Immunotherapy Combinations Gain Traction in Lung Cancer
Data from three trials presented at the International Association for the Study of Lung Cancer 17th World Conference on Lung Cancer in December 2017 suggest that strategic combinations can achieve higher response rates and more durable responses compared with those seen in monotherapy trials and may make immunotherapy an option for a broader population of patients.
Pembrolizumab/Chemotherapy in Nonsquamous NSCLC
Corey J. Langer, MD, Director of Thoracic Oncology and Professor of Medicine at the Hospital of the University of Pennsylvania in Philadelphia, reported on the phase II KEYNOTE-021 trial, which studied patients with advanced nonsquamous NSCLC (without epidermal growth factor receptor and anaplastic lymphoma kinase aberrations) who were treated in the first-line setting with carboplatin and pemetrexed chemotherapy, with or without pembrolizumab. All were permitted to receive pemetrexed as maintenance therapy. After a median follow-up of 10.6 months, the overall response rate was 55% with chemotherapy plus pembrolizumab, compared with 29% with chemotherapy alone (P = .0016).
As a result of these promising findings, an ongoing phase III trial, KEYNOTE-189, looking at chemotherapy alone or chemotherapy plus pembrolizumab is about two-thirds accrued, Dr. Langer said.
Pembrolizumab/Necitumumab in Nonsquamous NSCLC
A phase Ib trial that is part of KEYNOTE-099 is testing the combination of pembrolizumab with necitumumab in patients with metastatic NSCLC who have received at least one prior line of therapy. Benjamin Besse, MD, PhD, Head of the Thoracic Pathology Committee and medical oncologist at the Gustave Roussy Cancer Campus in Villejuif, France, reported interim results: the overall response rate was 29.4% with the combination of pembrolizumab and necitumumab. Overall response was above average among patients who were current or former smokers (37%), whose tumors were mostly negative for programmed cell death ligand 1, and who received more than two lines of chemotherapy. With a median follow-up of 6.0 months, the median progression-free survival was 6.9 months, and the 6-month response rate was 55.1%, Prof. Besse reported.