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Lung Cancer

EXPERT POINT OF VIEW: Balazs Halmos, MD

The study’s invited discussant, Balazs Halmos, MD, Director of Thoracic Oncology and Clinical Cancer Genomics at Montefiore Medical Center and Albert Einstein College of Medicine, New York, called tumor mutation burden a “highly promising” biomarker of response to immune checkpoint inhibitors....

Lung Cancer

Tumor Mutation Burden Shows Promise as a Response Biomarker in Small Cell Lung Cancer

Patients with small cell lung cancer (SCLC) and a high tumor mutation burden had a near doubling in response rate and 1-year overall survival when ipilimumab (Yervoy) was combined with nivolumab (Opdivo), vs nivolumab alone, new findings from CheckMate 032 have shown. Regardless of the treatment...

Lung Cancer

No Additional Benefit Found for Routine, Early Palliative Care in Mesothelioma

Early routine specialist palliative care for patients recently diagnosed with malignant pleural mesothelioma did not impact quality of life, an international multicenter study has found.1 “Regular early specialist palliative care for patients was not associated with improved quality of life, as...

Lung Cancer

EXPERT POINT OF VIEW: Kemp Kernstine, MD, PhD

The study’s invited discussant Kemp Kernstine, MD, PhD, the Robert Tucker Hayes Foundation Distinguished Chair in Cardiothoracic Surgery at The University of Texas Southwestern Medical Center, Dallas, welcomed the findings, but expressed some concerns about the study. To begin, of a database of...

Lung Cancer

Residual Tumor ‘Uncertain’ Classification Validated in Non–Small Cell Lung Cancer

After surgical resection of non–small cell lung cancer (NSCLC), investigators from the International Association for the Study of Lung Cancer (IASLC) have validated outcomes for tumors deemed to be of “uncertain” residual tumor status (ie, R[un]). “The residual tumor (R) classification reflects the ...

lung cancer

Novel Tyrosine Kinase Inhibitor for ALK- or ROS1-Rearranged NSCLC

A phase I trial has shown that the ALK and ROS1 tyrosine kinase inhibitor lorlatinib is active in patients with advanced ALK- or ROS1-positive non–small cell lung cancer (NSCLC), including those with central nervous system (CNS) metastases and failure on at least two prior tyrosine kinase...

lung cancer

CHEST 2017: American College of Chest Physicians Unveils New Lung Cancer Screening Guidelines

Low-dose computed tomography (CT) screening for lung cancer has become standard practice, mostly due to the results of the National Lung Screening Trial. Related evidence continues to evolve, informing the benefits and risks of low-dose CT in clinical practice. Mazzone et al presented new ...

lung cancer

CHEST 2017: Gender, Language, and Treatment Setting as Barriers in Screening and Patient Care in Lung Cancer

Two new studies from CHEST 2017, held recently in Toronto, reveal disparities in lung cancer screening and care that may impact detection as well as mortality and survival rates in the disease. Risk Status and Screening The first study from Lahey Hospital and Medical Center in Burlington,...

Lung Cancer

EXPERT POINT OF VIEW: Joan H. Schiller, MD

JOAN H. SCHILLER, MD, Deputy Director of Inova Schar Cancer Institute in Fairfax, Virginia, pointed out that no one particular chemotherapy regimen has been shown to improve overall survival vs other standard regimens. “So if we can’t identify one best chemotherapy, what else can we do to make...

