Today I’m speaking about some of the latest advances in the targeting of EGFR and ALK mutations in non-small cell lung cancer. There are multiple new drugs available in that space which have improved efficacy, ability to target resistance mutations, improved brain penetration and dramatically increased progression free survival and, in the case of alectinib, showing that first line use appears to be significantly better than waiting until progression on the first generation inhibitors. The data for osimertinib is not out yet in first line but we’re expecting that later this year.
The lung cancer space is rapidly changing. There have been many new drugs approved in the last year; we have many new opportunities for our patients. Advanced genetic analysis has identified multiple new genetic drivers with drugs that target them; we’ve improving the drugs that we have to target the known drivers and we have a whole new type of therapy with the immunotherapies. In making the lung cancer landscape much more complex than it was when I started my training twenty years ago but the outlook of patients is substantially better with median survivals in the 4-6 month range in the past and now with the immunotherapies and the targeted therapies we’re seeing median survivals of multiple years and examples of patients who live a decade or more with advanced lung cancer and this is truly remarkable. But it complicates the life for the medical oncologist treating lung cancer because keeping up to date with these advances, doing the appropriate biomarker testing and understanding the proper sequencing of these drugs, the management of their toxicities, is completely different than it was a few years ago, rapidly evolving and extremely important. These decisions impact the outcome of patients and the safety of patients with these new agents. So it’s incumbent upon people who treat lung cancer to stay informed.