Preface – ASCO Lung Cancer 2023

© private – Manali I. Patel, MD MPH MS, Associate Professor, Division of ­Oncology, Stanford University, School of Medicine, Staff Oncologist, Veterans ­Administration Palo Alto Health Care System Partnerships to Advance Cancer Care

© private – Manali I. Patel, MD MPH MS, Associate Professor, Division of ­Oncology, Stanford University, School of Medicine, Staff Oncologist, Veterans ­
Administration Palo Alto Health Care System Partnerships to Advance Cancer Care

Dear Colleagues,

under this year’s motto “partnering with patients: the cornerstone of cancer care and research”, oncology experts from around the world gathered at the Annual Meeting of the American Society of ­Clinical Oncology (ASCO) in Chicago, USA, and virtually from 2nd–6th June 2023, to discuss the latest data in lung cancer with emphasis on practice-changing new studies, less toxic treatments, precision oncology and new ways to reduce collateral damage.

Surgical resection followed by cis­platin-based platinum-doublet adjuvant chemotherapy has been a long-standing standard of care for patients with early-stage, resectable non-small-cell lung cancer. Since the incorporation of immunotherapy and targeted therapy into the perioperative setting has ­demonstrated improved disease-free or event-free survival in biomarker-­defined subsets of patients, the first chapter provides current insights into perioperative strategies including promising new treatment options.

Small-cell lung cancer with its distinct biological and clinical features is at the center of the second chapter that highlights the feasibility of conducting biomarker-selected trials, the first-­in-­human results for bispecific T-cell engager therapy, and progression-free ­survival improvements with first-line pembrolizumab plus etoposide and ­platinum chemotherapy.

Moreover, the potential of targeted therapies and immunotherapies in non-small-cell lung cancer is outlined, ­including the newest results for EGFR ­tyrosine kinase inhibitors either as ­monotherapy or in combination with chemotherapy or an EGFR-MET bispecific antibody, as well as HER2, KRASG12C, BRAF and ROS1 inhibitors.

Last but not least, this issue looks closely at stage IV lung cancer with ­Tumor Treating Fields therapy as an innovative, safe and effective option due to the amplification of the effects of immune checkpoint inhibitors and taxanes. Whereas an antibody-drug conjugate and anti-angiogenic treatment plus ­docetaxel both showed encouraging ­efficacy, immunotherapeutic treatment after failure of EGFR TKIs only prolonged progression-free survival and overall ­survival without reaching statistical significance.

Once again, experts gathered at the ASCO annual meeting to shape the ­future of cancer care and left Chicago feeling inspired for their daily practice. Since making a difference in patients’ lives begins with passion and oncology is full of exciting opportunities, feel encouraged to enter the field and increase your knowledge.

We hope you enjoy reading this ­special issue!

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Targeted approaches in advanced disease

cquired resistance to EGFR tyrosine kinase inhibitors (TKIs), even including the third-generation agent osimertinib, limits duration of response and survival in treated patients with EGFR-mutant lung tumors. A potential strategy to improve outcomes is the concomitant use of EGFR-targeted agents and platinum doublet chemotherapy, although EGFR TKI treatment might attenuate the effect of cytotoxic agents.

Small-cell lung cancer: novel agents & biomarkers

As is known, patients with extensive-stage small-cell lung cancer ­(ES-SCLC) tend to respond well to systemic induction therapy but frequently experience rapid disease progression. Subsequent treatment success remains a challenge; therefore, improving outcomes in the first line appears critical. Poly (ADP-ribose) polymerase (PARP) 1 has emerged as a potential therapeutic target in neuroendocrine tumors such as SCLC.

Early-stage NSCLC: current insights into perioperative strategies

The randomized phase III ADAURA study was conducted in response to the unmet need of improving 5-year overall survival (OS) rates in patients with completely resected EGFR-mutated, stage IB-IIIA non-small cell lung cancer (NSCLC), which are estimated to range between 45 % and 85 %. In ADAURA, 682 patients after complete resection of stage IB, II, or IIIA NSCLC with or without adjuvant chemotherapy received either osimertinib 80 mg OD or placebo for 3 years.

Preface – ASCO Lung Cancer 2023

Under this year’s motto “partnering with patients: the cornerstone of cancer care and research”, oncology experts from around the world gathered at the Annual Meeting of the American Society of ­Clinical Oncology (ASCO) in Chicago, USA, and virtually from 2nd–6th June 2023, to discuss the latest data in lung cancer with emphasis on practice-changing new studies, less toxic treatments, precision oncology and new ways to reduce collateral damage.