Module 1: Evolving Paradigms for Patients with Non-Small Cell Lung Cancer (NSCLC) and EGFR Tumor Mutations

DISCUSSION TOPICS

• Incidence and clinical implications of EGFR tumor mutations in patients with metastatic NSCLC
• Similarities and differences among approved first-, second- and third-generation EGFR tyrosine kinase inhibitors (TKIs)
• Data supporting the FDA approval of osimertinib as first-line therapy for metastatic NSCLC with an EGFR tumor mutation; effect of osimertinib compared to standard treatment on response rate, progression-free survival and overall survival
• Implications of EGFR mutation type for the use of osimertinib
• Documented activity of osimertinib in patients with CNS metastases
• Comparative incidence of gastrointestinal and dermatologic adverse events with osimertinib versus first-/second-generation EGFR TKIs; strategies to prevent and/or ameliorate these toxicities
• Mechanisms of treatment resistance in patients experiencing progressive disease on first-line EGFR TKI therapy; choice of second-line treatment after disease progression on first-line osimertinib
• Sequencing immune checkpoint inhibitors for patients with metastatic NSCLC and EGFR tumor mutations

Module 2: Emergence of Immune Checkpoint Inhibition as a Therapeutic Consideration for Patients with Locally Advanced NSCLC

DISCUSSION TOPICS

• Historical outcomes associated with standard concurrent chemoradiation therapy and consolidation chemotherapy in patients with unresectable Stage III disease
• Biologic rationale for the evaluation of immune checkpoint inhibition for patients with Stage III disease undergoing chemoradiation therapy; preclinical work supporting the synergistic effect between chemoradiation therapy and immune checkpoint inhibitors
• Key efficacy findings with the use of consolidation durvalumab after chemoradiation therapy for patients with unresectable Stage III NSCLC; patient selection for and practical implementation of sequential durvalumab in the management of unresectable Stage III NSCLC
• Efficacy and current role of durvalumab in prespecified subgroups (eg, histology, smoking status, PD-L1 status, disease with a targetable genomic alteration)
• Optimal timing for the use of durvalumab consolidation; impact of underlying radiation therapy-induced toxicities (eg, pneumonitis, esophagitis) on the potential introduction of durvalumab consolidation therapy
• Rates of Grade 3/4 adverse events, including pneumonitis and other immune-mediated toxicities, and treatment discontinuation among patients receiving consolidation durvalumab
• Optimal monitoring of patients receiving consolidation durvalumab for the presence of immune-mediated adverse events; supportive care protocols and indications for withholding or permanently discontinuing therapy

Module 3: Existing and Emerging Immunotherapeutic Combinations for NSCLC

DISCUSSION TOPICS

• Incidence of PD-L1 positivity in metastatic nonsquamous and squamous NSCLC
• Clinical and biologic factors affecting the selection of anti-PD-1 antibody monotherapy versus combined chemotherapy/immune checkpoint inhibition for patients with metastatic NSCLC
• Biologic rationale for the combination of anti-PD-1/PD-L1 antibody therapy with chemotherapy in metastatic NSCLC
• Documented efficacy results with the combination of carboplatin/pemetrexed/pembrolizumab as first-line therapy for metastatic NSCLC; incremental toxicity associated with this approach compared to anti-PD-1/PD-L1 antibody monotherapy
• Clinical research data supporting the potential synergy between anti-PD-1/PD-L1 antibodies and anti-VEGF agents
• Key efficacy and safety findings with atezolizumab/bevacizumab in combination with carboplatin/paclitaxel for chemotherapy-naïve metastatic nonsquamous NSCLC; clinical implications of the recent FDA approval of this combination
• Other data sets evaluating the addition of atezolizumab to chemotherapy for metastatic nonsquamous NSCLC
• Role of anti-PD-1/PD-L1 antibodies in combination with chemotherapy as first-line treatment for advanced squamous NSCLC