Podcasts about Osimertinib

This episode of Lung Cancer Considered covers the recent FDA approval of Osimertinib after chemo-radiation in EGFR positive NSCLC based on the LAURA trial which was presented at the 2024 ASCO Annual Meeting. Host Dr. Narjust Florez goes in depth with podcast guest Dr. Pamela Samson about the LAURA Trial and its implications for patients and clinicians. Guest: Dr. Pamela Samson is an assistant professor in the Department of Radiation Oncology at Washington University in St. Louis. Dr. Samson specializes in the care of thoracic malignancies and ways to deliver appropriate radiation therapy without compromising efficacy and diminishing toxicities.

A cancer patient relying on the kindness of strangers to fund life extending cancer medication wants to know why he's still waiting for Pharmac to deliver drugs the government committed to funding five months ago. After flip flopping on an election commitment; the government announced a 600 million dollar funding boost for cancer and other medications in June. It said seven of 13 drugs it promised on the election campaign would be covered and the others would be replaced by alternatives. Lung cancer drug Tagrisso or Osimertinib was supposed to be one of the first rolled out. It's a relief for former taxi driver and cancer patient Akhil Chaudhary; he's been funding an average of $1300 a week to buy the drug himself. But Pharmac is yet to make a decision on funding and Akhil is still paying, he spoke to Lisa Owen.

Description: The FDA approved amivantamab therapy for EGFR mutant NSCLC after progression on osimertinib. This approval is based on the phase III MARIPOSA-2 trial, with data first shared at ESMO 2023 in Madrid with a simultaneous publication in the Annals of Oncology. Lung Cancer Considered host Dr. Stephen Liu talks with two leading oncologists to learn more about how this therapy will be used by clinicians Guest: Dr. Karen Reckamp, Professor of Medicine, Director of the Division of Medical Oncology, and Associate Director of Clinical Research at Cedars-Sinai Medical Center Guest: Dr. William Nassib William, National Leader of Thoracic Oncology at Oncolinicas, Sao Paulo, Brazil

Results of the phase 3 LAURA clinical trial, presented at the 2024 American Society of Clinical Oncology Annual Meeting, showed that osimertinib significantly improves progression-free survival in patients with unresectable stage III EGFR-mutant non-small cell lung cancer (NSCLC) after chemoradiotherapy. “The benefits of osimertinib in this patient population when compared to placebo are just incredibly dramatic,” noted Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles. He spoke with lead study author Suresh S. Ramalingam, MD, the Roberto C. Goizueta Distinguished Chair for Cancer Research and the executive director at the Winship Cancer Institute of Emory University in Atlanta, about how oncologists should adjust their practice in the wake of these key findings. Dr. Ramalingam tackled questions about the optimal duration of osimertinib therapy, toxicity concerns, and notable benefits seen in the LAURA data. “Osimertinib reduced both intrathoracic progression and extrathoracic progression, particularly intracranial progression,” he noted. Dr. Ramalingam reported research funding from Amgen, AstraZeneca/MedImmune, Bristol Myers Squibb, Merck, Pfizer, and Takeda; travel, accommodations, and other expenses from AbbVie; and a relationship with the American Cancer Society. Dr. Figlin reported various financial relationships.

Dr. Megan Daly presents the latest rapid recommendation update to the ASCO management of stage III NSCLC guideline, based on data from the phase III randomized LAURA trial, presented at the 2024 ASCO Annual Meeting, and subsequently published. She discusses the results of the trial, shares the updated recommendation from the expert panel, and the impact for both clinicians and patients. We also discuss future research in the area and exciting new developments to watch out for in the field. Read the full rapid update, “Management of Stage III Non-Small Cell Lung Cancer: ASCO Rapid Guideline Update” at www.asco.org/thoracic-cancer-guidelines. TRANSCRIPT   This guideline, clinical tools, and resources are available at www.asco.org/thoracic-cancer-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology, https://ascopubs.org/doi/10.1200/JCO-24-01324. Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one at asco.org/podcasts. My name is Brittany Harvey, and today I'm interviewing Dr. Megan Daly from the University of California Davis Comprehensive Cancer Center, lead author on, “Management of Stage III Non–Small-Cell Lung Cancer: ASCO Rapid Guideline Update.” Thank you for being here today, Dr. Daly. Dr. Megan Daly: Thanks for having me, Brittany. Brittany Harvey: Great. Then before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO conflict of interest policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Daly, who has joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. So then, to start us off on the content of this update, first, this guideline was updated based off new evidence presented at the 2024 ASCO Annual Meeting. Dr. Daly, could you describe the trial that prompted this rapid update to the management of stage III non-small cell lung cancer guideline? Dr. Megan Daly: The trial that prompted this update is the LAURA trial. The LAURA trial was a phase III randomized trial conducted in patients with unresectable stage III non-small cell lung cancer harboring EGFR mutations, either exon 19 deletions or L858R insertions. Patients in this trial were randomized 2:1 between the third generation EGFR tyrosine kinase inhibitor osimertinib or placebo, and osimertinib or placebo were continued until progression or other reasons for discontinuation. Osimertinib was found to provide a considerable benefit in progression free survival, with a hazard ratio of 0.16. The median progression free survival for patients randomized to osimertinib was 39.1 months, and for patients on the placebo arm, it was 5.6 months. We did not yet have overall survival data from the LAURA trial. The data is not mature, but the considerable progression free survival benefit noted with osimertinib has drawn a lot of interest to this trial. Brittany Harvey: Absolutely. Thank you for describing the results of those trials and the endpoints. So then, based on this new evidence, what is the updated recommendation from the guideline expert panel? Dr. Megan Daly: The updated recommendation from the panel is that patients with unresectable stage III non-small cell lung cancer with an EGFR exon 19 deletion or exon 21 L858R mutation may be offered consolidation osimertinib after definitive chemoradiotherapy, which can be either platinum-based chemotherapy and thoracic radiation given either concurrently or sequentially. Our evidence quality is moderate and the strength of the recommendation is strong. Brittany Harvey: Great. And thank you for reviewing both the strength of the recommendation there as well as the evidence quality rating. So it's great to have this new option for patients. So what should clinicians know as they implement this new recommendation? Dr. Megan Daly: I think it's important for clinicians to know when they're counseling patients about considering osimertinib to understand that first, the LAURA trial enrolled patients who had common EGFR mutations. So exon 19 deletions or L858R mutations. Patients with other uncommon EGFR mutations were not included in the trial. It's important to know that overall survival data is not yet mature. We do not know yet whether the use of consolidation osimertinib leads to a survival benefit at this time. We only know that it leads to a progression-free survival benefit as compared to placebo. I think it's also important to know that there was increased toxicity noted on the experimental arm. Grade 3 or higher adverse events was significantly higher with the use of osimertinib. So these are all important considerations when counseling patients and considering the use of osimertinib. Brittany Harvey: Absolutely. Those are definitely key points, as you mentioned, to consider. And you've already touched on this a little bit. But how does this change impact patients living with stage III non-small cell lung cancer? Dr. Megan Daly: We do see in the LAURA trial a rather remarkable benefit for progression-free survival. The progression-free survival, as I already mentioned, increased from 5.6 months median on the control arm to 39.1 months on the experimental arm with consolidation osimertinib. So this is an exciting new option for patients with unresectable stage III non-small cell lung cancer who have one of these mutations to extend their progression-free survival by almost three years. And we hope that this progression-free survival benefit will end up translating into a considerable overall survival benefit as well. So, certainly, the overall survival data is eagerly awaited. Brittany Harvey: Definitely, this is a promising option for patients, and we look forward to future readouts of long-term data on this trial. So that's one of the outstanding questions here. But what other outstanding questions are there regarding the management of stage III non-small cell lung cancer? Dr. Megan Daly: I think what many of us question when we look at this data is whether we could extrapolate to the use of other targeted agents with other less common oncogenic driver mutations. Unfortunately, the answer is we simply don't know yet. We hope to see some ongoing data in the resectable setting. Doing randomized trials with rare oncogenic drivers in unresectable stage III lung cancer is very difficult, unfortunately, and there's always a degree of extrapolation for clinicians when trying to figure out how to best manage our patients. But for me, that's one of the biggest outstanding questions I think specifically ties into interpreting the LAURA trial and other related trials in patients with oncogenic driver mutations. I think there's still many outstanding questions about how we continue to improve outcomes for our patients with unresectable stage III non-small cell lung cancer, questions about how we optimize our radiation regimens to have the best possible local control while reducing toxicity. We still need to continue to have randomized trials looking at questions on optimizing radiation, optimizing concurrent chemotherapy, whether there are any settings where we might be able to reduce or omit chemotherapy in place of some of these newer agents. These are all outstanding questions that hopefully will be answered over the next several years. We also continue to have open questions about when patients are more appropriate for surgery and more appropriate for non-surgical options, those borderline patients with N2 nodes who may technically be surgical candidates or could potentially be downstaged with neoadjuvant therapy. So, I think there's a lot of exciting work going on in stage III right now. Brittany Harvey: Absolutely. We'll look forward to that more data that you mentioned for more optimal individualized options for these patients with stage III non-small cell lung cancer. And I want to thank you so much for your time to rapidly update this guideline based off new evidence presented and then published. And thank you for your time today, Dr. Daly. Dr. Megan Daly: Thank you, Brittany. It's great to be on here. Brittany Harvey: And thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline update, go to www.asco.org/thoracic-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.      

In this episode, hosts Drs. Rahul and Rohit Gosain are joined by special guest Dr. Joshua Sabari, a thoracic medical oncologist from NYU Langone Health. Together, they dive into the highlights from ASCO 2024, focusing on key studies in lung cancer. Here's a quick summary of what you can expect in this episode: •⁠  ⁠LAURA Trial: Discussing the use of Osimertinib as a consolidation approach after chemoradiation in unresectable stage 3 non-small cell lung cancer patients with common EGFR mutation. •⁠  ⁠MARIPOSA Study: Exploring the potential of Amivantamab and Lazertinib in common EGFR mutations. •⁠  ⁠CROWN Study and other ALK inhibitors: Alectinib, Lorlatinib, and Brigatinib for metastatic non-small cell lung cancer. •⁠  ⁠ADRIATIC Study: Examining the use of Durvalumab after concurrent chemoradiation in limited-stage small cell lung cancer. •⁠ PALOMA-3 Trial: Discussing subcutaneous Amivantamab vs. IV Amivantamab with Lazertinib Join the Oncology Brothers and Dr. Sabari as they break down these practice-changing studies and provide insights into the latest advancements in lung cancer treatment. Don't miss out on this informative and engaging discussion! Stay tuned for more ASCO 2024 highlights and updates on GI, GU, and breast cancer in the upcoming episodes. Subscribe to the Oncology Brothers Podcast for the latest in oncology news and research. Thank you for listening! Website: http://www.oncbrothers.com/ Twitter: https://twitter.com/oncbrothers Contact us at info@oncbrothers.com

New data from the Phase III LAURA study, reported in Chicago at the ASCO 2024 Annual Meeting Plenary Session, suggest that the tyrosine kinase inhibitor osimertinib could become standard of care for treating patients whose unresectable locally advanced lung cancers test positive for mutated epidermal growth factor receptor (EGFR) and have no progression after definitive chemoradiotherapy. In Chicago, Oncology Times reporter Peter Goodwin met up with lead author of the LAURA study, Suresh S. Ramalingam MD, Executive Director of the Winship Cancer Institute at Emory University School of Medicine in Atlanta.

This week's episode will be discussing updates from the ASCO 2024 annual meeting starting with the practice changing LAURA trial: Osimertinib after definitive chemoradiotherapy in patients with unresectable stage III epidermal growth factor receptor-mutated NSCLC: Primary results of the phase 3 LAURA study presented by Dr. Ramalingam.