Lung Cancer

Treatment Based on BRCA1 Expression Did Not Improve Survival in NSCLC

IN PATIENTS with early-stage non–small cell lung cancer (NSCLC), the use of expression of BRCA1 failed as an approach to customize chemotherapy, investigators from the Spanish Lung Cancer Cooperative Group reported at the 2017 International Association for the Study of Lung Cancer (IASLC) World...

lung cancer

PanCan Risk Model for Lung Cancer Screening

Results of the Pan-Canadian Early Detection of Lung Cancer (PanCan) study, reported in The Lancet Oncology by Tammemagi et al, indicate that the PanCan risk model is effective in identifying persons found to have early-stage lung cancer on low-dose computed tomography (CT) screening. Study Details ...

lung cancer

2-Year Survival Outcomes With Immunotherapy in Advanced NSCLC

Analysis of 2-year overall survival with nivolumab (Opdivo) vs docetaxel in the phase III CheckMate 017 and 057 trials showed a continued survival benefit with nivolumab in patients with previously treated advanced non–small cell lung cancer (NSCLC). The findings were reported by Horn et al...

palliative care
lung cancer

2017 ASCO Palliative Care: Yoga Can Be an Effective Supportive Therapy for People With Lung Cancer and Their Caregivers

In a feasibility trial of people with advanced lung cancer receiving radiation therapy and their caregivers, yoga was beneficial to both parties. These findings will be presented by Milbury et al at the upcoming 2017 Palliative and Supportive Care in Oncology Symposium in San Diego (Abstract 125). ...

lung cancer

FDA Accepts sBLA for Durvalumab in Locally Advanced Unresectable NSCLC

On October 17, the U.S. Food and Drug Administration (FDA) has accepted a supplemental Biologics License Application (sBLA) for durvalumab (Imfinzi) for the treatment of patients with locally advanced (stage III) unresectable non–small cell lung cancer (NSCLC) whose disease has not progressed ...

Lung Cancer

No Progression-Free Survival Benefit With First-Line Nivolumab vs Chemotherapy in Advanced PD-L1–Positive NSCLC

AS REPORTED BY David P. Carbone, MD, PhD, of The Ohio State University Comprehensive Cancer Center, Columbus, and colleagues in The New England Journal of Medicine, the phase III CheckMate 026 trial has shown no progression-free survival benefit for first-line nivolumab (Opdivo) vs platinum-based...

Lung Cancer

Phase III Trial Shows No Survival Benefit to Adding First-Line Ipilimumab to Chemotherapy in Advanced Squamous NSCLC

IN A PHASE III trial reported by Ramaswamy Govindan, MD, of Washington University School of Medicine, and colleagues in the Journal of Clinical Oncology, the addition of first-line ipilimumab (Yervoy) to paclitaxel/carboplatin did not improve overall survival in patients with advanced squamous...

Solid Tumors
Lung Cancer

Tremelimumab in Previously Treated Advanced Malignant Mesothelioma

In the randomized phase IIB DETERMINE trial, the cytotoxic T-lymphocyte–associated protein 4 (CTLA-4) inhibitor tremelimumab did not improve overall survival vs placebo as second- or third-line treatment of relapsed malignant mesothelioma. These findings were reported in The Lancet Oncology by...

Lung Cancer

Expert Point of View: Luis Paz-Ares, MD

FORMAL DISCUSSANT of the ALEX and ALUR trials, Luis Paz-Ares, MD, Professor of Medicine at the Hospital Universitario 12 de Octubre, Madrid, said that the ALEX trial is “good news” for patients. “Importantly, 40% had baseline metastases. Disease progression was nicely controlled with alectinib...

Lung Cancer

Alectinib Yields Favorable Results in Phase III Trials of ALK-Positive NSCLC

RESULTS OF TWO separate phase III trials confirm the activity of alectinib (Alecensa) in the central nervous system (CNS) in patients with anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC). Results lend support for alectinib as the better first-line treatment option over...

Lung Cancer

Expert Point of View: Brian G. Czito, MD, and Benjamin Movsas, MD

BRIAN G. CZITO, MD, a radiation oncologist at Duke Cancer Institute in Durham, North Carolina, commented on the study presented by Iyengar et al at the 2017 American Society for Radiation Oncology Annual Meeting.  “This study of focal high-dose radiation in stage IV patients with limited...

Lung Cancer

Consolidative Radiation Therapy: New Paradigm for Limited Metastatic NSCLC?

