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Community Practice Connections™: 2nd Annual European Symposium on Lung Cancers™
Release Date: August 30,, 2018
Expiration Date: August 30, 2019
Media: Internet - based
Instructions for This Activity and Receiving Credit
This educational activity is directed toward medical oncologists, radiation oncologists, thoracic surgeons, pulmonologists, and other healthcare professionals involved in the treatment and management of patients with lung cancer.
At the conclusion of this activity, you should be better prepared to:
- Discuss state-of-the-art application of immunotherapy in metastatic non-small cell lung cancer (NSCLC)
- Describe the emergence of immunotherapy in locally advanced NSCLC
- Review new standards for patients with EGFR-mutated and ALK-rearranged NSCLC, and recent data on therapies to target other oncogenic drivers
- Understand the role of liquid biopsies for treatment selection
- Describe the pulmonologist’s perspective on best practices in lung cancer diagnosis and therapy
- Gain insight into the therapeutic advances in small cell lung cancer (SCLC) and mesothelioma
Faculty, Staff, and Planners' Disclosure
Disclosure: Grant/Research Support: AstraZeneca, Bristol-Myers Squibb, Boehringer Ingelheim, Lilly, Pfizer, Roche/Genentech, sanofi-aventis, Clovis, GlaxoSmithKline, Servier, EOS Pharmaceutical Corp., Onxeo, OncoMed, Inivata, OSE Pharma
Disclosure: Consultant/Advisory Board:Roche, Lilly, AstraZeneca, Merck Sharp & Dohme, Bristol-Myers Squibb, Boehringer Ingelheim, Pfizer, Novartis, Celgene; Speakers Bureau: Roche, Lilly, AstraZeneca, Merck Sharp & Dohme, Bristol-Myers Squibb, Boehringer Ingelheim, Pfizer, Novartis, Celgene
The staff of Physicians’ Education Resource®, LLC have no relevant financial relationships with commercial interests to disclose.
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Off-Label Disclosure and Disclaimer
This CME/CE activity may or may not discuss investigational, unapproved, or off-label use of drugs. Participants are advised to consult prescribing information for any products discussed. The information provided in this CME activity is for continuing medical and nursing education purposes only, and is not meant to substitute for the independent clinical judgment of a physician or nurse relative to diagnostic, treatment, or management options for a specific patient’s medical condition. The opinions expressed in the content are solely those of the individual faculty members and do not reflect those of PER®.
PER Pulse™ Recaps
1 of 3
Immunotherapy in Locally Advanced NSCLC
The 2nd Annual European Symposium on Lung Cancers™, held 4-5 May, 2018, was convened to present recent advances in lung cancer, particularly in the areas of targeted therapy and immunotherapy, and discuss the integration of new approaches in the clinic. This first of 3 PER Pulse™ Recaps from the European Symposium on Lung Cancers™ focuses on the development of immunotherapy as consolidation following chemoradiation therapy (CRT) in patients with unresectable stage III non–small cell lung cancer (NSCLC).
- In February 2018, the FDA approved durvalumab for patients with unresectable stage III NSCLC who achieve at least stable disease after concurrent CRT.
- Approval was based on the phase III PACIFIC trial.
- Initial results showed an 11.2-month increase in progression-free survival with durvalumab compared with placebo.
- Subsequently, overall survival (OS) data were reported, showing a significant benefit with durvalumab (HR, 0.68; P = .0025).
- European approval was granted in September 2018; although the US approval did not include a biomarker requirement, approval in Europe includes patients with a PD-L1 expression level of ≥1%, based on an exploratory analysis of OS by PD-L1 status.
2 of 3
Immunotherapy in Metastatic NSCLC
The 2nd Annual European Symposium on Lung Cancers™, held 4-5 May, 2018, was convened to present recent advances in lung cancer, particularly in the areas of targeted therapy and immunotherapy, and discuss the integration of new approaches in the clinic. This second of 3 PER Pulse™ Recaps from the European Symposium on Lung Cancers™ focuses on immunotherapy-based therapy in patients with newly diagnosed metastatic non–small cell lung cancer (NSCLC).
- Single-agent immunotherapy as initial treatment was approved for patients with a PD-L1 expression level ≥50% in 2016 based on the KEYNOTE-024 trial comparing pembrolizumab to standard chemotherapy. Subsequently, the KEYNOTE-042 trial carried out this comparison with a lower PD-L1 expression cutoff of ≥1%. In the overall patient cohort, an overall survival benefit was seen with pembrolizumab, although no benefit was observed in patients with an expression level of 1% to 49%. In April 2019, the FDA expanded the approval of pembrolizumab monotherapy as initial therapy to include patients with an expression level ≥1%.
- Immunotherapy/chemotherapy combinations have also become approved first-line options in patients with metastatic NSCLC. The combination of pembrolizumab with pemetrexed/platinum in patients with nonsquamous NSCLC received full approval from the FDA in August 2018 based on the KEYNOTE-189 trial; European approval occurred in September 2018. Also in nonsquamous NSCLC, the IMpower150 trial led to approval in the US of atezolizumab plus bevacizumab/paclitaxel/carboplatin in December 2018; European authorities approved this regimen in March 2019. For patients with squamous NSCLC, the KEYNOTE-407 trial yielded US approval of pembrolizumab plus carboplatin and either nab-paclitaxel or standard paclitaxel in October 2018. In March 2019, European approval of this regimen was granted.
3 of 3
Targeted Therapy in Advanced NSCLC: Focus on EGFR and ALK Inhibition
The 2nd Annual European Symposium on Lung Cancers™, held 4-5 May, 2018, was convened to present recent advances in lung cancer, particularly in the areas of targeted therapy and immunotherapy, and discuss the integration of new approaches in the clinic. This third of 3 PER Pulse™ Recaps from the European Symposium on Lung Cancers™ focuses on new approaches for patients with advanced non–small cell lung cancer (NSCLC) and mutations in EGFR or ALK genes.
- For initial therapy of patients with EGFR mutation–positive NSCLC, the phase III FLAURA trial demonstrated a significant improvement in progression-free survival (PFS) with osimertinib compared with erlotinib or gefitinib; overall survival (OS) data were not mature at the time of initial reporting. These data led to approval in April 2018 by the FDA, with European approval occurring in June 2018.
- In the phase III ARCHER 1050 trial, dacomitinib was compared with gefitinib as initial therapy in patients with EGFR mutation–NSCLC, demonstrating improved PFS and OS. Authorities in the United States granted approval in September 2018, with the European Commission granting approval in April 2019.
- For patients with ALK-rearranged NSCLC whose disease progresses on crizotinib, several agents have been approved. However, for patients previously receiving a next-generation ALK inhibitor (ie, progressing after first-line crizotinib plus ≥1 additional ALK inhibitor or progressing on first-line alectinib or ceritinib), lorlatinib was the first agent approved, with FDA approval occurring in November 2018. In March 2019, the European Committee for Medicinal Products for Human Use recommended approval of lorlatinib.
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