WCLC 2016 – Lung Cancer

Nivolumab, a PD-1 immune checkpoint inhibitor, has demonstrated superior efficacy relative to docetaxel in patients with advanced non–small-cell lung cancer (NSCLC) who progressed on or after platinum-based chemotherapy regardless of PD-L1 expression. Researchers presented findings from a phase 1 study of nivolumab as first-line therapy for advanced NSCLC.

Extensive-stage disease (ED) small-cell lung cancer (SCLC) is characterized by limited treatment options and poor survival after platinum-based chemotherapy. Pembrolizumab, an inhibitor of PD-1, is active and safe in multiple solid tumors. Researchers presented updated safety and efficacy data for patients with ED SCLC who enrolled in KEYNOTE-028.

Atezolizumab, a humanized anti–PD-L1 monoclonal antibody, is being assessed in a phase 2 study in PD-L1–selected advanced non–small-cell lung cancer (NSCLC) patients. Initial analysis demonstrated a meaningful objective response rate with durable response in chemotherapy-naive first-line and relapsed PD-L1–selected patients. Researchers reported updated efficacy data in these first-line patients.

Based on data from the National Lung Screening Trial comparing lung cancer mortality associated with computed tomography (CT) and chest x-ray screening, CT screening is now standard clinical practice. However, questions about the value of CT screening remain given its cost and risk of false-positive results.

Rates of early detection of lung cancer remain poor. Identification of endobronchial lung dysplasia with a noninvasive sputum-based test could facilitate chemoprevention. Researchers evaluated a novel test for early-stage lung cancer to determine if it can identify tumor cells that have been exfoliated into sputum.

Osimertinib, an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), is indicated for use in patients with locally advanced or metastatic EGFR T790M-positive non–small-cell lung cancer (NSCLC) who have progressed on or after EGFR-TKI therapy. Researchers compared the efficacy and safety of osimertinib with platinum-based chemotherapy plus pemetrexed in this patient population.

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.