Below is an excerpt from an on-site interview with David Graham, MD, medical director at Levine Cancer Institute in Charlotte, North Carolina, on the key takeaways in lung cancer from ASCO 2019.
- "Immunotherapy is here to stay, and the impact is bigger than we could have imagined before. The 5-year follow-up data on KEYNOTE 1 showing that we had 5-year survival in 23% of patients treated with pembrolizumab in the phase 1 trial is astounding. We could have never imagined that in lung cancer before. Now we’re expanding how we look at the use of immunotherapy in the neoadjuvant setting. We’re not there yet, but we have some promising paths to go down."
- "We have a clear signal of commonsense ways to improve accruals on clinical trials by taking out some of the exclusion criteria that don’t really make any sense. The CancerLink data presented here showed that if you include patients with [central nervous system] metastases, patients with creatinine clearance above 30 instead of above 60, or patients with a second malignancy, we could double the number of people eligible to go on lung cancer trials."
- "We joke that on phase 2 trials you have to have someone who can run a 4-minute mile, and those aren’t the people we take care of every day."
- "The third major takeaway is that we have an ever-expanding palette of not only targeted therapies but targets to shoot for. There are multiple, multiple studies presented at this meeting showing lots of new targeted therapies. I would hesitate to pick out just 1 over all the rest. And, once we can target therapies and not have this blind cytotoxic approach, patients do better with fewer toxicities."
- "I don’t think there is 1 thing from this meeting that people are going to go home and change how they do things. This year, we’ve lit a lot of fuses that are going to go off in a few years."