IASLC Lung Cancer News - V1, N1

NEWSLUNG CANCER

I N T E R N A T I O N A L A S S O C I A T I O N F O R T H E S T U D Y O F L U N G C A N C E R

V1 / N1 / APRIL 2016

FOR THORACIC SPECIALISTSwww.iaslc.org

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INSIDE4th AACR-IASLC International Joint Conference Highlights

16th Annual Meeting on TargetedTherapies for Lung Cancer Highlights

FDA Corner

Best of the 16th WCLC Athens

Afatinib Outperforms Gefitinib in Advanced NSCLC

Update on Checkpoint Inhibitors

NCI Corner

Lung Cancer CT Screening

Clinicians and Tobacco

Lung Cancer Survivor Wins Trip

Perspective: When Breath Becomes Air by Kalanithi

Nurses Treating Lung Cancer

Lung Cancer Meetings Calendar

Names and News

Greetings. It is my privilege to introduce the IASLC Lung Cancer News (ILCN). I will be serving as Editor with the able assis-tance of my Associate Editors, Fabrice Barlesi, MD from Europe and Caicun Zhou, MD from Asia. ILCN is a new tabloid publication that will highlight updates on thoracic malignancy research, including diagnostics, screening, tobacco control, therapeutic interventions, quality of life, symptom management, and sur-vivorship. This tabloid will acknowledge the complex interplay that exists between these investigational realms and between all stakeholders in the research and care of individuals with thoracic cancers, and will feature expert commentary from thoracic oncology leaders, industry, and regulators. The target audience for this publication encompasses researchers, physicians, and other specialists, including allied health professionals, involved in the care of patients with thoracic malignancy. ILCN is structured to present the most recent and noteworthy lung can-cer-related information worldwide; in addition, themed issues will be planned around particular topics or meetings, and we will not shy away from ongoing controversies and debates. We have twin goals of facilitating professional devel-opment and improving patient care and

research, and ultimately clinical outcome. Year 1 of the publication will consist of 1 issue each quarter, 16 pages each, and will be distributed in print and electronically to US and international thoracic cancer specialists. During year 2, we plan to transition to an issue every two months, with up to 32 pages each. Each issue will include, but will not be limited to, the following topics:• MeetingHighlightsandPreviews• ExpertCorner• NCICorner• FDACorner• GlobalResearchSpotlights• RecentInternationalDrugApprovals• LungCancerScreening• TobaccoControlandSmoking

Cessation• NavigatingTherapeuticControversy

From the Editor / Corey J. Langer, MD, FACP

IASLC is proud to launch the IASLC Lung Cancer News. Lung cancer is a major health issue all over the world, with roughly 1.6 million patients diagnosed globally every year, includ-ing 225,000 new patients every year just in the US. In light of the progress happening these days in the preven-tion and treatment of this disease, from screening to novel treatments for advanced disease, including per-sonalized therapy, we see a strong

Welcome, IASLC Lung Cancer News!

From April 13-16, 2016, the International Association for the Study of Lung Cancer (IASLC) and the European Society for Medical Oncology (ESMO) will once again join forces to host the 6th European Lung Cancer Conference (ELCC) at Palexpo inGeneva, Switzerland.Thismeeting is a collaborative effort of key multidisciplinary societies representing thoracic oncology specialists—all work-ing to advance science, provide educa-tion, and enhance the practice of lung cancer specialists worldwide. It plays a

key role in providing an updated over-view of prevention, screening, diagnosis, and treatment of lung cancer, as well as results of basic, clinical, and translational research. Now held annually, ELCC is an important conference in Europe for all clinicians involved in the diagnostic workup and treatment of lung cancer and other thoracic malignancies. The conference attracts a diverse audience that includes medical oncologists, radio-therapists, thoracic surgeons, respiratory

physicians, interventional radiologists, and pathologists. In this way, the meet-ing aims to foster productive multidis-ciplinary interaction among specialists in order to strengthen an integrated approach to diagnosis and treatment of lung and other thoracic cancers. During the 4-day program, an inter-nationally renowned faculty of thoracic oncology specialists will present updates on a variety of topics that address the scientific and educational needs of

IASLC and ESMO Present 6th European Lung Cancer ConferenceBy Nicola M. Parry, DVM

M E E T I N G P R E v I E W H I G H L I G H T S

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Welcome from David Carbone, MD, PhD, IASLC PresidentThese are exciting times in lung cancer treatment and research, but there is still a lot of room for improvement in propagating these discoveries to all lung cancer patients around the world, and converting responses to cures; in this context,asPresidentoftheInternationalAssociation for the Study of Lung Cancer, I am pleased to welcome you to the first issue of IASLC Lung Cancer News. Important issues for lung cancer experts and health care providers world-wide will be covered in IASLC Lung Cancer News, spanning all specialties and ranging from the role of screening and early detection to the latest treatment approaches and management strategies for advanced disease.

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Fred R. Hirsch, MD, PhD IASLC CEO

2 IASLC LUNG CANCER NEwS / APRIL 2016

IASLC Lung Cancer News is published quarterly by the International Association for the Study of Lung Cancer (IASLC). IASLC Headquarters is located at 13100 East Colfax Avenue, Unit 10, Aurora, CO, 80011, US.

Purpose and Audience: IASLC Lung Cancer News features news about lung cancer research, patient care, tobacco control, and expert commentary from lung cancer leaders. The target audience for this publication is physicians and other specialists involved in the research and treatment of patients with lung cancer and other thoracic oncologic disorders.

Correspondence: Address correspondence to Corey J. Langer, MD, FACP, Editor, c/o [email protected].

Change of Address: Postmaster send address changes to IASLC Lung Cancer News, c/o IASLC Headquarters, 13100 East Colfax Avenue, Unit 10, Aurora, CO, 80011, US.

Subscription: To initiate or cancel a subscrip-tion to IASLC Lung Cancer News or to update your mailing address, please email [email protected] or call +1-720-325-2956.

Advertising: For information on advertis-ing rates or reprints, contact Kevin Dunn, Cunningham Associates, 201-767-4170, [email protected]. All advertising is subject to acceptance by IASLC. IASLC is not respon-sible for the content of advertising and does not endorse any advertiser or its products or services.

Disclaimer: The ideas and opinions expressed in IASLC Lung Cancer News do not necessarily reflect those of the International Association for the Study of Lung Cancer. The mention of any product, service, or therapy in this publication should not be construed as an endorsement, and the Association accepts no responsibility for any injury or damage to person or persons arising out of or related to any use of material contained in this publication or to any errors or omissions.

NEWSLUNG CANCER

I N T E R N A T I O N A L A S S O C I A T I O N F O R T H E S T U D Y O F L U N G C A N C E R

EDItOR Corey J. Langer, MD, FACP

ASSOCIAtE EDItORS Fabrice Barlesi, MD and Caicun Zhou, MD

IASLC CEO Fred R. Hirsch, MD, PhD

MANAgINg EDItOR AND PuBLISHER Deb Whippen, Editorial Rx, Inc.

PRODuCtION DIRECtOR Doug Byrnes

gRAPHIC DESIgNER Amy Boches, biographics

Welcome from page 1

4th AACR-IASLC International Joint Conference:Lung Cancer Translational Science from the Bench to the ClinicBy Nicola M. Parry, DVM

The 4th conference driven by the dyna-mic collaboration of the International Association for the Study of Lung Cancer (IASLC) and the American Association forCancerResearch(AACR)tookplaceJanuary 4-7 at the Hard Rock Hotelin San Diego, California. Combining the strengths of both organizations, this annual international joint confer-ence continues to attract a varied audi-ence, including physicians and patient advocates, as well as scientists in basic, translational, and clinical fields of lung cancer research. By bringing together this diverse group of professionals each year, this meeting aims to promote scien-tific interaction and discussion of recent advances in lung cancer research and treatment, to address important needs in these key areas. The focus of this year’s meeting was “LungCancerTranslationalSciencefromthe Bench to the Clinic.” Approximately 250 attendees heard about the most recent advances across the spectrum of lung cancer research. During the 4-day program, 7 plenary sessions covered a range of topics that included early detec-tion and prevention, immunotherapy, drug resistance, and novel targets and pathways; one of these sessions was devoted to presentations of highly rated abstracts, many by early-career research-ers.Anothersession—“HowAdvocacyisDriving Science”—discussed the role of advocates and advocacy organizations in driving lung cancer science, and high-lighted how patient advocates, scientists, and clinicians collaborate to fuel prog-ressagainstlungcancer.Topicsfeatured

in concurrent sessions included animal models, stem cells, diagnostics and bio-markers, and hot topics in radiation oncology. Throughout the conference, attendees shared updates from the meet-ing on social media using the dedicated #Lung16 hashtag.

