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Focus Questions
What pivotal trials have recently been reported on ADCs in second-line NSCLC? How does the efficacy compare with existing standard of care approaches?
What are the common adverse events associated with ADCs in patients with NSCLC, and how can they be managed?
How can biomarkers inform selection criteria for ADC therapy in patients with NSCLC?
What is the evidence for ADC efficacy in patients with NSCLC with an EGFR mutation?
How do emerging data on ADCs as monotherapy or combination strategies compare with standard of care approaches in first-line NSCLC?
What other data presented at WCLC or ESMO may help to inform the use of ADCs in patients with NSCLC?
What are the emerging trends and future directions for ADCs in NSCLC? How might the data we are seeing now impact future clinical practice?
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Focused insights: Data implications of ADCs in NSCLC treatment

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Prof. Céline Mascaux is a professor of thoracic oncology at Strasbourg University and head of the pulmonology department at Strasbourg University Hospitals in Strasbourg, France. read more

Prof. Mascaux is a renowned oncologist specializing in lung cancer. She has held academic and clinical positions at several prestigious institutions, including the Jules Bordet Cancer Center in Brussels, Belgium; the University of Colorado in Denver, CO, USA; Boston University in Boston, MA, USA; and the Princess Margaret Cancer Center in Toronto, ON, Canada.

Prof. Mascaux’s research focuses on advancing the understanding and treatment of lung cancer, particularly through innovative therapies and precision medicine. She is recognized for her expertise in both clinical practice and research, contributing significantly to the field of oncology.

Prof. Céline Mascaux discloses: Advisory board or panel fees from Amgen, AstraZeneca, Bristol Myers Squibb, Daiichi Sankyo, Kephren, Merck Sharp & Dohme, Pfizer, Roche, Sanofi and Takeda. Consultancy fees from Amgen, AstraZeneca, Bristol Myers Squibb, Daiichi Sankyo, Kephren, Merck Sharp & Dohme, Pfizer, Roche, Sanofi and Takeda.

Learning Objectives

After watching this activity, participants should be better able to:

  • Discuss how the evidence for the introduction of ADCs in second-line NSCLC changes the current treatment paradigm
  • Assess the latest data for ADCs in NSCLC and how they compare to standard of care approaches in terms of efficacy and safety
Overview

In this interview, Prof. Céline Mascaux explores the latest data on ADCs in NSCLC treatment, compares their efficacy to current first- and second-line therapies, and speculates on their future impact on clinical practice. read more

Target Audience

This activity has been designed to meet the educational needs of oncologists (including lung cancer specialists), pulmonologists, pathologists and oncology nurses involved in the management of patients with NSCLC.

USF Accreditation

Disclosures

USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.

Faculty

Prof. Céline Mascaux discloses: Advisory board or panel fees from Amgen, AstraZeneca, Bristol Myers Squibb, Daiichi Sankyo, Kephren, Merck Sharp & Dohme, Pfizer, Roche, Sanofi and Takeda. Consultancy fees from Amgen, AstraZeneca, Bristol Myers Squibb, Daiichi Sankyo, Kephren, Merck Sharp & Dohme, Pfizer, Roche, Sanofi and Takeda.

Content reviewer

Danielle Walker, DNP, APRN, AGNP-C, nurse reviewer and planner, has no financial interests/relationships or affiliations in relation to this activity.

Touch Medical Contributors

Kathy Day has no financial interests/relationships or affiliations in relation to this activity.

Rebecca Franklin discloses: Independent contractor relationships with Fishawack Communications (relationship terminated).

Accreditations

Physicians

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

USF Health designates this enduring material for a maximum of 0.5 AMA PRA Category 1 CreditsTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Advanced Practice Providers

Physician Assistants may claim a maximum of 0.5 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditsTM from organizations accredited by ACCME or a recognized state medical society.

The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditsTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

Nurses

USF Health is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

A maximum of 0.5 contact hour may be earned by learners who successfully complete this  continuing professional development activity. USF Health, the accredited provider, acknowledges touchIME as the joint provider in the planning and execution of this CNE activity.

This activity is awarded 0.5 ANCC pharmacotherapeutic contact hour.

Date of original release: 27 January 2025. Date credits expire: 27 January 2028.

If you have any questions regarding credit, please contact cpdsupport@usf.edu

EBAC® Accreditation

TouchIME is an EBAC® accredited provider since 2023.

This program is accredited by the European Board for Accreditation of Continuing Education for Health Professionals (EBAC®) for 35 mins of effective education time. 

EBAC® holds an agreement on mutual recognition of substantive equivalency with the US Accreditation Council for CME (ACCME) and the Royal College of Physicians and Surgeons of Canada, respectively. 

