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lung cancer

ELCC 2016: Osimertinib Given as First-Line Treatment May Alter Biology of EGFR-Mutated Non–Small Cell Lung Cancer

The third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor osimertinib (Tagrisso) is effective in the first-line treatment of EGFR-mutated non­­–small cell lung cancer (NSCLC), according to a late-breaking abstract presented by Ramalingam et al (Abstract...

lung cancer

ELCC 2016: Immunotherapy With Live Bacterium Improves Response Rate in Malignant Pleural Mesothelioma

Immunotherapy with a live bacterium combined with chemotherapy demonstrated more than 90% disease control and a 59% response rate in patients with malignant pleural mesothelioma, according to the results of a phase Ib trial presented by Jahan et al April 14 (Abstract 208O_PR) at the European Lung...

lung cancer

Noninferiority of Gefitinib vs Erlotinib Not Established in Japanese Trial in Advanced Lung Adenocarcinoma

In a Japanese phase III trial (WJOG 5108L) reported in the Journal of Clinical Oncology, Urata et al found that noninferiority of gefitinib vs erlotinib was not established in previously treated patients with advanced non–small cell lung cancer. Study Details In the open-label trial, 559...

lung cancer

Evidence of Intracranial Benefit With Crizotinib in Advanced ALK-Positive NSCLC

As reported in the Journal of Clinical Oncology, Solomon et al found that crizotinib (Xalkori) was associated with a significantly better disease control rate vs chemotherapy among patients with brain metastases in ALK-positive non–small cell lung cancer (NSCLC). Crizotinib was also...

Lung Cancer

Crizotinib in ROS1-Positive Metastatic Non–Small Cell Lung Cancer

On March 11, 2016, crizotinib (Xalkori) was approved for treatment of patients with metastatic non–small cell lung cancer (NSCLC) with ROS1 rearrangement–positive tumors.1,2 A U.S. Food and Drug Administration–approved test for the detection of ROS1 rearrangements in NSCLC is not currently...

Lung Cancer

Update of ASCEND-1 Trial Shows Ceritinib Highly Active in ALK-Rearranged NSCLC, Including Intracranial Disease

Updated results of the phase I ­ASCEND-1 trial, reported by Kim et al in The Lancet Oncology, indicate that the ALK inhibitor ceritinib (Zykadia) produced high response rates in advanced ALK-rearranged non–small cell lung cancer (NSCLC), including intracranial disease, in both patients with and...

lung cancer

Douglas E. Wood, MD, on Lung Cancer: Workup and Staging

Douglas E. Wood, MD, of the University of Washington, discusses best practices, which enable a complete workup in 1 to 2 weeks in almost all patients, saving unnecessary testing. 

lung cancer

Douglas E. Wood, MD, on Lung Cancer Screening: Status and Patient Selection

Douglas E. Wood, MD, of the University of Washington, discusses important new developments in early detection, the need to educate primary care physicians and patients, and the potential to save up to 15,000 lives each year.

Lung Cancer

The POPLAR Trial: PD-L1 Blockade With Atezolizumab in Second- or Third-Line Non–Small Cell Lung Cancer

The randomized phase II ­POPLAR trial—reported by Fehrenbacher and colleagues and reviewed in this issue of The ASCO Post—is another key piece of information for the medical community regarding the value of immune checkpoint blockers in second/third-line treatment of patients with non–small cell...

