Novel Triplet Under Study for Metastatic NSCLC: Early Phase II Results

By: Joshua D. Madera, MD
Posted: Thursday, September 5, 2024

For patients with metastatic non–small cell lung cancer harboring a targetable mutation, the combination of the PD-1 inhibitor pembrolizumab, the kinase inhibitor lenvatinib, and chemotherapy may be a potential therapeutic strategy after disease progression on standard tyrosine kinase inhibitors, according to a presentation given at the 2024 American Society of Clinical Oncology (ASCO) Breakthrough conference (Abstract 198). This triplet led to a favorable safety profile and objective response rate in this patient population, explained Hoi Wai Chan, MBBS, of the University of Hong Kong and Queen Mary Hospital, and colleagues.

A total of 19 patients with metastatic NSCLC were recruited for the study. All patients had adenocarcinoma with a sensitizing mutation of EGFR, ALK, or ROS1; they also had evidence of disease progression despite previous treatment with standard tyrosine kinase inhibitors. Patients were treated with pembrolizumab, lenvatinib, and chemotherapy, and clinical outcomes were closely monitored to determine treatment efficacy.

The study authors reported an objective response rate of 40%, all of which were partial responses, and a median progression-free survival of 11.9 months; overall survival was not reached. In addition, 74% of patients reported treatment-related adverse events, with 63% of experiencing grade 1 or 2 adverse events. Hypothyroidism (31.6%), thrombocytopenia (26.3%), neutropenia (26.3%), nausea (26.3%), anorexia (21.1%), hypertension (15.8%), rash (10.5%), pruritus (10.5%), and anemia (10.5%) were the most common treatment-related adverse events observed. The sole grade 4 treatment-related adverse event noted was thrombocytopenia. No deaths occurred as a result of the investigational treatment.

Disclosure: Dr. Chan reported no conflicts of interest. For full disclosures of the other study authors, visit coi.asco.org.

2024 ASCO Breakthrough

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