In the relentless battle against non-small cell lung cancer (NSCLC) driven by epidermal growth factor receptor (EGFR) mutations, the development of resistance has long been a formidable obstacle. Historically, first- and second-generation EGFR tyrosine kinase inhibitors (TKIs) like gefitinib, erlotinib, afatinib, and dacomitinib have faced a significant hurdle: the emergence of the T790M point mutation in approximately 50% of patients, rendering the tumor resistant to these therapies. This resistance stems from a sobering reality – before treatment, a small subset of cancer cells already harbor the T790M mutation, conferring no selective advantage initially. However, once treatment commences, these rare mutated cells proliferate selectively, eventually dominating the tumor population and diminishing the effectiveness of first- and second-generation TKIs. Full blog - https://www.oncotarget.org/2024/06/06/dr-blagosklonnys-strategy-from-osimertinib-to-preemptive-combinations/ Paper DOI - https://doi.org/10.18632/oncotarget.28569 Correspondence to - Mikhail V. Blagosklonny - Blagosklonny@oncotarget.com, Blagosklonny@rapalogs.com Video short - https://www.youtube.com/watch?v=UO5BGLIggTE Sign up for free Altmetric alerts about this article - https://oncotarget.altmetric.com/details/email_updates?id=10.18632%2Foncotarget.28569 Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ Keywords - cancer, lung cancer, NSCLC, EGFR, resistance, afatinib, gefitinib, capmatinib About Oncotarget Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. Oncotarget is indexed and archived by PubMed/Medline, PubMed Central, Scopus, EMBASE, META (Chan Zuckerberg Initiative) (2018-2022), and Dimensions (Digital Science). To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh Media Contact MEDIA@IMPACTJOURNALS.COM 18009220957

Featuring perspectives from Ms Marianne J Davies, Dr Alexander I Spira, Ms Jillian Thompson and Dr Helena Yu, including the following topics: Introduction (0:00) The Importance of EGFR Testing in Non-Small Cell Lung Cancer (NSCLC) (7:02) The Role of Osimertinib in Managing Localized and Locally Advanced NSCLC with an EGFR Mutation (11:58) Established First-Line Therapy for Metastatic NSCLC with an EGFR Mutation (32:38) Newly Approved and Promising Investigational Approaches to First-Line Therapy for Metastatic NSCLC with an EGFR Mutation (37:45) Common Toxicities Associated with Amivantamab (45:07) The Current and Future Management of Progressive NSCLC with an EGFR Mutation (55:06) Tolerability and Other Practical Considerations with HER3-DXd (1:01:06) Treatment for Metastatic NSCLC with EGFR Exon 20 Insertion Mutations (1:18:26) CME information and select publications

Dr. Joshua Reuss discusses the ADAURA trial, which suggested Osimertinib as treatment for EGFR+ NSCLC.

In this episode of Lung Cancer Considered, host Dr. Narjust Florez leads a discussion on the FLAURA2 study and changes in the first line treatment of EGFR NSCLC with guests Dr. Pasi Jänne and Dr. Marcelo Corassa. FLAURA2 was first presented at the 2023 WCLC in Singapore by Dr. Jänne.

BUFFALO, NY- March 19, 2024 – A new #research perspective was #published by Mikhail V. Blagosklonny M.D., Ph.D., from Roswell Park Comprehensive Cancer Center in Oncotarget's Volume 15 on March 15, 2024, entitled, “From osimertinib to preemptive combinations.” “Here, I suggest that while first-line osimertinib extends median progression-free survival (PFS) in EGFR-mutant lung cancer compared to first-generation TKIs, it reduces individual PFS in 15–20% of patients compared to first-generation TKIs. Since detecting a single resistant cell before treatment is usually impossible, osimertinib must be used in all patients as a first-line treatment, raising median PFS overall but harming some. The simplest remedy is a preemptive combination (PC) of osimertinib and gefitinib. A comprehensive PC (osimertinib, afatinib/gefitinib, and capmatinib) could dramatically increase PFS for 80% of patients compared to osimertinib alone, without harming anyone. This article also explores PCs for MET-driven lung cancer.” DOI - https://doi.org/10.18632/oncotarget.28569 Correspondence to - Mikhail V. Blagosklonny - Blagosklonny@oncotarget.com, Blagosklonny@rapalogs.com Sign up for free Altmetric alerts about this article - https://oncotarget.altmetric.com/details/email_updates?id=10.18632%2Foncotarget.28569 Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ Keywords - cancer, lung cancer, NSCLC, EGFR, resistance, afatinib, gefitinib, capmatinib About Oncotarget: Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. Oncotarget is indexed and archived by PubMed/Medline, PubMed Central, Scopus, EMBASE, META (Chan Zuckerberg Initiative) (2018-2022), and Dimensions (Digital Science). To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh Media Contact MEDIA@IMPACTJOURNALS.COM 18009220957

BUFFALO, NY- January 24, 2024 – A new #case report was #published in Oncotarget's Volume 15 on January 16, 2024, entitled, “Lazarus effect in a patient initially empirically treated with osimertinib for EGFR L858R mutant non-small cell lung cancer with leptomeningeal disease: a case report.” Osimertinib has been shown to be effective for patients with non-small cell lung cancer (NSCLC) with activating EGFR mutations. These patients are also at risk for leptomeningeal disease (LMD). LMD is characterized by central nervous system metastases with spread to the cerebrospinal fluid or leptomeninges. In patients with NSCLC with EGFR activating mutations, there is an increased occurrence of LMD, which occurs in 9% of patients. In this new report, researchers Shreya Bhatia, Manuel G. Cortez, Spencer Lessans, and Wade T. Iams from Vanderbilt-Ingram Cancer Center present a patient of East Asian descent whose initial presentation included severe, progressive leptomeningeal carcinomatosis and a small lung mass, with limited tissue available for molecular testing. She responded to empiric, urgent initiation of osimertinib, repeat tissue sampling revealed an EGFR L858R mutation, and she has experienced durable disease improvement for 18 months on osimertinib monotherapy. “Our case demonstrates the nuances of decision-making in starting osimertinib in urgent clinical settings. Given our patient's progressively worsening functional status and spread of disease to her CNS upon presentation, there was a need to begin treatment imminently. Time constraints, financial constraints, and lack of sufficient tissue for analysis ultimately led to the empiric use of osimertinib. Through the urgent initiation of appropriate anti-cancer therapy, she experienced both a life saving improvement in functional status and improvement in her LUL primary tumor one month into treatment.” DOI - https://doi.org/10.18632/oncotarget.28550 Correspondence to - Wade T. Iams - wade.t.iams@vumc.org Sign up for free Altmetric alerts about this article - https://oncotarget.altmetric.com/details/email_updates?id=10.18632%2Foncotarget.28550 Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ Keywords - cancer, EGFR mutation, leptomeningeal disease, non-small cell lung cancer, osimertinib About Oncotarget Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: SoundCloud - https://soundcloud.com/oncotarget Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh?si=&nd=1&dlsi=c12c9dbac1be421d Media Contact MEDIA@IMPACTJOURNALS.COM 18009220957

Hello and welcome to the very first episode of my new podcast. I am truly honored to have a special guest with me today, former presenter of A Place in the Sun, Jonnie Irwin, who has been bravely battling Stage 4 Lung Cancer for the past few years. Having connected with me in January last year, Jonnie has shared his journey and experiences and his inspiring attitude in face of adversity. In this episode Jonnie shares the trials of his journey with stage 4 lung cancer, unveiling the symphony of treatments that form the backdrop of his story including Intravenous Vitamin C, the use of off-label drugs, and the challenges faced with stage 4 cancer such as dealing with cachexia and his resistance to Osimertinib. We also discuss the misunderstandings around the Cancer Act 1939 and recent attempts to silence me. For more information on the topics discussed in this episode, please visit: https://www.howtostarvecancer.com/podcasts/ Exec Produced by Kheerut Punian. 

Dr. Joshua Reuss examines important details learned during the ADAURA trial, including overall survival, reduced risk of brain mets, and side effects.

This week's Pod dives into a new VEGF-R inhibitor, fruquintinib. We also ask if FLAURA2, osimertinib + chemotherapy in combination, will become a new standard of care in EGFR-mutated metastatic NSCLC.

How should results of the FLAURA2 clinical trial be applied in practice? The study examined the use of osimertinib plus chemotherapy in the first-line treatment of EGFR-mutated advanced non-small cell lung cancer (NSCLC) compared with osimertinib alone and found that progression-free survival was significantly improved with the combination treatment. Pasi A. Jänne, MD, PhD, director of three cancer centers at the Dana-Farber Cancer Institute in Boston, including the Lowe Center for Thoracic Oncology, shares his team's findings with Bob Figlin, MD, the Steven Spielberg Family Chair in hematology-oncology at Cedars-Sinai Cancer Center in Los Angeles. They discuss toxicity concerns, best practices for treatment assessment, and how to identify patients for whom the new strategy may yield the best results.

Patients with metastatic epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) are widely treated with osimertinib, the preferred first-line treatment option. However, disease progression inevitably occurs, driven by EGFR-dependent or EGFR-independent mechanisms of resistance. Platinum-based chemotherapy is the recommended treatment following progression with osimertinib but responses to platinum-based chemotherapy are transient. Salvage therapies, which are used after progression on platinum-based chemotherapy, have poor clinical outcomes in addition to substantial toxicity. In this podcast, authors discuss the current treatment landscape and emerging therapeutic options for patients with metastatic EGFR-mutated NSCLC whose disease has progressed following treatment with osimertinib and platinum-based chemotherapy.   This podcast is published open access in Advances in Therapy and is fully citeable. You can access the original published podcast article through the XX website and by using this link: https://link.springer.com/article/10.1007/s12325-023-02680-1. All conflicts of interest can be found online.   Open Access This podcast is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The material in this podcast is included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

Good morning from Pharma and Biotech daily: the podcast that gives you only what's important to hear in the Pharma and Biotech world. Roche has partnered with Ionis Pharmaceuticals to collaborate on the development of RNA medicines for Alzheimer's and Huntington's diseases. This collaboration will strengthen Roche's pipeline in neuroscience. However, BrainStorm's stem cell treatment for ALS has been deemed ineffective by an FDA panel. The panel voted against the clinical trial data, stating that it did not show the treatment to be effective for ALS. In other news, John Tsai, former Chief Medical Officer of Novartis, has been appointed as the CEO of ForceField Therapeutics, a UK-based biotech startup focused on developing heart drugs. ForceField recently licensed AAV technology from Freeline Therapeutics. Moving on, eight genetic fixes for inherited diseases have received approval in the US, showcasing the progress in gene therapy. However, there are concerns about the effects of gene therapy on a healthcare system designed around chronic treatment. Now, let's shift our focus to Johnson & Johnson (J&J), which has achieved a significant win in the lung cancer market with its drug combination of Rybrevant and Lazertinib. Patients treated with this combination showed improvement compared to AstraZeneca's Osimertinib. This positions J&J as a potential competitor in the lung cancer market.In another development, Alfasigma has acquired Intercept Pharmaceuticals in an $800 million cash deal. This acquisition provides an opportunity for Intercept to regain stability and expand its reach with the support of a larger pharmaceutical company.A study published in The New England Journal of Medicine suggests that a patient's death in 2022 was likely due to an adverse effect of recombinant AAV used in gene therapy. This highlights the importance of assessing safety and potential risks associated with gene therapies.Karuna Therapeutics has submitted a New Drug Application (NDA) for KarXT, an investigational treatment for schizophrenia. If approved by the FDA, this would provide new hope for improved treatment options for schizophrenia patients.Moving on, an FDA advisory committee has rejected BrainStorm Cell Therapeutics' therapy for ALS in a nearly unanimous vote. The committee concluded that BrainStorm did not demonstrate substantial evidence of efficacy for its therapy, called Nurown.These developments highlight significant advancements, challenges, and potential opportunities in the treatment of various diseases in the pharmaceutical industry.Now, let's talk about pharmaceutical giants, such as AstraZeneca, Bristol Myers Squibb, and Boehringer Ingelheim, indicating their participation in negotiations to agree on Medicare drug prices. Despite suing the federal government, these companies feel they have no choice but to participate.With drug prices in the public spotlight, pharma marketers are focused on reframing the narrative to communicate the value drugmakers bring to the healthcare system. In other news, a recent report showed that executive bonuses in the pharma industry pale in comparison to other industries. However, several executives still receive substantial packages. It is worth noting that Elon Musk's bonuses dwarf those of pharma executives.This newsletter also includes links to articles on topics such as women's health as a growing healthcare sector and trends in the rare disease treatment market. That's all for today's episode of Pharma and Biotech daily. Stay tuned for more important updates from the Pharma and Biotech world.

