Highlights from the World Conference on Lung Cancer

Authors: Andrew Ciupek, PhD, Associate Director, Clinical Research; Jennifer C. King, PhD, Chief Scientific Officer; Daniel A. Saez, MSc, Manager, LungMATCH Navigation Program

Doctors and scientists from around the world who are passionate about lung cancer convened last month to bring us the latest on the treatment landscape. GO2 sent multiple staff members to the World Conference on Lung Cancer as track chairs, poster presenters, oral presenters and more. Here’s a quick update on what we learned—and what you need to know about immunotherapy, targeted therapy, early stage, small cell lung cancer and survivorship.

Immunotherapy Updates

• Retrospective analysis of phase 3 clinical trials in non-small cell lung cancer (NSCLC) showed that rechallenging with second line immunotherapy in the form of Keytruda (pembrolizumab) had meaningful positive effects on patients who had experienced progression on first line immunotherapy in the form of Keytruda (pembrolizumab).
• The HUDSON clinical trial showed that patients who experienced progression on any anti PD-1/PD-L1 immunotherapy combined with chemotherapy in the first line setting stand to benefit from combination immunotherapy in the form of Imfinzi (durvalumab) combined with the ATR inhibitor ceralasertib.
• The POSEIDON trial suggests combining two different types of immunotherapy (CTLA-4 and PD-L1 inhibitors) with chemotherapy may work better when given in the first line setting than only one type of immunotherapy for patients with NSCLC having KRAS, KEAP1 and STK11 mutations (which are typically less responsive to immunotherapy).

Targeted Therapy Updates

• Several presentations provided early and promising data on treatments for lung cancer with a KRAS G12C mutation—both new KRAS G12C targeted therapies and new combination approaches with other targeted therapies or immunotherapy.
• The VISION trial provided confirmation that the FDA approved MET Exon 14 skipping mutation targeted therapy, Tepmetko (tepotinib), has durable effectiveness as both a first treatment and when used after other treatments—and has promising effectiveness against brain metastasis.
• There was a focus on treating EGFR-positive NSCLC that has progressed after being treated with currently approved EGFR targeted therapies, with several presentations of new drug combinations and new EGFR targeted therapies.
• There were several presentations with promising data on different treatment methods and new targeted therapies for non-small cell lung cancer with RET, ROS1 and ALK mutations.

Early-Stage Updates

• For very small lung tumors (stage 1A with no spread to the lymph nodes), the CALGB/Aliance trial showed that surgery that removes only part of a lobe of the lung has similar outcomes to a full lobectomy—meaning many patients can get a less extensive surgery.
• Retrospective analysis of trials suggests that circulating tumor DNA (ctDNA) may be able to give doctors insight into patient prognosis, but more direct research needs to be done.
• Trials, including Impower010, show increased disease-free survival in all populations receiving chemotherapy after surgery; but they only showed improved overall survival in populations of patients who did not have EGFR or ALK mutations.
• Clinical trials, including NADIM II and CheckMate 816, continue to demonstrate that receiving immunotherapy and chemotherapy prior to surgery improves outcomes for patients.
• Research is ongoing to attempt to identify predictive markers for response to immunotherapy in patients with early-stage lung cancer so that doctors can give patients the best treatment before surgery for improved outcomes.

Small Cell Update

• Some early studies hinted at promising new treatments for small cell lung cancer. For example, one study showed positive results for talazoparib—a type of drug approved in other cancers called a PARP inhibitor—in combination with temozolomide chemotherapy. And another study showed that a new type of drug, tarlatamab—an immune therapy targeted at a protein called DLL-3—was safe, and that there were some good responses to the drug. All of these drugs will now be studied in larger clinical trials.

Survivorship Update

• An important survivorship study conducted in partnership with GO2 for Lung Cancer’s Lung Cancer Registry examined the understudied impact of lung cancer treatment on women’s sexual health and found that 77% of women reported an impact on their sexual health. The study results pave the way for new interventions. Listen to a summary of the results by the principal investigator, Dr. Florez.