Highlights on lung cancer from the ASCO congress
The annual congress of American Society of Clinical Oncology is the most important meeting of oncologists worldwide, with about 35,000 delegates. Every year, numerous research activities are presented, bringing hope to patients and their loved ones about progress that can really make an impact in how they manage their condition. Many times, these activities can change the treatment of many types of cancer.
This year's congress was not an exception.
In the fields of lung cancer and mesothelioma, several developments were announced with interest to patients.
Targeted treatment for lung cancer had particularly interesting outcomes. More specifically:
- Patients with the “BRAF V600E” mutation and metastasis were given combined treatment with Dabrafenib and Trametinib, in a phase 2 clinical trial. Results were encouraging (with overall response 63% and disease control in 88% for 3 months) while only 20% of patients faced side effects like fever, weakness, rash and swelling.
- In another phase 2 trial, lung cancer patients with the ALK mutation and disease progression after a treatment with Crizotinib, received a targeted therapy with Alectinib. Although response rate reached 49.2%, 27.5% of patients also presented significant side effects.
- In a clinical trial across phases 1 and 2, patients with EGFR mutation benefited from Rociletinib at a response rate of 36% (in cases of negative mutation T790M) and 48% (in cases of positive mutation T790M).
Regarding treatment after the initial approach, the main outcomes were:
- In a phase 3 clinical trial, Afatinib and Erlotinib were tested against advanced squamous cell carcinoma, after platinum-based chemotherapy. Afatinib was proven more efficient than Erlotinib, both in the disease free interval (2.6 vs. 1.9 months) and in survival (7.9 vs. 6.8 months). The two treatments had similar toxicity.
- Patients with relapsed squamous cell lung carcinoma participated in a phase 3 trial, receiving one of the two combinations Nedaplatin - Docetaxel and Cisplatin - Docetaxel. Those who received the former had better survival scores (13.6 months vs. 11.4) than the latter, without additional toxicity.
- In a trial conducted in England, the addition of whole brain radiotherapy to the best supportive care for lung cancer patients with brain metastasis did not extend survival nor improve quality of life.
Immunotherapy in lung cancer
Throughout the congress, immunotherapy was a very central theme, with particularly interesting results for lung cancer.
- In early research, Nivolumab benefited patients, in particular those with squamous cell carcinoma. In a phase 3 trial, patients with adenocarcinoma whose condition deteriorated after platinum-based chemotherapy took either Nivolumab or Docetaxel. Those who took Nivolumab had better survival rate (12.2 vs. 9.4 months), higher response rate (19% vs 12%) and better safety profile than Docetaxel. As a result, Nivolumab can be considered as the preferred treatment for this patient group.
Patients with mesothelioma may benefit from the results of a phase 3 clinical trial.
- Patients with malignant mesothelioma received Bevacizumab in addition to the Cisplatin - Pemetrexed combination. This addition, in a phase 3 clinical trial, increased the disease-free period from 7.5 to 9.6 months, and the overall survival from 16.1 to 18.8 months.