From targeting to immune non-small cell lung cancer ushers in multiple breakthroughs!

the | The 2020 World Lung Cancer Congress (WCLC) was held from January 28-31, 2021, during which important findings from several clinical trials of lung cancer and other chest malignancies were reported.
as the WCLC conference progressed, non-small cell lung cancer (NSCLC) became the most discussed and popular topic.
1. A breakthrough in the treatment of late-stage NSCLC for KRASG12C mutations At the Presidential symposium, Bob T. Li presented the clinical results of Phase II of the high-profile CodeBreaK 100 study.
CodeBreaK 100 study is a study to evaluate the therapeutic effects of the oral inhibitor Sotorasib on late-stage NSCLC with KRASG12C mutations.
Generally speaking, patients with advanced non-small cell lung cancer (NSCLC) who received second- or third-line treatment had poor rehabilitation, a remission rate of <20%, and a medium progression-free lifetime (PFS) of less than 4 months, and about 13% of patients with pulmonary adenocarcinoma had KRASG12C mutations.
, formerly known as AMG 510, is a first-line drug that is specific and irreversibly inhibits KRASG12C.
in CodeBreaK 100's Phase I/II clinical trial results (NCT03600883), Sotorasib was well-resistant, with a remission rate (ORR) of 32.2% for all patients at all assessed dose levels.
32.2%, the medium mitigation duration (DoR) is 10.9 months, and the medium PFS is 6.3 months.
WCLC 2020, the researchers demonstrated for the first time the main clinical findings of phase II of the trial, including DoR, PFS and biomarkers.
results show that Sotorasib provides deep response and long-lasting clinical benefits in NSCLC patients with KRASG12C mutations, and has good safety, thus validating previous Phase 1 results.
more than four decades of scientists, Sotorasib may be the first targeted treatment option for NSCLC patients with KRASG12C mutations.
2. In another workshop, Girard and colleagues compared the clinical results of NSCLC patients with EGFRex20ins with EGFRex20ins mutations and common EGFR mutations, and found that patients with EGFRex20ins tended to have poor prognosis (disease progression and higher mortality rates) due to a lack of effective treatment.
study on treatment options for EGFRex20ins, Sabari and colleagues reported the latest results of the AMivantamab CHRYSALIS study (NCT02609776).
humanized EGFR-MET dual-specific antibody with immune cell-directed activity with amivantamab in the united States.
the CHRYSALIS study was designed to treat NSCLC patients with EGFRex20ins and MET mutations with amivantamab at the recommended stage II dose (RP2D) and who had previously underwent platinum chemotherapy.
data released by the U.S. Government show that in more than 250 patients treated with RP2D, the efficacy and long-lasting response are promising and safe.
Caisan, director of oncology at Shanghai Lung Hospital affiliated with Tongji University, also reported a study on treatment options for such patients.
in a study called I/II EXCLAIM Phase Study (NCT02716116), Professor Zhou's team evaluated a first-line tyrosine kinase inhibitor (TKI) mobocertinib for EGFRex20ins.
data (Table 1), Mobocertinib showed clinically significant and controllable safety benefits in patients with NSCLC who had been associated with the EGFRex20ins mutation and had previously underwent platinum chemotherapy.
Table 1. I / II EXCLAIM Phased Research Section Disclosure Data 3. Recalcitrant EGFR mutant NSCLC patients are ushering in a new dawn for EGFR TKI and platinum chemotherapy treatment failures in EGFR mutant NSCLC patients, Helena Yu and colleagues reported the safety and effectiveness of HER3-guided antibody-drug combination (ADC) Patritumab druxtecan in Phase I clinical trials (NCT03260491).
study evaluated 57 patients with local late stage or metastasis EGFR mutation NSCLC who had not been treated with a large number of other options.
results (Table 2), at a dose of 5.6 mg/kg, patritumab deruxtecan showed good anti-tumor activity and safety in the patient population.
Table 2. NCT03260491 Phased Studies partially disclosed data Spira and colleagues introduced the anti-TRP2 ADC Dato monomass (datopotamab deruxtecan, Dato-DXd; DS-1062) the latest results of the Phase I TRAPION-PanTumor01 study, a drug used in patients with advanced NSCLC.
summary of the study reported that among patients who had previously received standard treatment, datopotamab deruxtecan had excellent anti-tumor activity and controlled safety.
