ESMO E-Learning: Innovation in Lung Cancer Management

Learning Objectives

  1. To provide an update on results from the recent clinical trials in advanced non-small cell lung cancer (NSCLC)
  2. To contextualize at clinical practice level the advances in NSCLC treatment 
  3. To provide a new therapeutic scenario/algorithm in the management of advanced NSCLC
Title Duration Content CME Points CME Test
Innovation in Lung Cancer Management 24 min. 34 slides 1 Take Test
Federico Cappuzzo
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The landscape of therapeutic options for advanced non-small cell lung cancer (NSCLC) is rapidly evolving and although this E-Learning module had been planned as an update of a previously available module by the same author, it should be considered as a completely new work.In this E-Learning module, the author contextualizes the recent clinical practice changes in the treatment of advanced NSCLC.While the therapeutic stratification for NSCLC was based until recently on histology and EGFR and ALK status, the author emphasizes that in 2018 the medical oncologists face with a range of therapeutic scenarios in first- and second-line treatment for next settings:

  1. EGFR wild-type(wt)/ALK-negative/ROS1-negative/PD-L1 negative,
  2. EGFR wt/ALK-negative/ROS1-negative/PD-L1high (>50%),
  3. EGFR-positive,
  4. ALK-positive,
  5. ROS1-positive,
  6. BRAF V600E positive disease.

For these settings, the author provides a digest from pivotal trials and illustrates the presentation with key data and figures supporting the results findings. Therefore, this E-Learning module provides an essence in terms of current elaboration and understanding of the therapeutic scenario for advanced NSCLC.  The author emphasizes that immune checkpoint inhibitors are replacing chemotherapy in first-line setting in PD-L1 expressing NSCLC. Immunotherapy is the new standard for EGFR wt, ALK wt NSCLC in second line treatment irrespective of PD-L1 expression.Furthermore, the author concludes that gefitinib, erlotinib or afatinib seem to be equivalent in terms of efficacy irrespective of type of EGFR mutation.In addition, the author emphasizes that a combination of erlotinib and bevacizumab is more effective than erlotinib alone.In terms of EGFR T790M positive NSCLC, osimertinib is the best therapeutic option.  The author underlines that alectinib is replacing crizotinib in first-line therapy for ALK rearranged NSCLC.Furthermore, new EGFR or ALK inhibitors cross blood brain barrier extending patient survival and therefore impact on treatment of patients with brain metastases.

Last update: 07 May 2018

The author has reported to be a consultant and advisor for Roche, AstraZeneca, Bristol-Myers Squibb, MSD and Pfizer.