Scientific Advances in Thoracic Oncology 2016

Our plain-English summary of Scientific Advances in Thoracic Oncology 2016, by R.A. Soo, E.C.A. Stone, K.M. Cummings, et al (Journal of Thoracic Oncology, 2017).

The study

• Authors: R.A. Soo, E.C.A. Stone, K.M. Cummings, J.R. Jett, J.K. Field, H.J.M. Groen, J.L. Mulshine, Y. Yatabe, L. Bubendorf, S. Dacic, R. Rami-Porta, F.C. Detterbeck, E. Lim, H. Asamura, J. Donington, H.A. Wakelee, Y.L. Wu, K. Higgins, S. Senan, B. Solomon, D.W. Kim, M. Johnson, J.C.H. Yang, L.V. Sequist, A.T. Shaw, M.J. Ahn, D.B. Costa, J.D. Patel, L. Horn, S. Gettinger, S. Peters, M.W. Wynes, C. Faivre-Finn, C.M. Rudin, A. Tsao, P. Baas, R.J. Kelly, N.B. Leighl, G.V. Scagliotti, D.R. Gandara, F.R. Hirsch, D.R. Spigel
• Journal: Journal of Thoracic Oncology
• Published: 2017;12(8):1183-1209
• Type of article: Historical article, Review
• Cited by: 46 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

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.

Copyright © 2017 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

In plain English

This article is a review, not an original study. It is the second annual update from the International Association for the Study of Lung Cancer. Experts summarized 2016 advances in prevention, screening, diagnosis, staging and treatment of non-small cell lung cancer, small cell lung cancer and mesothelioma. The article does not discuss asbestos; its prevention section covers cigarettes, e-cigarettes and cannabis. In a short mesothelioma section, the authors reported that drugs that block PD-1 or PD-L1, given alone, had response rates of 9-28% and disease control rates of 50-77% in what they called unselected mesothelioma patients. However, their table shows that the trial reporting 28% (KEYNOTE-028) enrolled only PD-L1-positive patients. In the DETERMINE trial in mesothelioma, tremelimumab showed no benefit over placebo. They noted that the French MAPS trial found a benefit in progression-free and overall survival when bevacizumab was added to cisplatin-pemetrexed chemotherapy. They also described changes to the staging system for mesothelioma. The authors concluded that PD-1/PD-L1 inhibitors showed a preliminary modest signal, but that understanding the biology and developing new combination treatments remained a critical need.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative review (annual expert update) of research advances in thoracic cancers during 2016
• Who was studied: Published and presented research from 2016 on non-small cell lung cancer, small cell lung cancer and mesothelioma, reviewed by expert authors; no patients were studied directly
• Exposure: The article does not discuss asbestos or any fiber type. Its prevention section covers tobacco cigarettes, e-cigarettes and cannabis. The rest of the article addresses diagnosis and treatment.
• Main results:
  • In basket trials that included mesothelioma cohorts, PD-1/PD-L1 inhibitors given alone had reported response rates of 9-28% and disease control rates of 50-77%. The authors described these patients as unselected mesothelioma patients.
  • In Table 4, the trial with the highest response rate was KEYNOTE-028 (pembrolizumab, second line). It had a 28% response rate and a 76% disease control rate, and all of its patients were PD-L1 positive.
  • In mesothelioma, checkpoint inhibitors seemed more active in patients whose tumors tested PD-L1 positive. The authors described this association as not strong.
  • In the DETERMINE trial in mesothelioma, the CTLA4 inhibitor tremelimumab did not show any benefit over placebo.
  • The French MAPS trial in mesothelioma showed a benefit in progression-free and overall survival when bevacizumab was added to cisplatin-pemetrexed.
  • The revised TNM staging for mesothelioma made three changes. It combined T1a and T1b into a single T1 category, merged N1 and N2 into N1, and reclassified N3 as N2.
• The authors' conclusion: For mesothelioma, the authors concluded that PD-1/PD-L1 inhibitors show a preliminary modest signal. They added that there is still a critical need to understand the biology and develop novel combination therapies.

Topics

Medical terms in this study, explained in our Lexicon: Lung Cancer, Immunotherapy, Pathology, Staging, Adjuvant Therapy, Targeted Therapy, Mesothelioma.

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