December 2013 Newsletter
Newsletter - Spotlight on ALK
Table of Contents
- President's Corner
- CEO Corner
- Upcoming Deadlines & Events
- Meet the Investigators: Spotlight on ALK Trials
- Featured IASLC Committee: Education
- IASLC News
- Membership News
- All IASLC Events
Tony S.K. Mok, IASLC President
I would like to take this unique opportunity to wish all members of IASLC a prosperous 2014. According to the Chinese Lunar Calendar (New Year starts on January 31), 2014 is Year of the Horse, which represents energy, warmth, intelligence and durability. The Chinese word “Qianli Ma” literally means “thousand mile horse” implying someone with ability to endure hardship and to complete the designated mission.
IASLC is the “Qianli Ma” in thoracic oncology. In our forty-year history, we have taken thoracic oncology to a new level, and in the years to come, our mission will continue. 2014 will be a very interesting year for all of us. Results of a number of important clinical trials will become available. For example, the randomized phase III study comparing MetMab/Erlotinib with Erlotinib as second/third line therapy in cMET expression positive patient will likely be released in 2014. The randomized study on first line Crizotinib versus Pemetrexed/Platinum on ALK positive patients will also be available. Any of the trials, if positive, will impact on management of lung cancer. The question is how IASLC should embrace the upcoming new findings.
Many of our members participate and lead these studies. From study design to data interpretation, IASLC have directly and indirectly contributed. Once the data is available, IASLC provides multiple platforms for dissemination of information. We have just successfully held WCLC at Sydney in 2013. And in 2014, we shall co-host joint meetings, including AACR-IASLC Conference on the Molecular Origins of Lung Cancer (Jan 6-9), ELCC in Geneva (March 26-29), Chicago Multidisciplinary Symposium in Thoracic Oncology (Oct 30-Nov 1) and APLCC (Nov 6-8). In each of these meetings located in Europe, America and Asia we include both scientific sessions where new data are presented, and educational sessions where we can interpret and discuss the data. In addition, IASLC will also present multiple Webinars where we shall engage experts from around the world to present and discuss the new data. The objectives are to deliver and interpret the key clinical trials such that we can improve the treatment outcomes for our patients.
The IASLC “Qianli Ma” must keep running and we cannot run without infusion of energy from all members. I look forward to running with you in this prosperous Year of the Horse.
Fred R. Hirsch, IASLC Chief Executive Officer
As we are approaching the New Year, it is time for reflection and to set personal and professional goals for the New Year!
The goals for me as the IASLC CEO are many, but first and foremost to preserve and develop IASLC as the main source for distribution of educational knowledge about all aspects of lung cancer to the whole world, and to make the IASLC the go-to organization for information in a broad sense about lung cancer. The goals are ambitious, but achievable. In order to achieve the goals, much effort has to be put into new strategies, personnel resources and new technologies in order to stretch out to the needed “populations”.
One area, on which the President of IASLC and I are focusing, is how to reach out to community doctors and other health professionals working in community practices. Other areas are how IASLC can better make joint efforts and memberships with other organizations in achieving our common goals. For the first time, IASLC headquarters are working on an IASLC Annual Report, which we hope to launch within the next 1-2 months.
As a result of the many encouraging developments in lung cancer recently presented at the WCLC in Sydney, our “Best of WCLC” program has been a tremendous success. We have already had this program at 10 of the 17 planned sites in the US, Europe and Asia and the program has been met with much success, with 100-400 attendees participating on each site.
Our upcoming scientific meetings in San Diego (Biology), Santa Monica (Targeted therapies) and Geneva (ELCC) have raised great interest with many exciting abstracts submitted. We encourage all members to pay attention to these meetings and make registrations. Our webinar series' are expanding and the new initiative with “Grand Rounds”, led by Dr. Govindan, will be launched in January 2014.
We are also preparing in 2014 for a record number of the IASLC Fellowships and new models for fellowships and preceptorships for younger colleagues are under development.
From the IASLC headquarters, we wish all members a Happy Holiday and a healthy, happy and successful Year 2014! We are looking forward to collaborate with you on many new initiatives in 2014.
Fellowship and Young Investigator Applications Due Jan. 6, 2014
Applications are now requested for the 2014 - 2015 Fellowship and Young Investigator award cycle. Overall, there will be a minimum of three awards of $40,000, each for a duration of one year, with at least one recipient from each region (North America, Europe and Rest of the World) funded. View complete guidelines and application form. Announcement available in Chinese, Japanese and Spanish.