According to conference chair-persons Karen L. Kelly, MD (UC Davis Comprehensive Cancer Center, Sacramento, California) andAlice T.Shaw,MD,PhD(MassachusettsGeneralHospital Cancer Center, Boston,Massachusetts), this year’s meeting was an “absolute success” with many high-lights. In particular, they emphasized how the first session of the meeting, on small cell lung cancer, showcased how basic research can be translated into new and effective therapeutic strategies. “Until now, little progress has been made in small cell lung cancer, with the same che-motherapy regimens used over the last fewdecades,”notedDr.Shaw.However,“in this session, we heard about exciting new avenues in small cell lung cancer,

some of which have led to clinical trials that have had a real impact on patients with this disease,” she said. Updated results were also presented from several studies, including prelimi-naryfindingsfromtheongoingPhaseI/IIXalt2 trial on the investigational tyrosine kinaseinhibitor(TKI),X-396,inpatientswith anaplastic lymphoma kinase positive (ALK+) advanced non-small cell lung cancer(NSCLC).Dr.KarenL.Reckamp(CityofHopeComprehensiveCancerCenter) presented the safety and efficacy data, which continue to demonstrate that X-396haspromisingactivityinpatientswith ALK+ NSCLC. Data were also presented from a study involving LL-067, an epidermal growthfactorreceptor(EGFR)inhibi-tor currently in development. According to Nicholas Cacalano, MD (University of California Los Angeles David Geffen School of Medicine), study findings so far have shown that LL-067 accumulates in the brain and inhibits the growth of met-astatic NSCLC. Clinical trials involving LL-067 are expected to begin this year. In another presentation, Diane Legg, a lung cancer patient and survivor, shared a patient’s perspective on the impact of basic and clinical research on patient care.Diane,whohasadvancedEGFRmutant lung cancer, reflected on the remarkable path she has taken since her diagnosis over 10 years ago. “She dis-cussed how important it was for her to pursue a clinical trial in order to access new therapies that could be more effec-tive than standard therapy,” said Dr. Shaw. Diane participated in a clinical trial of a novel combination of targeted therapy and immunotherapy, and during her presentation, she also “reflected on how clinical trials can, on the flip side, expose patients to unexpected side effects that limit the potential benefit of the treat-ment,” added Dr. Shaw. Reflecting on the success of theconference, Dr. Shaw emphasized how it “brought together the various disci-plines who are invested in finding a cure for lung cancer—basic scientists, trans-lational scientists, clinicians, [and] drug makers.” She also noted the attendance of many trainees who are committed to studying lung cancer in order to find the next breakthroughs. “The meeting pro-vided a great opportunity for us not only to learn the latest advances from each other, but also to build collaborations,” Dr. Shaw concluded.✦

M E E T I N G H I G H L I G H T S

In this session, we heard about exciting new avenues in small cell lung cancer, some of which have led to clinical trials that have had a real impact on patients with this disease.

—Alice T. Shaw, MD, PhD

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need to initiate a forum to disseminate this knowledge to all individuals who deal with lung cancer patients, whether they are in academia or in the community, and to the public. We have also identified the need to have experts discuss the latestscientificadvancesandtoputtheseadvancesintoapatient/publicperspec-tive. As an “academic” organization that includes lung cancer experts from all medical disciplines and from all regions of the world, we believe it is both an obligation and an opportunity to offer this information to a broader audience, so that lung cancer patients, their families, and the caregivers can appreciate the latest developments as soon as possible with the experts’ perspective. It is our hope that the IASLC Lung Cancer News will fulfill this mission and will help optimize care for all lung cancer patients whether they are in the US or abroad; in so doing, we strongly believe that this new initiative will help bring hope and optimism to patients with lung cancer, so many of whom desperately need it. It is also our hope that the IASLC Lung Cancer News will help disseminate new perspectives and updated information to the public, so together we can fight and defeat this disease.✦

—Fred R. Hirsch, MD, PhDChief Executive Officer, IASLC

3IASLC LUNG CANCER NEwS / APRIL 2016

16th Annual Meeting on Targeted Therapies for Lung Cancer M E E T I N G H I G H L I G H T S

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In 2015, the US Food and Drug Administration (FDA) approved an unprecedented 7 new drugs or new uses for drugs for patients with lung cancer, an increase driven by the proliferation of targeted therapies in the area of thoracic oncology. The advent of preci-sion medicine in oncology has raised new questions about how to adapt the evaluation and approval process to capitalize on the potential of these new technologies. IASLC Lung Cancer News spoke with Gideon Blumenthal, MD, from the FDA’s Office of HematologyandOncologyProducts(OHOP)aboutthese challenges, including the use of surrogate endpoints in lung cancer trials and the emergence of next-generation sequencing (NGS) in oncology.

Q: Last year, you and your colleagues published a meta-analysis of NSCLC trials in the Journal of Clinical Oncology1 that showed a strong association between overall response rate (ORR) and progression-free survival (PFS), but not between either of these surrogate endpoints and overall survival (OS). Are there ways to improve how surrogate endpoints are used in clinical trials?

A: That is a great question, and certainly something we ruminate over all the time. WhileitistruethatwedidnotobserveassociationsonatriallevelbetweenORRandOSorbetweenPFSandOS,therearesomecaveatstothoseresults.Highratesof crossover might wash out the effect on OS, and if the target population is small, it may be hard to power a study to see a survival benefit. Also, patients with oncogene-addictedmalignanciessuchasEGFRorALKcanlivealongtimeafterprogres-sion, contributing to the difficulties of designing a study to detect a survival gain. Particularlyintrialsofsomeimmunotherapies,ORRandPFSdonotseemtofullycapture the clinical benefits of some of these agents. Are there new ways to measure responsestothesetreatments?ThatisanareainOHOPthatwearedefinitelyinvesti-gating. We are also talking to thought leaders in the lung cancer community because we know there are others in the academic community looking at this issue as well.

Q: NGS offers new opportunities to dramatically expand the genetic character-ization of both patients and tumors. How do you think these technologies will affect the way new cancer therapies are tested and used in the clinic?

A: I have recently co-written an article in JAMA Oncology on this issue.2 I think lung cancer doctors are at the forefront of using NGS both in terms of selecting patients for trials and in using information derived from NGS in the clinic because

thereareatleast2actionablemutationsinlungcancer,EGFRandALK,andin the near future there may be others. Using a single multiplex platform makes a lot of sense in lung cancer patients because tissue is scarce in the metastatic setting and we could potentially spare patients repeated biopsies. From a drug development standpoint, the model of 1 companion diagnostic for a single drug may soon give way to a model using a single platform that has several companion diagnostic indications with several drugs tied to it. That way, drug developers and device manufacturers don’t have to reinvent the wheel with every development program. It also makes a lot of sense from a research perspective because you can see many different genomic changes at the same time with a single test. There was a public workshop on February 25, 2016 to discuss some of these NGS-based oncology panels. We hope that there will be many platforms that can be used, but the key issue is standard-izing these platforms so that the calls you get on one platform are the same as the calls you get from a different vendor.

Q: Are there any big developments on the horizon in the development of precision medicine for lung cancer treatment such as testing circulat-ing tumor DNA (ctDNA), and if so, how will this be integrated into the approval process?

A: I think ctDNA is a very exciting emerging technology because it has a lot of potential clinical applications: early detection, risk stratification of patients aftersurgicalresection,monitoringpatients,andevenpotentiallydowntheroad as a surrogate endpoint to discern drug activity. The FDA is in the early planning stages of a workshop on ctDNA in lung cancer this summer. The other big development has been the emergence of immunotherapies in lung cancer. We approved our first 2 immunotherapies for the treatment of certain types of lung cancer in 2015, and there is a lot of interest in combining various immunotherapies, developing biomarkers to identify patients more likely to respond or not respond to an immunotherapy, and enhancing the immune response.

References1. BlumenthalGM,KaruriSW,ZhangH,etal.Overallresponserate,progression-freesurvival,

and overall survival with targeted and standard therapies in advanced non-small-cell lung cancer: US Food and Drug Administration trial-level and patient-level analyses. J Clin Oncol. 2015;33(9):1008-1014.

2. BlumenthalGM,MansfieldE,PazdurR.Next-GenerationSequencinginOncologyintheEraofPrecisionMedicine.JAMA Oncol. 2016;2(1):13-14.

INTERvIEW WITH GIdEON bLUmENTHAL, md / By ERIk J. MACLAREN, PHD

Leading experts in the biology, diagnosis and treatment of lung cancer met for 3 days in February 2016 at the 16th Annual MeetingonTargetedTherapiesforLungCancer.Held fromFebruary17-20 inSanta Monica, US, this work-in-progress meeting is an annual event sponsored by the IASLC and is designed to bring together translational researchers and lung cancer investigators to assess current areas of research and future directions. The meeting focused on new ideas and developments in lung cancer research, including the latest advances in immunotherapy, immunothera-peutic combinations, and biomarkers for immunotherapy, as well as target-delineatedtherapies, includingEGFR

and ALK, with a new focus on acquired resistance. The development of specific molec-ular treatments in lung cancer has led toaparadigmshiftinthoraciconcol-ogy research for which meetings such asTargetedTherapiesforLungCancerprovide vital leadership. Conferences such as this annual event serve to cata-lyze and promote new ideas, and foster active collaboration between multiple academic institutions and industry. The educationaldesignofTargetedTherapiesfor Lung Cancer is structured to provide an informal yet expert forum on research in progress. Advances in various areas of research as well as disappointing results in other

areas were the subject of network-ing events throughout the meeting. “The Santa Monica meetings provide a unique opportunity for thoracic oncol-ogy investigators from around the world

to informally discuss their latest research and network with colleagues,” says FredR.Hirsch,MD,PhD,IASLCChiefExecutive Officer. “Many of the scientific presentations later made at larger meet-ings around the globe are first discussed at this event.” “Coverage and summaries of sci-entific meetings around the globe and throughout the world are a core con-tent area of IASLC Lung Cancer News,” said Dr. Corey J. Langer, Editor. “The AnnualMeetingonTargetedTherapiesfor Lung Cancer is comprehensive; it provides an important platform leading to continued collaboration and scientific discovery so vital for the treatment of patients with lung cancer.”✦

Proceedings at the 16th Annual Meeting on targeted therapies for Lung Cancer.


