EGFR+ Lung Cancer

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 <em>Targeted Oncology, </em>the ways in which ACCC is improving the care landscape and outcomes for patients with advanced non&ndash;small cell lung cancer.

In an interview with <em>Targeted Oncology, </em>Shirish Gadgeel, MBBS, of the Department of Medicine, Hematology/Oncology Division, University of Michigan, discussed recent study updates from the phase III KEYNOTE-189 trial and potential implications for the combination on clinical practice.

During a recent&nbsp;<em>Targeted Oncology&nbsp;</em>live case-based peer perspectives presentation, Mary Jo J. Fidler, MD, reviewed treatment options in the first and second line based on a case study of a patient with NSCLC who experiences rapid progression on her first-line regimen.&nbsp;

The American Cancer Society, Dana-Farber Cancer Institute, Baptist Cancer Center, and the Mayo Clinic report&nbsp;that treatment patterns varied markedly by cancer type and care facility setting for patients with de novo metastatic disease who died within 1 month after diagnosis, based on an analysis of data from 100,848 patients collected from the National Cancer Database, a hospital-based cancer registry that captures 70% of patients in the United States with a new diagnosis.

The FDA recently released 5 new draft guidance documents that promote broader patient eligibility for cancer clinical trials. The policies encourage inclusion of certain individuals who were previously disqualified due to medical conditions or biological factors, including brain metastases, organ dysfunction, prior or concurrent malignancies, chronic infections, and age.

Two abstracts presented at the 2019 ASCO Annual Meeting analyzed potential combinations with osimertinib (Tagrisso), a third-generation EGFR TKI, with additional agents to potentially overcome resistance mutations following progression in patients with <em>EGFR</em>-mutant NSCLC.

In an interview with&nbsp;<em>Targeted Oncology</em>, Kazuhiko Nakagawa, MD, PhD discussed the findings from the RELAY trial for the combination of ramucirumab plus erlotinib compared to erlotinib plus placebo. He suggested that these data could be practice-changing for the treatment of newly diagnosed patients with&nbsp;<em>EGFR</em>-positive NSCLC.<br /> &nbsp;

Marina C. Garassino, MD, medical consultant, Thoracic Unit, Fondazione IRCCS &ndash; Istituto Nazionale dei Tumori, Milan, Italy, discusses the results from the randomized phase III RELAY trial, in which the combination of ramucirumab plus erlotinib was compared to erlotinib plus placebo in patients with EGFR-mutated non&ndash;small cell lung cancer. These data were presented at the 2019 ASCO Annual Meeting.

Kartik Konduri, MD, discussed with a group of physicians in a recent&nbsp;<em>Targeted Oncology&nbsp;</em>live case-based peer perspectives presentation the diagnostic workup and treatment considerations he makes when he sees a patient with non&ndash;small cell lung cancer in the clinic. Konduri explained his treatment decision making based on the case scenario of a patient with locally advanced NSCLC.&nbsp;

A cohort of cancer centers was selected to serve as models for identifying key strategies for racial and ethnic minority group engagement in clinical trials. On the basis of several qualifying criteria, such as sustained accrual of minorities into clinical cancer research, an established minority population &ge;10% in the overall catchment, an established clinical trial infrastructure, and a formal community outreach program, the investigators identified 8 cancer centers for participation.

In a case-based-style discussion, Tanios S. Bekaii-Saab, MD, and Wells Messersmith, MD, reviewed the treatment of patients with colorectal cancer whose tumors express rare gene mutations or molecular signatures, such as <em>NTRK</em> fusions.

<em>Targeted Oncology</em>&nbsp;spoke with experts in attendance at the 2019 ASCO Annual Meeting to review what they believed were some of the biggest takeaways from this year&#39;s presentation across the fields of lung cancer, breast cancer, GI cancers, genitourinary cancers, melanoma, and multiple myeloma.

Eric Harris, DO, hematologist/oncologist, Florida Cancer Specialists & Research Institute, gives Targeted Oncology an insiders perspective on the current state of community oncology in Florida and some ways the Florida Society of Clinical Oncology (FLASCO) aids in improving patient care by helping physicians.

Preliminary results from a phase II trial demonstrated promising activity for brigatinib in patients with non&ndash;small cell lung cancer with an&nbsp;<em>ALK&nbsp;</em>rearrangement who have progressed on treatment with another next-generation ALK tyrosine kinase inhibitor.

Alexander Drilon, MD, clinical director, Early Drug Development Service, and associate professor of the Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, discusses the data examining the role of entrectinib in patients with non&ndash;small cell lung cancer who are na&iuml;ve to treatment with a ROS1 tyrosine kinase inhibitor.

Two targeted therapies in development have demonstrated encouraging activity as potential treatments targeting hard-to-target driver alterations in lung cancer. During the 2019 ASCO Annual Meeting,&nbsp;Christine M. Lovly, MD, PhD, reviewed the early promising findings for TAK-788 for patients with&nbsp;non&ndash;small cell lung cancer harboring&nbsp;<em>EGFR</em> exon 20 insertions and for BLU-667 for patients with&nbsp;<em>RET&nbsp;</em>rearrangements.&nbsp;&nbsp;

When the targeted agents&nbsp;ramucirumab and erlotinib were combined, progression was delayed by 7 months in patients with newly diagnosed&nbsp;<em>EGFR</em>-positive non&ndash;small cell lung cancer compared to erlotinib alone, according to findings from the phase III RELAY trial.&nbsp;