The non-small cell lung cancer (NSCLC) treatment landscape is rapidly evolving, marked by advancements in biomarker testing, updated screening guidelines, and developments in antibody-drug conjugates (ADCs). These changes reflect both progress and challenges in improving patient outcomes.
The Importance of Biomarker Testing
Biomarker testing is now considered essential for personalized lung cancer care. According to David P. Carbone, MD, PhD, director of the thoracic oncology center at The Ohio State University, biomarker testing has transformed lung cancer treatment by allowing therapies to be tailored to the individual patient and their specific cancer profile. This approach benefits patients with both early- and late-stage disease, emphasizing the importance of conducting comprehensive panel testing prior to initiating therapy.
Updated Lung Cancer Screening Guidelines
In November 2023, the American Cancer Society updated its lung screening guidelines, removing the quit time criterion and reducing the pack-year criterion from 30 to 20. Melinda C. Aldrich, PhD, MPH, from Vanderbilt University, noted that these changes potentially expand the pool of patients eligible for lung cancer screening, aligning with recommendations from the US Preventive Services Task Force.
Sacituzumab Govitecan Trial Results
Recent data from the phase 3 EVOKE-01 trial revealed that sacituzumab govitecan-hziy (Trodelvy; Gilead), a TROP-2-directed ADC, did not improve overall survival (OS) as a monotherapy in NSCLC patients. While patients who did not respond to prior anti-PD-L1 treatment showed a 3-month OS improvement, this benefit was not observed in those who had responded to anti-PD-L1 therapy. Gilead reported that the treatment was well-tolerated, with no new safety signals identified.
Datopotamab Deruxtecan BLA Update
Daiichi Sankyo and AstraZeneca initially submitted a biologics license application (BLA) for datopotamab deruxtecan, supported by data from the phase 3 TROPION-Lung01 trial, which demonstrated a statistically significant improvement in progression-free survival compared to docetaxel in previously treated adults with locally advanced or metastatic nonsquamous NSCLC. However, the application was later withdrawn and replaced with a new BLA for accelerated approval based on data from the phase 2 TROPION-Lung05 trial, supported by data from TROPION-Lung01 and the phase 1 TROPION-PanTumor01 trial.
