ESMO 2017 featured the presentation of several practice changing studies in the field of lung cancer. With respect to immunotherapy, durvalumab showed a benefit for patients with Stage III non-small cell lung cancer (NSCLC) when taken after chemotherapy-radiation. This represents the first major study showing an immunotherapy benefit for patients with lung cancer that is not Stage IV.1 A second key immunotherapy study showed that stage IV NSCLC patients who continued to take nivolumab beyond 1 year had a significantly longer progression-free survival (PFS) than patients who took the drug for 1 year.2
Also in the field of targeted therapy, ESMO 2017 may have induced a paradigm shift. In the phase III FLAURA study, the third-generation EGFR tyrosine kinase inhibitor (TKI) osimertinib, which is already approved for recurrent NSCLC patients harboring an EGFRT790M mutation, was associated with a superior PFS to the current standard of care EGFR-targeted drugs. This was especially the case for patients with brain metastases.3 More positive data in NSCLC patients with brain involvement came from the ALUR trial and from a secondary analysis of the ALEX study, showing that alectinib can significantly decrease central nervous system (CNS) progression of NSCLC, both in the first-line and in the second-line setting.4,5
In addition to this, the combination of the BRAF inhibitor dabrafenib and the MEK inhibitor trametinib was shown to be an effective first treatment for BRAFV600E mutated NSCLC.6
A final study worth mentioning in this introduction consists of the IFCT-0302 trial which demonstrated that frequent CT scans after surgery for early-stage lung cancer surgery did not improve survival. This should inform follow-up recommendations and should give patients some peace of mind that they don’t necessarily need CT scans every six months.7
(BELG J ONCOL 2017;11(7):317–325)
