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Multimodality Treatment of Advanced Non-small Cell Lung Cancer: Where are we with the Evidence?

This article outlines the current and outstanding evidence for the use of multimodality treatment in this group of patients, including in combination with an increasing number of treatment options, such as immunotherapy and genotype-targeted small molecule inhibitors.Recent findingsOptimal therapy for surgically resectable stage III disease remains debatable and currently the choice of treatment reflects each individual patient ’s disease characteristics and the expertise and opinion of the thoracic multi-disciplinary team. Evidence for a distinct oligometastatic state in which improved outcomes can be achieved remains minimal and there is as yet no consensus definition for oligometastatic lung cancer. Whilst there is su pporting evidence for the aggressive management of isolated metastases, the use of consolidative therapy for multiple metastases remains unproven.SummaryEvolution of new RT technologies, improved surgical technique and a plethora of interventional-radiology-guided ablative therapies are widening the choice of available treatment modalities to patients with NSCLC. In the setting of resectable locally advanced disease and the oligometastatic state, there is a growing need for randomised comparison of the available treatment modalities to guide both treatment and patient selection.
Source: Current Surgery Reports - Category: Surgery Source Type: research

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Publication date: Available online 19 May 2018 Source:Seminars in Cancer Biology Author(s): George Cyriac, Leena Gandhi Immune checkpoint inhibition with anti-PD-1 therapy has been notably successful in non-small cell lung cancer (NSCLC) and changed standard practice in multiple settings. However, despite some durable benefits seen, the majority of unselected patients with NSCLC fail to respond to checkpoint inhibitors. Patient selection is crucial and will become even more important in the development of combination therapies with immune checkpoint inhibitors. PD-L1 expression by immunohistochemistry (IHC) has emerged as...
Source: Seminars in Cancer Biology - Category: Cancer & Oncology Source Type: research
Authors: Evans R, Reid M, Segal B, Abrams SI, Lee K Abstract In 1961, the USA severed diplomatic relations with Cuba, and in 1962 an embargo was imposed on trade and financial relations with that country. It was not until five decades later that the USA and Cuba would reestablish relations. This opened the way for the New York State Trade Mission to Cuba in April 2015, during which Cuba's Molecular Immunology Center and Buffalo, New York's Roswell Park Cancer Institute signed a formal agreement that would set in motion biotechnology research collaboration to address one of the most important causes of death in both...
Source: MEDICC Review - Category: International Medicine & Public Health Tags: MEDICC Rev Source Type: research
Thoracic oncologists Drs Jack West and Hossein Borghaei discuss critical questions in the treatment of low-expressing or PD-L1-negative non-small cell lung cancer patients.Medscape Oncology
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Hematology-Oncology Commentary Source Type: news
Thoracic oncologists Drs Jack West and Hossein Borghaei talk about when to add chemotherapy to immunotherapy in high PD-L1-expressing non-small cell lung cancer patients.Medscape Oncology
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Hematology-Oncology Commentary Source Type: news
We present a synopsis of the prospects for expanding the indications of dual immune-checkpoint inhibition therapy to a more diverse set of tumor histologies.
Source: Journal for Immunotherapy of Cancer - Category: Cancer & Oncology Source Type: research
Publication date: 14 May 2018 Source:Cancer Cell, Volume 33, Issue 5 Author(s): Martin Früh, Solange Peters In this issue of Cancer Cell, Hellmann et al. describe in two clinical trials the importance of tumor mutational burden as an independent predictive marker for outcomes with combination nivolumab plus ipilimumab as first-line therapy in metastatic non-small-cell lung cancer and in relapsed small-cell lung cancer. Teaser In this issue of Cancer Cell, Hellmann et al. describe in two clinical trials the importance of tumor mutational burden as an independent predictive marker for outcomes with combinatio...
Source: Cancer Cell - Category: Cancer & Oncology Source Type: research
Abstract The success of immune checkpoint inhibitors and the discovery of useful biomarkers to predict response to these agents has shifted much of the focus of personalized care for advanced non-small cell lung cancer towards harnessing the immune response. With further advancement, more effective immunotherapy options will emerge along with more useful biomarkers. For patients with advanced disease, minimally invasive techniques will remain most appropriate for acquisition of tissue. This is in contrast to default gold-standard large tissue specimens obtained through surgical resection. For the benefit of our pa...
Source: American Journal of Respiratory and Critical Care Medicine - Category: Respiratory Medicine Authors: Tags: Am J Respir Crit Care Med Source Type: research
Conclusion In patients with NSCLC with AID treated with a PD-(L)1 inhibitor, exacerbation of AID occurred in a minority of patients. The incidence of irAEs was similar to reported rates in clinical trials where patients with AID were excluded. Adverse events were generally manageable and infrequently led to permanent discontinuation of immunotherapy. PMID: 29746230 [PubMed - as supplied by publisher]
Source: Clinical Lung Cancer - Category: Cancer & Oncology Authors: Tags: J Clin Oncol Source Type: research
Roche (SIX: RO, ROG; OTCQX: RHHBY) announced that the US Food and Drug Administration (FDA) has accepted the company's supplemental Biologics License Application (sBLA) and granted Priority Review for TECENTRIQ® (atezolizumab), in combination with Avastin® (bevacizumab), paclitaxel and carboplatin (chemotherapy), for the initial (first-line) treatment of people with metastatic non-squamous non-small cell lung cancer (NSCLC).
Source: World Pharma News - Category: Pharmaceuticals Tags: Featured Roche Business and Industry Source Type: news
AbstractPurpose of ReviewCheckpoint blockade has changed the treatment landscape in non-small cell lung cancer (NSCLC), but single-agent approaches are effective for only a select subset of patients. Here, we will review the evidence for combination immunotherapies in NSCLC and the clinical data evaluating the efficacy of this approach.Recent FindingsClinical trials evaluating combination PD-1 and CTLA-4 blockade as well as PD-1 in combination with agents targeting IDO1, B7-H3, VEGF, and EGFR show promising results. Additional studies targeting other immune pathways like TIGIT, LAG-3, and cellular therapies are ongoing.Sum...
Source: Current Oncology Reports - Category: Cancer & Oncology Source Type: research
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