In discussion with Dr. Stephen Liu, covering the World Conference on Lung Cancer Highlights from Community Oncology perspective. We covered 4 important practice informing studies with Dr. Liu: - FLAURA2 - studying the importance of Osimertinib + chemo vs. Osimertinib in EGFRm patients, PFS benefit in the combination arm, though pending OS and most benefit derived in patients with CNS mets - CHRYSALIS-2 - post progression on EGFR therapy, there is ORR benefit from adding Amivantamab in combination with Lazertinib plus chemo - MARS2 - when compared surgery followed by chemo vs chemo alone, chemo alone had better outcomes in patients with resectable mesothelioma - EVOKE-02 - Sacituzumab approved bladder and breast cancer, was tested here along with Pembrolizumab in 1st line mNSCLC setting, with more data to come to confirm its arrival in this space #WCLC #IASLC #LungCancer #2023 #cancer #oncology #oncbrothers Website: http://www.oncbrothers.com/ Twitter: https://twitter.com/oncbrothers Contact us at info@oncbrothers.com

When Neal Augenstein started coughing, he thought it would soon go away, like any cough; but one test led to another, and Neal, who had never smoked a cigarette, soon learned he had Stage Four lung cancer.  Instead of chemo or radiation, he was put on a targeted therapy regimen.  Thanks to that, and a subsequent surgical procedure, he has survived advanced lung cancer.

Although findings have suggested that adjuvant osimertinib is beneficial in early-stage non-smallcell lung cancer (NSCLC), some concerns have persisted. Balazs Halmos, MD, MS, associate director of clinical science, and director of both thoracic oncology and clinical cancer genomics at Montefiore Einstein Cancer Center in New York, says that “all these doubts have been shifted away,” given recent data presented at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting. Dr. Halmos speaks with Bob Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer in Los Angeles, about data from the ADAURA trial and other studies. Dr. Halmos says that the new evidence is “not just practice-affirming” butcan be considered “practice-expanding,” resulting in complicated questions that necessitate morethorough collaborations among oncologists, surgeons, pathologists, and radiologists.

How does lung cancer immunotherapy osimertinib affect 5-year survival? Find out about this and more in today's PV Roundup podcast.

Dr. Nathan Goodyear was recently featured on Fox News, and on this podcast, he will comment and take a deeper dive on the findings of these new cancer pills that were featured in the article.   Personalized medicine is the future available today. With the integration of multiomics in the personalized treatment protocol not only of cancer patients but any chronic disease, the individual as a whole is being considered and the root cause is addressed through personalized and individualized care.   Targeted therapies, such as Osimertinib and Ribociclib, mark a significant advancement in cancer treatment. Osimertinib destructively targets abnormal proteins found in some cancers, while Ribociclib counteracts abnormal growth hormones in breast cancer, being used earlier in the treatment process to enhance survival rates. Employing these therapies proactively before recurrences can directly improve patient survival outcomes, revolutionizing cancer treatment.     ************* To learn more about Dr. Goodyear, visit his website at drgoodyear.com.  For more interesting videos on a variety of topics, TikTok videos are updated daily at www.tiktok.com/@briomedical and long-form videos can be found on our YouTube Channel www.youtube.com/@BrioMedical. Patients interested in pursuing their cancer healing journey can visit Dr. Goodyear at Brio Medical in Scottsdale, Arizona by visiting brio-medical.com.  

Through its participation in several stage III and IV lung cancer clinical trials, RUSH is a leader in identifying future treatments for patients with early and late-stage non-small cell lung cancer. By studying genetic mutations and analyzing genetic sequencing, RUSH is also developing new hypotheses about lung cancer progression through its partnership with Tempus. Mary Jo Fidler, MD, is a thoracic oncologist and professor of Internal Medicine at RUSH University Medical Center. She is the Medical Oncology Section Chief in the RUSH Cancer Center and is the national principal investigator for the ADAURA trial, which is studying the effects of postoperative Osimertinib in resected EGFR+ lung cancer patients. “We have at our fingertips an enormous amount of data [on non-small cell lung cancer]. When we generate hypotheses for tumor resistance and cancer cachexia, it is really helpful to have this large data set as we try to make sense out of the multitude of gene rearrangements, amplifications and RNA sequencing changes.”   CME Link: https://cmetracker.net/RUSH/Publisher?page=pubOpenSub#/event/489638/

In this episode of Lung Cancer Considered, host Dr. Stephen Liu leads a new Virtual Tumor Board on EGFR mutant NSCLC and acquired resistance. Dr. Liu is joined by two thoracic medical oncologists who are both global experts in targeted therapy.

In this podcast, Thomas John from the Department of Medical Oncology at the Peter MacCallum Cancer Centre in Melbourne, Margarita Majem from the Department of Medical Oncology at the Hospital de la Santa Creu i Sant Pau in Barcelona, Diane Legg, founder of LUNGSTRONG, and Jonathan Goldman from the David Geffen School of Medicine at the University of California in Los Angeles discuss health-related quality of life in resectable EGFR-mutant non-small cell lung cancer. This podcast is published open access in Targeted Oncology and is fully citeable. You can access the original published podcast article through the Targeted Oncology website and by using this link: https://link.springer.com/article/10.1007/s11523-022-00927-5. All conflicts of interest can be found online.   Open Access This podcast is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The material in this podcast is included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

Lung cancer is one of the most commonly diagnosed type of cancer and so it is fitting that we start the first of our disease-specific oncology series with this diagnosis. This week, we continue our discussion on metastatic non-small cell lung cancer, focusing on NSCLC with driver mutations. * The approach to treatment of a patient with widespread metastatic NSCLC (mNSCLC) is very different than a patient without distant disease, which highlights why we do what we do:- Important to complete staging (discussed in prior episodes) to determine the extent of disease- Important to check molecular testing (looking for mutations in the cancer cells) and IHC for tumor proportion score (TPS) helps determine treatment options - If your molecular testing is identified in a driver mutation gene, there are targeted options for this! *Driver mutations are predictive of response to an oral therapy and a LACK of response to immune therapy (particularly in EGFR and ALK mutated patients) * EGFR Mutation:- Pay attention to the types of mutation in EGFR (not all are the same):-- Exon 19 deletion -- Exon 19 L858R-- Exon 21 T790M-- Exon 20 Insertion (Osimertinib [see below] cannot be used for this mutation)- Osimertinib is first-line standard of care for patients with EGFR-- Used to be a second-line agent. Many patients with EGFR mutations receiving earlier generation TKIs would develop resistance and when these tumors were sequenced, they would have Exon 21 T790M mutations. Osimertinib was effective even with this mutation and had superior overall survival data compared to chemotherapy (AURA3 Trial)--Now it is used in first-line setting for patients with EGFR mutation based on the FLAURA trial --- In this study, patients received osimertinib as first line vs. older generation EGFR-targeting TKIs (erlotinib or gefitib) and Osimertinib had better outcomes: ---- Showed that the median OS was 38.6 months with Osi vs. 31.8 months; also improved brain penetration! ---- Also effective in patients with metastatic disease to the brain: ----- Only 6% of patients had CNS progression with Osi vs. 15% with others- What if a patient is on Osi and later develops new brain mets?-- If there is progression within just the brain (and good control in other sites of the body) you can refer patient to Radiation Oncology for SRS-- Remember, based on discussion with Dr. Osmundson in our RadOnc lectures (Episode 028), it is important to HOLD Osimertinib if patient is going to get radiation to minimize the side effects- What is patient had progression of disease in several sites throughout the body?-- Management is less straightforward. -- In many of these cases, you can consider:--- Consolidative radiation - If small amounts of disease--- Changing therapy - If there has been widespread progression; likely would change to chemotherapy (without IO, since lower predictive response to IO with EGFR mutation)---- No clear guidelines if you should continue the TKI---- Remember that IO + TKIs can cause increased risk of side effects, such as pneumonitis and hepatitis. DO NOT DO THIS!* ALK Mutation:- There are many options for ALK mutations-- The first generation drug is crizotinib--- Lots of side effects —> “It is crazy to start with crizotinib”--- Studies for later generation TKIs were compared to crizotinib -- Many people today will use third generation ALK-inhibitor alectinib (Important trials: ALEX Trial and J-ALEX Trial)--- With alectinib, PFS 34.8 months, RR 83%, less CNS progression (12% vs 45%)--- 5 year OS rate 62.5%- What to do with disease progression while on ALK inhibitor?-- In ALK, you can actually switch to another ALK inhibitor and many will respond well--- Of course, with each change, you may expect not as great of a response * Lots of other mutations!- TFOC recommends just looking these up!-- Link to NCCN Guidelines on NSCLC; Page 41 has full list!- Another way to think about this, when do we NOT do TKIs as first line: -- KRAS G12C-- EGFR Exon 20 Insertion-- HER2- How do you counsel a patient when considering/starting a TKI? -- Patients with highest chance of having a targeted mutation are younger non-smokers with adenocarcinoma-- Set expectations: great outcomes overall, but still not a cure. -- Remembering the drugs: All TKIs usually end in “-nib” -- In general, the way we recommend remembering this: “Fatigue, GI, Derm (skin/nail changes)”; rarely pneumonitis References:* AURA3 Trial - https://www.nejm.org/doi/full/10.1056/NEJMoa1612674Established osimertinib was better than chemo for patients with EGFR mutation and acquired Exon 21 T790M resistance mutation* FLAURA Trial - https://www.nejm.org/doi/full/10.1056/nejmoa1713137 Established osimertinib as first-line agent for patients with EGFR mutation * ALEX Trial - https://www.nejm.org/doi/full/10.1056/nejmoa1704795Helped establish alectinib as superior for ALK mutations compared to crizotinib * J-ALEX Trial - https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30565-2/fulltextHelped establish alectinib as superior for ALK mutations compared to crizotinib * NCCN Guidelines on NSCLC - https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1450 Please visit our website (TheFellowOnCall.com) for more information Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Google PodcastLove what you hear? Tell a friend and leave a review on our podcast streaming platforms!

In this episode, the experts discuss the latest insights on osimertinib resistance in EGFR-mutated NSCLC and promising new data on targeting MET amplification, one of the most common acquired resistance mechanisms to first-line osimertinib.

Dr. Chul Kim takes a look at the FLAURA Trial on untreated advanced NSCLC, and the role Osimertinib played in the trial.

In this episode, Ryan D. Gentzler, MD, MS, and Jonathan Riess, MD, MS, answer audience questions on managing EGFR-mutated non-small-cell lung cancer (NSCLC) from a live meeting series. The episode includes expert insights on:• Identifying patients who may benefit the most from adjuvant osimertinib  • Testing for EGFR mutations in early-stage NSCLC• Critical importance of getting molecular test results before starting immunotherapy• Monitoring cardiac toxicity in patients receiving osimertinib• Key ongoing trials in EGFR-mutated NSCLC for patients with newly diagnosed disease and following progression on osimertinibPresenters:Ryan D. Gentzler, MD, MSAssociate ProfessorDivision of Hematology/OncologyDepartment of MedicineUniversity of VirginiaThoracic Medical OncologistUniversity of Virginia Comprehensive Cancer CenterCharlottesville, VirginiaJonathan Riess, MD, MSAssociate ProfessorDepartment of Internal Medicine/Hematology-OncologyUniversity of California, DavisMedical Director, Thoracic OncologyUniversity of California, Davis Comprehensive Cancer CenterSacramento, CaliforniaLink to full program: https://bit.ly/3DZGzSO  

In this episode, experts explore new data related to EGFR TKI resistance, specifically resistance to osimertinib. Listen to our experts evaluating the real-world data on most common resistance mechanisms to osimertinib and emerging strategies to overcome resistance. 

