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Top 5 Developments in Lung Cancer in 2021

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Advances in gene targets and their treatments dominated the therapeutic landscape for 2021, says Dr Mark Kris.

Hi it’s a mark chris from memorial slim kettering uh again we’ve had another fantastic year for developments in the lung cancer field uh 2021 led to many important um presentations that showed us new medications uh that can lead to uh benefit and and hopefully the cure of more patients i’m just gonna highlight the uh the top five for this year i think number

Five would be the emergence of antibody drug conjugates uh dr bob lee my colleague uh years ago showed how edotrestusomabentancine was helpful for persons with lung cancers with the her2 mutations and this year he showed again that another adc trastuzumab derek’s tecan was even more helpful for patients that had her2 mutant lung cancers in a patient in the new

England journal i think other agents of this class are are moving forward as a construct the adcs are going to become more and more important the next extremely important development was the approval of at least three medications for targets where we didn’t have drugs previously for egfr exon 20 insertions we now have emmyvantanab and mobasartnip and for kris

G12c we have soda acid these were always targets where we thought we would have a target therapy but we’re close but not there and now we’re there all of these targets have uh fda approved uh therapies available uh in uh 2021. number three is the paper by dr ford at aacr that looked at neoadjuvant chemotherapy and nivolumab comparing it to chemotherapy alone and

There what they saw was a clear response benefit from the three drugs over the two and also a higher rate of pathologic complete response the main goal of the trial and also reported in a press release later later after the presentation in association between the treatment with nivolumab and chemotherapy over chemo alone improving disease-free survival here

Three cycles of therapy uh before treatment no adjuvant therapy actually given led to an improvement in dfs presented this year and hopefully a paper and an fda approval will follow that i think the uh second most important thing this year was the presentation uh uh at the uh asco meeting of adjuvant a tesla is a map there a tesla is a map in patients that had a

Pdl1 greater than one percent stages 2 and 3a had a significant and dramatic improvement in progression-free survival survival adding a tesla-ism ab in it’s become a new standard of care it’s been approved by the fda quickly included in guidelines so now in addition to uh osimertinib for patients with egfr mutations after chemotherapy after a curative surgery

We now have a tesolizumab for patients with pdl1 staining one percent or greater uh who have a complete resection i should also mention though that these things are mutually exclusive the patients that have targets do not achieve the degree of benefit as those patients that do not have a gene target and it’s important to test patients number one to find gene

Targets for patients that could benefit from drugs like a tesla is a map and conversely those that don’t have a target quickly make sure they get a tesla ism and i think the most dramatic development this year is we have finally hit the 50 level uh rounding up a little bit to the proportion of patients with egfr mutant cancers that have a a target a gene target

You know people always talked about oh it’s only a few percent of patients but when you add all those percents up we’re near 50 so i think this highlights the importance of testing it highlights the importance of matching those targeted therapies to the gene targets that are found in patients tumors and now the nearly half the patients are able to find a a target

That leads to therapy again a very good year developments all through the spectrum of care from early to late stage illnesses clear benefits from the new therapies we had and a lot of hope that this wave of research will continue and lead to even more benefits next year you

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Top 5 Developments in Lung Cancer in 2021 By Medscape