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
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.