In the primary analysis of OAK, a study of atezolizumab versus docetaxel in second- and third-line NSCLC, OS was improved with atezolizumab (HR, 0.73; 95% CI, 0.62-0.87); however, there was a similar PFS between the 2 arms (HR, 0.95; 95% CI, 0.82-1.10). Findings from this subanalysis of the OAK trial showed that atezolizumab had a clinical benefit in patients who received the PD-L1 inhibitor beyond progression.
“David Gandara, MD, and colleagues report that in the OAK trial of atezolizumab versus docetaxel as second-line therapy for advanced NSCLC, half of the patients demonstrating RECIST progression on atezolizumab continued it beyond progression. Among these 168 patients, 7% demonstrated a subsequent response, 44% achieved stable disease on later scans, and the median overall survival beyond progression was a rather impressive 12.7 months.
“There is obviously some selection bias of which patients were recommended to continue immunotherapy beyond progression, but it underscores the importance of distinguishing between RECIST progression and clinically significant progression, especially in a setting in which further treatment options are limited and the treatment is well tolerated, and immunotherapy may be particularly amenable to delayed benefits.
“It is important, however, for clinicians to avoid overgeneralizing to the conclusion that immunotherapy should be continued beyond progression in most or all patients, regardless of the degree of progression seen or the range of subsequent treatment options available.”Impact of MET inhibitors on survival among patients with MET exon 14 mutant NSCLC (Abstract 8511)
For patients with NSCLC who have activating mutations that lead to MET exon 14 (METdel14) skipping, responses to MET inhibitors have been observed. In this abstract, researchers report findings from their multicenter retrospective analysis of patients with METdel14
-mutant NSCLC, in which receiving a MET inhibitor was associated with an OS benefit.
“Though MET is not among the molecular markers routinely tested for in advanced NSCLC yet, work such as this will likely further drive the increasing trend toward broader genomic testing as the list of clinically relevant markers continues to grow. It argues that oncologists should seek to pursue MET inhibitor therapy, ideally in the setting of a clinical trial, in patients who have MET
exon 14 mutation–positive advanced NSCLC.”
HEMATOLOGIC MALIGNANCIES, SUPPORTIVE CARE
Michael A. Thompson, MD, PhD, medical director for the Early Phase Cancer Research Program, Patient-Centered Research at the Aurora Research Institute Overall survival results of a randomized trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment (Abstract LBA2)
This late-breaking abstract will unveil findings that have not yet been disclosed; however, Thompson explains the study will be of interest to multiple sectors of oncology.
Michael A. Thompson, MD, PhD
“This is somewhat of a departure from a plenary session drug study. It is of interest to patients, pharma [pharmaceutical companies], and the FDA. I previously chaired a session at the [2015 ASCO Annual Meeting] where Laura Strong, PhD, discussed this—‘The Past, Present, and Future of Patient-Reported Outcomes (PRO) in Oncology.’ PRO can be used in the short term for toxicity as well as for long-term events.”Routine molecular screening of advanced refractory cancer patients: an analysis of the first 2490 patients of the PROFILER Study (LBA100)
PROFILER is a nonrandomized, multicenter, cohort study that aims to implement a personalized cancer medicine approach by proposing to establish the genetic and immunologic profile of patients’ malignant tumors, in order to define a map of genetic and immunologic profiles for all studied types of cancer (NCT01774409). It calls for a different therapeutic management of patients, including targeted agents or immunotherapy, based on recommendations of a multidisciplinary molecular tumor board.
“This large precision medicine study from France should be of interest due to the large numbers of patients with advanced refractory cancer. This and the follow up SHIVA OS analyses (abstract 11515) will not resolve all issues in precision medicine, but may be informative about patient selection.”Next-generation sequencing in community oncology practice: beneficial or economical burden? (Abstract 102)
Researchers sought to examine the benefits and economical burden of using next-generation sequencing, especially in a nonacademic setting outside of a clinical trial, in this retrospective chart analysis of patients treated at a large community practice who had next-generation sequencing in 2015 and 2016.