Optimizing Therapies For Patients With Lung Cancer

The incidence and overall mortality of lung cancer has been declining in the United States, due in part to both reduced use of tobacco and better treatment options. Despite those treatment options, for patients with advanced disease, lung cancer remains difficult to treat.

In this issue of ONCOLOGY®, we spoke with Rogerio C. Lilenbaum, MD, director of Banner MD Anderson Cancer Center in Gilbert, Arizona, about the recent treatment breakthroughs for patients with lung cancer, and the obstacles that those breakthroughs bring.

“I think we still have some challenging issues,” Lilenbaum says. “Testing in this day and age is still erratic,” adds Lilenbaum. “Even within each category – EGFR, ALK, ROS, RET, BRAF – the information about how to best manage those patients is not always within the domain of the average oncologist.”

Lilenbaum also notes that identifying patients who benefit from immunotherapy and checkpoint inhibitors is also an issue. “Yes, PD-L1 is a marker that can help ascertain that magnitude of benefit, but it’s far from perfect,” said Lilenbaum. “I think we need additional predictors or predictive factors to justify the cost and the toxicity of these agents.”

Also in this issue, you will read a review of the recent advances in antibody-drug conjugates for patients with lymphoma. With the clinical successes of both polatuzumab vedotin (Polivy) and brentuximab vedotin (Adcetris), and several promising agents under development, this unique class of chemoimmunotherapy agents is poised to make a large impact in the treatment of lymphoma.

We also present a case of a patient with a metastatic pancreatic neuroendocrine tumor with hypercalcemia, elevated parathyroid hormone-related peptide, high tumor mutational burden, and high PD-L1 score. How do we treat a patient who presents with this rare condition? Read on to find out.

Within these pages, you’ll also read about some of the emerging therapeutics and diagnostic devices in the genitourinary cancer pipeline and a discussion of the FDA’s recent accelerated approval of pembrolizumab (Keytruda) in combination with chemotherapy for the treatment of patients with locally recurrent unresectable or metastatic triple-negative breast cancer.

I hope you find our journal helpful in caring for your patients through what is likely one of the most challenging times in their lives. As always, thank you for reading.