By Jennifer C. King, PhD, Director of Science & Research
2016 was another banner year for lung cancer science and research. Here is what you should know and what you should look for in 2017.
LUNG CANCER TREATMENT:
The biggest news of the year was all about immunotherapies for the treatment of non-small cell lung cancer (NSCLC). A new drug called Tecentriq (atezolizumab) joined Opdivo (nivolumab) and Keytruda (pembrolizumab) as an approved treatment for patients with metastatic NSCLC who have already had chemotherapy.
Even more notably, Keytruda was the first immunotherapy approved for “first-line” meaning as a treatment before chemotherapy for patients with metastatic NSCLC. Data presented in December show that Keytruda improved survival and quality of life compared to chemotherapy.
This is a huge advance, but patients should take note that they should only consider Keytruda first line if they 1) have a “high” score on a test for a biomarker called PD-L1 and 2) don’t have a mutation that would qualify them for a targeted therapy (such as EGFR, ALK or ROS). This is why molecular testing is so critical (see Diagnosis section below).
It is important to note for all of these immunotherapies that some patients who take them have very long-lasting benefits and very few side effects, yet still only a small percentage of people (typically 15-20%) are responding to them. They offer hope for many in our community but are not a miracle cure.
For small cell lung cancer, the research has been a little slower, but never fear, there are clinical trials of all the immunotherapy agents and in particular, combinations of different drugs that are showing some promise in small cell too.
Targeted therapy remains the best option for patients who have a targetable mutation. This year Xalkori (crizotinib) was approved for patients who tested positive for a ROS1 mutation. Xalkori is also still the only first-line drug for ALK positive patients. However, data was presented throughout 2016 that show ALK inhibitors Alecensa (alectinib) and Zykadia (ceritinib) working well in the first-line, particularly on brain metastases. These drugs could be approved for first-line in 2017.
For those with an EGFR mutation, data showed that for patients with a T790M mutation in EGFR (which is common after resistance to other EGFR-targeted drugs), Tagrisso (osimeritinib) is likely a better option for you than chemotherapy.
Many other targeted therapies are in clinical trials and could be an option for you based on your molecular testing results. For those with small cell lung cancer, there is now a large, international trial of a drug that could become the first targeted-therapy in small cell.
Lung Cancer Screening:
In early 2016, Medicare started paying claims for lung cancer screening. Now, if you are age 55-77, and smoked the equivalent of a pack (20 cigarettes) a day for 30 years, you can get a low-dose CT screen covered by Medicare that could potentially find lung cancer early, when it is most treatable. Talk to your doctor about this screening and if it’s right for you.
LUNG CANCER DIAGNOSIS:
Due to the changing options to treat lung cancer, it is critical to have molecular testing on your cancer when first diagnosed or as soon as possible. We have launched a new program called LungMATCH to answer questions and help walk you through this process. If you have not had testing, talk to your doctor or call us at 1-800-298-2436.
The science around lung cancer is improving at a rapid pace and we will keep you as up to date as possible on it all! Because no one deserves lung cancer and everyone deserves a cure.