Best of the 16th WCLC in Athens, GreeceM E E T I N G H I G H L I G H T S

The International Association for the Study of Lung Cancer (IASLC) and the Oncology Unit of the 3rd Department of Medicine, Medical School of Athens, "Sotiria" Hospital, Greece organizedand hosted the Best of the 16th World Conference of Lung Cancer (WCLC) in Athens, Greece, on January 14, 2016. The conference was successful.Almost 400 doctors attended. In addition, live streaming allowed further access both nationally and Europe-wide with 50 doc-tors from Athens, Greece, 140 European physiciansfromHungary,Russia,Poland,and the United Kingdom attending the conference virtually through the Internet. The meeting’s faculty was multinational and included Greek, British, French, Israeli,Spanish,Turkish,andAmericanspeakers. Each lecturer presented a medi-cal topic from the 16th WCLC honed to his or her special area of medical interest. The scientific program included thoracic oncology topics with high impact in our dailyclinical/researchpracticesuchasprevention/tobaccocontrol,screening/early detection of lung cancer, biology,

pathology, and molecular testing. A sepa-rate session that focused on the treatment of localized NSCLC disease concluded the first day of the meeting. In addi-tion,RamonRami-Porta,MD,chairedaround table on “New Staging System for NSCLC.” The second day of the meetingincluded updates from the 16th WCLC on the topics of screening for lung cancer, thoracic surgery, radiotherapy, medical oncology, nursing, tobacco control, sup-portive care and thoracic malignancies beyond NSCLC. The scientific audience was multidis-ciplinary in nature and included trainees, early career doctors, consultants, and experts from all the subspecialties involved in the management of lung cancer. The meeting was an opportunity for our colleagues from Greece to inter-act with colleagues from neighbor-ing countries, mainly the Balkans and the Middle East, and to participate at a highly scientific event that had con-tent focused on the latest studies pre-sented at the IASLC WCLC.✦

G L O B A L R E S E A R C H R E P O R T

Afatinib Outperforms Gefitinib in Advanced Non-Small Cell Lung Cancer By Erik J. MacLaren, PhD

The pan-ErbB inhibitor afatinib (Gilotrif) improvesprogression-freesurvival(PFS),time-to-treatment-failure(TTF)rate,andobjectiveresponserate(ORR)comparedtothefirst-generationEGFRinhibitorgefitinib (Iressa) as a first-line treatment inpatientswithEGFRmutation-positiveNSCLC, according to results presented at the ESMO Asia 2015 Congress in Singapore.1 Afatinib and gefitinib are both approved for first-line treatment of NSCLCwithEGFRmutationsbasedonphase 3 clinical trials that demonstrated their superiority to chemotherapy in that setting. In contrast to gefitinib, a first-generationEGFRtyrosinekinaseinhibitor (TKI), afatinib irreversiblyblocks members of the ErbB family of receptors,includingEGFR,HER2,andErbB4. In preclinical studies, afatinib has been shown to potently inhibit both wild typeandmutatedEGFRs,includingthosewith the resistance mutation T790M. Because acquired resistance fre-quently develops in patients treated

withEGFRTKIs,andpreviousstudieshad suggested that afatinib could pro-long responses and delay progression, KeunchilPark,MD,PhD,headoftheDivision ofHematology/Oncology atSamsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, and colleagues conducted a head-to-head comparison of afatinib and gefi-tinib in previously untreated patients.

A total of 319 patients were ran-domized to receive 40 mg daily afatinib (n = 160) or 250 mg daily gefitinib (n=159).Baselinecharacteristicsweresimilar in both treatment groups. Just over half of the participants were Asian (58.8%and55.3%,respectively),andthe

mostcommonEGFRmutationwasanexon19deletion,whichwasfoundin57.5%oftheafatinibgroupand58.5%ofthe gefitinib group. At the conference,Dr. Park high-lighted the positive results for progres-sion-freesurvival(PFS).“First-lineafa-tinib treatment significantly reduced the riskoflungcancerprogressionby27%versus gefitinib,” he said. “Interestingly,

theimprovementinPFSbecamemorepronounced over time, with a signifi-cantly higher proportion of patients aliveandprogression-freeat18months(27%vs15%;P=0.018)and24months(18%vs8%;P=0.018),showingagreaterlong-term benefit of using the irreversible

ErbB family blocker afatinib.” In addition to the promising PFSresults, response rates were also higher forpatients intheafatinibarm(70%)thanthosereceivinggefitinib(56%),andthe median duration of response was 10.1monthsforafatinibcomparedto8.4months for gefitinib. Discontinuation due toadverseeventswas6.3%forbotharms,indicating, from a practical standpoint, a comparable safety profile for both drugs. “Based on these results, I would con-siderafatinibastheEGFRTKIofchoicefor the first-line treatment for patients withEGFRmutation-positiveNSCLC,”notedDr.Park.✦

References

1. ParkK,TanE,ZhangL,etal.Afatinib(A)vsgefitinib (G) as first-line treatment for patients (pts) with advanced non-small cell lung cancer (NSCLC)harboringactivatingEGFRmutations:results of the global, randomized, open-label, PhaseIIbtrialLUX-Lung7(LL7).Paperpre-sented at: 2015 ESMO Asia Congress; December 18-21,2015;Singapore.

Professor kostas Syrigos and Fred R. Hirsch, MD, PhD.

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First-line afatinib treatment significantly reduced the risk of lung cancer progression by 27% versus gefitinib. —keunchil Park, MD, PhD

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MULTIDISCIPLINARY SYMPOSIUM inTHORACIC ONCOLOGYSeptember 22-24, 2016

IASLCCHICAGO2016

Chicago Marriott Downtown Magnificent Mile | Chicago

CO-SPONSORED BY:

IASLC WebinarsOnline Education in Thoracic OncologyOngoing online educational programs that fulfi ll IASLC’s commitment to education:

• Based on the structure of medical grand rounds

• Feature IASLC expert faculty and challenging cases in lung cancer

• Off er individual-case analyses and illustrate how to optimize real-life therapeutic decisions

register watch

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� Visit IASLC.org to take advantage of this unique educational program.

Many IASLC Webinars offer continuing medical education credit

INTERNATIONAL ASSOCIATION FOR THE STUDY OF LUNG CANCER


F E A T U R E A R T I C L E

The growing number of checkpointinhibitors currently being developed, without question, has ushered in a new era in clinical oncology, particularly in the treatment of thoracic malignancies. These agents block various components of the immune checkpoint pathway, such as programmedcelldeath-1(PD-1)recep-tor, which is expressed on the surface ofimmunecells,anditsligandPD-L1,which is frequently expressed on tumor cells and allows them to evade immune surveillance. By blocking checkpoint sig-naling, these drugs unleash the power of the patient’s own immune system against malignancies.DrugstargetingPD-1havemoved into the clinic in recent years for use in patients with melanoma, and in 2015, the FDA approved the first two immunotherapeutic agents for use in lung cancer. The PD-1 inhibitor nivolumab(Opdivo) received approval in March 2015 for use in patients with advanced squamous non-small cell lung cancer (NSCLC) whose disease has progressed on platinum-based chemotherapy. In October 2015, approval was expanded to advanced non-squamous NSCLC as well. That month, the FDA approved anotherPD-1antibodyforthetreatmentof NSCLC, pembrolizumab (Keytruda).

Nivolumab was also approved last year by the European Medicines Agency for sec-ond-line treatment of squamous NSCLC. Results from two phase 3 trials,CheckMate 0171 and CheckMate 057,2 demonstrated that second-line nivolumab prolonged overall survival (OS) com-pared to docetaxel in an unselected pop-ulation of patients with squamous and non-squamous NSCLC, respectively; andthephase3KEYSTONE-0103 trial showed that pembrolizumab increased OS compared to docetaxel in patients withPD-L1positiveNSCLC(Table1).Importantly, not only did these studies establish that nivolumab and pembroli-zumab prolonged patient survival, but they were also associated with far fewer adverse events and improved quality of life compared to docetaxel. These positive results in both histolog-ically determined, otherwise-unselected populations have raised questions about thepredictivepowerofPD-L1asabio-

marker. Data from the nivolumab trials showed that PD-L1 expression levelswere positively correlated with treat-ment benefits in non-squamous NSCLC with respect to response rates and OS, but not in squamous NSCLC. Consequently, work continues to better define the opti-malroleforPD-L1expressioninpatientselection. Thesuccessofanti-PD-1drugs inNSCLC has also led to a flurry of inter-est in other checkpoint inhibitors. The results of theBIRCH4 andPOPLAR5 trials of another PD-L1 antibody,

atezolizumab, were presented at the European Cancer Congress 2015 in Vienna, Austria. Data from these trials showed that atezolizumab had activity in patients with refractory lung cancer regardless of the number of prior treat-ments, and that it increased OS in unselected patients with NSCLC com-paredtosingle-agentdocetaxel.PD-L1expression levels, both in the cancer cells and in the immune microenvironment, were again positively correlated with treatment benefit. Studies are also being conducted in which monoclonal antibodies target-ingPD-1orPD-L1arecombinedwithinhibitors of another immune check-pointreceptorfoundonTcells,cyto-toxicT-lymphocyte-associatedprotein4(CTLA-4).Althoughcombinationsofcheckpoint inhibitors are predicted to have greater anti-tumor activity com-pared to either agent alone, concerns have been raised that patients will be unable to

tolerate the overlapping toxicity profiles of these drugs. Resultsfromaphase1btrialofthecombinationofthePD-L1antibodydur-valumab(MEDI4736)andtheCTLA-4antibody tremelimumab in patients with advanced NSCLC were presented at the European Society for Medical Oncology Asia Congress in Singapore in December 2015, and published this year in The Lancet Oncology.6 The authors identified a dose combination with a manageable safety profile and a response rateof23%. Incontrast to theresultsfrommanysingle-agentPD-1inhibitortrials,PD-L1statushadnoeffectontheobserved response rates. These results are being followed up with several phase 3 trials,NCT02352948,NCT02453282,andNCT02542293,toexaminetheefficacyofthis combination as first-line therapy for advanced NSCLC in a larger population. Considering these and other successes for checkpoint inhibitors in thoracic cancer, 2015 signals only the beginning of a gradual move away from chemo-therapy to agents that are more effective and safer for the treatment of advanced lung cancer. Clinicians and patients alike have reasons to follow the results of these trials with great interest.✦

References1. BrahmerJ,ReckampKL,BaasP,etal.Nivolumab

versus Docetaxel in Advanced Squamous-Cell Non-Small-Cell Lung Cancer. N Engl J Med. 2015;373(2):123-135.

