Interview: “These findings will change the standard-of-care”
Interview: Barbara Melosky, MD, FRCPC, University of British Columbia and British Columbia Cancer Agency, Vancouver, Canada
Will findings presented here at ASCO change the future of NSCLC therapy?
This year’s ASCO Congress was very interesting. The findings will definitely change the standard-of-care in non–small-cell and small-cell carcinoma.
Immune checkpoint inhibitors are the biggest news at this year’s ASCO Congress. They are showing survival advantages in small-cell cancer, and advantages have also been proven in squamous and non-squamous NSCLC in the second line. This is going to change the landscape and the standard-of-care, especially in the second-line setting, in both squamous and non-squamous NSCLC. Nivolumab has now been accepted by the FDA for the treatment of squamous cell carcinoma in the second-line setting.
Which molecular targets deserve the greatest attention at present?
There are many molecular targets and many ways to define molecular targets. We learnt that RET is an interesting target to look at; we learnt that new drugs are available for ALK; also, EGFR continues to be an extremely important issue with the emergence of third-generation EGFR inhibitors. Immunotherapy as a sort of targeted therapy against the immune system is also emerging as a major player in NSCLC and in SCC.
Should lung cancer in women be considered a “different disease”?
Lung cancer in women is an extremely important issue. We used to think that it was a different disease. I think what we are learning is that it is a different disease molecularly, because of issues like smoking. If we thus were to equalise patients for some of those other issues like smoking, we might find that we should treat male and female patients alike.
What potential promises and pitfalls are currently associated with immune checkpoint blockade in cancer treatment?
The biggest pitfall is the PD-1 or PD-L1 biomarker expression. One has to face questions as to which kit one should use, whether to assess the expression in the T cells or in the tissue or in the stroma, and which cut-off percentage to use – 1, greater than 5, greater than 10, or none? Therefore, the biggest pitfalls are the application of biomarkers, and of course the cost.
The interview was conducted by Dr. Judith Moser.
For more articles on cancer, lung cancer and respiratory medicine see
Barbara Melosky, MD, FRCPC, University of British Columbia and British Columbia Cancer Agency, Vancouver, Canada
- Pignon JP et al., Lung adjuvant cisplatin evaluation: a pooled analysis by the LACE Collaborative Group. J Clin Oncol 2008; 26(21): 3552-3559
- Chen L et al., Metastasis is regulated via microRNA-200/ZEB1 axis control of tumour cell PD-L1 expression and intratumoral immunosuppression. Nat Commun 2014; 5: 5241
- Cascone T et al., Neoadjuvant nivolumab or nivolumab plus ipilimumab for resectable non-small cell lung cancer (NSCLC): clinical and correlative results from the NEOSTAR study. J Clin Oncol 37, 2019 (suppl; abstr 8504)
- Kwiatkowski DJ et al., Neoadjuvant atezolizumab in resectable non-small cell lung cancer (NSCLC): interim analysis and biomarker data from a multicenter study (LCMC3). J Clin Oncol 37, 2019 (suppl; abstr 8503)
- Provencio M et al., Neo-adjuvant chemo-immunotherapy for the treatment of stage IIIA resectable non-small-cell lung cancer (NSCLC): a phase II multicenter exploratory study. Final data of patients who underwent surgical assessment (NADIM). J Clin Oncol 37, 2019 (suppl; abstr 8509)
- Kenmotsu H et al., Randomized phase III study of pemetrexed/cisplatin versus vinorelbine/cisplatin for completely resected non-squamous non-small-cell lung cancer. The JIPANG study. J Clin Oncol 37, 2019 (suppl; abstr 8501)
- Tang W et al., EGFR inhibitors as adjuvant therapy for EGFR mutation positive non-small cell lung cancer. J Clin Oncol 37, 2019 (suppl; abstr 8508)
- Khalil M et al., The tumor microenvironment in EGFR-driven loco-regional lung adenocarcinoma can predict higher risk of recurrence. J Clin Oncol 37, 2019 (suppl; abstr 8521)
- Chaft JE et al., Randomized phase II study of adjuvant afatinib for 3 months versus 2 years in patients with resected stage I-III EGFR mutant NSCLC. J Clin Oncol 37, 2019 (suppl; abstr 8507)
- Moding EJ et al., ctDNA for personalization of consolidation immunotherapy in localized non-small cell lung cancer. J Clin Oncol 37, 2019 (suppl; abstr 2547)
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