Lung Cancer—Non-Small Cell Metastatic

First-line nivolumab (NIVO) plus ipilimumab (IPI) plus two cycles of chemotherapy (chemo) versus chemo alone (4 cycles) in patients with advanced non-small cell lung cancer (NSCLC): Two-year update from CheckMate 9LA.

Martin Reck, Tudor-Eliade Ciuleanu, Manuel Cobo, et al.

This study demostrates with 1t-line NIVO + IPI + chemotherapy  after a 2 years’ minimum follow-up a durable survival and benefit vs chemotherapy in patients with advanced NSCLC; there were no new safety signals. CTI: NCT03215706

 

Outcomes of anti-PD-(L1) therapy in combination with chemotherapy versus immunotherapy (IO) alone for first-line (1L) treatment of advanced non-small cell lung cancer (NSCLC) with PD-L1 score 1-49%: FDA pooled analysis.

Oladimeji Akinboro, Jonathon Joseph Vallejo, Pallavi Shruti Mishra-Kalyani, et al.

In most subgroups of patients with advanced NSCLC with PD-L1 score, 1-49% chemo-IO may improve efficacy outcomes versus IO alone. Patients 75 and over across therapeutic options experienced similar outcomes.

 
Mark A. Socinski, Robert M. Jotte, Federico Cappuzzo, et al.
 
This analysis shows that patients with irAEs had longer overall survival than patients without irAEs in the atezolizumab-containing and control arms per the time-dependent Cox model and landmark analyses; after excluding rash this trend remained for the atezolizumab arm. Landmark analyses suggest that in the atezolizumab arm, patients with Grade 1/2 irAEs had the longest overall survival  & patients with Grade ≥3 irAEs had the shortest overall survival, potentially due to therapy interruption/discontinuation. Clinical trial information: NCT02367781; NCT02657434; NCT02366143
 
 
Ferdinandos Skoulidis, Bob T. Li, Ramaswamy Govindan, et al.
 
This exploratory analyses of the phase 2 CodeBreaK 100 trial demonstrates the clinical benefit of sotorasib across patient subgroups. Overall survival and updated exploratory analyses are presented during the oral session. Clinical trial information: NCT03600883
 
 
 
Nicholas J. Robert, Esmond D. Nwokeji, Janet L. Espirito, et al. 
 
In this real-world study most patients received at least one biomarker test prior to 1st-line therapy, but less than 50% received all five tests. Full next-generation sequencing panel testing occurred in less than 50% of patients but increased over the periods examined. Median time from diagnosis to 1st-line therapy was about 5 weeks and turnaround times from orders to results about 2 weeks. 
 
 
The use of next-generation sequencing-based testing - recommended by the NCCCN Clinical Guidelines in Oncology for patients with advanced/metastatic NSCLC -  is the most notable disparity among black patients: There is a more than a 10 percentage-point difference in receipt of this testing compared to white counterparts. This may partly contribute to the much higher rate of participation in clinical trials observed among white patients. The authors conclude that access to and receipt of appropriate biomarker testing may be an attenable goal to ensure equal access to quality care.
 
 
Joshua Bauml, Byoung Chul Cho, Keunchil Park, et al. 
 
The combination of amivantamab & lazertinib demonstrated responses in 36% of chemotherapy-naïve patients who progressed on osimertinib. Genetic EGFR and MET-based biomarkers of resistance identified a subgroup of patients more likely to respond to amivantamab & lazertinib. Additional patients without identified resistance markers also responded. The authors conclude, that an immunohistochemistry-based approach may identify patients most likely to benefit from the combination regimen, suggesting further investigations. Clinical trial information: NCT02609776
 
The treatment in heavily pretreated metastatic/locally advanced EGFRm NSCLC with,patritumab deruxtecan (5.6 mg/kg IV Q3W) showed antitumor activity across various EGFR TKI resistance mechanisms. The safety profile was comparable with earlier reports. A Phase 2 study of patritumab deruxtecan in patients with EGFRm NSCLC after the failure of EGFR TKI and platinum-based chemotherapy has been initiated (NCT04619004). Clinical trial information: NCT03260491
 
 
The rationally designed selective, irreversible EGFR exon20ins inhibitor DZD9008 showed promising anti-tumor efficacy in pre-treated NSCLC with EGFR exon20ins mutationsa with a favorable safety profile. Clinical trial information: NCT03974022