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Adjuvant nivolumab following neoadjuvant nivolumab plus chemotherapy and surgery may be effective at reducing the risk of disease recurrence or mortality in patients with resectable non–small cell lung cancer (NSCLC) compared with neoadjuvant nivolumab plus chemotherapy alone, according to new...
Despite significant improvements in the perception of biomarker testing compared with a 2018 survey, substantial barriers to implementation may persist globally, according to new findings presented by Smeltzer et al at the International Association for the Study of Lung Cancer (IASLC) 2024 World...
Researchers may have uncovered a metabolic pathway that could lead to the development of predictive biomarkers for immune checkpoint inhibitors, according to new findings presented by Kulasinghe et al at the International Association for the Study of Lung Cancer (IASLC) 2024 World Conference on...
In a phase III study conducted in China, the bispecific antibody ivonescimab demonstrated a statistically significant and clinically meaningful improvement in progression-free survival compared with the PD-1 inhibitor pembrolizumab as a first-line treatment of PD-L1–positive advanced non–small...
The antibody-drug conjugate ifinatamab deruxtecan (I-DXd) showed clinically meaningful responses in pretreated patients with extensive-stage small cell lung cancer (SCLC) in an interim analysis of the phase II IDeate-Lung01 study. The findings were presented at the International Association for...
As reported in the Journal of Clinical Oncology by Yang et al, the phase III KEYNOTE-789 trial has shown no significant improvement in progression-free or overall survival with the addition of pembrolizumab to pemetrexed/platinum in EGFR tyrosine kinase inhibitor (TKI)-resistant, EGFR-mutant...
Research suggests an artificial intelligence (AI) tool called DeepGEM may provide an advancement in genomic testing that offers an accurate, cost-effective, and timely method for gene mutation prediction from histopathology slides. The research was presented at the International Association for the ...
Investigators have revealed that patients with certain chronic conditions may face delays in being diagnosed with lung cancer, according to a recent study published by Rogers et al in the British Journal of Cancer. Background Lung cancer is currently one of the leading causes of cancer-related...
As reported in The Lancet Oncology by Zhao et al, meta-analyses of trials of immune checkpoint inhibitors (ICIs) in patients with advanced EGFR-mutated non–small cell lung cancer (NSCLC) progressing on EGFR tyrosine kinase inhibitor (TKI) treatment indicate that the optimal treatment strategy is...
In a French phase II study (RTEP7–IFCT-1402) reported in The Lancet Oncology, Vera et al found that adaptive radiotherapy based on fluorine F-18–labeled fluorodeoxyglucose (FDG)–positron-emission tomography (PET) residual uptake appeared to improve local disease control compared with standard...
Artificial intelligence (AI) tools may be used to better understand the risk of specific cardiac arrhythmias when various parts of the heart are exposed to different thresholds of radiation as part of a treatment plan for non–small cell lung cancer (NSCLC), according to a recent study published by...
The U.S. Food and Drug Administration (FDA) has approved the EGFR inhibitor lazertinib (Lazcluze) in combination with the EGFR/MET-targeting bispecific antibody amivantamab-vmjw (Rybrevant) for the first-line treatment of patients with locally advanced or metastatic non–small cell lung cancer...
Researchers have developed an alternative set of simple criteria using a prediction model to identify groups of patients who may benefit most from lung cancer screening but are disproportionately excluded by current eligibility criteria, according to a new study published by Kearney et al in the...
A subgroup analysis of data from the LIBRETTO-431 trial (ClinicalTrials.gov identifier NCT04194944) showed that the selective RET inhibitor selpercatinib safely improved progression-free survival compared to chemotherapy plus pembrolizumab in East Asian patients diagnosed with RET fusion–positive...
The U.S. Food and Drug Administration (FDA) has approved the PD-L1 inhibitor durvalumab (Imfinzi) with platinum-containing chemotherapy as neoadjuvant treatment followed by single-agent durvalumab as adjuvant treatment after surgery for adults with resectable (tumors ≥ 4 cm and/or node positive)...
