Dr. Joel Neal on anti-PD-1 Immunotherapy and Afatinib for EG

[NikoleV]

Dr. Joel Neal on anti-PD-1 Immunotherapy and Afatinib for EGFR Mutation-Positive Advanced NSCLC

September 14th, 2012 - by Dr. Jack West

http://blog.lungevity.org/2012/09/14/dr ... -afatinib/

We’ll continue with more post-ASCO highlights, now switching from Dr. Socinski to Dr. Joel Neal, who is an Assistant Professor at Stanford Cancer Center in Palo Alto, CA. Dr. Neal reviewed a series of presentations on targeted therapy options that are not yet in broad clinical use but are working their way through clinical trials. Perhaps the most exciting of these was the anti-PD-1 immunotherapy introduced by Dr. Julie Brahmer in a podcast several months ago. Dr. Brahmer led and presented the work on anti-PD-1 in lung cancer at ASCO, but she wasn’t able to share her exciting early results prior to that meeting, so here Dr. Neal provides both some background and a summary of the results that were so encouraging to the lung cancer community.

Click on the link above to view the podcasts and figures.

Dr. Neal ASCO LC Highlights 2012 Anti-PD-1 Video Podcast

Dr. Neal ASCO LC Highlights 2012 Anti-PD-1 Audio Podcast

Dr. Neal ASCO LC Highlights 2012 Anti-PD-1 Figs

Dr. Neal ASCO LC Highlights 2012 Anti-PD-1 Transcript

Dr. Neal also covered the LUX-Lung 3 trial, an international study that randomized advanced NSCLC patients with an EGFR mutation to either afatinib, an “irreversible pan-HER inhibitor” that might represent an advance over the current EGFR inhibitors currently available, or standard chemotherapy with cisplatin/Alimta (pemetrexed). You can learn more from his summary, but it essentially showed the same results we’ve seen with the currently available EGFR inhibitors Tarceva (erlotinib) and Iressa (gefitinib). The question remains whether survival with afatinib actually exceed what we might expect from Iressa and Tarceva, except in terms of side effects, which were more severe and more common with afatinib. Still, it was a statistically positive trial that I expect will lead to an FDA approval and the commercial availability of afatinib for this clinical population.

Here’s Dr. Neal’s coverage of the trial, in both video and audio podcast form, as well as the associated transcript and figures for the podcast.

Dr. Neal ASCO LC Highlights 2012 LUX-Lung 3 Video Podcast

Dr. Neal ASCO LC Highlights 2012 LUX-Lung 3 Audio Podcast

Dr. Neal ASCO LC Highlights 2012 LUX-Lung 3 Figs

Dr. Neal ASCO LC Highlights 2012 LUX-Lung 3 Transcript

What next? Very soon I’ll share Dr. Neal’s review of a trial featuring the MEK inhibitor selumetinib for KRAS mutation-positive patients available.

But for now, what do you think of these results with PD-1, as well as afatinib? Would you be inclined to favor afatinib now if you had an EGFR mutation, or would you favor Iressa or Tarceva instead? How much does your answer depend on the survival results for the afatinib?