On May 28, 2021, the U.S. Food and Drug Administration (FDA) granted accelerated approval to sotorasib (Lumakras™), a RAS GTPase family inhibitor, for adult patients with KRAS G12Cmutated locally advanced or metastatic non-small cell lung cancer (NSCLC), as determined by an FDA approved test, who have received at least one prior systemic therapy.

On May 21, 2021, the U.S. Food and Drug Administration (FDA) granted accelerated approval to amivantamab-vmjw (Rybrevant™), a bispecific antibody directed against epidermal growth factor receptor (EGFR) and MET receptor, for adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with EGFR exon 20 insertion mutations, as detected by an FDA-approved test, whose disease has progressed on or after platinum-based chemotherapy. FDA also approved the Guardant360^® CDx as a companion diagnostic.

Testing for molecular biomarkers has become a mainstay in determining treatment approaches for advanced-stage non-small cell lung cancer. Typically, next-generation sequencing identifies any potential genomic variants that are associated with oncogenic driver events and can be targeted with oral tyrosine kinase inhibitors.

Patients with higher muscle quality during treatment with PD-1/PD-L1 inhibitor monotherapy for non-small cell lung cancer (NSCLC) had higher overall response rates and longer progression-free survival than patients with lower-quality skeletal muscle, researchers reported in study findings published in Cancer Medicine.

The draft 2020 U.S. Preventive Services Task Force (USPSTF) lung cancer screening recommendations were intended to increase the number of high-risk minorities eligible for lifesaving tests. And they do, but not as much as USPSTF anticipated, still leaving gaps and disparities, researchers reported in the Journal of the National Cancer Institute. They created a risk model to augment the guidelines that eliminated the disparities for most racial groups.

On March 3, 2021, the U.S. Food and Drug Administration (FDA) granted regular approval to lorlatinib (Lorbrena®) for patients with metastatic non-small cell lung cancer (NSCLC) whose tumors are anaplastic lymphoma kinase (ALK)-positive, as detected by an FDA-approved test. FDA also approved the Ventana ALK (D5F3) CDx Assay as a companion diagnostic for lorlatinib.

On February 22, 2021, the U.S. Food and Drug Administration (FDA) approved cemiplimab-rwlc (Libtayo^®) for the first-line treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) who are not candidates for surgical resection or definitive chemoradiation and whose tumors have high PD-L1 expression (tumor proportion score ≥ 50%) as determined by an FDA-approved test, with no estimated aberrations to glomerular filtration rate, anaplastic lymphoma kinase, or receptor tyrosine kinase (encoded by the ROS1 gene). 

On February 3, 2021, the U.S. Food and Drug Administration (FDA) granted accelerated approval to tepotinib (Tepmetko^®) for adult patients with metastatic non-small cell lung cancer (NSCLC) harboring mesenchymal-epithelial transition exon 14 skipping alterations.

Although overall smoking rates are decreasing among adolescents and young adults, a new trend is emerging: those who smoked their first cigarette between ages 18–23 increased from 21% in 2002 to 43% in 2018, researchers reported in JAMA Network Open. The increase in young adult first-time smokers comes at a time when smoking initiation rates are decreasing among younger teenagers.

The U.S. Senate unanimously passed a resolution designating November as National Lung Cancer Awareness Month and supporting early detection of lung cancer, a crucial awareness with smoking on the rise among young adults.

On December 18, 2020, the U.S. Food and Drug Administration (FDA) approved osimertinib (Tagrisso^®) as adjuvant therapy after tumor resection for patients with non-small cell lung cancer (NSCLC) whose tumors have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 (L858R) mutations, as detected by an FDA-approved test. 

Lung cancer knows no state boundary or political ideology. But it can bring the two sides together, like it did when U.S. Senators Tina Smith (D-MN), member of the Senate Health Committee, and Marco Rubio (R-FL) introduced a resolution to recognize November as National Lung Cancer Awareness Month. The resolution, which ONS supports, promotes the importance of and need to improve lung cancer early detection.

The average age at which cigarette users start to smoke regularly has risen. Although the figures dropped from 45% of adults smoking cigarettes in the 1960s to 14% today, and teen smoking declined to 2.4% by 2019, results of a recent study show an upward trend of underage tobacco use in young adults.  

In May 2020, the U.S. Food and Drug Administration gave accelerated approval for selpercatinib (Retevmo^®) to treat RET-altered non-small cell lung cancer or thyroid cancer based on overall response rate and duration of response. Selpercatinib fights cancer by impeding RET protein activity. The determining clinical trial results demonstrated that it reduced tumor size in more than 50% of patients and was associated with fewer adverse reactions than other drugs that block the RET protein.

