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Lung Cancer

FDA Grants Breakthrough Therapy Designation to MPDL3280A for Non–Small Cell Lung Cancer

The U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation to Genentech’s investigational cancer immunotherapy MPDL3280A for the treatment of PD-L1–positive non–small cell lung cancer (NSCLC) that has progressed during or after platinum-based chemotherapy (and an...

Lung Cancer

I Refuse to Capitulate to Cancer

Editor’s note: We regret to announce that Paul Kalanithi, MD, passed away on March 9, 2015. Dr. Kalanithi was Chief Resident in Neurological Surgery at Stanford University when he shared his story, reprinted here, with The ASCO Post just over 1 year ago, in March 2014. We extend our deepest...

Issues in Oncology
Lung Cancer

The Ongoing Struggle Against Tobacco: Past Accomplishments, Future Steps

In 1913, 10 doctors and 5 laypersons in New York founded the American Cancer Society (ACS). At that time, a cancer diagnosis was almost always fatal and was rarely discussed in public. The Society’s original charter was to raise awareness about cancer, and although that mission has remained firm,...

Lung Cancer

Nivolumab in Metastatic Squamous Non–Small Cell Lung Cancer After Platinum Therapy

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 March 4, 2015, the anti–programmed cell death protein 1 (PD-1) ...

Lung Cancer

FDA Approves Nivolumab to Treat Metastatic Squamous NSCLC

The U.S. Food and Drug Administration (FDA) has approved the PD-1 inhibitor nivolumab (Opdivo) for the treatment of patients with metastatic squamous non–small cell lung cancer (NSCLC) who have progressed on or after platinum-based chemotherapy. Nivolumab is a monoclonal antibody that binds to the...

Lung Cancer

Results of RTOG 0617 Reconsidered

Radiation Therapy Oncology Group (RTOG) 0617 was a study initially designed to address an important issue in radiation oncology regarding the treatment of stage III non–small cell lung cancer (NSCLC): Are outcomes improved with high-dose as opposed to standard-dose thoracic radiation therapy? The...

Lung Cancer

No Benefit of High- vs Standard-Dose Radiotherapy or Addition of Cetuximab to Chemoradiation in Stage IIIA/IIIB NSCLC

As reported in The Lancet Oncology by Jeffrey D. Bradley, MD, of Washington University, and colleagues, the phase III Radiation Therapy Oncology Group 0617 trial showed no survival benefit of high- vs standard-dose radiotherapy or addition of cetuximab (Erbitux) to concurrent...

Issues in Oncology
Lung Cancer

New Tobacco Atlas Details Scale and Harm of the Tobacco Epidemic

The Tobacco Atlas, fifth edition, its companion mobile app, and website TobaccoAtlas.org, were released by the American Cancer Society and World Lung Foundation at the 16th World Conference on Tobacco or Health held March 17–21, 2015 in Abu Dhabi, United Arab Emirates. The Atlas details the scale...

Issues in Oncology
Lung Cancer

NCCN Publishes New Guidelines for Smoking Cessation

Tobacco-related diseases are the most preventable cause of death worldwide. According to the American Cancer Society, in 2015, nearly 171,000 of the estimated 589,430 cancer deaths in the United States—more than 25%—will be caused by tobacco smoking. Smoking cessation leads to improvement in cancer ...

Lung Cancer

Nivolumab in Lung Cancer

I find The ASCO Post to be a good way to hear about new ideas that I might otherwise have missed. I read an article recently about the approval of nivolumab (Opdivo) for treating metastatic squamous non-small cell lung cancer (The ASCO Post, April 10, 2015). I thought it would have been much more...

Lung Cancer
Pancreatic Cancer
Geriatric Oncology

Chemotherapy Trial Results Overestimate Survival for Elderly Medicare Patients With Lung and Pancreatic Cancers

Results of clinical trials evaluating chemotherapy regimens for advanced pancreatic and lung cancers “tended to correctly estimate survival for Medicare patients aged 65 to 74 years but to overestimate survival for older Medicare patients by 6 to 8 weeks,” Elizabeth B. Lamont, MD, MS, of...

Lung Cancer

Crizotinib Receives Breakthrough Therapy Designation for ROS1-Positive NSCLC

The U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation to crizotinib (Xalkori) for the potential treatment of patients with ROS1-positive non–small cell lung cancer (NSCLC). Crizotinib currently is FDA-approved for the treatment of patients with metastatic NSCLC...

Lung Cancer

EGFR L858R Mutation in Blood Sample May Serve as Surrogate for Biopsy in Determining EGFR-Mutation Status

Using a novel polymerase chain reaction assay “to efficiently assess” epidermal growth factor receptor (EGFR) mutations in circulating free DNA (cfDNA) from blood samples of patients with advanced non–small cell lung cancer (NSCLC), the Spanish Lung Cancer Group has “shown that the EGFR L858R...