ADDING CONSOLIDATIVE RADIATION therapy to maintenance chemotherapy had a robust effect on preventing disease progression compared with maintenance chemotherapy alone in patients with limited metastatic non–small cell lung cancer (NSCLC), according to a late-breaking study presented at the 2017...

lung cancer

IASLC 2017: Exercise Interventions in Advanced Lung Cancer Patients Led to Increased Functionality

Physical exercise and psychosocial interventions in patients with advanced-stage lung cancer improved functional capacity, which may be linked to quality-of-life benefits. Morten Quist, PT, PhD, MSc, of the University of Copenhagen, presented these findings at the International Association for the...

lung cancer

IASLC 2017: Community Engagement Interventions May Reduce Disparities in Lung Cancer Outcomes Among Minorities

Community-based interventions implemented in minority community sites resulted in changes in participants’ knowledge, attitudes, and beliefs about cancer, as well as perceived benefits and self-efficacy measures regarding lung cancer screening. Lovoria Williams, PhD, APRN-BC, FAANP, of...

lung cancer

IASLC 2017: Non–Small Cell Lung Cancer Survival Rates Higher Among Patients Treated at Academic Centers

As non–small cell lung cancer (NSCLC) survival rates have increased over time, new research sheds light on how NSCLC outcomes are significantly influenced by the type of treatment facility where patients undergo care. Bhagirathbhai Dholaria, MD, of the Moffitt Cancer Center, presented these...

lung cancer

IASLC 2017: Poziotinib Yields High Response Rates in Patients With NSCLC With EGFR Exon 20 Insertion

A targeted therapy studied at The University of Texas MD Anderson Cancer Center has produced high response rates among patients with metastatic non–small cell lung cancer (NSCLC) that carries a highly treatment-resistant mutation. Preliminary results were presented at the International...

lung cancer

IASLC 2017: First-Line Pembrolizumab Increases Overall Survival vs Chemotherapy in Metastatic NSCLC With High Levels of PD-L1

Updated overall survival findings from the phase III KEYNOTE-024 trial evaluating pembrolizumab (Keytruda) as a first-line monotherapy in patients with non–small cell lung cancer (NSCLC) whose tumors express high levels of programmed cell death ligand 1 (PD-L1) were presented at the...

Solid Tumors
Lung Cancer

ASCO Guideline on Stage IV NSCLC Therapy Updated

An update of the ASCO clinical practice guideline on the systemic treatment of patients with stage IV non–small cell lung cancer (NSCLC) clarifies the role of immunotherapy in this setting. The update was published by Hanna et al in the Journal of Clinical Oncology.1 “This guideline update...

lung cancer

IASLC 2017: IASLC Releases New Atlas of EGFR Testing

The International Association for the Study of Lung Cancer (IASLC) released its Atlas of EGFR Testing in Lung Cancer at the IASLC 18th World Conference on Lung Cancer (WCLC) in Yokohama, Japan. The EGFR Atlas provides health-care professionals with information on EGFR testing processes and...

lung cancer

IASLC 2017: Treatment Based on BRCA1 Level Does Not Increase Survival of Stage II/III NSCLC Node-Positive Resected Patients

New research shows that treating stage II and III non–small cell lung cancer (NSCLC) node-positive resected patients with customized chemotherapy based on their specific BRCA1 expression levels, as opposed to providing the standard treatment, did not increase overall survival rates among...

lung cancer

IASLC 2017: Biopsy Specimen Found to Be Reliable for Evaluating DLL3 Expression in Small Cell Lung Cancer

Small cell lung cancer (SCLC) biopsy specimens were found to be reliable material for evaluating DLL3 expression, and high levels of DLL3 in SCLC are correlated with poor survival trends. Researchers from Guangdong General Hospital and Guangdong Academy of Medical Sciences in China presented...

lung cancer

Outcomes in Patients With Metastatic Lung Cancer Receiving PD-1/PD-L1 Inhibitors With Thoracic Radiotherapy

