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Survivorship
Lung Cancer

Precision Medicine and My Own Activism Are Keeping Me Alive

In 2009, I was living my dream. My work as a business development manager for a technology company was thriving; I had a satisfying social life; I was active in sports, especially hiking and biking; and I was involved in social justice causes as a volunteer at San Quentin State Prison, helping...

Lung Cancer

Osimertinib in Metastatic EGFR T790M–Mutant NSCLC After EGFR Inhibitor Therapy

On March 30, 2017, osimertinib (Tagrisso) was granted regular approval for the treatment of patients with metastatic epidermal growth factor receptor (EGFR) T790M–mutant non–small cell lung cancer (NSCLC), as detected by a U.S. Food and Drug Administration (FDA)-approved test, who have progressed...

Lung Cancer

The Ongoing Challenges of Lung Cancer Screening

Lung cancer persistently remains the leading cause of cancer death among men and women in the United States. Only about 15% of lung cancers are diagnosed at the localized stage, when clinical intervention could markedly improve patient outcomes. For decades, lung cancer specialists and advocacy...

Hematologic Malignancies
Breast Cancer
Lung Cancer
Kidney Cancer
Sarcoma
Bladder Cancer
Colorectal Cancer
Multiple Myeloma
Genomics/Genetics

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): 2017 Guidelines

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): 2017 Guidelines In 1996, the National Comprehensive Cancer Network® (NCCN®) published its first set of Clinical Practice Guidelines in Oncology®, covering 8 tumor types. Guidelines are now published for more than 60 tumor types and...

Lung Cancer

Lung Cancer: Hope From Science

The following essay by Paul A. Bunn, Jr, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org. I grew up in ...

lung cancer

MEK Inhibitor Selumetinib and Docetaxel in KRAS-Mutant Advanced NSCLC

A phase III trial (SELECT-1) has shown no improvement in progression-free survival with the addition of the MEK inhibitor selumetinib to docetaxel in the second-line treatment of patients with KRAS-mutant non–small cell lung cancer (NSCLC). Trial results were reported by Jänne et al in...

lung cancer

Brigatinib in Advanced Crizotinib-Refractory ALK-Positive NSCLC

As reported by Kim et al in the Journal of Clinical Oncology, the phase II ALTA trial showed that the next-generation oral ALK inhibitor brigatinib produced a high response rate, including intracranial responses, in patients with advanced crizotinib-refractory non–small cell lung cancer...

lung cancer

ASCO 2017: Gefitinib Treatment Can Delay Recurrence of Intermediate-Stage Lung Cancer

The targeted therapy gefitinib (Iressa) appears more effective in preventing recurrence after lung cancer surgery than the standard of care, chemotherapy. In a phase III clinical trial, patients with epidermal growth factor receptor (EGFR)-positive, stage II to IIIA non–small cell lung cancer ...

lung cancer

FDA Approves Pembrolizumab as First-Line Combination Therapy With Pemetrexed and Carboplatin for Metastatic Nonsquamous NSCLC

On May 10, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda), an anti–programmed cell death protein 1 (PD-1) therapy, in combination with pemetrexed (Alimta) and carboplatin for the first-line treatment of metastatic nonsquamous non–small cell lung cancer...

Lung Cancer

Never Smokers Account for Increased Proportion of NSCLC Cases

In a retrospective study in three U.S. institutions reported in the Journal of the National Cancer Institute, Pelosof et al found that never smokers accounted for an increasing proportion of cases of non–small cell lung cancer (NSCLC) during the period from 1990 to 2013. Joan Schiller, MD, of the...

Lung Cancer

Gefitinib or Erlotinib vs Chemotherapy in Advanced NSCLC

In an individual patient data meta-analysis reported in the Journal of the National Cancer Institute, Lee et al found no difference in overall survival for first-line treatment with the first-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors gefitinib (Iressa) or...

lung cancer

ELCC 2017: Prospective Study Shows Concordance of EGFR Mutation Detection Between ctDNA and Tumor Samples

Detection of EGFR mutations in circulating tumor (ct) DNA from plasma samples can be accomplished using the cobas platform, according to findings presented by Kumar et al at the 2017 European Lung Cancer Conference (ELCC) (Abstract 95PD). Assays of ctDNA offer a noninvasive method of finding EGFR...

lung cancer

ELCC 2017: Specific Immune Cell Profiles Potentially Identify Patients With Lung Cancer Responsive to Anti–PD-1 Immunotherapy

An investigation of immune cell subtypes in the tumor microenvironment of patients with lung adenocarcinoma and squamous cell carcinoma (SCC) identified an immune subgroup that associates with prolonged patient survival and may be prognostic of response to nivolumab, according to findings presented ...

