Publications by authors named "Gadgeel S"

: Despite advances in targeted therapies and immunotherapies, traditional treatments like microtubule stabilizers (paclitaxel, docetaxel), DNA-intercalating platinum drugs (cisplatin), and radiation therapy remain essential for managing locally advanced and metastatic lung cancer. Identifying novel molecular targets could enhance the efficacy of these treatments. : We hypothesize that BUB1 (Ser/Thr kinase) is overexpressed in lung cancers and its inhibition will sensitize lung cancers to chemoradiation.

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Lung cancer is the leading cause of cancer death in the US and globally. The mortality from lung cancer has been declining, due to a reduction in incidence and advances in treatment. Although recent success in developing targeted and immunotherapies for lung cancer has benefitted patients, it has also expanded the complexity of potential treatment options for health care providers.

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  • Tarlatamab, an immunotherapy targeting delta-like ligand 3, shows promising anticancer effects in small cell lung cancer (SCLC) based on the DeLLphi-300 and DeLLphi-301 trials, with manageable safety profiles.
  • In the extended follow-up of DeLLphi-300, the overall response rate was 25%, with a median duration of response of 11.2 months and a median overall survival of 17.5 months across 152 patients.
  • Among those receiving a specific dose regimen (10 mg every two weeks), 35.3% experienced a response, and notable intracranial tumor shrinkage was found in patients with existing brain lesions, highlighting tarlatam
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  • The trial assessed the effectiveness of adding epacadostat, an IDO1 inhibitor, to pembrolizumab and chemotherapy for treating advanced non-small cell lung cancer (NSCLC) without targetable mutations.
  • Patients were divided into three treatment groups: one receiving the combination of epacadostat, pembrolizumab, and chemotherapy; another receiving epacadostat and pembrolizumab; and a placebo group also receiving pembrolizumab and chemotherapy.
  • Results showed that the combination of epacadostat, pembrolizumab, and chemotherapy had a lower objective response rate (26.4%) compared to the placebo combination (44.8%), indicating that adding epacadostat might not improve treatment outcomes for patients.
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  • Amivantamab-lazertinib demonstrated better progression-free survival (PFS) rates than osimertinib in patients with EGFR-mutant advanced non-small-cell lung cancer (NSCLC), particularly benefiting those with TP53 mutations and detectable circulating tumor DNA (ctDNA).
  • A study involving 858 treatment-naive patients showed that amivantamab-lazertinib outperformed osimertinib in various high-risk subgroups, including individuals with baseline liver metastases and those who did not clear ctDNA during treatment.
  • Results indicated significant improvements in median PFS for patients treated with amivantamab-lazertinib across multiple categories, showcasing its potential as a more effective option for managing advanced
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  • - The study investigates the effectiveness of amivantamab plus lazertinib compared to osimertinib in treating patients with advanced non-small-cell lung cancer (NSCLC) caused by specific genetic mutations.
  • - Results showed that patients receiving the amivantamab-lazertinib treatment had a significantly longer progression-free survival (23.7 months) than those on osimertinib (16.6 months), and the response rate was similar among both groups.
  • - Side effects primarily related to treatment were noted, but the overall survival analysis indicated a potential benefit for amivantamab-lazertinib over osimertinib, with fewer serious complications leading to treatment discontinuation.
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Although comprehensive biomarker testing is recommended for all patients with advanced/metastatic non-small cell lung cancer (NSCLC) before initiation of first-line treatment, tissue availability can limit testing. Genomic testing in liquid biopsies can be utilized to overcome the inherent limitations of tissue sampling and identify the most appropriate biomarker-informed treatment option for patients. The Blood First Assay Screening Trial is a global, open-label, multicohort trial that evaluates the efficacy and safety of multiple therapies in patients with advanced/metastatic NSCLC and targetable alterations identified by liquid biopsy.