Lung Cancer

Atezolizumab Improves Survival vs Docetaxel in Previously Treated NSCLC: Increased Benefit With Increased PD-L1 Expression

In the phase II POPLAR trial reported in The Lancet, Louis Fehrenbacher, MD, of Kaiser Permanente Medical Center, and colleagues found that the investigational anti–programmed cell death ligand 1 (PD-L1) antibody atezolizumab improved overall survival vs docetaxel in patients with non–small cell...

lung cancer

Rogerio Lilenbaum, MD, on Metastatic NSCLC: Managing EGFR-Mutation–Positive Disease

Rogerio Lilenbaum, MD, of Yale Cancer Center/Smilow Cancer Hospital, discusses the importance of tumor profiling for non–small cell lung cancer and strategies for treating EGFR-positive disease in the first-line setting.

lung cancer

Lung Cancer Incidence and Mortality in Individuals With a Negative Low-Dose CT Prevalence Screen

In an analysis of the National Lung Screening Trial (NLST) cohort reported in The Lancet Oncology, Patz et al found that participants who had a negative low-dose computed tomography (CT) prevalence screen had a low incidence of lung cancer detected at first annual screen and exhibited reduced...

lung cancer

No Treatment Failure or Survival Benefit but Less Toxicity With Comprehensive Geriatric Assessment in Elderly Patients With Advanced NSCLC

Use of comprehensive geriatric assessment to guide therapy in elderly patients with stage IV non–small cell lung cancer (NSCLC) did not improve treatment failure–free or overall survival but was associated with slightly reduced toxicity, based on the results of the phase III...

lung cancer
gastroesophageal cancer

Possible Overuse of PET to Detect Recurrence of Lung and Esophageal Cancers

Healy et al found that greater use of positron-emission tomography (PET) for detection of recurrence of lung and esophageal cancers was not associated with improved survival, suggesting potential overuse of the modality in this setting. They reported their results in the Journal of the National...

lung cancer

Occult Metastasis on Immunohistochemistry May Affect Survival in Stage I NSCLC

Mature results of the Cancer and Leukemia Group B 9761/Alliance study, reported in the Journal of Clinical Oncology by Martin et al, indicate that occult metastases detected by immunohistochemistry in N2 lymph nodes may be associated with poorer overall survival after resection in clinical stage I...

Lung Cancer

FDA Approves Crizotinib for ROS1-Positive Metastatic Non–Small Cell Lung Cancer

The U.S. Food and Drug Administration has approved the tyrosine kinase inhibitor crizotinib (Xalkori) for the treatment of patients with metastatic non–small cell lung cancer (NSCLC) whose tumors are ROS1-positive. Crizotinib was first approved in 2011 for the treatment of patients whose tumors are ...

lung cancer

Update of ASCEND-1 Trial Shows Ceritinib Highly Active in ALK-Rearranged NSCLC, Including Intracranial Disease

Updated results of the phase I ASCEND-1 trial, reported by Kim et al in The Lancet Oncology, indicate that the ALK inhibitor ceritinib (Zykadia) produced high response rates in advanced ALK-rearranged non–small cell lung cancer (NSCLC), including intracranial disease, in both patients with...

breast cancer
leukemia
lung cancer

Specific Form of CYP3A7 Gene Associated With Poor Outcomes for Patients With Several Cancer Types

Among patients with breast cancer, lung cancer, or chronic lymphocytic leukemia (CLL), those who had a specific form of the CYP3A7 gene (CYP3A7*1C) had worse outcomes compared with those who did not have CYP3A7*1C. This may be related to how the patients metabolize the therapeutics used to treat...

lung cancer

Dietary Glycemic Index Linked to Lung Cancer Risk in Non-Hispanic White Populations

Consuming a diet with a high glycemic index was independently associated with an increased risk of developing lung cancer in non-Hispanic whites, according to a new epidemiologic study from The University of Texas MD Anderson Cancer Center. This research, published by Melkonian et al in Cancer...

lung cancer

Atezolizumab Improves Survival vs Docetaxel in Advanced NSCLC in Relation to Increased PD-L1 Expression

In the phase II POPLAR trial reported in The Lancet, Fehrenbacher et al found that the anti–PD-L1 (programmed cell death ligand 1) antibody atezolizumab improved overall survival vs docetaxel in patients with non–small cell lung cancer (NSCLC) who had progressed on prior platinum-based...

