Durvalumab in Heavily Pretreated Patients With Advanced Lung Cancer
Posted: Thursday, April 26, 2018
Heavily pretreated patients with advanced non–small cell lung cancer (NSCLC) showed durable responses to durvalumab in a phase II, open-label trial led by Marina Chiara Garassino, MD, of Fondazione IRCCS Istituto Nazionale dei Tumori in Milan. According to the study published in The Lancet Oncology, the proportion of patients achieving a response was greater among those with higher PD-L1 expression, but durable responses were observed irrespective of PD-L1 expression status.
Patients with and without EGFR tyrosine kinase or ALK genetic aberrations were assessed. A total of 444 patients from study centers in Asia, Europe, and North America were split into 3 cohorts and treated with durvalumab for up to 12 months. Patients in the first cohort (111) had EGFR-positive/ALK-positive NSCLC with ≥ 25% or < 25% PD-L1 expression on tumor cells. Cohorts 2 and 3 included patients with EGFR-negative/ALK-negative NSCLC. Those in cohort 2 (265) had disease with ≥ 25% or < 25% PD-L1 expression, and those in cohort 3 (68) had disease with at least 90% PD-L1 expression.
Overall, the proportion of patients without genetic aberrations showed higher response rates than did those with EGFR mutations or ALK rearrangements. Among patients with ≥ 25% PD-L1 expression, objective response was observed in 12.2% of 74 patients in cohort 1, 16.4% of 146 patients in cohort 2, and 30.9% of 68 patients in cohort 3. The safety and efficacy of durvalumab seemed to be comparable to those of other anti–PD-1 and PD-L1 agents.