Doctors Jared Weiss, Ibiayi Dagogo-Jack, and Jeffrey Thompson discuss their opinions on costs and treatment options, such as double dose Osimertinib

In this podcast episode, Conor Ernst Steuer, MD, a medical oncologist; Frank Schneider, MD, a pathologist; and Elise Hitron, MSN, FNP-C, a phase I clinical trials nurse practitioner, engage in a multidisciplinary discussion of the latest management strategies for EGFR-mutated NSCLC. Topics include:Testing for targetable biomarkersTalking with patients about biomarker testingFrontline therapy for EGFR-positive NSCLCResistance to front-line osimertinibTreatment of EGFR TKI–resistant disease, including the emerging antibody–drug conjugate patritumab deruxtecanHER3 protein testingPathology considerationsNursing considerationsInterdisciplinary communicationPresenters:Conor Ernst Steuer, MDAssistant ProfessorDepartment of Medical OncologyWinship Cancer InstituteEmory UniversityAtlanta, GeorgiaFrank Schneider, MDAssociate Professor of PathologyDepartment of Pathology and Laboratory MedicineDirector, Cancer Tissue and Pathology Shared ResourceWinship Cancer InstituteEmory UniversityAtlanta, GeorgiaElise Hitron, MSN, FNP-CAdjunct InstructorSchool of NursingPhase I Clinical Trials Nurse PractitionerWinship Cancer InstituteEmory UniversityAtlanta, GeorgiaSupported by an educational grant from Daiichi Sankyo, Inc.Link to full program, including a series of short interactive virtual presentations with downloadable slidesets on EGFR-mutated advanced NSCLC, including the evolving role of HER3 in the setting of EGFR TKI resistance:https://bit.ly/3G32Jkm

November is Lung Cancer Awareness Month, and what better way is there to spend your time than getting to know the recent advances in adjuvant therapy for early-stage lung adenocarcinoma?  Learning Objectives -        Review work-up and treatment of lung adenocarcinoma -        Review evidence behind Osimertinib as an adjuvant therapy in EGFR mutation positive disease -        Review recent advances in gene expression profiles for targeted application of adjuvant chemotherapy -        Discuss future directions for research -        Discuss additional advancements in diagnosis, monitoring, and immunotherapy Referenced Material -        Wu Y, Tsuboi M, He J, et al. Osimertinib in resected EGFR-mutated non-small-cell lung cancer. N Engl J Med 2020; 383:1711-1723. DOI: 10.1056/NEJMoa2027071  https://www.nejm.org/doi/full/10.1056/NEJMoa2027071 -        Woodard GA, Wang SX, Kratz JR, et al. Adjuvant Chemotherapy Guided by Molecular Profiling and Improved Outcomes in Early Stage, Non-Small-Cell Lung Cancer. Clin Lung Cancer 2018;19(1):58-64. DOI: 10.1016/j.cllc.2017.05.015 https://www.clinical-lung-cancer.com/article/S1525-7304(17)30150-X/fulltext -        Woodard GA, Kratz JR, Haro G, et al. Molecular Risk Stratification is Independent of EGFR Mutation Status in Identifying Early-Stage Non-Squamous Non-Small Cell Lung Cancer Patients at Risk for Recurrence and Likely to Benefit From Adjuvant Chemotherapy. Clin Lung Cancer. 2021;20:S1525-7304(21)00212-6. DOI: 10.1016/j.cllc.2021.08.008 https://www.clinical-lung-cancer.com/article/S1525-7304(21)00212-6/fulltext Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

It's been a while! I think we will call this the second season as it seems fitting as I head into another season of battling cancer. Devastated and angry are just two of the words that come to mind. But also with that come to surrender and faith. Thank you for being on the journey with me so far. Tag along as I fight cancer again. If you enjoyed this episode, make sure and give us a five star rating  and leave us a review on iTunes, Podcast Addict, Podchaser and Castbox. Sign up for the next DAC Bootcamp Follow me on Social Media:Amy on IGAmy on Facebook Resources:AmyLedin.comLean Bodies Consulting (LBC)LBC University 

In this episode, Nathan Pennell, MD, PhD; Jamie E. Chaft, MD; and Stephen V. Liu, MD, answer questions asked by an audience of healthcare professionals during a live CCO webinar on biomarker-driven therapies for NSCLC. Topics include:Choosing between immune checkpoint inhibitor monotherapy and combination therapy with an immune checkpoint inhibitor plus chemotherapy for newly diagnosed NSCLCIncorporating newly approved immunotherapies into practiceEvolving guidelines and recommendations for biomarker testing  RNA- vs DNA-based next-generation sequencingInterpretation of NGS resultsUse of frontline TKI therapy for patients with CNS metastasesFuture role of KRAS inhibitors in the treatment of advanced NSCLCImproving rates of biomarker testing in lung cancerPresenters:Nathan Pennell, MD, PhDProfessorDirector, Cleveland Clinic Lung Cancer Medical Oncology ProgramDepartment of Hematology and Medical OncologyCleveland Clinic Taussig Cancer InstituteCleveland, OhioJamie E. Chaft, MDAssociate Attending PhysicianThoracic Oncology ServiceMemorial Sloan Kettering Cancer CenterNew York, New YorkStephen V. Liu, MDAssociate Professor of MedicineDepartment of Medical OncologyLombardi Comprehensive Cancer CenterGeorgetown UniversityWashington, DCSupported by educational grants from Amgen; Lilly; Regeneron Pharmaceuticals, Inc.; and Sanofi Genzyme. For further information concerning Lilly grant funding, visit www.lillygrantoffice.com.Link to full program, including an downloadable slidesets and an on-demand webcast:https://bit.ly/3npjyyb 

Featuring an interview with Dr Roy S Herbst, including the following topics: Localized Non-Small Cell Lung Cancer (NSCLC) with an EGFR Mutation (0:00) Phase III ADAURA Trial — Study Design and Characteristics of Enrolled Patients (3:32) Efficacy Data from the Phase III ADAURA Study Evaluating Adjuvant Osimertinib in Resected NSCLC with an EGFR Mutation (8:07) Tolerability and Toxicity of Osimertinib in the ADAURA Trial; Impact of Adjuvant Chemotherapy on Disease-Free Survival Outcomes (15:17) FDA Approval of Osimertinib as Adjuvant Therapy in Early-Stage NSCLC with an EGFR Mutation; Future Direction of Clinical Research (23:13) CME information and select publications

In this episode, Enriqueta Felip, MD, PhD, and Matthew Gubens, MD, MS, discuss evolving practice standards for EGFR-mutated non-small-cell lung cancer with topics including:Biomarker testing and strategiesOptimal first-line therapy in patients with NSCLCManagement of patients with CNS diseaseSelecting therapy for patients with noncanonical mutationsManagement strategies after progression on first-line EGFR TKI therapySelecting therapy for patients with early stage diseasePresenters: Enriqueta Felip, MD, PhDHead, Thoracic Oncology UnitOncology ServiceVall d'Hebron University HospitalBarcelona, SpainMatthew Gubens, MD, MSAssociate ProfessorThoracic OncologyUniversity of California, San FranciscoSan Francisco, CaliforniaContent based on an online CME program supported by an educational grant from AstraZeneca.Link to full program, including associated downloadable slidesets:https://bit.ly/2PpFFHM

In this episode, Jamie E. Chaft, MD, provides her expert perspective on new data from WCLC 2020 in early-stage NSCLC, with topics including:Updated results from ADAURA on HRQoL and DFS outcomes with or without postoperative chemotherapy after adjuvant osimertinibAn analysis of the ongoing ITACA study of personalizing chemotherapy based on biomarkers of drug resistanceFDG PET/CT adaptive radiotherapy in RTOG 1106The TALENT study in Taiwan screening nonsmokers for lung cancerPresenter:Jamie E. Chaft, MDAssociate Attending PhysicianThoracic Oncology ServiceMemorial Sloan Kettering Cancer CenterNew York, New YorkContent supported by educational grants from Amgen; Bristol-Myers Squibb; Ipsen Biopharmaceuticals; Janssen Pharmaceutica NV; Jazz Pharmaceuticals; Regeneron Pharmaceuticals, Inc. & Sanofi Genzyme; and Takeda Oncology.Link to full program, including a downloadable highlights slideset, and ClinicalThought commentaries:http://bit.ly/2NzE6X6

In this episode, Helena A. Yu, MD, and Maria E. Arcila, MD, provide medical oncology and pathology perspectives, respectively, on new data from ESMO 2020 informing precision medicine in NSCLC, with topics including:Updated efficacy data from the phase III ADAURA study of adjuvant osimertinib for resected EGFR-mutated NSCLC with a focus on CNS disease recurrenceBiomarker testing in early-stage lung cancer New data for sotorasib, a small molecule inhibitor of KRAS G12C, in heavily pretreated NSCLCInterim results from the phase I portion of the CHRYSALIS trial evaluating amivantamab, a bispecific antibody that targets EGFR and MET, in combination with lazertinib, a third-generation EGFR TKI, for the treatment of EGFR-mutated NSCLCPhase I data on the HER3-directed antibody–drug conjugate patritumab deruxtecan for NSCLC with progression on an EGFR TKIPresenters:Helena A. Yu, MDAssistant AttendingDepartment of MedicineMemorial Sloan Kettering Cancer CenterNew York, New YorkMaria E. Arcila, MDPathologistDirector, Diagnostic Molecular Pathology LaboratoryMemorial Sloan Kettering Cancer CenterNew York, New YorkContent supported by an educational grant from Lilly.Link to full program, including an associated Podcast Pearls PDF, downloadable slidesets, and on-demand Webcasts:http://bit.ly/3a3e1Xs

Anchor lead: There’s good news for people with one type of lung cancer, Elizabeth Tracey reports If you have non-small cell lung cancer with a receptor called EGFR, you are likely to respond to an agent called osimertinib, a new study finds. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, is excited. […]

Co-hosts Charu Aggarwal and Jack West are joined by guest expert Sanjay Popat to discuss how practice should change & open questions on molecular testing & adjuvant EGFR inhibitor osimertinib for resected early stage EGFR mutation-positive NSCLC.

This Beat episode, featuring Joel Dunning, cardiothoracic surgeon at the James Cook University Hospital in Middlesbrough, UK, as the host, discusses:if the tide is turning on EXCEL and the European guidelinesa meta-analysis of percutaneous interventions with coronary bypass surgerya document on the triage and management of aortic emergencies during the COVID-19 pandemicosimertinib in positive resected cancer

Dr. Jared Weiss, Vice President of the GRACE Board of Directors and GRACE faculty, discusses the ADAURA trial; the first global trial for an EGFR inhibitor to show statistically significant and clinically meaningful benefit in adjuvant treatment of lung cancer.

