Solange Peters, MD, PhD, Review Evolving Lung Cancer Treatment Trends

Creating a more diverse workplace for lung cancer clinicians, especially those participating in clinical trials, has become a major focus in the field of oncology in recent years. In addition, clinicians are learning how to be more prominent in the field, and how to speak up and be recognized.

In an interview with Oncology®, Solange Peters, MD, PhD, He talked about recent research trends and the biggest obstacles to lung cancer that experts are facing today.

Peters also elaborated on how to do that HER2 Mutations have led to the development of lung cancer treatment and discussed barriers to molecular testing. In addition, she shared advice for people trying to break into the field of lung cancer.

Q: Q: What trends have you seen so far in 2022? Do you think you can see it again?

Peters: Lung cancer [used to be in the] A category of diseases with very poor outcomes. With conventional surgery, chemotherapy, and radiation therapy, the outcome of lung cancer was disappointing. [Now]Two big chapters have dramatically changed fate [patients with] Malignant tumor of the chest. The first chapter is molecular biology: trying to understand and discover genes, or oncogenes, [that is causing the cancer. The discovery] Analysis of oncogenes that lead to malignant phenotypes has led to a portfolio of targeted therapies.

[Also included in] The first chapter is molecular characterization, tumor gene poisoning, and targeted therapies. [about] 15 years ago EGFR mutation.Now we have 15 [driver] Mutations that can be treated with first-line or second-line treatment without chemotherapy or radiation therapy, [using] Targeted therapy.This has been gradual in the last 15 years and we [continuing to keep] Adjust the pace by discovering new compounds or new targets. [However], The hanging fruit may have been caught. What we can improve as much as possible is the pharmacology of targeted therapies. We have been dealing with more powerful medicines in terms of preventing resistance.

Chapter 2 includes immunotherapy, which leads to long-term survival for some lung cancer patients despite metastatic disease.When I started, I couldn’t imagine that patients with metastatic disease could survive for years, but now [they can], With immunotherapy. There is strong data showing that immunotherapy should be used alone or in combination with chemotherapy in all front-line metastatic diseases. However, these immunotherapies are now transitioning to early-stage illnesses. [such as in those cases with] A small nodule that is excised and treated for healing purposes.First data [have been presented from] Already 3 trials. This year there are more trials for early illness.These tests
Immunotherapy has a place and role in early illness, [along] With surgery and all kinds of curative treatment. This is a revolution not only in lung cancer, but also in other types of cancer.For lung cancer, a combination of immunotherapy and old strategies [potentially] Cure the patient.

Q: Q: What are some of the barriers and problems surrounding molecular testing for early-stage disease?

Peters: Unfortunately, looking at pictures of molecular tests in Europe, less than half of the patients have access to a decent test.in [those who do have access]Some are very minimal [testing].. Less than half of patients have tumors that are characterized from a targeted perspective. It’s probably where most progress is needed. [the current situation] It creates unacceptable inequality in cancer and the journey of cancer.

Q: Q: How HER2 Did the mutation appear as an associated target for lung cancer?

Peters: That’s interesting. Because it’s a journey taken by lung cancer specialists for breast cancer.We don’t treat the same HER2 Changes in lung cancer. [In breast cancer, they treat] What we call amplification, which is also converted to overexpression. What we are talking about in lung cancer is mutations. It’s a protein modification. Usually it is the insertion of a gene into an exon 20. This is the change we are targeting for lung cancer today.

I tried using a breast cancer drug like trastuzumab [Herceptin] A compound such as positiveotinib that gave rise to activity. When trying to make a risk-benefit assessment, [however, we found that] No one has [achieved efficacy that is significant enough to] Think of them as standard of care. The toxicity of such compounds can be very high.

Until now, there was no standard option for HER2 Mutations in non-small cell lung cancer. Suddenly, an idea came from this new generation of drugs. It is an antibody drug conjugate. A very important drug, called the payload, binds to specific antibodies that are very similar to trastuzumab. Based on that, we can provide treatment to the right place. T-DM1 [trastuzumab
emtansine; Kadcyla] It has had great results not only for breast cancer but also for lung cancer. This is where the threshold is reached with a response rate close to 60%.It may go the way later and [that it is] Recognized as a second line treatment everywhere, I would say [it will be] Frontline strategy for patients.Suddenly we overcame these limits, and we [found] option.

Q: Q: What are the major research trends that you find most interesting?

Peters: We are trying to treat more patients. That’s the difference between us and breast cancer professionals. [who are currently better able to cure patients].. When breast cancer specialists treat them with chemotherapy, hormone therapy, and surgery, they become cured. Breast cancer survival curves are high, between 80% and 100%. In lung cancer, surgery and chemotherapy cure half of the patients, perhaps about 40%.Lung cancer with all the specialists cures the disease [is a challenge].. Further screening for lung cancer and regular CT scans will begin implementing a program for heavy smokers. This leads to a gradual transition from advanced illness to early illness.You will have earlier illnesses documented and better treatment [available]..Keeping these advances together will revolutionize lung cancer. [become] A treatable illness, or at least a more treatable illness.

Q: Q: Any advice for up-and-coming oncologists?

Peters: First, oncology research and academic careers are a commitment. You need to concentrate on long hours of work, [although] It does not mean that you do not have a hobby or family. It’s about the amount of work and loving it.You really need to feel like doing it [committing to] heavy [workload]..

Second, you need to find a mentor.The mentor takes you to the scene, and [for instance], Give your name to talk. Even if you deserve it, someone has to show the community that you are very good.Find the mentor you are in [work]-Or even elsewhere, many mentorships [remote]— But find a mentor to help you.

[Lastly], Everything is about selection. You have to make a good decision. Diversity is my main goal as ESMO President. Make sure you understand where you are from, or whatever your gender, life preferences, and decision-making tendencies, you can make a career. [When I first began my career]there were [almost] There are no women in the field. The image of gender has changed considerably.You need to be well surrounded by vocals [colleagues] It can be a little unstable at first, but you need to see yourself.Be brave: your work is recognized and everything [the] Work at the end.