Mark G. Kris, MD

Disclosures

May 22, 2015

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This is Mark Kris from Memorial Sloan Kettering, speaking to you in preparation for the upcoming meeting of the American Society of Clinical Oncology (ASCO) in Chicago.

This year in the lung cancer sessions there will be many very interesting presentations, and many of the topics that we have seen developing over the years have now come to fruition. The most talked-about abstracts will likely be the studies of the inhibitors of PD-L1, the immune checkpoint inhibitors targeting PD-L1 and CTLA-4.

We will hear randomized trials, some of which have been reported already in press releases, for the use of nivolumab both in patients with squamous cell carcinoma[1] and—as you may have heard in the recent press releases—in adenocarcinoma.[2] The data on using these agents after the failure of initial therapy, and comparing them with single-agent docetaxel, have led to a clear-cut improvement in overall survival of approximately 3 months. Those data are going to be very important and it will be a big topic of discussion.

The immune checkpoint inhibitors are also being used in other types of cancers. There will be abstracts reporting the use of nivolumab[3] and pembrolizumab[4] in small cell lung cancer, and also looking at PD-L1 expression in thymic carcinoma.[5] We are going to see more definitive data about the use of immune checkpoint inhibitors. We are also going to see the use of immune checkpoint inhibitors in cancers other than lung.

The molecular characteristics that have defined lung cancers and have led to many therapeutic advances are going to be explored even further. There will be data looking at BRAF-mutant lung cancers and the combination of dabrafenib and trametinib.[6] There will be data with cabozantinib looking at RET-rearranged lung cancers,[7] and a new aberration in the MET gene-splicing variants in exon 14 leading to sensitivity to crizotinib in patients with lung adenocarcinomas[8] and also with an unusual and traditionally hard-to-get cancer, sarcomatoid carcinomas.[9] All of these will be presented.

We are going to hear more about rociletinib and AZD9291, the new third-generation tyrosine kinase inhibitors recently reported in the New England Journal of Medicine,[10] with even more updated information presented at ASCO.[11] The use of these agents as initial therapy is something we're all looking forward to.[12] Last, some data about the chemotherapy agent nedaplatin will be presented.[13]

Although many people receive targeted therapies and these drugs are extremely important to improve outcomes, at some point, virtually every patient with a lung cancer receives a traditional cytotoxic chemotherapy, so developing new chemotherapies and keeping them in the discussion is very important.

In summary, ASCO this year is going to be about a lot of new developments. We are going to hear about studies that have been presented in phase 1 and 2 and are now reaching fruition in phase 3. We will hear about continued development with more molecularly determined cancer targets and targeted therapies, and also some new information about some of our standard-drug chemotherapies.

It will be a great time in Chicago, with developments in many other cancers as well. I encourage you to attend.

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