immunotherapy. “I think we’re unlikely to have a larger prospective study [in...
Lung Cancer Progression-Free Survival With Immunotherapy Varies Significantly by Tumor-Mutation Subtype, Real-World Data Show
A real-world study of single-agent immune checkpoint inhibitors in driver-mutated non–small cell lung cancer (NSCLC) has demonstrated significant variation in progression-free survival between mutation subtypes, according to data presented during the International Association for the Study of Lung...
Early-Stage Lung Cancer: An Overview of the Clinical Trial Landscape
Although early-stage, resectable disease represents the best chance for meaningful long-term survival and cure for patients with lung cancer, there are still high rates of recurrence. According to Rajwanth Veluswamy, MD, MSCR, neoadjuvant and adjuvant treatments are needed to improve surgical...
Expert Point of View: Thomas J. Dilling, MD, MS
Formal discussant Thomas J. Dilling, MD, MS, of Moffitt Cancer Center, Tampa, Florida, congratulated the authors on this study. He noted that early findings from both treatment arms showed similar rates of grade 3 and higher toxicity. “However, in the [four-fraction] arm, a fatal event occurred in...
Single-Fraction SBRT May Be Equivalent to Four in Patients With Oligometastatic Lung Disease
Delivering stereotactic body radiation therapy (SBRT also called stereotactic ablative radiotherapy) in one or four treatment sessions led to similar outcomes in patients with up to three lung metastases (ie, oligometastatic disease) in the phase II randomized SAFRON II trial. The study, conducted...
Expert Point of View: Matthijs Oudkerk, MD
Matthijs Oudkerk, MD, Professor of Radiology at the University Medical Center Groningen, Netherlands, and Principal Investigator for Radiology of the NELSON Lung Cancer Detection Study, stressed that detecting individuals who have early-stage lung cancer with more virulent biologic behavior is...
Surgical Resection of Stage I Lung Cancer: Rating the Evidence of Benefit
A recent report from the U.S. Preventive Services Task Force (USPSTF) has undermined the evidentiary basis for the primary treatment of stage I non–small cell lung cancer (NSCLC) while rating the evidence for the benefit of screening as “high.”1 According to David F. Yankelevitz, MD, these...
Proportion of Never-Smokers Among Patients With Lung Cancer in Seven U.S. States
In a study reported in a research letter in JAMA Oncology, Siegel et al found that never-smokers accounted for 12.5% of patients diagnosed with lung cancer in seven U.S. states during a recent 6-year period, with women accounting for a higher proportion than men. Study Details The study included...
Native American Ancestry May Impact Somatic Alterations Among Latin American Patients With Lung Cancer
A research brief by Carrot-Zhang et al published in Cancer Discovery investigating inherited lung cancer risk—especially in nonsmokers—in Latin America has found that independent of smoking status, variation in EGFR and KRAS mutation frequency in Latin American patients with lung cancer was...
FDA Pipeline: Agents in DLBCL, SCLC, AML, and More
Recently, the U.S. Food and Drug Administration (FDA) has issued regulatory decisions for agents to treat diffuse large B-cell lymphoma (DLBCL), small cell lung cancer (SCLC), acute myeloid leukemia (AML), biliary tract cancer, and graft-vs-host disease. Priority Review for Loncastuximab Tesirine...
First-Line Atezolizumab Improves Overall Survival vs Chemotherapy in Certain Patients With Metastatic NSCLC
As reported in The New England Journal of Medicine by Roy S. Herbst, MD, PhD, of Yale School of Medicine, and colleagues, the phase III IMpower110 trial has shown significantly prolonged overall survival with first-line atezolizumab vs platinum-based chemotherapy in metastatic non–small cell lung...
Racial Disparities in Treatment of Common Lung Cancer Persist Despite Gains
Lung cancer continues to be the most deadly solid cancer in the world, despite the fact that survival rates have been improving over the past decade. However, Black patients have worse outcomes and shorter lifespans after being diagnosed with lung cancer. A study published in the Journal of...
KRAS Inhibitor Adagrasib Shows Activity in Non–Small Cell Lung Cancer
Another novel oral KRAS inhibitor—adagrasib (MRTX849)—has shown promise in early clinical trials, according to investigators of the KRYSTAL-1 study who reported findings at the virtual 32nd EORTC-NCI-AACR Symposium on Molecular Targets and Cancer Therapeutics.1,2 The conference is jointly provided...
