scholarly journals Sequencing Therapy for Patients With Lung Cancer

2020 ◽  
Vol 18 (7.5) ◽  
pp. 945-948
Author(s):  
Gregory J. Riely
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Single Agent ◽  
Initial Therapy ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line Therapy ◽  
Platinum Based Chemotherapy ◽  
Biomarker Evaluation

Non–small cell lung cancer (NSCLC) can no longer be considered as one disease, nor can it be treated as one. Understanding tumor histology in NSCLC is critical to understanding optimal biomarker evaluation and initial therapy. Proper biomarker evaluation includes both evaluation of PD-L1 status, as well as testing for actionable oncogenic drivers such as EGFR, ALK, ROS1, BRAF, Met Exon 14, RET, and NTRK. For patients with NSCLC and a driver oncogene, preferred treatment is targeted therapy. Conversely, for those without an oncogenic driver, preferred initial treatment is pembrolizumab in combination with chemotherapy for patients with low PD-L1 expression (1%–49%) or as a single-agent for high PD-L1 expression (≥50%). For small cell lung cancer (SCLC), the first major NCCN Guideline changes occurred in 2019, with the addition of either atezolizumab or durvalumab to platinum-based chemotherapy and etoposide as first-line therapy for patients with extensive-stage SCLC.

scholarly journals Pembrolizumab and platinum-based chemotherapy as first-line therapy for advanced non–small-cell lung cancer: Phase 1 cohorts from the KEYNOTE-021 study

Lung Cancer ◽  
2018 ◽  
Vol 125 ◽  
pp. 273-281 ◽  
Author(s):  
Shirish M. Gadgeel ◽  
James P. Stevenson ◽  
Corey J. Langer ◽  
Leena Gandhi ◽  
Hossein Borghaei ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Phase 1 ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Platinum Based Chemotherapy

Clinical responses and survival in Hispanic patients with non-small cell lung cancer treated with immunotherapy compared with non-Hispanic whites.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18109-e18109
Author(s):  
Luis E. Raez ◽  
Diana Saravia ◽  
Rossana Ruiz ◽  
Daniel Sumarriva ◽  
Teresita Munoz-Antonia ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Single Agent ◽  
Progression Free Survival ◽  
Small Cell ◽  
Second Line ◽  
Small Cell Lung ◽  
First Line ◽  
First Line Therapy

e18109 Background: The main immunotherapy (IMMUNO) trials that led to the approval of these agents for non-small cell lung cancer (NSCLC) accrued a minimum number of Hispanic (HISP) patients (pts) or, in some studies, no HISP pts at all. Additional data is thus needed to validate outcomes in HISP pts with NSCLC treated with IMMUNO. While it is known that genomic profiles and cancer survivals are different between HISP, Non-Hispanic Whites (NHW), and African-Americans; no study has yet looked at differences in IMMUNO outcomes between these populations. Methods: We present data in 436 NSCLC pts treated with IMMUNO at 5 large institutions (3 in the US, 2 in Latin America). The agents evaluated include: nivolumab, pembrolizumab and atezolizumab. 256 pts were HISP and 180 pts were NHW. Most of the pts were treated with single agent therapy as second line (or beyond) while a small group of pts were treated as first line. The primary endpoints of the study were: response rate (ORR), progression free survival (PFS) and overall survival (OS). Results: Among NHW pts, disease control rate (DCR) was 67% for Adenocarcinomas (Adeno) and 46% for squamous cell carcinomas (SQCC). In HISP pts there were no differences in DCR rates between both histologies: 68% for Adeno and 67% SQCC. There were no statistical significant differences among HISP and NHW pts regarding ORR, PFS, OS, and responses according to PD-L1 status. Conclusions: This is the largest publication and comparison of NSCLC immunotherapy outcomes in HISP vs NHW pts. No significant differences were found in the clinical outcomes between these 2 ethnic groups despite expected genomic differences. Pts with actionable mutations were excluded as they usually do not get IMMUNO as first or second line; an approach that might change after IMPOWER 150. These results are comparable to the ones seen in Checkmate and Keynote studies. As expected, higher response rates were seen in first line therapy and pts with PD-L1 (+) status. Further comparisons will be better addressed by a larger prospective study.[Table: see text]

