Conference Recap

Asthma highlights from ACAAI 2021 range from efficacy of biologic therapies to the late effects of COVID-19 in asthma patients, as reported by Dr Sandhya Khurana from the University of Rochester, in Rochester, New York.   

Dr Khurana opens by discussing a study that examined real-world data to assess the effect of COVID-19 infection in asthma patients. The study found that when adjusting for age, sex, BMI, use of inhaled corticosteroids, and atopy, Latino patients, when compared with non-Latino White and Black patients, were more susceptible to prolonged respiratory inflammation after COVID-19 infection.   

She then reports on a study that examined potential long-term morbidities associated with systemic corticosteroid (SCS) therapy. The study, which drew from a large administrative claims database, found that high-risk SCS exposure was associated with lifelong adverse chronic health conditions, including type 2 diabetes, hypertension, osteoporosis, and depression. Children ages 4-11 are particularly at risk.  

Next, Dr Khurana highlights studies evaluating the efficacy of dupilumab and tezepelumab, two novel biologics, in asthma patients who also have allergies. Both studies demonstrated a potential benefit for a broad population of patients with severe, uncontrolled asthma.   

Finally, Dr Khurana comments on ZEPHYR 2, a retrospective cohort study that looked to quantify the real-world impact of switching between biologics.  

--

Sandhya Khurana, MD, Professor, Department of Medicine, University of Rochester; Director, Mary Parkes Center for Asthma, Allergy & Pulmonary Care, Rochester, New York 

Sandhya Khurana, MD, has disclosed the following relevant financial relationships: 
Received research grant from: GlaxoSmithKline 

Asthma highlights from ACAAI 2021 range from efficacy of biologic therapies to the late effects of COVID-19 in asthma patients, as reported by Dr Sandhya Khurana from the University of Rochester, in Rochester, New York.   

Dr Khurana opens by discussing a study that examined real-world data to assess the effect of COVID-19 infection in asthma patients. The study found that when adjusting for age, sex, BMI, use of inhaled corticosteroids, and atopy, Latino patients, when compared with non-Latino White and Black patients, were more susceptible to prolonged respiratory inflammation after COVID-19 infection.   

She then reports on a study that examined potential long-term morbidities associated with systemic corticosteroid (SCS) therapy. The study, which drew from a large administrative claims database, found that high-risk SCS exposure was associated with lifelong adverse chronic health conditions, including type 2 diabetes, hypertension, osteoporosis, and depression. Children ages 4-11 are particularly at risk.  

Next, Dr Khurana highlights studies evaluating the efficacy of dupilumab and tezepelumab, two novel biologics, in asthma patients who also have allergies. Both studies demonstrated a potential benefit for a broad population of patients with severe, uncontrolled asthma.   

Finally, Dr Khurana comments on ZEPHYR 2, a retrospective cohort study that looked to quantify the real-world impact of switching between biologics.  

--

Sandhya Khurana, MD, Professor, Department of Medicine, University of Rochester; Director, Mary Parkes Center for Asthma, Allergy & Pulmonary Care, Rochester, New York 

Sandhya Khurana, MD, has disclosed the following relevant financial relationships: 
Received research grant from: GlaxoSmithKline 

Asthma highlights from ACAAI 2021 range from efficacy of biologic therapies to the late effects of COVID-19 in asthma patients, as reported by Dr Sandhya Khurana from the University of Rochester, in Rochester, New York.   

Dr Khurana opens by discussing a study that examined real-world data to assess the effect of COVID-19 infection in asthma patients. The study found that when adjusting for age, sex, BMI, use of inhaled corticosteroids, and atopy, Latino patients, when compared with non-Latino White and Black patients, were more susceptible to prolonged respiratory inflammation after COVID-19 infection.   

She then reports on a study that examined potential long-term morbidities associated with systemic corticosteroid (SCS) therapy. The study, which drew from a large administrative claims database, found that high-risk SCS exposure was associated with lifelong adverse chronic health conditions, including type 2 diabetes, hypertension, osteoporosis, and depression. Children ages 4-11 are particularly at risk.  

Next, Dr Khurana highlights studies evaluating the efficacy of dupilumab and tezepelumab, two novel biologics, in asthma patients who also have allergies. Both studies demonstrated a potential benefit for a broad population of patients with severe, uncontrolled asthma.   

Finally, Dr Khurana comments on ZEPHYR 2, a retrospective cohort study that looked to quantify the real-world impact of switching between biologics.  

--

Sandhya Khurana, MD, Professor, Department of Medicine, University of Rochester; Director, Mary Parkes Center for Asthma, Allergy & Pulmonary Care, Rochester, New York 

Sandhya Khurana, MD, has disclosed the following relevant financial relationships: 
Received research grant from: GlaxoSmithKline 

Dr Mitzi Joi Williams, medical director of the Joi Life Wellness Group in Atlanta, Georgia, shares updates from the 2021 CMSC Annual Meeting on the use of disease-modifying therapies (DMTs) in progressive multiple sclerosis (MS).  

Dr Williams begins with a review of findings from ACAPELLA, a prospective real-world study of ocrelizumab-associated adverse events. The various subanalyses found no higher rates of adverse events on the basis of age or EDSS scores, no downward trend in IgG levels, and mild B-cell repletion that had no significant correlation between disease activity or adverse events. 

Next, she turns to several subanalyses from the EXPAND trial that looked at efficacy and safety of siponimod in patients with secondary progressive MS. Siponimod provided similar clinical benefits in all age groups and was well-tolerated at 3 and 6 months. Several MRI measures were found to be prognostic of disease worsening or improvement. 

Dr Williams concludes with a first look at a new agent, ATA188, which is being studied in adults with progressive forms of MS. This phase 1/2 double-blind, placebo-controlled, dose-expansion trial aims to evaluate the effect of ATA188 on clinical disability, characterize the agent's safety and tolerability, and evaluate the impact of treatment on biological markers in progressive MS. 

--

Mitzi Joi Williams, MD, Assistant Professor, Department of Neurology, Emory University; Medical Director, Joi Life Wellness Group, Atlanta, Georgia 

Mitzi Joi Williams, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Alexion; Genentech; EMD Serono; Novartis; Biogen Idec 

Serve(d) as a speaker or a member of a speakers bureau for: AbbVie; Genentech; Novartis; Biogen; EMD Serono  

Received research grant from: Novartis; Genentech 

Dr Mitzi Joi Williams, medical director of the Joi Life Wellness Group in Atlanta, Georgia, shares updates from the 2021 CMSC Annual Meeting on the use of disease-modifying therapies (DMTs) in progressive multiple sclerosis (MS).  

Dr Williams begins with a review of findings from ACAPELLA, a prospective real-world study of ocrelizumab-associated adverse events. The various subanalyses found no higher rates of adverse events on the basis of age or EDSS scores, no downward trend in IgG levels, and mild B-cell repletion that had no significant correlation between disease activity or adverse events. 

Next, she turns to several subanalyses from the EXPAND trial that looked at efficacy and safety of siponimod in patients with secondary progressive MS. Siponimod provided similar clinical benefits in all age groups and was well-tolerated at 3 and 6 months. Several MRI measures were found to be prognostic of disease worsening or improvement. 