AACR-IASLC Joint Conference on the Molecular Origins of Lung Cancer
*NEW* IASLC Lung Cancer Grand Rounds Webinar Series
A Monthly Series of Live Webinars; Ramaswamy Govindan, MD - Program Chair
1st Webinar: Immunotherapy of Lung Cancer - Jan 8, 2014 at 8:00 pm EST - View Details
European Lung Cancer Conference (ELCC)
Early Registration Deadline: Jan 22, 2014
Late-breaking abstracts: Due Jan 23, 2014 - View Details
All IASLC Meeting Information
To see the full schedule of IASLC Meetings, visit our event page.
Meet the Investigator: Spotlight on ALK Trials - IASLC Member Benjamin Solomon, PhD,MBBS,FRACP
Associate Professor, Peter MacCallum Cancer Centre
Primary Specialty: Medical Oncology
Q1 & 2 (1) Please briefly list and describe the current ALK trials that you feel are the most interesting or promising (2) Please briefly describe for our members what you feel are the very latest ALK developments that occurred in 2013.
There continues to be rapid progress in approaches to target ALK rearrangements in NSCLC in 2013. The PROFILE 1007 which compared crizotinib to chemotherapy in ALK positive NSCLC was published and lead to regulatory approval of crizotinib in many parts of the world. Results from several interesting trials--many of which are ongoing--with novel and highly potent ALK inhibitors, including LDK378 (Ceretinib), CH5424802 (Alectinib) and AP, were reported or updated in 2013. These agents have impressive activity in patients that not only are crizotinib naïve but also in crizotinib refractory patients and in patients with brain metastases.
Resistance to crizotinib has now become a significant clinical problem. In addition to the studies with novel more potent ALK inhibitors there are also an interesting group of studies combining ALK inhibitors with HSP 90 inhibitors in an effort to combat acquired resistance to crizotinib, including a study of LDK378 with AUY922.
The firstline study PROFILE 1014 which compared crizotinib to platinum/penetrexed completed accrual in 2013 and will report in the first half of 2014. This is only the second phase III study to be completed in ALK + patients (that alone being a significant achievement) and will, if positive, establish crizotinib as the standard firstline therapy for patients with ALK arrangements around the world. Firstline phase III studies with LDK378 (ceretinib) and CH5424802 (Alectinib) are also planned.
3.Please briefly describe the key aspects of your latest ALK research and key developments.
Our group has been fortunate to be involved in clinical research with ALK inhibitors beginning with the phase I study with crizotinib and extending to the recently completed phase III studies with crizotinib and studies with newer ALK inhibitors. This has been enabled by excellent collaborations with colleagues around the world and with industry partners. These clinical studies have lead on to our laboratory work, which has focused on optimal methods to detect ALK rearrangements in clinical samples and studying mechanisms of resistance to crizotinib.
4. Over the course of your career in lung cancer, who has inspired you the most and why?
I feel fortunate to be a member of a society such as the IASLC that can boast the membership of so many luminaries in lung cancer. On a personal level the two (of many) I would single out are Paul Bunn and David Ball. I was fortunate to work with Dr. Bunn for two years during a very enjoyable fellowship in Colorado.
I learned much in that time (including how to ski!) – but remain in awe of Dr Bunn’s knowledge and skill as a clinician and scientist, his leadership qualities and his single-minded determination to improve outcomes for patients with lung cancer. Closer to home my inspiration has come from another mentor, David Ball, who I am privileged to work with in our lung clinic each week.
5. Where do you see this field going/what future developments lie ahead?
A great deal of progress has been made in the relatively short period of time since the identification of ALK rearrangements in lung cancer patients in 2007. Many challenges remain, including dealing with the problem of brain metastases and acquired resistance. The large number of highly effective ALK inhibitors in clinical trials raises the question of what is/are the best drugs to use and when. And finally the question remains if these drugs can be combined with immunotherapies or agents enhancing apoptosis result in deeper or more durable responses.
