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Thousands of oncologists, scientists, biotech and pharmaceutical representatives, patients, and advocates (including LUNGevity staff) met to discuss lifesaving cancer research at the annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago from May 31 through June 4, 2024.
The theme for this year’s conference, “The Art and Science of Cancer Care: From Comfort to Cure,” highlighted the importance of using both our creativity and our scientific prowess to increase access to treatment.
It’s a time when we’ve made and continue to make extraordinary progress in cancer treatment, leading to better outcomes, even cures, for many patients. But my theme also recognizes that these advances are not benefiting all patients. Sometimes our best treatments don’t work, or the cancer becomes resistant, or, tragically, too many patients lack access to treatment. This discordant reality means that while we continue advancing oncology science and fully leveraging the latest technologies, we must ensure these innovations benefit all patients, wherever they live, and we must increase our emphasis on the art of cancer care for all patients.
Lynn M. Schuchter, MD, 2023-2024 president of the American Society of Clinical Oncology (ASCO)
Throughout the conference, researchers presented data on many different aspects of lung cancer research and treatment. Here we highlight some of the most impactful and interesting lung cancer studies presented at this year’s meeting.
Small Cell Lung Cancer (SCLC)
This year was a big year for advances in small cell lung cancer (SCLC) treatment. After more than 50 years without an improvement in treatment, patients with limited-stage SCLC finally have another treatment option that goes beyond surgery, radiation, and chemotherapy. Data from the ADRIATIC study showed that after using chemotherapy and radiation to treat inoperable limited-stage SCLC, patients can now consider immunotherapy (durvalumab) to help keep the cancer at bay. These results, much needed for patients with SCLC, earned the researchers a standing ovation from the conference attendees and offer a new standard of care for treating patients with limited-stage SCLC.
Other investigations to identify SCLC subtypes that will make SCLC treatment more personalized and to test new types of SCLC treatments are great testaments to the progress we are making.
Non-Small Cell Lung Cancer (NSCLC)
Researchers have made huge strides in treating non-small cell lung cancer (NSCLC) over the past 20 years.
Biomarker-driven NSCLC: A major part of this progress has been due to the development of biomarkers and targeted therapies. Scientists presented data at ASCO 2024 that suggests more biomarkers, such as fibroblast growth factor receptor (FGFR) alterations and mesenchymal-epithelial transition factor (cMet) overexpression, may be on the horizon for patients with advanced NSCLC. This is great news because new biomarkers are likely to pave the way for more personalized treatment for patients.
ALK+ Lung Cancer
Researchers presented the five-year data for the CROWN study, which looked at lorlatinib (a third-generation tyrosine kinase inhibitor, or TKI) compared to crizotinib (a first-generation TKI) in patients with advanced ALK+ NSCLC. The data showed that 63% of patients treated with this drug didn’t have cancer recurrence yet, and the drug also seemed to be effective at preventing the cancer from spreading to the brain. To date, this is the longest progression-free survival seen in patients with any type of advanced NSCLC. It was another widely celebrated study at ASCO 2024!
Patient experiences and the impact of treatment on quality of life have become a focal point for the lung cancer community. Quality-of-life data from the global, phase 3 ALINA clinical trial, which looked at treating patients with early-stage ALK+ NSCLC with alectinib (an ALK-targeted TKI) compared to chemotherapy after surgery, confirmed that patients treated with alectinib reported better quality of life. This study and others like it will help researchers understand the impact of treatments on the lives of patients and ultimately bring better treatments to patients everywhere.
EGFR+ Lung Cancer
This year marks the 20th anniversary of the identification of EGFR's role in NSCLC, which ushered in the era of precision medicine. The progress for patients with EGFR+ NSCLC continues for all stages of the disease.
The current standard of care for patients with stage III EGFR+ NSCLC is treatment with a combination of chemotherapy and radiation, which is typically followed with immunotherapy. But the benefit of chemo-radiation with immunotherapy for patients with EGFR-positive lung cancer isn’t clear.
The third big lung cancer win presented at ASCO 2024 was the LAURA study, which showed that using osimertinib (a third-generation TKI) after chemoradiotherapy had a strong benefit for patients with EGFR+ NSCLC. This research brings an exciting new standard of care for patients with stage III EGFR+ NSCLC and a more personalized approach for treatment.