Dr Williams concludes with a first look at a new agent, ATA188, which is being studied in adults with progressive forms of MS. This phase 1/2 double-blind, placebo-controlled, dose-expansion trial aims to evaluate the effect of ATA188 on clinical disability, characterize the agent's safety and tolerability, and evaluate the impact of treatment on biological markers in progressive MS. 

--

Mitzi Joi Williams, MD, Assistant Professor, Department of Neurology, Emory University; Medical Director, Joi Life Wellness Group, Atlanta, Georgia 

Mitzi Joi Williams, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Alexion; Genentech; EMD Serono; Novartis; Biogen Idec 

Serve(d) as a speaker or a member of a speakers bureau for: AbbVie; Genentech; Novartis; Biogen; EMD Serono  

Received research grant from: Novartis; Genentech 

Dr Mitzi Joi Williams, medical director of the Joi Life Wellness Group in Atlanta, Georgia, shares updates from the 2021 CMSC Annual Meeting on the use of disease-modifying therapies (DMTs) in progressive multiple sclerosis (MS).  

Dr Williams begins with a review of findings from ACAPELLA, a prospective real-world study of ocrelizumab-associated adverse events. The various subanalyses found no higher rates of adverse events on the basis of age or EDSS scores, no downward trend in IgG levels, and mild B-cell repletion that had no significant correlation between disease activity or adverse events. 

Next, she turns to several subanalyses from the EXPAND trial that looked at efficacy and safety of siponimod in patients with secondary progressive MS. Siponimod provided similar clinical benefits in all age groups and was well-tolerated at 3 and 6 months. Several MRI measures were found to be prognostic of disease worsening or improvement. 

Dr Williams concludes with a first look at a new agent, ATA188, which is being studied in adults with progressive forms of MS. This phase 1/2 double-blind, placebo-controlled, dose-expansion trial aims to evaluate the effect of ATA188 on clinical disability, characterize the agent's safety and tolerability, and evaluate the impact of treatment on biological markers in progressive MS. 

--

Mitzi Joi Williams, MD, Assistant Professor, Department of Neurology, Emory University; Medical Director, Joi Life Wellness Group, Atlanta, Georgia 

Mitzi Joi Williams, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Alexion; Genentech; EMD Serono; Novartis; Biogen Idec 

Serve(d) as a speaker or a member of a speakers bureau for: AbbVie; Genentech; Novartis; Biogen; EMD Serono  

Received research grant from: Novartis; Genentech 

Dr Mitzi Joi Williams, medical director of Joi Life Wellness Group in Atlanta, Georgia, reviews updates from the 2021 CMSC Annual Meeting focusing on important considerations for patients with multiple sclerosis (MS) who have comorbid physical and mental health conditions.  

She begins with a longitudinal mediation analysis that assessed how differences in socioeconomic status, lifestyle, and comorbidities may affect Black vs White patients with MS. Overall, Black patients had longer timed 25-foot walks than White patients, and it was concluded that elevated BMIs, higher rates of hypertension, and living in lower income neighborhoods all played partial roles in this disparity.  

Dr Williams next discusses a study that examined the prevalence of depression and anxiety in patients with primary-progressive MS (PPMS), secondary-progressive MS (SPMS), and relapsing-remitting MS (RRMS). Rates of both conditions were lower in patients with PPMS than in those with SPMS and RRMS, but overall they were higher in patients with MS compared with the general population.  

The final study she reports on looked at the relationships between cognitive, emotional, and physical factors and weekly engagement in physical activity among patients with MS. Unsurprisingly, meeting weekly physical exercise recommendations was associated with improvement in leg functioning, whereas decreased exercise was associated with increased symptoms of depression and with underweight and obese BMIs.  

--

Mitzi Joi Williams, MD, Assistant Professor, Department of Neurology, Emory University; Medical Director, Joi Life Wellness Group, Atlanta, Georgia 

Mitzi Joi Williams, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Abbvie; Alexion; Genentech; EMD Serono; Novartis; Biogen Idec  

Serve(d) as a speaker or a member of a speakers bureau for: Abbvie; Genentech; Novartis; Biogen; EMD Serono  

Received research grant from: Novartis; Genentech  

Dr Mitzi Joi Williams, medical director of Joi Life Wellness Group in Atlanta, Georgia, reviews updates from the 2021 CMSC Annual Meeting focusing on important considerations for patients with multiple sclerosis (MS) who have comorbid physical and mental health conditions.  

She begins with a longitudinal mediation analysis that assessed how differences in socioeconomic status, lifestyle, and comorbidities may affect Black vs White patients with MS. Overall, Black patients had longer timed 25-foot walks than White patients, and it was concluded that elevated BMIs, higher rates of hypertension, and living in lower income neighborhoods all played partial roles in this disparity.  

Dr Williams next discusses a study that examined the prevalence of depression and anxiety in patients with primary-progressive MS (PPMS), secondary-progressive MS (SPMS), and relapsing-remitting MS (RRMS). Rates of both conditions were lower in patients with PPMS than in those with SPMS and RRMS, but overall they were higher in patients with MS compared with the general population.  

The final study she reports on looked at the relationships between cognitive, emotional, and physical factors and weekly engagement in physical activity among patients with MS. Unsurprisingly, meeting weekly physical exercise recommendations was associated with improvement in leg functioning, whereas decreased exercise was associated with increased symptoms of depression and with underweight and obese BMIs.  

--

Mitzi Joi Williams, MD, Assistant Professor, Department of Neurology, Emory University; Medical Director, Joi Life Wellness Group, Atlanta, Georgia 

Mitzi Joi Williams, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Abbvie; Alexion; Genentech; EMD Serono; Novartis; Biogen Idec  

Serve(d) as a speaker or a member of a speakers bureau for: Abbvie; Genentech; Novartis; Biogen; EMD Serono  

Received research grant from: Novartis; Genentech  

Dr Mitzi Joi Williams, medical director of Joi Life Wellness Group in Atlanta, Georgia, reviews updates from the 2021 CMSC Annual Meeting focusing on important considerations for patients with multiple sclerosis (MS) who have comorbid physical and mental health conditions.  

She begins with a longitudinal mediation analysis that assessed how differences in socioeconomic status, lifestyle, and comorbidities may affect Black vs White patients with MS. Overall, Black patients had longer timed 25-foot walks than White patients, and it was concluded that elevated BMIs, higher rates of hypertension, and living in lower income neighborhoods all played partial roles in this disparity.  

Dr Williams next discusses a study that examined the prevalence of depression and anxiety in patients with primary-progressive MS (PPMS), secondary-progressive MS (SPMS), and relapsing-remitting MS (RRMS). Rates of both conditions were lower in patients with PPMS than in those with SPMS and RRMS, but overall they were higher in patients with MS compared with the general population.  

The final study she reports on looked at the relationships between cognitive, emotional, and physical factors and weekly engagement in physical activity among patients with MS. Unsurprisingly, meeting weekly physical exercise recommendations was associated with improvement in leg functioning, whereas decreased exercise was associated with increased symptoms of depression and with underweight and obese BMIs.  

