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AACR 2022: Neoadjuvant Durvalumab Alone or in Combination for Early-Stage Lung Cancer

By: Lauren Harrison, MS
Posted: Friday, April 22, 2022

The phase II NeoCOAST trial compared the use of a combination of durvalumab (a PD-L1 inhibitor) and either oleclumab (an anti-CD73 antibody), monalizumab (an anti-NKG2A antibody), or danvatirsen (an anti-STAT3 antisense oligonucleotide) with durvalumab alone as treatment of resectable, early-stage non–small cell lung cancer (NSCLC). All three of these combinations generated improved major pathologic response and pathologic complete response rates when compared with durvalumab monotherapy. These results were presented at the American Association for Cancer Research (AACR) Annual Meeting 2022 (Abstract CT011) by Tina Cascone, MD, PhD, of The University of Texas MD Anderson Cancer Center, Houston.

“This study builds on the growing evidence that combination immunotherapy has a role in the neoadjuvant setting for this patient population,” said Dr. Cascone in a press release.

A total of 83 patients with previously untreated, stage I to IIIA NSCLC were enrolled in this trial. Patients were randomly assigned 1:1:1:1 to receive 1,500 mg of intravenous durvalumab alone (26 patients) every 4 weeks or in combination with 3,000 mg of intravenous oleclumab every 2 weeks (21 patients), 750 mg of intravenous monalizumab every 2 weeks (20 patients), or 200 mg of intravenous danvatirsen every week (16 patients) for one 28-day cycle. All patients underwent surgical resection after neoadjuvant chemotherapy.

A major pathologic response was reported in 11.1% of patients receiving durvalumab monotherapy, 19.0% of those receiving the oleclumab combination, 30.0% of those receiving monalizumab, and 31.3% of those receiving danvatirsen. A pathologic complete response was noted in 3.7%, 9.5%, 10.0%, and 12.5% of patients, respectively. Across all arms, a major pathologic response was more common in patients who had a baseline PD-L1 expression of at least 1%.

Treatment-related adverse events occurred in 34.6% of patients in the durvalumab-monotherapy group, 57.1% of those in the oleclumab group, 50.0% of those in the monalizumab group, and 43.8% of those in the danvatirsen group. Most patients (91.6%) underwent surgery with no significant delay.

Disclosures: For a full list of authors’ disclosures, visit abstractsonline.com.


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