lung cancer

ELCC 2017: Ensartinib Demonstrates CNS Activity in ALK-Positive NSCLC

Ensartinib demonstrated intracranial responses in patients with anaplastic lymphoma kinase (ALK)–positive non–small cell lung cancer (NSCLC) and central nervous system (CNS) metastases, according to findings presented by Reckamp et al at the 2017 European Lung Cancer Conference (ELCC)...

lung cancer

ELCC 2017: Development and Validation of Lung Toxicity Prediction Models Aids Effective Use of Radiotherapy in NSCLC

Validation using patient data of an outcome prediction model for the development of dyspnea subsequent to radiotherapy revealed that the prognostic factors in the model did not adequately predict for delta toxicity endpoints, according to results reported by Defraene et al at the 2017 European Lung ...

lung cancer

Prognostic and Predictive Effects of TP53 With KRAS or EGFR Mutation Status in NSCLC

In a pooled analysis of four trials of platinum adjuvant therapy vs observation in resected early-stage non–small cell lung cancer (NSCLC), Shepherd et al found no prognostic effect of KRAS or EGFR with TP53 comutation but a potential negative predictive effect for adjuvant therapy with TP53...

Lung Cancer

Expert Point of View: Ashish Saxena, MD, PhD

After the data were presented, Ashish Saxena, MD, PhD, Assistant Professor of Medicine at Weill Cornell Medical College and Assistant Attending Physician at the NewYork-Presbyterian Hospital, New York, weighed in on the CA209-003 study. “The results of this trial are exciting and give hope to...

Lung Cancer

Five-Year Survival Quadrupled in Responders to Immunotherapy for Non–Small Cell Lung Cancer

At 5 years, the overall survival rate was 16% in patients with advanced non–small cell lung cancer (NSCLC) treated with single-agent nivolumab (Opdivo), according to follow-up of a phase Ib dose-ranging study (CA209-003), presented at the American Association for Cancer Research (AACR) Annual...

lung cancer

ELCC 2017: Study Shows White Blood Cell–Boosting Drugs Safe During Small Cell Lung Cancer Chemoradiotherapy

A late-breaking subanalysis of the phase III CONVERT trial presented by Gomes et al at the 2017 European Lung Cancer Conference (ELCC) shows that white blood cell–boosting drugs are safe during concurrent chemoradiotherapy of small cell lung cancer (SCLC, Abstract LBA2_PR). “The...

lung cancer

ELCC 2017: Some Patients With Lung Cancer Benefit From Immunotherapy Even After Disease Progression

Some patients with advanced lung cancer benefit from immunotherapy, even after the disease has progressed as evaluated by standard criteria, according to research presented by Artal-Cortes et al at the 2017 European Lung Cancer Conference (ELCC, Abstract 96PD). The findings pave the way for certain ...

lung cancer

ELCC 2017: White Blood Cell Count May Predict Response to Lung Cancer Immunotherapy

White blood cell counts may predict whether patients with lung cancer will benefit from immunotherapy, according to research presented by Tiseo et al at the 2017 European Lung Cancer Conference (ELCC, Abstract 30PD). “Immune checkpoint inhibitors such as nivolumab [Opdivo] and...

lung cancer

ELCC 2017: Osimertinib Improves Symptoms in Advanced Lung Cancer

Osimertinib (Tagrisso) improved cancer-related symptoms in patients with advanced lung cancer, according to an analysis of patient-reported outcomes from the AURA3 phase III clinical trial presented by Lee et al at the 2017 European Lung Cancer Conference (ELCC, Abstract 85O). “With my...

lung cancer

Genomic Intratumor Heterogeneity and Evolution of NSCLC Tumors

In a study reported in The New England Journal of Medicine, Jamal-Hanjani et al found that early stage non–small cell lung cancer (NSCLC) tumors were characterized by widespread intratumor genomic heterogeneity and that increased subclonal copy-number alterations in this context were...

lung cancer

ELCC 2017: Men May Need More Frequent Lung Cancer Screening Than Women

Men may need more frequent lung cancer screening than women, according to research to be presented by Koo et al at the 2017 European Lung Cancer Conference (ELCC). The U.S. Preventive Services Task Force recommends annual screening for lung cancer with low-dose computed tomography (CT) in adults...

lung cancer

ASCO/CCO Clinical Practice Guideline Update: Adjuvant Therapy for Resected Non–Small Cell Lung Cancers

As reported in the Journal of Clinical Oncology by Mark G. Kris, MD, of Memorial Sloan Kettering Cancer Center, and colleagues, ASCO and Cancer Care Ontario (CCO) have issued an update to the ASCO/CCO clinical practice guideline on adjuvant systemic therapy and adjuvant radiation therapy for stage...

