Corey J. Langer, MD, director, Thoracic Oncology, Abramson Cancer Center, professor of medicine, Perelman School of Medicine, University of Pennsylvania, discusses the impact of targeted therapy in non–small cell lung cancer.
Corey J. Langer, MD, director, Thoracic Oncology, Abramson Cancer Center, professor of medicine, Perelman School of Medicine, University of Pennsylvania, discusses the impact of targeted therapy in non—small cell lung cancer (NSCLC).
Targeted therapies have irrevocably transformed the outlook of oncogene-driven NSCLC. In the past, patients with EGFR-positive NSCLC would have been treated with chemotherapy alone or with bevacizumab (Avastin), yielding response rates of around 30% and progression-free survival (PFS) of approximately 6 months. Now with the rise of EGFR TKIs like osimertinib (Tagrisso), response rates are as high as 70% and median PFS is nearly 19 months. In many studies, median overall survival (OS) has not been reached at 3 and 4 years with osimertinib.
Langer says the field has seen even more success in ALK-positive patients. This is a rarer driver, occurring in approximately 3% to 8% of patients with advanced nonsquamous NSCLC compared with around 15% of patients harboring EGFR mutations. Alectinib (Alecensa) and brigatinib (Alunbrig) have emerged as the optimal frontline agents, leading to response rates of over 70% and an unprecedented median PFS of about 3 years. Median OS in these patients is as high as 6 or 7 years, Langer notes.