Biomarker-Driven Lung Cancer

The CheckMate-451 trial missed its primary endpoint of overall survival with the combination of nivolumab and ipilimumab as a maintenance therapy for patients with extensive-stage small cell lung cancer without disease progression following frontline platinum-based chemotherapy.

During a <em>Targeted Oncology </em>case-based peer perspectives program, Ryan Gentzler, MD, reviewed with other physicians his clinical considerations for the management of non&ndash;small cell lung cancer.

Vassiliki A. Papadimitrakopoulou, MD, Jay and Lori Eisenberg Distinguished Professor of Medicine and section chief of thoracic medical oncology in the department of thoracic/head and neck medical oncology at The University of Texas MD Anderson Cancer Center, discusses the data that were presented at the World Conference on Lung Cancer earlier this year for the IMpower 132 trial comparing the combination of carboplatin/cisplatin plus atezolizumab (Tecentriq) to standard chemotherapy in patients with non&ndash;small cell lung cancer.

Using durvalumab&nbsp;(Imfinzi) combined with&nbsp;tremelimumab for the frontline treatment of patients with metastatic non&ndash;small cell lung cancer did not result in a&nbsp;statistically significant improvement in overall survival compared to standard chemotherapy, according to a press release from AstraZeneca.

Alexander E. Drilon, MD, discusses&nbsp;developing markers in the non&ndash;small cell lung cancer paradigm.

Alectinib (Alecensa) was found to be superior to&nbsp;crizotinib (Xalkori) as frontline therapy in Asian patients with&nbsp;untreated <em>ALK</em>-positive advanced non&ndash;small cell lung cancer (NSCLC), according to findings reported at the 2018 ESMO Congress.

Gilberto Lopes, MD,&nbsp;discusses findings from the phase III KEYNOTE-042 trial and ongoing developments with immunotherapy in NSCLC.

Lorlatinib (Lorbrena) has been granted an accelerated approval by the FDA for use in patients with&nbsp;<em>ALK</em>-positive metastatic non&ndash;small cell lung cancer who have progressed on 1 or more ALK tyrosine kinases inhibitors.

James L. Wade III, MD, FACP, FASCO, discusses the importance of clinical trials in the community.

Based on findings from the phase III KEYNOTE-407 trial, pembrolizumab (Keytruda) has been approved by the FDA for use in combination with carboplatin and either paclitaxel or nab-paclitaxel (Abraxane) for the frontline treatment of patients with metastatic squamous non&ndash;small cell lung cancer.

I think one of the most important advancements in biomedical technology that has improved our understanding of the complexities of cancer is the ability to sequence the cancer genome for any individual patient, in a rapid and cost-effective manner, to help us make treatment decisions in the clinic.

Groundbreaking developments in cancer therapies can change lives, extending survival and sending patients who previously thought their chances were slim into remission. But these therapies come at a cost, and many patients reel at the prospect of heavy financial burdens. To help patients and programs meet the challenges of affording cancer treatments, community cancer centers are expanding the role of financial advocates in their organizations.

Thomas A. Gallo, MS, MDA, president of the Association of Community Cancer Centers, discusses his mission as president to &ldquo;reflect, renew, and reignite&rdquo; in order to create a more resilient oncology team for the community.

Results from the phase III IMpower130 trial demonstrated a statistically significant improvement in both progression-free survival and overall survival with a triplet regimen of&nbsp;atezolizumab, carboplatin, and nab-paclitaxel compared with chemotherapy alone in patients with previously untreated stage IV nonsquamous non&ndash;small cell lung cancer.

Three months have been added on by the FDA to the review period for the supplemental biologics license application for the frontline treatment combination of nivolumab plus low-dose ipilimumab for patients with advanced non&ndash;small cell lung cancer with tumor mutational burden &ge;10 mutations per megabase.

Ulrik Lassen, MD, PhD, discusses the updated response findings with larotrectinib in TRK+ cancers.

Among patients with advanced solid tumors associated with <em>NTRK</em> gene fusions, more than half had responses to&nbsp;the small-molecule inhibitor entrectinib, according to an integrated analysis of 3 clinical trials presented at the 2018 ESMO Annual Congress.

Larotrectinib induced an objective response rate of 80% in patients with advanced solid tumors who harbored&nbsp;<em>NTRK&nbsp;</em>gene fusions, according to results pooled from 3 small trials of the TRK inhibitor. Results were presented during the 2018 ESMO Congress.

Patients with <em>EGFR</em>-mutant non&ndash;small cell lung cancer who had&nbsp;<em>MET</em> amplification and <em>EGFR</em> C797S mutations were most likely to have resistance to first-line treatment with&nbsp;osimertinib (Tagrisso),&nbsp;according to preliminary findings presented at the 2018 ESMO Congress.

Rising prescription drug prices continue to add to the burden of paying for quality healthcare. In an effort to confront such costs, the Centers for Medicare &amp; Medicaid Services has rescinded a prohibition on step therapy for Medicare Advantage plans. But some contend such a policy will reduce patient access to optimal medication.

Tumor mutational burden, also referred to as tumor mutational load, is a measure of the number of mutations in tumor tissue taken from a patient. Recently, several studies have been investigating the utility of TMB as a biomarker to predict response to therapy in patients with non&ndash;small cell lung cancer.

According to topline findings, the phase III CheckMate-331 trial of nivolumab monotherapy for patients with small cell lung cancer who relapsed following platinum-based chemotherapy failed to meet its primary endpoint of improved overall survival compared with the standard topotecan or amrubicin.

Justin F. Gainor, MD, assistant professor of medicine, Harvard Medical School, Massachusetts General Hospital, discusses the treatment landscape of oncogenic driver-positive NSCLC.

Alexander Drilon, MD, clinical director of Early Drug Development Service at Memorial Sloan Kettering Cancer Center, discusses the evolving role of immune-checkpoint blockade in NSCLC.

Lung and bronchus cancer are the leading causes of cancer-related deaths in the United States and will be responsible for an estimated 154,050 American deaths in 2018. An estimated 234,030 new cases of lung and bronchus cancer will be diagnosed in 2018, which represents 13.5% of all new cancer diagnoses in the United States.

Durvalumab (Imfinzi) demonstrated an improvement in overall survival compared with placebo in patients with stage III, unresectable non&ndash;small cell lung cancer who have not progressed following chemoradiotherapy, according to updated findings from the PACIFIC trial recently&nbsp;presented at the 19th World Conference on Lung Cancer and simultaneously published in the <em>New England Journal of Medicine</em>.

Infographic: Here, we share the top 5 oncology news stories we reported this week, including the most recent FDA updates and expert insights on key developments in the field.

In an interview with <em>Targeted Oncology</em>, Geoffrey Oxnard, MD, discussed the promise of genome-wide sequencing in cfDNA.

A look back at all the&nbsp;FDA news&nbsp;that happened in the month of&nbsp;September 2018, including several new approvals, priority reviews, a breakthrough therapy designation, and more, in a variety of cancer types.

Rachel Sanborn, MD, recently discussed the treatment options and considerations she makes when treating patients with non&mdash;small cell lung cancer. Sanborn, director of Thoracic Oncology, Providence Cancer Center, explained her treatment decisions based on 2 case scenarios during a <em>Targeted Oncology </em>live case-based peer perspectives presentation.