The World Conference on Lung Cancer (WCLC) was recently held in Toronto. Three of the studies selected as ‘top 5’ abstracts in this conference were published in the New England Journal of Medicine.

In the PACIFIC trial, the efficacy and safety of durvalumab are being tested in patients with locally advanced, unresectable non-small-cell lung cancer (NSCLC) and good performance status after chemoradiotherapy. An analysis of the second primary end point, overall survival (OS), was presented: 24-month OS was 66.3% and 55.6% with durvalumab and placebo, respectively (P = 0.0025). Grade 3–4 adverse events (AEs) occurred in 30.5% and 26.1% of patients, respectively, leading to treatment discontinuation rates of 15.4% and 9.8%.

Brigatinib is compared with crizotinib as a first-line treatment for patients with ALK-rearranged advanced-stage NSCLC in the ALTA-1L trial. At a median follow-up duration <12 months, the objective response rate was higher with brigatinib: 71% versus 60%. The confirmed rates of intracranial response were 78% and 29%, respectively. The incidence of grade 3–5 AEs was also higher in the brigatinib group (61% versus 55%).

In IMpower133, first-line carboplatin and etoposide were combined with atezolizumab or placebo as a first-line treatment for patients with extensive-stage small-cell lung cancer. At 13.9 months, median OS durations were 12.3 months with atezolizumab and 10.3 months with placebo (P = 0.007). The incidence of AEs of any grade was similar (94.9% versus 92.3%).

The other two studies were LUME-Meso, testing the addition of nintedanib versus placebo to standard-of-care chemotherapy in patients with unresectable malignant pleural mesothelioma, and the NELSON trial, comparing CT screening with no screening in asymptomatic individuals deemed at high risk for lung cancer. Promising results have been obtained in both studies, which, to our knowledge, have not yet been published.