Dr. Rami Manochakian Discusses Major Lung Cancer Updates

Rami Manochakian, MD, FASCO, of the Mayo Clinic, Florida, who served as the lung cancer panelist during Advancements in Oncology, discusses what oncologists need to know about advances in lung cancer treatment and the latest data.

Dr. Manochakian joined The Oncology Brothers, Rahul Gosain, MD, MBA, and Rohit Gosain, MD, during their Advancements in Oncology event held on June 1 to discuss major updates in lung cancer treatment from the 2024 American Society of Clinical Oncology Annual Meeting.

Major topics of discussion included readouts from phase 3 trials in lung cancer that were presented during the annual meeting. For example, the 5-year follow-up of the phase 3 CROWN trial, which compared lorlatinib with crizotinib in patients with advanced non-small cell lung cancer (NSCLC), showed the median progression-free survival (PFS) had yet to be reached in patients receiving lorlatinib.

Dr. Manochakian discussed the implications of the study, noting that questions remain about treatment sequencing with lorlatinib, as there are no head-to-head comparisons of it with similar treatments, such as alectinib and brigatinib.

He also spoke about the LAURA trial, which was presented by Suresh S. Ramalingam, MD, FACP, FASCO, of the Winship Cancer Institute of Emory University, during the plenary session on June 2.

The LAURA trial, a double-blinded and placebo-controlled phase 3 trial, assessed the efficacy and safety of osimertinib in adults with unresectable stage III EGFR-mutated NSCLC who received definitive platinum-based concurrent or sequential chemoradiotherapy and did not have progression.

Dr. Manochakian spoke about how the LAURA trial may shape practice, explaining that it’s important for community oncologists and any oncology provider to recognize that the regimen used in LAURA is “probably a new standard of care” for this population of patients.

Beyond LAURA, he discussed the surprising results of the phase 3 PALOMA-3 trial, which evaluated subcutaneous amivantamab plus lazertinib versus intravenous (IV) amivantamab plus lazertinib in patients with refractory EGFR-mutated, advanced NSCLC. The analysis, presented as an oral abstract at the annual meeting by Natasha B. Leighl, MD, FASCO, of the Princess Margaret Cancer Centre and the University of Toronto, showed that patients receiving subcutaneous amivantamab had longer overall survival and PFS than those receiving IV amivantamab.

Dr. Manochakian spoke about the practical implications of the study, explaining that subcutaneous injections are “definitely much easier” for patients, oncology providers, and institutions, as they are faster than IV administration. The reduced administration time, combined with the results showing improved survival and reduced adverse events associated with the subcutaneous injection, make the PALOMA-3 trial results “potentially practice-changing,” he said.