--

Mitzi Joi Williams, MD, Assistant Professor, Department of Neurology, Emory University; Medical Director, Joi Life Wellness Group, Atlanta, Georgia 

Mitzi Joi Williams, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Abbvie; Alexion; Genentech; EMD Serono; Novartis; Biogen Idec  

Serve(d) as a speaker or a member of a speakers bureau for: Abbvie; Genentech; Novartis; Biogen; EMD Serono  

Received research grant from: Novartis; Genentech  

Dr Darcy Marciniuk, of the University of Saskatchewan in Saskatchewan, Canada, discusses essential abstracts in the management of patients with COPD presented at the American College of Chest Physicians' annual meeting, CHEST 2020, which was held virtually this year because of the coronavirus.

Dr Marciniuk reviews new data from a phase 3 ETHOS substudy evaluating lung function decline in patients receiving inhaled corticosteroid (ICS)-containing therapies vs non–ICS-containing therapies. He also discusses a retrospective cohort study using Medicare data from 2012-2017 evaluating the association of noninvasive ventilation at home with risk for death, hospitalizations, and emergency room visits.

Additionally, he highlights a multi-institutional, post hoc analysis of the phase 3 IMPACT trial to estimate cardiovascular event risk following acute exacerbation in patients with COPD.

From another post hoc analysis, this one from the SUMMIT trial comparing fluticasone, vilanterol, and ICS/LABA with placebo, Dr Marciniuk reports on an investigation of all-cause mortality and severe exacerbation risk in a subgroup of patients with a history of exacerbation.

Finally, he highlights a retrospective cohort study using data from the US 2015 Inpatient Sample, which compared outcomes of patients admitted to hospitals with COPD exacerbations with and without mobility impairment.

--

Darcy D. Marciniuk, MD, Master FCCP, Professor, Department of Medicine, Division of Respirology, Critical Care, and Sleep Medicine, University of Saskatoon, Saskatoon, Saskatchewan, Canada.

Darcy D. Marciniuk, MD, Master FCCP, has disclosed the following relevant financial relationships:
Serve(d) as a consultant for: Alberta Lung Association; AstraZeneca; Boehringer Ingelheim; Canadian Foundation for Healthcare Improvement; GlaxoSmithKline; Heath Canada; Lung Association of Saskatchewan; Mylan; Novartis; Saskatchewan Ministry of Health; Saskatchewan Health Authority; Yukon Health and Social Services
Received research funding (managed by University of Saskatchewan) from: AstraZeneca; Boehringer Ingelheim; Canada Health Infoway; Canadian Institute of Health Research; GlaxoSmithKline; Grifols; Lung Association of Saskatchewan; Lung Health Institute of Canada; Novartis; Sanofi; Saskatchewan Health Research Foundation; Schering-Plough
Serve(s) as deputy editor of: CHEST Journal.

Dr Darcy Marciniuk, of the University of Saskatchewan in Saskatchewan, Canada, discusses essential abstracts in the management of patients with COPD presented at the American College of Chest Physicians' annual meeting, CHEST 2020, which was held virtually this year because of the coronavirus.

Dr Marciniuk reviews new data from a phase 3 ETHOS substudy evaluating lung function decline in patients receiving inhaled corticosteroid (ICS)-containing therapies vs non–ICS-containing therapies. He also discusses a retrospective cohort study using Medicare data from 2012-2017 evaluating the association of noninvasive ventilation at home with risk for death, hospitalizations, and emergency room visits.

Additionally, he highlights a multi-institutional, post hoc analysis of the phase 3 IMPACT trial to estimate cardiovascular event risk following acute exacerbation in patients with COPD.

From another post hoc analysis, this one from the SUMMIT trial comparing fluticasone, vilanterol, and ICS/LABA with placebo, Dr Marciniuk reports on an investigation of all-cause mortality and severe exacerbation risk in a subgroup of patients with a history of exacerbation.

Finally, he highlights a retrospective cohort study using data from the US 2015 Inpatient Sample, which compared outcomes of patients admitted to hospitals with COPD exacerbations with and without mobility impairment.

--

Darcy D. Marciniuk, MD, Master FCCP, Professor, Department of Medicine, Division of Respirology, Critical Care, and Sleep Medicine, University of Saskatoon, Saskatoon, Saskatchewan, Canada.

Darcy D. Marciniuk, MD, Master FCCP, has disclosed the following relevant financial relationships:
Serve(d) as a consultant for: Alberta Lung Association; AstraZeneca; Boehringer Ingelheim; Canadian Foundation for Healthcare Improvement; GlaxoSmithKline; Heath Canada; Lung Association of Saskatchewan; Mylan; Novartis; Saskatchewan Ministry of Health; Saskatchewan Health Authority; Yukon Health and Social Services
Received research funding (managed by University of Saskatchewan) from: AstraZeneca; Boehringer Ingelheim; Canada Health Infoway; Canadian Institute of Health Research; GlaxoSmithKline; Grifols; Lung Association of Saskatchewan; Lung Health Institute of Canada; Novartis; Sanofi; Saskatchewan Health Research Foundation; Schering-Plough
Serve(s) as deputy editor of: CHEST Journal.

Dr Darcy Marciniuk, of the University of Saskatchewan in Saskatchewan, Canada, discusses essential abstracts in the management of patients with COPD presented at the American College of Chest Physicians' annual meeting, CHEST 2020, which was held virtually this year because of the coronavirus.

Dr Marciniuk reviews new data from a phase 3 ETHOS substudy evaluating lung function decline in patients receiving inhaled corticosteroid (ICS)-containing therapies vs non–ICS-containing therapies. He also discusses a retrospective cohort study using Medicare data from 2012-2017 evaluating the association of noninvasive ventilation at home with risk for death, hospitalizations, and emergency room visits.

Additionally, he highlights a multi-institutional, post hoc analysis of the phase 3 IMPACT trial to estimate cardiovascular event risk following acute exacerbation in patients with COPD.

From another post hoc analysis, this one from the SUMMIT trial comparing fluticasone, vilanterol, and ICS/LABA with placebo, Dr Marciniuk reports on an investigation of all-cause mortality and severe exacerbation risk in a subgroup of patients with a history of exacerbation.

Finally, he highlights a retrospective cohort study using data from the US 2015 Inpatient Sample, which compared outcomes of patients admitted to hospitals with COPD exacerbations with and without mobility impairment.

--

Darcy D. Marciniuk, MD, Master FCCP, Professor, Department of Medicine, Division of Respirology, Critical Care, and Sleep Medicine, University of Saskatoon, Saskatoon, Saskatchewan, Canada.