lung cancer

Resensitization to Crizotinib via Acquisition of Lorlatinib ALK Resistance Mutation Reported in Patient With NSCLC

As reported by Shaw et al in The New England Journal of Medicine, a woman with metastatic ALK-rearranged non–small cell lung cancer (NSCLC) who had received multiple prior therapies, including the first- and second-generation ALK inhibitors crizotinib (Xalkori) and ceritinib (Zykadia),...

lung cancer

FDA Approves Crizotinib for ROS1-Positive Metastatic NSCLC

The U.S. Food and Drug Administration today approved the tyrosine kinase inhibitor crizotinib (Xalkori) for the treatment of patients with metastatic non–small cell lung cancer (NSCLC) whose tumors are ROS1-positive. Crizotinib was first approved in 2011 for the treatment of patients...

lung cancer
issues in oncology
gastroesophageal cancer

PET Scan Use in Follow-up Care for Lung and Esophageal Cancer Shows Wide Variation Between Hospitals, No Impact on Survival

A new study suggests that one approach to watching for a cancer's return is being inappropriately used at many hospitals and isn't helping patients survive longer. The findings are published by Healy et al in the Journal of the National Cancer Institute. The study looked at how often survivors ...

lung cancer

Anamorelin Increases Lean Body Mass in NSCLC Patients With Cachexia

Anamorelin (a ghrelin-receptor agonist) increased lean body mass but had no beneficial effect on handgrip strength vs placebo in patients with advanced non–small cell lung cancer (NSCLC) and cachexia, according to two international phase III trials (ROMANA 1 and 2) reported in The Lancet...

lung cancer

Metabolic Phenotyping of Blood Plasma Allows for the Detection of Lung Cancer

Metabolic phenotyping of blood plasma by proton nuclear magnetic resonance (H-NMR) identified unique metabolic biomarkers specific to lung cancer patients and allowed for the accurate identification of a cohort of patients with early and late-stage lung cancer. These findings were published by...

lung cancer

Racial/Ethnic Variations in Lung Cancer Incidence and Mortality in the Women’s Health Initiative Study Cohort

As reported by Patel et al in the Journal of Clinical Oncology, analysis of lung cancer incidence and mortality in the Women’s Health Initiative Study cohort of postmenopausal women showed a marginally significant lower risk of cancer in Hispanic women vs white women and no difference in...

lung cancer
global cancer care

Study Finds 36% Increase in Number of Male Smokers in India Over 17 Years

The number of men smoking tobacco in India rose by more than one third to 108 million between 1998 and 2015, according to a new study published in the journal BMJ Global Health. The study also found that cigarettes were replacing the traditional bidi, a small, inexpensive Indian cigarette,...

lung cancer

Improved Outcomes Reported With Adjuvant Therapy in Patients With Early-Stage SCLC Undergoing Complete Resection

Adjuvant chemotherapy and chemotherapy plus prophylactic cranial irradiation were associated with significantly improved survival vs surgery alone in patients with early-stage small cell lung cancer (SCLC) undergoing complete resection, according to an analysis of National Cancer Data Base data...

lung cancer
gastrointestinal cancer

FDA Approves Everolimus for Neuroendocrine Tumors of Gastrointestinal or Lung Origin

The U.S. Food and Drug Administration today approved everolimus (Afinitor) for the treatment of adult patients with progressive, well-differentiated nonfunctional neuroendocrine tumors of gastrointestinal or lung origin with unresectable, locally advanced, or metastatic disease. ...

lung cancer

UK Trial Shows No Survival Benefit of Low–Molecular-Weight Heparin in Patients With Lung Cancer

In the UK phase III FRAGMATIC trial reported in the Journal of Clinical Oncology, Macbeth et al found no survival benefit of adding low–molecular-weight heparin to standard treatment in patients with lung cancer. Previous evidence suggested that low–molecular-weight heparin might...

lung cancer

No Survival Benefit of Pemetrexed/Cisplatin Chemoradiation vs Standard Treatment in Nonresectable Stage III NSCLC

As reported by Senan et al in the Journal of Clinical Oncology, the phase III PROCLAIM trial showed no significant improvement in overall survival for chemoradiation with pemetrexed (Alimta)/cisplatin vs etoposide/cisplatin followed by consolidation pemetrexed vs a platinum-based doublet in...

