Dr. Jack West asks the question of whether newer, more active ALK inhibitors such as alectinib should be used as first line therapy rather than for acquired resistance, including introducing the ALEX trial that is trying to answer this question.

Dr. Jack West introduces the question of whether third generation EGFR tyrosine kinase inhibitors osimertinib and rociletinib should be used as first line therapy rather than for acquired resistance, including discussing key clinical trials on the topic.

Liquid biopsies (also called serum testing) is a practice already approved in Europe for EGFR lung cancer patients. Drawing blood to test for acquired resistance is easier and quicker than needle biopsies. How long until it is standard practice in the US?

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A study released at ASCO 2015 showed that the BRAF V600E mutation had a high response rate to combination therapy Tafinlar (dabrafenib) plus Mekinist (trametinib), which led the doctors to agree that BRAF testing in lung cancer should become commonplace.

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A French study presented at ASCO 2015 showed a survival benefit with Avastin (bevacizumab) added to standard chemo, unlike a prior US study. The doctors discuss the influence of this trial and future potential benefits from immunotherapy in mesothelioma.

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Managing brain metastases is a big concern for lung cancer patients. The doctors discuss the drawbacks of whole brain radiotherapy and the fact that there are still unknowns regarding more targeted stereotactic radiosurgery.

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A Japanese study of squamous cell carcinoma showed value in nedaplatin vs cisplatin/Taxotere (docetaxel). But with differences in how Asian versus Caucasian patients metabolize chemotherapy, can we presume this benefit would exist for everyone?

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A trial studying Cometriq (cabozantinib) for RET rearrangements showed a promising response rate, which led the doctors to discuss if they think RET is going to be the next actionable target in lung cancer.

Please feel free to offer comments and raise questions in our Discussion Forums.

A trial comparing Tarceva (erlotinib) to Cometriq (cabozantinib) showed modest benefit for EGFR wild type patients, but the challenging side effect profile should lead us to question if we can identify only patients most likely to benefit from Cometriq.

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Squamous cell carcinoma patients have limited options. Data presented at ASCO 2015 showed positive patient outcomes with Gilotrif (afatinib) vs Tarceva (erlotinib), but some feel that there is little value in a treatment with only modestly better results.

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