In a research letter to JAMA Oncology, Hwang et al detailed the outcomes of patients with metastatic lung cancer receiving an inhibitor of programmed cell death protein 1 (PD-1) or its ligand (PD-L1) with or without thoracic radiotherapy at Massachusetts General Hospital. Study Details The...

lung cancer

IASLC 2017: REVEL Trial Subgroup Analysis Further Clarifies Outcomes With Ramucirumab Plus Docetaxel in Advanced Non–Small Cell Lung Cancer

New subgroup analysis from the phase III REVEL trial of ramucirumab (Cyramza) in advanced non–small cell lung cancer (NSCLC) was presented at the International Association for the Study of Lung Cancer (IASLC) 18th World Conference on Lung Cancer in Yokohama, Japan. Specifically, these...

lung cancer

IASLC 2017: Research Confirms IASLC Characterization of Uncertain R Status With Prognosis Between R0 and R1

The findings of a recent study confirm the International Association for the Study of Lung Cancer (IASLC)’s proposed criteria for uncertain resection margin status, R(un), in residual tumor (R) classification. John Edwards, PhD, MBChB, of the University of Sheffield in the United Kingdom,...

lung cancer

IASLC 2017: Integration of Smoking Cessation With CT Lung Cancer Screenings

A study that integrated robust smoking cessation programs into an organized low-dose computed tomography (CT) lung cancer screening program found that the inclusion of both interventions has the potential to decrease mortality rates—while being relatively cost-effective. William Evans,...

lung cancer

IASLC 2017: Race, Socioeconomic Factors Are Influential in NSCLC Survival Rates

New research found race and specific socioeconomic factors to have a significant influence on disparities in the survival rates of non–small cell lung cancer (NSCLC) patients. Yanyan Lou, MD, PhD, of the Mayo Clinic, presented these findings at the International Association for the Study of...

lung cancer

IASLC 2017: Lorlatinib in ALK-Positive and ROS1-Positive Advanced Non–Small Cell Lung Cancer

At the International Association for the Study of Lung Cancer (IASLC) 18th World Conference on Lung Cancer in Yokohama, Japan, Pfizer announced full results from the phase II clinical trial of the investigational, next-generation tyrosine kinase inhibitor lorlatinib. The agent exhibited clinically...

lung cancer

IASLC 2017: CheckMate-032: Nivolumab Alone or With Ipilimumab in Recurrent SCLC With High Tumor Mutation Burden

At the International Association for the Study of Lung Cancer (IASLC) 18th World Conference on Lung Cancer in Yokohama, Japan, Bristol-Myers Squibb announced data evaluating nivolumab (Opdivo) and nivolumab plus ipilimumab (Yervoy) in previously treated small cell lung cancer (SCLC) patients whose...

lung cancer

IASLC 2017: Brigatinib in ALK-Positive Non–Small Cell Lung Cancer

Data from the phase II ALTA clinical trial evaluating brigatinib (Alunbrig) in patients with locally advanced or metastatic anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC) who have disease progression on crizotinib were presented at the International...

lung cancer

IASLC 2017: Early Palliative Care Provides No Quality-of-Life Benefits for Patients With Recently Diagnosed Malignant Pleural Mesothelioma

Early specialist palliative care for patients that were recently diagnosed with malignant pleural mesothelioma does not impact quality-of-life measures, according to research presented by Fraser Brims, MBcHB, MRCP, MD, FRACP, of Curtin University in Australia, at the International Association...

lung cancer

IASLC 2017: Combination of Lurbinectedin and Doxorubicin in Relapsed Small Cell Lung Cancer

The final efficacy and safety data obtained from a phase I/II trial combining lurbinectedin (PM1183) with doxorubicin in relapsed small cell lung cancer were presented during a Research Perspectives oral session at the International Association for the Study of Lung Cancer (IASLC) 18th World...