E-cigarettes are dangerous and their risks outweigh any potential smoking-cessation benefits, the U.S. Government Accountability Office explained in a new two-page resource that analyzes the science and technology behind the devices.

Lung cancer is the leading cause of cancer death in the United States, accounting for about one quarter of cancer deaths, and more than a quarter of million lung cancer diagnoses are projected in the United States for 2020. Lung cancer has various types, pathologies, and histologies, each with its own prognosis and treatment plan. Non-small cell lung cancer consists of about 80%–85% of lung cancer diagnoses.

On September 4, 2020, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pralsetinib (Gavreto™) for adult patients with metastatic, RET fusion-positive non-small cell lung cancer (NSCLC) as detected by an FDA approved test.

Patients with lung cancer who also had mental health disorders saw improved cancer-related outcomes when their mental illness was treated, according to findings from a study published in JAMA Oncology.

On August 7, 2020, the U.S. Food and Drug Administration (FDA) approved the Guardant360 CDx assay as the first liquid biopsy companion diagnostic that also uses next-generation sequencing (NGS) technology to identify patients with specific types of mutations of the epidermal growth factor receptor gene in patients with metastatic non-small cell lung cancer (NSCLC). This is the first approval to combine two technologies in one diagnostic test to guide treatment decisions. 

Durvalumab immunotherapy became a new standard of care for patients with stage III unresectable non-small cell lung cancer whose disease did not progress following two cycles of platinum-based chemoradiotherapy after its approval in February 2018, and in March 2020, its indication was expanded for use as first-line treatment in patients with extensive-stage small cell lung cancer as well. Key to keeping patients on immunotherapy treatment and giving them the best chance at long-term survival is effective management of immune-related adverse events.

The disproportionate adverse health impact from smoking on African Americans is striking. Although oncology nurses are well aware of tobacco’s carcinogenic effects, they also need to understand the implications for comorbid conditions they may see in smokers with cancer. A recent study, through the National Institutes of Health (NIH), confirmed that African Americans have a 2.5 times higher incident of smoking-related strokes than those who never smoke.

Along with many other healthcare organizations, including ONS, last week the American Nurses Association (ANA) took a bold stand against racism, calling it a public health crisis. On June 12, 2020, ANA President Earnest Grant shared how racism is embedded in health care and what nurses should do to end it.

On May 18, 2020, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq^®) for first-line treatment of adult patients with metastatic non-small cell lung cancer (NSCLC) whose tumors have high PD-L1 expression (PD-L1 staining ≥ 50% of tumor cells [TC] or PD-L1-stained tumor-infiltrating immune cells [IC] covering ≥ 10% of the tumor area), with no epidermal growth factor receptor or anaplastic lymphoma kinase genomic tumor aberrations. 

On May 15, 2020, the U.S. Food and Drug Administration (FDA) approved the combination of nivolumab (Opdivo^®) and ipilimumab (Yervoy^®) as first-line treatment for patients with metastatic non-small cell lung cancer (NSCLC) whose tumors express PD-L1 (≥ 1%), as determined by an FDA-approved test, with no epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) genomic tumor aberrations. 

On May 8, 2020, the U.S. Food and Drug Administration (FDA) granted accelerated approval to selpercatinib (Retevmo™) for adult patients with metastatic, RET fusion–positive non-small cell lung cancer (NSCLC); adult and pediatric patients aged 12 or older with advanced or metastatic RET-mutant medullary thyroid cancer (MTC) who require systemic therapy; and adult and pediatric patients aged 12 or older with advanced or metastatic RET fusion–positive thyroid cancer who require systemic therapy and who are refractory to radioactive iodine (if radioactive iodine is appropriate). This is the first drug approval for RET genetic alterations.

On May 6, 2020, the U.S. Food and Drug Administration (FDA) granted accelerated approval to capmatinib (Tabrecta™) for adult patients with metastatic non-small cell lung cancer whose tumors have a mutation that leads to mesenchymal-epithelial transition exon 14 skipping, as detected by an FDA-approved test. It is the first drug approval for this specific patient population and the first targeted therapy for the indication.

On April 1, 2020, the U.S. House of Representatives Subcommittee on Economic and Consumer Policy asked the U.S. Food and Drug Administration (FDA) to clear the market of e-cigarettes because of the COVID-19 coronavirus pandemic. It was responding to FDA’s request to give e-cigarette manufacturers four additional months to submit applications to stay on the market before enforcing a ban.  

On March 27, 2020, the U.S. Food and Drug Administration (FDA) approved durvalumab (Imfinzi®) in combination with etoposide and either carboplatin or cisplatin as first-line treatment of patients with extensive-stage small cell lung cancer (ES-SCLC). 