Management of Recurrent Small Cell Lung Cancer

2008 ◽  
Vol 6 (3) ◽  
pp. 323-331 ◽  
Author(s):  
Bryan J. Schneider
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Performance Status ◽  
Single Agent ◽  
Small Cell ◽  
Poor Performance Status ◽  
Small Cell Lung ◽  
Phase Ii Studies ◽  
Platinum Based Chemotherapy

Small cell lung cancer remains one of the more frustrating malignancies for oncologists to treat. Although responses to initial platinum-based chemotherapy are high, most are not durable, and many patients are candidates for further palliative chemotherapy. Therapeutic options include reinduction or single-agent chemotherapy, depending on the duration of response to front-line treatment. Topotecan is the only approved agent for patients with relapsed disease. Several phase II studies have shown a modest benefit with other agents used today, although combination chemotherapy should be avoided because of increased toxicity. Palliative care should always be the focus, especially in patients with recurrent or chemorefractory small cell lung cancer and a poor performance status.

scholarly journals Immunotherapy In Advanced Lung Cancer

ONCOLOGY ◽  
2020 ◽  
pp. 272-279
Author(s):  
Joy Huang ◽  
Karen Reckamp
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Immune Checkpoint ◽  
Single Agent ◽  
Standard Of Care ◽  
Small Cell ◽  
Advanced Lung Cancer ◽  
Small Cell Lung ◽  
Platinum Based Chemotherapy

Historically, platinum-based chemotherapy was the standard of care for metastatic lung cancer. However, since the success of immune checkpoint inhibitors (ICIs) in melanoma, PD-1/PD-L1 and CTLA-4 immune checkpoint pathways have been established as effective therapies to manage advanced non–small cell lung cancer (NSCLC) and extensive-stage (ES) small cell lung cancer (SCLC). Multiple large-scale randomized clinical trials have analyzed the effects of ICIs in NSCLC, and results of these trials have since translated to the approval of single-agent PD-1/PD-L1 inhibitors, and the combination of PD-1 inhibitors with platinum-based chemotherapy has become the new standard of care for patients with advanced NSCLC. Furthermore, in ES SCLC, in which chemotherapy or chemoradiation has been the standard of care for decades, 2 anti–PD-1/PD-L1 agents have been approved for use in the frontline setting for ES SCLC, in combination with chemotherapy. Despite progressive integration of immunotherapy into treatment regimens, there remains a need for reliable biomarkers to precisely determine therapy candidates.

Efficacy of immunotherapy in KRAS-mutant non-small-cell lung cancer with comutations

Immunotherapy ◽  
2021 ◽  
Author(s):  
Alexander P Davis ◽  
Wendy A Cooper ◽  
Michael Boyer ◽  
Jenny H Lee ◽  
Nick Pavlakis ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Single Agent ◽  
Small Cell ◽  
Significant Heterogeneity ◽  
Small Cell Lung ◽  
Kras Mutations ◽  
First Line Therapy ◽  
Improved Outcomes

KRAS-mutant non-small-cell lung cancer is the most common molecular driver of lung adenocarcinoma in western populations. No  KRAS specific therapy has been approved by the FDA until 2021. Despite significant heterogeneity in comutations, patients typically receive single-agent immunotherapy or chemoimmunotherapy as standard first-line therapy. It is unclear whether KRAS mutations predict outcomes with immunotherapy; however, there is emerging data suggesting improved outcomes in patients with a  TP53 comutation and worse outcomes in patients with a  STK11/LKB1 or  KEAP1 comutation.

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