Josephine Louella Feliciano, MD, assistant professor of oncology, Johns Hopkins Medicine, discusses the use of nivolumab (Opdivo) in patients with small cell lung cancer (SCLC).

In August, the FDA granted an accelerated approval of single-agent nivolumab for the treatment of patients with SCLC with disease progression after platinum-based chemotherapy and 1 other line of therapy. This gives patients another therapeutic option, says Feliciano, though patients with progressive SCLC tend to experience a lot of physical decline, so selecting the right patients will be important.

The approval of nivolumab was based on the results of the CheckMate-032 trial in which patients with extensive-stage SCLC were randomized to nivolumab and nivolumab plus ipilimumab (Yervoy). Data indicated an objective response rate of approximately 12% (95% CI, 6.5-19.5) with single-agent nivolumab and some durable responses, notes Feliciano.

Eleven percent of patients experienced a partial response and 0.9% experienced a complete response. The median duration of response was 17.9 months (95% CI, 7.9-42.1). At 12 months, 62% patients continued to show a response to the therapy, with 39% of patients still responding at 18 months.

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Dr. Feliciano on Nivolumab in Small Cell Lung Cancer

Josephine Louella Feliciano, MD, assistant professor of oncology, Johns Hopkins Medicine, discusses ROS1-targeted therapy in patients with non—small cell lung cancer (NSCLC).

 translocation, explains Feliciano. It has a similar configuration in the receptor. Many of the tyrosine kinase inhibitors (TKIs) that are effective for 

 mutations. Its efficacy reflects high response rates and long durations of response for patients with NSCLC. 

 occurs in about 1% of patients with NSCLC and tends to be mutually exclusive of 

Other ALK inhibitors such as ceritinib (Zykadia) have been studied and show high response rates in 

. Lorlatinib is a later-generation TKI that has been shown to be effective in tumors that have become resistant to crizotinib, says Feliciano. However, there are common secondary mutations that can develop on most of these drugs, so physicians are now starting to develop regimens for resistance mutations.

Josephine Louella Feliciano, MD, assistant professor of oncology, Johns Hopkins Medicine, discusses ROS1-targeted therapy in patients with non–small cell lung cancer (NSCLC).

Josephine L. Feliciano, MD

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Dr. Feliciano on Nivolumab in Small Cell Lung Cancer

Dr. Feliciano on ROS1-Targeted Therapy in NSCLC