Overview of New Drugs in Non-small Cell Lung Cancer, Implications for the Treatment Landscape

Pharmacy Times interviewed Melissa Johnson, MD, program director of Lung Cancer Research at the Sarah Cannon Research Institute, on her presentation at the Community Oncology Alliance 2022 conference on exciting new drugs in non-small cell lung cancer.

Question: What are some of the updates in the non–small cell lung cancer treatment space?

Melissa Johnson: It's been an exciting time for early-stage lung cancer. We've had 2 FDA approvals. In the last 6 months or so adjuvant atezolizumab, a PD-L1 inhibitor, and just recently in the last couple of weeks, neoadjuvant, chemo, and immunotherapy.

These are exciting trials with impressive results, but they're even more important because they are showing us what's possible in the early stage setting not just in the care of metastatic patients. I’m excited to be able to use the word cure with my lung cancer patients.

Question: What are some of the exciting new drugs in non–small cell lung cancer hitting the market this year?

Melissa Johnson: The KRAS G12C inhibitors are the front liners in my mind. KRAS mutations happen in about 30% of lung cancer and G12C mutations happen in about 30% of KRAS mutations.

So, 13% of non–small cell lung cancer will harbor KRAS G12C mutations. Now we have figured out how to target those with a drug that stops the cancer from growing, and this is a mutation that has been elusive in drug development for 30 years.

It's important, for that fact, that we have a new therapy, and it's well tolerated. We have a second probably on the way, but it's also important because it's opened the door for other KRAS inhibitors not for KRAS G12C, maybe but KRAS G12D, that's very common in colorectal cancer, as well as lung, as well as combinations, at a grasp and soltar acid plus ship inhibitors, SOS1 inhibitors, ERK inhibitors, other ways of targeting the MAP kinase pathway downstream.

So, it's really a whole new sort of subculture within drug development for lung cancer, and for that reason, it's a substantive step forward.

Question: What are the implications of some of these new drugs in non­­–small cell lung cancer on treatment practice for this disease state?

Melissa Johnson: Well, as a drug developer, I tell my patients that the side effects should not be as bad as chemotherapy, and I think all the drugs that we are developing and are becoming FDA-approved, share, that they are better tolerated.

On the other hand, all drugs have side effects, and so I also see that technology is beginning to help us monitor side effects in our patients. It's helping patients report their side effects without waiting to talk to a nurse on the phone with patient-recorded outcomes.

I think that we are teaching patients how to be more informed, educated consumers of the drugs that we use, and that's a step forward too.