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Background: Lung cancer is a major public health concern, with high incidence and mortality. Despite advances in targeted therapy and immunotherapy, microtubule stabilizers (paclitaxel, docetaxel), DNA intercalating platinum drugs (cisplatin) and radiation therapy continue to play a critical role in the management of locally advanced and metastatic lung cancer. Novel molecular targets would provide opportunities for improving the efficacies of radiotherapy and chemotherapy.

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  • RAF inhibitors have improved treatment for BRAFV600-mutant cancers, but challenges like ERK signaling adaptation and poor brain penetration limit their effectiveness.
  • PF-07799933 is a new, brain-penetrant, selective pan-mutant BRAF inhibitor that shows promising results in preclinical trials by inhibiting dimer signaling and maintaining wild-type ERK signaling.
  • A clinical trial for PF-07799933 demonstrated it was well-tolerated and led to multiple positive responses in patients with treatment-resistant BRAF-mutant tumors, highlighting its potential as an effective therapy combined with MEK inhibitors.
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Background: We report long-term outcomes from a pooled analysis of patients with previously untreated metastatic NSCLC with programmed cell death ligand 1 (PD-L1) tumor proportion score (TPS) less than 1% enrolled in phase III studies of pembrolizumab plus chemotherapy versus placebo plus chemotherapy.

Methods: This exploratory pooled analysis included individual patient data from the KEYNOTE-189 global (NCT02578680) and Japan extension (NCT03950674) studies of metastatic nonsquamous NSCLC without EGFR or ALK alterations and the KEYNOTE-407 global (NCT02775435) and People's Republic of China extension (NCT03875092) studies of metastatic squamous NSCLC. Patients received pembrolizumab or placebo plus pemetrexed and cisplatin or carboplatin in KEYNOTE-189 and pembrolizumab or placebo plus carboplatin and paclitaxel or nab-paclitaxel in KEYNOTE-407.

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Background: This study investigated real-world time on treatment (rwToT) and overall survival (OS) for patients with metastatic non-small cell lung cancer (mNSCLC) who initiated first-line (1L) pembrolizumab monotherapy. We also explored discontinuation reasons and subsequent treatments, stratified by number of cycles among those who completed ≥17 cycles of 1L pembrolizumab.

Methods: Patients with mNSCLC without actionable genetic aberrations, Eastern Cooperative Oncology Group performance status (ECOG PS) 0-2 and unknown, and PD-L1 TPS ≥ 50% starting 1L pembrolizumab monotherapy between 24-Oct-2016 and 31-Dec-2018 within The US Oncology Network were identified retrospectively and evaluated using structured data, with a data cutoff of 30-Sep-2021.

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  • The purpose of this guideline is to provide updated, evidence-based treatment recommendations for patients with stage IV non-small cell lung cancer (NSCLC) who do not have specific genetic driver alterations.
  • The recommendations are based on recent systematic reviews and randomized clinical trials, focusing on both efficacy and safety, and were developed by an Expert Panel with diverse expertise.
  • The latest update identified ten new randomized clinical trials and consolidates previous recommendations, covering treatment options for first, second, and subsequent lines of therapy.
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  • The guideline aims to provide evidence-based recommendations for treating stage IV non-small cell lung cancer patients with specific driver alterations.
  • It is regularly updated based on systematic reviews of clinical trials, with the latest review covering studies from February to October 2023.
  • The latest update identified eight new randomized controlled trials and refined treatment recommendations for different stages of therapy based on targetable driver alterations.
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Central nervous system (CNS) metastases are frequently diagnosed in patients with non-small cell lung cancer (NSCLC). Only recently, clinical trials are broadening eligibility to include patients with brain metastases, offering the potential for some assessment of CNS efficacy to be made. In this work we aim to review the available information on the activity of small molecule targeted drugs for advanced NSCLC with respect to CNS metastases.

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There are few reported cases of ALK gene rearranged (ALK+) non-small cell lung cancer (NSCLC) during pregnancy. There is a lack of information on the safety of ALK inhibitors in pregnant patients. We present a 25-year-old African American woman who was diagnosed with metastatic ALK+ lung adenocarcinoma at 15 weeks of gestation.

