Biomarker-Driven Lung Cancer

Promising responses have been seen with 2 highly selective, investigational MET inhibitors&mdash;tepotinib and capmatinib&mdash;in both the&nbsp;first- and second-line setting for patients with&nbsp;<em>MET</em> exon 14&ndash;altered advanced non&ndash;small cell lung cancer.

According to a subgroup analysis from the phase III IMpower150 trial presented at the 2019 ASCO Annual Meeting, the addition of immunotherapy to&nbsp;bevacizumab and a chemotherapy doublet improved progression-free survival in patients with&nbsp;non&ndash;small cell lung cancer and baseline liver metastases.

Findings from 2 studies of patients&nbsp;with operable early-stage non&ndash;small cell lung cancer showed preoperative immunotherapy had positive activity and favorable toxicity, according to a presentation at the 2019 ASCO Annual Meeting, and phase III clinical trials are already testing these stratgies.&nbsp;

Nearly double the number of patients with advanced non-small cell lung cancer would be eligibile for clinical trial enrollment if a&nbsp;broader set of eligibility criteria proposed by the American Society of Clinical Oncology and Friends of Cancer Research was implemented,&nbsp;according to data presented at the 2019 ASCO Annual Meeting.

Single-agent lurbinectedin induced an overall response rate of 35.2% in the second-line setting for the treatment of patients with small cell lung cancer in a phase II basket trial, presented at the 2019 ASCO Annual Meeting.

Overall survival from the KEYNOTE-001 trial in patients with advanced non&ndash;small cell lung cancer showed treatment with pembrolizumab monotherapy produced more favorable rates of response at 5 years when compared with historical, pre-immunotherapy standard-of-care regimens.&nbsp;

In an interview with&nbsp;<em>Targeted Oncology</em>, experts in gynecology, gastrointestinal, genitourinary, lung, and breast cancers spoke to the significance of the abstracts they are most looking forward to at the 2019 ASCO Annual Meeting.

The NovoTTF-100L System has received approval from the FDA&nbsp;in combination with pemetrexed and platinum-based chemotherapy as a frontline treatment for patients with unresectable, locally advanced or metastatic malignant pleural mesothelioma.

Mark Socinski, MD, explained to a group of physicians at a recent <em>Targeted Oncology </em>live case-based peer perspectives presentation the treatment considerations and decisions he makes when seeing patients with non&ndash;small cell lung cancer in the clinic.

During a recent <em>Targeted Oncology </em>live case-based peer perspectives presentation, Paul K. Paik, MD, explained to a group of physicians the treatment considerations and decisions he makes when seeing a patient with non&ndash;small cell lung cancer.

Nicolas Girard, MD,&nbsp;discussed the importance of evaluating durvalumab in a real-world setting. In addition, he highlights other questions that remain unanswered in this area, as well as the role of immunotherapy in patients with NSCLC.

Tony Mok, MD, discusses the next steps for pembrolizumab (Keytruda) as a treatment option for patients with non-small cell lung cancer after the phase III KEYNOTE-042 trial.

A look back at all the&nbsp;FDA news&nbsp;that happened in the month of&nbsp;April 2019, including several new approvals, a priority review, breakthrough designation, and more.

David R. Gandara, MD, discusses the treatment decisions he makes and the data that support his recommendations for treating patients with non&ndash;small cell lung cancer

Significantly higher response rates were seen in patients with&nbsp;<em>ALK</em>-positive non&ndash;small cell lung cancer who had been treated with at least 1 prior ALK tyrosine kinase inhibitor &nbsp;before receiving lorlatinib and who harbored an&nbsp;<em>ALK&nbsp;</em>resistance mutation compared with those who did not have an&nbsp;<em>ALK&nbsp;</em>mutation.

During a <em>Targeted Oncology </em>live case-based peer perspectives presentation, Josephine Louella Feliciano, MD, explained the treatment considerations and decisions she makes when treating a patient with non&ndash;small cell lung cancer in the clinic and the data that support these options to a group of physicians.

The approval of the PD-L1 22C3 pharmDX assay has been expanded by the FDA to be used as a companion diagnostic for identifying more patients with stage III or metastatic&nbsp;non&ndash;small cell lung cancer who can undergo frontline treatment with pembrolizumab.

According to new findings, tumor mutational burden showed promise as a predictive biomarker for survival benefit in patients with advanced non&ndash;small cell lung cancer (NSCLC) treated with&nbsp;the PD-L1 inhibitor durvalumab (Imfinzi) as initial therapy versus chemotherapy,&nbsp;even though there was no difference seen between the 2 treatment groups in the primary analysis of the randomized trial.

Silvia C. Formenti, MD, discusses the advantages of radiation therapy in patients with lung cancer compared to other modalities.

Benjamin P. Levy, MD, recently discussed the treatment considerations and decisions he makes when treating patients with non&ndash;small cell lung cancer. Levy, the clinical director of medical oncology and associate professor of oncology at Johns Hopkins Sidney Kimmel Cancer Center at Sibley Memorial Hospital, revealed his treatment decisions to the group based on 2 case scenarios of patients with NSCLC that does not have a genetic driver.

Adding&nbsp;bevacizumab to erlotinib significantly improved&nbsp;progression-free survival compared with erlotinib&nbsp;alone in patients with <em>EGFR</em>-positive, advanced nonsquamous non&ndash;small cell lung cancer, suggesting the combination may have the potential to become standard of care for this patient population.

Suresh S. Ramalingam, MD, professor of hematology and medical oncology at the Emory University School of Medicine, discusses the challenge of brain metastases in <em>EGFR</em>-mutated lung cancer and the data surrounding osimertinib (Tagrisso) in this patient population.

Alexander Drilon, MD,&nbsp;discussed updated findings with larotrectinib in <em>NTRK</em> fusion&ndash;positive tumors and entrectinib in <em>ROS1</em> fusion&ndash;positive NSCLC.<br /> &nbsp;

The approval for&nbsp;pembrolizumab (Keytruda) has been expanded to include the&nbsp;frontline treatment of patients with stage III non&ndash;small cell lung cancer, who are ineligible for surgery or definitive chemoradiation, or metastatic NSCLC, with a PD-L1 expression level of &ge;1% and do not harbor <em>EGFR</em> or <em>ALK</em> aberrations.

Before a community oncology practice considers getting involved in clinical trials research, there are many factorsto consider. Perhaps foremost is the fact that cancer clinical trials provide the evidence base for new advances in oncology.&nbsp;

Artificial intelligence has made inroads in many industries&mdash;banking, finance, security&mdash;but its adoption in healthcare has been lagging and real-world clinical implementation has yet to become a reality. Nonetheless, proponents say it is only a matter of time and pilot programs are starting to yield some practical results.&nbsp;

Naiyer A. Rizvi, MD, explained, in a presentation at the European Society of Medical Oncology 2019 International Congress on Targeted Anticancer Therapies, that plasma assays for determining TMB are becoming more diagnostically relevant.

A look back at all the&nbsp;FDA news&nbsp;that happened in March 2019, including several new approvals, a clinical hold, an orphan drug designation, and more.

In findings presented during the 2019 AACR Annual Meeting, safety and efficacy was seen with CAR T cells targeting&nbsp;mesothelin-expressing tumors&nbsp;in a preliminary clinical evaluation in patients with malignant pleural disease.

Lurbinectedin (PM1183) monotherapy induced responses in patients with relapsed small cell lung cancer, achieving the primary endpoint of overall response rate in a single-arm phase II trial, according to an announcement from PharmaMar, the company developing lurbinectedin.