Lung Cancer

Prior Cancer Does Not Affect Outcomes Among Patients With Advanced Lung Cancer, Suggesting They Be Included in Clinical Trials

Analysis of data from 102,929 patients with stage IV lung cancer found that “prior cancer does not convey an adverse effect on clinical outcomes, regardless of prior cancer stage, type, or timing.” Based on these findings, investigators from the Harold C. Simmons Cancer Center, University of Texas...

Lung Cancer

Pembrolizumab Safe and Effective in Patients With NSCLC, Especially in Those With Tumors Showing High Levels of PD-L1 Expression

Add lung cancer to the growing list of cancers that may derive benefit from immunotherapy. The KEYNOTE-001 trial found that pembrolizumab (Keytruda) achieved durable responses in a proportion of patients with non–small cell lung cancer (NSCLC) and high levels of expression of the protein PD-L1...

Issues in Oncology
Lung Cancer

The Basket Trial: An Evolving Clinical Trial Design

The recently published results of the CUSTOM (Molecular Profiling and Targeted Therapies in Advanced Thoracic Malignancies) trial, reviewed in this issue of The ASCO Post, describe a basket trial focused on identifying molecular biomarkers in advanced non­­–small cell lung cancer (NSCLC), small...

Lung Cancer

Outcomes of the CUSTOM ‘Basket’ Trial of Molecular Profiling and Targeted Therapy in Advanced Thoracic Malignancies

In the phase II CUSTOM trial reported in the Journal of Clinical Oncology, Ariel Lopez-Chavez, MD, Anish Thomas, MD, and colleagues performed molecular profiling of tumors in patients with advanced non–small cell lung cancer (NSCLC), small cell lung cancer (SCLC), or thymic malignancies and...

Lung Cancer

Second-Line Nivolumab Therapy Improves Survival in Patients With Nonsquamous Non–Small Cell Lung Cancer

Anti–programmed cell death protein 1 (PD-1) immunotherapy with nivolumab (Opdivo) extended survival in patients with the most common form of lung cancer—nonsquamous non–small cell lung cancer (NSCLC). Patients whose disease progressed on standard platinum doublet therapy who were treated with...

Lung Cancer

Date of Last Chemotherapy Is Not a Proxy for Deciding When to Stop Treating Metastatic NSCLC

“Patients, their families, and oncologists recognize the administration of chemotherapy near death as aggressive and poor-quality care,” William F. Pirl, MD, MPH, and colleagues from Massachusetts General Hospital, Boston, wrote in the Journal of Oncology Practice. “However, rates have been slowly...

Lung Cancer

Pembrolizumab in Advanced NSCLC: The Promise of Immune Checkpoint Inhibitors

Drugs targeting the immune-checkpoint pathways have shown promising activity in non–small cell lung cancer (NSCLC). In a recent article in The New England Journal of Medicine, Garon and colleagues reported the results of the KEYNOTE-001 clinical trial evaluating single-agent pembrolizumab...

Lung Cancer

PD-1 Inhibitor Pembrolizumab Active in Advanced NSCLC: Outcomes Better With Higher PD-L1 Expression

In the phase I KEYNOTE-001 trial reported in The New England Journal of Medicine,1 Edward B. Garon, MD, of the David Geffen School of Medicine at the University of California, Los Angeles, and colleagues found that the programmed cell death protein 1 (PD-1) inhibitor pembrolizumab (Keytruda)...

Lung Cancer

ASCO Endorses ASTRO Guideline on Definitive and Adjuvant Radiotherapy in Locally Advanced NSCLC

As reported in the Journal of Clinical Oncology by Andrea Bezjak, MD, of Princess Margaret Cancer Center, Toronto, and colleagues,1 ASCO has recently endorsed the American Society for Radiation Oncology (ASTRO) evidence-based guideline on external-beam radiotherapy for patients with locally...

Lung Cancer

Progress in the Treatment of Patients With EGFR-Mutated NSCLC

Approximately 10% to 15% of patients with advanced non–small cell lung (NSCLC) cancer have mutations in the epidermal growth factor receptor (EGFR) in tumor cells. Specific therapies to inhibit the activity of EGFR-mutated NSCLC have now been clearly shown to improve response rate and...

Lung Cancer

Early-Phase Studies Show Activity of Novel EGFR Inhibitors Rociletinib and AZD9291 in T790M-Positive NSCLC

Two early-phase studies have shown that the novel epidermal growth factor receptor (EGFR) inhibitors rociletinib and AZD9291 exhibit high activity in non–small cell lung cancer (NSCLC) patients with the EGFR T790M mutation who had progressed on prior EGFR inhibitor therapy.1,2 The T790M mutation...

