Non-Small Cell Lung Cancer (NSCLC)

Narjust Florez, MD, emphasizes the importance of treating CNS metastases in KRAS G12C mutated NSCLC, highlighting the promising but limited data on adagrasib’s CNS penetrance and intracranial response, as shown in the KRystal-1b study, making it a preferred option for patients with CNS metastases despite its associated side effects.

Dr Narjust Florez discusses the higher incidence of hepatotoxicity with sotorasib as shown in real-world data, and suggests adagrasib as a preferable option for patients with pre-existing liver dysfunction or inflammation, highlighting the need to consider patient history and liver function when choosing KRAS inhibitors.

The application for amivantamab and lazertinib for locally advanced or metastatic non–small cell lung cancer is supported by data from the phase 3 MARIPOSA trial.

“KRAS is probably the most exciting area in clinical trials right now, not only in thoracic oncology but also pancreatic and colorectal cancer, where we’ve seen a lot of combination therapies. My view is the small molecule inhibitors are the base, not the ceiling.”

During the 2023 European Society of Medical Oncology, experts in the field of lung cancer convened to discuss the use of biomarker testing and updated trial results that were presented.

Dr Narjust Florez discusses the hepatoxicity associated with KRAS G12C inhibitors, noting both adagrasib and sotorasib pose liver damage risks, but real-world data suggests adagrasib may have a lower risk; she emphases the importance of considering other causes of hepatoxicity before attributing it solely to these therapies.

CodeBreaK 100 compares the safety and efficacy of pembrolizumab combined with adagrasib or sotorasib in treating KRAS G12C NSCLC, noting sotorasib has a longer presence and familiarity in clinical use.

Alykhan Nagji, MD, provides a brief overview of the landscape surrounding the treatment of patients with stage-III resectable NSCLC.

Data from a real-world study may help clinicians in treatment decision-making for those with extensive-stage small cell lung cancer who are unable to afford PD-L1 inhibitors.

Adding camrelizumab to chemotherapy appears tolerable for patients with resectable stage IIIA or IIIB non–small cell lung cancer in the phase 2 TD-FOREKNOW trial.

KRYSTAL-7 is a study exploring the efficacy of adding adagrasib to first-line pembrolizumab in patient with NSCLC with varying PD-L1 expression levels, showing promising response rates and progression-free survival, but also adverse events like hepatotoxicity.

Dr Narjust Florez discusses the KRYSTAL-1 trial, focusing on the effectiveness and side effects of adagrasib in treating patients with NSCLC and KRASG12C mutations, and noting their impact on progression-free and overall survival.

The panelists close their discussion on non-small cell lung cancer by emphasizing the need for continued research, early screening, and collaboration with dermatologists to address the unmet needs and improve overall outcomes.

Treatment with visugromab plus nivolumab in patients with relapsed/refractory solid tumors in the phase 2a GDFATHER-2 trial appears to exhibit safety and tolerability.

Dr Narjust Florez outlines FDA-approved firstline therapy options for KRAS G12C mutated non-small cell lung cancer, and notes most patients progress and require second line targeted therapy.

Narjust Florez, MD, discusses KRAS G12C mutated non-small cell lung cancer, a subset of KRAS mutations which comprises 14% of NSCLC cases.

Data from the phase 1b/3 IMscin001 trial support the Committee for Medicinal Products for Human Use’s positive opinion on subcutaneous atezolizumab in lung cancer and other disease types.

The safety profile of durvalumab plus chemoradiation among patients with unresectable non–small cell lung cancer in the phase 3 PACIFIC-2 trial appears to be consistent with prior reports.

A medical oncologist reviews intracranial efficacy data from HERTHENA-Lung01 on patritumab deruxtecan (HER3-DXd) in patients with previously treated advanced EGFR-mutated NSCLC.

Alexander I. Spira, MD, PhD, FACP, reviews recent data from MARIPOSA-2 looking at amivantamab plus chemotherapy, with or without lazertinib, in EGFR-mutated advanced NSCLC.

Cell therapy and vaccine approaches are among the several potential options for targeting KRAS in patients with KRAS G12C–mutated non–small cell lung cancer, says Sandip P. Patel, MD.

Data from the phase 3 MARIPOSA-2 study support the supplemental biologics license application for amivantamab plus chemotherapy in EGFR-mutated advanced or metastatic non–small cell lung cancer.

Drs Janellen Smith and Misako Nagasaka discuss dermatological adverse events in patients with non-small cell lung cancer associated with EGFR tyrosine kinase inhibitors, offering advice on prevention, treatment, and when to involve a dermatologist.

Dr Sai-Hong Ou and Dr Misako Nagasaka discuss the treatment strategies for EGFR-mutant non-small cell lung cancer, emphasizing the importance of individualized decision making and a multidisciplinary approach.

An expert on lung cancer discusses data from TROPION-Lung05 on datopotamab deruxtecan in patients with previously treated NSCLC with actionable genomic alterations.