Dr. Raja Mudad is a medical oncologist specializing in lung cancer at Florida Precision Oncology. In today's ASCO eLearning Podcast, Dr. Mudad will discuss two patient cases related to the treatment of advanced non-small cell lung cancer harboring an EGFR mutation. While the two cases are similar, the recommended treatments can be different. We hope you enjoy this episode. To hear the latest eLearning Podcast episodes as soon as they are available, please subscribe on Apple Podcasts [https://podcasts.apple.com/us/podcast/asco-elearning-weekly-podcasts/id1375021523] or Google Play [https://play.google.com/music/listen?u=0#/ps/Igjyhvqqrvuc5mjvlljhzkpvgeu]. We truly value your feedback, so please leave a review. To access our entire library of podcasts and other amazing eLearning content, visit elearning.asco.org [https://elearning.asco.org/homepage]. The purpose of this podcast is to educate and inform. This is not a substitute for medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Hello. My name is Raja Mudad. I'm a medical oncologist specializing in lung cancer. I work at Florida Precision Oncology, a practice dedicated to an academic approach in the treatment of cancer. Today, we compare two patient cases that relate to the treatment of advanced stage non-small cell lung cancer harboring an EGFR mutation. These two cases have similarities, yet the recommended treatments may be different. Let us look at the cases. Patient case 1, our first patient case is Roberto. He is a 34-year-old man with stage 4 non-small cell lung cancer harboring an EGFR deletion 19 mutation. The patient, a never smoker, presented with chest pain and was diagnosed with a pulmonary embolus. CT scan of the chest also demonstrated bilateral lung nodules. Biopsy revealed adenocarcinoma. Staging workup revealed multiple small brain metastases. Patient case 2, our second patient case is Heidi. She is a 60-year-old woman with stage four non-small cell lung cancer with an exon 21 mutation in EGFR gene. She presented with a cough. A CT scan of the chest showed a left lung mass. An endobronchial ultrasound guided biopsy revealed no evidence of mediastinal disease. And a biopsy was positive only in the mass showing adenocarcinoma. She was taken to surgery but found to have multiple pericardial nodules. No distant metastases were seen on the PET scan. The two cases are clinically similar. Would any of the differences lead you to select a different treatment for each patient? Let's take a look. The two patients have the exact disease, a similar stage, and mutations in the same EGFR gene. Their initial treatment is the same. The initial treatment in both cases, osimertinib, is considered the standard of care in the United States, with a median progression-free survival of 19 months. Roberto started on treatment with osimertinib, and the follow-up PET scan and brain MRI showed complete resolution of all of the abnormalities. In the second case, surgery was aborted, and the patient started on osimertinib. About 1.5 years after Roberto started on osimertinib, progressive disease developed with a new adrenal mass, a new bone metastasis, and progression in the brain. He received stereotactic radiosurgery to the brain. A repeat biopsy of the adrenal mass revealed the same histology but with a MET amplification detected on next-generation sequencing. About eight months after starting osimertinib, Heidi developed progressive disease, and a repeat biopsy confirmed the same histology and the original EGFR mutation but no additional abnormalities. As you can see, the two cases are similar at presentation. However, upon progression, both cases have peculiarities that make them different. Which differences in the two cases do you think may inform treatment choices? Would the differences lead your choice of treatment in a different direction, or would both patients receive the same treatment? If treatment is different, what is the difference that changes your choice of treatment? The standard of care for non-small cell lung cancer with an EGFR mutation upon progression on first-line tyrosine kinase inhibitor is generally chemotherapy, possibly combined with immunotherapy. In non-small cell lung cancer with an EGFR mutation, there are multiple suggested mechanisms of resistance to osimertinib. These involve new mutations in the EGFR gene, alterations in parallel or downstream oncogenes, such as MET, KRAS, and PIK3CA, or histological transformation to small-cell carcinoma. MET amplification is a very common abnormality seen in those patients. Upon progression, patients have several options, and their treatment should be directed based on the results of the repeat molecular evaluation. That is why it is important to repeat a biopsy on patients with disease progression. Nowadays, liquid biopsy is also helpful in detecting these abnormalities without the need for an actual biopsy. Roberto can benefit from a MET-directed therapy using a tyrosine kinase inhibitor. He did receive stereotactic radiosurgery to the brain due to the presence of mild symptoms. He is clinically doing well, so the need to initiate immediate systemic cytotoxic chemotherapy is not urgent. In this patient, I would offer him an oral MET inhibitor and repeat his imaging in three months. On the other hand, the second patient, Heidi, did not have an actionable mutation upon re-biopsy. The patient is best served by a clinical trial. However, if a trial is not available, or if she is not eligible, then systemic chemotherapy and immunotherapy would be the standard of care. In my practice, and based on the results of the IMpower 150 trial, the use of the combination of carboplatin, paclitaxel, atezolizumab, and bevacizumab is preferred. The subset analysis of the EGFR-positive patients in this trial favored the use of the quadruplet combination. Thank you for listening to this episode of the ASCO eLearning Podcast. For more information on the treatment of non-small cell lung cancer, including additional patient cases and opportunities for self-evaluation, please visit the comprehensive eLearning center at elearning.asco.org. Thank you for listening to this week's episode of the ASCO eLearning weekly podcast. To make this part of your weekly routine, click Subscribe. Let us know what you think by leaving a review. For more information, visit the comprehensive eLearning center at elearning.asco.org.

Roy Herbst, MD and Robert Figlin, MD discuss the implications of the recent ASCO20 presentation of the ADAURA study investigating the use of Tagrisso (osimertinib) in Stage I-III EGFR+ NSCLC patients

Roy Herbst, MD, and Robert Figlin, MD, discuss the implications of the ADAURA study investigating the use of Tagrisso (osimertinib) in stage I-III EGFR+ NSCLC patients