Lung Cancer

ASTRO Guidelines on Radiotherapy in Locally Advanced NSCLC: A Good Place to Start

ASCO’s endorsement of the American Society for Radiation Oncology (ASTRO) guidelines on the role of radiotherapy in locally advanced non–small cell lung cancer (NSCLC) is an important summary of the best evidence on the appropriate role and techniques for radiotherapy in this disease.1 These...

Lung Cancer

ODAC Discussion ‘Constructive’ About Necitumumab for Squamous NSCLC

The U.S. Food and Drug Administration’s (FDA) Oncologic Drugs Advisory Committee (ODAC) favored the approval of necitumumab in combination with gemcitabine and cisplatin for use in first-line treatment of patients with locally advanced or metastatic squamous non–small cell lung cancer (NSCLC). In...

Lung Cancer

Gefitinib in EGFR-Mutant Metastatic NSCLC

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 July 13, 2015, gefitinib (Iressa) was approved for first-line ...

Lung Cancer

Immunotherapy Makes Inroads in Small Cell Lung Cancer

Early data on immunotherapy for small cell lung cancer (SCLC) have been encouraging. SCLC may catch up to non–small cell lung cancer (NSCLC), where immunotherapy is now standard of care, if these early data are borne out in phase III trials. Phase Ib and II studies of immunotherapy in SCLC were...

Lung Cancer

Moving Forward in Non–Small Cell Lung Cancer: Targeted Combinations and Immunotherapy

The newer targeted therapies and immunotherapies have proven to be a boon to the treatment of lung and other cancers, but how best to deploy those therapies remains a burning question. Another important focus of current research is the identification and validation of biomarkers for these...

Lung Cancer

Immune Checkpoint Inhibitors: The Dawn of a New Era for Lung Cancer Therapy

The therapeutic paradigm for lung cancer has changed rapidly over the past few years toward individualized therapy. For certain subsets of patients, molecularly targeted agents have resulted in robust gains in overall survival and quality of life. However, for the majority of patients with...

Lung Cancer

Roswell Park Cancer Institute Partners With Cuban Scientists to Develop Lung Cancer Vaccine

Just 4 months after President Barack Obama’s announcement in December 2014 that there would be an easing of the trade embargo between the United States and Cuba, a deal was struck between Roswell Park Cancer Institute in Buffalo, New York, and the Center for Molecular Immunology (CIM) in Havana,...

Lung Cancer
Issues in Oncology

Positioning Targeted and Immunotherapy-Based Approaches in Lung Cancer

With immunotherapy changing the face of lung cancer, is there still a place for targeted therapy? Two experts from Emory University debated this issue at the 2015 Debates and Didactics in Hematology and Oncology Conference held in Sea Island, Georgia. Fadlo Khuri, MD, was recently named President...

Lung Cancer

‘Encouraging Results’ With Newer EGFR TKIs in Patients With NSCLC Who Progressed After Prior EGFR TKI Therapy

Two studies of third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors among patients with non–small cell lung cancer (NSCLC) who had progressive disease following treatment with a first-generation EGFR tyrosine kinase inhibitor “show encouraging results,” according to...

Lung Cancer

Immune Checkpoint Inhibitor Nivolumab Is Active in Patients With Heavily Pretreated Advanced Non–Small Cell Lung Cancer

In a phase I cohort expansion trial reported in the Journal of Clinical Oncology, Scott N. Gettinger, MD, of Yale Cancer Center, New Haven, Connecticut, and colleagues found that monotherapy with the anti–programmed cell death protein 1 (PD-1) checkpoint inhibitor antibody nivolumab (Opdivo)...

Lung Cancer

Bevacizumab Plus Standard Chemotherapy Improves Survival in Mesothelioma

The standard of care for malignant pleural mesothelioma may be poised for change, judging by results from a study by the French Cooperative Thoracic Intergroup. The addition of bevacizumab (Avastin) in the first-line setting to the current standard of care, pemetrexed (Alimta)/cisplatin, improved...

Lung Cancer

First-Line Nivolumab/Ipilimumab Combination in Non–Small Cell Lung Cancer Shown to Be Tolerable

For advanced non–small cell lung cancer (NSCLC), first-line treatment with combined immune checkpoint blockade—in novel doses and schedules—was associated with deep and durable responses, encouraging progression-free survival, and much better tolerability than has been previously observed with...

Lung Cancer

Nivolumab in Lung Cancer Supported by Updated Trial Data

For the treatment of advanced squamous non–small cell lung cancer (NSCLC), the programmed cell death protein 1 (PD-1) antibody nivolumab (Opdivo) continues to show results in key trials that now report 18-month data. The updates were reported at the 16th World Conference on Lung Cancer in Denver,...