2. BorghaeiH,Paz-AresL,HornL,etal.Nivolumabversus Docetaxel in Advanced Nonsquamous Non-Small-Cell Lung Cancer. N Engl J Med. 2015;373(17):1627-1639.

3. HerbstRS,BaasP,KimDW,etal.Pembrolizumabversusdocetaxelforpreviouslytreated,PD-L1-positive, advanced non-small-cell lung cancer (KEYNOTE-010):arandomisedcontrolledtrial.Lancet. 2015.

4. BesseB,JohnsonM,JännePA,etal.PhaseII,single-armtrial(BIRCH)ofatezolizumabasfirst-

line or subsequent therapy for locally advanced ormetastaticPD-L1-selectednon-smallcelllungcancer(NSCLC).Paperpresentedat:EuropeanCancer Congress2015; Vienna, Austria.

5. Vansteenkiste J, Fehrenbacher L, Spira AI, et al. Atezolizumabmonotherapyvsdocetaxelin2L/3Lnon-smallcelllungcancer:Primaryanalysesforefficacy, safety and predictive biomarkers from arandomizedphaseIIstudy(POPLAR).Paperpresented at: European Cancer Congress2015; Vienna, Austria.

6. Antonia S, Goldberg SB, Balmanoukian A, et al. Safety and antitumour activity of durvalumab plus tremelimumab in non-small cell lung cancer: a multicentre, phase 1b study. Lancet Oncol. 2016.

Table 1. Summary of Phase 3 trial Results for Nivolumab and Pembrolizumab in NSCLC.

Checkmate 017 Checkmate 057 KEYNOTE-010

Histology Squamous Non-squamous Squamous and Non-squamous; PD-L1 positive

treatment group Nivolumab (n = 135)

Docetaxel(n= 37)

Nivolumab (n=292)

Docetaxel(n=290)

Pembrolizumab 2 mg/kg (n=345)

Pembrolizumab 10 mg/kg(n=346)

Docetaxel(n = 343)

Response Rate 20%P=0.008

9% 19%P=0.002

12% 18%P=0.0005

18%P=0.0002

9%

Median PFS*[95% CI]

3.5 months[2.1—4.9]

2.8[2.1—3.5]

2.3 [2.2—3.3]

4.2 [3.5—4.9]

3.9 4.0 4.9

Median OS**[95% CI]

9.2 months[7.3—13.3]

6.0 [5.1—7.3]

12.2 [9.7—15.0]

9.4 [8.1—10.7]

10.4[9.4—11.9]

12.7[10.0—17.3]

8.5[7.5—9.8]

Hazard ratio for death 0.59P<0.001

0.73 P=0.002

0.71P=0.0008

0.61P<0.0001

* Progression-free survival **Overall Survival

Update on Checkpoint Inhibitors in Lung CancerBy Erik J. MacLaren, PhD

the success of these anti-PD-1 drugs in NSCLC has also led to a flurry of interest in other checkpoint inhibitors.

6th ELCC from page 1

clinician attendees who treat these can-cers. This year’s meeting will highlight several themes. These include advances in immunotherapy, stereotactic radiation therapy, the treatment of molecularly defined non-small cell lung cancer, cancer screening, and minimally inva-sive local treatments. The new World Health Organization classificationof lung tumors will also be featured, including its impact on patient care, from both the surgeon’s and patholo-gist’s viewpoint. The new IASLC staging system will also be discussed. More than 1,600 international clini-cians are expected to attend this year’s meeting, and throughout the confer-ence, attendees can share updates from the meeting on social media using the dedicated #ELCC16 hashtag. The meet-ing will also feature eight industry satel-lite symposia and a wide range of com-mercial exhibitors, and will provide excellent opportunities for networking. IASLC Lung Cancer News, this new professional tabloid publication targeted to thoracic cancer specialists, will also be launching at this meeting; conference delegates are encouraged to stop by and see us at the IASLC booth.✦


co

rn

er

In late 2015, the US National Cancer Institute (NCI) ThoracicMalignancySteeringCommittee(TMSC)published its strategic priorities for the coming years. These include: (1) innovative clinical trials to facilitate the development of immunotherapies and targeted therapies; (2) rapid testing of new agents to treat small cell lung cancer (SCLC); (3) exploration of neoadju-vant therapy for resectable non-small cell lung cancer (NSCLC); and (4) determining the optimal roles for new radiation approaches such as stereotactic body radiation therapy (SBRT).1 IASLC Lung Cancer News spoke with Shakun Malik, MD,Head,ThoracicandHead&NeckCancerTherapeutics,fromtheNCICancerTherapyEvaluationProgram(CTEP),andamemberoftheTMSC,aboutthesegoalsandthefutureofthoraciccancertrialsunder the aegis of the NCI.

Q: What is your current vision for the NCI Thoracic Oncology Program?

A: My vision is to enhance our preclinical and translational work in a way that ultimately helps us design clinical trials leading to new innovative treatments to improve the care and overall survival of patients with lung cancer. There are many molecular targets that have been discovered recently; however, we need to get a better understanding of how they drive tumor growth. We now have a prolifera-tion of immunotherapies in oncology, but we still do not know which patients will benefit the most from these new agents. In clinical trials data, there is a tail end of the curve where some patients have benefited the most. We need to focus our efforts and learn more about the tumor characteristics of these patients. WiththefocusonexpandingPrecisionMedicineclinicaltrials,thereisanoppor-tunity for all of us (NCI, pharma industry, FDA, and private sectors) to work in unison to accelerate clinical research leading towards improvements in treatment.

Q: How do you see the NCI functioning in the context of both industry and the National Clinical Trials Network (NCTN), which was formerly known as the Cooperative Group Program?

A: I do not think that one can function without the other in this era of precision medicine clinical trials and drug development. There has to be cooperation among allstakeholders,particularlyindustry,theNCTN,theNCI,andtheFDA.Withthediscovery of multiple molecular targets that drive cancer cell growth, a common cancer like lung cancer is now recognized as having multiple molecular subtypes of the disease. Collaborations among all stakeholders can accelerate progress on new treatments.

Q: Please describe the concept behind master protocols like S1400. Where else in thoracic oncology do you think this can be implemented?

A: The concept of using master protocols came about in 2012, during an NCIandFDAworkshopthatledtothedevelopmentoftheLung-MAPandALCHEMISTtrials.2 The goal was to provide a centralized screening approach in one master protocol in order to match patients to sub-studies testing inves-tigational new treatments based on the molecular characterization of their tumors instead of mounting multiple, separate clinical trials. It takes an exten-sive infrastructure and resources to conduct master protocols. Of course, there has been a bit of a learning process with these new master protocol studies, but I think both of the trials are doing very well. This strategy can be implemented in other areas as well when there is a need for a central-ized screening approach to match patients to studies based on the molecular characteristics of their tumors.

Q: Can you tell us what studies have been approved by CTEP recently?

A: There are a number of studies that we are working on currently. Over the lastyear,wehaveaddedacombinationimmunotherapyarmtoLung-MAPforpatients with advanced squamous cell lung cancer in the second-line clinical setting.ForALCHEMIST,wehaveapprovedanadditionaltreatmenttrialthatwill test an immunotherapeutic agent, nivolumab, in patients with resected early-stagelungcanceraftercompletionofstandardtherapy. Inadditiontoactivatingastudyofafatinib,(asecond-generationEGFRsmallmoleculeinhibitor)withorwithoutcetuximab(anEGFRantibody)inpatientswithEGFRmutationintheirtumors,atrialofimmunotherapywithorwithoutStereotacticBodyRadiationTherapy(SBRT)inlimitedmetastaticsetting has also just been approved. Several phase I and small phase II trials testingothernewinvestigationaltreatmentshavealsobeenapprovedbyCTEP’searly-phaseExperimentalTherapeuticsClinicalTrialsNetwork(ETCTN).

Q: What other issues should be addressed by the NCI and the NCTN?

A:TheNCTNisintendedtoencourageaconsistentlyexcellentclinicaltrialsprogram executed by an integrated Network of Groups conducting trials across a broad range of diseases and diverse patient populations. The challenge is to continue to work together to design and conduct clinically meaningful trials and to use the resources of the entire network to ensure timely completion of the studies in order to accelerate progress in cancer treatment.

References

1. Thoracic Malignancy Steering Committee. 2015 Strategic Priorities: Thoracic Malignancy Steering Committee (TMSC).http://www.cancer.gov/about-nci/organization/ccct/steering-committees/2015-TMSC-StrategicPriorities:NationalCancerInstitute;November2015.

2. MalikSM,PazdurR,AbramsJS,etal.ConsensusreportofajointNCIthoracicmalignanciessteering committee: FDA workshop on strategies for integrating biomarkers into clinical development of new therapies for lung cancer leading to the inception of “master protocols” in lung cancer. J Thorac Oncol.2014;9(10):1443-1448.