lung cancer

Addition of EGFR Tyrosine Kinase Inhibitor to Chemotherapy in Resistant Non–Small Cell Lung Cancer

As reported by Mok et al in the Journal of Clinical Oncology, overall survival analysis of the phase III IMPRESS trial indicated a poorer outcome when adding gefitinib (Iressa) vs placebo to chemotherapy after disease progression on first-line gefitinib in epidermal growth factor receptor...

lung cancer

Results From the Phase III JUNIPER Trial Evaluating Abemaciclib in KRAS-Mutated, Advanced NSCLC

On October 10, Eli Lilly and Company announced that its phase III JUNIPER study evaluating abemaciclib (Verzenio), a cyclin-dependent kinase (CDK) 4 and CDK6 inhibitor, as monotherapy in KRAS-mutated, advanced non–small lung cancer (NSCLC) did not meet its primary endpoint of overall...

lung cancer

Osimertinib Granted Breakthrough Therapy Designation for First-Line Treatment of EGFR Mutation–Positive NSCLC

On October 9, AstraZeneca announced that the U.S. Food and Drug Administration (FDA) granted Breakthrough Therapy designation for osimertinib (Tagrisso) for the first-line treatment of patients with metastatic epidermal growth factor receptor (EGFR) mutation–positive non–small cell lung ...

lung cancer

Immune-Related Adverse Events and Outcomes With Immunotherapy for NSCLC

In a Japanese analysis reported in JAMA Oncology, Haratani et al found that development of immune-related adverse events was associated with improved survival among patients receiving nivolumab (Opdivo) for advanced or recurrent non–small cell lung cancer (NSCLC). Study Details The study...

Lung Cancer

Expert Point of View: Paul Baas, MD, PhD

INVITED DISCUSSANT Paul Baas, MD, PhD, of The Netherlands Cancer Institute, called the MAPS2 trial an “excellent example of how studies in mesothelioma should be run.”  As Dr. Baas pointed out, both arms performed well as second- and third-line treatment, with median progression-free survival with ...

Lung Cancer

Relapsed Mesothelioma Controlled by Checkpoint Inhibition

IN PATIENTS with malignant pleural mesothelioma, combination immunotherapy with two checkpoint inhibitors in the second or third line of treatment extended survival to at least 15 months in the MAPS2 trial,1 sponsored by the Intergroupe Francophone de Cancérologie Thoracique (IFCT) and reported at ...

Lung Cancer

‘Clinically Meaningful’ Results With First-Line Osimertinib in EGFR–Positive NSCLC

OSIMERTINIB (TAGRISSO) showed encouraging results as first-line therapy for patients with epidermal growth factor receptor (EGFR)–mutated non–small-cell lung cancer (NSCLC) in the phase III FLAURA trial, according to results presented at the 2017 European Society for Medical Oncology (ESMO)...

Lung Cancer

Expert Point of View: Tony Mok, MD, FASCO

“IN 2008, I presented the IPASS results. FLAURA has beaten me to the ground. The results exceeded expectations, and FLAURA is undoubtedly a positive study,” stated formal discussant Professor Tony Mok, MD, FASCO, Chair of Department of Clinical Oncology, the Chinese University of Hong Kong. “It is ...

Lung Cancer

‘Clinically Meaningful’ Results With First-Line Osimertinib in EGFR–Positive NSCLC

OSIMERTINIB (TAGRISSO) showed encouraging results as first-line therapy for patients with epidermal growth factor receptor (EGFR)–mutated non–small-cell lung cancer (NSCLC) in the phase III FLAURA trial, according to results presented at the 2017 European Society for Medical Oncology (ESMO)...

lung cancer

Comparison of First-Line Treatments for EGFR-Mutant NSCLC

The phase III ARCHER 1050 trial has shown superior progression-free survival with the second-generation irreversible epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor dacomitinib vs gefitinib (Iressa) in the first-line treatment of advanced EGFR-mutant non–small cell lung...

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