Although U.S. smoking rates have hit an all-time low of 14%, 34 million American adults are still considered active smokers, according to the U.S. surgeon general’s January 2020 report on smoking cessation. It’s the first new report focused directly on smoking cessation from the surgeon general’s office in 30 years. 

Overall U.S. cancer mortality fell 2.2% from 2016 to 2017, the largest reduction for a single year, according to the American Cancer Society’s “Cancer Statistics, 2020,” published in CA: A Cancer Journal for Clinicians.

Pegilodecakin, an investigational, first-in-class drug currently in clinical trials, is demonstrating positive safety results and measurable responses when used in combination with pembrolizumab or nivolumab in patients with non-small cell lung cancer (NSCLC) or kidney cancer. The findings from the multicenter, phase IB study were published in Lancet Oncology.

On December 3, 2019, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq®) in combination with paclitaxel protein-bound and carboplatin for the first-line treatment of adult patients with metastatic non-squamous non-small cell lung cancer (NSCLC) with no EGFR or ALK genomic tumor aberrations.

As the leading cause of cancer death in the United States, lung cancer is pervasive and deadly. But like many cancers, patients have a better chance at successful treatment outcomes and survival if caught early through screening and early detection efforts. Despite lung cancer being the second most diagnosed cancer for men and women, not all Americans are aware of its screening recommendations. To address the gap in awareness, the Centers for Disease Control and Prevention (CDC) is promoting a new public health campaign on the issue.

A blood test evaluating several biomarkers was able to reduce the number of lung cancers detected at later stages, according to study results presented at the 2019 World Conference on Lung Cancer.

A risk-prediction model that combines patients’ health history with clinical characteristics of their lung nodules may help physicians determine which will develop into cancer, according to the results of a study published in Cancer Prevention Research.

The U.S. Food and Drug Administration (FDA) first approved atezolizumab (Tecentriq^®) in 2016, but it received additional approvals when used in combination treatments for locally advanced or metastatic triple negative breast cancer (TNBC) and small cell lung cancer (SCLC) in March 2019.

With faster and equally accurate results, liquid biopsy may be an option for identifying guideline-recommended targeted therapies for non-small cell lung cancer (NSCLC), according to findings presented at the 2019 American Association for Cancer Research Annual Meeting in Atlanta, GA. 

On March 18, 2019, the U.S. Food and Drug Administration (FDA) approved atezolizumab in combination with carboplatin and etoposide, for the first-line treatment of adult patients with extensive-stage small cell lung cancer.

Which of the Following Leads to the Greatest Percentage of Superior Vena Cava Syndrome Cases?           

A. Small cell lung cancer

B. Non-Hodgkin lymphoma

C. Non-small cell lung cancer 

D. Kaposi sarcoma                

Some patients receiving checkpoint inhibitors for lung cancer may experience increased risk for hyperprogressive disease (HPD), according to results of a study reported in JAMA Oncology.

On November 2, 2018, the U.S. Food and Drug Administration (FDA) granted accelerated approval to lorlatinib (Lorbrena) for patients with anaplastic lymphoma kinase (ALK)-positive metastatic non-small cell lung cancer (NSCLC) whose disease has progressed on crizotinib and at least one other ALK inhibitor for metastatic disease or whose disease has progressed on alectinib or ceritinib as the first ALK inhibitor therapy for metastatic disease.

In September 2018, the U.S. Food and Drug Administration (FDA) issued more than 1,100 warning letters and fines to retailers and issued 131 fines for selling vaping pod products to minors. The agency also told manufacturers that the industry has 60 days to provide a plan to limit underage access to these products or face penalties.

Lung cancer is the second most common cancer in both men and women (after skin cancer) and is the leading cause of cancer death among both men and women. Histology has become an important determinant in choosing therapy for various types of cancer, including non-small cell lung cancer (NSCLC). Currently, biomarker testing is the standard of care in lung cancer; with biomarker testing, patients likely to respond to targeted therapy can be identified. As the number of targeted agents continues to increase, so does the demand for continued biomarker testing and adequate tumor tissue samples.

On August 16, 2018, the U.S. Food and Drug Administration (FDA) granted accelerated approval to nivolumab for patients with metastatic small cell lung cancer (SCLC) with progression after platinum-based chemotherapy and at least one other line of therapy.

Which of the Following Patient Types Is Not Indicated for Lung Cancer Screening With Low-dose Helical Computed Tomography?

A. Is a current or former smoker

B. Is 55–74 years old

C. Has a 10–20 pack-year history

D. Has a 30 pack-year history but no signs or symptoms of lung cancer 

Combining pembrolizumab and platinum chemotherapy plus pemetrexed doubles survival in patients with nonsquamous non-small cell lung cancer (NSNSCLC) without EGFR or ALK gene mutations, according to the results of a study published in the New England Journal of Medicine.