Immune checkpoint inhibitors, including atezolizumab, have been evaluated in several phase II trials for neoadjuvant therapy in resectable lung cancer, both with and without chemotherapy, such as the LCMC3 trial and CheckMate 816. Ongoing studies, including the IMpower030 trial, are further...
In an analysis from the CALGB 140503 trial reported in JAMA Oncology, Nasser Altorki, MD, and colleagues found that pathologically identified visceral pleural invasion was associated with poorer outcomes in patients undergoing surgery for non–small cell lung cancer (NSCLC). Study Details The trial ...
In a retrospective study (TURBO-NSCLC) reported in the Journal of Clinical Oncology, Pike et al found that the addition of upfront stereotactic radiosurgery (SRS) to central nervous system (CNS)-penetrant tyrosine kinase inhibitor (TKI) treatment prolonged time to CNS progression vs TKI treatment...
In an article in the Journal of Clinical Oncology, corresponding author Benjamin J. Solomon, MBBS, BS, PhD, of Peter MacCallum Cancer Centre, Melbourne, and colleagues provided a long-term analysis of 5-year outcomes from the phase III CROWN trial.1 Median progression-free survival had not been...
Cancer screening may cost more than $40 billion annually in the United States, according to a recent study published by Halpern et al in the Annals of Internal Medicine. Study Methods and Results In the recent modeling study, investigators used national health-care survey and cost resources data to ...
The survival rates of patients with advanced non–small cell lung cancer (NSCLC) have improved since the introduction of the first immunotherapeutic in this population in the United States in 2015, according to a recent study published by Wang et al in Cancer. NSCLC accounts for up to 90% of all...
Lung cancer is the leading cause of cancer-related death worldwide, accounting for the highest mortality rates among both men and women. Most lung cancers—between 80% and 85%—are non–small cell lung cancer (NSCLC), and between 1% and 2% of patients are diagnosed with RET-altered NSCLC. The results...
Lung cancer remains the leading cause of cancer-related deaths worldwide. Detecting this disease in its early stages significantly improves survival rates, making low-dose computed tomography (CT) screening an essential component in the fight against lung cancer. Recent studies, particularly from...
In the phase II INSIGHT 2 trial reported in The Lancet Oncology, Yi-Long Wu, MD, and colleagues found that the combination of tepotinib plus osimertinib showed clinically meaningful activity in patients with advanced or metastatic EGFR-mutated non–small cell lung cancer (NSCLC) with MET...
People who use e-cigarettes in conjunction with cigarette smoking are four times more likely to develop lung cancer than people who just smoke cigarettes, according to new study published by Harris et al the Journal of Oncology Research and Therapy. These findings were consistent across gender and...
In a study reported in the Journal of Clinical Oncology, Arielle Elkrief, MD, and colleagues found that detection of intratumoral Escherichia was associated with improved overall survival in patients with advanced non–small cell lung cancer (NSCLC) receiving single-agent immune checkpoint inhibitor ...
The oral KRAS G12C inhibitor glecirasib has emerged as a therapeutic option for previously treated KRAS G12C–mutated non–small cell lung cancer (NSCLC). It may potentially improve efficacy and tolerability compared with current U.S. Food and Drug Administration–approved agents, according to data...
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...
The international meeting in Madrid of the newly formed Alliance for Global Implementation of Lung and Cardiac Early Disease Detection and Treatment (AGILE) was held in May 2024. This diverse forum included health-care professionals, public health leaders, industry representatives, and patient...
This is Part 3 of ALK-Positive Metastatic NSCLC: Where Are We Now?, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Todd Bauer, Narjust Florez, and Sai-Hong Ignatius Ou discuss the second-line treatment of ALK-positive non–small cell lung cancer (NSCLC) with CNS progression on first-line crizotinib. The patient was initially diagnosed with metastatic EML4::ALK-positive NSCLC at age 40 years in 2013. He did not have any CNS lesions present at the time of diagnosis and started treatment with first-line crizotinib. In February 2014, he developed seizures and was found to have multiple CNS lesions, which were treated with whole-brain irradiation. He subsequently enrolled in the phase I lorlatinib trial in April 2014. In November 2018, while at the 75-mg daily dose, he developed grand mal seizures with no evidence of disease progression, and lorlatinib was held; 11 days later, he returned to his baseline. He resumed treatment with lorlatinib at 50 mg daily and has maintained a near–complete response since that time. In April 2024, he developed recurrent seizures and has been holding lorlatinib since that time with resolution of symptoms. In the conversation that follows, the faculty discuss the long-term toxicities vs benefit of lorlatinib, the management of toxicities associated with lorlatinib, and the impact of dose reduction on efficacy.
