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For instructor materials including Power Points, Answers to Clinical Encounter Questions, please contact userservices@mhprofessional.com.
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Content Update
September 9, 2021
Amivantamab Approved for Treatment of EGFR exon 20 insertion-mutated Locally Advanced or Metastatic Non-small Cell Lung Cancer: Amivantamab is a bispecific EGFR receptor and MET receptor-directed antibody approved as a single agent for the treatment of EGFR exon 20 insertion-mutated locally advanced or metastatic non-small cell lung cancer in patients who have progressed on or after platinum based therapy. Amivantamab binds to both EGFR and MET, blocking ligand binding and which disrupts signaling pathways and causes degradation of EGFR and MET. In a phase 1 single arm trial enrolling 81 patients with EGFR exon 20 insertion mutations, the overall response rate was 40% with a median progression free survival of 8.3 months. Common adverse events included rash, infusion reactions, and hypokalemia.
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Content Update
June 14, 2021
Sotorasib Approved for Treatment KRAS G12C-mutated Locally Advanced or Metastatic Non-small Cell Lung Cancer: Sotorasib is a RAS inhibitor approved as a single agent for treatment of RAS G12C-mutated locally advanced or metastatic non-small cell lung cancer in patients who have received at least one prior therapy. Sotorasib is small molecule that covalently and irreversibly binds to the unique cysteine of KRAS G12C, which locks the protein in an inactive state that prevents further RAS signaling, ultimately inhibiting cell growth and promoting apoptosis. In a phase 2 single arm trial enrolling 124 patients with KRAS G12C mutations, the overall response rate was 37% with a median progression free survival of 6.8 months. Common adverse events included diarrhea, myopathy, and hepatotoxicity.
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LEARNING OBJECTIVES
Upon completion of the chapter, the reader will be able to:
Identify major risk factors for the development of lung cancer.
Explain the pathologic progression of lung cancer and its relationship with signs and symptoms of the disease.
Make appropriate recommendations for screening and preventive measures in high-risk patients.
Understand staging of lung cancer patients and how it influences treatment decisions.
Explain how histology, biomarkers, and genetic mutational testing are used to select therapy.
List the rationale, advantages, and disadvantages for neoadjuvant and adjuvant chemotherapy in non–small cell lung cancer (NSCLC).
Identify the treatment of choice and treatment goals for limited and extensive small cell lung carcinoma.
Identify the treatment of choice and treatment goals for local, locally advanced, and advanced non–small cell lung carcinoma.
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Lung cancer continues to be one of the most commonly diagnosed cancers and the leading cause of cancer-related mortality. Although treatment can cure some patients, most therapies only prolong survival and improve symptoms. Recent advances in lung cancer research has provided a number of new therapies that provide significant benefit for some populations of patients; however, antismoking campaigns still appear to offer the best opportunity to reduce lung cancer incidence and mortality.