Probably the most immediate potentially practice-changing presentation from ASCO was the Japanese J-ALEX study in the subset of about 4-5% of patients with non-small cell lung cancer (NSCLC) who have the molecular driver known as an anaplastic lymphoma kinase (ALK) rearrangement, which we now routinely test for from the tumor tissue of patients with a non-squamous metastatic NSCLC.

It seemed inevitable, I think.  Several immuntherapy agents known as PD-1 or PD-L1 checkpoint inhibitors have been shown to lead to better survival, higher response rates, and a better side effect profile than second line chemotherapy with Taxotere (docetaxel) in broad populations or subsets with tumors positive for the marker PD-L1 that correlates with a higher probability of a good response.

After completing my unpacking from ASCO and beginning to see a path of light as I dig out from under the backup of work that accumulated, I wanted to begin covering a few of the most relevant content from ASCO. Though covering only preliminary work, an abstract presented by radiation oncologist Daniel Gomez from MD Anderson Cancer Center was among those that I think could have sweeping implications.

Dr. Jack West, Swedish Cancer Institute, discusses current trials seeking to determine the efficacy of combining immunotherapy agents in lung cancer.

Dr. Jack West, Swedish Cancer Institute, raises the question of whether to use immune checkpoint inhibitors as first-line treatment of lung cancer, alone or in combination with chemotherapy.

Dr. Jed Gorden, Swedish Cancer Institute, reviews the lung cancer screening process, including low-dose CT scanning, smoking cessation, follow-up testing and counseling, and describes the potential benefits.

Dr. Jed Gorden, Swedish Cancer Institute, describes the differences between bronchoscopy and endobronchial ultrasound, highlighting the advantages of EBUS in diagnosis and staging.

Dr. Jack West, Swedish Cancer Institute, defines maintenance therapy in advanced NSCLC and discusses maintenance treatment strategies.

Dr. Jack West, Swedish Cancer Institute, reviews trial evidence for the efficacy of rociletinib and osimertinib for EGFR acquired resistance not driven by a T790M mutation.