Perspectives in Thoracic Oncology 2019: Chair Insights

Perspectives in Thoracic Oncology, now in its 24th year, is taking place in two cities this fall. The meeting will be held at the New York Marriott Marquis October 18-19 and at the Hyatt Regency Long Beach November 22-23. In this short webinar, you’ll hear from Corey J. Langer, MD, Director of Thoracic Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia. Dr. Langer is Conference Chair and shares content previews and insights about the expert faculty this year. For more information and to register for the meeting, visit thoraciccancermeeting.com.

Transcript:

Corey J. Langer:  Hi, my name's Corey Langer. I'm the Director of Thoracic Oncology at the Abramson Cancer Center, Philadelphia, Professor of Medicine at the University of Pennsylvania.

It's my privilege and honor to host and co-chair the upcoming Perspectives in Thoracic Oncology meetings. It'll actually be bi-coastal this year for the first time. This is our 24th annual event.

The first meeting will take place in October, October 18th and 19th in New York City, as it has traditionally. For the first time, we are featuring a meeting on the West Coast in Long Beach, California, which will be co-chaired by myself and Dr. Eddie Garren from LA.

This will take place on November 22nd and 23rd, so roughly a month apart. It's been my privilege, now, to chair this meeting for 14 years, ever since I inherited the mantle from Dr. Mark Green who was the originator of the series of meetings.

Perspectives in Thoracic Oncology is unique in that it really discusses all aspects of lung cancer research as well as research and recent updates in other thoracic malignancies, including thymoma and mesothelioma, some of the orphan diseases that are often not covered at typical thoracic conferences.

In addition, we focus not just on stage IV disease or recurrent disease but, really, run the entire gamut of stage I through IV.

We also focus on tobacco-related issues. For several years now, we've looked at the genetics of smoking addiction, how to wean patients off cigarettes and attempt to make treatment more tolerable, and, of course, to reduce the burden of tobacco addiction.

We've also looked at screening, which is not typically seen in most thoracic meetings. Dr. Mulshine and others have focused on this aspect.

The meeting is really geared toward members of the general oncology community with an interest in thoracic malignancies. This includes medical oncologists, nurse practitioners, physician assistants, radiation oncologists, surgeons, and oncology pharmacists who are truly interested in knowing about the latest advances in the management of this awful disease.

The goal of this meeting is not merely to disseminate data and to educate interested practitioners, but really to offer a true information exchange to establish give and take. We leave plenty of time for questions. We have case-based discussions. We have panels. I really encourage the participants to engage the faculty who will be lecturing.

I pretty much managed the meeting in that manner since I started to try to really get the audience involved. I'm tremendously opposed to the passive osmosis of data. I think it's quite important that those who participate engage and challenge the speakers who come.

These are experts, but thoracic oncology is a rapidly evolving field. The treatment landscape has been irrevocably transformed in the last 10 years, certainly in last 3 to 5 years with the advent of immunotherapy. Just wrapping our heads around all the recent advances requires a lot of time and expertise that's frequently not available outside the setting of this meeting.

I pride myself on selecting speakers who have a good relationship with the practitioners in the community, who see patients themselves and know how to communicate with patients, particularly know how to communicate with individuals who attend these kinds of meetings.

It's important to boil down all the recent advances into digestible sound bites that are meaningful and that can really relate to the patients that we see on a day to day basis.

The learning objectives for this meeting will include an assessment of the really complicated current staging system, how to boil that down into understandable vignettes, recent molecular testing updates, a focus on the advent of liquid biopsies, novel imaging and diagnostic techniques, the impact of screening, for instance, on lung cancer diagnosis and how best to manage patients who are diagnosed on the basis of screening.

We'll also look at the role of cell-free DNA, not just in terms of determining who might have mechanism resistance to targeted therapy, but potential role in establishing tumor-mutation burden.

We will focus on the ever-expanding portfolio of molecular markers, molecular abnormalities that are increasingly guiding our therapeutic decision-making.

We have expanded beyond EGFR and ALK and ROS1 to several other key markers including c-MET, RET, BRAF, and others. Although quite rare, when these markers appear, there is a separate treatment paradigm that is dictated by their existence, which is important for the general practitioner to know about, at least know where the resources are to help guide treatment.

We will focus on some of the controversies that exist in early stage resectable disease, the guidelines that exist for adjuvant treatment, the increasing weight of evidence for neoadjuvent immunotherapy and immunotherapy combined with chemotherapy, a number of ongoing phase III studies that will either establish or refute the role of immunotherapy in early stage disease.

