The 2013 ASCO Annual Meeting highlighted the emergence of immunotherapy as a treatment in multiple types of cancer, says Roy S. Herbst, MD, PhD, a professor of Medicine at Yale Cancer Center and chief of Medical Oncology at Smilow Cancer Hospital at Yale-New Haven in Connecticut.

Herbst presented data on the antibody MPDL3280A that targets PD-L1. This agent produced a 21% response rate for patients with multiple solid tumors, including non-small cell lung cancer. Additionally, Herbst adds, the safety profile was acceptable, with only a few patients experiencing immune related adverse events.

Immunotherapeutic approaches are very promising in the treatment of NSCLC, Herbst points out. This is further highlighted by trials exploring the agent nivolumab, which targets PD-1. The combination of data from the trials exploring PD-1 and PD-L1 demonstrates the emergence of an effective new avenue in the treatment of patients with lung cancer, Herbst believes.

Videos

Roy S. Herbst, MD, PhD, from the Yale Cancer Center, describes the emergence of immunotherapy as a treatment in multiple types of cancer that was highlighted at the 2013 ASCO Annual Meeting.

Dr. Herbst on the Emergence of Immunotherapy in Cancer

Roy S. Herbst, MD, PhD, Chief of Medical Oncology, Director for Translational Research, Clinical Research Program Leader, Thoracic Oncology Program, Yale Cancer Center, discusses determining the eligibility of patients with non-small cell lung cancer (NSCLC) for molecular testing.

Overall, Herbst recommends molecular testing for all patients with NSCLC, regardless of whether they are smokers or nonsmokers. However, he adds, some mutations, such as 

, are known to be more common in nonsmokers, but they’re not unheard of in smokers. In general, the frequency of this mutation depends on how much someone smoked and when they stopped smoking.

Herbst believes it is important to test all patients with NSCLC for molecular aberrations because of the magnitude of benefit derived if an actionable mutation is found. In general, he notes, clinical characteristics are trumped by the molecular profile.

Roy S. Herbst, MD, PhD, from the Yale Cancer Center, discusses determining the eligibility of patients with non-small cell lung cancer for molecular testing.

Dr. Herbst on Selecting Patients for Molecular Testing

Roy S. Herbst MD, PhD, Chief of Medical Oncology, Director for Translational Research, Clinical Research Program Leader, Thoracic Oncology Program, Yale Cancer Center, explores the driver mutations and molecular testing techniques that can be utilized to help determine an effective treatment for patients with lung cancer.

	Herbst says using a multiplex assay to detect multiple gene aberrations is the future, since biopsy samples are limited. It is important to detect mutations in 

 translocations because these are actionable with either erlotinib or crizotinib. Additionally, the 

 translocation is also treatable with crizotinib. These mutations make up approximately 18-20% of all lung cancer patients.

	The remaining 80% will have mutations in the PI3-kinase pathway, 

 but all in the order of one or two percent. Multiplexing allows you to detect these at the same time as the actionable driver mutations. If you know the molecular makeup of the patient, you can put them on an applicable clinical trial.

	Herbst is an advocate for rebiopsy. Inevitably when you treat a patient with crizotinib or an EGFR inhibitor like erlotinib, they will become refractory because of resistance through certain mechanisms. This may call for a need to rebiopsy, in order to understand why the patient has become resistant and to tailor the next treatment. For instance, it may be useful to understand the role of a 

Dr. Roy S. Herbst, from Yale Cancer Center, Explores Molecular Testing in Lung Cancer 

Dr. Herbst Explores Molecular Testing in Lung Cancer

Conference co-director, Roy S. Herbst, MD, PhD, Chief of Medical Oncology, Yale Comprehensive Cancer Center, describes the 12th International Lung Cancer Congress as very timely because it comes directly after the ASCO annual meeting and the World Lung Conference in Amsterdam.

Herbst describes the conference as a chance for practitioners to learn how the recent advances in the biology of lung cancer are translating into new therapies. One of the most unique aspects of the conference is that many of the presenters or representatives come from cooperative groups studying lung cancer from across the world. The conference provides a chance to become immersed in lung cancer therapy in order to understand recent advances and how they affect patients.

Dr. Roy S. Herbst from Yale Comprehensive Cancer Center on Themes From the 2011 Lung Cancer Congress

Dr. Herbst on the 2011 Lung Cancer Congress Themes 

Roy S. Herbst, MD, PhD, Chief of Medical Oncology, Yale Comprehensive Cancer Center, describes the 12th International Lung Cancer Congress that he co-leads with David Gandara, MD. He explains this years congress is unique from previous years because of its excellent faculty and timely breakout sessions. The breakout sessions were designed in the past 2 months in order to be up-to-date with recent events.

Dr. Roy S. Herbst from Yale comprehensive cancer center on the International Lung Cancer Congress

Dr. Herbst on the International Lung Cancer Congress

Roy S. Herbst, MD, PhD, Chief of Medical Oncology, Yale Comprehensive Cancer Center, and co-chair of the 12th International Lung Cancer Congress, discusses the screening topics that will be discussed at the Congress taking place at the Park Hyatt Aviara in Carlsbad, CA, August 11-14, 2011.

Herbst explains that there are still as many questions as there are answers. He believes the next step for the oncology academic community is to use molecular epidemiology to identify patients at the most risk and to discover minimally invasive techniques and treatment options for early lesions to prevent metastatic cancer.

Dr. Roy Herbst from the Yale Comprehensive Cancer Center on Screening Studies at the Upcoming Lung Cancer Congress

Roy S. Herbst, MD, PhD

Articles

Dr. Herbst on the Emergence of Immunotherapy in Cancer

Dr. Herbst on Selecting Patients for Molecular Testing

Dr. Herbst Explores Molecular Testing in Lung Cancer

Dr. Herbst on the 2011 Lung Cancer Congress Themes

Dr. Herbst on the International Lung Cancer Congress

Dr. Herbst on the 2011 Lung Cancer Congress Topics