Issues in Oncology
Lung Cancer
Geriatric Oncology

Management of Advanced Lung Cancer in the Elderly: A Reason to Rejoice or a Cause for Concern?

There is ample evidence to suggest that older adults with a good performance status (0 or 1) with advanced non–small cell lung cancer (NSCLC) should be treated with combination chemotherapy akin to younger patients.1,2 However, older adults comprise a heterogeneous group that has been...

lung cancer
issues in oncology

Autoantibodies May Help Detect Lung Cancer Earlier

Preliminary research has identified autoantibodies—immune proteins found in the blood specific for one's own proteins—that can potentially detect lung cancer early by distinguishing between smokers with or without lung cancer and can also discriminate between lung cancer and low-dose...

lung cancer

Intense Tumor Lymphocytic Infiltration Prognostic of Better Outcome in Resectable NSCLC

Intense tumor lymphocytic infiltration was associated with improved outcomes in patients with resectable non–small cell lung cancer, according to a study reported in the Journal of Clinical Oncology by Brambilla et al. Study Details The LACE-Bio (Lung Adjuvant Cisplatin Evaluation...

lung cancer

Addition of TG4010 Vaccine to First-Line Chemotherapy Appears to Improve Progression-Free Survival in Advanced NSCLC

As reported in The Lancet Oncology by Quoix et al, the addition of immunotherapy with TG4010—the modified vaccinia Ankara expressing MUC1 and interleukin 2—to first-line chemotherapy improved progression-free survival in patients with advanced non–small cell lung cancer (NSCLC) in ...

Lung Cancer

Alectinib in ALK-Positive Metastatic NSCLC After Crizotinib

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs.   On December 11, 2015, alectinib (Alecensa) was granted...

lung cancer
solid tumors

French Trial Shows Addition of First-Line Bevacizumab to Cisplatin/Pemetrexed Improves Survival in Malignant Pleural Mesothelioma

In the French phase III MAPS trial reported in The Lancet, Zalcman et al found that the addition of bevacizumab (Avastin) to standard cisplatin/pemetrexed (Alimta) treatment increased overall and progression-free survival in patients with newly diagnosed pleural mesothelioma. Vascular endothelial...

palliative care
lung cancer
issues in oncology

Afatinib Shows Clinical Benefit for Non–Small Cell Lung Cancer Patients With Brain Metastases

Non­–small cell lung cancer (NSCLC) patients with common epidermal growth factor (EGFR) mutations and brain metastases showed improved progression-free survival and response from the EGFR tyrosine kinase inhibitor afatinib (Gilotrif) compared to standard platinum doublet chemotherapy....

lung cancer

John C. Grecula, MD, on the Role of Radiation Therapy in Management of SCLC

John C. Grecula, MD, of The Ohio State University Comprehensive Cancer Center and the James Cancer Hospital and Solove Research Institute, discusses the evolution of precision delivery of radiation for patients with small cell lung cancer and advances that include prophylactic cranial radiotherapy, thoracic radiotherapy, and the use of PET-CT.

lung cancer

Thomas A. D’Amico, MD, on Diagnosis and Treatment of NSCLC Using Minimally Invasive Techniques

Thomas A. D’Amico, MD, of Duke Cancer Institute, discusses the superior efficacy of thoracoscopic lobectomy. This minimally invasive procedure is used in only 50% of lung cancer surgeries in the United States, in 30% of procedures in Asia, and in as few as 10% to 20% of procedures in Europe.

