WCLC 2016 – Lung Cancer

Ceritinib is approved for use in patients with advanced ALK-positive non–small-cell lung cancer (NSCLC) who have progressed following treatment with crizotinib. In ASCEND-4, a multicenter randomized trial in previously untreated adult patients, researchers assessed progression-free survival outcomes for ceritinib compared with standard first-line and maintenance chemotherapy.

Necitumumab, an epidermal growth factor receptor inhibitor, is approved with gemcitabine and cisplatin for previously untreated advanced squamous non–small-cell lung cancer (NSCLC). Nivolumab, a PD-1 inhibitor, is approved for previously untreated NSCLC, as well as relapsed NSCLC, based on PD-L1 expression. This phase 1b study evaluated combination use of these agents.

Platinum-based chemotherapy with or without bevacizumab is standard first-line therapy for patients with advanced non–small-cell lung cancer (NSCLC) without genetic aberrations. Pembrolizumab has demonstrated activity in PD-L1–positive advanced NSCLC. Cohort G of the phase 1/2 KEYNOTE-021 study compared pembrolizumab + carboplatin and pemetrexed (CP) with CP in patients with treatment-naive advanced nonsquamous NSCLC.

Abemaciclib, a small-molecule inhibitor of both cyclin-dependent kinase (CDK)4 and CDK6, has demonstrated single-agent activity in patients with solid tumors, including non–small-cell lung cancer (NSCLC). Pembrolizumab, an inhibitor of PD-1, is approved for patients with metastatic PD-L1–positive NSCLC. Researchers studied abemaciclib combined with pembrolizumab in pretreated patients with NSCLC.

Use of an ALK inhibitor is standard in patients with ALK-positive non–small-cell lung cancer (NSCLC). In this phase 3 study, researchers compared 2 ALK inhibitors: crizotinib and alectinib. This randomized trial was designed to demonstrate superior progression-free survival for alectinib compared with crizotinib in ALK-inhibitor–naïve ALK-positive NSCLC.

The SQUIRE study demonstrated that the addition of necitumumab to gemcitabine plus cisplatin improved overall survival in patients with metastatic squamous non–small-cell lung cancer (NSCLC). Researchers evaluated the clinical outcomes associated with this triplet regimen in a subset of patients in the SQUIRE trial whose tumors expressed an epidermal growth factor receptor (EGFR).

Afatinib, an irreversible ErbB family blocker, and gefitinib, a reversible EGFR tyrosine kinase inhibitor, are approved for first-line treatment of advanced EGFR-mutated non–small-cell lung cancer (NSCLC). Researchers reported updated OS findings from a phase 2b trial (LUX-Lung 7) that compared afatinib versus gefitinib in first-line patients.

Atezolizumab, a humanized anti–PD-L1 monoclonal antibody, is approved for the treatment of patients with metastatic non–small-cell lung cancer (NSCLC) whose disease progressed during or following platinum-containing chemotherapy. OAK is one of the 2 international, randomized, open-label clinical trials that demonstrated superior efficacy for atezolizumab over docetaxel.

Patients with SCLC whose disease progressed during or after initial platinum-based chemotherapy have few treatment options. Nivolumab alone and combined with ipilimumab has demonstrated clinical benefit in multiple tumor types. Researchers presented updated results for the SCLC cohort of the phase 1/2 CheckMate 032 trial.