Darcy D. Marciniuk, MD, Master FCCP, has disclosed the following relevant financial relationships:
Serve(d) as a consultant for: Alberta Lung Association; AstraZeneca; Boehringer Ingelheim; Canadian Foundation for Healthcare Improvement; GlaxoSmithKline; Heath Canada; Lung Association of Saskatchewan; Mylan; Novartis; Saskatchewan Ministry of Health; Saskatchewan Health Authority; Yukon Health and Social Services
Received research funding (managed by University of Saskatchewan) from: AstraZeneca; Boehringer Ingelheim; Canada Health Infoway; Canadian Institute of Health Research; GlaxoSmithKline; Grifols; Lung Association of Saskatchewan; Lung Health Institute of Canada; Novartis; Sanofi; Saskatchewan Health Research Foundation; Schering-Plough
Serve(s) as deputy editor of: CHEST Journal.

Dr Nichole Tanner, associate professor at the University of South Carolina, discusses new data on lung cancer biomarker testing from CHEST 2021.  

First, Dr Tanner shares two abstracts that discuss how endobronchial ultrasound (EBUS) demonstrated high-success yields in next-generation sequencing. One of the abstracts looked at EBUS transbronchial needle aspiration in patients with lung cancer, whereas the other examined EBUS-guided fine needle aspiration in patients with nonsquamous non–small cell lung cancer. 

Next, she discusses a small study that demonstrated the ability of the Percepta Genomic Sequencing Classifier to successfully reclassify patients in whom bronchoscopy was nondiagnostic. About half of the patients were either down-classified to low risk, which can help to avoid additional invasive procedures, or up-classified to high risk, which can inform next steps for intervention.  

Dr Tanner concludes by reviewing a retrospective analysis of the PANOPTIC clinical trial, which used the Nodify CDT test to evaluate a panel of seven lung cancer–associated autoantibodies in study patients who had incidentally discovered indeterminate pulmonary nodules. The autoantibodies were able to detect likely malignant nodules regardless of lung cancer type, histology, or stage. 

--

Nichole T. Tanner, MD, MSCR, FCCP, Associate Professor, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina 

Nichole T. Tanner, MD, MSCR, FCCP, has disclosed no relevant financial relationships. 

Dr Nichole Tanner, associate professor at the University of South Carolina, discusses new data on lung cancer biomarker testing from CHEST 2021.  

First, Dr Tanner shares two abstracts that discuss how endobronchial ultrasound (EBUS) demonstrated high-success yields in next-generation sequencing. One of the abstracts looked at EBUS transbronchial needle aspiration in patients with lung cancer, whereas the other examined EBUS-guided fine needle aspiration in patients with nonsquamous non–small cell lung cancer. 

Next, she discusses a small study that demonstrated the ability of the Percepta Genomic Sequencing Classifier to successfully reclassify patients in whom bronchoscopy was nondiagnostic. About half of the patients were either down-classified to low risk, which can help to avoid additional invasive procedures, or up-classified to high risk, which can inform next steps for intervention.  

Dr Tanner concludes by reviewing a retrospective analysis of the PANOPTIC clinical trial, which used the Nodify CDT test to evaluate a panel of seven lung cancer–associated autoantibodies in study patients who had incidentally discovered indeterminate pulmonary nodules. The autoantibodies were able to detect likely malignant nodules regardless of lung cancer type, histology, or stage. 

--

Nichole T. Tanner, MD, MSCR, FCCP, Associate Professor, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina 

Nichole T. Tanner, MD, MSCR, FCCP, has disclosed no relevant financial relationships. 

Dr Nichole Tanner, associate professor at the University of South Carolina, discusses new data on lung cancer biomarker testing from CHEST 2021.  

First, Dr Tanner shares two abstracts that discuss how endobronchial ultrasound (EBUS) demonstrated high-success yields in next-generation sequencing. One of the abstracts looked at EBUS transbronchial needle aspiration in patients with lung cancer, whereas the other examined EBUS-guided fine needle aspiration in patients with nonsquamous non–small cell lung cancer. 

Next, she discusses a small study that demonstrated the ability of the Percepta Genomic Sequencing Classifier to successfully reclassify patients in whom bronchoscopy was nondiagnostic. About half of the patients were either down-classified to low risk, which can help to avoid additional invasive procedures, or up-classified to high risk, which can inform next steps for intervention.  

Dr Tanner concludes by reviewing a retrospective analysis of the PANOPTIC clinical trial, which used the Nodify CDT test to evaluate a panel of seven lung cancer–associated autoantibodies in study patients who had incidentally discovered indeterminate pulmonary nodules. The autoantibodies were able to detect likely malignant nodules regardless of lung cancer type, histology, or stage. 

--

Nichole T. Tanner, MD, MSCR, FCCP, Associate Professor, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina 

Nichole T. Tanner, MD, MSCR, FCCP, has disclosed no relevant financial relationships. 

Dr Joseph Berger of the Perelman School of Medicine in Philadelphia discusses abstracts from ECTRIMS 2021 focusing on the use of disease-modifying therapies (DMTs) in patients with relapsing-remitting multiple sclerosis.

Dr Berger discusses ULTIMATE I and ULTIMATE II results, in which ublituximab — a novel monoclonal antibody — improved annualized relapse rates, Multiple Sclerosis Functional Composite scores, and percentages of patients with no evidence of disease activity compared to teriflunomide.

Dr Berger also highlights a study that examined the association between serum neurofilament light (NfL) levels and disease progression in patients on natalizumab. Although NfL levels were significantly reduced after initiation of therapy, no differences were evident between progressors and nonprogressors.

Next, he examines 3-year data from the CASTING study, which assessed ocrelizumab in patients who had a suboptimal response to one or two previous DMTs. Follow-up analysis showed that patients who received ocrelizumab had consistently low disease activity throughout the study period; mean Expanded Disability Status Scale (EDSS) scores, annualized relapse rates, and no evidence of disease activity were also stable.

Dr Berger concludes with a comparative analysis of patients who started on or switched to dimethyl fumarate or teriflunomide. Dimethyl fumarate showed more favorable outcomes in time to relapse, time to EDSS worsening, and sensitivity analysis.

--

Joseph R. Berger, MD, Professor; Associate Chief, Department of Neurology, Multiple Sclerosis Division, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania

Joseph R. Berger, MD, has disclosed the following relevant financial relationships:

Received research grant from: Biogen; Roche/Genentech

Received income in an amount equal to or greater than $250 from: Amgen; Biogen; Bristol-Myers Squibb; Celgene; Genzyme; Excision Bio; Dr. Reddy; Serono; Morphic; Novartis; Inhibikase; Morphic; Encycle; Merck; Mapi

Dr Joseph Berger of the Perelman School of Medicine in Philadelphia discusses abstracts from ECTRIMS 2021 focusing on the use of disease-modifying therapies (DMTs) in patients with relapsing-remitting multiple sclerosis.

Dr Berger discusses ULTIMATE I and ULTIMATE II results, in which ublituximab — a novel monoclonal antibody — improved annualized relapse rates, Multiple Sclerosis Functional Composite scores, and percentages of patients with no evidence of disease activity compared to teriflunomide.

Dr Berger also highlights a study that examined the association between serum neurofilament light (NfL) levels and disease progression in patients on natalizumab. Although NfL levels were significantly reduced after initiation of therapy, no differences were evident between progressors and nonprogressors.