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Purpose: Standard therapy for locally advanced non-small-cell lung cancer (LA-NSCLC) is concurrent chemoradiotherapy followed by adjuvant durvalumab. For biomarker-selected patients with LA-NSCLC, we hypothesized that sequential pembrolizumab and risk-adapted radiotherapy, without chemotherapy, would be well-tolerated and effective.

Methods: Patients with stage III NSCLC or unresectable stage II NSCLC and an Eastern Cooperative Oncology Group performance status of 0-1 were eligible for this trial.

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Background: Postimmunotherapy (IO) treatment options for stage IV non-small-cell lung cancer (NSCLC) remain limited. Docetaxel alone or in combination with ramucirumab remains a standard of care, but response rates and survival benefit are suboptimal. Cullin-RING ligases (CRL) catalyze degradation of tumor suppressor proteins and are overactivated in NSCLC.

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Purpose: African American individuals are disproportionately affected by lung cancer in terms of incidence and mortality. In oncogene-driven non-small-cell lung cancer (NSCLC), emerging evidence indicates that underlying molecular heterogeneity, which can be affected by ancestry, contributes to variable drug sensitivity and therapeutic responses. The purpose of this study was to evaluate race-associated differences in reported treatment decisions, therapeutic outcomes, and molecular features in and -mutant NSCLC.

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Background: Polygenic risk scores (PRS) have become an increasingly popular approach to evaluate cancer susceptibility, but have not adequately represented Black populations in model development.

Methods: We used a previously published lung cancer PRS on the basis of 80 SNPs associated with lung cancer risk in the OncoArray cohort and validated in UK Biobank. The PRS was evaluated for association with lung cancer risk adjusting for age, sex, total pack-years, family history of lung cancer, history of chronic obstructive pulmonary disease, and the top five principal components for genetic ancestry.

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JCO Patients with Kirsten rat sarcoma viral oncogene homolog ()-mutated non-small-cell lung cancer (NSCLC) and untreated CNS metastases have a worse prognosis than similar patients without mutations. Adagrasib has previously demonstrated CNS penetration preclinically and cerebral spinal fluid penetration clinically. We evaluated adagrasib in patients with -mutated NSCLC and untreated CNS metastases from the KRYSTAL-1 trial (ClinicalTrials.

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Unlabelled: Rationally targeted therapies have transformed cancer treatment, but many patients develop resistance through bypass signaling pathway activation. PF-07284892 (ARRY-558) is an allosteric SHP2 inhibitor designed to overcome bypass-signaling-mediated resistance when combined with inhibitors of various oncogenic drivers. Activity in this setting was confirmed in diverse tumor models.

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Purpose: Efficacy of MEK inhibitors in KRAS+ NSCLC may differ based on specific KRAS mutations and comutations. Our hypothesis was that docetaxel and trametinib would improve activity in KRAS+ NSCLC and specifically in KRAS G12C NSCLC.

Patients And Methods: S1507 is a single-arm phase II study assessing the response rate (RR) with docetaxel plus trametinib in recurrent KRAS+ NSCLC and secondarily in the G12C subset.

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Objective: To evaluate antibiotic prescribing in ambulatory oncology clinics and to identify opportunities to improve antibiotic use.

Methods: Retrospective cohort of adult patients who received care at 4 ambulatory oncology clinics from May 2021 to December 2021. Patients were included if they actively followed with a hematologist-oncologist for a cancer diagnosis and received an antibiotic prescription for uncomplicated upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), urinary tract infection (UTI), or acute bacterial skin-skin structure infection (ABSSSI) at an oncology clinic.

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Purpose: As screening chest computed tomography for patients at high risk for cancer has become more widely accepted, increasing numbers of patients with early-stage small cell lung cancer (SCLC) are being diagnosed. Although surgery is an accepted option for patients with early-stage SCLC, for patients who decline or cannot undergo surgery, stereotactic body radiation treatment (SBRT) is an alternative. Although prophylactic cranial irradiation (PCI) improves survival in patients with limited-stage SCLC, PCI for early-stage SCLC (stage T1-T2) has not been explored.

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