In honor of November being Lung Cancer Awareness Month, here is a look back at some of the most impactful developments in the space from 2023.

Approval of Braftovi with Mektovi Adds to Targeted Options for Metastatic NSCLC

The Food and Drug Administration (FDA) recently approved Braftovi (encorafenib) with the combination of Mektovi (binimetinib) for the treatment of adult patients with metastatic non-small cell lung cancer (NSCLC). This FDA approval became the latest development as a targeted therapy to treat patients with lung cancer.

“It’s just one more in a series of approvals of targeted therapies in lung cancer, which is a story that dates back now for about 15 years (which) is when this originally started,” Dr. Gene G. Finley, assistant professor at Drexel University of College of Medicine and medical oncologist at AHN Cancer Institute, Allegheny Clinic Medical Oncology, said.

The most recent approval was based off the PHAROS trial, which, published in the Journal of Clinical Oncology, stated that “for patients with treatment-naïve and previously treated BRAF V600E-mutant metastatic NSCLC, (Braftovi) plus (Mektovi) showed a meaningful clinical benefit with a safety profile consistent with that observed in the approved indication in melanoma.”

Trodelvy May Provide Benefits in Extensive-Stage Small Cell Lung Cancer

Trodelvy (sacituzumab govitecan-hziy) led to clinical benefit when used as second line treatment for patients with extensive-stage small cell lung cancer (ES-SCLC), according to part of a phase 2 trial that was shared at the 2023 ESMO Congress.

The study focuses on 30 patients, all of which received a partial response within the study. “Seventy-seven percent of patients (who underwent) post-baseline tumor assessment (experienced) some kind of tumor reduction, and 43% had a reduction of greater than 30%,” lead study author Dr. Afshin Dowlati said in a presentation of the data. “Very few patients had up-front (disease) progression on their first imaging.”

Trodelvy is now being investigated for the treatment of solid tumors in a TROPiCS-03 study, where about 40 patients plan to be enrolled in, while taking doses of Trodelvy.

“These results are encouraging in (patients with) ES-SCLC. The trial is ongoing, and we will hopefully have full results early (in 2024) with a full cohort. We believe that further investigation of (Trodelvy) in SCLC is warranted,” Dowlati concluded.

Anamorelin Improves Weight Gain in Patients with Lung Cancer Experiencing Cachexia

Anamorelin improved weight gain for patients with non-small cell lung cancer (NSCLC) with cachexia over a placebo. These results were found within trials ANAM 17-20 and ANAM-17-21, presented at the 2023 ESMO Annual Congress.

A total of 318 patients were enrolled in each study, which investigated if the placebo group or anamorelin group experienced more weight gain improvement. Efficiency and safety of anamorelin was also investigated within the study.

“As an oral medication, it is convenient for patients and because of its longer half-life life, it can be given once daily,” David Currow, deputy vice chancellor, University of Wollongong in Australia,explained during a presentation of the data. Anamorelin was favored over the placebo based on age, degree of weight loss, stage of disease, functional status and whether they underwent treatment with chemotherapy or immunotherapy.

Both trials showed that weight gain had improved within the anamorelin group of patients and remained consistent in comparison to the placebo group.

Jemperli Plus Chemo Continues to Demonstrate Strong Outcomes in Advanced NSCLC

When being treated with Jemperli (dostarlimab-gxly) plus chemotheraphy, patients with treatment-naïve, nonsquamous non-small cell lung cancer (NSCLC) experienced a higher objective response rate (ORR; patients who disease had responded to the treatment given) and overall survival improvements compared to Keytruda (pembrolizumab) combined with chemotherapy. These results were shown at the 2023 ESMO Congress.

“Results are consistent with the study hypothesis that (Jemperli) and (Keytruda) have similar efficacy,” Dr. Solange Peters, ESMO past president, full professor and chair of medical oncology and the thoracic malignancies program in the department of oncology at the University Hospital of Lausanne in Switzerland, said in a presentation of the data. “…These results support further investigation of (Jemperli) as a treatment backbone in combination with standard-of-care treatments and future novel cancer therapies in patients with NSCLC.”

These findings supported the examination of Jemperli and an upcoming 2 GALAXIES LUNG-201 study will be focusing on the safety, efficiency pharmacokinetics and pharmacodynamics of novel immunotherapy combinations versus single-agent immunotherapy drugs in patients with NSCLC, with Jemperli being one of them.

Rybrevant Plus Chemo Offers Better Progression-Free Survival for NSCLC Subset

Rybrevant (amivantamab-vmjw) combined with chemotherapy showed improved progression-free survival (PFS; time of started treatment until death or disease worsening) in patients with advanced EGFR exon 20 insertion-positive non-small cell lung cancer in comparison with chemotherapy treatment alone. These findings come from a phase 3 trial explained at the 2023 ESMO Congress.

A total of 308 patients were enrolled into the phase 3 trial, with 153 patients in the chemotherapy combined with Rybrevant group, and 155 in the chemotherapy group.

“Consistent PFS benefit (was seen) across predefined subgroups by blinded independent central review. (Rybrevant)-chemotherapy represents the new standard of care for first-line EGFR exon 20 insertion-mutated advanced NSCLC,” Dr. Nicolas Girard, professor of respiratory medicine at Versailles Saint Quentin University and professor and head of the Curie-Montsouris Thorax Institute at the Institut Curie in France, said in the presentation that revealed the study’s data.

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