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Optimal Sequencing and Patient Selection Investigated in NSCLC

Danielle Bucco
Published: Monday, Dec 04, 2017

Frank E. Mott, MD

Frank E. Mott, MD
As novel agents, such as checkpoint inhibitors and targeted therapies, continue to emerge for the treatment of patients with non–small cell lung cancer (NSCLC), the sequencing of these agents is a new challenge for physicians.

on Advanced Non–Small Cell Lung Cancer, Mott, an associate professor in the Department of Thoracic/Head and Neck Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discussed optimal treatment selection strategies for patients with NSCLC.

OncLive: Can you discuss molecular profiling for patients with adenocarcinoma of the lung?

Mott: Adenocarcinoma of the lung has come a long way in the last decade in terms of new treatment options based on molecular targets. It is now standard of care to analyze the tumor for the presence of targets such as EGFR, ALK/ROS1, and PD-L1. There are some newer targets that have approved therapies; these include the MET exon 14 skipping mutation and BRAF mutations. 

What immunotherapy and targeted therapies are showing excitement right now?

In ALK-positive tumors, which only represent 2% to 4% of patients with NSCLC, we have new data suggesting that targeted therapies demonstrate a better response than chemotherapy. Also, some newer agents, such as alectinib (Alecensa), are demonstrating good penetration for patients with central nervous system metastases. Those patients are responding well with good durable responses in PFS. We are seeing changing patterns of care with some of these drugs.
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