Meet the Investigator: Spotlight on ALK Trials - IASLC Member Sai-Hong (Ignatius) Ou, MD, PhD
Associate Professor, Chao Family Comprehensive Cancer Center, UC Irvine School of Medicine
Primary Specialty: Medical Oncology
1. Please briefly list and describe the current ALK trials that you feel are the most interesting or promising.
PROFILE1014 (NCT01154140) is comparing platinum/pemetrexed chemotherapy to crizotinib in treatment-naïve ALK+ NSCLC patients. The primary endpoint is progression-free survival. While many investigators have predicted that the outcome will be in favor of crizotinib, and given there is no pemetrexed maintenance [which was not the standard of care when the trial was written] in the chemotherapy arm this is likely the outcome; however, the results are not a given since pemetrexed has significant clinical activity in ALK+ NSCLC. It will also be important to see if there are significant differences in the mode of disease progression between the patients randomized (i.e. will there be more ALK+ NSCLC patients on crizotinib who relapse in the brain compared to ALK+ NSCLC patients on chemotherapy). The results should teach us a lot about the natural history of ALK+ NSCLC.
There is currently a head-to-head trial comparing alectinib versus crizotinib in ALK+ NSCLC being conducted in Japan. Alectinib has demonstrated significant clinical activity in crizotinib-naïve Japanese ALK+ NSCLC patients and potential significant clinical activity in CNS metastasis (Seto et al, Lancet Oncology, 2013;7:590-598). It will be important to see if alectinib can delay CNS metastasis and/or overcome CNS mets when compared to crizotinib. This is the first head-to-head trial of ALK inhibitors in ALK inhibitor naïve ALK+ NSCLC patients with similar trials in planning but the results will be illustrative.
2. Please briefly describe for our members what you feel are the very latest ALK developments that occurred in 2013.
Several second generation ALK inhibitors (LDK378, CH5424802 [alectinib], AP26113) have presented data on their efficacies in crizotinib-refractory ALK+ NSCLC and both have reported clinical activity in progressing brain mets from ALK+ NSCLC who failed crizotinib. It is likely one or more of them will be approved by the FDA in 2014.
3. Please briefly describe the key aspects of your latest ALK research and key developments.
Given I am a clinician investigator, my research is mostly clinical trials involving various target therapies in receptor tyrosine kinase driven NSCLC. We will have a brief report coming in JTO confirming the in vitro resistance observed in one of the acquired secondary ALK resistance mutation confer resistance to one of the second generation ALK inhibitor (alectinib).
4. Over the course of your career in lung cancer, who has inspired you the most and why?
There is no one person. However, Dr. Daniel Karp in his unique way introduced me to the field of lung cancer (and upper aerodigestive tract malignancy) clinical research during my fellowship training. Dr. Paul Bunn was our small group leader during the AACR Vail clinical research course in 2013 while he was the ASCO president. His insight and analysis, though succinct, is piercing and I learned a lot from the interaction. Dr. Bunn has not just built the SWOG lung cancer committee and the IASLC into prominence, but launched the Lung Cancer Mutation Consortium (LCMC) that has been copied all over the world and has sped up the research in lung cancer and hopefully inspire the other oncology discipline (such has GI) to do the same. Being very fortunate to be one of the principal investigators of original phase I crizotinib trial, I have the opportunity to collaborate and learn from many of the younger investigators involved. In particular, Dr. Alice T. Shaw and Dr. D. Ross Camidge, whom I consider two of the most eminent thoracic oncologists of our time. Being a contemporary to them, I am inspired to dedicate myself everyday to advance the treatment of lung cancer.
5. Where do you see this field going/what future developments lie ahead?
The future is to understand resistance mechanism so that we can tailor the various second ALK inhibtors (and other TKIs) use according to the resistance mechanisms not just in lung cancer but also in other epithelial maglinancies driven by abberations in various receptor tyrosine kinases (RTKs). Another future is to develop specific TKIs that can overcome CNS metastasis from various RTK-driven NSCLC primarily through overcoming the active efflux mechanisms of drugs mediated by active transporters in the CNS headlined by P-gp and breast cancer resistance protein (BCRP). CNS metastasis represents the final frontier in lung cancer treatment and in 2013 there are glimpses of evidence that we can finally confront this frontier successfully.
Featured Committee - IASLC Education Committee
In recent years, there has been a tremendous expansion in the knowledge regarding the biology of lung cancer, which has major translational and therapeutic implications. A major mission of the IASLC is to educate the membership and others on the new developments on lung and other thoracic malignancies. The Education Committee is tasked with developing programs that will convey important changes in treatment paradigms for lung cancer, and to inform the membership about new research findings. The committee includes broad representation from a variety of sub-specialties, and also from all major regions of the world. In its role, the committee reviews all educational programs conducted/endorsed by IASLC and provides recommendations to the Board of Directors for each program. The review process includes consideration of the target audience, the program content, speakers, representation of various sub-specialties, multi-disciplinary focus and alignment with overall objectives of IASLC. The applications for education programs are reviewed by at least two members and are subsequently discussed by the entire committee. In addition, the committee has also played a major role in development of webinars and other educational material that focus on key topics on lung cancer and other thoracic malignancies.