ASCO: You’re listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the world’s leading professional organization for doctors who care for people with cancer. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Cancer research discussed in this podcast is ongoing, so the data described here may change as research progresses. Every year, the ASCO Annual Meeting brings together attendees from around the globe to learn about the latest research in the treatment and care of people with cancer. This year, a record 42,750 attendees from 138 countries worldwide gathered virtually for the ASCO20 Virtual Scientific Program, held Friday, May 29 through Sunday, May 31. In the annual Research Round Up podcast series, Cancer.Net Associate Editors answer the question, “What was the most exciting or practice-changing research in your field presented at the ASCO20 Virtual Scientific Program?” In this first episode, 3 editors discuss new research in the fields of leukemia, colorectal cancer, and lung cancer. First, Dr. Jessica Altman will discuss 2 studies in myelodysplastic syndromes and acute myeloid leukemia. Dr. Altman is Associate Professor of Medicine in the Hematology Oncology Division at the Feinberg School of Medicine, Northwestern Medicine. She is also the Cancer.Net Associate Editor for Leukemia. View Dr. Altman’s disclosures at Cancer.Net. Dr. Altman: Hi, everyone. My name is Jessica Altman. I am a leukemia physician at Northwestern Memorial Hospital in Chicago, and I am pleased to talk today about some interesting studies that were presented at ASCO 2020 and really use that as a marker of the excitement that is ongoing in the field of myeloid malignancies. In both myelodysplastic syndrome and acute myeloid leukemia, there have been a lot of novel therapies that have been recently approved, and other agents that are currently ongoing in a clinical trial. I think it's important for me to mention that the studies that I will be discussing today, I do not have any direct conflicts of interest, but I am involved with the development of other novel therapies. I'll be talking about two studies today. The first one is a clinical trial, and the second one is a palliative care study that was conducted. The first study that I would like to discuss is the study presented in an oral session at this year's ASCO presented by Dr. David Sallman on behalf of his group at Moffitt and a large clinical trial network of other investigators. They studied the combination of a novel agent called magrolimab, which I'll mention more in a moment, in combination with a standard lower-intensity chemotherapy called azacitidine. This is studied for the treatment of high-risk myelodysplastic syndrome and acute myeloid leukemia. Magrolimab is an antibody that blocks something called PD47, which is a macrophage immune checkpoint and essentially a signaling cancer that says, "Don't eat me." And this antibody allows the engulfment or destruction of tumor cells and also is able to eliminate the really deep stem cells that cause the development or maintain the leukemia and MDS. So in this study, the investigators conducted a trial of azacitidine in combination with magrolimab, and they treated a handful of patients with both myelodysplastic syndrome and acute myeloid leukemia. And what they found was that the combination therapy was both well tolerated and resulted in a better-than-anticipated response rate. So better than what we would anticipate with a low-intensity chemotherapy alone. In particular, they found a nice response rate in individuals whose leukemia or MDS expresses a specific mutation. That mutation is called TP53, and that mutation has been associated with a poor chance of response to the available therapies and particularly a short duration of response. This trial is particularly exciting to me because it demonstrates the ability to combine novel therapies with lower-intensity treatments and allows what we hope for will be a higher chance of response. This is with a relatively limited study, and further trials in this space involving this agent and combination are planned and are ongoing. There are other agents that are also targeting the TP53 mutation, and those are things to watch out for as well. I'd like to move on to a supportive care study that was presented as well. This was a study that was presented by Dr. El-Jawahri, and funded by the Leukemia and Lymphoma Society. This is a study that looked at patients with acute myeloid leukemia receiving intensive chemotherapy. The relevance and importance for the study is because supportive care trials, and particularly looking at palliative care in general in acute myeloid leukemia have not frequently been done to date. And the background for this study is that individuals with acute myeloid leukemia frequently can experience decline in their quality of life and mood during their hospitalization for induction therapy. And it is not uncommon for adults with acute myeloid leukemia to receive aggressive care at the end of life. So this group sought to examine the effect of an integrative palliative and oncology care and affect quality of life, mood and symptoms associated with things like post-traumatic stress and with a huge emphasis on end-of-life outcomes. And what this group found was that the integrative palliative and oncology care model for patients with acute myeloid leukemia receiving intensive chemotherapy led to improvements in patients' quality of life, their psychological distress and the care at the end of life. And the investigators asked for consideration of palliative care as a standard of care for all adults with acute myeloid leukemia, from really thinking about the incorporation of palliative care model, from diagnosis and throughout treatment and not just reserving that to the end of life. Thank you for your time. I was very excited with the numerous clinical trials in the myeloid neoplasm space presented at this year's ASCO. And the work that was presented is really a marker of how much excitement there is that's ongoing in this field. Thank you. ASCO: Thank you, Dr. Altman. Next, Dr. Jeffrey Meyerhardt will discuss 4 studies in colorectal cancer. Dr. Meyerhardt is the Douglas Gray Woodruff Chair in Colorectal Cancer Research, Clinical Director and Senior Physician at the Gastrointestinal Cancer Center at the Dana-Farber Cancer Institute, Deputy Clinical Research Officer at the Dana-Farber Cancer Institute, and Professor of Medicine at Harvard Medical School. He is also the Cancer.Net Associate Editor for Gastrointestinal Cancers. View Dr. Meyerhardt’s disclosures at Cancer.Net. Dr. Meyerhardt: Hi my name's Jeff Meyerhardt from the Dana Farber Cancer Institute in Boston, Massachusetts. I'm going to speak about some of the key abstracts that were presented at this year's virtual ASCO meeting in 2020. I have no pertinent disclosures related to the abstracts I'm going to discuss. So the first and probably the most prominent and abstract, which was presented in the plenary session, was a study called KEYNOTE-177. It was a study specifically for patients with a certain subtype of metastatic colorectal cancer, what's called microsatellite unstable tumors. It's a way that colorectal cancers first emerged when they developed from normal cells to abnormal cells. It only constitutes about 3 to 5 percent of metastatic colorectal cancers. But we know a lot about those cancers because some of them are related to inherited conditions and some are not related to conditions, but they land up at those other cancers that seem to be much more susceptible to immunotherapy. And in fact, they're the ones that immunotherapy indicated for in terms of colorectal cancer. And so the study that was presented was comparing patients receiving what's called a checkpoint inhibitor and a type of immunotherapy, in this case, pembrolizumab, to standard chemotherapy. So chemotherapy that we would typically give as initial treatment for metastatic colorectal cancer. Currently, the indication with the FDA is that patients would receive immunotherapy later as a later line of therapy, if other things weren't working and this was really to say, should we be giving it much earlier on? So as a randomized trial, it was about 300 patients and they compared starting just with an immunotherapy, pembrolizumab versus chemotherapy and either a drug called bevacizumab or a type of a another inhibitor called an EGFR inhibitor, cetuximab.  And it lands up starting with the pembrolizumab had a real significant improvement in progression free survival. It was a comparison of actually 8.2 months with standard treatments, which is what we see in a lot of trials versus 16.5 months. That's essentially for the times we had to switch to different therapy and all these other endpoints were also met in terms of a 12-month and two years of progression free survival. It was a statistically significant event, and it really will change practice for that subpopulation of patients with metastatic colorectal cancer. What's still really important is to try to figure out for the rest of the patients how immunotherapy can benefit them. And that unfortunately, we don't have as much data yet. Another abstract presented this year at ASCO was a sort of update of what's called the BEACON trial, and this is, again, another subgroup of colorectal cancers, colorectal cancers that have a particular mutation in them, what's called a BRAF mutation. We know that occurs in somewhere between 5 and 10 percent of colorectal cancers. They can sometimes be a more aggressive cancer and there were multiple drugs that have been tested in multiple combinations of those drugs over the past 10 years, but the largest effort was really looking at trying to give patients a standard treatment to combining a BRAF inhibitor, in this case, encorafenib, which is an oral pill, with an EGFR inhibitor called cetuximab and also potentially adding a third drug, binimetinib, which is called a MEK inhibitor, also an oral pill. And the study, the BEACON study, which was a large international randomized study compared those three arms. The main comparison was saying, should you have two drugs compared to control or three drugs compared to control, control being standard treatment. And looking at both of those compared to standard treatments. They weren't actually meant to compare the two to three drug and initially the results suggest that three drugs was optimal. But the study that was presented at ASCO and ultimately actually led to the actual FDA approval, is using a two drug combination. So encorafenib and cetuximab, which again was better than control and really becomes the standard for later line treatment of BRAF mutated colorectal cancer. We don't know if that should be the initial treatment. That study is now about to get started to say, "Should we start with BRAF directed therapy?" but we know that if you had progressed in other standard treatment, that is certainly an option that should be considered. There were two studies that looked at adjuvant therapy for colon cancer. Adjuvant is after someone has surgery and then they receive chemotherapy to reduce their risk of recurrence, one of them was a follow up to an effort to look at how many months of adjuvant therapy is necessary. This was called the IDEA collaboration. It was an international effort that included 14000 patients randomized to three months of treatment versus six months of treatment. And what we learned from that is for patients, particularly, who have a better risk tumor. So they all have stage III disease. Meaning they had surgery, the pathology showed some lymph nodes in the sample, but they didn't have evidence of metastatic disease at the time when they were diagnosed and those patients that they received three months of therapy if they only had one to three positive lymph nodes or not all the way through the bowel wall. Three months of therapy seemed to be just as good as six months, particularly when you do a combination of oral drug capecitabine with an IV medication called oxaliplatin and those with higher risk disease, those patients should probably receive six months, though in some cases, three months also seems to be sufficient. And this was a follow up to show that actually overall survival also was not inferior to do three months versus six months in those patients who have better risk disease or with capecitabine and oxaliplatin. The second adjuvant trial was one that I actually led. It was a large trial that was run through the National Cancer Institute. It was looking at standard chemotherapy in stage III colon cancer, same population I just discussed, and whether adding celecoxib, which is what's called a Cox-2 inhibitors. It's kind of like aspirin, a little bit more specific. And then there was a lot of data that those type of drugs could be helpful in patients to reduce polyps and may potentially be beneficial in patients who already had colorectal cancer. So we conducted a large clinical trial, comparing standard chemotherapy with the celecoxib or standard chemotherapy alone. And unfortunately, adding the celecoxib didn't actually add any statistically significant benefit. There was a slight improvement, but it wasn't statistically significant. So it is a negative study and unfortunately does not move the field in terms of improving outcomes for patients with stage 3 colon cancer. There are still some ongoing studies, specifically looking at aspirin that we await to see if that would make a difference in outcomes. So those are some of the highlighted studies focused on colon and colorectal cancer from ASCO this year. Thank you very much. And again, my name's Jeff Meyerhardt from the Dana Farber Cancer Institute. ASCO: Thank you, Dr. Meyerhardt. Next, Dr. Jyoti Patel discusses 3 studies in non-small cell lung cancer. Dr. Patel is the Medical Director of Thoracic Oncology and Assistant Director for Clinical Research at the Lurie Cancer Center of Northwestern University. She also serves as Associate Vice Chair for Clinical Research in the Department of Medicine. She is also the Cancer.Net Associate Editor for Lung Cancer. View Dr. Patel’s disclosures at Cancer.Net. Dr. Patel: Hi. My name's Jyoti Patel. I'm a professor of medicine at Northwestern University and associate editor of Cancer.Net for lung cancer, and I'm going to talk about some of the most exciting lung cancer abstracts that were presented at the 2020 ASCO Annual Meeting. One of the most important and, I think, impactful to patients and practice-changing studies was actually selected as a plenary session abstract, and plenary abstracts are those that are rated the highest of all of the thousands of abstracts that are submitted, so whenever there's one in our particular disease site, we're always really excited, and we've been waiting for this ever since we heard from a press release that a positive study on lung cancer was going to be presented. The study was called the ADAURA study. And the ADAURA study was sponsored by AstraZeneca, and I have worked as a consultant for AstraZeneca in the past.  So the study was looking at a drug called osimertinib, in patients who had early-stage lung cancer which was surgically resected. So as we know, a minority of patients, unfortunately, have stage I and stage II lung cancer, and about 30% of patients have stage III lung cancer. For many of these patients, surgery is the primary modality, and we do surgery with curative intent. However, despite doing surgery, there is a significant chance that the cancer can recur. So the study was looking at osimertinib as adjuvant therapy in patients with resected lung cancer. Osimertinib is an EGFR tyrosine kinase inhibitor. It's a targeted therapy that blocks the EGFR protein, which is often mutated in patients with lung cancer. So osimertinib is the treatment of choice for patients with advanced lung cancer that harbor an EGFR mutation. That mutation occurs in about 15% of American patients, and higher proportions of patients in some parts of the world. These patients, early on, had surgery, and then they were found to have an EGFR mutation, and then they were randomized to either three years of osimertinib as a daily tablet, versus a placebo, and the endpoint of this study was disease-free survival, so that's the length of time until there's evidence that the cancer has recurred. In this study, taking osimertinib significantly reduced the chance that the cancer would return within those three years, and the magnitude of benefit was highly significant. So with higher stages of disease, the likelihood that the cancer could come back is higher, and so the benefit was greatest in patients with stage 2 and stage 3 disease, and in fact, in patients with stage 3 disease, it decreased the recurrence rate by almost 85%. So really, really significant and impactful to our patients. Some people have questions about whether this should now be a standard of care, because we're not really showing whether we're improving the overall survival of patients. Many oncologists, myself included, think that survival with no evidence of disease is really meaningful for patients. It's going to be important, as the study matures, to see what the overall survival data look like, but in the three years of taking the drug, which is relatively well tolerated, the survival benefits, to me, translates to better quality of life, return to function and work, and staying away from catastrophic complications of cancer recurrence, like cancer coming back in the brain, or in the bone, and really impacting quality of life. And the next study I want to discuss is a study looking at immunotherapy and chemotherapy in patients with non-small cell lung cancer. So the study is called 9LA. It's a CheckMate trial, so BMS studied their drugs nivolumab and ipilimumab in combination with chemotherapy. My institution has received research funding from BMS for the study of nivolumab and ipilimumab, and I've served as a consultant in the past. In this study, patients who were treatment-naive, so hadn't received prior therapy, were randomized to either chemotherapy, which was an older standard, admittedly, versus a combination of a short course of chemotherapy, so only for six weeks, in combination with the immunotherapies nivolumab and ipilimumab. The rationale for giving chemotherapy with immunotherapy is multifold. So one is that chemotherapy kills cancer cells, and in doing so, it releases neoantigens, or proteins, that might make the immunotherapy more effective. It sort of targets these cells as foreign, and it kind of helps amp up the immune system. It also sort of decreases the cancer burden, and we know that immunotherapy tends to be more effective when there's fewer sort of volumes of cancer to treat. So this was a really interesting design, and impactful because the chemotherapy is given for such a short course, so the ongoing toxicities of chemotherapy over several months, it sort of goes away. So less fatigue, less lowering of blood counts. The study was looking at overall survival, and the study was positive, and this led to an FDA approval in May. The study showed that, in the initial time in which chemotherapy and immunotherapy were given, patients did quite well, and then they sort of plateaued, and at 12 months, almost two-thirds of patients were on the immunotherapy, compared to about half of patients which were on chemotherapy. And so that was significant. Although these results are comparable to other treatment options we have with ongoing chemotherapy and immunotherapy, are in patients with really high PDL numbers of immunotherapy alone, I think this trial is important for patients because it offers a different alternative. Having a short course of chemotherapy may make a lot of sense for patients. The cumulative toxicity from chemotherapy, it can't really be understated. Although our chemotherapies are better tolerated than ever before, the idea of just six weeks of chemotherapy and then going into immunotherapy, I think, is really an attractive one, and may give us options from multiple other treatments down the line. So I think this is important for patients. I think it certainly makes life a little bit more complicated for medical oncologists because now we have multiple options to discuss with patients, but at the end of the day, that's the best way we can personalize therapy for our patients, really taking into account overall disease status, as well as patient preferences, and tolerance of toxicities, and aims in the future. The last study that I want to highlight is a study called the DESTINY study. I don't have any disclosures for this study. This study was looking at a subgroup of patients with lung adenocarcinoma with HER2 mutations. So there have been a lot of targeted therapies that have gained our attention and FDA approvals in the past couple of years, and it's really exciting. We're understanding that development of targeted therapies is based on early assessment of mutations in our patients, and we have a host of mutations, now, with FDA approved drugs. Just in May, drugs targeting RET, or R-E-T fusions was approved. Another drug targeting MET exon 14 skipping mutation was approved. HER2 mutations represent a subset of patients, a small subset of patients, about 2% of lung cancer patients, and they've been really difficult to treat. We know about HER2 because it's often a target for breast cancer, but in lung cancer, it's often a small mutation that causes activation, that causes the cells to grow. We haven't had a lot of really great options for these patients, and although there are multiple drugs in development, this particular trial gained a fair bit of attention because it looks quite promising. So this study was looking at trastuzumab deruxtecan, and that's an antibody-drug conjugate. So the idea is it's an antibody that binds to HER2-- which is on cancer cells. When it binds to that target, the drug conjugate, or the payload, is released into the cancer cell. So there's less toxicity. It's a targeted therapy with very sort of directive toxin to the cancer cells. There are a number of antibody-drug conjugates in development, and some are FDA approved for other indications. In this study - it was a single-arm study - patients with HER2 mutations received the antibody-drug conjugate, and they saw a really significant response rate. Almost all patients had some disease diminution, some response, with about 60% of patients having what we call a partial response, a 30% reduction in tumor cells. What was also exciting was that some patients have been able to show that their responses are quite durable, and so the disease control has lasted. Certainly, this is an early trial. Only about 39 patients were treated. So we look forward to further studies of this compound, but finally, it's nice to have something that looks this promising in this particular patient population. ASCO: Thank you, Dr. Patel. Learn more about the research presented at the ASCO20 Virtual Scientific Program at www.cancer.net/blog, and subscribe to Cancer.Net podcasts on Apple Podcasts or Google Play for additional episodes in the Research Round Up series, released throughout the summer. This Cancer.Net podcast is part of the ASCO Podcast Network. This collection of 9 programs offers insight into the world of cancer care, covering a range of educational, inspirational, and scientific content. You can find all 9 shows, including this one, at podcast.asco.org. Cancer.Net is supported by Conquer Cancer, the ASCO Foundation, which funds breakthrough research for every type of cancer, helping patients everywhere. To help fund Cancer.Net and programs like it, donate at conquer.org/donate.