Next, he examines 3-year data from the CASTING study, which assessed ocrelizumab in patients who had a suboptimal response to one or two previous DMTs. Follow-up analysis showed that patients who received ocrelizumab had consistently low disease activity throughout the study period; mean Expanded Disability Status Scale (EDSS) scores, annualized relapse rates, and no evidence of disease activity were also stable.

Dr Berger concludes with a comparative analysis of patients who started on or switched to dimethyl fumarate or teriflunomide. Dimethyl fumarate showed more favorable outcomes in time to relapse, time to EDSS worsening, and sensitivity analysis.

--

Joseph R. Berger, MD, Professor; Associate Chief, Department of Neurology, Multiple Sclerosis Division, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania

Joseph R. Berger, MD, has disclosed the following relevant financial relationships:

Received research grant from: Biogen; Roche/Genentech

Received income in an amount equal to or greater than $250 from: Amgen; Biogen; Bristol-Myers Squibb; Celgene; Genzyme; Excision Bio; Dr. Reddy; Serono; Morphic; Novartis; Inhibikase; Morphic; Encycle; Merck; Mapi

Dr Joseph Berger of the Perelman School of Medicine in Philadelphia discusses abstracts from ECTRIMS 2021 focusing on the use of disease-modifying therapies (DMTs) in patients with relapsing-remitting multiple sclerosis.

Dr Berger discusses ULTIMATE I and ULTIMATE II results, in which ublituximab — a novel monoclonal antibody — improved annualized relapse rates, Multiple Sclerosis Functional Composite scores, and percentages of patients with no evidence of disease activity compared to teriflunomide.

Dr Berger also highlights a study that examined the association between serum neurofilament light (NfL) levels and disease progression in patients on natalizumab. Although NfL levels were significantly reduced after initiation of therapy, no differences were evident between progressors and nonprogressors.

Next, he examines 3-year data from the CASTING study, which assessed ocrelizumab in patients who had a suboptimal response to one or two previous DMTs. Follow-up analysis showed that patients who received ocrelizumab had consistently low disease activity throughout the study period; mean Expanded Disability Status Scale (EDSS) scores, annualized relapse rates, and no evidence of disease activity were also stable.

Dr Berger concludes with a comparative analysis of patients who started on or switched to dimethyl fumarate or teriflunomide. Dimethyl fumarate showed more favorable outcomes in time to relapse, time to EDSS worsening, and sensitivity analysis.

--

Joseph R. Berger, MD, Professor; Associate Chief, Department of Neurology, Multiple Sclerosis Division, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania

Joseph R. Berger, MD, has disclosed the following relevant financial relationships:

Received research grant from: Biogen; Roche/Genentech

Received income in an amount equal to or greater than $250 from: Amgen; Biogen; Bristol-Myers Squibb; Celgene; Genzyme; Excision Bio; Dr. Reddy; Serono; Morphic; Novartis; Inhibikase; Morphic; Encycle; Merck; Mapi

Benjamin Cooper, MD, director of Proton Therapy services at NYU Langone Health, shares key findings from early-stage non-small cell lung cancer (NSCLC) trials presented at the 2021 ESMO Congress. 

Dr Cooper begins with the LungART trial, which evaluated whether postoperative radiotherapy (PORT) would benefit patients with completely resected NSCLC and mediastinal N2 involvement. Use of PORT reduced the risk of mediastinal relapse but did not show significant impact on disease-free survival (DFS).  

Next, he turns to findings from the COAST trial, which compared durvalumab monotherapy, durvalumab plus oleclumab, and durvalumab plus monalizumab in patients with locally advanced, unresectable stage III NSCLC. Both combination regimens increased the objective response rate and significantly improved progression-free survival (PFS) vs durvalumab alone.  

Dr Cooper also reviews sites of disease relapse and post-relapse treatment from IMpower010, which evaluated atezolizumab versus best supportive care after adjuvant chemotherapy in patients with resected stage IB-IIIA NSCLC. Similar patterns of relapse were seen across study arms, but patients with PD-L1 levels of 50% or higher experienced greatest DFS benefits. 

Lastly, Dr Cooper highlights GEMSTONE-301, which tested the novel anti-PD-L1 drug sugemalimab in patients with unresectable, stage III NSCLC who did not progress after concurrent or sequential radiotherapy. There was a statistically significant and clinically meaningful PFS improvement in patients receiving sugemalimab compared to placebo. 

--

Benjamin Cooper, MD, Assistant Professor, Department of Radiation Oncology, Director, Proton Therapy Services, NYU Grossman School of Medicine, New York, New York 

Benjamin Cooper, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AstraZeneca. 

Benjamin Cooper, MD, director of Proton Therapy services at NYU Langone Health, shares key findings from early-stage non-small cell lung cancer (NSCLC) trials presented at the 2021 ESMO Congress. 

Dr Cooper begins with the LungART trial, which evaluated whether postoperative radiotherapy (PORT) would benefit patients with completely resected NSCLC and mediastinal N2 involvement. Use of PORT reduced the risk of mediastinal relapse but did not show significant impact on disease-free survival (DFS).  

Next, he turns to findings from the COAST trial, which compared durvalumab monotherapy, durvalumab plus oleclumab, and durvalumab plus monalizumab in patients with locally advanced, unresectable stage III NSCLC. Both combination regimens increased the objective response rate and significantly improved progression-free survival (PFS) vs durvalumab alone.  

Dr Cooper also reviews sites of disease relapse and post-relapse treatment from IMpower010, which evaluated atezolizumab versus best supportive care after adjuvant chemotherapy in patients with resected stage IB-IIIA NSCLC. Similar patterns of relapse were seen across study arms, but patients with PD-L1 levels of 50% or higher experienced greatest DFS benefits. 

Lastly, Dr Cooper highlights GEMSTONE-301, which tested the novel anti-PD-L1 drug sugemalimab in patients with unresectable, stage III NSCLC who did not progress after concurrent or sequential radiotherapy. There was a statistically significant and clinically meaningful PFS improvement in patients receiving sugemalimab compared to placebo. 

--

Benjamin Cooper, MD, Assistant Professor, Department of Radiation Oncology, Director, Proton Therapy Services, NYU Grossman School of Medicine, New York, New York 

Benjamin Cooper, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AstraZeneca. 

Benjamin Cooper, MD, director of Proton Therapy services at NYU Langone Health, shares key findings from early-stage non-small cell lung cancer (NSCLC) trials presented at the 2021 ESMO Congress. 

Dr Cooper begins with the LungART trial, which evaluated whether postoperative radiotherapy (PORT) would benefit patients with completely resected NSCLC and mediastinal N2 involvement. Use of PORT reduced the risk of mediastinal relapse but did not show significant impact on disease-free survival (DFS).  

Next, he turns to findings from the COAST trial, which compared durvalumab monotherapy, durvalumab plus oleclumab, and durvalumab plus monalizumab in patients with locally advanced, unresectable stage III NSCLC. Both combination regimens increased the objective response rate and significantly improved progression-free survival (PFS) vs durvalumab alone.  

