Researchers reported a number of important findings in lung cancer treatment at the 2017 Annual Meeting of the American Society of Clinical Oncology:

Alectinib may become the first-line standard of care for ALK-positive non-small cell lung cancer (NSCLC)

The ALK-inhibitor alectinib is approved by the FDA as a second-line treatment for ALK-positive NSCLC in patients whose disease has progressed after being treated with the first-line treatment crizotinib.

The randomized open-label phase III J-ALEX trial, consisting of just over 200 patients, compared alectinib to the ALK-inhibitor crizotinib as a front-line treatment for ALK-positive NSCLC. Compared to crizotinib, alectinib reduced the risk of disease progression or death, with fewer side effects.

What Patients Need to Know

In September 2016, the FDA granted alectinib Breakthrough Therapy Designation (BTD) for the first-line treatment of people with advanced ALK-positive NSCLC, and the latest results from the J-ALEX trial will be submitted to the agency for evaluation.

Trial evaluated the safety of resuming immunotherapy after side effects have resolved

“Checkpoint inhibitors,” a type of immunotherapy, are an effective treatment option for some patients with lung cancer, but one-quarter to one-third of these patients will develop side effects that result in the stoppage of treatment.

The RETROSPECTIVE trial was conducted to determine if treatment can safely resume for these patients once the side effects are resolved. The trial determined that resuming treatment is feasible and safe (with some caveats) in selected patients with non-small cell lung cancer (NSCLC) treated with anti–programmed cell death protein 1 (PD-1) and anti–programmed cell death ligand 1 (PD-L1) checkpoint inhibitors.

What Patients Need to Know

The RETROSPECTIVE trial also indicated that resuming treatment may not add any additional benefit if the patient was an “early responder” to the immunotherapy, and had experienced a major shrinkage of the cancer. As additional side effects could be experienced, the decision whether or not to resume treatment is made on a case-by-case basis.

Nivolumab before surgery is safe and feasible for early non-small cell lung cancer (NSCLC)

Results of a new trial indicated that neoadjuvant (prior to surgery) immunotherapy with nivolumab, an immunotherapy treatment, is safe and feasible for early stage NSCLC. This was the first trial of this type of drug as neoadjuvant therapy in early stage lung cancer; previous studies were conducted on the effect of nivolumab and similar immunotherapy drugs in metastatic or advanced lung cancer.

What Patients Need to Know

The trial included 20 patients who received two doses of nivolumab at four and two weeks prior to surgical resection of the tumor. The trial found that there were no significant safety concerns and that the treatment was feasible, as it did not delay surgery.

Post-surgery, the targeted therapy gefitinib appears to be more effective than chemotherapy in preventing recurrence of EGFR-positive non-small cell lung cancer (NSCLC)

Chemotherapy is the current standard of care in preventing recurrence of lung cancer after surgery. A phase lll clinical trial showed that the targeted treatment gefitinib appears to be more effective than chemotherapy for patients with epidermal growth factor (EGFR)-positive, stage ll to stage lllA NSCLC.

What Patients Need to Know

The median time for disease-free survival was 28.7 months for patients who received gefitinib after surgery, compared to 18 months for patients who received chemotherapy after surgery. With gefitinib, 12 percent of patients experienced severe side effects, compared to 48 percent with chemotherapy.

Web-based tool to communicate symptoms improves survival in patients being treated for metastatic lung cancer

According to the findings of a randomized trial, patients receiving treatment for metastatic lung cancer who used a web-based tool to report their symptoms to their health care team lived an average of five months longer than patients whose symptoms were monitored in a standard way.

The results showed that patients who used the tool were also able to stay on their chemotherapy longer, had fewer emergency visits, and experienced better quality of life and physical function.

What Patients Need to Know

Between visits, patients who are experiencing symptoms are often hesitant to contact their health care team unless those symptoms become severe. Even during visits, symptoms are often not fully communicated. The web-based tool allowed for better communication between patient and their health care team.