ASCO 2016: New Antibody-Drug Conjugate Shows Early Promise in Small Cell Lung Cancer

Excerpt:

“Early findings from a first-in-human clinical trial showed that the antibody-drug conjugate rovalpituzumab tesirine (Rova-T) shows promising efficacy against recurrent small cell lung cancer (SCLC). The treatment, which combines a novel anti-DLL3 antibody with a powerful anticancer agent, halted tumor growth in 89% of patients with high levels of DLL3 in the tumor and shrank tumors in 39%.

“The study by Rudin et al was presented today at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract LBA8505).

“ ‘We’ve seen too few successes in recent years for small cell lung cancer, which makes these early signs of efficacy all the more encouraging,’ said lead study author Charles M. Rudin, MD, PhD, a medical oncologist and Chief of Thoracic Oncology Service at Memorial Sloan Kettering Cancer Center in New York. ‘Although these results are preliminary, rovalpituzumab tesirine seems to be the first targeted therapy to show efficacy in small cell lung cancer, and we may have identified DLL3 as the first predictive biomarker in this disease.’ ”

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ASCO 2016: Nivolumab Alone or in Combination With Ipilimumab Active in Recurrent Small Cell Lung Cancer

Excerpt:

“A study presented by Antonia et al at the 2016 ASCO Annual Meeting (Abstract 100) showed that utilizing the immunotherapeutic agents nivolumab (Opdivo) and ipilimumab (Yervoy) could lead to more effective treatment options for patients with small cell lung cancer (SCLC) who have progressed after prior chemotherapy.

“Studies have shown that nivolumab combined with ipilimumab results in improved antitumor activity when compared with either agent alone. The U.S. Food and Drug Administration recently approved this two-drug combination for the treatment of advanced melanoma.

“Given the promising activity of the immunotherapy combination in melanoma, researchers wanted to assess whether this regimen could also be effective in other types of tumors with few to no therapeutic options.”

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Expert Examines Immunotherapy Potential in Small Cell Lung Cancer

Excerpt:

“Several ongoing clinical trials are examining the efficacy and safety of immunotherapy agents in patients with small cell lung cancer (SCLC), explains David P. Carbone, MD, PhD.

“Two early phase studies have already shown encouraging results. In the phase I/II CheckMate-032 trial, pretreated patients with SCLC received monotherapy with the PD-1 inhibitor nivolumab (Opdivo) or the combination of nivolumab plus the CTLA-4 inhibitor ipilimumab (Yervoy). Data showed that the median progression-free survival (PFS) was 3.35 months with the combination and 1.38 months with nivolumab alone. Median OS was 7.75 months with the combination and 3.55 months with single-agent therapy. The objective response rate (ORR) with the combination was 31.1%.

“In the phase Ib KEYNOTE-028 trial, the PD-1 inhibitor pembrolizumab (Keytruda) had an ORR of 29.2% (95% CI, 12.6-51.1) in patients with SCLC who had prior chemotherapy.”

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Study Shows Statins Could Be Effective against Small Cell Lung Cancer

“In a recent study, researchers at Cancer Treatment Centers of America (CTCA) at Western Regional Medical Center (Western), in collaboration with international colleagues, found that statins could be an effective therapeutic against metastatic small cell lung cancer (SCLC).

“The study of 876 late-stage SCLC patients, published today in the peer-reviewed scientific journal PLOS ONE, showed that statins, a class of drugs primarily used to lower cholesterol in patients at risk for heart disease, appeared to provide an increase in overall survival for those cancer patients who received them.

” ‘Small cell lung cancer is one of the most aggressive types of cancer, and yet in nearly three decades, no new classes of treatments have been adopted as new benchmarks for standard therapy,’ said Dr. Glen Weiss, M.D., M.B.A., Director of Clinical Research and Medical Oncologist at CTCA at Western in Goodyear, Ariz., and the study’s senior author. ‘Our study showed that statins appear to provide a statistically significant survival benefit among patients with metastatic SCLC.’ “


New Promising Drugs for Small Cell Lung Cancer


Any type of advanced lung cancer is bad news, but a diagnosis of small cell lung cancer (SCLC) is a particularly grim one to receive. About 30 years have passed since any new treatments for SCLC were developed, and patients’ responses to standard chemotherapy with etoposide and cisplatin are short-lived. Hopefully, this will change soon.

