Scientific Advances in Thoracic Oncology 2016

Abstract

Lung cancer care is rapidly changing with advances in genomic testing, the development of next-generation targeted kinase inhibitors, and the continued broad study of immunotherapy in new settings and potential combinations. The International Association for the Study of Lung Cancer and the Journal of Thoracic Oncology publish this annual update to help readers keep pace with these important developments. Experts in thoracic cancer and care provide focused updates across multiple areas, including prevention and early detection, molecular diagnostics, pathology and staging, surgery, adjuvant therapy, radiotherapy, molecular targeted therapy, and immunotherapy for NSCLC, SCLC, and mesothelioma. Quality and value of care and perspectives on the future of lung cancer research and treatment have also been included in this concise review.

Malignant Pleura Mesothelioma: Clinical Perspectives

“…[3] According to WHO, the United Kingdom (UK) follows, having 14,6% of MPM deaths worldwide. [4] Despite having banned the import of asbestos for two decades into the UK, Health and Safety Executive data for 2012 show that MPM caused 2535 deaths in England, Wales and Scotland [13]. According to the WHO list with the top ten countries with MPM deaths between 1994 and 2008, Japan follows further with a percentage of 12,1%, Germany with 10,4% and France with 7,2%.…”

Moving more potent and less toxic options to the frontline in the management of advanced lung cancer

“…These well vetted targeted therapies have demonstrated superior and more durable clinical outcomes and quality of life in patients with genotype-defined advanced NSCLC, as compared to the efficacy and toxicity profiles associated with cytotoxic chemotherapies in this disease. Ongoing research also shows promising potential for use of kinase inhibitors for other putative driver mutations in NSCLC (17).…”

Can radiotherapy potentiate the effectiveness of immune checkpoint inhibitors in lung cancer?

“…By activating the immune system to recognize and eliminate cancer, immune checkpoint blockade has the potential to elicit durable responses and augment survival outcomes for a subset of patients [1,2]. In addition, the ability of radiotherapy to induce an immunogenic response and neutralize the immune-suppressive effects of the tumor microenvironment, uniquely positions it as a synergistic tool at the center of emerging multimodal therapies utilizing immune checkpoint blockade [3][4][5][6][7].Immune checkpoint inhibitors of the PD-1/PD-L1 pathway have emerged as a promising new therapeutic strategy [8][9][10][11]. These agents have produced durable clinical responses and antitumor activity in Phase I trials, leading to subsequent randomized Phase II and III trials that demonstrated significant improvements in overall survival when compared with cytotoxic chemotherapy alone [12][13][14][15][16].…”

“…Immune checkpoint inhibitors of the PD-1/PD-L1 pathway have emerged as a promising new therapeutic strategy [8][9][10][11]. These agents have produced durable clinical responses and antitumor activity in Phase I trials, leading to subsequent randomized Phase II and III trials that demonstrated significant improvements in overall survival when compared with cytotoxic chemotherapy alone [12][13][14][15][16].…”

“…These agents have produced durable clinical responses and antitumor activity in Phase I trials, leading to subsequent randomized Phase II and III trials that demonstrated significant improvements in overall survival when compared with cytotoxic chemotherapy alone [12][13][14][15][16]. These studies have established PD-1/PD-L1 pathway blockade as a powerful new line of therapy for patients with advanced NSCLC following progression after platinum-based therapy [9,11]. Despite unprecedented improvements in clinical outcomes, less than 20% of patients respond to anti-PD-1/PD-L1 agents, necessitating strategies that explore combined treatment modalities in order to extend the benefits of immune checkpoint blockade to a broader patient population.…”