“Immunotherapy agents, both as monotherapy and in combination, are emerging in the pipeline of non–small cell lung cancer (NSCLC) and could end up competing as frontline treatment for patients, explains Sukhmani Padda, MD.
“For example, the PD-1 inhibitor pembrolizumab (Keytruda) is the sole immunotherapy agent approved in the first-line setting for patients with NSCLC; however, many other immunotherapy agents and combination regimens are in development that are aimed at this line of therapy.”
“Patients with small-cell lung cancer derived no survival benefit from cholesterol-lowering medication, according to a phase 3 randomized, double blind, multicenter, placebo-controlled study published in Journal of Oncology.
” ‘There’s no reason for people to stop taking statins to manage their cholesterol, but it’s extremely unlikely, for patients with small-cell lung cancer, that taking statins will make any difference to their cancer treatment outcome,’ Michael J. Seckl, MD, professor of molecular cancer medicine at Imperial College London, said in a press release. ‘Because all statins work in a similar way to lower cholesterol, it’s relatively unlikely that statins other than pravastatin would have a different, more beneficial effect.’ ”
“You’ve probably heard about powerful new cancer medicines like Keytruda and Opdivo. As advertisedon TV, these drugs release brakes on the immune system to make tumors disappear and extend survival in deadly diseases like lung cancer and melanoma. But these agents, called checkpoint inhibitors, work in only a fraction of patients. Scientists are searching for diagnostic tests to predict who will be helped, and who won’t.
“A promising solution comes from Foundation Medicine, a molecular diagnostics company headquartered in Cambridge, Mass. Foundation offers a cancer genome profiling test that evaluates mutations in DNA. With results from its standard FoundationOne panel, Foundation calculates a Tumor Mutation Burden (TMB) score. This quantitative readout―based on the number and type of DNA changes per megabase, a length of DNA―may prove helpful to patients considering immune treatment for many advanced forms of cancer.”
“Roche has presented late-stage data showing that its Alecensa was superior to Pfizer’s Xalkori on progression-free survival in patients with a specific type of lung cancer.
“The global, randomised Phase III ALEX study hit its primary endpoint in showing that Alecensa (alectinib) as a first-line treatment significantly reduced the risk of disease worsening or death (progression-free survival, PFS) versus Xalkori (crizotinib) in people with anaplastic lymphoma kinase (ALK)-positive advanced non-small cell lung cancer (NSCLC).”
“Currently available as a second-line therapy for patients with ALK-positive non–small cell lung cancer (NSCLC), alectinib’s (Alecensa) frontline potential is being explored in the ongoing phase III ALEX study (NCT02075840), which could transform first-line treatment for these patients.
“This study is comparing alectinib with crizotinib (Xalkori)—a current first-line option—in the frontline setting for patients with ALK-positive NSCLC. The oncology community is anticipating reports on the data in the first half of 2017.”
“Long-term survival in non-small cell lung cancer (NSCLC) exceeded historical standards among patients treated with the immune checkpoint inhibitor nivolumab (Opdivo), according to a study reported here.
“The 129 patients in the study had an estimated 5-year overall survival of 16%. Among those with measurable levels of PD-L1 expression, 5-year survival ranged as high as 43%.”
“Cancers driven by the RAS oncogene are aggressive and difficult to treat, and thus far precision drugs haven’t been able to target the mutant RAS gene successfully.
“But in a presentation at the American Association for Cancer Research Annual Meeting on Monday, April 3, 2017 at 10:30 a.m., in Washington DC, Dana-Farber Cancer Institute scientists said a number of patients in a small study with RAS-driven lung, ovarian, and thyroid cancers got long-term clinical benefit from a combination of two drugs that targeted molecular pathways controlled by the RAS gene.
” ‘Between one-quarter and one-third of patients got long-term clinical benefit,’ said Geoffrey Shapiro, MD, PhD, director of Dana-Farber’s Early Drug Development Center. ‘Several patients were on the drugs for more than a year, and one patient has been on treatment for two and a half years. And these were heavily-treated patients without many options.’ ”
“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. Although the benefit of the doublet was modest in the overall study population, the study’s findings were striking in two ways: the duration of response was 7 times that achieved with docetaxel alone, and patients with measurable disease had a 4.6-month improvement in survival.”
“Treatment with the immune checkpoint inhibitor nivolumab (Opdivo) yielded durable responses in some patients with advanced non-small cell lung cancer (NSCLC), with a five-year survival rate of 16 percent, according to data from a phase I clincal trial presented here at the AACR Annual Meeting 2017, April 1-5.
“According to the National Cancer Institute’s SEER data, five-year survival rate for patients with advanced lung and bronchus cancer is 4.3 percent, and for those with advanced NSCLC, it is 4.9 percent.
” ‘This is the first report of the long-term survival rate in patients with metastatic NSCLC treated with an immune checkpoint inhibitor. Our study results show that for a small subset of patients, immunotherapy can work for a very long time,’ said Julie Brahmer, MD, associate professor of oncology at the Bloomberg~Kimmel Institute for Cancer Immunotherapy at Johns Hopkins.”