JAMA Oncology : Durvalumab With or Without Tremelimumab vs Standard Chemotherapy for Metastatic NSCLC
Interview with Naiyer A. Rizvi, MD, author of Durvalumab With or Without Tremelimumab vs Standard Chemotherapy in First-line Treatment of Metastatic Non–Small Cell Lung Cancer: The MYSTIC Phase 3 Randomized Clinical Trial
Overall survival (OS) benefit derived from frontline treatment with nivolumab plus ipilimumab combined with 2 cycles of platinum-doublet chemotherapy in patients with metastatic or recurrent non-small cell lung cancer was further improved after at least 12 months of follow-up.
Frontline treatment with nivolumab plus ipilimumab induced durable and long-term efficacy, compared with chemotherapy, in patients with advanced non-small cell lung cancer, regardless of PD-L1 expression.
ConclusionRegardless of the NSCLC patients who were less or more than 65 years, immune checkpoint inhibitors could achieve better OS than chemotherapy. But there was no significant difference when NSCLC patients who were more than 75 years old. Older patient should be offered immune therapies if it is possible and the mechanism in old age treatment should be further s tudied.
CONCLUSION: While pembrolizumab is superior to standard chemotherapy in improving overall survival and progression-free survival, results suggest that it is unlikely to be cost-effective at its current price in Singapore. Factors including clinical effectiveness, safety and budget impact should also be considered when making national funding decisions. PMID: 32462958 [PubMed - as supplied by publisher]
The development of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) have dramatically improved the prognosis of non –small cell lung cancer (NSCLC) patients, with higher objective response rates and increased progression-free survival compared to former cytotoxic chemotherapy [1–3]. However, durable responses cannot be achieved as acquired resistance to EGFR TKIs inevitably develops . Therefore, investigat ion into the molecular mechanisms of acquired resistance and subsequent development of novel drugs to overcome such resistance are essential in the treatment of NSCLC.
Conclusion Abnormal activation of EGFR may induce wtEGFR NSCLC cell resistance to cisplatin. The combined effects of cisplatin/gefitinib suggest that gefitinib, as a combination therapy for patients with cisplatin-resistant wtEGFR NSCLC should be considered.
AbstractPurposeApproximately 30% of NSCLC patients cannot obtain tissue sample or sufficient tissue sample for molecular subtyping. Cell-free circulating tumor DNA (ctDNA) in plasma is a potential alternative specimen type to assess genomic variants in patients with non-small cell lung cancer (NSCLC). The purpose of this study was to identify the genomic alteration profile of ctDNA in real-world Chinese NSCLC patients.MethodsA total of 325 subjects with pathological diagnosis of NSCLC were enrolled. 10 ml Peripheral blood was collected in streck tube, and ctDNA NGS analysis was carried out using an Ampliseq-based 11-...
Conclusions: Radiotherapy with induction and concurrent PP/DP chemotherapy is feasible for patients with unresectable Stage III NSCLC. IC may improve the survival of IC responders, as predicted by elevated CEA and CYFRA21-1 levels and classification as stage N3 cancer. Additional randomized trials on IC may consider these predictors to tailor individualized treatments.
The FDA approved the use of nivolumab plus ipilimumab given with 2 cycles of platinum-doublet chemotherapy as a first-line treatment for adult patients with metastatic or recurrent non-small cell lung cancer.
Angiogenesis is important for tumor cell growth, proliferation, and metastasis of many cancer types [1,2], including non ―small cell lung cancer (NSCLC) . Vascular endothelial growth factor (VEGF), a key regulator of vascular growth , is overexpressed in many cancer types and is associated with tumor cell proliferation, increased microvessel density, and poor prognosis [1,5–10]. Bevacizumab, a humanized mono clonal antibody that targets VEGF, has shown clinical benefit in many types of cancers and is approved as first-line treatment for patients with nonsquamous NSCLC when administered in combination with pac...