Stephen V. Liu, MD, Director of Thoracic Oncology and Head of Developmental Therapeutics, Lombardi Comprehensive Cancer Center, Georgetown University Washington DC, USA
After 2 years of virtual meetings in the midst of the COVID-19 pandemic, the Annual Meeting of the American Society of Clinical Oncology (ASCO) returned to its live format, as oncology experts from around the world gathered again in Chicago, USA, and virtually from 3rd–7th June 2022, to discuss the most exciting updates in the field of lung cancer.
As always, “discoveries are nice, but validation is what moves science forward” – and we have seen significant forward progress in the area of resectable stage IIIA-B non-small-cell lung cancer (NSCLC), with a proof-of-concept study (NADIM I), confirmation of these findings in CheckMate 816, and data from NADIM II validating the superiority of neoadjuvant nivolumab plus chemotherapy in this setting. For unresectable stage III NSCLC, there has also been notable recent progress. After decades of failed attempts to improve on combination chemotherapy and radiation for unresectable stage III NSCLC, the incorporation of immunotherapy in the PACIFIC study has prolonged overall survival. Other strategies are also under investigation, exemplified by the encouraging results in the updated two-year follow-up of KEYNOTE-799.
An entire chapter is devoted to new ways to further improve patient outcomes by targeting KRASG12C, METex14, EGFR and ALK. For patients who do not harbor genomic alterations, various first-line regimens consisting of anti-PD-(L)1 antibodies with or without chemotherapy have been approved. Deeper insights into combinations of immune checkpoint inhibitors with other drug classes, e.g. the soluble LAG-3 protein eftilagimod alpha or the multikinase inhibitor cabozanitinib, are outlined due to their early clinical activity. Moreover, synergistic benefits of immuno¬therapy plus an anti-VEGFR-2 antibody in the immune checkpoint inhibitor-refractory setting of patients with stage IV or recurrent NSCLC who had received prior immunotherapy were explored in the S1800A substudy of Lung-MAP, which is a US-wide precision medicine master protocol. This randomized phase II study showed an impressive improvement in overall survival and will likely lead to further study.
Last but not least, this issue looks closely at patients with extensive-stage small-cell lung cancer where negative data of the SKYSCRAPER-02 trial investigating the addition of an anti-TIGIT agent to chemoimmunotherapy were presented at ASCO 2022. We did, however, see further evidence of the benefit observed with adding immunotherapy to chemotherapy. The phase III ASTRUM-005 study showed that the addition of the anti-PD-1 antibody serplulimab to standard chemotherapy improved overall survival compared to chemotherapy in the first-line setting.
Once again, the ASCO Congress highlighted the importance of multidisciplinarity and collaborations for accelerating future cancer care – establishing new standards of care with an eye to even better outcomes in the very near future.
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