David Spigel, MD

David Spigel, MD, chief scientific officer, Sarah Cannon Research Institute, director of the Lung cancer Research Program, and member of the Association of Community Cancer Centers (ACCC) explains to

the ways in which ACCC is improving the care landscape and outcomes for patients with advanced nonsmall cell lung cancer (NSCLC).

Advances in care related to diagnostics for stage III/IV NSCLC can make disease management more difficult for community oncologists. This is because there are many different medical disciplines who get involved in the management and care of a patient, says Spigel. From the time of diagnosis, managing NSCLC can involve radiation, surgery, immunotherapy, chemotherapy, and morea large multidisciplinary team. Once all of the important people have become involved in the patient&rsquo;s care, they can they work together to understand the challenges associated with treating stage III or IV NSCLC and find solutions for those problems.

Videos

David Spigel, MD, chief scientific officer, Sarah Cannon Research Institute, director of the Lung cancer Research Program, and member of the Association of Community Cancer Centers explains to Targeted Oncology, the ways in which ACCC is improving the care landscape and outcomes for patients with advanced non&ndash;small cell lung cancer.

Fostering Excellence in Care and Outcomes in Patients With Stage III and IV NSCLC

David Spigel, MD, chief scientific officer of Sarah Cannon Research Institute, gives a recap on the phase III PACIFIC study, with facts and perceptions surrounding the latest data that study researchers reported during the 2019 ASCO Annual Meeting.

Three years ago, the PACIFIC study resulted in a reduction in risk of death in patients with locally advanced, unresectable nonsmall cell lung cancer (NSCLC) receiving durvalumab (Imfinzi) following chemoradiotherapy. Although the median overall survival still has not been reached in the durvalumab arm compared with 29.1 months in the placebo arm, the latest data also show a substantial reduction in the risk of death for durvalumab treatment, with a hazard ratio of 0.69 (95% CI, 0.55-0.86). This shows consistency in the efficacy and safety of treatment with durvalumab for patients with locally advanced NSCLC, even after 3 years, says Spigel.

Patients in the PACIFIC trial also demonstrated a longer progression-free survival when receiving durvalumab compared with placebo (16.8 months versus 5.6 months; HR, 0.52; 95% CI, 0.42-0.65;

<.001). The results were consistent regardless of PD-L1 status and included patients with a PD-L1 tumor proportion score (TPS) of 0.

In early 2019, it was reported that the PACIFIC study left unresolved questions related to PD-L1 consideration during the treatment of NSCLC with immunotherapy. With these questions in mind, Spigel comments on the controversaries that arose after the European Union required oncologists to consider levels of PD-L1 expression when selecting patients for treatment with durvalumab. There is no such indication in the United States, which leaves some clinicians unsure about the drug&rsquo;s safety for patients with negative PD-L1 expression.

Examining Recent PACIFIC Trial Updates for Durvalumab in Locally Advanced NSCLC

David Spigel, MD, chief scientific officer, Sarah Cannon Research Institute, discussed with

at the 2019 ASCO Annual Meeting how the Association of Community Cancer Centers (ACCC) is the change agent for helping physicians provide their patients with quality care.

Staying up-to-date with the latest advances in cancer care for optimal patient management is one of the key challenges that community oncologists face. Spigel notes that industry events, like the ASCO Annual Meeting, are important. These events are a source of new information on diagnostic and molecular advancements and changes in preferred cancer regimens that can simplify clinical practice and improve the quality of care for patients. Spigel explains that the ACCC is working to get these updates into the hands of community oncologists to uncomplicate cancer treatment for patients across the United States through education and advocacy.

David Spigel, MD, chief scientific officer, Sarah Cannon Research Institute, discussed with&nbsp;Targeted Oncologyat the 2019 ASCO Annual Meeting how the Association of Community Cancer Centers (ACCC) is the change agent for helping physicians provide their patients with quality care.&nbsp; 
&nbsp;

ACCC Addresses Education Needs for Community Oncologists

David Spigel, MD, medical oncologist and Chief Scientific Officer at Sarah Cannon Research Institute, discusses the updated results for the PACIFIC trial, a randomized phase III trial investigating the addition of durvalumab (Imfinzi) to chemoradiation versus placebo in patients with unresectable stage III lung cancer.

In this trial, patients with unresectable phase III disease, either squamous or nonsquamous, and regardless of PD-L1 expression, were given chemoradiation. They were then randomized to receive durvalumab every 2 weeks for up to 1 year. The primary endpoint of this trial was progression-free survival (PFS) with a secondary endpoint of overall survival (OS).

David Spigel, MD | Authors

Articles

Fostering Excellence in Care and Outcomes in Patients With Stage III and IV NSCLC

Examining Recent PACIFIC Trial Updates for Durvalumab in Locally Advanced NSCLC

ACCC Addresses Education Needs for Community Oncologists

Updated Results for PACIFIC Trial Establish New Standard of Care in Lung Cancer