FDA Approves Atezolizumab for Extensive-Stage Small Cell Lung Cancer

Excerpt:

“On March 18, 2019, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq) in combination with carboplatin and etoposide for the first-line treatment of adult patients with extensive-stage small cell lung cancer.

Approval was based on the IMpower133 study, a randomized (1:1), multicenter, double-blind, placebo-controlled trial in 403 patients with extensive-stage small cell lung cancer who received no prior chemotherapy for extensive stage disease and had ECOG performance status 0 or 1.”

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Super ASK Patient: Carla Takes Charge of Her Own Lung Cancer Treatment


In the fall of 2014, I experienced an unusual dry cough with nasal drain, and was just not feeling like myself—someone who rarely got sick. My general practitioner performed several tests that revealed nothing, and lung cancer was never suspected because I hadn’t been a smoker and had no family history.

By the following summer, when I developed shortness of breath, I was tested again, was told I had asthma, and received a prescription for steroid treatment. Only then did I take charge of the situation, question my doctor, and ask for a chest X-ray, which showed a three-by-four-inch tumor in my right lung. In October of 2015, I was diagnosed at age 53 with stage 4 non-small cell lung cancer (NSCLC). I had a pleural effusion, and my cancer had the mutations EGFR +ve and exon 19 deletion.

Needless to say, I was shocked…and it seemed ludicrous to me to accept the grim prognosis of 9 to 12 months, as if every patient was the same. After researching this deadly disease, I refused to accept a short life expectancy based solely on historical data. Lung cancer research had been disproportionately underfunded and little progress had been made for decades. But things had advanced substantially in the last five years, so it was time for new statistics!

Carla with her husband and son in Panama

After five days of radiation, I was prescribed afatinib (often sold under the brand name Gilotrif). This was effective for three years, during which I was blessed with an excellent “normal” quality of life. Now I am on Tagrisso (generic name osimertinib), which is working well, and thankfully, without side effects.

My advice to any cancer patient is to take control…it is YOUR life! I have changed hospitals three times and am fortunate to have sought out an amazing oncologist who is compassionate, knowledgeable, and proactive, always welcoming my input. I partnered with the best naturopath in the province, who specializes in cancer and guided me towards the most effective supplements and adjuvant therapies. While I live and have received most of my treatment in Canada, I also researched international alternative treatments and travelled to Cuba several times for Vaxira vaccines. And I found Emma at Cancer Commons, who has been a wonderful support and incredible resource.

I would also advise any patient to listen to your body and always go with your gut. Though I had no symptoms, 1.5 years after diagnosis I felt I should have another brain MRI “just in case.” Lo and behold, it revealed four small brain metastases, which were immediately and successfully Gamma Knifed and have not returned.

Carla and extended family in Mexico

A year after that, my CT scan showed “thickening of the omentum” and growths on my ovaries, which my gynecologist did not think was related to the NSCLC. I persevered and requested surgery, which discovered and removed tumors in my abdominal area. These proved to be metastases from NSCLC. They tested positive for the necessary resistance mutation (T790M), which allowed me to start my second targeted therapy (Tagrisso). I have been taking this drug since October 2018, and I am doing very well now.

Lastly, I advise any cancer patient to surround yourself with positivity. Read stories about cancer survivors. Talk to people who have open minds and are optimists. And most important, allow yourself to have HOPE!

Travelling has always been my passion, and this health “scare” has made that a bigger priority than ever. I have taken advantage of the companionship of friends and family and experienced over a dozen fabulous adventures since my diagnosis just over three years ago. Do more of what you love!

***

Super Patients are cancer survivors who learned to be more engaged in their own care. Cancer Commons believes every patient can be a Super Patient or benefit from a Super Caregiver or Super Advocate. We hope these stories will provide inspiration and hope for your or your loved one’s own treatment journey.


