Advances in lung cancer treatment include immunotherapy, new approvals
With multiple approvals and more treatments in the pipeline, there have been “amazing” advances in lung cancer treatment over the past year, Roy Herbst, MD, PhD, told Healio.
Healio spoke with Herbst, associate cancer center director for translational research at Yale Cancer Center, about how clinicians can navigate these advances and the unmet needs that remain for patients.
Healio: Have there been any potential practice changing FDA approvals?
Herbst: Yes. It has been an amazing year. We have seen approvals with drugs for a number of targets, including RET, MET, ALK and of course EGFR. EGFR is one that I was involved with in patients with early-stage lung cancer disease.
Healio: What are some treatments in the pipeline you are anticipating?
Herbst: Very excited now about KRAS drugs. There have been great data on KRAS, Amgen 510, Mirati MRTX849 drugs, all showing activity in lung cancer where the response rate is [in the] 30% to 40% range and very good median survival. I anticipate this will be one of the next classes of drugs we will see.
Healio: With so many new options for treatments becoming available, what advice do you have for clinicians navigating the management of patients with lung cancer?
Herbst: It’s amazing the products we have seen in 20 years — even in 10 or 5 years — especially targeted therapy, now immunotherapy, now with combinations. Patients should ask that their tumors be profiled. They need to know their PD1 status as this will be important for their treatment.
Healio: Are there any areas of unmet need in treatment research?
Herbst: There continue to be areas of unmet need in metastases of the liver, lungs, bones; [that is] certainly a big area. Resistance to immunotherapy. Immunotherapy is having such a big impact on the field. However, immunotherapy is a situation where, despite all the advances, we continue to have 70% or so of patients recur, or even more. There needs to be more personalized immunotherapy. After 20 years, we are first beginning to really find the benefits of targeted therapy. Now, we have to find targeted immunotherapy. That will be the challenge in the next few years.
Healio: How is immunotherapy impacting the field?
Herbst: Immunotherapy has allowed some patients to survive 5 years or more after diagnoses with late-stage lung cancer. But this only happens to 20% to 30% of patients. We need to continue our work to identify biomarkers that can predict response in patients and provide other options to patients who we know will not respond to immunotherapy.
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Healio Interview