Mark A. Socinski, MD, executive medical director of the AdventHealth Cancer Institute, discusses the evolving paradigm of targeted therapy in lung cancer.

During week 2 of the 2021 AACR Annual Meeting, Socinski gave a presentation on advances that have been made in the diagnosis, screening, and treatment of lung cancer. In terms of treatment, the incorporation of targeted therapy into the lung cancer armamentarium has revolutionized the treatment of patients with specific genomic abnormalities, says Socinski. However, the first step in getting patients matched with a targeted therapy is to perform comprehensive genomic testing, which remains underutilized in the United States, Socinski explains. Without an accurate diagnosis, patients cannot benefit from the growing list of FDA-approved targeted options, Socinski adds. 

In eligible patients, targeted therapies have demonstrated high efficacy compared with chemotherapy, Socinski explains. Moreover, these patients would likely not respond as well, if at all, to immunotherapy, Socinski adds.

Despite these advances, additional research is needed to understand resistance mechanisms to first-line TKIs, Socinski says. Although many patients derive durable responses with TKIs in the frontline setting, identifying resistance patterns and overcoming them remains challenging, Socinski says. As such, novel strategies or combination regimens could answer some of the remaining questions with resistance mechanisms and ensure that each patient receives the optimal treatment, concludes Socinski.

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Mark A. Socinski, MD, discusses the evolving paradigm of targeted therapy in lung cancer.  



Dr. Socinski on the Evolving Paradigm of Targeted Therapy in Lung Cancer 

Mark A. Socinski, MD, executive medical director of the Florida Hospital Cancer Institute, discusses challenges facing immunotherapy combinations in patients with non—small cell lung cancer (NSCLC).

Immunotherapy is an exciting treatment, but it can be improved upon in several ways, explains Socinski. There is supporting evidence stating that selecting patients who strongly stain for PD-L1 have better outcomes when treated with immunotherapies. Combining agents with chemotherapy also has encouraging data that can help maximize the outcome of immunotherapy.

The combination of PD-1 and CTLA-4 agents have shown an increase in response rates, causing many physicians to be excited about the future combinations of immune agents, says Socinski. However, the concern is once the number of immunotherapeutic agents combined increases, there is an enhanced risk of toxicity.

Mark A. Socinski, MD, executive medical director of the Florida Hospital Cancer Institute, discusses challenges facing immunotherapy combinations in patients with non–small cell lung cancer (NSCLC).

Mark A. Socinski

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Dr. Socinski on the Evolving Paradigm of Targeted Therapy in Lung Cancer

Dr. Socinski on Challenges Facing Immunotherapy Combinations