Dr. Gandara on Practice-Changing Studies in Lung Cancer

David R. Gandara, MD, director, Thoracic Oncology Program, professor, senior advisor to director, UC Davis Comprehensive Cancer Center, treasurer, International Association for the Study of Lung Cancer (IASLC), a 2017 Giant of Cancer Care^® in Lung Cancer, discusses practice-changing studies in lung cancer.

Currently, the 2 most prominent clinical trials in the field are the PACIFIC trial for stage III non—small cell lung cancer (NSCLC) and the IMpower133 study for extensive-stage small cell lung cancer (SCLC). Both studies showed survival benefit with the addition of immunotherapy to standard chemotherapy. Gandara explains that these diseases have high rates of morbidity and mortality. These clinical trials are huge steps to improve outcomes for these patients.

Despite being practice-changing, Gandara says, these trials leave some unanswered questions. In the PACIFIC trial, he questions which chemotherapy regimen is best to give, and can durvalumab (Imfinzi), a PD-L1 inhibitor, be given to patients with low PD-L1 expression? Still, Gandara adds, the combination of immunotherapy and chemotherapy is the standard of care for the vast majority of patients with lung cancer.