What were the practice-changing studies presented at the 2020 ASCO Annual Meeting? Podcast host David H. Henry, MD, and retired oncologist Alan P. Lyss, MD, reviewed 12 studies and assessed their potential impact on treatment.  Breast cancer Three-year follow-up of neoadjuvant chemotherapy with or without anthracyclines in the presence of dual HER2-blockade for HER2-positive breast cancer (TRAIN-2): A randomized phase III trial. (Abstract 501) The addition of anthracyclines did not improve event-free or overall survival. The results suggest patients can avoid the toxicities of anthracycline regimens without compromising efficacy, Dr. Henry said. KEYNOTE-355: Randomized, double-blind, phase III study of pembrolizumab + chemotherapy versus placebo + chemotherapy for previously untreated locally recurrent inoperable or metastatic triple-negative breast cancer. (Abstract 1000) Pembrolizumab improved responses, particularly in patients with higher PD-L1 expression. Dr. Lyss noted that pembrolizumab was combined with a “broad range” of chemotherapy regimens in this study.   A randomized phase III trial of systemic therapy plus early local therapy versus systemic therapy alone in women with de novo stage IV breast cancer: A trial of the ECOG-ACRIN Research Group (E2108). (Abstract LBA2) Early local therapy did not improve disease-free survival or overall survival. “We probably should not be recommending planned treatment for the intact primary tumor in most women who have stage IV breast cancer,” Dr. Lyss said. Bladder cancer Maintenance avelumab + best supportive care (BSC) versus BSC alone after platinum-based first-line (1L) chemotherapy in advanced urothelial carcinoma (UC): JAVELIN Bladder 100 phase III interim analysis. (Abstract LBA1) Avelumab maintenance prolonged overall survival, although 12% of patients discontinued the treatment due to toxicity. Because avelumab “meaningfully prolongs overall survival … using it upfront makes a lot of sense,” Dr. Lyss said. Colorectal cancer Pembrolizumab versus chemotherapy for microsatellite instability-high/mismatch repair deficient metastatic colorectal cancer: The phase 3 KEYNOTE-177 study. (Abstract LBA4) Pembrolizumab improved responses and progression-free survival. All patients with colorectal cancer should be tested for microsatellite instability-high status “because these results really do influence practice immediately,” Dr. Lyss said. He suggested that pembrolizumab should probably be used as first-line treatment for these patients even though overall survival results are not yet available.   Short-course radiotherapy followed by chemotherapy before TME in locally advanced rectal cancer: The randomized RAPIDO trial. (Abstract 4006) Short-course radiotherapy followed by consolidative chemotherapy and surgery significantly reduced the rate of treatment failure. Dr. Lyss called the pathologic complete response rate “impressive” and said it may contribute to a higher rate of rectal preservation.   A randomized phase II/III trial comparing hepatectomy followed by mFOLFOX6 with hepatectomy alone for liver metastasis from colorectal cancer: JCOG0603 study. (Abstract 4005) There was no improvement in overall survival with mFOLFOX6. “The take-home to me … is this is probably not a necessary strategy and certainly not standard of care,” Dr. Henry said.   Hodgkin lymphoma KEYNOTE-204: Randomized, open-label, phase III study of pembrolizumab (pembro) versus brentuximab vedotin (BV) in relapsed or refractory classic Hodgkin lymphoma (R/R cHL). (Abstract 8005) Pembrolizumab improved progression-free survival. Dr. Henry marveled that pembrolizumab bested brentuximab vedotin, which previously produced impressive results in patients with relapsed/refractory Hodgkin lymphoma. Lung cancer Nivolumab + ipilimumab versus platinum-doublet chemotherapy as first-line treatment for advanced non-small cell lung cancer: Three-year update from CheckMate 227 Part 1. (Abstract 9500) Nivolumab plus ipilimumab improved overall survival but increased toxicity and treatment discontinuation. The combination is “not for the faint hearted” but is appropriate for certain patients, Dr. Lyss said, noting there is “room for clinical judgement.”   Osimertinib as adjuvant therapy in patients (pts) with stage IB–IIIA EGFR mutation positive (EGFRm) NSCLC after complete tumor resection: ADAURA. (Abstract LBA5) Osimertinib improved disease-free survival compared with placebo. It isn’t clear how osimertinib will impact overall survival, but “we should be using this drug” once it’s approved, Dr. Lyss said.   Smoking cessation (SC) and lung cancer (LC) outcomes: A survival benefit for recent-quitters? A pooled analysis of 34,649 International Lung Cancer Consortium (ILCCO) patients. (Abstract 1512) Quitting smoking can improve overall survival in lung cancer patients, even if they quit as little as 2 years prior to diagnosis. “Somewhat counterintuitively, convincing patients to quit smoking at any point in their trajectory, even just prior to their diagnosis, seems to make a difference in survival,” Dr. Lyss said.   Ovarian cancer Final overall survival (OS) results from SOLO2/ENGOT-ov21: A phase III trial assessing maintenance olaparib in patients (pts) with platinum-sensitive, relapsed ovarian cancer and a BRCA mutation. (Abstract 6002) Olaparib maintenance improved overall survival and time to next treatment. Significant benefits were seen in the olaparib arm in spite of a high rate of crossover, Dr. Henry noted. *  *  *   Disclosures: Dr. Henry, of Penn Medicine in Philadelphia, reported having no financial disclosures relevant to this episode. Dr. Lyss was a community-based medical oncologist and clinical researcher for more than 35 years before his recent retirement. He is a columnist for MDedge Hematology/Oncology. He has no other conflicts of interest. *  *  *   For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgehemonc David Henry on Twitter: @davidhenrymd

The Oncology Journal Club - Delivering Oncology News DifferentlyThe Oncology Podcast, brought to you by www.oncologynews.com.au, is proud to present the next episode of The Oncology Journal Club.This week we have our first post ASCO 2020 Review episode, hosted by the brilliant Professor Eva Segelov from Monash University. She is joined by Dr Craig Underhill from Albury-Wodonga who interviews one of the presenters from ASCO 2020 – Professor Natasha Leighl from the Princess Margaret Cancer Centre in Toronto.Eva gives us expert analysis of KEYNOTE 355 and tells us why you need to watch out for monoclonal payloads.  Also this week, Eva and Professor Hans Prenen from Belgium, present some of their ‘Winners and Losers from ASCO 2020'.With the usual knock-about banter between our awesome presenters you are in for a great episode of The Oncology Journal Club. As ever, the links to all the papers discussed today are available on our website.About The Oncology Journal ClubWe have taken an old concept and updated it with a new format. In each episode a team of expert contributors will review topical journal papers and studies presented at key meetings to help keep you informed of the latest developments on the go.For the latest oncology news visit www.oncologynews.com.au and for regular oncology updates for healthcare professionals, please subscribe to The Oncology Newsletter.The Oncology Podcast - An Australian Oncology Perspective

Commentary by Dr. Julia Grapsa

Commentary by Dr. Katherine Ruddy

This podcast describes the results of the BLOOM study, evaluating the efficacy of osimertinib in EGFR-mutated lung cancer with leptomeningeal disease after failure of prior EGFR TKI therapy. TRANSCRIPT This JCO Podcast provides observations and commentary on the JCO article “Osimertinib In Patients With Epidermal Growth Factor Receptor Mutation-Positive Non-Small-Cell Lung Cancer and Leptomeningeal Metastases: The BLOOM Study” by Yang et al. My name is Jürgen Wolf and I am the medical director of the Center for Integrated Oncology at the University Hospital of Cologne in Germany. I am a medical oncologist with expertise in personalized lung cancer care.   About 10% of patients with advanced EGFR-mutated lung cancer suffer from leptomeningeal disease. While this disease manifestation in non-small-cell lung cancer is generally associated with a particularly poor prognosis, with survival times of only a few months, the question arises whether treatment with specific tyrosine kinase inhibitors might enable a better disease control. Most studies evaluating the efficacy of 1st and 2nd generation EGFR-TKIs in leptomeningeal disease were retrospective and difficult to interpret, given the heterogeneity of the disease as well as of the preceding treatment procedures. Small prospective studies with patient numbers below 20 tested standard dose erlotinib or afatinib as well as high-dose pulsatile EGFR TKI treatment and reported disappointing results with survival times of around 4 months only.   The 3rd generation EGFR TKI osimertinib initially was approved for T790M positive failure of 1st and 2nd generation EGFR TKIs and is now commonly regarded as 1st line standard treatment for EGFR-mutated lung cancer based on a superior progression-free survival, overall survival and toxicity profile. In studies with primates and healthy volunteers, osimertinib has been shown to exert a higher blood-brain barrier permeability and a higher brain exposure compared with other TKIs. In the AURA clinical development program for osimertinib, 22 patients with T790M-positive relapse after EGFR TKI treatment and leptomeningeal disease were retrospectively identified, and an impressive median overall survival of 18.8 months was reported. A small prospective Japanese trial evaluated osimertinib in 13 patients with T790M-positive leptomeningeal disease which, however, could be confirmed only in 5 patients. Responses were seen in some patients, and the median progression free survival for all patients was reported with 7.2 months.   The BLOOM study part B, which is discussed in this podcast, is a multicenter phase I study evaluating osimertinib in EGFR-mutated lung cancer patients with leptomeningeal metastases and failure of previous EGFR TKI treatment. Study objectives were the assessment of clinical parameters like response, overall survival neurological status, and safety but also pharmacokinetics in blood and cerebrospinal fluid. Main inclusion criteria included confirmed diagnosis of EGFR Exon 19 deletion or L858R mutation and confirmation of leptomeningeal disease by positive cytology of cerebrospinal fluid and at least one leptomeningeal site assessable by MRI. There were two sequential cohorts, one unselected for the T790M mutation and with stable non-CNS disease at enrollment, and one for T790M positive patients without the requirement for stable non-CNS disease. Osimertinib dose was 160 mg once daily, which is twice the approved dose. Besides investigator-based response assessment, according to RECIST, leptomeningeal disease was also assessed by a neuroradiological blinded central review according to the RANO-LM working group criteria, which integrates clinical examination, cerebrospinal fluid cytology and neuraxis MRI.   41 patients from South Korea and Taiwan were included, 20 in the unselected and 21 in the T790M-positive cohort. About 70% of the patients had co-existing brain mets and about 50% prior radiotherapy. For 4 patients, no response data from the independent review were available.   The confirmed overall response rate for leptomeningeal disease was impressive at 62% as assessed by blinded independent review and nearly identical between both cohorts.  By comparison, the overall response rate was only 27% by investigator assessment, which, in turn, revealed a higher stable disease rate. Prior brain radiotherapy had no influence on efficacy. Median duration of response was comparable between blinded independent review and investigator, with 15.2 and 18.9 months, respectively. In about one third of the evaluable patients confirmed CSF clearance could be observed. PK analysis indicated that plasma concentration of osimertinib and its active metabolites reached steady state by day 15; the ratio for osimertinib exposure in cerebrospinal fluid vs. plasma was around 16%.   Surprisingly, only half of the patients had an abnormal neurological baseline assessment, most of them with mild symptoms. Symptom stabilization occurred in 54% during treatment; only 5% showed regression of neurological functions.   Overall, median progression-free survival, as assessed by the investigators, was 8.6 months and median overall survival 11 months. Progression-free survival and overall survival differed markedly between both cohorts. For instance, overall survival was 16.6 months in the unselected and 8.1 months in the selected group. Possibly, the requirement for stable non-CNS disease in the unselected group was partly responsible for the better survival outcome in this subset . However, this has to be interpreted cautiously in view of small patient numbers and large confidence intervals.   Osimertinib 160mg was well tolerated in the majority of patients with the known osimertinib side-effect profile. However, 24% of the patients suffered from adverse events grade 3 or more—possibly related to osimertinib, according to the investigators’ assessment. Dose reduction had to be performed in 12% and discontinuation of treatment in 22% of the patients due to adverse events. 17% of the patients had fatal events that did not appear to be causally related to osimertinib.   What can we learn from this study? This is the largest prospective study so far in this setting and osimertinib clearly shows clinical efficacy. The study methodology was sound, with response assessment by blinded independent review and based on RECIST criteria as well as on the RANO criteria established in particular for leptomeningeal disease. The overall response rate of leptomeningeal disease of around 60% and the duration of response of around 15 months is clinically relevant in particular, as it is correlated with improvement or at least neurological stabilization in most patients. Although the toxicity of the treatment is substantially higher than reported in osimertinib trials so far, it is manageable, and the risk/benefit ratio appears to be favorable.   What are the limitations of the study? Patient numbers are small, and the patients are heterogeneous with respect to several important factors such as pretreatment whole-brain radiotherapy, occurrence of simultaneous CNS metastases and neurological symptoms. Thus, absolute values for efficacy have to be interpreted cautiously, and comparison with already published trials remains difficult. Also, unfortunately in view of the toxicity, the question remains open whether the 160mg dose, which is not approved, is actually necessary. Finally, since osimertinib increasingly becomes the first-line treatment standard in EGFR-mutated lung cancer, the number of patients with failure of 1st- or 2nd-generation EGFR TKI treatment will decrease.   Despite these limitations, the trial provides the most convincing data so far in this special patient population and, in my opinion, defines  an important new option to consider for patients with EGFR-mutated lung cancer and leptomeningeal disease after failure of previous EGFR TKI treatment.   This concludes this JCO Podcast. Thank you for listening.

