Non-small cell lung cancer
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August 22, 2018
CNS Activity of EGFR Tyrosine Kinase Inhibitor in T790M-Positive Advanced NSCLC Bookmark
Emma Shtivelman, PhDExcerpt from The ASCO Post:
“In a planned subgroup analysis of the phase III AURA3 trial reported in the Journal of Clinical Oncology, Wu et al found that the third-generation EGFR tyrosine kinase inhibitor osimertinib (Tagrisso) produced higher central nervous system (CNS) response rates vs platinum plus pemetrexed (Alimta) in patients with advanced EGFR T790M-positive non–small cell lung cancer (NSCLC).
“In AURA3, 419 patients with disease progression on prior EGFR tyrosine kinase inhibitor treatment were randomized 2:1 to receive osimertinib at 80 mg once daily or platinum plus pemetrexed. The current subgroup analysis was conducted in patients with measurable or nonmeasurable CNS lesions on baseline brain scan by blinded independent central neuroradiologic review.”
Go to full article published by The ASCO Post on Aug 13, 2018.
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August 21, 2018
Brigatinib Confers Intracranial Responses in ALK-Positive Non-Small Cell Lung Cancer Bookmark
Emma Shtivelman, PhDExcerpt from Healio:
“Brigatinib conferred substantial intracranial responses and durable PFS among patients with brain metastases and ALK-positive, non-small cell lung cancer previously treated with crizotinib, according to ongoing study results.
” ‘Crizotinib [Xalkori; Pfizer, EMD Serono], the first licensed ALK inhibitor, is very active but has clear central nervous system liability from poor CNS penetration. All of the next-generation ALK inhibitor drugs have started to show CNS efficacy consistent with their superior activity in the brain compared with crizotinib,’ D. Ross Camidge, MD, PhD, director of thoracic oncology at University of Colorado, told HemOnc Today. ‘The whole clinical trials field has had to evolve around these events in terms of how we should capture and present CNS data. Brigatinib [Alunbrig; Takeda Oncology, Ariad] was one of the drugs that helped with this.’ ”
Go to full article published by Healio on July 25, 2018.
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August 5, 2018
FDA Grants Priority Review to Keytruda Plus Chemotherapy for Lung Cancer Subtype Bookmark
Emma Shtivelman, PhDExcerpt from Healio:
“The FDA granted priority review designation to a supplemental biologics license application that seeks approval of pembrolizumab for use in combination with chemotherapy as first-line treatment of metastatic squamous non-small cell lung cancer regardless of PD-L1 expression.
“The agency set a target action date of Oct. 30.”
Go to full article published by Healio on July 2, 2018.
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August 5, 2018
Steroids Lower Survival Benefits Associated with Immune Checkpoint Inhibitors in Lung Cancer Bookmark
Emma Shtivelman, PhDExcerpt from Healio:
“The use of steroids at baseline was associated with inferior survival outcomes in patients with advanced non-small cell lung cancer who were starting either PD-1 or PD-L1 blockade therapy, according to retrospective data presented at ASCO Annual Meeting.
” ‘Treatment with PD-1 and PD-L1 inhibitors is now standard therapy for nearly all patients with advanced non-small cell lung cancer,’ Kathryn C. Arbour, MD, a fellow at Memorial Sloan Kettering Cancer Center, said during her presentation. ‘The potential impact of steroids in patients with PD-1 or PD-L1 blockade has been an open question. Steroids are frequently used as a supportive medication in cancer care and can provide rapid relief of numerous cancer-related symptoms, including dyspnea, anorexia, pain, fatigue and symptoms associated with brain metastases. However … [physicians] routinely recognize that there can be substantial toxicities associated with long-term steroid use.’ ”
Go to full article published by Healio on July 10, 2018.
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May 29, 2018
Practice-Changing Developments in Treatment of Metastatic NSCLC
Emma Shtivelman, PhDImmune checkpoint inhibitor drugs that target the proteins PD-1 and PD-L1 are by now well established in the treatment of non-small cell lung cancer (NSCLC). In 2015, the U.S. Food and Drug Administration (FDA) approved nivolumab (Opdivo), an anti-PD-1 drug, for treatment of patients with metastatic NSCLC who progressed or relapsed after platinum-based chemotherapy. Atezolizumab (Tecentriq), an anti-PD-L1 drug, was approved in 2016 for… Read more »
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January 16, 2018
Targetable Mutations in NSCLC: More Testing Needed!
Emma Shtivelman, PhDDiagnosis of adenocarcinoma of the lung, a major subtype of non-small lung cancer (NSCLC), nowadays triggers mandatory testing of tumor tissue for alterations in four genes: EGFR, ALK, ROS1, and more recently, BRAF. If present, these alterations predict sensitivity to specific targeted drugs approved by the U.S. Food and Drug Administration (FDA) that work better and often longer than standard chemotherapy, and are better… Read more »
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December 21, 2017
A Gut Feeling: Bacteria in Your Gut May Affect Cancer Treatment
Emma Shtivelman, PhDThe human gut contains hundreds of species bacteria, which are known to contribute to various bodily functions (such as digestion, of course!) but they also shape our immune system. Now, recent research has revealed how our microbiomes (the abundant bacteria living in our bodies) may affect the efficacy of immune checkpoint blockade (ICB) in cancer treatment. How it started: about two years ago, an… Read more »
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September 5, 2017
EGFR-mutant NSCLC: Choice of First-Line Treatment May Get More Complicated
Emma Shtivelman, PhDMedical guidelines for treatment of newly diagnosed non-small cell lung cancer (NSCLC) mandate upfront testing of tumor tissue for mutations in the EGFR gene (as well as ALK and ROS gene translocation). EGFR mutations are found in 10 to 15% of white patients, but in patients of East Asian origin such mutations are in encountered in approximately 48%. However, with new data and drugs… Read more »
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November 10, 2016
War of the Checkpoint Inhibitors: Anti-PD-1 Drugs Move into First-Line Treatment in NSCLC
Emma Shtivelman, PhDLast year, the U.S. Food and Drug Administration (FDA) approved two anti-PD-1 checkpoint inhibitors, a type of immunotherapy, for treatment of non-small cell lung cancer (NSCLC) in patients whose cancer has progressed after first-line treatment with chemotherapy. Now, the manufacturers of both drugs, pembrolizumab (made by Merck) and nivolumab (made by Bristol-Myers Squibb; BMS) are intent on expanding the indications for use of their… Read more »
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March 29, 2016
New Insights on Lung Cancer in Younger Patients
Emma Shtivelman, PhDLung cancer—in particular, non-small cell lung cancer (NSCLC)—in young people is a topic of great interest. It has been made even more so by the recent publication of a study in The Journal of the American Medical Association (JAMA) that analyzed over 2,000 NSCLC patients of all ages and resulted in two major conclusions: First, that younger patients (less than 40 years old) have a higher frequency of targetable mutations. Second, that they have relatively poor survival when compared to older patients, except those older than 70 years.