The latest in lung cancer

Clinicians from The Royal Marsden have been in Toronto over the past few days, presenting new research and providing expert comment at this year’s World Conference on Lung Cancer (WCLC). 

Conferences such as WCLC are a critical opportunity for scientists to network, share and learn about the latest findings, and establish collaborations for future research.  

Dr Sanjay Popat, Dr Fiona McDonald, Dr Adam Januszewski and others from our Lung Unit joined over 5000 oncologists from across the world. 

‘Hope for patients’ 

Dr Januszewski, an Academic Clinical Fellow who is part-funded by The Royal Marsden Cancer Charity, is leading pioneering research with Dr Popat, analysing the DNA of pleomorphic lung tumours. At WCLC he presented some initial and very promising early data on this rare type of lung cancer. 

“We found for the first time that the presence of a genetic abnormality changes across the tumour. This has been shown in some circumstances to be treatable in other tumour types,” he explains.

“This research has given us a solid groundwork, and I anticipate that we will present more data in the next few months. We hope this new information could offer hope for patients with this difficult to treat cancer.”

‘A potential new treatment option’

New research presented at the conference, and published in the New England Journal of Medicine, argues that brigatinib should be a first-line treatment option for advanced ALK-positive non-small cell lung cancer.

The phase 3 trial, ALTA-1L, compared brigatinib with crizotinib – both ALK inhibitors, and included over 270 patients. 

Dr Sanjay Popat, Consultant Medical Oncologist at The Royal Marsden and Senior Author of the research, said: “These early results have demonstrated a marked benefit for brigatinib.

“If it gains the necessary regulatory approvals, brigatinib could offer significant hope for ALK positive lung cancer patients in the form of a new treatment option.”

‘One of the most important studies into lung cancer in 20 years’

At this year’s WCLC, the pharmaceutical company Astra Zeneca presented new findings from their study PACIFIC, which analysed the drug durvalumab. A type of immunotherapy, durvalumab was shown in their findings to significantly improve the overall survival of patients.

Dr Popat, who was not involved in the study said: “This is one of the most important studies into lung cancer treatment for the past 20 years.

“For the first time it shows that immunotherapy can markedly improve survival in stage III NSCLC, when used after chemotherapy and high dose radiotherapy.

The PACIFC data fundamentally changes how we should treat this difficult disease, when there is still a chance of curing the patient.”

There have been a small number of patients at The Royal Marsden who have recently been treated with durvalumab.

Sam, 47, was diagnosed with stage III lung cancer in December 2017. After receiving chemotherapy and radiotherapy she was given the news in April that there was no evidence of active disease. Soon after this, she started on durvalumab and expects to be on the drug for about a year.

She says: “My clinicians here at The Royal Marsden have been really pleased with how I’ve responded to treatment. I’ve not had any side effects so have found it quite manageable, and have even started going back to work for a few hours a week.”

Read more about advances in lung cancer treatment over the past decade, which have transformed outcomes for patients, in RM magazine