LUNG CANCER

In addition to late patient presentation, the high mortality rate in lung cancer can be largely attributed to the complex nature of the disease and a very high rate of heterogeneity in the causative molecular abnormalities.

Immunotherapies (immune checkpoint inhibitors) and targeted therapies (tyrosine kinase inhibitors [TKIs] that target specific mutations in one or more oncogenic drivers) represent two of the most researched types of therapy under investigation for the treatment of non-small cell lung cancer (NSCLC).

An impressive array of newly approved treatments, as well as investigational agents, for non–small cell lung cancer (NSCLC) emerged in the first 6 months of 2015.

Martin Reck, MD, PhD, Head of Thoracic Oncology, Hospital Grosshansdorf, discusses the phase III SQUIRE trial in patients with non-small cell lung cancer (NSCLC) treated with necitumumab.

The University of Texas MD Anderson Cancer Center in Houston has been selected as the site for one of two new Genome Characterization Centers (GCCs) funded by the National Cancer Institute (NCI) and National Institute of Health (HHSN261200800001E).

Breakthrough therapy designation has been granted by the US Food and Drug Adminstration (FDA) to the combination of the BRAF inhibitor dabrafenib (Tafinlar) and the MEK inhibitor trametinib (Mekinist) as treatment for patients with BRAF V600E-mutant non–small cell lung cancer

Nivolumab (Opdivo) was recently approved by the European Commission as a treatment for patients who have locally advanced or metastatic squamous non-small cell lung cancer (NSCLC), following prior chemotherapy, based on findings from the phase III Checkmate-017, as well as the phase II Checkmate-063 trials.

Ginseng polysaccharides may affect the balance of T-helper cells in patients with non-small cell lung cancer.

Mark A. Socinski, MD, professor, Medicine and Cardiothoracic Surgery, director, Lung Cancer Section, Division of Hematology/Oncology, clinical associate director, Lung SPORE, co-director, UPMC Lung Cancer Center of Excellence, co-leader, UPCI Lung Cancer Program, University of Pittsburgh, discusses the adverse events, as well as the overall significance, of nivolumab in patients with advanced non-squamous non-small cell lung cancer (NSCLC).

Gefitinib (Iressa) was recently approved by the FDA for the frontline treatment of patients who have metastatic, EGFR-positive non-small cell lung cancer (NSCLC) with an exon 19 deletion or exon 21 (L858R) substitution.

The approval of necitumumab, combined with gemcitabine and cisplatin for the first-line treatment of patients who have locally advanced or metastatic squamous non-small cell lung cancer (NSCLC), was supported by FDA’s Oncologic Drugs Advisory Committee (ODAC).

James Stevenson, MD, Department of Hematology and Oncology, Cleveland Clinic, discusses the impact of a stage IV non-small cell lung cancer (NSCLC) care pathway on frontline and maintenance chemotherapy use.

Clovis Oncology has initiated the rolling submission process for rociletinib in EGFR T790M-positive advanced non–small cell lung cancer following prior treatment with a TKI.

Jennifer S. Temel, clinical director, Thoracic Oncology, Massachusetts General Hospital, discusses a phase III study that examined the impact of anamorelin in patients with advanced non-small cell lung cancer (NSCLC) and cachexia.

Roy S. Herbst, MD, PhD, Ensign Professor of Medicine (medical oncology), professor of Pharmacology, chief, Medical Oncology, Yale Cancer Center and Smilow Cancer Hospital at Yale-New Haven, associate director, Translational Research, Translational Working Group Leader, Thoracic Oncology Program, Yale Cancer Center, discusses the results of the CheckMate-057 trial, which examined nivolumab in patients with NSCLC, and possible biomarkers that could be identified.

Researchers at the Wistar Institute Cancer Center have discovered a new potential circulating biomarker for non–small cell lung cancer. It is a cancer testis antigen expressed by a cancer/testis gene called AKAP4. The exciting prospect this heralds is the development of an accurate, quick blood test for early-stage NSCLC.

Veena Singh, MD, senior vice president and senior medical director, Biocept, Inc., discusses the clinical validation and utility of a liquid biopsy in non-small cell lung cancer (NSCLC) using circulating tumor cells (CTCs) and ctDNA to analyze EGFR, ALK and ROS status.

The next-generation ALK inhibitor alectinib has demonstrated robust objective response rates (ORR) in patients with ALK-positive non–small cell lung cancer, including those with central nervous system metastases.

An immunotherapy combination demonstrated an overall response rate of 27% in previously treated non–small cell lung cancer across a range of doses, according to results of an ongoing phase Ib study.

The FDA has granted a priority review to pembrolizumab as a potential treatment for patients with advanced non-small cell lung cancer following treatment with chemotherapy or a targeted therapy, if applicable.

Single-agent atezolizumab (formerly MPDL3280A) had excellent clinical activity in both chemotherapy-naïve and previously treated patients with metastatic non–small cell lung cancer (NSCLC) in the phase II FIR study,

Nivolumab (Opdivo) improved overall survival and was less toxic compared with docetaxel in chemotherapy-pretreated patients with nonsquamous non–small cell lung cancer.

MPDL3280A reduced the risk of death by 53% compared with docetaxel in previously treated patients with PD-L1-positive squamous and non-squamous non-small cell lung cancer.

D. Ross Camidge, MD, director, Thoracic Oncology Clinical Program, program director, Thoracic Oncology Clinical and Translational Research Fellowship, University of Colorado Denver, discusses MET as a secondary driver in lung cancer.

Edward S. Kim, MD, chairman, Solid Tumor Oncology and Investigational Therapeutics, Levine Cancer Institute, Carolinas HealthCare System, discusses combining bevacizumab with EGFR tyrosine kinase inhibitors (TKI) in the treatment of lung cancer.

John Heymach, MD, PhD, chair of Thoracic/Head and Neck Medical Oncology, MD Anderson Cancer Center, discusses the characteristics of three more KRAS subsets in lung cancer, which researchers discovered in a recent study.

Leaders of Roswell Park Cancer Institute (RPCI) in Buffalo, New York, have agreed to collaborate with the Center for Molecular Immunology (CIM) in Cuba to evaluate a therapeutic anticancer vaccine for non–small cell lung cancer (NSCLC) in the United States.

The third-generation EGFR inhibitor rociletinib demonstrated promising responses in patients with EGFR-mutated non-small cell lung cancer with or without the acquired resistance mutation T790M.

Treatment with the third-generation EGFR inhibitor AZD9291 was found to be highly active in patients with EGFR T790M-mutated NSCLC following progression on prior therapy with an EGFR TKI.

Despite their promise, checkpoint inhibitors are not effective in every patient, and research suggests the STING (stimulator of interferon genes) pathway may hold important clues as to why some tumors fail to respond.