INTERvIEW WITH SHAKUN mALIK, md / By ERIk J. MACLAREN, PHD

• Collaboration with a global team of thoracic oncology experts and leaders

• Member access to Journal of Thoracic Oncology, the premier journal in lung cancer, as well as the latest classification and staging publications

• Multidisciplinary education, including latest in ground-breaking research and treatment of thoracic malignancies

And much more

JoinToday

Visit www.iaslc.org to learn more

IASLC membership helps you keep pace with the rapidly advancing science of lung cancer.

IASLC MeMberShIp benefItS InCLude:


Implementation of Lung Cancer CT Screening: A Global Dream or a Real Possibility?By Professor John k. Field MA, PhD, BDS, FRCPath

The advent of lung cancer computed tomography(CT)screeningwasinitiatedbytheEarlyLungCancerActionProject(ELCAP)groupin19991 with their semi-nal publication in Lancet. This focused attention on the possibility of introduc-ingCTscreeningasanearlydetectionstrategy, resulting in the funding of the NationalLungScreeningTrial(NLST)>53,000 persons trial in 2002, which by all accounts has been the largest randomized controlled lung cancer trial ever under-taken.TheNLSTtrialdemonstrateda20%relativereduction in lungcancermortalityintheCT-screenedarmcom-pared to the chest X-ray arm.2,3 IASLC heldaspecialCTscreeningworkshopjustdaysafterthispublicationatWorldConference on Lung Cancer (WCLC) 2011, from which the 75-member work-ing group published their set of recom-mendations and posed specific outstand-ing questions.4 This is the good news; however,ithastakensometimeforCTscreening to be implemented in the US, andonlyafterrecommendationsfromtheUSPreventiveServicesTaskForceonCTscreening and Medicare’s agreement to fund screening, within specific criteria.5 In Europe, a number of smaller trials have been undertaken in Italy, Denmark, Germany, and more recently in the UK; the largest of the European trials is the NELSON, which was undertaken in the NetherlandsandBelgium(RCTCTvsnoscan).6 We eagerly await the outcome of theNELSONtrialin2016/17,whichwillpotentially herald the implementation ofCTscreeninginEurope.Thereisalsoconsiderable experience in lung cancer CTscreeningtrialsinJapan,andmorerecently in China and Australia. ThequestionmaybeaskedwhyhasCTscreening not been readily implemented outside the US? Clearly, the US has an insurance-based health care system, which is different from Europe and many otherpartsoftheworld.However,thefocus is not only on a mortality reduc-tion but also on cost-effectiveness. The NLSTcost-effectivenessworkedoutto$81,000(CI$52,000-$186,000)perqual-ity adjusted life year (QALY), but most likely reflects the more costly health care system in the States.7Recently,theUKLung Cancer Screening (UKLS) modelled the baseline screening cost-effectiveness at£8,466perQALY,($13,071perQALYgained(CI$8,556-$19,405).8 Thus, even allowing for the UKLS modelling being basedonthebaselineCTscans,itfalls

comfortably within the acceptable UK NationalInstituteforHealthandCareExcellence (NICE) guidelines (£20,000-£30,000/QALY). One of the outcomes of the IASLC CTscreeningworkshopin2011wasset-ting up the IASLC Strategic Screening Advisory Committee (SSAC), which has hosted 1-day workshops at WCLC 2013 in Australia and WCLC 2015 in Denver. These SSAC workshops have provided an opportunity to collegially involve global experts in discussing the outstanding

questions concerning the practical issue of implementation, radiologic protocols, management of indeterminate nodules using volumetric analysis and volume doubling time (Figure 1), as well as con-sidering the screening intervals and the patients’ lifetime involvement in future CTscreeningprogramsasoutlinedina series of questions in Lancet in 2013 (Figure 2).9 We now need to focus on identifying the “hard-to-reach” com-munities and use the risk prediction models that have been demonstrated

to successfully guide the selection of high-risk individuals for lung cancer CTscreeningprograms.Lookingtothefuture, the development and incorpora-tion of molecular-genetic risk biomarkers into clinical-epidemiologic risk models will be a major research focus in the coming years. Currently, there is little discussion in the literature as to how the implementationoffutureCTscreeningprograms will affect health care ser-vice delivery and how we will develop

L U N G C A N C E R S C R E E N I N G

Surgery:VATS?

Stereotactic radiotherapy

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LDCT size and volume

protocol

FNA, EBUS other?

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model

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Screen for defined period?

Cost- effectiveness

How much?Years?Repeat

CT scan?Treatment?Workup?How?When?Who?

Figure 2. Decisions for implementation of Ct screening. LDCt=low-dose Ct. FNA=fine-needle aspiration. EBuS=endobronchial ultrasound. VAtS=video-assisted thoracoscopic surgery. Reprinted with permission from: Prospects for population screening and diagnosis of lung cancer. Field Jk, Oudkerk M, Pedersen JH, Duffy Sw. Lancet. 2013 Aug 24;382(9893):732-41.

Figure 1. Examples of various sizes of nodules visually detected and characterized volumetrically using Siemens LungCare software (from individu-als enrolled in the ukLS pilot study). A) Inconspicuous small nodule not fulfilling the volumetric size criterion of a ukLS Category 1 nodule (>15mm3 volume) – this 9.59mm3 nodule would not be followed up in the ukLS care pathway. b) Category 2 nodule (15-49 mm3) – a follow-up Ct would be performed at 1 year. C) Category 3 nodule (50-500 mm3) – a follow-up Ct would be performed at 3 months. d) Category 4 nodule (>500 mm3) – such a nodule would mandate referral for multidisciplinary team assessment. Reprinted with permission from: Ct screening for lung cancer: countdown to implementation. Field Jk, Hansell DM, Duffy Sw, Baldwin DR. Lancet Oncol. 2013 Dec;14(13):e591-600.

continued on page 13

Ab

C

d

International Association for the Study of Lung Cancer

Lung Cancer Foundation of America and The International Association for the Study of Lung Cancer

are proud to announce a

Request for Application for:

For more information, please visit:www.LCFAmerica.org/Lung-Cancer-Research-Grants-2016.html

• 2 LUNG CANCER RESEARCH GRANTS

• $200,000 EACH GRANT

• OVER 2 YEARS


Clinicians and Tobacco—What Can We Really Do?By Emily Stone, MBBS, MMed, FRACP, and graham warren, MD, PhD

Tobaccocontrolissettobecomeoneofthe most clinically effective and rapidly developing areas in lung cancer medi-cine. Since the original publication of theUSSurgeonGeneral’sReport(SGR)on Smoking andHealth in 1964, the2014SGRreportdetailsthemostcurrentadvances and observations: 1) tobacco use causes a wide spectrum of diseases, 2) tobacco cessation at any age results in significant health benefits, 3) smoking by cancer patients and survivors causes adverse cancer treatment outcomes, and 4) continued tobacco consumption will cause substantial financial and health-related economic costs worldwide.1Toprevent these effects, tobacco control measures must reduce smoking rates. The link between smoking and lung cancer cannot be refuted. Starting with large pivotal studies that linked higher rates of lung cancer in people with higher rates of smoking,2,3 data are now conclu-sive that smokingcauses80%-90%ofall lung cancer. The concomitant rise in tobacco consumption has turned lung cancer from a rare disease with several hundredcasesannuallyin1900tosev-eral hundred thousand cases currently. Patternshave emergedworldwide. Inhigh-income countries, the lung cancer epidemic is showing the effects of strong tobacco control, with peak lung-cancer incidence rates in men occurring around 1980,4acoupleofdecadesafterthefirstUSSurgeonGeneral’sReport.Between1964and1980,thesecountrieswitnessedthe institution of multiple tobacco con-trol measures and a subsequent decline in smoking in men. In many countries, we have yet to see stabilization or decline inlungcancerratesinwomen.Productdesign, including the introduction of filtered cigarettes and menthol over the past 50 years, has not reduced the harms of tobacco consumption and, in fact, has resulted in a more severe addiction.5

The benefits of smoking cessation are particularly relevant to lung cancer screening and cancer treatment. TheNationalLungScreeningTrialstudyorig-inallyshoweda20%reductioninmortal-ityforpatientswhoreceivedCTscreen-ing.6 Impressively, follow-up analysis of the same trial demonstrated substantial reductions in mortality for patients who quit smoking, benefits that matched those ofCTscreeningforpatientswhoquitsmoking for 7 years.7 Smoking cessation reducedmortalityby45%inacohortoflung cancer patients who received phone-based cessation support.8 The benefits of smokingcessationafterdiagnosishave

also been shown in patients treated with stereotactic body radiotherapy.9 Several studieshighlightedinthe2014SGRdelin-eate the benefits of smoking cessation.1 The National Comprehensive Cancer Network (NCCN) has recently devel-oped structured guidelines for smoking cessation in all cancer patients.10 Smoking cessation in patients with known or sus-pected lung cancer is an essential part of lung cancer treatment. Asclinicians,weoftendiscusssmok-ing cessation with our patients, but we may less commonly consider the effect ofpopulation-basedstrategies.Tobaccocontrol strategies have dramatically reduced smoking rates and improved health outcomes in countries that have implemented them. Clinicians can act as leaders to assist in local, regional, and

national tobacco control efforts. The cor-nerstone of international tobacco control is theWHO Framework ConventiononTobaccoControlanditsMPOWERmeasures. The most effective strategies focus on tobacco taxation and cigarette price, smoking bans, and advertising bans including plain packaging. The many examples of such strategies are outside the scope of this brief article, but the accompanying figures demonstrate their effects on tobacco consumption in the US (Figure 1), in South Africa (Figure 2), and on adolescent smoking rates in Australia (Figure 3). Unfortunately, adverse gov-ernmental influence can severely impair tobacco control efforts. In China, the tobacco industry is a state-owned monopoly regulated (and promoted) at the highest government level, with power

over the introduction of tobacco control measures due to its structural integration into the government bodies that over-see both tobacco industry growth and tobaccocontrol.InPoland,recenteffortsby tobacco industry representatives have influenced the content of tobacco control legislation. In the Netherlands, weaken-ing of tobacco control legislation over recent years has raised concern about links between senior government mem-bers and the tobacco industry. The global tobacco industry is a critical driver of the current and future lung cancer epi-demic. Opposing this are groups in all countries working actively to curb the adverse effects of tobacco. When pro-

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Family Smoking Prevention and Tobacco Control Act

Fairness Doctrinemessages on broadcast media

Nonsmokers’rightsmovementbegins

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1986 SurgeonGeneral’s report on secondhand smoke

Cigarette price drop

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Figure 1. Adults aged ≥18 years per capita cigarette consumption and major smoking and health events, united States, 1900–2012. Reprinted from u.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. Atlanta, gA: u.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.