Another major initiative of the committee under the leadership of Past Chair Dr. Primo Lara was to develop a CME curriculum on lung cancer for various sub-specialties. This outline will serve as a framework for future educational activities. The draft of the curriculum has been reviewed by the committee members and will be adopted at the next planned meeting. The Education Committee also includes the CME Sub-committee and the Advanced Radiation Technology Sub-committee that play important roles in executing the educational objectives.
The committee is presently evaluating the development of certain educational tools for physicians and other care providers who are in the process of achieving certification/recertification by their respective specialty boards. The planned material will focus on lung and thoracic malignancies with a ‘multiple-choice questions and answers’ model. The committee is also reviewing educational print materials that are produced at the World Lung Cancer Conferences as to how they meet the needs of the membership. In the upcoming months, the committee will continue to facilitate the development of cutting-edge educational programs, mainly utilizing the electronic format, which will focus on new research and optimal patient care for lung and other thoracic cancers. The Education Committee also works closely with other IASLC Committees such as the publications committee on collaborative projects. We welcome suggestions for topics and other feedback from the IASLC membership. Please email Committee Chair, Suresh Ramalingam at firstname.lastname@example.org.
Visit the IASLC Committee Page to view Committee Membership, or to self-nominate for the IASLC Education Committee.
IASLC ALK Atlas now Available for Apple and Android
The new IASLC Atlas of ALK Testing in Lung Cancer is designed to help pathologists, laboratory scientists, and practicing physicians better understand the background, protocol, and the interpretation of results of ALK testing in patients. The Atlas is now available for downloading to iPhones, iPads and Android devices. Just like the book, the app addresses methods of testing and interpretation. With the added capability of search and extensive links the app engages the reader in the latest science. The app is available to download from the Apple iTunes App Store or the Android Google Play Store for U.S. $4.99. Published in conjunction with Editorial Rx Press and with the support of Pfizer, Inc., the IASLC Atlas of ALK Testing in Lung Cancer was first distributed to attendees at the recent IASLC World Conference on Lung Cancer in Sydney, Australia. A view only version is available on the IASLC.org website in the Research & Education/Publications section. Additional distribution channels are expected to be announced in the coming weeks.
The IASLC Multidisciplinary Approach to Thoracic Oncology is a comprehensive text with over 150 contributors. The text is being developed under the leadership of Harvey I. Pass, MD, Executive Editor and David Ball, MD, FRANZCR and Giorgio V. Scagliotti, MD, Editors. Attendees at the WCLC had an opportunity to see a pre-print of one chapter: Gender-Related Differences in Lung Cancer written by Silvia Novello, MD, PhD, Laura P. Stabile, PhD and Jill M. Siegfried, PhD. The book will be available in print and electronic versions at the ASCO meeting next May. Stay tuned for more announcements in the coming months.
IASLC Launches 40th Anniversary Celebration in Sydney
WCLC 2013 delegates all received a copy of the Progress in Lung Cancer booklet. ALL IASLC Members who receive the print version of the JTO received a 40th Anniversary DVD which features experts telling the story of lung cancer over the past 40 years! All IASLC members and other interested individuals may also view the videos and timeline from each decade: Watch the 40th Anniversary videos online. You can also now Download the IASLC Progress in Lung Cancer Monograph. Support for this project from Lilly Oncology and Company is gratefully acknowledged.
IASLC Shares in Mourning the Loss of LCFA Co-Founder, Lori Monroe
The LCFA has partnered with IASLC over the past few years to fund grants in translational lung cancer research. We applaud Lori's vision and strength and support of research to fight lung cancer. View information on past LCFA/IASLC grant winners.
1958 - 2013
IASLC 2014 Online Member Registration is Open - 3-year Membership Now Available
All Members will begin receiving their member renewal notices via email. Please note that IASLC dues for Regular Members from developed countries have increased to $250.00, while dues for Developing Country and Allied Health Professional Members remain $50.00.
There are new options for each member category and Regular Members from developed countries may "lock-in" the previous member rates, and save $150.00 over three years by selecting the 3-year Membership option ($600.00).
We encourage all members to renew early so we can ensure you have no interruption of benefits or JTO delivery and online access. Please review the single-year and multi-year options available to you!
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