Dr Cooper also reviews sites of disease relapse and post-relapse treatment from IMpower010, which evaluated atezolizumab versus best supportive care after adjuvant chemotherapy in patients with resected stage IB-IIIA NSCLC. Similar patterns of relapse were seen across study arms, but patients with PD-L1 levels of 50% or higher experienced greatest DFS benefits. 

Lastly, Dr Cooper highlights GEMSTONE-301, which tested the novel anti-PD-L1 drug sugemalimab in patients with unresectable, stage III NSCLC who did not progress after concurrent or sequential radiotherapy. There was a statistically significant and clinically meaningful PFS improvement in patients receiving sugemalimab compared to placebo. 

--

Benjamin Cooper, MD, Assistant Professor, Department of Radiation Oncology, Director, Proton Therapy Services, NYU Grossman School of Medicine, New York, New York 

Benjamin Cooper, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AstraZeneca. 

Obese or overweight children with asthma could be using inhaled corticosteroids (ICS) to no avail, combined results from observational studies suggest.

Using Mendelian randomization, a method for reducing bias in observational studies, investigators from the University of Amsterdam Medical Center performed an analysis of data from four cross-sectional studies and one cohort study on a total of 1,511 children with asthma.

They showed that every 1-unit increase in the body mass index (BMI) z score was associated with a more than twofold higher odds ratio for exacerbation, reported Cristina Longo, PhD, a former postdoctoral fellow at AMC, and assistant professor of medicine at the University of Montreal.

“In this large, multicenter Mendelian randomization study, our findings support current evidence that children with higher BMI status respond inadequately to inhaled corticosteroids, and that this association is likely not explained by measured confounding or reverse causation,” she said in an oral abstract presentation during the European Respiratory Society International Congress.
 

Unmeasured confounding

The obese-asthma phenotype in children is characterized by reduced lung function, high symptom expression, poor response to ICS, and high health care utilization.

“While most observational studies suggest that weight status is associated with asthma exacerbations, despite using inhaled corticosteroids, it’s unclear whether these associations may be due to unmeasured confounding or reverse causation, which captures the idea that perhaps obesity is a consequence rather than a cause of uncontrolled severe asthma,” she said.

Traditional observational studies of the obesity-asthma link rely on comparing data on asthma in a target population and comparing nonobese patients with obese patients. The problem with this method, Dr. Longo contended, is that the exposure assignment – weight status – is not random, and could lead to bias from potential imbalance of confounders, leading to unintentionally biased results.

In contrast, Mendelian randomization uses genetic data to approximate random assignment of exposures, using a risk score for BMI based on genetic susceptibility. The score is based on the accumulation of genetic variants (single-nucleotide polymorphisms, or SNPs) that predispose individuals to obesity, with higher numbers of variants results in a higher risk score.

The scores are then used to determine the comparison groups for evaluating the obesity-asthma association.
 

Alphabet soup

Dr. Longo and colleagues analyzed data on a total 1,511 children enrolled in four observational studies (PACMAN, PAGES, HPR, CLARA) and one cohort study (ALSPAC).

They included children with an asthma diagnosis who used ICS and had available information on both BMI and genetics.

The Mendelian randomization analysis was based on a weighted allele score based on 97 SNPs predictive of BMI based on large-scale genomewide association studies. The exposure for the analysis was age- and sex-adjusted BMI z scores based on World Health Organization growth charts for children.

They found that using the Mendelian randomization approach, for each standard deviation increase in BMI, the OR for any parent-reported asthma exacerbations, including urgent care visits or use of oral corticosteroids, was 2.31 (95% confidence interval, 1.26-4.25).

In contrast, if the traditional observational model had been used, the OR would be a nonsignificant 1.10 (95% CI, 0.99-1.22).

“Treatment guidelines recommend steroids for children with asthma who have a higher-than-normal BMI,” Dr. Longo said in a statement. “Our research group felt that the one-size fits-all approach to treating children with asthma with inhaled steroids as their first-line treatment, particularly those with excess weight, warrants revision. At the very least, research identifying potential alternative treatments should be encouraged and prioritized, especially since 30% of children with asthma are also obese. With the childhood obesity epidemic rising, we expect this percentage to increase meaning this problem of poor control will be seen more frequently in routine clinical practice.”

Christopher E. Brightling, PhD, professor of respiratory medicine at the University of Leicester (England), commented that “this is very good and fascinating research with findings that are important and novel.

“It sheds light on the complex interplay between genes, weight, and response to inhaled corticosteroids, underscoring the need to combine drug treatments with lifestyle and diet modifications. Policy makers, health care providers and families need to do much more to tackle the growing obesity epidemic in young people,” he said.

Dr. Brightling was not involved in the study.

The study was supported by the ERS and the European Union’s H2020 research and innovation program. Dr. Longo was a Horizon 2020 Marie-Sklodowska Cure Respire-3 fellow. Dr. Brightling reported no relevant disclosures.

Obese or overweight children with asthma could be using inhaled corticosteroids (ICS) to no avail, combined results from observational studies suggest.

Using Mendelian randomization, a method for reducing bias in observational studies, investigators from the University of Amsterdam Medical Center performed an analysis of data from four cross-sectional studies and one cohort study on a total of 1,511 children with asthma.

They showed that every 1-unit increase in the body mass index (BMI) z score was associated with a more than twofold higher odds ratio for exacerbation, reported Cristina Longo, PhD, a former postdoctoral fellow at AMC, and assistant professor of medicine at the University of Montreal.

“In this large, multicenter Mendelian randomization study, our findings support current evidence that children with higher BMI status respond inadequately to inhaled corticosteroids, and that this association is likely not explained by measured confounding or reverse causation,” she said in an oral abstract presentation during the European Respiratory Society International Congress.
 

Unmeasured confounding

The obese-asthma phenotype in children is characterized by reduced lung function, high symptom expression, poor response to ICS, and high health care utilization.

“While most observational studies suggest that weight status is associated with asthma exacerbations, despite using inhaled corticosteroids, it’s unclear whether these associations may be due to unmeasured confounding or reverse causation, which captures the idea that perhaps obesity is a consequence rather than a cause of uncontrolled severe asthma,” she said.

Traditional observational studies of the obesity-asthma link rely on comparing data on asthma in a target population and comparing nonobese patients with obese patients. The problem with this method, Dr. Longo contended, is that the exposure assignment – weight status – is not random, and could lead to bias from potential imbalance of confounders, leading to unintentionally biased results.

In contrast, Mendelian randomization uses genetic data to approximate random assignment of exposures, using a risk score for BMI based on genetic susceptibility. The score is based on the accumulation of genetic variants (single-nucleotide polymorphisms, or SNPs) that predispose individuals to obesity, with higher numbers of variants results in a higher risk score.

The scores are then used to determine the comparison groups for evaluating the obesity-asthma association.
 

Alphabet soup

Dr. Longo and colleagues analyzed data on a total 1,511 children enrolled in four observational studies (PACMAN, PAGES, HPR, CLARA) and one cohort study (ALSPAC).

They included children with an asthma diagnosis who used ICS and had available information on both BMI and genetics.

