ASCO-SEP® 7th Edition, is a comprehensive resource designed to help providers assess their level of knowledge in the various areas of oncology. This chapter provides a current understanding of lung cancer, its treatment, and the supportive care needed to optimize the quality of life for people with lung cancer.
Immunotherapy continues to improve outcomes in non–small-cell lung cancer (NSCLC). The US Food and Drug Administration (FDA) has approved several chemoimmunotherapy combinations (independent of PD-L1 expression) for patients with advanced NSCLC after demonstrating improvement in overall survival compared with chemotherapy alone. The combination of carboplatin, pemetrexed, and pembrolizumab (Gandhi L, N Engl J Med 2018) and the four-drug regimen of carboplatin, paclitaxel, bevacizumab, and atezolizumab (Socinski M, N Engl J Med 2018) are approved for patients with nonsquamous NSCLC, and carboplatin with paclitaxel or nab-paclitaxel and pembrolizumab is approved for patients with squamous NSCLC. (Paz-Ares L, N Engl J Med 2018)
The addition of the atezolizumab to standard carboplatin plus etoposide for extensive-stage small-cell lung cancer was approved on the basis of an improvement in progression-free survival and overall survival. (Horn L, N Engl J Med 2018)
After definitive chemoradiation for unresectable stage III NSCLC, consolidation therapy with durvalumab led to a significant improvement in overall survival and FDA approval. (Antonia S, N Engl J Med 2018)
Larotrectinib (Drilon A, N Engl J Med 2018) and entrectinib (Paz-Ares L, Ann Oncol 2019) both received tumor-agnostic FDA approval for the treatment of cancers harboring a fusion in NTRK1-3, after demonstrating high response rates across tumor types, including NSCLC.
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