Non-Small Cell Lung Cancer Coverage from Every Angle

ESMO 2020: Combining Ipilimumab With PD-1 Blockade in Advanced Lung Cancer

By: Lauren Harrison, MS
Posted: Tuesday, September 29, 2020

Second-line treatment of non–small cell lung cancer (NSCLC) with less than 50% PD-L1 expression using cemiplimab and ipilimumab demonstrated higher antitumor activity when compared with cemiplimab monotherapy. Byoung Young Shim, MD, of The Catholic University of Korea in Suwon, Korea, presented these study findings from the phase II EMPOWER-lung 4 trial on behalf of his colleagues at the European Society for Medical Oncology (ESMO) Virtual Congress 2020 (Abstract 1269P). Cemiplimab’s effect comes from targeting the PD-1/PD-L1 pathway.

This open-label study enrolled and treated 27 patients with advanced NSCLC, and 57.1% of these patients had a PD-1 level of less than 1%. Patients were randomly assigned 1:1:1 to receive 350 mg of cemiplimab once every 3 weeks (arm A, 8 patients), 350 mg of cemiplimab every 3 weeks plus 50 mg of ipilimumab once every 6 weeks (arm B, 11 patients), or 1,050 mg of cemiplimab every 3 weeks (arm C, 8 patients).

The median duration of treatment on arms A, B, and C was 10.8, 17.9, and 10.8 weeks, respectively. The overall response rate was 0% in arm A, 45.5% in arm B, and 11.1% in arm C. Among the patients with a PD-L1 level less than 1%, the overall response rates were 36.4% in arm B and 11.1% in arm C. Patients with PD-L1 levels between 1% and 49% had overall response rates of 9.1% in arm B and 0% in arm C.

The most commonly seen treatment-emergent adverse events of any grade were constipation (37.5% of patients) and decreased appetite (37.5%) in arm A, hypothyroidism and pneumonia in arm B (36.4% each), and decreased appetite (37.5%) in arm C. The only grade 3 adverse event seen in more than one patient was elevated levels of alanine aminotransferase (arm B, 18.2% of patients).

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