Lung Cancer

The rising cost of healthcare, including cancer care, is an established trend in the United States. In 2015, Americans spent $3.2 trillion (nearly $10,000 per person) on healthcare, including hospital inpatient and outpatient care, physicians’ services, and prescription drugs. The National Cancer Institute estimates that by 2020, the annual cost of healthcare for Americans with cancer will reach $156 billion; based on current trends, this means that cancer care will represent approximately 20% of the country’s annual healthcare expenditures.

Copenhagen, Denmark—Immunotherapy for advanced non–small-cell lung cancer (NSCLC) took a step toward first-line indication as results from a randomized clinical trial showed that patients who received pembrolizumab (Keytruda) plus chemotherapy had a significantly higher response rate compared with patients who received chemotherapy alone, reported Corey J. Langer, MD, Abramson Cancer Center of the University of Pennsylvania, Philadelphia, at the 2016 European Society for Medical Oncology (ESMO) Congress. The clinical trial results (KEYNOTE-021) were also published in Lancet Oncology, and are available online.

Copenhagen, Denmark—Immunotherapy competition in non–small-cell lung cancer (NSCLC) continued to heat up as atezolizumab (Tecentriq) improved overall survival (OS) versus docetaxel, according to results from the randomized, phase 3 OAK clinical trial reported at the 2016 European Society for Medical Oncology Congress by Fabrice Barlesi, MD, Professor of Medicine, Aix-Marseille University, France.

Copenhagen, Denmark—Patients with heavily pretreated ALK mutation and non–small-cell lung cancer (NSCLC) had significant improvement in progression-free survival (PFS) after receiving the next-generation ALK inhibitor ce­ritinib, according to results from the ASCEND-5 study reported at the 2016 European Society for Medical Oncology Congress by Giorgio Scagliotti, MD, Professor of Respiratory Medicine, University of Torino, Italy.

Copenhagen, Denmark—Patients with non–small-cell lung cancer (NSCLC) who lack targetable EGFR or ALK mutations typically receive platinum-based doublet chemotherapy as first-line therapy. Two phase 3 clinical trials presented at the 2016 European Society for Medical Oncology (ESMO) Congress compared immunotherapy and platinum-based chemotherapy as first-line treatment for ­patients with NSCLC. In KEYNOTE-024, pembrolizumab (Keytruda) was superior to chemotherapy in terms of progression-free survival (PFS) and overall survival (OS), whereas in CheckMate-026, nivolu­mab (Opdivo) failed to improve PFS compared with chemotherapy.

The first liquid biopsy used to detect gene mutations that are associated with non–small-cell lung cancer (NSCLC) was approved by the FDA. The cobas EGFR Mutation Test v2 (Roche Molecular Systems), a blood-based companion diagnostic for erlotinib (Tarceva), is indicated as an initial test to detect EGFR gene mutations in patients with NSCLC.