This is Part 2 of ALK-Positive Metastatic NSCLC: Where Are We Now?, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Todd Bauer, Narjust Florez, and Sai-Hong Ignatius Ou discuss the first-line management of ALK-positive non–small cell lung cancer (NSCLC) with CNS metastases at basement and CNS toxicity early in treatment. The patient is a 76-year-old prior smoker who presented to the emergency room in February 2024 with complaints of dyspnea. Imaging revealed a 3.2-cm right lower lobe lung mass and a widely metastatic process. Lung biopsy confirmed metastatic NSCLC, and liquid next-generation sequencing (NGS) revealed an EML::ALK variant 3a/b rearrangement. MRI of the brain revealed a 4-mm right frontal lobe metastasis. The patient started first-line lorlatinib at 100 mg daily in March 2024, and 3.5 weeks later showed decreased conspicuity of the CNS lesion. However, he also began to note mild confusion and “chemo fog” after his second cycle of therapy. In the conversation that follows, the faculty discuss common toxicities associated with lorlatinib, the role of dose reduction in managing toxicities, and the importance of taking a social history to obtain a holistic understanding of patients.
This is Part 1 of ALK-Positive Metastatic NSCLC: Where Are We Now?, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Todd Bauer, Narjust Florez, and Sai-Hong Ignatius Ou discuss the first-line management of metastatic non–small cell lung cancer (NSCLC) with CNS metastases at baseline. The patient presented at age 38 years for evaluation of headaches in 2021. A head CT revealed two lesions with surrounding edema but no midline shift, which was concerning for metastatic disease. A CT of the chest, abdomen, and pelvis revealed a 4-cm left upper lobe lung mass, hilar adenopathy, and a 2-cm liver lesion. Liver biopsy confirmed metastatic NSCLC. While awaiting next-generation sequencing (NGS), the patient was started on carboplatin plus pemetrexed and was referred for radiation to the CNS lesions. NGS returned with an EML4::ALK variant 1 translocation, and she began treatment with alectinib. One week after alectinib was started, she underwent stereotactic radiosurgery to the CNS lesion. In the conversation that follows, the faculty discuss the importance of NGS testing for actionable driver mutations regardless of smoking history, appropriate therapy options when starting treatment prior to having NGS results, and the role of stereotactic radiosurgery in the first-line setting.
As reported in The New England Journal of Medicine by Byoung Chul Cho, MD, PhD, and colleagues, the phase III MARIPOSA trial has shown improved progression-free survival with amivantamab-vmjw plus lazertinib vs osimertinib in previously untreated patients with EGFR-mutated advanced non–small cell...
Second-line therapy with the KRAS inhibitor adagrasib modestly improved progression-free survival and objective response rate over docetaxel in previously treated patients with advanced KRAS G12C–mutated non–small cell lung cancer (NSCLC), according to the primary analysis of the phase III...
Early palliative care can be integrated into the course of treatment for patients with advanced lung cancer via delivery by telehealth with outcomes similar to when palliative care is delivered via in-person visits, according to results of the REACH PC trial presented by Joseph Greer, PhD, of...
Consolidation therapy with the PD-L1 antibody durvalumab after chemoradiotherapy extended survival in patients with limited-stage small cell lung cancer (SCLC) compared with standard-of-care chemoradiotherapy alone, according to the first planned interim analysis of the phase III ADRIATIC trial...
On April 18, 2024, the ALK inhibitor alectinib was approved by the U.S. Food and Drug Administration (FDA) for adjuvant treatment after tumor resection in patients with ALK-positive non–small cell lung cancer (NSCLC), as detected by an FDA-approved test.1 Supporting Efficacy Data Approval was based ...
