LUNG CANCER
NEWS
V2/ N4 / AUGUST 2017
FOR THORACIC SPECIALISTS www.iaslc.org
I N T E R N AT I O N A L A S S O C I AT I O N F O R T H E S T U D Y O F L U N G C A N C E R GLOBAL RESEARCH REPORT
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IASLC Workshop in Lung Cancer Clinical Research
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Comments on the 8th Edition of the TNM Classification of Lung Cancer
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Names and News
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FDA Corner: In Speech to Agency, New FDA Commissioner Highlights Anti-Smoking Effort
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Shanghai Cancer Recovery Club
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NCI Corner: Interview with Jeff Abrams, MD Breaking News Briefs Ellen V. Sigal, PhD: Leading the Cancer Research Advocacy Community
Changing Treatment Paradigm for ALK-Positive Lung Cancer By Cynthia L. Kryder, MS, CCC-Sp
Rearrangements in the anaplastic lymphoma kinase (ALK) gene occur in approximately 2% to 7% of patients with advanced non-small cell lung cancer (NSCLC).1 For patients with advanced ALK-positive NSCLC, the current firstline standard of care is crizotinib, a MET tyrosine kinase inhibitor (TKI) with activity in ALK-rearranged NSCLC. It has been shown to yield very high response rates (exceeding 60%) and to improve progression-free survival (PFS) compared with standard chemotherapy when used in patients with advanced ALK-positive NSCLC whose disease has progressed on previous chemotherapy, including those with brain metastases.2-4 Nevertheless, most patients with ALK-positive NSCLC treated with firstline crizotinib will eventually relapse, either due to the development of ALK resistance mutations or inadequate CNS drug penetration.3,5
Ceritinib, alectinib, and brigatinib are next-generation ALK TKIs that have emerged as standard therapy for patients with advanced ALK-positive NSCLC who experience disease progression while on crizotinib. These agents have been shown to be more potent with more brain penetrance than crizotinib. Additionally, ceritinib and alectinib both demonstrate activity against common crizotinib-resistance mutations, such as the gatekeeper ALK L1196M mutation.6,7 Emerging data suggest that these agents also may have a role in the first-line setting. The global, randomized phase III ASCEND-4 trial compared ceritinib with platinum/pemetrexed chemotherapy in newly diagnosed patients with advanced ALK-positive NSCLC. Ceritinib reduced the risk of disease progression or death by 45% compared with standard chemotherapy. Patients who received ceritinib had significantly longer median PFS, 16.6
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months versus 8.1 months in the chemotherapy arm (HR = 0.55, P<0.00001).8 Based on these positive results, ceritinib (Zykadia) was approved by the FDA on May 26, 2017, for first-line treatment of patients with ALK-positive, advanced NSCLC. Following closely behind is alectinib, which in the phase III global ALEX trial showed superior efficacy compared with crizotinib as first-line therapy for treatment-naive patients with advanced ALK-positive NSCLC. Compared with crizotinib, alectinib prolonged PFS, as well as the time to CNS progression, in treatment-naive patients with ALKpositive NSCLC. Results of the ALEX trial were presented in June at the 2017 annual meeting of the American Society of Clinical Oncology during the thoracic oncology plenary session.9 continued on page 4
IN MEMORIAM
World No-Tobacco Day 2017: Women Against Lung Cancer in Europe’s European Union Event on Primary Prevention By Gian Piero Bandelli, MD, Federica Ferraresi, WALCE Advocate, and Silvia Novello, MD, PhD
On the occasion of World No Tobacco Day 2017, Women Against Lung Cancer in Europe (WALCE), in partnership with European Network for Smoking and Tobacco Prevention (ENSP), European Lung Foundation (ELF), European Respiratory Society (ERS), Fondazione Insieme Contro il Cancro, and Associazione Italiana Pneumologi Ospedalieri (AIPO), promoted a double event in Brussels focused on primary prevention and smoking cessation. The initiative was a great success, both in broad appeal and in terms of the number of visitors. On May 30-31, a 2-day exhibition entitled “Go out of the tunnel. Don’t burn away your future” was held in Place de la Monnaie (Figure 1A) in a structure shaped like a giant cigarette. Committed pulmonologists and oncologists performed counseling during the exhibition,
and educational materials on smoking cessation were displayed. Attendees were offered a basic spirometry test; a total of 450 spirometries were performed. Over 600 people of all ages, mainly smokers,
reviewed the exhibit and requested information on smoking-related diseases and smoking cessation programs (Figures 1B and 1C). There is a lack of knowledge in the general population about pulmonary function tests and about the wide array of diseases related to smoking history. For example, most of the people entering the exhibit did not know that 3.1 million people continued on page 7
Figure 1. A) External view of campaign exhibit for “Go out of the tunnel. Don’t burn away your future,” Place de la Monnaie, Brussels. B) Internal view of campaign exhibit: attendees waiting for spirometry, C) attendees asking for information.
Robert L. Comis, MD Clinical Trial Leader and Patient Champion Passes Away at 71 Robert L. Comis, MD, passed away suddenly in his home on May 10, 2017. He was 71. A leader in international oncology research since 1977, Dr. Comis was a champion of patient access to clinical studies in cancer, spearheading initiatives to raise awareness about the pivotal role of cancer clinical trials in cancer prevention, detection, and treatment. Dr. Comis’ leadership in the field of oncology was key to the development of continued on page 6