The Mendelian randomization analysis was based on a weighted allele score based on 97 SNPs predictive of BMI based on large-scale genomewide association studies. The exposure for the analysis was age- and sex-adjusted BMI z scores based on World Health Organization growth charts for children.

They found that using the Mendelian randomization approach, for each standard deviation increase in BMI, the OR for any parent-reported asthma exacerbations, including urgent care visits or use of oral corticosteroids, was 2.31 (95% confidence interval, 1.26-4.25).

In contrast, if the traditional observational model had been used, the OR would be a nonsignificant 1.10 (95% CI, 0.99-1.22).

“Treatment guidelines recommend steroids for children with asthma who have a higher-than-normal BMI,” Dr. Longo said in a statement. “Our research group felt that the one-size fits-all approach to treating children with asthma with inhaled steroids as their first-line treatment, particularly those with excess weight, warrants revision. At the very least, research identifying potential alternative treatments should be encouraged and prioritized, especially since 30% of children with asthma are also obese. With the childhood obesity epidemic rising, we expect this percentage to increase meaning this problem of poor control will be seen more frequently in routine clinical practice.”

Christopher E. Brightling, PhD, professor of respiratory medicine at the University of Leicester (England), commented that “this is very good and fascinating research with findings that are important and novel.

“It sheds light on the complex interplay between genes, weight, and response to inhaled corticosteroids, underscoring the need to combine drug treatments with lifestyle and diet modifications. Policy makers, health care providers and families need to do much more to tackle the growing obesity epidemic in young people,” he said.

Dr. Brightling was not involved in the study.

The study was supported by the ERS and the European Union’s H2020 research and innovation program. Dr. Longo was a Horizon 2020 Marie-Sklodowska Cure Respire-3 fellow. Dr. Brightling reported no relevant disclosures.

Obese or overweight children with asthma could be using inhaled corticosteroids (ICS) to no avail, combined results from observational studies suggest.

Using Mendelian randomization, a method for reducing bias in observational studies, investigators from the University of Amsterdam Medical Center performed an analysis of data from four cross-sectional studies and one cohort study on a total of 1,511 children with asthma.

They showed that every 1-unit increase in the body mass index (BMI) z score was associated with a more than twofold higher odds ratio for exacerbation, reported Cristina Longo, PhD, a former postdoctoral fellow at AMC, and assistant professor of medicine at the University of Montreal.

“In this large, multicenter Mendelian randomization study, our findings support current evidence that children with higher BMI status respond inadequately to inhaled corticosteroids, and that this association is likely not explained by measured confounding or reverse causation,” she said in an oral abstract presentation during the European Respiratory Society International Congress.
 

Unmeasured confounding

The obese-asthma phenotype in children is characterized by reduced lung function, high symptom expression, poor response to ICS, and high health care utilization.

“While most observational studies suggest that weight status is associated with asthma exacerbations, despite using inhaled corticosteroids, it’s unclear whether these associations may be due to unmeasured confounding or reverse causation, which captures the idea that perhaps obesity is a consequence rather than a cause of uncontrolled severe asthma,” she said.

Traditional observational studies of the obesity-asthma link rely on comparing data on asthma in a target population and comparing nonobese patients with obese patients. The problem with this method, Dr. Longo contended, is that the exposure assignment – weight status – is not random, and could lead to bias from potential imbalance of confounders, leading to unintentionally biased results.

In contrast, Mendelian randomization uses genetic data to approximate random assignment of exposures, using a risk score for BMI based on genetic susceptibility. The score is based on the accumulation of genetic variants (single-nucleotide polymorphisms, or SNPs) that predispose individuals to obesity, with higher numbers of variants results in a higher risk score.

The scores are then used to determine the comparison groups for evaluating the obesity-asthma association.
 

Alphabet soup

Dr. Longo and colleagues analyzed data on a total 1,511 children enrolled in four observational studies (PACMAN, PAGES, HPR, CLARA) and one cohort study (ALSPAC).

They included children with an asthma diagnosis who used ICS and had available information on both BMI and genetics.

The Mendelian randomization analysis was based on a weighted allele score based on 97 SNPs predictive of BMI based on large-scale genomewide association studies. The exposure for the analysis was age- and sex-adjusted BMI z scores based on World Health Organization growth charts for children.

They found that using the Mendelian randomization approach, for each standard deviation increase in BMI, the OR for any parent-reported asthma exacerbations, including urgent care visits or use of oral corticosteroids, was 2.31 (95% confidence interval, 1.26-4.25).

In contrast, if the traditional observational model had been used, the OR would be a nonsignificant 1.10 (95% CI, 0.99-1.22).

“Treatment guidelines recommend steroids for children with asthma who have a higher-than-normal BMI,” Dr. Longo said in a statement. “Our research group felt that the one-size fits-all approach to treating children with asthma with inhaled steroids as their first-line treatment, particularly those with excess weight, warrants revision. At the very least, research identifying potential alternative treatments should be encouraged and prioritized, especially since 30% of children with asthma are also obese. With the childhood obesity epidemic rising, we expect this percentage to increase meaning this problem of poor control will be seen more frequently in routine clinical practice.”

Christopher E. Brightling, PhD, professor of respiratory medicine at the University of Leicester (England), commented that “this is very good and fascinating research with findings that are important and novel.

“It sheds light on the complex interplay between genes, weight, and response to inhaled corticosteroids, underscoring the need to combine drug treatments with lifestyle and diet modifications. Policy makers, health care providers and families need to do much more to tackle the growing obesity epidemic in young people,” he said.

Dr. Brightling was not involved in the study.

The study was supported by the ERS and the European Union’s H2020 research and innovation program. Dr. Longo was a Horizon 2020 Marie-Sklodowska Cure Respire-3 fellow. Dr. Brightling reported no relevant disclosures.

Dr. Laura Goff presents treatment updates in hepatocellular carcinoma (HCC) that were presented at the ASCO 2021 Annual Meeting.

Updated data from the phase 3 KEYNOTE-240 study demonstrated that overall survival, progression-free survival, and objective response rate were maintained over 3 years with pembrolizumab compared to placebo in patients with advanced HCC previously treated with sorafenib.

An exploratory analysis of IMBRAVE150 examined the association between best overall response and overall survival, as well as independent predictors of survival in patients with unresectable HCC treated with atezolizumab plus bevacizumab versus sorafenib. In the study treatment population, confirmed response by RECIST 1.1 and by HCC mRECIST were associated with improved overall survival. Data suggested that both confirmed response and stable disease are associated with improved clinical outcomes in patients treated with this regimen.

Lastly, a retrospective cohort study comparing sorafenib, and nivolumab as first-line systemic therapies for patients with advanced HCC and Child-Pugh class B cirrhosis found that nivolumab was associated with better overall survival as a first-line treatment.

--

Laura W. Goff, MD is an Associate Professor at Vanderbilt University Medical Center in Nashville, Tennessee.

Dr. Goff discloses previous work with: Agios, ArQule; ASLAN Pharmaceuticals; Astellas Pharma; Basilea Pharmaceutica; BeiGene; Bristol Myers Squibb; Eli Lilly and Company; H3 Biomedicine; Incyte; Leap Therapeutics; Merck; Onyx Pharmaceuticals; Pfizer; SunPharma.

