The broad range of therapies available in metastatic non–small cell lung cancer (NSCLC) has dramatically improved — but also complicated — treatment strategies. Getting "the right treatment, to the right patient, at the right time" in advanced disease is the oncologist's challenge, says Dr Mark Socinski. Joined by Drs Liza Villaruz and Thomas Stinchcombe, Dr Socinski discusses the importance of testing for the 10 biomarkers for which there are approved targeted therapies, the necessity of treatment with targeted therapies in the first-line setting, and management of toxicities that may develop.
The roundtable panelists open by providing an overview of NSCLC management options, which now include a range of targeted therapies and immunotherapies and the challenge of determining the optimal choice of therapy on the basis of oncogenic mutation status.
The panelists then underscore the importance of performing comprehensive genomic profiling, given that 30%-40% of NSCLC patients diagnosed with metastatic disease have an actionable oncogenic driver that could be treated with targeted therapy. They discuss next-generation sequencing and DNA and RNA analysis, as well as the use of both plasma and tissue testing.
Next, Dr Socinski and colleagues address toxicities of targeted therapies, describing them as more manageable than those of chemotherapy. The panel also addresses the advisability to retest mutation status at the time of progression to identify further therapeutic options.
Mark Socinski, MD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Spectrum; Lilly
Serve(d) as a speaker or a member of a speakers bureau for: Genentech; AstraZeneca; Lilly; Jazz; G1Therapeutics; Blueprint; Janssen
Received research grant from: Genentech; Novartis; Pfizer; Daiichi-Sankyo; Spectrum; Mirati
Liza Villaruz, MD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Janssen; IntervenBio; Sanofi; Takeda
Thomas E. Stinchcombe, MD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: EMD Serono; Janssen Oncology; Turning Point Therapeutics; Sanofi/Aventis; GlaxoSmithKline; Genentech/Roche; Daiichi Sankyo/Astra Zeneca; Takeda; Eisai/H3 Biomedicine; G1 Therapeutics; Spectrum Pharmaceuticals
Received research grant from: AstraZeneca; Takeda; Regeneron; Seagen; Mirati Therapeutics; Genentech/Roche