Lung Cancer

Copenhagen, Denmark—Patients with non–small-cell lung cancer (NSCLC) who lack targetable EGFR or ALK mutations typically receive platinum-based doublet chemotherapy as first-line therapy. Two phase 3 clinical trials presented at the 2016 European Society for Medical Oncology (ESMO) Congress compared immunotherapy and platinum-based chemotherapy as first-line treatment for ­patients with NSCLC. In KEYNOTE-024, pembrolizumab (Keytruda) was superior to chemotherapy in terms of progression-free survival (PFS) and overall survival (OS), whereas in CheckMate-026, nivolu­mab (Opdivo) failed to improve PFS compared with chemotherapy.

The first liquid biopsy used to detect gene mutations that are associated with non–small-cell lung cancer (NSCLC) was approved by the FDA. The cobas EGFR Mutation Test v2 (Roche Molecular Systems), a blood-based companion diagnostic for erlotinib (Tarceva), is indicated as an initial test to detect EGFR gene mutations in patients with NSCLC.

Tyrosine kinase inhibitors (TKIs) are the mainstay of therapy for patients with epidermal growth factor receptor (EGFR) mutation–positive non–small-cell lung cancer (NSCLC), according to the updated National Comprehensive Cancer Network (NCCN) NSCLC guideline. The NCCN guideline recommends EGFR testing as part of a broad molecular profiling in patients with NSCLC.

The third-generation EGFR tyrosine kinase inhibitor (TKI), osimertinib (Tagrisso) targetsEGFR mutations, including T790M. Osimertinib was approved by the FDA in November 2015 for the treatment of patients with metastatic non–small-cell lung cancer (NSCLC) and theT790M mutation whose disease progressed during or after EGFR TKI therapy.

Boston, MA—In a first-of-its-kind study, aprepitant (Emend), a centrally acting neurokinin (NK)-1 antagonist indicated for the treatment of chemotherapy-induced nausea and vomiting (CINV), led to a reduction in cough frequency and an improvement in the objective and subjective measures of cough in patients with lung cancer.

Boston, MA—What is the best chemotherapy regimen to use for patients with locally advanced nonsquamous non–small-cell lung cancer (NSCLC)? The phase 3 PROCLAIM trial attempted to answer this question, but the study failed to determine the best regimen for this patient population.

Geneva, Switzerland—Circulating DNA (ctDNA) in the blood of patients with cancer appears to detect lung cancer mutations, providing similar information to tumor tissue sampling, according to a study presented at the 2015 European Lung Cancer Conference. This makes blood testing for ctDNA an attractive option when tumor tissue sampling is not accessible.

Geneva, Switzerland—A study with ­real-world data showed that almost 1 in 4 (24%) patients with advanced lung cancer are not receiving appropriate testing for EGFR mutations, even though guidelines recommend this genetic test to guide the selection of the most appropriate therapy.

Toronto, Canada—Survival is not improved with routine surveillance using computed tomography (CT) versus chest x-ray in patients who have undergone resection for stage I non–small-cell lung cancer (NSCLC), according to the results of a new analysis presented at the 2014 American Association for Thoracic Surgery meeting.

San Francisco, CA—The use of stereotactic body radiotherapy (SBRT), also called stereotactic radiotherapy or radiosurgery, is an effective option for elderly patients with cancer who are inoperable or who decline surgery, but its safety and efficacy compared with surgery have not been investigated.