EGFR+ Lung Cancer

A 60-Year Old Man With Untreated Stage IV EGFR-Mutated Non-Small Cell Lung Cancer

High volumes of mutations observed through liquid biopsies may be associated with an improvement in progression-free survival  and clinical benefit after first-line standard-of-care pembrolizumab-based therapy in patients with metastatic non-small cell lung cancer, according to findings from a prospective biomarker trial conducted by investigators at the University of Pennsylvania Perelman School of Medicine and Abramson Cancer Center, which were published in Clinical Cancer Research.

In an interview with Targeted Oncology, Zofia Piotrowska, MD, MHS, discussed the role of EGFR inhibition as frontline treatment of patients with EGFR-mutant lung cancers, as well as the combinations with osimertinib that are currently underway and appearing promising for this treatment landscape.

The FDA Oncologic Drugs Advisory Committee agreed that ramucirumab plus erlotinib showed a favorable benefit/risk profile in patients with untreated metastatic EGFR-positive non&ndash;small cell lung cancer in the phase III RELAY study. The vote was 6 to 5 in favor of the combination and ODAC has scheduled a hearing to discuss the terms of the Biologic License Application.<br /> &nbsp;

In a <em>Targeted Oncology</em>&trade; case-based peer perspective live discussion, Sandip P. Patel, MD, associate professor of medicine at the University of California San Diego Health, discussed EGFR inhibition options for patients with non&ndash;small cell lung cancer, based on the case of a real patient.

To help clinicians cope with an increasing number of geriatric patients with cancer, the Association of Community Cancer Centers is addressing this problem with a 2-pronged approach that focuses on the delivery of care and diagnostic assessment.

The FDA has granted Priority Review to the New Drug Application for brigatinib as first-line treatment for patients with ALK-positive metastatic non&ndash;small cell lung cancer as detected by an FDA-approved test, Takeda Pharmaceutical Company announced in a press release.

Preliminary results from a safety and tolerability phase I/II study signal promise for ADXS-503 alone and in combination with pembrolizumab as treatment of patients with metastatic squamous and non-squamous non&ndash;small cell lung cancer, Advaxis, Inc, announced in a press release. Findings were presented during the International Association for the Study of Lung Cancer 2020 Targeted Therapies of Lung Cancer Meeting, February 19-22, 2020, in Santa Monica, California.

As one of the main challenges faced by cli&shy;nicians who treat non small cell lung cancer, drug resistance continues to thwart efforts to mitigate disease progression. This is especially true for the class of drugs called tyrosine kinase inhibitors, which inhibit adenosine triphosphate at the binding site of tyrosine kinase.

The FDA has granted Priority Review to the supplemental Biologic License Application for atezolizumab as first-line treatment of patients with advanced non-squamous and squamous non-small cell lung cancer without&nbsp;EGFR&nbsp;or&nbsp;ALK&nbsp;mutations with high PD-L1 expression, as determined by PD-L1 biomarker testing.&nbsp;

The FDA has granted Priority Review to the New Drug Application for lurbinectedin, which is being considered for accelerated approval as a treatment of patients with small cell lung cancer who have progressed after prior platinum-containing therapy.

Pepinemab plus avelumab has shown initial signals of antitumor activity and is well tolerated in patients with advanced non&ndash;small cell lung cancer, according to an interim analysis of the CLASSICAL-Lung phase Ib/II clinical trial presented at the 2020 American Society of Clinical Oncology-Society for Immunotherapy of Cancer Clinical Immuno-Oncology Symposium in Orlando, Florida.

The FDA granted Priority Review to the New Drug Application for capmatinib, an investigational selective MET inhibitor, which will be used as treatment for first-line and previously treated patients with locally advanced or metastatic MET exon 14 skipping-mutated non–small cell lung cancer, Incyte announced in a press release.

The FDA has granted approval to injectable pemetrexed for the treatment of patients with locally advanced or metastatic nonsquamous non&ndash;small cell lung cancer and for those with malignant pleural mesothelioma.

A subgroup analysis of Korean patients from the pooled data of two global phase II trials, AURA extension and AURA2, has found that osimertinib is as safe and effective in this subgroup of patients with pretreated EGFR-mutated advanced non-small cell lung cancer with T790M positive status as it was in the parent trials.

In January 2020, the FDA approved new treatment options in gastrointestinal stromal tumors, bladder cancer, and epithelioid sarcoma. The FDA also granted several Priority Review Designations, orphan drug designations, and a Fast Track designation, as well as a Breakthrough Therapy designation.

Afatinib demonstrated clinical activity against uncommon and compound <em>EGFR</em> mutations in patients with EGFR tyrosine kinase inhibitor-naive non&ndash;small cell lung cancer, a patient population for which limited data exist on the efficacy of treatment with EGFR- tyrosine kinase inhibitors, according to Yang et al.

Nasser H. Hanna, MD, discusses the key takeaways on the current role of consolidation immunotherapy in patients with lung cancer, which has become standard in this setting. He highlights questions that still need to be addressed in this space.