Dr. Laura Goff presents treatment updates in hepatocellular carcinoma (HCC) that were presented at the ASCO 2021 Annual Meeting.

Updated data from the phase 3 KEYNOTE-240 study demonstrated that overall survival, progression-free survival, and objective response rate were maintained over 3 years with pembrolizumab compared to placebo in patients with advanced HCC previously treated with sorafenib.

An exploratory analysis of IMBRAVE150 examined the association between best overall response and overall survival, as well as independent predictors of survival in patients with unresectable HCC treated with atezolizumab plus bevacizumab versus sorafenib. In the study treatment population, confirmed response by RECIST 1.1 and by HCC mRECIST were associated with improved overall survival. Data suggested that both confirmed response and stable disease are associated with improved clinical outcomes in patients treated with this regimen.

Lastly, a retrospective cohort study comparing sorafenib, and nivolumab as first-line systemic therapies for patients with advanced HCC and Child-Pugh class B cirrhosis found that nivolumab was associated with better overall survival as a first-line treatment.

--

Laura W. Goff, MD is an Associate Professor at Vanderbilt University Medical Center in Nashville, Tennessee.

Dr. Goff discloses previous work with: Agios, ArQule; ASLAN Pharmaceuticals; Astellas Pharma; Basilea Pharmaceutica; BeiGene; Bristol Myers Squibb; Eli Lilly and Company; H3 Biomedicine; Incyte; Leap Therapeutics; Merck; Onyx Pharmaceuticals; Pfizer; SunPharma.

Dr. Laura Goff presents treatment updates in hepatocellular carcinoma (HCC) that were presented at the ASCO 2021 Annual Meeting.

Updated data from the phase 3 KEYNOTE-240 study demonstrated that overall survival, progression-free survival, and objective response rate were maintained over 3 years with pembrolizumab compared to placebo in patients with advanced HCC previously treated with sorafenib.

An exploratory analysis of IMBRAVE150 examined the association between best overall response and overall survival, as well as independent predictors of survival in patients with unresectable HCC treated with atezolizumab plus bevacizumab versus sorafenib. In the study treatment population, confirmed response by RECIST 1.1 and by HCC mRECIST were associated with improved overall survival. Data suggested that both confirmed response and stable disease are associated with improved clinical outcomes in patients treated with this regimen.

Lastly, a retrospective cohort study comparing sorafenib, and nivolumab as first-line systemic therapies for patients with advanced HCC and Child-Pugh class B cirrhosis found that nivolumab was associated with better overall survival as a first-line treatment.

--

Laura W. Goff, MD is an Associate Professor at Vanderbilt University Medical Center in Nashville, Tennessee.

Dr. Goff discloses previous work with: Agios, ArQule; ASLAN Pharmaceuticals; Astellas Pharma; Basilea Pharmaceutica; BeiGene; Bristol Myers Squibb; Eli Lilly and Company; H3 Biomedicine; Incyte; Leap Therapeutics; Merck; Onyx Pharmaceuticals; Pfizer; SunPharma.

Dr Thomas Stinchcombe, from Duke Cancer Center in Durham, North Carolina, highlights key abstracts in locally advanced non–small cell lung cancer (NSCLC) presented at the 2021 annual meeting of the American Society of Clinical Oncology. 

First, he reviews the IMpower010 trial, which compares atezolizumab vs best supportive care in patients with surgically resected NSCLC who had received adjuvant chemotherapy. 

He then discusses surgical outcomes from the CheckMate 816 trial in patients with resectable NSCLC who had been treated with nivolumab plus platinum-doublet chemotherapy vs chemotherapy alone. 

Finally, Dr Stinchcombe discusses the IMPACT trial, which looked at adjuvant gefitinib vs cisplatin/vinorelbine in completely resected NSCLC patients with EGFR mutations.
--

Thomas E. Stinchcombe, MD, Medical Oncology, Duke Cancer Center, Durham, North Carolina.

Thomas E. Stinchcombe, MD, has disclosed the following relevant financial relationships:
Received research funding from: Genentech/Roche; Blueprint Medicines; AstraZeneca
Received income in an amount equal to or greater than $250 from: Takeda; AstraZeneca; Genentech/Roche; Foundation Medicine; Pfizer; EMD Serono; Novartis; Daiichi Sankyo; Eli Lilly and Company; Medtronic.
 

Dr Thomas Stinchcombe, from Duke Cancer Center in Durham, North Carolina, highlights key abstracts in locally advanced non–small cell lung cancer (NSCLC) presented at the 2021 annual meeting of the American Society of Clinical Oncology. 

First, he reviews the IMpower010 trial, which compares atezolizumab vs best supportive care in patients with surgically resected NSCLC who had received adjuvant chemotherapy. 

He then discusses surgical outcomes from the CheckMate 816 trial in patients with resectable NSCLC who had been treated with nivolumab plus platinum-doublet chemotherapy vs chemotherapy alone. 

Finally, Dr Stinchcombe discusses the IMPACT trial, which looked at adjuvant gefitinib vs cisplatin/vinorelbine in completely resected NSCLC patients with EGFR mutations.
--

Thomas E. Stinchcombe, MD, Medical Oncology, Duke Cancer Center, Durham, North Carolina.

Thomas E. Stinchcombe, MD, has disclosed the following relevant financial relationships:
Received research funding from: Genentech/Roche; Blueprint Medicines; AstraZeneca
Received income in an amount equal to or greater than $250 from: Takeda; AstraZeneca; Genentech/Roche; Foundation Medicine; Pfizer; EMD Serono; Novartis; Daiichi Sankyo; Eli Lilly and Company; Medtronic.
 

Dr Thomas Stinchcombe, from Duke Cancer Center in Durham, North Carolina, highlights key abstracts in locally advanced non–small cell lung cancer (NSCLC) presented at the 2021 annual meeting of the American Society of Clinical Oncology. 

First, he reviews the IMpower010 trial, which compares atezolizumab vs best supportive care in patients with surgically resected NSCLC who had received adjuvant chemotherapy. 

He then discusses surgical outcomes from the CheckMate 816 trial in patients with resectable NSCLC who had been treated with nivolumab plus platinum-doublet chemotherapy vs chemotherapy alone. 

Finally, Dr Stinchcombe discusses the IMPACT trial, which looked at adjuvant gefitinib vs cisplatin/vinorelbine in completely resected NSCLC patients with EGFR mutations.
--

Thomas E. Stinchcombe, MD, Medical Oncology, Duke Cancer Center, Durham, North Carolina.

Thomas E. Stinchcombe, MD, has disclosed the following relevant financial relationships:
Received research funding from: Genentech/Roche; Blueprint Medicines; AstraZeneca
Received income in an amount equal to or greater than $250 from: Takeda; AstraZeneca; Genentech/Roche; Foundation Medicine; Pfizer; EMD Serono; Novartis; Daiichi Sankyo; Eli Lilly and Company; Medtronic.