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Lung cancer

 Last Update: 2021-06-22
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Lung cancer is the cancer with the highest morbidity and mortality in the world

At the 2021 ASCO annual meeting, data from multiple clinical trials including immunotherapy combined with chemotherapy/immunization were updated, summarized as follows:

▌Adjuvant treatment: "T drug" delays early relapse of patients

In recent years, immunotherapy has achieved remarkable results in advanced NSCLC, which has changed the treatment mode of such patients
.
Now, researchers are beginning to explore whether immunotherapy as a neoadjuvant/adjuvant therapy can benefit patients with early-stage NSCLC
.

In the IMpower010 clinical trial, 1280 patients with high-risk early NSCLC after complete resection were enrolled.
After 4 weeks of chemotherapy, 1005 patients were randomized to receive atilizumab or the best supportive treatment
.

The results show that:

In patients with stage II-IIIA with PD-L1 ≥ 1%, the median disease-free survival (DFS) of atilizumab had not yet reached at the end of the data statistics, compared with 36.
3 months in the control group
.

Among all patients with stage II-IIIA, the median DFS of the atilizumab group and the control group were 42.
3 and 35.
3 months, respectively
.
At present, the OS data for this study is not yet mature
.

These data indicate that adjuvant atelizumab therapy can significantly prolong the disease-free survival of patients with stage II-IIIA lung cancer, especially in patients with tumors with high PD-L1 expression
.
In addition, adjuvant therapy has a long-lasting effect, and can still reduce the recurrence rate of patients 2 years after stopping the drug
.

▌Neo-adjuvant therapy: "O drug" for early lung cancer

Nivolumab ("O drug") is the first PD-1 immune checkpoint inhibitor approved globally, and was first launched in 2014
.

CheckMate -816 is a phase 3 randomized, open-label, multicenter trial that evaluates the possibility of nivolumab plus chemotherapy as a neoadjuvant treatment compared with chemotherapy alone
.

The results show that:

Among patients with resectable NSCLC, the complete pathological response rate (PCR) of nivolumab plus chemotherapy as the neoadjuvant treatment group before surgery was significantly higher than that of neoadjuvant chemotherapy, 24% and 2.
2%, respectively;

The main pathological response rate (MPR) of the treatment group and the control group were 36.
9% VS 8.
9%, respectively
.

In addition, as a neoadjuvant treatment, nivolumab + chemotherapy did not adversely affect the time and feasibility of surgery, and the treatment was tolerable without increasing surgical complications
.

These results support nivolumab combined with chemotherapy as a potential neoadjuvant treatment option for patients with non-metastatic, resectable NSCLC
.

▌Five-year data update: 43% of patients have long-lasting benefits!

Generally, patients with stage III NSCLC have a median survival time of only one year due to the inability to surgically remove the tumor, and the 5-year survival rate is low
.

At this ASCO conference, the "I drug" Duvalizumab for the treatment of phase III, non-resectable non-resectable lung cancer phase 3 PACIFIC clinical trial data was updated again
.

The results show that:

The median OS of the duvalizumab group was 47.
5 months (nearly 4 years), which was 18.
4 months (one and a half years) longer than the 29.
1 months of the placebo group; the OS rates of the two groups were 42.
9 % And 33.
4%
.

The median PFS of the duvalizumab group and the placebo group were 16.
9 months and 5.
6 months, respectively; the 5-year PFS rates of the two groups were 33.
1% and 19.
0%, respectively, indicating that 33% of the patients in the treatment group 5 There was no recurrence within the year
.

Since 2017, this study has updated four sets of data, each time bringing new surprises
.
At the same time, these data also further verify that duvalizumab can bring significant and lasting benefits to patients
.

In addition, the two-year follow-up data of the CheckMate -9LA study of "O drug" nivolumab combined with "Y drug" ipilimumab was also announced at this conference
.

The results show that:

Compared with receiving four cycles of chemotherapy alone, the median overall survival of nivolumab + ipilimumab + two cycles of chemotherapy was 15.
8 months vs.
11 months, and the 2-year OS rate of the two groups was 38%.
And 26%
.

Moreover, regardless of the patient's PD-L1 expression level and tumor histological type, clinical benefits were observed
.
O+Y+ chemotherapy brings long-lasting survival benefits to patients with first-line advanced non-small cell lung cancer
.

Reference material: ASCO official website

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