lung cancer

Leora Horn, MD, MSc, on Targeted and Emerging Therapies for Metastatic NSCLC

Leora Horn, MD, MSc, of the Vanderbilt-Ingram Cancer Center, discusses the range of treatment options for people with lung cancer, including third generation inhibitors, and the key clinical trials studying alternatives for patients with acquired resistance.

lung cancer

Gregory A. Otterson, MD, on Adjuvant Therapy and Immunotherapy for Lung Cancer

Gregory A. Otterson, MD, of The Ohio State University Comprehensive Cancer Center and the James Cancer Hospital and Solove Research Institute, discusses the evolution of lung cancer treatment from adjuvant chemotherapy to immunotherapy and the clinical trials underway.

lung cancer

David E. Gerber, MD, and James L. Mulshine, MD, on Bringing Genomic Discovery and Targeted Therapies to Early-Stage Lung Cancer

James L. Mulshine, MD, of Rush University Medical Center, and David E. Gerber, MD, of The University of Texas Southwestern Medical Center, discuss the ALCHEMIST trial, an NCI initiative to address the role of molecular testing and targeted therapies for earlier-stage lung disease (Abstract TPS7583).

lung cancer

Carolyn Jean Presley, MD, and James L. Mulshine, MD, on New Lung Cancer CT Screening Guidelines and Treatment Burden

James L. Mulshine, MD, of Rush University Medical Center, and Carolyn Jean Presley, MD, of Yale Cancer Center/Yale School of Medicine, discuss the burden on patients and the Medicare system as new lung cancer CT guidelines are put into effect and treatment of early-stage NSCLC increases (Abstract 7533).

palliative care
lung cancer
survivorship

Areej El-Jawahri, MD, and Eric Roeland, MD, FAAHPM, on Quality of Life and Satisfaction With Care

Eric Roeland, MD, FAAHPM, of the University of California, San Diego Moores Cancer Center, and Areej El-Jawahri, MD, of Massachusetts General Hospital, discuss two important studies on early palliative care and the use of anamorelin in advanced NSCLC with cachexia.

lung cancer
palliative care
symptom management

Charles F. von Gunten, MD, PhD, Discusses Anamorelin and Olanzapine for Palliative Care

Charles F. von Gunten, MD, PhD, of OhioHealth Kobacker House discusses the ROMANA 1 and 2 trials on cachexia in NSCLC and a study on olanzapine vs fosaprepitant for the prevention of nausea and vomiting (Abstracts 9500 and 9502).

lung cancer

Luis G. Paz-Ares, MD, PhD, Summarizes Results of the CheckMate 057 Trial on Nonsquamous Cell NSCLC

Luis G. Paz-Ares, MD, PhD, of the Hospital Universitario Doce De Octubre, discusses the superior overall survival in patients taking nivolumab vs docetaxel in advanced nonsquamous NSCLC (Abstract LBA109).

lung cancer

Ramaswamy Govindan, MD: Roundup of Lung Cancer Findings

Ramaswamy Govindan, MD, of Washington University, summarizes three important papers: ROVA-T in relapsed and refractory small cell lung cancer, genomic characterization of large-cell neuroendocrine tumors, and the ECOG study on bevacizumab following chemotherapy for resected non–small cell lung cancer.

lung cancer

Guneet Walia, PhD, on Central Issues in Lung Cancer Care

Guneet Walia, PhD, of the Lung Cancer Foundation, summarizes some key presentations: bridging the quality chasm, patients’ attitudes and physicians’ perceptions on maintenance therapy, and patient advocacy.

lung cancer

Jennifer King, PhD: Scientific Perspectives From the Lung Cancer Alliance

Jennifer King, PhD, of the Lung Cancer Alliance, gives her perspective on major themes of this year’s meeting: the stigma of lung cancer, the changing face of who is affected, early detection, and advances in immunotherapy.

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