Lung Cancer

Lung Cancer Rates Doubling Among Nonsmokers

Lung cancer is becoming an equal-opportunity malignancy—with rates rising among never-smokers, especially females, according to studies presented at the 16th World Conference on Lung Cancer in Denver. British investigators reported that in one large tertiary medical center, the proportion of...

Lung Cancer

AZD9291 Updates Encouraging for Treatment-Resistant NSCLC

At the 16th World Conference on Lung Cancer, several studies showed consistent activity with the investigational third-generation inhibitor AZD9291 in patients with advanced non–small cell lung cancer (NSCLC) that is resistant to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors....

Lung Cancer

EGFR Gene Copy Number as Biomarker for Antibody Treatment in Squamous Cell NSCLC

Two studies presented at the 16th World Conference on Lung Cancer suggest that high expression of the epidermal growth factor receptor (EGFR), or gene copy number, may indicate potential benefit from EGFR antibodies in squamous cell non–small cell lung cancer (NSCLC). The studies were presented by...

Lung Cancer

Patients Whose Treatment Included Bevacizumab Were More Likely to Experience Toxicity but Less Likely to Be Hospitalized

A study among patients with advanced non–small cell lung cancer (NSCLC) treated with carboplatin-paclitaxel or carboplatin-paclitaxel-bevacizumab (Avastin) found that those receiving the triplet were more likely to experience a toxicity event but less likely to be hospitalized within 180 days after ...

Lung Cancer

Anti-EGFR Therapy in Squamous Cell Lung Carcinoma: Swimming With or Against the Tide?

Lung cancer is the most common, lethal, and costly cancer worldwide, accounting for at least 1.8 million new cases per year (12.9% of the total).1 Over the past decade, there has been a major shift in the treatment of non–small cell lung cancer (NSCLC), especially in adenocarcinoma, accompanied by...

Lung Cancer

Addition of Necitumumab to First-Line Gemcitabine/Cisplatin Improves Overall Survival in Stage IV Squamous NSCLC

In the phase III SQUIRE trial reported in The Lancet Oncology, Nick Thatcher, PhD, FRCP, of The Christie Hospital NHS Trust, Manchester, UK, and colleagues found that the addition of the second-generation epidermal growth factor receptor (EGFR) antibody necitumumab to first-line...

Lung Cancer

Pembrolizumab in Previously Treated PD-L1–Positive Metastatic NSCLC

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 October 2, 2015, the U.S. Food and Drug Administration granted...

Lung Cancer

FDA Grants Accelerated Approval to Pembrolizumab for Advanced NSCLC

The U.S. Food and Drug Administration (FDA) has granted accelerated approval for pembrolizumab (Keytruda) to treat patients with metastatic non–small cell lung cancer (NSCLC) whose disease has progressed after other treatments and with tumors that express programmed cell death-ligand 1 (PD-L1)....

Lung Cancer

FDA Approves Use of Nivolumab in Metastatic Nonsquamous Lung Cancer

The U.S. Food and Drug Administration (FDA) has approved nivolumab (Opdivo) to treat patients with metastatic nonsquamous non–small cell lung cancer (NSCLC) whose disease progressed during or after platinum-based chemotherapy. Nivolumab is a monoclonal antibody that that blocks the PD-1/PD-L1...

Lung Cancer

Smoking Cessation Reduces Mortality in Lung Cancer Screening Population

Data from an analysis of lung cancer screening programs in Italy add further evidence that smoking cessation reduces mortality. Heavy smokers screened by low-dose computed tomography (CT) who stopped smoking before or during the screening period had a three- to fivefold reduction in mortality...

Lung Cancer

Atezolizumab Makes Inroads in Non–Small Cell Lung Cancer

The anti–PD-L1 (programmed cell death-ligand 1) antibody atezolizumab (formerly known as MPDL3280A) achieved encouraging outcomes in patients with non–small lung cancer (NSCLC) in two different trials: POPLAR1 and BIRCH.2 PD-L1 has emerged as a predictive biomarker for atezolizumab response in both ...

Lung Cancer

Nivolumab in Metastatic NSCLC After Platinum Therapy

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 October 9, 2015, the anti–programmed cell death protein 1...

Lung Cancer
Issues in Oncology

LUNGevity Foundation and Celgene Collaborate to Create Resource for Lung Cancer Caregivers

The LUNGevity Foundation and the biopharmaceutical company Celgene have joined forces to launch a new resource for caregivers of people diagnosed with lung cancer. The program, “Your Journey Together,” is a support tool focusing on the specific needs of this group and includes a series of videos,...

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