Figure 2. Smoking rates in South Africa by income. Source: tobaccoatlas.org

• Smokingcessationreducestheriskof lung cancer and of overall cause mortality in smokers, with up to 10 years of life saved in young smokers who quit

• Smokingcessationinlungcancerpatients improves outcomes, including after treatment

• Smokingcessationmaybeenhanced by lung cancer screening

• Tobaccocontrolstrategiesarehighly successful in reducing smoking rates and improving cessation wherever they are effectively applied

• Thetobaccoindustryactivelyopposes tobacco control, interfering with government policy and pursuing new markets in vulnerable populations

key Message Box


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1999 2002 2005 2008 2011 2014

2010Point-of-sale reforms, including tobacco display ban

25% increase in tobacco excise

2009Ban on smoking in cars with children

2008Increased penalties for selling tobacco and nontobacco smoking products to minors

2007Smoke-free enclosed public places in pubs, clubs, nightclubs and casinos (except private gaming areas)

1997Launch of National Tobacco Campaign

1999Changes to tobacco excise

2000Smoking banned inside restaurants and cafes

2004NSW announced smoking in indoor areas or licensed premises would be phased out by July 2007

2005Commencement of antismoking campaigns in NSW

2006Health warnings on tobacco packaging

ACCC National Tobacco Campaign

ACCC=Australian Competition and Consumer Commission; NSW=New South Wales

moting tobacco cessation in cancer care, clinicians should consider the tobacco control context in which they work and promote tobacco control efforts that benefit their patients and their own society. ✦

References1. AlbergAJ,ShoplandDR,CummingsKM.The

2014SurgeonGeneral’sReport:Commemoratingthe50thAnniversaryofthe1964ReportoftheAdvisory Committee to the US Surgeon General andUpdatingtheEvidenceontheHealthConsequences of Cigarette Smoking. Am J Epidemiol.2014;179:403–12.

2. WynderEL,GrahamEA.Tobaccosmokingasapossible etiologic factor in bronchiogenic carcinoma;astudyof684provedcases.J Am Med Assoc.1950;143:329–36.

3. DollR,HillAB.Smokingandcarcinomaofthelung; preliminary report. Br Med J.1950;2:739–48.

4. IslamiF,TorreLA,JemalA.Globaltrendsoflungcancer mortality and smoking prevalence. Transl Lung Cancer Res.2015;4:327–38.

5. Thun MJ, Carter BD, Feskanich D, et al. 50-Year TrendsinSmoking-RelatedMortalityintheUnited States. N Engl J Med.2013;368:351–64.

6. NationalLungScreeningTrialResearchTeam,ChurchTR,BlackWC,etal.Resultsofinitiallow-dose computed tomographic screening for lung cancer. N Engl J Med.2013;368:1980–91.

7. TannerNT,KanodraNM,GebregziabherM, et al. The Association Between Smoking Abstinence and Mortality in the National Lung ScreeningTrial.Am J Respir Crit Care Med. 2015;

Figure 3. Factors affecting declines in adolescents smoking in Australia, 1996–2014. Reprinted from Public Health Res Pract. 2016;26(1):e2611605.

Availablefrom:http://www.atsjournals.org/doi/abs/10.1164/rccm.201507-1420OC.

8. DobsonAmatoKA,HylandA,ReedR,etal.TobaccoCessationMayImproveLungCancerPatientSurvival.JTO.2015;10:1014–9.

9. RoachMC,RehmanS,DeWeesTA,AbrahamCD,BradleyJD,RobinsonCG.It’snevertoolate:Smokingcessationafterstereotacticbodyradia-tion therapy for non-small cell lung carcinoma improves overall survival. Pract Radiat Oncol. 2016;6:12-8.

10.NCCNClinicalPracticeGuidelinesinOncology,SmokingCessation.2015.Availablefrom:http://www.nccn.org/professionals/physician_gls/pdf/smoking.pdf.

Help Others Succeed

foundation

learn mOreat www.iaslc.org/foundation

The IaSlC Foundation

supports the education

of fellows and young

investigators who will be

the next generation of

lung cancer physicians

and scientists.

From the Editor from page 1

IASLC President Welcome from page 1

Up until a few years ago, we had a one-size-fits-all approach to the management oflungcancer.Tumorgenomicsandmoleculartherapeuticshaverecentlyspurredaparadigmshiftinourtreatmentstandardsforlungcancer.Wenowknowthateverylung cancer and every patient is unique, and that defining the presence or absence of key biomarkers in each patient is crucial for matching that patient to the most appropriate treatments.Today,patientswithlungcancerandrelatedmalignanciescanbeofferedhope for more effective, less toxic personalized therapies. Science is directly affecting patient care, and scientists who take care of patients are discovering new science. In this and future issues, contributors will describe new insights, opportunities, and challenges of potential importance for researchers and health care providers relevant to our patients with thoracic cancers. I welcome the readership to this important publication.✦

• Managing Toxicities and Patient Expectations

• SurvivorshipPerspectives• LungCancerintheMedia• NamesintheNews

Our intention is to accomplish the following:• Signalourevolvingunderstanding

of tobacco control and lung cancer screening

• Underscorecurrentdebatesandcon-troversies in the interdisciplinary man-agement of patients with lung cancer

• Summarizerecentadvancesandinno-vations in genomic sequencing and target therapies

• Expandourworkingknowledgeofimmunotherapeutics in thoracic malignancy

• Describereportedadvancesinbasicand translational sciences by lung cancer researchers

• Highlighttheactivitiesandimpactoflung cancer leaders and advocates in the care of patients with lung cancer

On behalf of my Associate Editors and Deborah Whippen, Managing Editor andPublisher,Iwelcomeyourattention,your input, and suggestions.✦

Corey J. Langer, MD, FACPEditor, IASLC Lung Cancer NewsDirector of Thoracic Oncology Abramson Cancer CenterProfessorofMedicine PerelmanSchoolofMedicineUniversityofPennsylvania


Lung Cancer Survivor Wins Trip to US NFL 2016 Pro Bowl By Nicola M. Parry, DVM

Lung cancer survivor Kathy Weber is an ardent ambassador for the International Association for the Study of Lung Cancer (IASLC). “My involvement with the IASLC comes from attending the World Con-ference on Lung Cancer (WCLC), as

well as a survivors’ get-together at their main office,” she explained, emphasizing how impressed she is with the IASLC—the only global organization that unites experts across different disciplines who are involved in treating lung cancer, with more than 5,000 members in over 100 countries. Kathy—an otherwise healthy, young, never-smoker—was diagnosed with stage 1A lung cancer in the spring of 2014. Havingcompetedinfigurebodybuilding,she was very aware of her body, and knew something was wrong when she devel-oped muscle atrophy and nerve pain in her right shoulder and could no longer do apush-up.Herphysical therapist,JohnGraham,PT,wasalsoconcernedthat these issues were not just related to a muscle problem, but could signify a serious underlying problem such as a tumor in her right upper chest. “Without question,myPTJohnwassomeoneItrusted,” said Kathy. “So, when he agreed that something was wrong, there was no doubt I was going to pursue it.” Indeed, afterconsultingherphysicianabouttheproblem, a diagnostic workup was pur-sued,andx-raysandCTscansofKathy’schest ultimately revealed the presence of a small nodule, which was later removed at surgery and diagnosed as stage IA lung adenocarcinoma. Kathy then underwent a partial lobectomy, and she credits much of her remarkable recovery to the expertise of her University of Colorado surgeon, Michael Weyant, MD. “I had a video-assisted thoracoscopic surgery proce-dure,” she said, adding that, “with a sur-gery this big, what you want to hear when it is over is ‘there were no complications.’” She recognizes that her active, healthy lifestyle also contributed to her speedy recovery. “I was told the best thing for mewastowalk,”shesaid.Twoweeksafterher surgery, Kathy said she was walking

2.5 miles each day: “My son was a huge helper, he walked with me every day—encouraging me to go to the next fence post, or next gate, each time we walked. Hewouldsay,‘Youcandoit,Mom,justa little further.’”