Phase III GEMSTONE-302 Trial Finds CS1001 Plus Platinum Chemotherapy Prolongs Progression-Free Survival in NSCLC
The addition of CS1001, an anti–PD-L1 monoclonal antibody, to platinum-based chemotherapy significantly prolonged progression-free survival vs chemotherapy in treatment-naive patients with advanced non–small cell lung cancer (NSCLC), according to phase III findings presented by Zhou et al at the...
Nivolumab Plus Ipilimumab in First-Line NSCLC: Two New Indications, Many More Questions
In May 2020, the combination of nivolumab and ipilimumab was approved by the U.S. Food and Drug Administration (FDA) for two separate indications in the first-line setting of advanced non–small cell lung cancer (NSCLC). One was in metastatic NSCLC with tumors that have PD-L1 expression ≥ 1% with...
First-Line Lorlatinib vs Crizotinib in Advanced ALK-Positive NSCLC
As reported in The New England Journal of Medicine by Alice T. Shaw, MD, PhD, and colleagues, an interim analysis of the phase III CROWN trial has shown that first-line lorlatinib significantly improved progression-free survival and intracranial response rate vs crizotinib in patients with advanced ...
State of Lung Cancer Report Finds People of Color Face Greater Burden, Worse Lung Cancer Outcomes in the United States
People of color diagnosed with lung cancer face worse outcomes compared to White Americans, according to the American Lung Association’s third annual State of Lung Cancer report. The 2020 State of Lung Cancer report tracks the toll of lung cancer by state, and for the first time, this year’s report ...
Study Finds the Lung Microbiome May Affect Tumor Progression and Prognosis in Patients With Lung Cancer
A new study by Tsay et al sheds light on the role the lung microbiome may play in lung cancer pathogenesis and prognosis. According to the study’s findings, enrichment of the lungs with oral commensal microbes was associated with advanced-stage disease, worse prognosis, and tumor progression....
Adjuvant Irinotecan/Cisplatin vs Etoposide/Cisplatin for Resected High-Grade Neuroendocrine Carcinoma of the Lung
In a Japanese phase III trial reported in the Journal of Clinical Oncology, Kenmotsu et al found that adjuvant irinotecan/cisplatin did not improve relapse-free survival vs etoposide/cisplatin in patients with completely resected, pathologic stage I–IIIA, high-grade neuroendocrine carcinoma of the...
Mary Pasquinelli, DNP, APRN, FNP-BC, on Addressing Lung Cancer Care Equity in Vulnerable Communities
Mary Pasquinelli, DNP, APRN, FNP-BC, of the University of Illinois Hospital and Health Science System, discusses proposed U.S. Preventive Services Task Force lung cancer screening guidelines, which show race and gender disparities, and how modifying these recommendations with a risk prediction model may improve health care.
Study Finds State-Level Lung Cancer Screening Rates Not Aligned With Lung Cancer Burden in the United States
A new study published by Stacey A. Fedewa, PhD, and colleagues in JNCI: Journal of the National Cancer Institute found that state-level lung cancer screening rates were not aligned with the national lung cancer burden. The report provides the first population-based state-level screening data for...
James L. Mulshine, MD, on Meeting Highlights: Advancing Quantitative Low-Dose CT Imaging in Thoracic Disease
James L. Mulshine, MD, of Rush University Medical Center, offers an overview of the 2020 Quantitative Imaging Workshop, whose mission is to leverage the use of CT to speed early detection and improve the management of lung cancer and other thoracic diseases.
Medicaid Expansion Associated With Decreased Mortality in Patients With Newly Diagnosed Breast, Colorectal, and Lung Cancers
In states that have expanded Medicaid availability as part of the Affordable Care Act (ACA), mortality rates for three major types of cancer are significantly lower than in states that have not expanded their Medicaid, according to findings from a new study published by Miranda B. Lam, MD, MBA, and ...
Combination of Nivolumab and Ipilimumab for Unresectable Malignant Pleural Mesothelioma
On October 2, 2020, the combination of nivolumab (Opdivo) plus ipilimumab (Yervoy) was approved for first-line treatment of adult patients with unresectable malignant pleural mesothelioma.1-3 Supporting Efficacy Data Approval was based on findings in the open-label phase III CheckMate 743 trial...