Through an agreement between the European Board for Accreditation of Continuing Education for Health Professionals (EBAC®) and the American Medical Association, physicians may convert EBAC® External CME credits to AMA PRA Category 1 Credits™. Information on the process to convert EBAC® credit to AMA credit can be found on the AMA website. Other health care professionals may obtain from the AMA a certificate of having participated in an activity eligible for conversion of credit to AMA PRA Category 1 Credit™. 

EBAC® is a member of the International Academy for CPD Accreditation (IACPDA) and a partner member of the International Association of Medical Regulatory Authorities (IAMRA).

Faculty Disclosure Statement/Conflict of Interest Policy

In compliance with EBAC® guidelines, all speakers/chairpersons participating in this programme have disclosed or indicated potential conflicts of interest which might cause a bias in the presentations. The Organizing Committee/Course Director is responsible for ensuring that all potential conflicts of interest relevant to the event have been mitigated and declared to the audience prior to the CME activities.

Requirements for Successful Completion

Certificates of Completion may be awarded upon successful completion of the post-test and evaluation form. If you have completed one hour or more of effective education through EBAC® accredited CE activities, please contact us at accreditation@touchime.org to receive your EBAC® CE credit certificate. EBAC® grants 1 CE credit for every hour of education completed.

Date of original release: 27 January 2025. Date credits expire: 27 January 2026.

Time to Complete: 35 minutes

If you have any questions regarding the EBAC® credits, please contact accreditation@touchime.org

This activity is CE/CME accredited

To obtain the CE/CME credit(s) from this activity, please complete this post-activity test.

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Focused insights: Data implications of ADCs in NSCLC treatment
0.5 CE/CME credit

Question 1/5
During a multidisciplinary team meeting, you are discussing whether the TROP2 ADC datopotamab deruxtecan would be a good option for a patient with advanced EGFR-mutant nonsquamous NSCLC. They received targeted therapy in the first line and now show evidence of disease progression and brain metastases while on second-line platinum-based chemotherapy. Which of these insights would you share about datopotamab deruxtecan based on recent data after progression on therapy?

ADC, antibody–drug conjugate; EGFR, epidermal growth factor receptor; NSCLC, non-small cell lung cancer; TROP2, trophoblast cell surface antigen 2.

Brain metastases frequently occur in patients with NSCLC, particularly those with actionable genomic alterations, and are associated with poor prognosis.1 Exploratory analyses of the TROPION-Lung01 and TROPION-Lung05 trials indicated that datopotamab deruxtecan may have intracranial efficacy.2,3 In TROPION-Lung01, trends towards improved systemic efficacy were observed with datopotamab deruxtecan vs docetaxel in patients with and without baseline brain metatases.2 In TROPION-Lung05, systemic efficacy and safety outcomes were similar in patients with and without baseline brain metastases.3

Abbreviations

EGFR, epidermal growth factor receptor; NSCLC, non-small cell lung cancer.

References

  1. Gillespie CS, et al. J Thorac Oncol. 2023;18:1703–13.
  2. Pons-Tostivint E, et al. Presented at: ESMO, Barcelona, Spain. 13–17 September 2024. 1312P.
  3. Lisberg A, et al. Presented at: ASCO, Chicago, IL, USA. 31 May–4 June 2024. 8593.
Question 2/5
You are discussing treatment options with a patient eligible for patritumab deruxtecan via a clinical trial for advanced NSCLC. The patient asks how the safety profile of this ADC compares with the current standard of care. What actions will you take?

ADC, antibody–drug conjugate; ILD, interstitial lung disease; NSCLC, non-small cell lung cancer.

Safety data for patritumab deruxtecan from the HERTHENA-Lung01 trial showed that nausea, thrombocytopenia and decreased appetite were the most common any-grade TEAEs; thrombocytopenia and neutropenia were the most common grade ≥3 TEAEs and were typically transient.1,2 These side effects are also often seen in patients receiving standard of care platinum-based chemotherapy.3 However, ILD has been identified as a risk associated with deruxtecan-containing ADCs,4 and ILD occurred in 14 patients (6%) in HERTHENA-Lung01, including four grade 3 and one grade 5.1 Vigilant monitoring for signs and symptoms of ILD, prompt dose interruption, and intervention with high-dose corticosteroid treatment can help mitigate the development of severe ILD.2

Abbreviations

ADC, antibody–drug conjugate; ILD, interstitial lung disease; TEAE, treatment-emergent adverse event.