We begin this post with the immune checkpoint inhibitors, a type of immunotherapy that is explored in seemingly every type of cancer, including SCLC. Reports from two clinical trials of these drugs were recently made available at two meetings on lung cancer treatment. Continue reading…


Checkpoint Inhibitors Show Promise in SCLC, Mesothelioma

“Immune checkpoint inhibitors have demonstrated encouraging results for patients with small cell lung cancer (SCLC) and mesothelioma, two aggressive thoracic malignancies with few options, according to a presentation by M. Catherine Pietanza, MD, at the 10th Annual New York Lung Cancer Symposium.

“ ‘The antibodies to CTLA-4, PD-1, and PD-L1 can be safely given to these patients. Responses are seen and are durable. There is a benefit in both platinum-sensitive and platinum-refractory SCLC,’ said Pietanza, a medical oncologist at Memorial Sloan Kettering Cancer Center.

“Chemotherapy has traditionally been the treatment of choice for most patients with SCLC and mesothelioma beyond the frontline setting. However, outcomes are poor with these therapies, specifically for SCLC, where the median survival following second-line therapy ranges from 6 to 9 months.”


CRT May Be Preferred Strategy for Elderly with Lung Cancer

“Chemoradiotherapy (CRT) is associated with survival benefit over chemotherapy (CT) alone for elderly patients with limited-stage small-cell lung cancer, according to a study published online Oct. 19 in the Journal of Clinical Oncology.

“Christopher D. Corso, M.D., Ph.D., from the Yale University School of Medicine in New Haven, Conn., and colleagues examined outcomes for elderly patients (≥70 years) treated with CT versus CRT. Data were included for 8,637 patients with limited-stage small-cell lung  in the National Cancer Data Base between 2003 and 2011.

“The researchers found that 43.7 and 56.3 percent of the patients received CT and CRT, respectively. CRT receipt was less likely with increasing age, clinical stage III disease, female sex, and the presence of medical comorbidities (all P < 0.01). Compared with CT, CRT use correlated with increased overall survival on univariate and multivariate analysis (median overall survival, 15.6 versus 9.3 months). Survival benefit associated with CRT was confirmed in a propensity score-matched cohort of 6,856 patients (hazard ratio, 0.52; P < 0.001). In subset analysis, patients who were alive at four months after diagnosis had a  with concurrent versus sequential CRT (median overall survival, 17.0 versus 15.4 months; log-rank P = 0.01).”


Chemotherapy Use, Survival in SCLC Increased Over 20 Years

“A study looking at trends from 1985 to 2005 found that overall survival has increased in Medicare patients with small-cell lung cancer (SCLC), and that treatment with chemotherapy is associated with improved survival.

“ ‘Although the proportion of cases diagnosed as SCLC has declined from approximately 20% to 13%, this subset is still a major cause of disease burden with close to 30,000 new cases annually,’ wrote study authors led by Madhusmita Behera, PhD, of Emory University in Atlanta. The use of chemotherapy in real-world populations is limited by significant toxicity, they added, and whether recommended therapies are adopted has not been well studied.

“The new study used the SEER database to study trends in outcome and treatment; it included 47,351 eligible patients divided into 5-year intervals, with 1985–1990 used as the baseline. Results were published online ahead of print in Cancer.”


COPD Heightens Deadly Lung Cancer Risk in Smokers

“Smokers who have chronic obstructive pulmonary disorder (COPD) may face nearly twice the risk of getting small cell lung cancer (SCLC)—the deadliest form of lung cancer—than smokers who don’t have COPD, according to a large worldwide study led by researchers at the Harvard T.H. Chan School of Public Health.

“The study was published online September 24, 2015 in EBioMedicine.

“The new study—the largest-ever epidemiologic study of SCLC—is the first to look at how much COPD, a progressive disease that makes it hard to breathe, increases smokers‘ risk of getting SCLC. Although it’s long been known that smoking is a major risk factor for lung cancer, the new study estimates the risk more precisely than before.”