CCO_Clin_Onc_June_XXXX_downloadable_Slides

clinicaloptions.com/oncologyLungCancerMay31-June4,2013Chicago,IllinoisLungCancerCCOIndependentConferenceCoverageofthe2013AmericanSocietyofClinicalOncologyAnnualMeeting**CCOisanindependentmedicaleducationcompanythatprovidesstate-of-the-artmedicalinformationtohealthcareprofessionalsthroughconferencecoverageandothereducationalprograms.ThisprogramissupportedbyaneducationalgrantfromThisprogramissupportedbyeducationalgrantsfromclinicaloptions.com/oncologyLungCancerAboutTheseSlidesUsersareencouragedtousetheseslidesintheirownnoncommercialpresentations,butweaskthatcontentandattributionnotbechanged.UsersareaskedtohonorthisintentTheseslidesmaynotbepublishedorpostedonlinewithoutpermissionfromClinicalCareOptions([e-mail])DisclaimerThematerialspublishedontheClinicalCareOptionsWebsitereflecttheviewsoftheauthorsoftheCCOmaterial,notthoseofClinicalCareOptions,LLC,theCMEproviders,orthecompaniesprovidingeducationalgrants.ThematerialsmaydiscussusesanddosagesfortherapeuticproductsthathavenotbeenapprovedbytheUnitedStatesFoodandDrugAdministration.Aqualifiedhealthcareprofessionalshouldbeconsultedbeforeusinganytherapeuticproductdiscussed.Readersshouldverifyallinformationanddatabeforetreatingpatientsorusinganytherapiesdescribedinthesematerials.clinicaloptions.com/oncologyLungCancerFacultyDavidR.Gandara,MDProfessorofClinicalMedicineUCDavisComprehensiveCancerCenterSacramento,CaliforniaHeatherWakelee,MDAssociateProfessorofMedicine,OncologyDepartmentofMedicine/OncologyStanfordUniversityStanford,Californiaclinicaloptions.com/oncologyLungCancerDisclosuresDavidR.Gandara,MD,hasdisclosedthathehasreceivedfundsforresearchsupportfromAbbott,Bristol-MyersSquibb,EliLillyandCompany,Genentech,ImClone,Merck,Novartis,andPfizer;andhasreceivedconsultingfeesfromAmgen,AstraZeneca,Boehringer-Ingelheim,Bristol-MyersSquibb,Celgene,GlaxoSmithKline,Genentech,ImClone,Merck,Novartis,Pfizer,ResponseGenetics,Sanofi-Aventis,andSyntia.HeatherWakelee,MD,hasdisclosedthatshehasreceivedconsultingfeesfromGileadSciencesandfundsforresearchsupportfromAgennix,Arqule,AstraZeneca,Celgene,Clovis,EliLillyandCompany,Exelixis,Genentech,Merck,Novartis,Pfizer,andRegeneron.clinicaloptions.com/oncologyLungCancerOverviewLocal-RegionalNSCLC–PhaseIIIRTOG0617:74Gyvs60GyRT–PhaseIIISTART:tecemotide(L-BLP25)vsplaceboEGFRTKIsinAdvancedNSCLC–PhaseIIIPRONOUNCE:Pem/Carbo→PemvsPac/Carbo→Bev–PhaseIIIPROSE:serumproteintestinpredictingsurvivalforpatientsonsecond-lineerlotinibvschemotherapyExtensive-StageSmall-CellLungCancer–PhaseIICALGB30504:chemo±maintenancesunitinibTargetedTherapy–PhaseIIILUMELung1:docetaxel±nintedatinibinadvanced/metastaticNSCLC–PhaseIIGALAXY-1:docetaxel±ganetespibinadenocarcinoma–PhaseIstudyofnivolumab(anti–PD-L1antibody)monotherapyinNSCLC–PhaseIAstudyofMPDL3280A(anti–PD-L1antibody)insolidtumors–PhaseIstudyofLDK378inadvancedALK+NSCLC–PhaseIIstudyofdabrafenib(BRAFV600Ekinaseinhibitor)instageIVNSCLCclinicaloptions.com/oncologyLungCancerLocal-RegionalNSCLCclinicaloptions.com/oncologyLungCancerRTOG0617:PhaseIIITrialof74Gyvs60GyRTinUnresectableStageIIINSCLCPrimaryendpoint:OSBradleyJD,etal.ASCO2013.Abstract7501.Usedwithpermission.*CTconsistedofcarboplatin/paclitaxel.†400mg/m2loadingdoseonDay1,followedbyweeklydoseof250mg/m2Patientswithnewlydiagnosed,unresectablestageIIIA/IIIBNSCLC(N=464)StratifiedbyRTtechnique,Zubrodstatus,PETstaging,histologyConcurrentTreatmentConsolidationTreatmentStandard-DoseRT+concurrentCT*(n=125)ConsolidationCT*High-DoseRT+concurrentCT*(n=121)ConsolidationCT*Standard-DoseRT+concurrentCT*+Cetuximab†(n=108)ConsolidationCT*+Cetuximab†High-DoseRT+concurrentCT*+Cetuximab†(n=110)ConsolidationCT*+Cetuximab†clinicaloptions.com/oncologyLungCancerRTOG0617:SurvivalEfficacyOutcomeStandard-DoseRT(n=213)High-DoseRT(n=206)HR(95%CI)PValueMedianOS,mos28.719.51.56(1.19-2.06).000718-moPFS,%36.626.31.30(1.04-1.63).011618-molocalfailure,%25.134.31.37(0.99-1.89).031918-modistantfailure,%42.447.81.15(0.87-1.51).1576BradleyJD,etal.ASCO2013.Abstract7501.Usedwithpermission.clinicaloptions.com/oncologyLungCancerRTOG0617:SafetyGrade3esophagitisoccurredsignificantlymoreoftenwithhigh-dosevsstandard-doseRT(20.9%vs7.0%;P=.0003)AdverseEventsDefinitely,Probably,orPossiblyRelatedtoTreatment,%Standard-DoseRT(n=213)High-DoseRT(n=206)WorstnonhematologiceventsGrade346.046.1Grade49.911.2Grade50.94.9WorstoverallGrade346.541.7Grade426.831.6Grade50.94.9BradleyJD,etal.ASCO2013.Abstract7501.Usedwithpermission.clinicaloptions.com/oncologyLungCancerSummaryHigh-doseRT(74Gy)associatedwithhigherriskofdeath,locoregionalrecurrence,andincidenceoffatalAEsvslow-doseRT(60Gy)whenadministeredwithconcurrentCTinpatientswithnewlydiagnosed,unresectablestageIIINSCLCAnalysisoftheadditionofcetuximabtohigh-andlow-doseRTwithconcurrentCTisongoingBradleyJD,etal.ASCO2013.Abstract7501.Usedwithpermission.clinicaloptions.com/oncologyLungCancerTecemotide(L-BLP25):NovelLipopeptideCancerVaccineAdjuvant=MonophosphoryllipidATheadjuvantsupportsT-cellresponsebyinducingpro-inflammatorycytokines(viaTL