Volume 22, Issue 1, January 2017

Until recently, options were limited for patients with non‐small cell lung cancer who progressed while receiving epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs), but improvements in molecular profiling and the approval of osimertinib afford the opportunity for improved outcomes in many patients with the EGFR T790M mutation. This article explains the options available after progression on initial EGFR TKI therapy and the importance of molecular testing at progression in making treatment decisions.

Evidence supports use of first‐line dual endocrine therapy (ET) regimens, particularly in ET‐naïve patients, or palbociclib plus letrozole, as well as everolimus plus exemestane or palbociclib plus fulvestrant as second‐line therapy for HR‐positive, HER2‐negative advanced breast cancer. Some combinations are associated with increased risk of class‐specific toxicities.

This study evaluates the safety, efficacy, and biomarkers of response to cabozantinib, a multikinase inhibitor, in patients with metastatic triple‐negative breast cancer (mTNBC). Cabozantinib showed encouraging safety and efficacy signals but did not meet the prespecified primary endpoint in pretreated mTNBC. Exploratory analyses of circulating biomarkers showed that cabozantinib induces systemic changes consistent with activation of the immune system and antiangiogenic activity, and soluble MET should be further evaluated as a potential biomarker of response.

Here are described the first 469 image‐guided biopsies collected in a large collaboration in The Netherlands (Center for Personalized Cancer Treatment).The utility of these specimens for next‐generation sequencing analysis is shown, revealing that image‐guided biopsy procedures for biomarker discovery to enable personalized cancer treatment are safe and feasible and yield a highly valuable biobank.

Research activities for a biomarker that has been in development for at least 12 years—excision repair cross‐complement group 1 protein, as a biomarker for predicting clinical benefit with platinum‐based chemotherapy in non‐small cell lung cancer—were systematically mapped.

The present study assessed the impact of >25 lymph node retrieval on the survival outcome of patients with advanced gastric cancer after curative‐intent gastrectomy. The clinicopathological parameters and overall survival were analyzed according to the number of lymph nodes examined. Retrieving more than 25 lymph nodes during curative‐intent gastrectomy substantially improved survival and survival stratification of advanced gastric cancer without compromising patient safety.

Tumor thymidylate synthase (TS) levels were prospectively evaluated in two adjuvant therapy trials for patients with resected stage II or III colon cancer. Results indicated that high tumor TS levels were associated with improved disease‐free survival and overall survival following adjuvant therapy for colon cancer, although tumor TS expression did not predict benefit of 5‐fluorouracil‐based chemotherapy.

The key data for sunitinib establishing it as a reference standard of care for first‐line advanced renal cell carcinoma (RCC) and significantly altering the treatment landscape are discussed. The key insights regarding study design and data interpretation and how these findings and the sunitinib development program can be a model for successful development of other agents are explored. The ongoing research of sunitinib in RCC management is also discussed.

The prevalence of chemotherapy use toward the end of life (EOL) for patients with solid cancers was studied in China. Correlations among EOL chemotherapy, clinicopathological features, and overall survival (OS) were investigated. EOL chemotherapy was associated with reduced OS, more aggressive care measures, and higher in‐hospital death rates. Oral anticancer agents were associated with fewer intensive care‐unit admissions and lower in‐hospital death rates than intravenous therapy.

The occurrence and prognostic significance of mixed responses to systemic therapies among patients with non‐small cell lung cancer were evaluated by positron emission tomography/computed tomography scans (PET/CT) to provide comprehensive measurements of each lesion. Clinical biomarkers were explored to identify potential molecular mechanisms resulting in mixed response. The results of this study may help us to understand the clinical and molecular features of mixed response and provide a foundation to explore subsequent therapeutic strategies.

This review summarizes the required monitoring and appropriate management of immune‐related adverse events in lung cancer patients receiving nivolumab and pembrolizumab.

Immune checkpoint inhibitors have emerged as promising therapeutic agents in non‐small cell lung cancer (NSCLC). Programmed cell death protein‐1/programmed cell death ligand‐1 inhibitors have produced significant improvements in overall survival compared with single‐agent docetaxel, effectively establishing a new standard of care in NSCLC. An overview of the rationale for checkpoint inhibitors in lung cancer, recent clinical trial data, and the need for predictive biomarkers is provided.

Improper use, storage, and disposal of prescribed opioids can lead to diversion or accidental poisoning. The present study compared 300 adult cancer outpatients receiving opioids who had also received educational material (EM) with 300 patients who had not received EM. The use of EM on opioid safety for patients with advanced cancer was associated with improved patient‐reported safe opioid use, storage, and disposal.