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ASCO Highlights for Metastatic Non-Small Cell Lung Cancer

— James Stevenson, MD, offers an overview of the oral session at ASCO

Ƶ MedicalToday

The showcased new findings in the field of lung cancer that might immediately change practice, with others pointing toward exciting future opportunities.

In this exclusive Ƶ video, James Stevenson, MD, of the Cleveland Clinic in Ohio, discusses some of the highlights in metastatic non-small cell lung cancer.

Following is a transcript of his remarks:

The major abstracts from the metastatic non-small cell lung cancer oral session involved one trial that looked at the combination of pembrolizumab [Keytruda] and ramucirumab [Cyramza] after frontline immune checkpoint inhibitor therapy and platinum-based chemotherapy. This was a positive trial in that pembrolizumab plus ramucirumab showed improved survival when compared to standard-of-care chemotherapy by over 3 months. So the endpoint was met.

This was a randomized phase II trial, not definitely practice changing yet, but sent a good signal that will make it worthy of a phase III trial. And again, we're looking for improving on therapies in the post-checkpoint inhibitor setting in metastatic non-small cell lung cancer.

Also in that session, we heard about a drug called adagrasib, which is a KRAS G12C tyrosine kinase inhibitor. And it's an oral agent that showed activity in patients with KRAS G12C mutations -- non-small cell lung cancer patients we're talking about here. And the response rate was over 40%. Again, showing clear activity of this drug in this selected population. So this is a drug that may get approved in the not-too-distant future for us to use in the clinic.

It'll be the second KRAS G12C inhibitor that we have. We already have sotorasib [Lumakras]. In terms of any new signals with adagrasib compared to sotorasib, activity seems like it might be comparable. So it's another option. Maybe a little bit of a different adverse event profile, slightly different, but we'll see. But likely we'll have two options to use in KRAS G12C-mutated non-small cell lung cancer here not too far down the road.

The other thing, looking at posters today, we heard a lot about antibody drug conjugates in non-small cell lung cancer. Some of the interesting ones were patritumab deruxtecan, which targets HER3, but a poster presented today showed the activity of this drug in an unselected, non-small cell lung cancer patient population that did not have activating EGFR mutations where we already know that this drug has some activity.

So nice to see a response rate of just over 40% in unselected lung cancer with this targeted therapy.

Another antibody drug conjugate [ADC] that we heard about in the poster session was telisotuzumab vedotin, which is a c-MET antibody drug conjugate. And this drug also looks to be active in patients with c-MET-overexpressing non-small cell lung cancer.

One poster described the trial looking at it in patients with EGFR mutations after failure of osimertinib [Tagrisso] in frontline therapy who have c-MET overexpression, definitely showed activity when this drug was added to osimertinib in tolerability.

And then also looking at the drug telisotuzumab on its own in c-MET overexpressing non-small cell lung cancer without EGFR mutations, also showing activity there that seem to be dependent on the level of c-MET expression. So another interesting ADC that looks like the target is predictive of its effect, and look forward to hearing more.

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    Greg Laub is the Senior Director of Video and currently leads the video and podcast production teams.