Recent developments driving the 'evolution' of lung cancer treatments
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2022 has brought many research updates and approvals in lung cancer.
Healio spoke with Pasi A. Jänne, MD, PhD, director of Lowe Center for Thoracic Oncology at Dana-Farber Cancer Institute, to discuss the most important updates in lung cancer, and where research is heading in the years to come.
“The last decade has been really exciting in the evolution of treatments for lung cancer, moving from really a one-size-fits-all to a more personalized, precision therapy approach,” Jänne told Healio. “We think that that pattern will continue moving forward, and of course there’s applicability to other cancers as well and hopefully we’ll see those translated into improved outcomes for our patients.” Spur
Recent drug approvals, research in lung cancer
Jänne noted that in recent years, there have been important developments in the treatment of specific subsets of lung cancer — one being the use of fam-trastuzumab deruxtecan-nxki (Enhertu; AstraZeneca, Daiichi Sankyo) for HER2-mutated lung cancer.
The drug, which has previously been approved for HER2-positive breast cancer, received accelerated approval from the FDA for the treatment of HER2-mutated NSCLC in August. Jänne explained that this drug has been shown to be a “very effective therapy” in this patient population.
Additionally, he explained that sotorasib (Lumakras, Amgen), which was approved in May 2021, was a critical approval in the treatment of KRASG12C-mutated locally advanced or metastatic non-small cell lung cancer.
At the 2022 ESMO Congress in September, researchers presented data showing that sotorasib as a second-line therapy significantly extended progression-free survival in patients with KRASG12C-mutated NSCLC compared with docetaxel.
Jänne noted that another treatment targeted for KRASG12C, adagrasib (MRTX849, Mirati Therapeutics), has been researched and is up for FDA approval.
In research presented at ASCO 2022, adagrasib demonstrated efficacy in patients with KRASG12C-mutated NSCLC.
“It’s an active area of drug development — there’s lots of other drugs in the clinical pipeline for this patient population, and we’ll look forward to seeing how those do in the [clinical setting],” Jänne said. “KRAS mutations are of course not just found in lung cancer, but they’re found in pancreatic cancer, colon cancer [and] other cancers, so this has implications for cancers beyond lung cancer as well.”
2023 and beyond
Jänne noted that, looking toward upcoming research in lung cancer, there will be a continued focus on “next-generation versions” of these and other agents.
This includes researching combinations of these agents to determine if they are more effective than a single agent and evaluating the toxicity of these combinations.
He explained that, moving forward, researchers are hoping that the treatment of lung cancer will evolve to be similar to the treatment of other conditions, such as HIV and other complicated infections.
Jänne said that as for conditions “like HIV — where we give multiple drugs simultaneously to attack a foreign virus in multiple different ways — if we can attack lung cancers in multiple different ways that can hopefully lead to improved outcomes.”
He explained that researchers are already approaching this type of method through the use of chemotherapy and immunotherapy, but “there are many other ways of doing this, and many of those are being tested in clinical trials at the moment. We hope that those will be successful and ultimately be available for our patients.”
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