Biomarker-Driven Lung Cancer

According to a retrospective analysis of a randomized study presented at the 2017 ESMO Congress, a liquid biopsy that measures tumor mutational burden showed promise for predicting benefit in patients with non–small cell lung cancer treated with a checkpoint inhibitor. 

Treatment with the PD-L1 inhibitor durvalumab (Imfinzi) improved median PFS by 11.2 months compared with placebo for patients with locally advanced, unresectable stage III non–small cell lung cancer who had not progressed following chemoradiotherapy, according to phase III results from the PACIFIC trial presented at the 2017 ESMO Congress.

In results from the phase III FLAURA study of frontline osimertinib (Tagrisso) in patients with <em>EGFR</em>-mutant non&ndash;small cell lung cancer, osimertinib demonstrated a progression-free survival &nbsp;rate of 18.9 months (95% CI, 12.5-21.4), which was significantly improved over standard therapy.&nbsp;

According to findings from the phase III ALUR and ALEX studies announced ahead of the 2017 ESMO Congress,^&nbsp;Alectinib demonstrated promising efficacy for patients with <em>ALK</em>-translocated non&ndash;small cell lung cancer with central nervous system metastases in both the first- and second-line setting.

The 2017 ESMO Annual Congress, taking place September 8 to 12 in Madrid, Spain, will feature several late-breaking abstracts that are poised to change the future of treatment for patients with lung cancer, pending their results, including the&nbsp;phase III PACIFIC and FLAURA studies.

Omid Hamid, MD, shares&nbsp;the top melanoma abstracts to look out for at the 2017 ESMO Annual Congress, which is taking place September 8 to 12 in Madrid, Spain, as well as some background on the promising phase I/II results he will be presenting for the combination of epacadostat plus pembrolizumab in patients with advanced melanoma.

Non-small cell lung cancer is the most common type of lung cancer, accounting for approximately 80% to 85% of lung cancer cases, whereas small cell lung cancer comprises approximately 10% to 15% of lung cancer cases.

Systemic anticancer therapy recommendations for patients with stage IV non&ndash;small cell lung cancer (NSCLC) depend on individual tumor histology, patient performance status, and driver oncogene biomarker status, which are most often anaplastic lymphoma kinase (ALK) translocation or epidermal growth factor receptor (EGFR) mutation.

Lyudmila A. Bazhenova, MD, discusses&nbsp;the nondriver NSCLC population, the treatment strategies available for them, and challenges physicians continue to face with this subgroup of patients.

Lyudmila A. Bazhenova, MD, medical oncologist, professor of medicine, UC San Diego Health, discusses the prevalence of patients with non-driver non&ndash;small cell lung cancer.

Lyudmila A. Bazhenova, MD, medical oncologist, professor of medicine, UC San Diego Health, discusses the currently available treatment strategies for patients with non-driver non&ndash;small cell lung cancer.

Lyudmila A. Bazhenova, MD, medical oncologist, professor of medicine, UC San Diego Health, discusses the factors to take into consideration when treating a patient with non-driver non&ndash;small cell lung cancer with bevacizumab (Avastin).

Lyudmila A. Bazhenova, MD, medical oncologist, professor of medicine, UC San Diego Health, discusses what potential impact immunotherapy agents could have on outcomes for patients with non-driver non&ndash;small cell lung cancer.

Lyudmila A. Bazhenova, MD, medical oncologist, professor of medicine, UC San Diego Health, discusses ongoing and remaining challenges in the field of non-driver non&ndash;small cell lung cancer, as well as a look toward the future treatment landscape.

Lyudmila A. Bazhenova, MD, medical oncologist, professor of medicine, UC San Diego Health, discusses the prevalence of patients with non-driver non&ndash;small cell lung cancer.

Corey Langer, MD,&nbsp;provides details on the goals and implications of the KEYNOTE-021 trial. Moreover, he discusses the current arena in NSCLC treatment and the obstacles that remain in treating patients without driver mutations effectively.

A Case of Metastatic ALK-Rearranged Non-Small Cell Lung Cancer

Anne Chiang, MD, PhD, professor and thoracic oncologist at Yale Cancer Center, discusses ipilimumab (Yervoy) plus nivolumab (Opdivo) in small cell lung cancer (SCLC).

The investigators discuss their findings that demonstrate patients with previous radiotherapy experienced significantly longer PFS and OS with pembrolizumab treatment versus those with no previous radiotherapy.

David R. Gandara, MD, director, Thoracic Oncology Program, and professor, UC Davis Comprehensive Cancer Center, discusses the combination of CTLA-4 agents with PD-1 and PD-L1 agents for the treatment of lung cancer.

Christine M. Lovly, MD, PhD, assistant professor of medicine (hematology/oncology), assistant professor of cancer biology, medical oncologist, Vanderbilt-Ingram Cancer Center, discusses phase II results for cabozantinib (Cabometyx) in patients with RET-rearranged lung cancer.

Paul A. Bunn, MD, distinguished professor, Division of Medical Oncology, and James Dudley Chair in Lung Cancer Research, University of Colorado, discusses pseudoprogression in lung cancer.

Roy S. Herbst, MD, PhD, discusses how the therapeutic paradigm will continue to evolve in the next few years for&nbsp;non&ndash;small cell lung cancer, with an increased emphasis on rational combinations and biomarkers.

David R. Gandara, MD, discusses toxicity management with the combination of&nbsp;dabrafenib and trametinib in&nbsp;non&ndash;small cell lung cancer.

A supplemental new drug application (sNDA) for alectinib (Alecensa) has been granted a priority review by the FDA for the frontline treatment of patients with <em>ALK</em>-positive locally advanced or metastatic non&ndash;small cell lung cancer (NSCLC), according to Genentech (Roche), the manufacturer of the second-generation&nbsp;ALK inhibitor.