Joshua K. Sabari, MD, is an associate professor in the Department of Medicine at New York University (NYU) Grossman School of Medicine. He is also medical director, ofThoracic Medical Oncology at NYU Langone Health’s Perlmutter Cancer Center.

Joshua K. Sabari, MD; Jamie Chaft, MD; and Vamsidhar Velcheti, MD, highlight the intriguing data in the realm of EGFR exon 21 insertion mutations in non–small cell lung cancer presented during the 2021 ASCO Annual Meeting.


The episode is part of the third series of Thoracic Night Live, a program devoted to spotlighting the biggest topics in lung cancer and pivotal studies discussed at medical meetings throughout the year. 

Videos

Joshua K. Sabari, MD; Jamie Chaft, MD; and Vamsidhar Velcheti, MD, highlight the intriguing data in the realm of EGFR exon 21 insertion mutations in non–small cell lung cancer presented during the 2021 ASCO Annual Meeting. 


Enthusiasm With EGFR Exon 20+ in NSCLC

Good evening and welcome! Thank you for joining OncLive’s third episode of Thoracic Night Live, a program devoted to spotlighting the biggest topics in lung cancer and pivotal studies discussed at medical meetings throughout the year.

Live from New York City, I’m Josh Sabari, MD, an assistant professor in the Department of Medicine at NYU Grossman School of Medicine, and it’s great to be back on this program, this time as your host!

But it’s not just me tonight. Virtually joining me tonight is Dr Jamie Chaft, associate professor and thoracic medical oncologist at Memorial Sloan Kettering Cancer, and Dr Vamsidhar Velcheti, associate professor and director of thoracic medical oncology and at NYU Langone’s Perlmutter Cancer Center. Welcome to you both and it’s an honor to share this virtual stage with you!

Tonight’s discussion is going to focus on novel targeted therapeutics in KRAS as well as EGFR exon 20 insertion mutations; and neoadjuvant breakthroughs in lung cancer presented at the 2021 ASCO Annual Meeting. We’re also going to discuss some intriguing data with circulating tumor DNA that was presented at this year’s conference.

Funding provided by Daiichi Sankyo/Content Developed Independently by OncLive

OncLive’s third episode of Thoracic Night Live, a program devoted to spotlighting the biggest topics in lung cancer and pivotal studies discussed at medical meetings throughout the year, focuses on findings presented at the 2021 ASCO Annual Meeting. 

Kicking Off With KRAS in NSCLC

Vamsidhar Velcheti, MD, director of thoracic medical oncology at NYU Langone Perlmutter Cancer Center, discusses the results from the primary analysis of the CodeBreaK 100, which examined sotorasib (formerly AMG 510) in patients with 

 G12C–mutated non–small cell lung cancer (NSCLC).

The goal of the open-label, single-arm, multicenter, global phase 2 CodeBreaK 100 study was to evaluate sotorasib in a total of 126 patients with 

 G12C–mutated lung adenocarcinoma, according to Velcheti. Patients enrolled on the trial had previously received treatment with systemic therapies. Of the patients enrolled, 120 had centrally-evaluable scans for RECIST baseline evaluation, says Velcheti.

Results from the primary analysis, which were presented during the 2020 World Conference on Lung Cancer, indicated that sotorasib elicited a confirmed objective response rate of 37.1%. in this population. Among responders, 3 patients achieved a complete response, while 43 experienced confirmed partial responses. The preliminary findings appear to be consistent with previously reported phase 1 data in the same patient population, Velcheti concludes.

Vamsidhar Velcheti, MD, discusses the results from the primary analysis of the CodeBreaK 100, which examined sotorasib in patients with KRAS G12C–mutated non–small cell lung cancer.

Dr. Velcheti on the Results of the CodeBreaK 100 Primary Analysis in KRAS G12C+ NSCLC

Vamsidhar Velcheti, MD, an assistant professor of Medicine at Cleveland Clinic Lerner School of Medicine, discusses the ALK inhibitor alectinib and what potential the agent could have in the frontline setting for patients with ALK-positive non—small cell lung cancer (NSCLC). Velcheti shared this insight in an interview during the 2016 

 State of the Science Summit on Non—Small Cell Lung Cancer.

An exciting clinical trial in this space is the Japanese J-ALEX study of alectinib, which is a newer generation and more potent ALK inhibitor in the first-line setting in patients who have metastatic lung cancer and ALK fusion, Velcheti explains. This study compared against the standard of care crizotinib (Xalkori) in patients who were previously untreated.

Results of the study showed that there was a significant increase in progression-free survival (PFS) of 66%, as well as a hazard ratio of .34. Velcheti adds that this is an incredible advance in treating patients with 

-positive lung cancers. This demonstrates that use of more potent ALK inhibitors in the frontline setting offers a better progression-free control and could have a significant clinical benefit.

In October 2016, the FDA granted alectinib a breakthrough therapy designation as a frontline treatment for patients with 

-positive NSCLC, based on the J-ALEX findings. The trial randomized 207 Japanese patients with 

-positive advanced or recurrent NSCLC who had not previously received an ALK inhibitor to alectinib at 300 mg twice daily, or crizotinib at 250 mg twice daily. Patients continued treatment until disease progression or unacceptable toxicity.

The median PFS was not reached (95% CI, 20.3—not estimated) in the alectinib arm compared with 10.2 months (95% CI, 8.2-12) in the crizotinib cohort (HR, 0.34; 99% CI, 0.17-0.70; 

<.0001). In a subgroup of patients with brain metastases at baseline, the hazard ratio for PFS with alectinib versus crizotinib was .08 (95% CI, 0.01-0.61).

The investigator-assessed objective response rates (ORRs) were 85.4% in the alectinib group and 70.2% in the crizotinib arm. By the independent review, the ORR was 91.6% in alectinib cohort.

Vamsidhar Velcheti, MD, an assistant professor of Medicine at Cleveland Clinic Lerner School of Medicine, discusses the ALK inhibitor alectinib (Alecensa) and what potential the agent could have in the frontline setting for patients with ALK-positive non–small cell lung cancer (NSCLC). Velcheti shared this insight in an interview during the 2016 OncLive State of the Science Summit on Non–Small Cell Lung Cancer.

Vamsidhar Velcheti, MD

Articles

Enthusiasm With EGFR Exon 20+ in NSCLC

Kicking Off With KRAS in NSCLC

Dr. Velcheti on the Results of the CodeBreaK 100 Primary Analysis in KRAS G12C+ NSCLC

Dr. Velcheti on Potential of Alectinib in Frontline ALK-Positive NSCLC