LUNG CANCER
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September 28th 2019
By Silas Inman
Median overall survival was improved by 6.8 months with osimertinib as a first-line treatment for patients with metastatic, <em>EGFR</em>-mutant non–small cell lung cancer compared with erlotinib or gefitinib, despite crossover between arms, according to updated data from the phase III FLAURA study presented at the 2019 ESMO Congress.
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In his presentation on translational research in non–small cell lung cancer during the <em>20th Annual </em>International Lung Cancer Congress®, Scagliotti, a professor of oncology at the University of Torino in Italy, discussed the promising evolution of therapeutic options, pointing to steps being taken to create a larger precision medicine ecosystem.
Based on findings from retrospective analyses and clinical trial data, patients with <em>ALK</em>-rearranged non–small cell lung cancer may be able to receive sequential ALK inhibitors following progression with similar second and third-generation agents.
Patients with non–small cell lung cancer on radiotherapy had a worse overall survival when a hurricane disaster was declared for their hospital than patients who did not experience a declaration, according to a study published in<em> JAMA</em>.
A matched retrospective comparison showed that progression-free survival in patients with advanced non-small cell lung cancer and actionable mutations was similar whether treatment went was guided with the use of tissue or circulating tumor DNA analysis with the Guardant360 assay.
Relapsed ALK-Rearranged NSCLC
Atezolizumab monotherapy demonstrated a statistically significant overall survival benefit in comparison with chemotherapy doublets in patients with untreated advanced non–small cell lung cancer with high PD-L1 expression and without <em>ALK </em>or <em>EGFR </em>mutations. This met the primary endpoint for the phase III IMpower110 trial, according to initial results release by Genentech, the developer of the PD-L1 inhibitor.
The combination of atezolizumab plus carboplatin and nab-paclitaxel demonstrated a clinical overall survival benefit in a subgroup of patients with advanced squamous non–small cell lung cancer and a high level of PD-L1 expression in the phase III IMpower131 trial. Final data for this study was presented at the 2019 World Conference on Lung Cancer.
The FDA has granted a breakthrough therapy designation to tepotinib, an investigational MET inhibitor, for the treatment of patients with metastatic non–small cell lung cancer harboring a MET exon 14 skipping alteration who have progressed following platinum-based therapy.
Treatment with selpercatinib induced responses in 68% of patients with <em>RET </em>fusion–positive non–small cell lung cancer, according to findings from the phase I/II LIBRETTO-001 trial.
Bemcentinib, a first-in-class AXL inhibitor, in combination with the PD-1 inhibitor pembrolizumab showed activity in patients with immunotherapy-naive advanced non–small cell lung cancer, according to findings from the phase II study presented at the 2019 World Conference on Lung Cancer.
A statistically significant improvement in overall survival was demonstrated with durvalumab, a PD-L1 inhibitor, combined with chemotherapy in patients with previously untreated extensive-stage small cell lung cancer, according to findings from the phase III CASPIAN trial, presented at the 2019 World Conference on Lung Cancer.
The FDA has granted a fast track designation to AMG 510 for the treatment of patients with previously treated metastatic non–small cell lung cancer harboring a <em>KRAS </em>G12C mutation.
In a recent analysis published in <em>JAMA</em>, data were evaluated from a collection of clinical trials and analyzed for important takeaways in the testing and treatment of patients with non–small cell lung cancer. The authors stress the importance of molecular testing in patients with NSCLC as more targeted therapies become available. <br />
The FDA has granted capmatinib a breakthrough therapy designation as a first-line treatment for patients with <em>MET </em>exon 14 skipping mutation–positive non–small cell lung cancer.
Corey J. Langer, MD, detailed the best courses of treatment for a patient with non–small cell lung cancer to a group of physicians during a recent Targeted Oncology live case-based peer perspectives discussion.
Sarah B. Goldberg, MD, MPH, discusses the role of clinical trials in patients with lung cancer who have molecularly altered tumors, such as <em>EGFR</em>, <em>ALK</em>, <em>BRAF</em>,<em>ROS1, </em>or other alterations. These patients typically consider either targeted therapy or immunotherapy treatment options.
The review period has been extended by the FDA for a supplemental biologics license application for atezolizumab as a frontline treatment for patients with metastatic nonsquamous non–small cell lung cancer who do not have <em>EGFR</em> or <em>ALK</em> aberrations, in combination with carboplatin and nab-paclitaxel.
Findings from a phase II study in patients with small cell lung cancer suggested tumor immune phenotypes can be predictive of response to immune checkpoint blockade. Responses to the combination of durvalumab plus olaparib were observed in all patients where tumors had an inflamed phenotype.
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