Researchers are also working on many other aspects of EGFR+ NCSLC, including identifying additional biomarkers, improving treatment options for patients with atypical EGFR mutations (mutations that do not respond to osimertinib), increasing options for addressing brain metastases, and testing combination treatments for early-stage disease.
HER2+ Lung Cancer
A promising new treatment for HER2+ NSCLC was showcased at ASCO 2024. Zongertinib is a HER2-specific TKI being tested in a phase 1 clinical trial called Beamion-LUNG1. While it’s still early in the testing process, this treatment looks promising compared to other HER2 TKIs. The study continues to enroll patients.
KRAS+ Lung Cancer
ASCO 2024 had an entire session dedicated to interesting and impactful KRAS+ NSCLC research. In 2022, the US Food and Drug Administration (FDA) issued an accelerated approval for adagrasib (a KRAS G12C-targeted TKI) for treating patients with KRAS+ NSCLC. Researchers presented data from KRYSTAL-12, a phase 3 clinical trial, which showed the continued benefit from adagrasib treatment without any additional safety concerns. These results may help lay the foundation for a full approval of adagrasib by the FDA.
In a separate study, researchers tested sotorasib (a KRAS G12C-targeted TKI that earned accelerated approval by the FDA in 2021) in combination with chemotherapy as a way to treat and overcome drug resistance in patients with advanced KRAS+ NSCLC. The results of this study were promising and led to a follow-up clinical trial, CodeBreaK 202, which is currently enrolling patients.
While the standard first-line treatment for advanced KRAS+ NSCLC is often immunotherapy, researchers wonder if we can improve this approach by adding a targeted therapy to the treatment regimen. Researchers presented the results of a study that added olomorasib (a second-generation KRAS G12C-targeted TKI) to pembrolizumab (an immunotherapy). Although there are some side effects of the treatment to be aware of, the data looks promising. Researchers are continuing to pursue this work in a global phase 3 clinical trial called SUNRAY-01, which is currently enrolling patients.
ROS1+ Lung Cancer
In a phase 2 clinical trial, researchers studied lorlatinib (a third-generation TKI) that is known to reduce brain metastases and target ALK and ROS1. They found that lorlatinib is likely to be a promising candidate to treat advanced ROS1+ NSCLC.
Lung Cancer in Younger Patients
Researchers are also studying the growing population of younger adults (under age 50) who are diagnosed with lung cancer. Learn more about the unmet financial, physical, and social needs of younger adults with lung cancer presented at this year’s conference by LUNGevity awardee Narjust Florez, MD.
Cancer Care that Centers Around Patients
While most studies at ASCO 2024 focused on improving treatments for patients with cancer, there is a growing interest in understanding other aspects of the patient experience. In particular, there were two eye-opening lung cancer studies that addressed other challenges patients face.
It is well documented that early integration of palliative care into a patient’s treatment plan can improve their quality of life. However, most patients don’t receive early palliative care. There are many reasons for this, such as transportation difficulties and having enough palliative care specialists available for the appointments.
To help address these challenges, researchers conducted the REACH study to determine the effectiveness of early palliative care when it's delivered in person vs. when it's delivered online to patients with advanced NSCLC.
Their findings showed that online or virtual palliative care appointments had the same effectiveness as in-person appointments. This important data may empower clinics in rural settings or with limited palliative care resources to adopt virtual palliative care appointments as an important tool to help patients get the care they need.
There was also compelling data presented from the PALOMA study that challenged one of the basic tenets of cancer care. In this study, researchers wanted to know if patients with advanced NSCLC truly needed to go into the clinic for an IV (intravenous) infusion of amivantamab (a drug that targets both EGFR and MET) or if injections given at home would be just as effective. The results of this global phase 3 trial show surprising results: injections were not less effective than IV infusion and, in some cases, even provided better clinical outcomes for patients.
While more studies are needed, these findings may encourage cancer clinics to consider manual, at-home injections for some patients.
Conclusion
There was an impressive breadth and depth of lung cancer studies presented at the annual ASCO conference, with researchers aiming to improve outcomes for patients with lung cancer in the US and across the globe. Working together, we are getting closer to our vision of a world where no one dies of lung cancer.