In her continued support of the IASLC, Kathy recently raised more than $10,000 to benefit the IASLC Foundation

andtheChrisDraftFamilyFoundation,asthefirstrunner-upinTeamDraft’s2016 Lung Cancer Survivors’ Super Bowl Challenge.TeamDraftwasfoundedbyformer US National Football League (NFL)playerChrisDraftandhis latewife,Keasha,whodiedattheageof38afterayear-longstrugglewithstageIVlung cancer. The Super Bowl Challenge recruits lung cancer survivors in a friendly competition to raise both awareness and research funding for lung cancer—and the top 3 fundrais-ers enjoy trips to the NFL Super Bowl championshipgame,theNFLProBowl,and theTasteof theNFL.Achievingsecond place in the fundraising chal-lenge earned Kathy and her family a trip tothisyear’sNFLProBowlinHawaiionJanuary 31st. KathyfoundoutaboutTeamDraft'sChallenge from her aunt, also a lung cancersurvivor,whohadmetChrisDraftatthe2015WCLCinDenver,US.Afterlearning about Keasha’s story and Chris Draft’scommitmenttochangingthefaceof lung cancer, Kathy knew she had to getinvolved.“Initially,aftermydiagno-sisandsurgery18monthsago,Ireallydidn'twanttotalkaboutlungcancer.Ijust wanted to get on with my life and kind of forget about the whole thing. I think they call that denial,” she said. Although Kathy and her family were excited to go onto the field during the third quarter of this year’s Pro Bowl

game, she particularly enjoyed attending ProBowlpractice.“Meetingtheplayersand sharing my story was quite the expe-rience,” she said. Another highlight was gettingtoknowChrisDraft,hisdadTony,KeithSinger(videographer/photogra-pher), and Billy Nash (Board Member fortheChrisDraftFamilyFoundation).“Tobeabletosharethisexperiencewithmy family was truly a blessing,” she said. “The memories we made will be cher-ished forever.” During their trip, Kathy and her family also hiked to Likeke Falls, visitedthePolynesianCulturalCenterandPearlHarbor,andenjoyedamazingshrimp scampi atGiovanni's ShrimpTruck. Today,Kathyisdoingextremelywell.She works out in the gym 3 or 4 days each week, and stressed that “being fast is not mygoal,butbeingstrongis”.Hernextgoal is to compete in a figure bodybuild-ing competition in the summer of 2017, just before she turns 50 years old. “I am currently training hard to put back on some muscle mass that I lost following surgery,” she said. While half of the money Kathy raised willbenefitTeamDraft,theotherhalfwillgo to the IASLC Foundation. “My goal is to continue to be an ambassador for the IASLC, raising lung cancer awareness and funding, and also supporting their research commitment for lung cancer patients like me who are young non-smokers,” she concluded.✦

S U R v I v O R S H I P

Having competed in figure bodybuilding, she was very aware of her body, and knew something was wrong when she developed muscle atrophy and nerve pain in her right shoulder and could no longer do a push-up.

kathy weber post-op day 1.

kathy weber (R) and her aunt Christie Malnati (L), at a bodybuilding competition.

kathy weber and family at uS 2016 Pro Bowl.


HowdoesapersonwithstageIVlungcancer live a meaningful life? That’s the questionPaulKalanithiexploresinWhen Breath Becomes Air, the number 1 book on the New York Times Best Sellers list. Kalanithi’s moving and honest reflection of his life as he transforms from physician to patient resonates with both oncologists and patients alike. Kalanithi is a brilliant neurosurgical resident and only 36 years old when stage IV lung cancer is diagnosed, a diagnosis

thathenotesisgiventoonly0.0012%ofpeople his age. But statistics have a dif-ferent meaning for him now that he has become one, he writes. Once so sure of his career plan—20 years as a surgeon-scientist and 20 years as a writer—he now wrestles with how to live out the rest of his days, especially given the uncer-tainty of how many days he actually has.Hecravesaspecificprognosis,buthis oncologist persists in not giving him one, instead repeatedly telling him, “You have to figure out what’s most important to you.” Is this the best approach? “The statistics can never say how long anindividualwillsurvive.Togivealimiton survival can mean taking away what an individual can be or do, and it can be wrong.Patientsmustfindtheirowntruthand meaning, and all doctors can do is to helpframethat,”saysTraceyEvans,MD,AssociateProfessorofClinicalMedicine,UniversityofPennsylvania. Heather Wakelee, MD, AssociateProfessor of Medicine, StanfordUniversity Medical Center, agrees. “It would be so much easier if we could tell people how much time they have, but we can’t, and helping people learn to

live with uncertainty is one of our great challenges.” In justifying his need for knowing the prognosis,Kalanithiwrites, “Theway forward would seem obvious, if only I knew how many months or years I had left.Tellmethreemonths,I’dspendtimewithfamily.Tellmeoneyear,I’dwritea book. Give me ten years, I’d get back to treating diseases. The truth that you live one day at a time didn’t help: What was I supposed to do with that day?” In

the end, Kalanithi goes back to his sur-gical residency, valiantly working to fulfill the requirements for graduation from his residency. And he and his wife Lucy decide to have the child they have always wanted. “Is it better to overestimate, underesti-mate, or leave it open?” asks Dr. Evans. “It wasclearPaulknewthestatistics,yettheinformation provided by his oncologist still carried so much weight. I find this so incredibly humbling.” Kalanithi’s struggles with a cancer diagnosis go beyond trying to identify his values. “The curse of cancer created a strange and strained existence, challeng-ing me to be neither blind to, nor bound by, death’s approach,” he writes. “Even when the cancer was in retreat, it cast long shadows.” Living in the shadow of a cancer diag-nosis raises unanswerable questions for patients.“Aftermythird-linetreatment,when I achieved no evidence of disease (but unsure of how long it might last), I found myself wondering why I found effective treatment when so many others died. It made me question why I was here and how I could make the best use of my

giftsinthedaysremainingtome,”saysJanet Freeman-Daily, now a lung cancer advocate and creator of the website, GrayConnections:PerspectivesonLungCancer, Brain Science, and Other Stuff. “Facing the very real possibility of death in the near term changes one’s perspec-tive on life,” adds Freeman-Daily. “The

Western world is obsessed with denying death as long as possible, yet the reality is that we will all die. Lung cancer forces one to confront that fact and accept that one’s time on earth is limited. It’s oddly free-ing, enabling me to live in the joy of the moment and cherish whatever time I’ve been given. Yet, I sometimes feel regret for the things cancer and its treatment have taken from me.” Physiciansfeelthisregretaswell.“Itreat patients with cancer every day, and I am acutely aware of what cancer steals from the individual with the illness and theirlovedones,”saysDr.Evans.“Paul’swriting makes that all the more appar-ent.Nooneisleftuntouchedbycancerbecause…amazingindividualslikePaularetakenfromus.Hewouldhavecon-tributed so much as a neurosurgeon, a physician, and a writer. All we have to offerdidnotallowPaultolive,togiveusyears as a practicing physician or loving father.However,Ithenrealizethateventhe seemingly small accomplishments matter. The targeted treatment Paulreceived did not give him decades, but it gave him time to become a father and to write this book.”✦

Memoir Resonates with Oncologists and Patients with Lung CancerBy Lori Alexander, MtPw, ELS, MwC

P E R S P E C T I v E

When Breath Becomes Air byPaulKalanithi,MD

Credit: Norbert Von Der Groeben/Stanford Health Care

the way forward would seem obvious, if only I knew how many months or years I had left. tell me three months, I’d spend time with family. tell me one year, I’d write a book. give me ten years, I’d get back to treating diseases.

“

”

Lung Cancer CT Screening from page 6

accreditation systems for the next gen-erationofradiologistsinvolvedinCTscreening programs. In this inaugural issue of IASLC Lung Cancer News, an overview of thecurrentstatusofCTscreeninghasbeen provided. Future issues of IASLC Lung Cancer News will focus on spe-cificCT screeningquestions,whichstill need to be resolved, to continu-ously improve lung cancer early detec-tion. The IASLC SSAC Workshops and meetings will take the lead on behalf of the Association to move this forward.✦

References1. HenschkeCI,McCauleyDI,YankelevitzDF,et

al.EarlyLungCancerActionProject:Overalldesign and findings from baseline screening. Lancet.1999;354:99-105.

2. AberleDR,BergCD,BlackWC,etal.TheNationalLungScreeningTrial:Overviewandstudy design. Radiology.2011;258:243-253.

3. NationalLungScreeningTrialResearchTeam,AberleDR,AdamsAM,etal.Reducedlung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011; 365:395-409.

4. FieldJK,SmithRA,AberleDR,etal.International Association for the Study of Lung CancerComputedTomographyScreeningWorkshop2011Report.J Thorac Oncol. 2012;7: 10-19.

5. deKoningHJ,MezaR,PlevritisSK,etal.Benefits and harms of computed tomography lung cancer screening strategies: A comparative modelingstudyfortheU.S.PreventiveServicesTaskForce.Ann Intern Med. 2014; 160: 311-320.

6. vanKlaverenRJ,OudkerkM,ProkopM,etal. Management of lung nodules detected by volumeCTscanning.N Engl J Med.2009;361:2221-2229.

7. Black WC, Gareen IF, Soneji SS, et al, National LungScreeningTrialResearchT.Cost-effectivenessofCTscreeningintheNationalLungScreeningTrial.N Engl J Med. 2014; 371:1793-1802.

8. FieldJK,DuffySW,BaldwinDR,etal.UKLungCancerRCTPilotScreeningTrial:Baseline findings from the screening arm pro-vide evidence for the potential implementation of lung cancer screening. Thorax. 2016; 71: 161-170.

9. FieldJK,OudkerkM,PedersenJH,DuffySW.Prospectsforpopulationscreeninganddiagno-sis of lung cancer. Lancet.2013;382:732-741.