As reported in the Journal of Clinical Oncology by Benjamin J. Solomon, MBBS, PhD, and colleagues, analysis of 5-year outcomes in the phase III CROWN trial showed that median progression-free survival had not been reached in previously untreated patients receiving lorlatinib vs a median of 9.1...
As reported in The Lancet Oncology by Aerts et al, the phase II/III DENIM trial showed no overall survival benefit with a treatment comprising dendritic cells loaded with allogeneic tumor cell lysate (called MesoPher) plus best supportive care vs best supportive care alone as maintenance therapy in ...
As reported in the Journal of Clinical Oncology by Luis G. Paz-Ares, MD, PhD, and colleagues, the phase III EVOKE-01 trial has shown a numeric but not statistically significant improvement in overall survival with sacituzumab govitecan-hziy vs docetaxel in patients with metastatic non–small cell...
Investigators have found that U.S. veterans who underwent lung cancer screening prior to diagnosis were potentially more likely to be diagnosed with earlier-stage disease and have a higher cure rate compared with those who did not undergo screening, according to a recent study published by Edwards...
In a study reported in JAMA Internal Medicine, Bandi et al found that only 18% of eligible individuals in the United States were considered up to date—defined as undergoing screening within the past year—for recommended annual lung cancer screening in 2022. As stated by the investigators, “The U.S. ...
On February 15, 2024, tepotinib (Tepmetko)-—a kinase inhibitor directed against MET, including variants with exon 14 skipping—was granted regular approval for patients with metastatic non–small cell lung cancer (NSCLC) harboring mesenchymal-epithelial transition (MET) exon 14–skipping ...
Osimertinib significantly improved progression-free survival compared with placebo in patients with unresectable stage III EGFR-mutated non–small-cell lung cancer (NSCLC) following definitive chemoradiotherapy. These findings of the phase III LAURA trial suggest that osimertinib may become a new...
Researchers have found that about 6% of patients with non–small cell lung cancer (NSCLC) and KRAS, EGFR, or ALK gene mutations may also have HER2 alterations, according to recent findings presented by Dahake et al at the 2024 ASCO Annual Meeting (Abstract 8534). Background Lung adenocarcinoma is...
Researchers have shown the effectiveness of more scalable ways of delivering palliative care in patients with advanced lung cancer, according to new findings published by Temel et al in JAMA and simultaneously presented at the 2024 ASCO Annual Meeting (Abstract 12000). Background More intensive...
Exposure to increased neighborhood violence may change the glucocorticoid receptor for the stress hormone cortisol and influence the aggressiveness of lung cancer, according to new findings presented by Heath et al at the Endocrine Society’s Annual Meeting & Exposition 2024. Study Methods and...
Narjust Florez, MD, of the Dana-Farber Cancer Institute, and Suresh S. Ramalingam, MD, of Emory University School of Medicine, Winship Cancer Institute, discuss potentially practice-changing phase III results from the LAURA study. This trial showed that osimertinib after definitive chemoradiation therapy improved progression-free survival for patients with unresectable stage III EGFR-mutated non–small cell lung cancer (NSCLC), suggesting this agent may represent a new standard of care in this setting (LBA4).
Minesh P. Mehta, MD, of Miami Cancer Institute, part of Baptist Health South Florida, discusses results from the METIS (EF-25) trial evaluating the efficacy and safety of tumor treating fields therapy following stereotactic radiosurgery in patients with mutation-negative non–small cell lung cancer (NSCLC) and brain metastases. Tumor treating fields therapy prolongs time to intracranial disease progression and may postpone whole-brain radiation therapy without declines in quality of life and cognition (Abstract 2008).
Narjust Florez, MD, of Dana-Farber Cancer Institute, and David R. Spigel, MD, of Sarah Cannon Research Institute, discuss phase III findings showing that durvalumab as consolidation treatment after concurrent platinum-based chemoradiotherapy improved survival outcomes compared with placebo in patients with limited-stage small cell lung cancer. According to Dr. Spigel, these data support durvalumab as a new standard of care in this population (Abstract LBA5).