We will also look at locally advanced non-small-cell lung cancer, some of the recent advances in technology including protons and stereotactic radiation that have changed how we approach these patients, as well as some of the recent immunotherapy data that has, again, completely altered how we manage these folks after they complete chemoradiation.

We'll discuss some of the ongoing studies. There's a constant tension that exists between biology and technology, and that is felt no where as much as it is in stage III disease.

Finally, for stage IV and recurrent non-small-cell, we'll concentrate on the major impact, the lasting irrevocable impact, that immunotherapy has had both second line and, now, front line.

The treatment paradigm for stage IV disease for non-small-cell has completely transformed since 2015, and there seems to be a tsunami of trials that just keep rolling in month by month, even week by week.

Even for those of us who spend our entire thoracic careers focused on thoracic oncology, it's a lot to wrap our heads around. Distilling this into some basic truisms, easily understood guidelines is certainly a focus of this meeting.

Finally, I don't want to neglect small cell. Hereto, in the last two to three years, we've seen major advances once more focusing on immunotherapy.

IMpower133 showed the lasting impact on survival for concurrent atezolizumab during chemotherapy and its consolidation, thereafter, in recurrent or extensive small cell.

There are a number of additional trials that definitely need attention, including several that will be presented in 2019 at meetings in the fall, which will actually predate our fall meetings. We'll have the benefit of very recent data, very recent meetings to focus on.

We have a diverse faculty, including Laura Bierut who will reprise and update her work, looking at the challenges of smoking cessation in the lung cancer population and in those at risk, focusing on some of the genetic abnormalities that exist in a vulnerable population.

Dr. Marc Ladanyi and Ignacio Wistuba will look at the pathologist's role in negotiating the challenges of molecular and immune testing in lung cancer. We've been met by an avalanche of data over the last two to three years, and really, sorting out the wheat from the chaff is absolutely crucial.

Jeff Thompson, pulmonologist on staff at University of Pennsylvania, will look at the maturing role of liquid biopsies in thoracic malignancy, both at diagnosis and in follow-up.

In the realm of locally advanced non-small-cell, we'll have input from all three major disciplines, surgical oncology, Jessica Donington, Martin Edelman from medical oncology, and Abby Berman for radiation oncology.

This is truly the realm of thoracic oncology where all the major disciplines have to come together, where interdisciplinary management is key and essential to optimal outcomes.

We'll also have a session on squamous cell and on small cell, all led by Paul Paik and Steve Liu, respectively, focusing on the latest advances hereto for the first time. In 15, 20 years, we've seen major advances that previously just escaped us, that we were not able to realize until very recently.

When it comes to biomarkers, particularly EGFR, Greg Riley will focus on some of the latest trials, some of the front line setting in patients with actionable EGFR mutations. Lyudmila Bazhenova will look at mechanisms to understand, prevent, and delay EGFR resistance.

As you're well aware, resistance to TKIs, tyrosine kinase inhibitors, in the settings of EGFR is virtually inevitable, and the best way we can prolong progression-free survival, avoid the ultimate advent of chemotherapy in this population, the better off our patients will be.

In the realm of ALK and ROS1, doctors Ignatius Ou and Leora Horn will focus on those abnormalities, as well as the less common molecular alterations that act as oncogenic drivers, including HER2, BRAF, MET, TRK, and RET, and very recently inroads into the management of KRAS, a major agent from Amgen AMG 510 has finally shown some activity.

Here's a mutation that we knew about for the last 30 years which has absolutely defied targeting, and for the first time, we are seeing some inroads that had previously not been observed.

Finally, when it comes to immunotherapy, doctors Edelman and Gadgeel, Martin Edelman and Shirish Gadgeel, from Fox Chase and the University of Michigan, respectively, will focus on first line treatment and the emerging biomarkers that exist for the management of patients with advanced disease with wild-type non-oncogenic-driven malignancies.

Doctors Aggarwal and Bazhenova, from the University of Pennsylvania and the University of California in San Diego, respectively, will talk about emerging immunotherapeutics' new combinations that exist to help reverse resistance, and also on the complex management of immunotherapy toxicity, which is very unlike the toxicities we typically dealt with, with either chemotherapy or with the tyrosine kinase inhibitors.

This is truly an all-star faculty. They're expert speakers. They're experts in their fields. I promise you a very edifying, enlightening, and illuminating experience.

I look forward to your attending Perspectives in Thoracic Oncology. Whether you're on the East Coast or the West Coast, you have two shots on goal, similar though not completely identical faculty. I look forward to meeting you at this event. I hope that you'll come and interact with our wonderful faculty.

Finally, if you have any questions regarding this meeting, registration or sign-up, please go to thoraciccancermeeting.com. Again, thank you.