lung cancer

FDA Approves Brigatinib for Metastatic ALK-Positive Non–Small Cell Lung Cancer

On April 28, 2017, the U.S. Food and Drug Administration (FDA) granted accelerated approval to brigatinib (Alunbrig) for the treatment of patients with metastatic anaplastic lymphoma kinase (ALK)-positive non­–small cell lung cancer (NSCLC) who have had disease progression on or are...

lung cancer

Potential Predictive Biomarker of Response to Crizotinib in Lung Cancer

Although the duration and magnitude of clinical response are unpredictable in patients with ALK-rearranged non–small cell lung cancer (NSCLC) treated with crizotinib (Xalkori), eventually all patients develop resistance to the drug. A study by Pailler et al evaluating whether circulating...

lung cancer

FDA Grants Lorlatinib Breakthrough Therapy Designation for ALK-Positive Metastatic Non–Small Cell Lung Cancer

On April 27, the investigational next-generation ALK/ROS1 tyrosine kinase inhibitor lorlatinib was granted Breakthrough Therapy designation from the U.S. Food and Drug Administration (FDA) for the treatment of patients with anaplastic lymphoma kinase (ALK)-positive metastatic non–small cell...

lung cancer
issues in oncology

ELCC 2017: Patients With Lung Cancer Treated With PD-1/PD-L1 Checkpoint Inhibitors May Experience Adverse Events After Influenza Vaccination

Patients with lung cancer treated with programmed cell death protein 1/programmed cell death ligand 1 (PD-1/PD-L1) checkpoint inhibitors may be at increased risk of adverse events after receiving the seasonal influenza vaccination, according to the first study measuring this effect. The results, to ...

lung cancer

Prophylactic Cranial Irradiation vs Observation in Extensive-Disease Small Cell Lung Cancer

A Japanese phase III trial has shown no survival benefit of prophylactic cranial irradiation vs observation in patients with extensive-disease small cell lung cancer who had any response to platinum-based doublet chemotherapy and no brain metastases at baseline. These findings were reported in The...

Lung Cancer

Adding Bevacizumab to Cisplatin/Etoposide in Extensive-Disease Small Cell Lung Cancer

In an Italian phase III trial reported in the Journal of Clinical Oncology, Marcello Tiseo, MD, of Azienda Ospedaliero-Universitaria, Parma, Italy, and colleagues found that adding first-line bevacizumab (Avastin) to cisplatin/etoposide did not prolong overall survival in patients with...

Lung Cancer

Stage I Lung Cancer: Treatment Advances Have Changed the Game

Read more in the Journal of Oncology Practice (JOP). Visit ASCOPubs.org/journal/jop Patients with stage I lung cancer are achieving excellent local tumor control, thanks to an evolution in radiotherapy and surgical approaches. Jeffrey A. Bogart, MD, Professor and Chair of the Department of...

lung cancer

Cardiac Events After Radiotherapy for Locally Advanced Lung Cancer

An analysis of patients from 4 prospective radiotherapy trials for locally advanced non–small cell lung cancer (NSCLC) conducted at 2 centers in Michigan showed that grade ≥ 3 cardiac events occurred in more than 10% of patients. The study was reported by Dess et al in the Journal of...

lung cancer

AACR 2017: 5-Year Survival Rate for Nivolumab-Treated Advanced Lung Cancer Higher Than Historical Rate in Early-Phase Trial

Treatment with the immune checkpoint inhibitor nivolumab (Opdivo) yielded durable responses in some patients with advanced non–small cell lung cancer (NSCLC), with a 5-year survival rate of 16%, according to data from a phase I clinical trial presented by Brahmer et al at the American...

lung cancer

FDA Grants Osimertinib Full Approval in Metastatic EGFR T790M Mutation–Positive NSCLC

On March 30, 2017, the U.S. Food and Drug Administration (FDA) granted regular approval to osimertinib (Tagrisso) for the treatment of patients with metastatic epidermal growth factor receptor (EGFR) T790M mutation–positive non–small cell lung cancer (NSCLC), as detected by an...

lung cancer

Assessment of Immunohistochemistry Assays for PD-L1 Expression in NSCLC

In a study of four immunohistochemistry programmed cell death ligand 1 (PD-L1) expression assays registered with the U.S. Food and Drug Administration (FDA), scoring was highly concordant for expression in tumor cells but poorly concordant for scoring in immune cells in non–small cell lung...

lung cancer

3-Year Follow-up of Japanese Trial of Alectinib in ALK-Positive NSCLC

Promising 3-year outcomes were found in patients from a Japanese phase I/II study of alectinib (Alecensa) in previously treated patients with ALK-positive non–small cell lung cancer (NSCLC). The findings were reported by Tamura et al in the Journal of Clinical Oncology. Study Details In the ...

