Lung Cancer EGFR: What Are The Latest Advanced Treatments in 2023? Insights from Ravi Salgia MD
By Ravi Salgia, MD, PhD
As I said, I’ve been in practice for a long time and I was on the East Coast and then the Midwest and the West Coast. The lung cancer population is different and we know on the West Coast. There are a lot of non-smokers and we know that there can be a lot of molecular alterations in lung cancer, so molecular alterations such as EGFR can happen, but there are many molecular alterations of EGFR, such as the L858R, as well as Exon 19 deletion, as well as Exon 20 and many others over 50 alterations.
We know that there are various therapeutics against the EGFR. So traditionally we had used Gefitinib and then Erlotinib, and then Afatinib, and now Osimertinib and more drugs are coming to fruition for the canonical EGFR mutations. We also know resistance is a very important aspect of how we treat EGFR patients.
So that’s to be considered. And there are genetic mechanisms of resistance and non-genetic mechanisms of resistance. We also know EGFR is different as compared to ALK fusions. So there can be a number of out. Fusions such as EML4 ALK, and there are many therapeutics against ALK that we need to utilize in our clinical practice.
Again, I come back to that theme of resistance, the genetic and the non-genetic. The third one I talk about is KRAS, so KRAS G12C, which was really an unbreakable code for us until very recently. So there have been drugs that have been developed such as Sotorasib and at aggressive that are effective.
But they’re not effective as much as we want or as long as we want, so we wanna be able to look at how we overcome that resistance. Finally, I talk about immunotherapy, how immunotherapy is incredibly important. We’ve come a long way, or as I say, we’ve come a long way, and we know that for immunotherapy, there’s a large subset of patients who can respond even with just immunotherapy alone or with chemotherapy or in certain other combine. So I’m actually looking forward to the next 30 years of my career where we will see a lot of cures, even in stage four disease.
Lot of questions we get is, how does resistance develop? What do you do if, for example, if someone transforms from non-small cell lung cancer into small cell lung cancer? What are the best therapy? What happens if the molecular alteration or the molecular evolution occurs? And then how do you treat that?
And then what are some of the combinatorial effects and what are the clinical trials that are ongoing, and how should we deal with toxicities weak. Face a lot of toxicity issues in our medical oncology practice, and those are all important for us. And not only do my colleagues ask or our colleagues ask, but also our patients, their families, what our goal should be is the maximum efficacy with the minimum toxicity. And so that’s the, those are the questions we were asked.
My goal, our goal as thoracic oncologists, as cancer specialists, as clinicians and clinician scientists is to cure lung cancer. We’ve come a long way in terms of early stage disease in terms of screening and detect. Stability, but we’re not there yet. We also know stage four, we’ve made huge strides in the EGFR ALK METex14, which came out of my lab.
We know that we really have made a huge difference, but it’s not good enough. I’ve practiced for such a long time. I’m a clinician. I’m a clinician scientist, and it really pains me to see that we’re not making strong research efforts in stage four or even stage one or early detection. So we need to put a lot of time and effort into the whole spectrum, early detection, surveillance, as well as therapeutics.
I wanna emphasize that without research we wouldn’t be here. Our patients wouldn’t have benefited, but we need to do a lot more research. We need to fund fundamental research. Basic science, translational science, clinical research, reverse translational science. And we really need to make a point that lung cancer is very important for us and we need to be able to make it curable for every stage.
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Video Summary on Lung Cancer EGFR
Dr. Ravi Salgia, MD, PhD, who is an expert in thoracic oncology. In his presentation, he provides an overview of the latest clinical trials in thoracic oncology in 2023, highlighting the need for ongoing research to improve outcomes for patients with lung cancer, mesothelioma, and other thoracic cancers.
Dr. Salgia begins his presentation by discussing the current state of treatment options for thoracic cancer. While there have been some recent advancements in the field, he emphasizes that there is still a need for better treatments that can improve survival and quality of life for patients. He explains that clinical trials are critical for developing new treatments and improving existing ones.
Dr. Salgia then goes on to discuss several ongoing clinical trials in detail. One area of focus is immunotherapy, which uses the patient’s immune system to fight cancer. He highlights the results of recent studies that have shown promising results for immunotherapy in treating advanced lung cancer. He also discusses ongoing studies that are exploring the use of immunotherapy in combination with other treatments.
Another area of focus for clinical trials in thoracic oncology is targeted therapies. These treatments are designed to specifically target cancer cells and spare healthy cells, which can reduce side effects. Dr. Salgia explains that there are several ongoing studies exploring different targeted therapies for lung cancer and mesothelioma.
Dr. Salgia also discusses combination therapies, which are treatments that use multiple drugs or other treatments together to improve outcomes. He explains that there are several ongoing studies exploring different combination therapies for thoracic cancers.
Throughout his presentation, Dr. Salgia emphasizes the importance of patient participation in clinical trials. He explains that clinical trials are necessary to develop new treatments and improve existing ones, and that patients who participate in trials may have access to cutting-edge treatments that are not yet available to the general public.
In conclusion, Dr. Salgia’s presentation provides a comprehensive overview of the latest clinical trials in thoracic oncology in 2023. He highlights the need for ongoing research to improve outcomes for patients with these challenging cancers and discusses several promising areas of study, including immunotherapy, targeted therapies, and combination therapies. By encouraging patient participation in clinical trials, he hopes to accelerate the development of new treatments and ultimately improve outcomes for patients with thoracic cancers.
Ravi Salgia, MD, PhD – About The Author, Credentials, and Affiliations
He then did a fellowship in hematology and oncology at the University of California, Los Angeles (UCLA). During this time, he became very interested in thoracic oncology. He then did a fellowship in hematology and oncology at the University of California, Los Angeles (UCLA). During this time, he became very interested in thoracic oncology.
Through his groundbreaking research and clinical work, Dr. Salgia has worked hard to move the field of thoracic oncology forward over the course of his career. He has written many papers that have been published in the New England Journal of Medicine, the Journal of Clinical Oncology, and Cancer Research, among others. He has also been asked to talk about his research at many national and international conferences.
Dr. Salgia’s clinical expertise is highly sought after, and he has been recognized as one of the top oncologists in the United States by Castle Connolly and U.S. News & World Report. He is also a member of many professional groups, such as the American Society of Clinical Oncology, the International Association for the Study of Lung Cancer, and the American Association for Cancer Research.
At the City of Hope, Dr. Salgia serves as the Chair of the Department of Medical Oncology & Therapeutics Research as well as the Associate Director for Clinical Sciences in the Comprehensive Cancer Center. In these roles, he is in charge of overseeing clinical trials, coming up with new treatments for cancer patients, and giving his colleagues expert advice.
Overall, Dr. Ravi Salgia is a highly accomplished and respected physician-scientist whose work has had a significant impact on the field of thoracic oncology. His hard work to improve cancer treatment and patient outcomes has won him the respect of his colleagues and the thanks of many patients and their families.