References

  1. Hayashi H, et al. Presented at: ELCC, Prague, Czech Republic. 20–23 March 2024. 11P.
  2. Yu HA, et al. J Clin Oncol. 2023;41:5363–75.
  3. van den Boogaard WMC, et al. Cancers. 2022;14:627.
  4. Jänne PA, et al. Cancer Discov. 2022;12:74–89.
Question 3/5
Your patient with HER2-overexpressing (IHC 2+) advanced nonsquamous NSCLC may benefit from treatment with trastuzumab deruxtecan following progression on first-line immunotherapy. Based on data from the DESTINY-Lung clinical trial programme, which of these insights would you add to the multidisciplinary team debate?

EGFR, epidermal growth factor receptor; HER2, human epidermal growth factor receptor 2; IHC, immunohistochemistry; NSCLC, non-small cell lung cancer.

DESTINY-Lung03 assessed trastuzumab deruxtecan monotherapy in previously treated patients with HER2-overexpressing (IHC 2+ or 3+) nonsquamous NSCLC. Results showed an ORR of 44% across the total patient population; 56% in the HER2 IHC 3+ group and 35% in the HER2 IHC 2+ group, indicating activity in HER2-overexpressing (IHC 2+ or 3+) NSCLC. Median PFS and OS were numerically greater in the IHC 2+ group than the IHC 3+ group. The ORR was higher in patients with prior EGFR tyrosine kinase inhibitor exposure than those without.

Abbreviations

EGFR, epidermal growth factor receptor; HER2, human epidermal growth factor receptor 2; IHC, immunohistochemistry; NSCLC, non-small cell lung cancer; ORR, objective response rate; OS, overall survival; PFS, progression-free survival.

Reference

Planchard D, et al. Presented at: WCLC, San Diego, CA, USA. 7–10 September 2024. OA16.05.

Question 4/5
Based on findings from the TROPION-Lung01 and TROPION-Lung05 trials, how would you assess the potential impact of datopotamab deruxtecan on the current treatment paradigm and influence your future treatment decisions for patients with advanced/metastatic nonsquamous NSCLC in the second- or third-line setting?

EGFR, epidermal growth factor receptor; NSCLC, non-small cell lung cancer; OS, overall survival; PFS, progression-free survival.

TROPION-Lung01 assessed datopotamab deruxtecan vs docetaxel in patients with advanced/metastatic NSCLC with/without actionable genomic alterations following one/two prior lines of therapy.1,2 The dual primary endpoint of PFS was met with a statistically significant improvement in favour of datopotamab deruxtecan vs docetaxel, especially in the nonsquamous population and nonsquamous with actionable genomic alterations.1 While the dual primary endpoint of OS was not met, a numerical improvement with datopotamab deruxtecan vs docetaxel was seen, especially in the nonsquamous population (14.6 vs 12.3 months).2 Analysis of data from the EGFR-mutant patient populations treated with datopotamab deruxtecan in TROPION-Lung01 and TROPION-Lung05 showed OS values of 15.6 months and 18.3 months, respectively, indicating a potential future clinical role for this ADC in previously treated patients with EGFR-mutant advanced/metastatic NSCLC.3

Abbreviations

ADC, antibody–drug conjugate; EGFR, epidermal growth factor receptor; NSCLC, non-small cell lung cancer; OS, overall survival; PFS, progression-free survival.

References

  1. Ahn M-J, et al. J Clin Oncol. 2024. doi: 10.1200/JCO-24-01544 (Online ahead of print).
  2. Sands J, et al. Presented at: WCLC, San Diego, CA, USA. 7–10 September 2024. OA08.03.
  3. Ahn M-J, et al. Presented at: ESMO Asia, Singapore. 6–8 December 2024. LBA7.
Question 5/5
What was an initial efficacy finding from the phase II EVOKE-02 trial, which assessed first-line sacituzumab govitecan + pembrolizumab + carboplatin in patients with metastatic NSCLC without actionable genomic alterations, presented at the World Conference on Lung Cancer 2024?

NSCLC, non-small cell lung cancer; PD-L1, programmed death-ligand 1; TPS, tumour proportion score.

Initial results from the ongoing EVOKE-02 trial were presented by PD-L1 TPS (<1%/1–49%/≥50%) and histology (nonsquamous/squamous). In the PD-L1 TPS <1%, 1–49% and ≥50% groups, respectively, ORR was 43%, 33% and 67%, and median PFS was 8 months, 7 months and not reached, indicating efficacy across PD-L1 expression levels. Data by histology showed an ORR of 45% in the nonsquamous population and 39% in the squamous population; median PFS was 8 months in both populations.

Abbreviations

ORR, objective response rate; PD-L1, programmed death-ligand 1; PFS, progression-free survival; TPS, tumour proportion score.

Reference

Gray JE, et al. Presented at: WCLC, San Diego, CA, USA. 7–10 September 2024. OA08.07.

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