Lung Cancer

New First-Line Options for ALK-Positive Lung Cancer on the Horizon

Anaplastic lymphoma kinase (ALK) rearrangements define a subset of non–small cell lung cancer (NSCLC) patients for whom ALK inhibitors are highly effective. In PROFILE 1014, the multitargeted ALK inhibitor crizotinib (Xalkori) was shown to be superior to platinum/pemetrexed (Alimta) chemotherapy...

Lung Cancer

Markedly Improved Progression-Free Survival With First-Line Ceritinib vs Platinum Chemotherapy in ALK-Rearranged NSCLC

In the phase III ASCEND-4 trial reported in The Lancet, Jean-Charles Soria, MD, of Institut Gustave Roussy, and colleagues found that ceritinib (Zykadia) improved progression-free survival vs platinum-based chemotherapy in the first-line treatment of advanced anaplastic lymphoma kinase...

Lung Cancer

Expert Point of View: Heather L. McArthur, MD, MPH

Discussant Heather L. McArthur, MD, MPH, Medical Director of Breast Oncology at Cedars-Sinai Medical Center, Los Angeles, called the plinabulin findings “provocative,” especially considering the substantial impact on durability of response. Specifically with the addition of plinabulin to docetaxel, ...

Lung Cancer

Plinabulin Improves Survival in Subset of Patients With Non–Small Cell Lung Cancer

The investigational small-molecule plinabulin yielded some interesting benefits when added to docetaxel in previously treated patients with stage III/IV non–small cell lung cancer (NSCLC), in a phase II study.1 Although the benefit of the doublet was modest in the overall study population, the...

lung cancer

IASLC Endorses Tobacco Reform Report Outlining Progress Toward Ending Adult Cigarette Smoking

The International Association for the Study of Lung Cancer (IASLC) has endorsed a report released by the Core Team for Tobacco Control that outlines key action items that can be taken immediately to accelerate progress toward ending cigarette smoking in adults. Issuing their Executive Summary ...

Lung Cancer

Expert Point of View: Ann W. Silk, MD

Ann W. Silk, MD, of Rutgers Cancer Institute of New Jersey, New Brunswick, presented the day’s highlights and commented that the study by Hellmann et al shows the utility, and, in fact, the necessity, of developing a new means of estimating outcomes for patients treated with immunotherapies....

Lung Cancer

Pembrolizumab Affords Long-Term Survival to One-Fourth of Selected Patients With NSCLC, Alternative Statistical Model Suggests

Statistical modeling of long-term survival from the KEYNOTE trials of the programmed cell death protein 1 (PD-1)–inhibitor pembrolizumab ­(Keytruda) estimates that one-quarter of appropriately selected patients with advanced non–small cell lung cancer (NSCLC) may attain long-term survival.1 “In...

lung cancer

Multikinase Inhibitor Treatment Responses in Patients With RET-Rearranged NSCLC

In a report from the Global, Multicenter RET Registry in the Journal of Clinical Oncology, Gautschi et al documented response rates with multikinase RET inhibitors in patients with RET-rearranged non–small cell lung cancer (NSCLC). Study Details The study involved registry data (through...

lung cancer

Thoracic 2017: SBRT Offers Curative Option for Patients With Lung Cancer Aged 80 and Older

Patients in their 80s and 90s who have early-stage lung cancer but cannot undergo an operation can be treated safely and effectively with stereotactic body radiation therapy (SBRT), according to research presented by Cassidy et al at the 2017 Multidisciplinary Thoracic Cancers Symposium (Abstract...

lung cancer

Thoracic 2017: Updated Data Confirm Benefits of Single-Fraction SBRT for NSCLC

New research led by a radiation oncologist at Roswell Park Cancer Institute indicates that less may be more when it comes to some forms of radiation therapy for cancer. In a presentation highlighted in a plenary session (Abstract 4) at the 2017 Multidisciplinary Thoracic Cancers Symposium in San...

lung cancer

Douglas E. Wood, MD, on Lung Cancer Screening

Douglas E. Wood, MD, of the University of Washington, discusses the importance of broad access to and education about lung cancer screening—now approved for people at high risk for the disease—and the need for expanded criteria for screening eligibility.

lung cancer

Charles B. Simone, II, MD, on NSCLC: CTCs as a Biomarker for Early Detection

Charles B. Simone, II, MD, of the University of Maryland Medical Center, discusses results from a large prospective study in locally advanced non–small cell lung cancer, which suggest that circulating tumor cells may be a promising biomarker of progressive or recurrent disease and may help guide...

lung cancer

Boris Sepesi, MD, on NSCLC, TILs, and Overall Survival

Boris Sepesi, MD, of The University of Texas MD Anderson Cancer Center, discusses immune cells within tumors and the potential role for checkpoint inhibitor therapy in the neoadjuvant setting of locally advanced lung cancer (Abstract 7).

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