Articles

Highlights in thoracic oncology

BJMO - volume 12, issue 8, december 2018

V. Surmont MD, PhD

The introduction of immune checkpoint inhibitors in the treatment arsenal of NSCLC patients revolutionised the way these patients are treated. Similarly, the development of several next-generation tyrosine kinase inhibitors, targeting activating EGFR and ALK mutations/rearrangements, has changed the treatment paradigm for patients with oncogene-driven NSCLC. While these agents were initially used in the relapsed setting, both immune checkpoint inhibitors and next-generation TKIs were now successfully tested in the first-line treatment of metastatic NSCLC patients. ESMO 2018 featured the presentation of a long list of these trials. In addition, efforts are being made to improve the outcome of patients with stage III NSCLC and also in this setting interesting data were presented.

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Second-line treatment of non-small cell lung cancer adenocarcinoma patients not harbouring an oncogene driver mutation anno 2017–2018: A consensus group meeting

BJMO - volume 12, issue 2, march 2018

P-E. Baugnée , L. Bosquée MD, PhD, C. Compère MD, N. D’Haene MD, PhD, I. Demedts , D. Galdermans MD, P. Germonpré , M. Gustin , V. Ninane MD, PhD, S. Ocak , P. Pauwels MD, PhD, T. Pieters MD, PhD, A. Sadowska MD, A. Sibille MD, V. Surmont MD, PhD, J. Vansteenkiste MD, PhD

Summary

The treatment landscape for patients with advanced non-small cell lung cancer, who do not harbour an oncogenic driver abnormality, has changed dramatically over the last years. Second-generation antiangiogenic agents, such as nintedanib and ramucirumab, and particularly PD-1/PD-L1 inhibitors, such as nivolumab, pembrolizumab and atezolizumab have shown to prolong survival in pretreated non-small cell lung cancer patients. Immune checkpoint inhibition in the treatment of advanced non-small cell lung cancer comes with the promise of durable responses in responding patients. Nevertheless, one must appreciate that the average response rate seen with these PD-1/PD-L1 targeting agents is only about 20%. While PD-L1 testing may be used as an enrichment biomarker, a substantial proportion of patients still do not benefit from these agents. They could benefit from alternative therapeutic options, including novel anti-angiogenic agents. In this paper, a treatment algorithm is proposed that aims to optimise the second-line treatment choice for patients with lung adenocarcinoma, based on the available clinical data.

(BELG J MED ONCOL 2018;12(2):61–66)

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Highlights in thoracic oncology

BJMO - volume 10, issue 5, august 2016

V. Surmont MD, PhD

Summary

During ASCO 2016, 190 abstracts were presented in the lung cancer track: 18 oral presentations, 22 discussion sessions and 172 posters. This report will highlight 7 selected phase III trials and 3 small but promising phase I/II trials.
This year’s ASCO focused on the promising and exciting domain of immunotherapy with checkpoint inhibitors. Of special interest were the data in first line treatment of NSCLC, the combination of PD-L1 and CTLA-4 antibodies, and the phase I/II results in mesothelioma, small cell lung cancer and thymic carcinoma.
Other highlights of ASCO 2016 in the field of thoracic oncology included updated results of new targeted therapies for patients with defined molecular targets and for patients with acquired resistance after firstgeneration EGFR or ALK-inhibitors.

(BELG J MED ONCOL 2016;10(5):179–185)

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Highlights in lung cancer

BJMO - volume 9, issue 4, august 2015

V. Surmont MD, PhD

This report will highlight 8 important phase III studies presented during ASCO 2015 and 5 small but promising phase I/II trials. This year’s ASCO will be remembered for the paradigm shift and step forward in the treatment of lung cancer with immunotherapy via checkpoint inhibitors. Two important phase III trials in second-line NSCLC with anti-PD-1 inhibition were presented at ASCO this year and are discussed below. Also in small cell lung cancer and mesothelioma this approach seems promising.

Other highlights of the ASCO 2015 congress in the field of thoracic oncology include new targeted therapies for patients with defined molecular targets and for patients with acquired resistance after first-line first generation tyrosine kinase inhibitors (TKI) or first generation ALK inhibitors.

(BELG J MED ONCOL 2015;9:122–7)

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