Nakagawa and colleagues reported on the medium-term efficacy and safety results of the TESTINY-Lung01 Phase II Study (NCT03505710).
this study is about the anti-tumor activity of Trastuzumab deruxtecan (T-DXd) in patients with NSCLC in patients with HER2 over-expression (center-confirmed IHC 2 plus or 3 plus) that has been ineffective in a number of other treatments.
this interim analysis, T-DXd has been shown to be anti-tumor active in a large number of NSCLC patients who overtreated HER2.
the safety of T-DXd is also manageable, treatment-related interstitiotic lung disease (ILD) remains a serious adverse event that requires active monitoring and care.
Gillianne Geet Yi Lai and colleagues reported randomized Phase II clinical studies in patients with TKI-resistant EGFR mutant NSCLC who were individually treated with nivolumab or in association with ipilimumab.
although there was no significant toxicity problem in patients with TKI-resistant EGFR mutant NSCLC, the study did not show long-lasting anti-tumor effects.
4. The 2020 Meeting on Immunotherapy-Assisted NSCLC Treatment WCLC also provided data from several trials evaluating the use of immunotherapy in lung cancer.
Michael Boyer and colleagues provided data from the KEYNOTE-598 Phase III Clinical Study (NCT03302234), which assessed the efficacy of Pembrolizumab and ipilimumab in previously untreated, accompanying PD-L1 tumor ratio scores ≥50 percent (TPS≥50 percent) in metastasis NSCL patients.
point out that adding ipilimumumab to Pembrolizumab does not improve efficacy.
, the combination drug is more toxic than the first-line therapy that uses Pembrolizumab alone as a metastasis NSCLC.
data confirm that Pembrolizumab monotherapy is the standard care for this population.
Kilickap and colleagues reported the results of an empower-Lung Phase III clinical trial that assessed the efficacy of cemiplimab and platinum double chemotherapy as a first-line treatment in 437 patients with PD-L1 expression ≥50% of patients with advanced NSCLC.
data show (Figure 1) that Semipri monoantitherapy is better at inhibiting tumor volume growth, and that Symepri monoantitherapy is better than platinum-based chemotherapy in terms of ORR, PFS, and overall survival (OS), which is associated with an increase in PD-L1 expression.
Figure 1. Correlation between PD-1 expression and tumor volume reduction5. The adsive therapy NSCLC has opened a new chapter in the field of adject therapy for NSCLC patients, Margarita Majem provides the results of the ADAURA Phase III Clinical Study (NCT02511106).
the study analyzed the reported results of NSCLC patients who were treated with the admissive omiteni to remove the EGFR mutation and the use and effect of postoperative chemotherapy in the early stages of NSCLC, where the EGFR mutation is positive.
in Fact, by May 2020, the study had been reported that removed IB/II/IIIA phase NSCLC-assisted oxytinib significantly reduced the risk of recurrence (HR:0.21; P .lt;001) and improve disease-free survival (HR: 0.17; P .lt;.0001), which led the FDA to approve osimertinib as an auxiliary therapy after removal of the EGFR-changed (exon 19 missing or exon 21 L858R mutation) NSCLC.
report provides more detail on the benefits of admissibility to chemotherapy-assisted admissibility otinib.
addition, phase III clinical trials involving multiple research centers revealed a comparison of the therapeutic effects of drug genomics-assisted chemotherapy with standard assisted chemotherapy in patients with phase II-IIIA NSCLC after removal.
results showed that in the fully removed Phase II-III NSCLC-assisted chemotherapy program, the adulents selected based on mRNA expression did not have a statistically significant survival advantage in terms of overall survival and recurrence.
other studies on NSCLC that require attention are the following studies of the predicted value of variation in DNA injury repair pathways in patients treated with atezolizumab or docetaxel (abstract OA07.03) Retrospective analysis of the interdependence of KRAS and TP53 mutations in predicting the immunopsuppressive effects of EGFR/ALK-positive NSCLC Initial experience of small pulmonary lesions around the micro-ablation of bronchoscope microwaves (summary MA02.04) phase II RTOG1106 randomized Phase II trial (abstract OA02.04) for PET/CT-guided adaptive radiation therapy in local late NSCLC (Abstract OA02.04)