Lung Cancer Highlights from the ASCO 2019 Annual Meeting

It's an exciting time for lung cancer research with new insights and discoveries coming out of the recent American Society of Clinical Oncology (ASCO) meeting in Chicago.  Each year around 40,000 cancer healthcare professionals from all over the world gather for the annual meeting to learn, share and engage with other experts in the cancer field. Every year, researchers report on exciting advancements in the field of cancer and this year lung cancer had some truly intriguing developments. Here are some of the most important meeting highlights that detail what is to come for lung cancer patients.

1. New drugs to target KRAS and RET are in the works
   Some lung cancer patients have cellular mutations that cause their lung cancer to grow. Major advancements have been made in the discovery of drugs that "target" these mutations. Though this used to be a frustrating diagnosis for patients, the data presented at ASCO shows hope for a new drug for both the KRAS and RET mutations. More studies need to be done before these drugs can be released for widespread use, but it is certainly something to watch.
2. Immunotherapy is increasing the lifespan of some cancer patients
   The KEYNOTE-001 trial showed almost a quarter of non-small cell lung cancer (NSCLC) patients enrolled who had never been on another treatment lived at least 5 five years after diagnosis after taking pembrolizumab (pembro), an immunotherapy drug. Over 15 percent of the patients who had been on another treatment first lived at least five years after diagnosis. This is a major jump in the five-year overall survival rate for patients with advanced NSCLC (which was an estimated 5 percent before immunotherapy drugs were introduced). These patients had levels of PD-L1 (an important biomarker that may indicate who responds well to immunotherapy drugs) of at least 50 percent.  Research will continue to show which lung cancer patients benefit most from immunotherapy and what we can expect that benefit to be.
3. The FDA is making experimental cancer drugs easier to get
   For some patients, physicians recommend drugs that are not yet approved by the FDA but could be helpful if they have exhausted all other treatment options. This is referred to as expanded access or "compassionate use." Historically, physicians have had to jump through many hoops to get these treatments for their patients, but the FDA announced a new pilot program called "Project Facilitate" which will make it easier for physicians to work with drug companies to improve access to certain medications for cancer patients.
4. There is discussion about changing lung cancer clinical trial inclusion criteria
   Clinical trials are not only an important part of lung cancer research, but a trial may be the best treatment option for a lung cancer patient. To keep patients safe, clinical trial enrollment criteria can be very strict. But some researchers are worried that the current criteria is outdated because it's based on safety concerns from patients taking chemotherapy and doesn't take into account the way newer drugs like targeted therapies and immunotherapies work. By adjusting and expanding the criteria, the researchers believe they can keep patients safe AND offer clinical trials to many more lung cancer patients. Let's hope we see this in practice sometime soon!
5. Not enough oncologists are ordering biomarker testing for their patients
   Biomarker testing, also known as molecular, genomic or tumor testing, looks for certain mutations or markers in a patient's tumor. The results provide invaluable information about what treatment is best for the patient. A new study reports biomarker testing is underused in the oncology community, especially in community hospitals and private practices. More physician education is needed because currently patients can't always rely on their doctor to order this testing when it is appropriate. Our resources help patients navigate this discussion, but more work needs to be done to ensure all physicians are treating patients with the current standard of care.
6. Another drug to treat small cell lung cancer is being studied
   Small cell lung cancer (SCLC) is aggressive and has significantly fewer treatment options than non-small cell lung cancer. A new drug currently in a phase two clinical trial is showing some positive results for SCLC patients whose cancer has grown or spread after their first treatment. Stay tuned for more information about these much-needed treatment options for SCLC patients.
7. Biomarkers in the blood are being looked at to personalize lung cancer treatment
   Circulating tumor DNA (ctDNA) refers to pieces of cancer cells that are shed into the bloodstream when live cancer cells die. Research done by members of the SU2C-LUNGevity-American Lung Association Lung Cancer Interception Research Team looked at whether or not NSCLC patients with detectable levels of ctDNA in their blood needed immunotherapy after chemoradiation to help kill any cancer cells left in the body. The results suggest that ctDNA analysis may help determine which patients need immunotherapy after chemoradiation, but more research needs to be done.

This is just some of the many findings that were presented at ASCO. Researchers are also studying other topics like the right combination and sequencing of drugs for patients, drugs to treat mutation resistance and rare lung cancer mutations just to name a few. Visit Lung.org/lung-cancer for comprehensive lung cancer information and check out lung cancer research led by the Lung Association Research Team.