Biomarker-Driven Lung Cancer

The results of the phase III PACIFIC trial made a significant impact on the treat­ment landscape for locally advanced non−small cell lung cancer when both the progression-free survival and overall survival results were announced separately.

The FDA has approved an update to the durvalumab label for patients with unresectable, stage III non&ndash;small cell lung cancer whose disease has not progressed following concurrent platinum-based chemoradiotherapy in order to include overall survival data from the phase III PACIFIC trial.<br /> &nbsp;

Charu Aggarwal, MD, MPH, the Leslye M. Heisler Assistant Professor for Lung Cancer Excellence at Perelman School of Medicine, University of Pennsylvania, and other researchers conducted a prospective study using next-generation sequencing as a biomarker to predict response and progression-free survival rates in patients with non&ndash;small cell lung cancer &nbsp;receiving pembrolizumab monotherapy. The data were presented during the 2019 ASCO Annual Meeting.

Advances in targeted therapies show encouraging activity as treatment for tough-to-target driver alterations in non&ndash;small cell lung cancer emerge, according to data presented at the 2019 ASCO Annual Meeting. The discovery of additional oncogenic drivers and promising targeted therapies means that certain patients will receive treatments that produce favorable outcomes based on their disease characteristics.

The combination of erlotinib and ramucirumab showed better progression-free survival in patients with newly diagnosed&nbsp;<em>EGFR</em>-mutant metastatic non&ndash;small cell lung cancer compared with erlotinib plus placebo, based on findings from the RELAY trial presented during the 2019 ASCO Annual Meeting.&nbsp;

General Cancer

The FDA has granted an orphan drug designation to durvalumab (Imfinzi) for the treatment of patients with small cell lung cancer (SCLC).<br /> &nbsp;

Hussain Borghaei, DO, MS, discusses the significance of the overall survival data update from the KEYNOTE-001 trial. This trial investigated the PD-1 inhibitor pembrolizumab as a treatment for patients with advanced non&ndash;small cell lung cancer.

In an interview with&nbsp;Targeted Oncology, David Spigel, MD, discussed the updated findings from the PACIFIC trial and how these data will impact the treatment landscape for patients with stage III NSCLC, as well as those with earlier-stage disease. He also highlighted controversies that clinicians face with incorporating immunotherapy into their practice for patients.

Treatment with erlotinib significantly extended progression-free survival in patients with stage IIIA-N2&nbsp;<em>EGFR-</em>mutant non&ndash;small cell lung cancer compared with a combined chemotherapy regimen of gemcitabine plus cisplatin, according to clinical trial results published recently in the&nbsp;<em>Journal of Clinical Oncology</em>.

Biomarker expansion has enjoyed a boom since 2006, with patient incidence of positive biomarkers reaching up to 50% in non&ndash;small cell lung cancer and melanoma and 25% in acute myeloid leukemia and myelodysplastic syndromes, according&nbsp; to the <em>Global Oncology Trends 2018</em> report.

A new study shows comparability between liquid biopsy and tissue biopsy in both diagnostics and monitoring of non&ndash;small cell lung cancer (NSCLC). However, based on the results, liquid biopsies may be preferable to help oncologists make swifter decisions that help manage the disease.<br /> &nbsp;

In June 2019, the FDA approved a number of agents many fields, including diffuse large B-cell lymphoma, head and neck squamous cell carcinoma, small cell lung cancer, gastroenteropancreatic neuroendocrine tumors, and multiple myeloma. The FDA also approved the fifth biosimilar for trastuzumab and another biosimilar for&nbsp;bevacizumab across several indications.

The FDA has approved Zirabev, a biosimilar to bevacizumab for 5 indications.&nbsp;Zirabev has been approved for the treatment of patients with metastatic colorectal cancer; unresectable, locally advanced, recurrent or metastatic non-squamous non&ndash;small cell lung cancer; recurrent glioblastoma; metastatic renal cell carcinoma; and persistent, recurrent or metastatic cervical 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;