Liquid Biopsy: Mounting Evidence Shows Clinical Utility in Tumor Monitoring
A “blood-first” approach could soon shift the diagnostic paradigm in advanced lung cancer, replacing tissue biopsy with minimally invasive assays. According to Natasha B. Leighl, MD, MMSc, FRCPC, FASCO, there is rapidly mounting evidence that liquid biopsy serves a prognostic function in advanced...
Fragment Analysis as a MET Exon 14 Screening Strategy in NSCLC Tumors
Comparison of two techniques used in screening non–small cell lung cancer (NSCLC) tumor samples demonstrated that fragment analysis could detect large MET exon 14 skipping deletions that were missed by next-generation sequencing, according to findings presented at the Molecular Analysis for...
Lung Cancer: Precision Therapies at the Forefront
What a difference 20 years have made! In the year 2000, the results of the ECOG 1594 trial were reported at the plenary session of the ASCO Annual Meeting. The study demonstrated comparable outcomes between four different platinum-based chemotherapy regimens for the treatment of metastatic...
David Yankelevitz, MD, on Early-Stage Lung Cancer: Renewed Interest in Combined-Modality Treatment
David Yankelevitz, MD, of the Icahn School of Medicine at Mount Sinai, discusses the renewed interest in applying adjuvant and neoadjuvant targeted treatments to earlier-stage lung cancer, given the promising results in more advanced disease. The challenges, he says, include identifying patient subgroups with a high likelihood for recurrence and therapeutic toxicities.
FDA Approves Companion Diagnostic for Three Targeted Therapies for Advanced Ovarian, Breast, and Non–Small Cell Lung Cancers
On October 27, 2020, the U.S. Food and Drug Administration (FDA) approved the FoundationOne Liquid CDx test for three new companion diagnostic indications to help match patients who may benefit from treatment with specific FDA-approved targeted therapies. The new indications are for alpelisib...
Fred R. Hirsch, MD, PhD, on Early-Stage Lung Cancer: Targeted Treatment and Screening
Fred R. Hirsch, MD, PhD, of The Tisch Cancer Institute at Mount Sinai, discusses lung cancer screening for aggressive early-stage lung cancer; adjuvant and neoadjuvant treatment, including the ADAURA study of EGFR-positive tumors; and how cell-free DNA analysis might be used in the future to monitor therapy.
Biomarker-Driven Master Protocol to Test Therapies for Previously Treated Patients With Squamous NSCLC
In an article published in The Lancet Oncology, Redman et al described the conduct of and findings from the Lung Cancer Master Protocol (Lung-MAP; SWOG S1400), a completed biomarker-driven master protocol designed to address the need for improved therapies for previously treated patients with...
Daniel G. Petereit, MD, on Disparities in Lung Cancer Care for Northern Plains American Indians
Daniel G. Petereit, MD, of the John T. Vucurevich Cancer Care Institute and Monument Health, discusses the Walking Forward health-care program designed for a South Dakota–based Native American population, whose members have high smoking and death rates from lung cancer as well as limited access to low-dose CT scans.
FDA Pipeline: Priority Reviews in NSCLC, Gastric Cancer
Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review to a PD-1 inhibitor for the treatment of patients with locally advanced or metastatic non–small cell lung cancer (NSCLC), and also granted Priority Review to a HER2-directed antibody-drug conjugate for patients with...
Multisystem Immune-Related Adverse Events and Disease Outcomes Among Patients With NSCLC Treated With Immunotherapy
In a retrospective cohort study reported in JAMA Oncology, Shankar et al found improved progression-free and overall survival among patients who experienced multisystem immune-related adverse events after anti–PD-1 or anti–PD-L1 immune checkpoint inhibitor therapy for stage III/IV non–small cell...
Capmatinib Active in Advanced NSCLC With MET Exon 14 Skipping Mutations
As reported inThe New England Journal of Medicine by Jürgen Wolf, MD, of the Center for Integrated Oncology, University Hospital Cologne and University of Cologne, and colleagues, the phase II GEOMETRY mono-1 trial has shown durable responses with the selective MET inhibitor capmatinib in patients...
EMPOWER-Lung 1 Trial: Cemiplimab Improves Survival Over Chemotherapy in Advanced NSCLC
The European Society for Medical Oncology (ESMO) Virtual Congress 2020 presented several abstracts with good news for patients with lung cancer. Long-term follow-up of immunotherapies showed excellent survival, a promising new ALK inhibitor improved outcomes compared with the standard of care, the...