Osimertinib for the win, Prostate Fossa SBRT, Fractionated Stereotactic Radiosurgery for large brain mets, IGRT Consensus, PSMA-PET, Jacksonville's Carbon

Osimertinib bringt sieben Monate mehr Leben. Weitere Informationen: https://www.nejm.org/doi/full/10.1056/NEJMoa1713137

Osimertinib vs comparator EGFR-TKI as first-line treatment for EGFRm advanced NSCLC (FLAURA): Final overall survival analysis. The phase III trial Osimertinib vs comparator EGFR-TKI as first-line treatment for EGFRm advanced NSCLC (FLAURA) showed a significant increase in progression free survival. In the now available finale survival analysis also the overall survival showed a statistical significant increase. Expert: Suresh S. Ramalingam, Winship Cancer Institute of Emory University, Atlanta, GA

Lung Cancer Update – Part 1: Our interview with Dr Ramalingam highlights the following topics as well as cases from his practice: Mechanisms of resistance to osimertinib and management of non-small cell lung cancer (NSCLC) with EGFR tumor mutations in patients who experience disease progression on first-line osimertinib: 0m0s Results of the Phase III IMpower150 trial: Atezolizumab and chemotherapy with or without bevacizumab versus bevacizumab and chemotherapy for chemotherapy-naïve metastatic nonsquamous NSCLC: 3m55s Role of bevacizumab in combination with EGFR tyrosine kinase inhibitors (TKIs) for patients with NSCLC and EGFR tumor mutations: 5m22s Emerging data with novel TKIs for patients with NSCLC and MET gene amplifications: 8m0s Incidence and clinical significance of MET amplifications and MET exon 14 mutations: 10m22s Use of liquid biopsies to detect mutations in patients with lung cancer: 13m52s FLAURA study results: Osimertinib versus erlotinib or gefitinib as first-line therapy for advanced NSCLC with an EGFR tumor mutation: 17m11s Ongoing evaluation of EGFR TKIs for Stage III NSCLC: 19m4s Perspective on the use of osimertinib in the adjuvant setting: 21m52s Case: A 62-year-old man and never smoker with Stage IV NSCLC and an EGFR exon 19 deletion receives osimertinib as first-line treatment: 23m30s Response to osimertinib in patients with brain metastases: 27m5s Case: A 44-year-old man and never smoker with metastatic NSCLC and an ALK rearrangement receives alectinib after disease progression on crizotinib with an anti-PD-1 antibody: 31m3s ALTA-1L: A Phase III trial evaluating brigatinib versus crizotinib for advanced NSCLC with an ALK rearrangement: 35m44s Efficacy and tolerability of lorlatinib in patients with NSCLC and an ALK rearrangement: 39m43s Case: A 52-year-old woman and nonsmoker with metastatic NSCLC and a BRAF V600E tumor mutation receives dabrafenib and trametinib as second-line therapy: 42m13s Use of targeted therapy as first-line treatment for patients with NSCLC: 44m42s Case: A 58-year-old man with locally advanced squamous cell carcinoma of the lung receives durvalumab as consolidation therapy after chemoradiation therapy: 46m59s Overall survival with the addition of durvalumab to chemoradiation therapy for patients with Stage III NSCLC: 48m45s Pulmonary toxicity associated with durvalumab: 50m47s Ongoing investigation of immune checkpoint inhibitors in the adjuvant setting: 55m30s Management of metastatic small cell lung cancer: 58m5s Novel agents under investigation for small cell lung cancer: 1h0m15s Emerging research aimed at enhancing the efficacy of immune checkpoint inhibitors: 1h5m2s Select publications

PharmaPills - Pillole dal farmaceutico: Novità, Curiosità e Lavoro dal mondo del farmaceutico. A cura di Stefano LagravineseIn questa puntata parliamo di:Aziende: Aurobindo Pharma Italia, Abiogen Pharma Nuove terapie: Osimertinib, Cemiplimab, Ibrutinib, Belimumab.Patologie: Carcinoma polmonare, Carcinoma cutaneo a cellule squamose, leucemia linfatica cronica, lupus eritematoso sistemico.Lavoro: Clinical Research Manager, Clinical Trial Assistant, Site Qualification Manager.Ogni mercoledì alle h 12.00 su Spreaker.com e iTunes.Seguici su: www.telegram.me/pharmapillswww.facebook.com/pharmapills/

PharmaPills - Pillole dal farmaceutico: Novità, Curiosità e Lavoro dal mondo del farmaceutico. A cura di Stefano LagravineseIn questa puntata parliamo di:Aziende: Aurobindo Pharma Italia, Abiogen Pharma Nuove terapie: Osimertinib, Cemiplimab, Ibrutinib, Belimumab.Patologie: Carcinoma polmonare, Carcinoma cutaneo a cellule squamose, leucemia linfatica cronica, lupus eritematoso sistemico.Lavoro: Clinical Research Manager, Clinical Trial Assistant, Site Qualification Manager.Ogni mercoledì alle h 12.00 su Spreaker.com e iTunes.Seguici su: www.telegram.me/pharmapillswww.facebook.com/pharmapills/

Dr. Jack West reviews the pros and cons of using osimertinib first line vs. "saving" it as a second line therapy, trying to determine the optimal sequence for EGFR-directed therapy in advanced EGFR mutation-positive NSCLC.

Dr. Jack West discusses the implications of a positive FLAURA trial, which revealed a significant improvement in progression-free survival for first line osimertinib over gefitinib or erlotinib in patients with EGFR mutation-positive advanced NSCLC.

FDA D.I.S.C.O.: Osimertinib for Non-Small Cell Lung Cancer FDA medical oncologists discuss the approval of osimertinib for EGFR mutation-positive non-small cell lung cancer.

FDA medical oncologists discuss the approval of osimertinib for EGFR mutation-positive non-small cell lung cancer. Released July 28, 2017

FDA medical oncologists discuss the approval of osimertinib for EGFR mutation-positive non-small cell lung cancer. Released July 28, 2017

FDA medical oncologists discuss the approval of osimertinib for EGFR mutation-positive non-small cell lung cancer. Released July 28, 2017

FDA medical oncologists discuss the approval of osimertinib for EGFR mutation-positive non-small cell lung cancer. Released July 28, 2017

FDA medical oncologists discuss the approval of osimertinib for EGFR mutation-positive non-small cell lung cancer. Released July 28, 2017

FDA medical oncologists discuss the approval of osimertinib for EGFR mutation-positive non-small cell lung cancer. Released July 28, 2017

FDA medical oncologists discuss the approval of osimertinib for EGFR mutation-positive non-small cell lung cancer. Released July 28, 2017

Dr. Jack West, Swedish Cancer Institute, reviews trial evidence for the efficacy of rociletinib and osimertinib for EGFR acquired resistance not driven by a T790M mutation.

Dr. Jack West, Swedish Cancer Institute, reviews trial evidence for the efficacy of rociletinib and osimertinib for EGFR acquired resistance not driven by a T790M mutation.

Dr. Jack West, Swedish Cancer Institute, reviews trial evidence for the efficacy of rociletinib and osimertinib for EGFR acquired resistance not driven by a T790M mutation.

Dr. Jack West suggests that progression in T790M-negative EGFR lung cancer patients may not require a change in therapy. In this video he details what should go into the decision to modify treatment for those patients.

Dr. Jack West suggests that progression in T790M-negative EGFR lung cancer patients may not require a change in therapy. In this video he details what should go into the decision to modify treatment for those patients.

Dr. Jack West suggests that progression in T790M-negative EGFR lung cancer patients may not require a change in therapy. In this video he details what should go into the decision to modify treatment for those patients.

Drs. Ben Solomon, Leora Horn, & Jack West compare the clinical data with the third generation EGFR TKIs so active in acquired resistance and consider whether there are significant differences between them.

Drs. Ben Solomon, Leora Horn, & Jack West compare the clinical data with the third generation EGFR TKIs so active in acquired resistance and consider whether there are significant differences between them.

Drs. Ben Solomon, Leora Horn, & Jack West compare the clinical data with the third generation EGFR TKIs so active in acquired resistance and consider whether there are significant differences between them.

Drs. Ben Solomon, Leora Horn, & Jack West review whether the data and clinical experience suggest any clinically significant differences among the first and second generation EGFR TKIs (Iressa, Tarceva, Gilotrif/Giotrif).

Drs. Ben Solomon, Leora Horn, & Jack West review whether the data and clinical experience suggest any clinically significant differences among the first and second generation EGFR TKIs (Iressa, Tarceva, Gilotrif/Giotrif).

Drs. Ben Solomon, Leora Horn, & Jack West review whether the data and clinical experience suggest any clinically significant differences among the first and second generation EGFR TKIs (Iressa, Tarceva, Gilotrif/Giotrif).

Drs. Leora Horn, Ben Solomon, & Jack West consider whether third generation EGFR TKIs, so active in patients with acquired resistance, might be best used prior to development of acquired resistance.

Drs. Leora Horn, Ben Solomon, & Jack West consider whether third generation EGFR TKIs, so active in patients with acquired resistance, might be best used prior to development of acquired resistance.

Drs. Leora Horn, Ben Solomon, & Jack West consider whether third generation EGFR TKIs, so active in patients with acquired resistance, might be best used prior to development of acquired resistance.

Dr. Jack West reviews treatment options for patients with an EGFR activating mutation and acquired resistance but no T790M mutation, focusing on a clinical trial with the novel hypoxia-induced pan-HER inhibitor TH4000.

Dr. Jack West reviews treatment options for patients with an EGFR activating mutation and acquired resistance but no T790M mutation, focusing on a clinical trial with the novel hypoxia-induced pan-HER inhibitor TH4000.

Dr. Jack West reviews treatment options for patients with an EGFR activating mutation and acquired resistance but no T790M mutation, focusing on a clinical trial with the novel hypoxia-induced pan-HER inhibitor TH4000.

Dr. Jack West introduces the question of whether third generation EGFR tyrosine kinase inhibitors osimertinib and rociletinib should be used as first line therapy rather than for acquired resistance, including discussing key clinical trials on the topic.

Dr. Jack West introduces the question of whether third generation EGFR tyrosine kinase inhibitors osimertinib and rociletinib should be used as first line therapy rather than for acquired resistance, including discussing key clinical trials on the topic.

Dr. Jack West introduces the question of whether third generation EGFR tyrosine kinase inhibitors osimertinib and rociletinib should be used as first line therapy rather than for acquired resistance, including discussing key clinical trials on the topic.