ESMO Field Direct Attack Late NSCLC Field: A Key Research Inventory of First-Line Immunization Combination Programs (Oral Presentation)

The Annual Meeting of the European Society of Oncology (ESMO) is the most prestigious and influential oncology conference

This paper collates four research advances

A preliminary exploration of MEDI5752 combined with chemotherapy first-line treatment of advanced NSCLC

background

Previous studies have shown that PD-(L)1/CTLA-4 bispecific antibodies have shown benefit particularly in patients with PD-L1-negative NSCLC, but their use has been limited

Enrolled patients were randomly assigned to the random group (R) and the one-arm group (S

As of 12 July 2022, the study included a total of 105 patients

Compared with P+C, M1500+C improves patient DOR, PFS, and OS

Previous phase III POSEIDON studies have shown that at median follow-up of 34.

Patients with wild-type metastatic NSCLC EGFR/ALK are randomly assigned 1:1:1 to D (until progression) ± a limited course of T (up to 5 doses) + platinum-containing CT (up to 4 cycles) or CT (up to 6 cycles).

As of The data analysis update on March 11, 2022, T+D+CT still had an OS benefit (HR 0.

The results of an exploratory analysis of the POSEIDON study showed that the addition of a limited course of tremelimumab and 4 cycles of chemotherapy to duvallizumab at a median follow-up of 4 years still conferred lasting OS benefits

background

Previous phase III KEYNOTE-189 results showed that pambolizumab plus platinum-containing chemotherapy significantly improved survival

Enrolled patients were randomly assigned to either pambolizumab (200 mg) or placebo (Q3W) in a 2:1 ratio for up to 35 cycles (2 years

The study included 616 patients, 410 in the pambolizumab and placebo groups, and 206 in the placebo group, respectively, with a median follow-up time of 64.

Regardless of PD-L1 expression, first-line pambolizumab + pemetrexed + platinum can still bring OS and PFS benefits with controlled safety
.

Patients who completed 35 cycles of pambolizumab produced a lasting response
.

The findings further support the availability of pambolizumab plus chemotherapy as the standard treatment option
for metastatic nonsquamous NSCLC without EGFR-sensitive mutations/ALK rearrangements.

Phase III KEYNOTE-407 Study: 5-year follow-up results updated

background

The phase III KEYNOTE-407 study showed that pamberizumab plus platinum-containing chemotherapy significantly prolonged OS (HR=0.
64) and PFS (HR=0.
56)
in patients with squamous NSCLC who were newly treated with squamous NSCLC compared with placebo +chemotherapy.

At this year's ESMO conference, Professor Silvia Nivello presented the results of a 5-year follow-up of patients in the ITT population and 35 pambolizumab treatment cycles
.

method

Eligible patients were randomly assigned to receive pambolizumab (200 mg) + carboplatin + paclitaxel/albumin paclitaxel or placebo + carboplatin and paclitaxel/albumin paclitaxel (Q3W, 4 cycles) in a 1:1 ratio, sequentially pambolizumab or placebo therapy for up to 35 cycles
.

Eligible patients in the placebo group are allowed to cross to the pambolizumab group
.

The primary endpoints were OS and PFS
assessed by BICR according to ECIST v1.
1.

outcome

Enrolled patients were randomly assigned to the pambolizumab group (278 cases) or placebo group (281).


As of 23 February 2022, the median follow-up time was 56.
9 months, with 117 patients crossing from the placebo group to being treated with pambolizumab and another 26 patients receiving follow-up PD-(L)1 monoclonal antibody therapy with an effective crossover rate of 50.
9%.


In the ITT population, the median OS of the pambolizumab group and the placebo group were 17.
2 months and 11.
6 months (HR=0.
71), respectively, and the 5-year OS rates of the two groups were 18.
4% and 9.
7%,
respectively.

OS results
The median PFS of the pambolizumab group and the placebo group were 8.
0 months and 5.
1 months (HR=0.
62), respectively, and the 5-year PFS rates of the two groups were 10.
8% and 3.
5%,
respectively.

The incidence of grade 3-5 AE in the two groups of PFS results
was 74.
8% and 70.
0%,
respectively.

In 55 patients who completed 35 cycles of pambolizumab, the ORR was 90.
9% and the OS rate at 3 years (about 5 years of randomization) was 69.
5%.


Efficacy analysis of patients over 35 treatment cycles was completed

conclusion

Results from 5-year follow-up showed that pambolizumab + chemotherapy still conferred OS and PFS benefits in patients with squamous NSCLC without increased
toxicity compared with chemotherapy alone.

By the time the data were complete, the majority of patients who had completed 35 treatment cycles were still alive
.

Studies further support the availability of pambolizumab plus chemotherapy as a standard treatment option
for patients with metastatic squamous NSCLC.

References:

LBA56-MEDI5752 or pembrolizumab （P） plus carboplatin/ pemetrexed （CP） in treatment-naïve （1L） non-small cell lung cancer （NSCLC）: A phase Ib/II trial.
2022 ESMO.

LBA59-Durvalumab （D） ± tremelimumab （T） + chemotherapy （CT） in 1L metastatic （m） NSCLC: Overall survival （OS） update from POSEIDON after median follow-up （mFU） of approximately 4 years （y）.
2022 ESMO.

973MO-KEYNOTE-189 5-year update: First-line pembrolizumab （pembro） + pemetrexed （pem） and platinum vs placebo （pbo） + pem and platinum for metastatic nonsquamous NSCLC.
2022 ESMO.

974MO-5-year update from KEYNOTE-407: Pembrolizumab plus chemotherapy in squamous non-small cell lung cancer (NSCLC).
2022ESMO.

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