David R. Gandara, MD
Annual International Lung Cancer Congress, which began today in Huntington Beach, California and will continue through Saturday, will offer an array of information presented by multidisciplinary experts—in a brand-new format.
“It’s set up to be a think tank, with 200 lung cancer experts plus participants [from the audience endeavoring] to digest what was presented earlier in the year at ASCO [the American Society of Clinical Oncology] and other conferences,” said Program Director David R. Gandara, MD, professor of Medicine in the Division of Hematology/Oncology, director of the Thoracic Oncology Program, and senior advisor to the director at the University of California Davis Comprehensive Cancer Center, in Sacramento.
Serving as a program director alongside Gandara is Roy S. Herbst, MD, PhD, Ensign Professor of Medicine (Medical Oncology), professor of Pharmacology, chief of Medical Oncology, and associate director for Translational Research at Yale Cancer Center in New Haven, Connecticut.
“We have leaders from all different specialties in lung cancer—pulmonary medicine, radiology, surgery, radiation oncology, medical oncology, molecular biology, pathology—on the faculty,” Gandara continued. “We will discuss management of cases where multiple modalities are required, such as surgery plus chemotherapy and radiation, and how to do molecular testing on patients. We’ll talk about that in panel discussions, and we’ll have a community-based multi-modality tumor board, during which we’ll talk about cases. Participants from the community can bring up cases in their practice and ask the expert panel how they would manage this sort of thing.”
In an interview with OncLive
, Gandara discussed some other anticipated highlights of the conference.
“Our faculty includes international experts, such as Giorgio Scagliotti, MD, PhD, of Italy, and James CH Yang, MD, PhD, from Taiwan, this year, because many of the lead studies at ASCO and other recent conferences were presented by these people,” Gandara said. “Dr. Yang announced for the first time, at ASCO, that patients with a certain EGFR mutation—the exon 19 deletion—who received afatinib had an overall survival improvement.1
Seven prior studies looked at first-generation agents, and an overall survival improvement has never been seen, so we’ll be able to discuss that among our expert faculty and the participants to reach some conclusions about how we think about those data and how they might be taken into clinical practice. This will probably lead to increased use of afatinib in the first-line setting.”
Lung Cancer Screening
“Also exciting will be a presentation on lung cancer screening by James L. Mulshine, MD, [professor, associate provost for Research, and vice president of Rush University Medical Center in Chicago, Illinois],” Gandara said. “This has been an area of a lot of excitement and controversy over the last few months. The National Lung Screening Trial in the United States showed a 20% reduction in lung cancer death by screening with low-dose CT scan [compared to x-rays], yet [the Medicare Evidence Development & Coverage Advisory Committee] made a preliminary decision not to recommend reimbursement for screening. Dr. Mulshine is an expert in this area, and we have a number of other experts in this field who will attend and discuss this with him. That clearly will be a highlight of the meeting, which is usually focused [strictly] on lung cancer treatment.”
“Another area of tremendous interest I’d call ‘targeted immunotherapy,’ particularly with drugs against the target CDL1,” Gandara said. “There are half a dozen drugs targeting this immunotherapeutic molecular target. We’ll talk—both in lectures and panel discussions—about data, how to measure the degree of activity, and whether there is too much hype about these agents, so we’ll be able to reach some consensus.
We’ll have Vassiliki Papadimitrakopoulou, MD [professor in the Department of Thoracic/Head and Neck Medical Oncology at the University of Texas MD Anderson Cancer Center, in Houston] talk about why we must use different response measurements to determine how effective these drugs are. In immune therapy, T cells are invading the tumor initially, and with these treatments, the tumor can swell and look larger on a CT scan, so how does the physician know if the cancer is getting worse or if it’s an immune response and will get better with continued treatment? She’ll talk about this challenge.