2020年5月30日

ASCO 2020: NSCLC (非小細胞肺癌のまとめ)

スライド画像付きのツイートを中心にまとめました。
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Index

  • [Molecular targets] EGFR, ALK, HER2, RET, MET, KRAS, CAECAM5, screening
  • [IO] Advanced stage, Stage III, biomarkers, microbiome
  • [Adjuvant] ADAURA, CTONG 1104

Metastatic NSCLC highlights

Stephen V Liu @StephenVLiu

#ASCO20 Lung Cancer (metastatic NSCLC) highlights by @benlevylungdoc - 5 thought provoking trials to be discussed here. #OncoAlert #LCSM pic.twitter.com/p6j4Aaqfus

2020-05-31 23:18:44
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Stephen V Liu @StephenVLiu

#ASCO20 Many first line options in #NSCLC. All compared to chemotherapy alone, an old standard. Difficult to compare across studies. #OncoAlert #LCSM pic.twitter.com/6RHOASmavp

2020-05-31 23:24:23
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Stephen V Liu @StephenVLiu

#ASCO20 Review of 3y outcomes of CM227 (nivo/ipi) and first report of CM9LA (nivo/ipi/chemo) confirm these as viable options but the endpoint of most interest is long term survival - and we will have to wait a bit to see that... #OncoAlert #LCSM pic.twitter.com/9hb2Y6L7UM

2020-05-31 23:28:07
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Stephen V Liu @StephenVLiu

#ASCO20 Another highlight is the trastuzumab-deruxtecan data. Multiple strategies ongoing - I suspect some of these can be complementary or used in sequence. Great to have multiple options in development! #OncoAlert #LCSM pic.twitter.com/AFBnKzfzKH

2020-05-31 23:32:59
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Joshua Bauml, MD @Jbauml

Completely agree with @benlevylungdoc that the data on trastuzumab deruxtecan are some of the most exciting data in #LCSM from #ASCO20. Toxicity is greater than we often see with a targeted therapy, but on par with chemotherapy pic.twitter.com/xsEEItQeSI

2020-05-31 23:27:58
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Stephen V Liu @StephenVLiu

#ASCO20 Two #EGFR studies highlighted. One trial combining osimertinib and gefitinib as an effort to delay acquired resistance. Another incorporating SBRT up front for oligometastatic EGFR+ NSCLC (osi +/- SBRT to up to 5 lesions, no CNS) - note high screen fail rate. #OncoAlert pic.twitter.com/OM0vX3Erx5

2020-05-31 23:37:05
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[Molecular targets]

EGFR

exon 20 ins highlights

Joshua Bauml, MD @Jbauml

OK now @DrSteveMartin is going to walk me through some exciting new abstracts in EGFR Exon 20 insertion. I always enjoy his talks - I am excited! #LCSM #ASCO20

2020-05-30 02:10:48
Joshua Bauml, MD @Jbauml

The first topic that he discussed is the abstract by @ZPiotrowskaMD and colleagues. From preclinical models osimertinib might have some efficacy. In contrast to many other TKI's in this space, we know that osimertinib is well tolerated (even at the 160 mg dose) #LCSM #ASCO20 pic.twitter.com/yzOPTNx3J6

2020-05-30 02:15:12
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Joshua Bauml, MD @Jbauml

Osimertinib at 160 mg did have some efficacy, though substantially less than what we see in classic mutations. This also has the advantage of being already available in the market. #ASCO20 #LCSM pic.twitter.com/5MLhFtlqYp

2020-05-30 02:16:53
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Joshua Bauml, MD @Jbauml

Next he spoke about poziotinib, based on a poster from Dr Le. Toxicity is a major problem - 68% of patients needed a dose reduction and 10% had to stop treatment. Despite this toxicity, the ORR was relatively disappointing (and notably lower than osimertinib) #ASCO20 #LCSM pic.twitter.com/yzjOk93K6q

2020-05-30 02:19:01
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Joshua Bauml, MD @Jbauml

Next he discussed amivantamab, an EGFR/MET bispecific Ab, based on the abstract from Dr Park. I have been involved in the development of this drug. It is pretty well tolerated, though has a common infusion reaction with cycle 1 day 1. #ASCO20 #LCSM pic.twitter.com/jUZUV8EGJR

2020-05-30 02:21:50
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Joshua Bauml, MD @Jbauml

Efficacy of amivantamab in this population has been quite good >40% in patients who had progressed on prior platinum. #ASCO20 #LCSM pic.twitter.com/zEqlmT7pZ3

2020-05-30 02:22:39
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Joshua Bauml, MD @Jbauml

There are many drugs in this space beyond these (TAK788, tarloxotinib, and others). One variable that is critical here is the specific insertion that is present. Some of the insertions are quite sensitive to even classical TKIs, very heterogeneous field #ASCO20 #LCSM

2020-05-30 02:26:00
Joshua Bauml, MD @Jbauml

Great slide from @DrSteveMartin via @JackWestMD that sums up some of the limitations of the described agents quite well. #ASCO20 #LCSM pic.twitter.com/gtfbLF0laI

2020-05-30 02:26:50
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Antonio Passaro @APassaroMD

#ASCO20 #LCSM Completing the acircle of EGFR (Exon 20) directed therapies by @DrSteveMartin Osimertinib double dose (160mg) interesting and safe, although limited in efficacy Poziotinib...probably failed Avintanamab very promising...stay tuned for further data pic.twitter.com/WOD9oowDAQ

2020-05-30 06:36:03
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Jill Feldman @jillfeldman4

Some promising abstracts for #NSCLC #EGFR #Exon20. THANK YOU @DrSteveMartin for acknowledging patients-"They are family & friends who just want a seat at the table" They may not be perfect, as seen in @JackWestMD stool analogy, but having a stool/option is a start #LCSM #ASCO20 pic.twitter.com/87s8PCIvr4

2020-05-30 03:21:54
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No.9513 exon 20 ins: ≥2L osimertinib 160mg, phase II (ECOG-ACRIN 5162)

Antonio Passaro @APassaroMD

#ASCO20 #LCSM Very interesting study by @RamalingamMD @LeciaSequist @ZPiotrowskaMD evaluating the role of osimertinib 160 mg in NSCLC with EGFR exon 20 insertions (N = 21) ORR = 24% DCR = 82% mPFS: 9.6 m Looking forward to a specific inhibitor, very interesting data pic.twitter.com/jGqWfB0bp6

2020-05-29 21:39:15
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