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Nurses Treating Lung Cancer, IASLC and BeyondBy Beth Eaby-Sandy, MSN, CRNP, OCN

As a nurse practitioner in an academic center in the US, I work in a thoracic medical oncology practice; however, in the US, it is uncommon for nurses or other advanced practice providers to specialize in one cancer disease site. AccordingtotheNCIwebsite,85%ofoncology patients in the US receive care in community settings, where disease spe-cializationisuncommon.Tothatend,inthe US, we do not have any type of lung cancer-specific nursing organization. Interestingly, in other countries, these organizations exist. For example, in the UK, there is the National Lung Cancer Forum for Nurses (NLCFN), a very active organization that, for the past 17 years, has held annual conferences. Likewise, the Australian New Zealand Lung Cancer Nurses Forum (ANZ-LCNF) has held an annual conference 6 years running. The International Thoracic Oncology NursingForum(ITONF)isarecentlyformed organization that aims to bring together lung cancer nurses from around the world and provide a platform and resources for lung cancer nurses. The ITONFprovidesaCE-accreditedhalf-day workshop at the IASLC World Conference on Lung Cancer (WCLC) for nurses and other allied health care providers attending the conference. This year, it will take place on December 4, 2016 at the Messe Wien Exhibition and Congress Center in Vienna, Austria, 7:30 am-12 noon, with breakfast included. Please visit www.itonf.com for moreinformation regarding registration. Recognizingthegrowingroleofnursepractitioners and other allied health care professionals, IASLC, three years ago,

formed the IASLC Nurses and Allied HealthProfessional(AHP)Committeewith the aim of enhancing multiple core objectives of IASLC, including the pro-motion of education, research and sci-ence, organizational growth, professional membership, charitable giving and phil-anthropic relationships, and operational soundness. The main responsibilities of theNursesandAHPsubgroupare toincreasenursingandAHPattendanceat WCLC, to strengthen IASLC’s com-municationplantonursesandAHPs,tofocus on developing education strategy toreachallnursesandAHPsworkinginlung cancer across the globe, to promote research activity and support, and to increasemembershipofnursesandAHP.The committee membership is evolving and now includes representatives from key national and international nursing organizations. JohnWhite,RN,fromLEEDShospi-tal in the UK has taken over as the chair of the Nurses and AHP Committee.In this role he will lead efforts to inte-grate nursing and other allied health care professionals into the curriculum for IASLC and the WCLC. Currently,

White leads the Macmillan Lung Cancer Nurse Specialist team, which consists of 5 nurse specialists. The cancer unit sees around 550 new lung cancer patients every year, with its main focus on sup-porting patients from the time cancer is first diagnosed, through clinical inves-tigations, treatment, survivorship, and end-of-life care. They have a very close working relationship with respiratory physicians, oncologists, thoracic sur-geons, and palliative care teams on-site. The team is research-active and hasjust received institutional review board (IRB)approvaltorunatrialexaminingthe potential benefits of yoga following thoracicsurgery.Hisexperienceasapro-fessional in this field will greatly benefit IASLC.

This brings up a dilemma. Where do lungcancernursesandAHPsgoforcontinuing education and networking? In the US, the Oncology Nursing Society (ONS)andtheAdvancedPractitionerSocietyforHematologyandOncology(APSHO)are twoorganizationswithexcellent annual conferences as well as publications and regional symposia. However, theyaregeneralizedoncol-ogy organizations and not specific to lung cancer. Although they serve the needs of most of the oncology nursing andAHPcommunityintheUS,aswelook forward, there will undoubtedly be increasing specialization in oncology care by disease site and a need for more specialized educational platforms.✦

P A T I E N T C A R E

Beth Ivimey presents at the ItONF workshop at wCLC in Denver 2015.

In the uS, we do not have any type of lung cancer-specific nursing organization.

–Beth Eaby-Sandy, MSN, CRNP, OCN

“

”

John white, RN, chair of the Nurses and AHP Committee.

APRIL

IASLC and ESMO Present

6th European Lung Cancer Conference

April 13–16

geneva, Switzerland

workshop in Lung Cancer Clinical Research for LAtAM Region

April 28–30

Santiago, Chile

mAY

IASLC Asia Pacific Lung Cancer Conference (APLCC)

May 13–16

Chiang-Mai, thailand

JUNE

American Society of Clinical Oncology (ASCO)June 3–7Chicago, IL, uS

AUGUST

17th Annual International Lung Cancer CongressAugust 4–6Huntington Beach, CA, uS

Latin American Lung Cancer Conference (LALCA)August 25–27Panama City, Panama

SEPTEmbER

IASLC Chicago Multidisciplinary Symposium in thoracic OncologySeptember 22–24Chicago, IL, uS

dECEmbER

world Conference on Lung CancerDecember 4–7Vienna, Austria

JANUARY 2017

Best of wCLC, SeoulJanuary 16, 2017Seoul, South korea

LuNg CANCER MEEtINgS CALENdAR

2016


Alex A. Adjei, MD, PhD, FACP, has been appointedProfessorofOncologyatMayoClinic,Rochester,US.HeisalsoDirectoroftheEarlyCancerTherapeuticsProgramandDirector of Global Oncology at Mayo’s three sites in Arizona, Florida, and Minnesota. Dr. Adjei is Editor-in-Chief of the Journal of Thoracic Oncology and previously was ProfessorandChairoftheDepartmentofMedicine and the Katherine Anne Gioia ChairinCancerMedicineatRoswellParkCancer Institute.

Dr. Federico Cappuzzo, MD, PhD, has been appointed as the new Director of Medical Oncology at Azienda Unità Sanitaria Locale (AUSL)dellaRomagnainRavenna,Italy.Dr. Cappuzzo was previously the Director of the Medical Oncology Department at the Ospedale Civile, Livorno.

Bruce E. Johnson, MD, FASCO, has been electedPresidentoftheAmericanSocietyof Clinical Oncology (ASCO) for the term beginning in June 2017. Dr. Johnson is ChiefClinicalResearchOfficerandInstitutePhysician at the Dana-Farber CancerInstitute,Boston,US,ProfessorofMedicineatHarvardMedicalSchool,andDirectoroftheDana-Farber/HarvardCancerCenterLungCancerProgram.

Karen Kelly, MD, has been named chair of the Lung Committee of SWOG, one of the US’s leading cooperative cancer research organizations. Dr. Kelly is Professor ofMedicine,holdstheJenniferReneHarmonTegley and Elizabeth Erica HarmonEndowedChairinCancerClinicalResearch,and is the Associate Director for Clinical ResearchatattheUCDavisComprehensiveCancer Center, Sacramento, US.

Lee M. Krug, MD has taken a position as theImmuno-OncologyDiseaseAreaHeadforLungandHead&NeckCancersinUSMedicalatBristol-MyersSquibb.Heassumesthis role following 15 years on the Thoracic Oncology Service at Memorial Sloan Kettering Cancer Center where he focused his clinical research primarily in small-cell lung cancer and mesothelioma.

Names and News

Prof Sylvie Lantuejoul moved in May 2015 to Centre Léon Bérard, a cancer institute under the aegis of the Unicancer Consortium in Lyon,France.ShecontinuesasProfessorinPathologyattheGrenobleAlpesUniversity.ProfLantuejoulalsoworksfortheNationalReference Center, MESOPATH-dir Pr FGalateau-Sallé, a French network dedicated to the diagnosis of mesothelioma and rare tumors of the peritoneum and translational research in these diseases.

Suresh S. Ramalingam, MD, has been appointed Deputy Director of Winship Cancer Institute of Emory University and Assistant Dean for Cancer Research inthe Emory School of Medicine, Atlanta, US. Dr. Ramalingam previously was Director of Medical Oncology at Winship and itsLungCancerProgram,andco-ledWinship’s Discovery and Developmental TherapeuticsProgram.HeisalsotheChairoftheECOG-ACRINCancerResearchGroupThoracic Committee.

Ravi Salgia, MD, PhD has been appointed Chair for the Department of Medical OncologyandTherapeuticsResearchandthe Associate Director for Clinical Sciences inCityofHope'sComprehensiveCancerCenter, Duarte, US. Dr. Salgia was on fac-ulty at the Dana-Farber Cancer Institute for a decade and then moved to the University of Chicago as the Director of Thoracic Oncology Program,whereheservedasProfessorofMedicine,Pathology,andDermatology.

Joan H. Schiller, MD, has been appointed Deputy Director for Clinical Investigation at the Inova Schar Cancer Institute, Falls Church, US.Dr.SchillerwaspreviouslytheProfessorandChief,Hematology/OncologyDivisionattheUTSouthwesternHaroldC.SimmonsComprehensive Cancer Center.

Frances A. Shepherd, MD, FRCPC, has been appointed as an Officer of the Order of Canada for her leadership in improving treat-ment options and outcomes for individuals with advanced lung cancer. Dr. Shepherd is Senior Staff Physician at The PrincessMargaretCancerCentre,Toronto,Canada,wheresheholdstheScottTaylorChairinLungCancerResearch.SheisFullProfessorofMedicineattheUniversityofToronto.

ReadersareinvitedtosubmitnewcontentforafutureNamesandNewscolumntoEditor@iaslclungcancernews.net;submissions received will be subject to review and approval by the Editor, and selection for publication is not guaranteed.➲

17TH WORLD CONFERENCE ONLUNG CANCERDecember 4 – 7, 2016vienna, austriaconference president:robert pirker, md

SAVETHE DATE!

WWW.IASLC.ORGTOGETHER AGAINST LUNG CANCER

IMPORTANT DATES

Online Registration & Housing NOW OPEN

Abstract Submission NOW OPEN

Abstract Submission Deadline JULY 15, 2016

Author Notifications SEPTEMbER 14, 2016

Early Registration Deadline SEPTEMbER 23, 2016

Late-breaking Abstract Submission Deadline OCTObER 15, 2016

Regular Registration Deadline OCTObER 21, 2016

Documents

IASLC Lung Cancer News - V1, N1