Biomarker-Driven Lung Cancer

In non–small cell lung cancer, EGFR mutations, MET exon 14 skipping mutations, and HER2 mutations are common mutation for which directed therapies are available.

Two experts discuss the evolving treatment landscape for patients with non-small cell lung cancer (NSCLC) and reviews the role of molecular testing and discusses some of the challenges faced.

Luis E. Raez, MD, FACP, FCCP, immediate past president of Florida Society of Clinical Oncology, evaluates the role of biomarker testing for lung cancer and other disease types.

KRYSTAL-1 results led the FDA to accelerate the approval of adagrasib for KRAS G12C-mutated locally advanced or metastatic non–small cell lung cancer.

During a Targeted Oncology case-based roundtable event, Benjamin Levy, MD, discussed the current targeted treatment options that target lung cancers that are positive for ALK rearrangements.

Preliminary findings from the KRYSTAL-1 and KRYSTAL-7 trials show the potential for adagrasib in combination with pembrolizumab for patients with non-small cell lung cancer who’s cancer harbors a KRASG12C mutation.

During a Targeted Oncology case-based roundtable event, Gregory Riely, MD, PhD, discussed with participants the adverse event management and expected efficacy of mobocertinib for patients with non–small cell lung cancer and an EGFR exon 20 insertion. This is the second of 2 articles based on this event.

Although HER2 mutations present in many solid tumors, lung cancer is of particular interest because a significant number of mutations are found in the tyrosine kinase domain of the gene. Of those, about 90% take the form of insertions or deletions, according study findings.

Updated findings from the TRIDENT-1 suggest that repotrectinib could represent a potential new treatment option for patients with ROS1- positive advanced non–small cell lung cancer, according to Byoung Chul Cho, MD, PhD.

"We should continue to see steady gains in new targets and improvements in our targeted therapies that make these options available for an ever-larger subgroup of patients with non–small cell lung cancer who can derive longer duration of benefit from additional lines of treatment," says H. Jack West, MD.

Updated analysis from the phase 1/2 ARROW study evaluating pralsetinib in patients with RET fusion-positive non–small cell lung cancer showed the agent to be well tolerated and to elicit clinical activity at a dose of 400 mg daily.

During a Targeted Oncology case-based roundtable event, Gregory Riely, MD, discussed the case of a patient with advanced non–small cell lung cancer who had an EGFR exon 20 insertion. This is the first of 2 articles based on this event.

By combining telisotuzumab vedotin with erlotinib for patients with c-MET protein expressing non–small cell lung cancer, researchers saw promising early antitumor activity.

Melina E. Marmarelis, MD, reports the rationale and key findings from the Chrysalis-2 trial of patients with EGFR-mutated advanced non–small cell lung cancer.

During a Targeted Oncology case-based roundtable discussion, Zofia Piotrowska, MD, MHS, discussed the data from clinical trials supporting mobocertinib and amivantamab for patients with non–small cell lung cancer and an EGFR exon 20 insertion mutation.

Considering the potential to fill a treatment gap in the KRAS G12C-mutant non–small cell lung cancer population, the FDA has granted a fast track designation to the combination of BBP-398 and sotorasib.

Cary Gross, MD, discusses the background of his research on patients with lung cancer and Medicaid.

Based on the efficacy, toxicity, dose-optimization, and lack of confirmatory data for poziotinib in HER2 exon 20 insertion-positive non–small cell lung cancer, ODAC has voted that the drug has an unfavorable risk/benefit profile.

Following a report of impressive 2-year follow-up data, the FDA has granted a regular approval to selpercatinib.

With extended follow-up, selpercatinib has maintained its efficacy and safety in patients with RET fusion-positive non-small cell lung cancer.

Topline data presented at ESMO 2022 showed DZD9008 met its primary end point of objective response rate and had a benign safety profile in non–small cell lung cancer with EGFR exon 20 insertion mutations.

In an interview with Targeted Oncology, David Oubre, MD discussed the use of liquid biopsy to identify prognostic and predictive biomarkers in patients with non–small cell lung cancer. He also explained the results and implications of the INSIGHT study.

In the CodeBreaK 200 clinical trial, progression-free survival was extended with sotorasib treatment in patients with KRAS G12C-mutated non–small cell lung cancer vs standard of care chemotherapy.

Cary Gross, MD, discusses the key takeaways from his retrospective research examining patients with advanced non–small cell lung cancer and its association with Medicaid insurance, rates of biomarker testing, and patient outcomes.

In an interview with Targeted Oncology, Brandon Sheffield, MD, discussed relevant biomarkers for testing in patients with non–small cell lung cancer, and the cost-effectiveness of single-gene test vs next-generation sequencing.

In an interview with Targeted Oncology, Cary Gross, MD, discussed retrospective research that revealed testing and treatment disparities among Medicaid beneficiaries with advanced non–small cell lung cancer, and the steps needed to improve outcomes for the patient population.

An accelerated approval by the FDA for capmatinib has be converted to a regular approval based on new data from adults patients with metastatic non–small cell lung cancer whose tumors have a mutation leading to MET exon 14 skipping.

The combination of tremelimumab plus durvalumab and chemotherapy in the first-line elicited survival benefit in patients with metastatic nonsquamous cell non–small cell lung cancer who harbor STK11, KEAP1, and KRAS mutations.

Sotorasib and RMC-4630 elicited promising preliminary activity in pretreated and KRAS G12C inhibitor–naïve patients with non–small cell lung cancer.

Tepotinib achieved robust efficacy in patients with non–small cell lung cancer harboring MET exon 14 skipping alterations, according to a primary analysis of cohort C of the phase 2 VISION trial.