Founded in 2009 and working with a variety of sponsors over the past decade, the LCMC has conducted four studies. Involving thousands of lung cancer patients, these studies have primarily focused on genomic testing in patients with both metastatic and early-stage disease.
The first study, LCMC1, undertook routine (reflex) genomic testing, deploying multiplex panel testing for detecting driver genomic changes in patients with stage IV lung cancers. A structure that included multiple pharmaceutical sponsors enabled the development of linked therapeutic trials of agents matched to the genomic alterations detected. After the initial accrual of one thousand patients, a second trial (LCMC2) accrued an additional thousand patients. This cohort, with stage IV lung cancers whose tissue samples were tested with a larger panel of molecular targets, received approved medications or were again enrolled into therapeutic trials to receive agents matched to the specific alterations detected. The LCMC1 and LCMC2 studies demonstrated that oncogenic drivers were detected in tumors in more than half of patients with lung adenocarcinomas and that patients treated with tyrosine kinase inhibitors and other targeted agents had superior survival compared to those with alterations but not treated with a targeted agent or to patients without these genetic changes. The LCMC2 trial also established that secondary genetic alterations that are not drivers (e.g. p53) could influence the outcomes of patients receiving targeted therapy. Ultimately, these studies led to major changes in guidelines for biomarker testing including advocating for routine next generation sequencing at diagnosis.
With success in patients with stage IV disease, the LCMC3 study shifted attention to early stage lung cancers. For the first time, the study scope included thoracic surgery leaders from member institutions, recognizing their central role in care and research in the peri-operative setting. , LCMC3 began in 2017 and was designed as a neoadjuvant and adjuvant trial of immune checkpoint blockade for stages IB-IIIA NSCLC. Currently nearing completion, the goal of this study is to provide early stage patients with a new treatment option and to leverage the LCMC’s expertise in multicenter studies to address questions about the biology of response and resistance to immunotherapeutics.
Work is currently underway on LCMC4, which is focused on genomic testing but expands on our work in the neoadjuvant setting. For additional information on LCMC4, please click here.