By Jennifer C. King, PhD, Chief Scientific Officer, GO2 for Lung Cancer

New advances in lung cancer research were presented earlier this year at the 2020 World Conference on Lung Cancer (WCLC). Due to the COVID-19 pandemic, this conference had been rescheduled from August 2020 and was held virtually. The 2021 WCLC will still be taking place in September 2021.  Here are some of the highlights:

Targeted Therapies
  • New data was presented on sotorasib, a drug that targets changes in the cancer gene KRAS to the G12C variant. This change happens in ~13% of the adenocarcinoma type of non-small cell lung cancer (NSCLC). The response rate to the drug was 31% and 80% of people experienced disease control (shrinkage or no change in tumor growth). The average time before the cancer progressed was 6.8 months. We expect that this data will lead to Food and Drug Administration approval soon, which would be the first approved drug targeting KRAS.
  • Multiple new drugs for NSCLC with EGFR changes in exon 20, which are not targeted by currently approved EGFR targeted therapies, are in the pipeline. Clinical trial data for two of these, amivantamab and mobocertinib, were presented. They had a 40% and 26% response rate respectively, in a population of patients who had received previous therapies. There was also data on new potential therapies for changes in exon 18 and an interesting pre-clinical talk on how to potentially target the right EGFR inhibitors to cancers with rare EGFR mutations.
  • There were multiple promising studies on development of a newer type of targeted therapy called a “antibody drug-conjugate” (ADC) where a toxic drug is targeted directly to cancer cells, including one for lung cancers that overexpress HER2.
Immunotherapies
  • Negative data is important too! Research comparing Keytruda (pembrolizumab) by itself to Keytruda plus Yervoy (ipilumimab) for people with a lung cancer that has >50% PD-L1 showed that it was not helpful to add the second drug. Keytruda alone remains the best choice, saving patients additional side-effects from taking two drugs.
  • A new study confirmed what was already believed, that there is not a significant benefit of immunotherapy (in this case Opdivo (nivolumab) and Yervoy) for patients who have already progressed on an EGFR targeted therapy.
Early Stage Treatments
  • Taking immunotherapy before surgery may be a worthwhile treatment option coming in the future. The Lung Cancer Mutation Consortium (LCMC) 3 study showed that Tecentriq (atezolizumab) taken before surgery could cause regression in tumors, particularly those that are PD-L1 high.
  • More data was released from the ADAURA trial of Tagrisso (osimertinib) taken after surgery in Stage I-IIIA lung cancer (see recent FDA approval here). There was no significant decrease in quality of life caused by taking Tagrisso as measured by the SF-36 scale. In addition, the benefits of taking Tagrisso did not depend on whether the patient had also received chemotherapy. We still are waiting for the data on whether taking Tagrisso after surgery improves length of survival.
Small Cell Lung Cancer (SCLC)
  • One study confirmed the importance of patients with SCLC taking “maintenance” immunotherapy after taking the 1st line chemotherapy-immunotherapy that is now the current standard of care.
  • There are promising new drugs and combinations to watch such as AMG-757 and Zepzelca (lurbinectedin) with irinotecan, but data from larger clinical trials are needed.
  • A lot of work is being done on understanding biomarkers and subtypes of SCLC, as well as the role of having a family history of SCLC.
Advances in Early Detection
  • The Taiwan Lung Screening Program presented their TALENT study. They found a 2.6% detection rate of lung cancer in never- or light ex-smokers in Taiwan by low dose CT (LDCT) screening, almost all of which (97%) were early stage. There was a significant increase in detection rate for those with a family history of lung cancer. There was no control arm to this study and it was done in a Taiwanese population that has a higher rate of lung cancer, so it is not directly comparable to the United States population, where LDCT screening is not currently approved for never-smokers. However, it provides intriguing data to further investigate whether risk factors other than smoking, such as family history, also increase detection rates and should be considered for screening eligibility.
  • One plenary talk was on the state of biomarker research for early detection. The summary: there are multiple strong candidates, but they still need to be validated in clinical utility studies.
Patient Engagement

If you enjoyed this article, GO2 for Lung Cancer has recently launched a new quarterly newsletter, The Magnifying LeNS. The Magnifying LeNS highlights the lung cancer treatment landscape as seen by GO2 for Lung Cancer’s Science and Research team. Catch up on the very first issue here and please register to receive the Magnifying LeNS by emailing Daniel Saez at dsaez@go2.org.