NCCN 2019 Annual Conference Includes Focus on Patient Experience with Innovative Therapies, Plus Updates on Biomarkers, Biosimilars, and the Latest Research on Cancer Care

Excerpt:

“More than 1,500 cancer care professionals are meeting in Orlando, Florida, March 21-23, for the NCCN 2019 Annual Conference, presented by the National Comprehensive Cancer Network® (NCCN®)—an alliance of 28 leading cancer centers. The conference offers more than 25 sessions presenting the latest treatment recommendations for lung, breast, prostate, colon, and other cancers, including new and emerging therapies. Other key topics include coordination of care, pain management during an opioid crisis, biosimilars, cancer-associated distress, biomarkers, genetic testing, and appropriate transition to end-of-life care. The keynote session highlights the benefits and challenges of treatment with new and innovative therapies (e.g. CAR T-cell) from the perspective of the patient and the clinicians caring for them.”

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Structural and Clinical Barriers Keep 3 of 4 Cancer Patients from Participating in Trials

Excerpt:

“A new meta-analysis led by Dr. Joseph Unger of Fred Hutchinson Cancer Research Center has revealed that structural and clinical barriers prevent more than 3 out of 4 cancer patients from participating in clinical trials.

“The study is part of an ongoing effort to understand why patient participation is so low in cancer clinical trials. Unger, a health services researcher and biostatistician who focuses on disparities in cancer research, published his findings today in JNCI, the Journal of the National Cancer Institute.”

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‘Eye-Popping’ pCR Rate With SABR Alone in Early Lung Cancer

Excerpt:

“Stereotactic ablative radiotherapy (SABR) yielded a surprisingly low pathologic complete response (pCR) rate in a phase II trial of operable, early-stage lung cancer patients, raising questions about SABR alone in this setting.

“In the first study to examine neoadjuvant SABR prior to surgery in non-small cell lung cancer (NSCLC), SABR yielded a 60% pCR rate at 10 weeks post-radiation (95% CI 44%-76%), a rate far lower than hypothesized when the trial was designed, reported David Palma, MD, PhD, of the London Health Sciences Centre in London, Ontario, Canada, and colleagues, in JAMA Oncology.”

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Lung-MAP Precision Medicine Trial Expands

Excerpt:

The Lung Cancer Master Protocol (Lung-MAP), the first precision medicine trial in lung cancer supported by the National Cancer Institute (NCI), is undergoing a major expansion to include patients with all non–small cell lung cancers (NSCLCs).

“The trial previously tested treatments for people with advanced-stage squamous cell lung cancer. Opening the trial to all types of advanced-stage NSCLCs means that thousands of new patients will be eligible to enroll.”

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Yale Cancer Center Scientists Advise Caution in Immunotherapy Research

Excerpt:

“In a new study by Yale Cancer Center, scientists suggest that as the number of clinical trials in cancer immunotherapy grows exponentially, some caution should be exercised as we continue to better understand the biology of these new therapeutic targets.  The findings are published today in the journal Cell.

“Researchers around the world have been racing to create therapies that unleash the power of our immune systems against cancer. The most successful of these immunotherapies, which target a molecular pathway known as PD-1/PD-L1, have brightened the landscape for many people suffering with lung cancer and other types of tumors.”

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ASCO and Friends of Cancer Research Applaud NCI’s Expansion of Clinical Trial Eligibility Criteria

Excerpt:

“ASCO and Friends of Cancer Research (Friends) applaud the National Cancer Institute’s (NCI) recent revision of its clinical trial protocol template to broaden eligibility criteria for cancer clinical trials. The protocol template was expanded to help increase the opportunity for participation in NCI-funded clinical trials for patients with certain health-care conditions, as well as to provide an opportunity for patients younger than age 18 to participate in adult clinical trials in certain circumstances.”

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Roche’s Tecentriq Wins Speedy U.S. FDA Review for Small Cell Lung Cancer

Excerpt:

“Swiss group Roche Holding AG said on Wednesday its Tecentriq immunotherapy mixed with chemotherapy won priority review from the U.S. regulator for treating a type of lung cancer, a potential boost to the drug that has been trailing rivals’ revenues.

“The announcement comes after Roche in September said patients with untreated extensive-stage small cell lung cancer (SCLC) lived a median 12.3 months after getting the Tecentriq cocktail, compared to 10.3 months for those getting chemotherapy alone.

“Winning the speedy review from the U.S. Food and Drug Administration sets up possible U.S. approval for Tecentriq in this indication by March 18, the drugmaker said in a statement.”

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