Lung Cancer—Non-Small Cell Metastatic

Lung Cancer—Non-Small Cell Metastatic

LUNG CANCER—NON-SMALL CELL METASTATIC 9500 Oral Abstract Session, Fri, 8:00 AM-11:00 AM Nivolumab + ipilimumab versus platinum-doublet chemotherapy as first-line treatment for advanced non-small cell lung cancer: Three-year update from CheckMate 227 Part 1. Suresh S. Ramalingam, Tudor Eliade Ciuleanu, Adam Pluzanski, Jong-Seok Lee, Michael Schenker, Reyes Bernabe Caro, Ki Hyeong Lee, Bogdan Zurawski, Clarisse Audigier-Valette, Mariano Provencio, Helena Linardou, Sang-We Kim, Hossein Borghaei, Matthew David Hellmann, Kenneth John O’Byrne, Luis G. Paz-Ares, Martin Reck, Faith Ellen Nathan, Julie R. Brahmer; Winship Cancer Institute, Emory University, Atlanta, GA; Institutul oncologic Orif Dr Ion Chiricuta and UNF Iulia Hatieganu, Cluj Napoca, Romania; Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland; Seoul National University Bundang Hospital, Seongnam, South Korea; SF. Nectarie Oncology Center, Craiova, Romania; Hospital Universitario Virgen Del Rocio, Seville, Spain; Chungbuk National Uni- versity Hospital, Cheongju, Chungbuk, South Korea; Ambulatorium Chemioterapii, Bydgoszcz, Poland; Hopitalˆ Sainte Musse, Toulon, France; Hosp. Univ. Puerta de Hierro, Madrid, Spain; Metropolitan Hospital, Athens, Greece; Asan Medical Center, Seoul, Korea, Republic of (South); Fox Chase Cancer Center, Philadelphia, PA; Memorial Sloan Kettering Cancer Center, New York, NY; Princess Alexandra Hospital, Brisbane, Australia; Hospital Universitario 12 de Octubre, CNIO, Universidad Complutense & CiberOnc, Madrid, Spain; Lung Clinic Grosshansdorf, Airway Research Center North, German Center for Lung Research, Grosshansdorf, Germany; Bristol-Myers Squibb, Princeton, NJ; Sidney Kimmel Com- prehensive Cancer Center at Johns Hopkins, Baltimore, MD Background: In the phase 3 CheckMate 227 Part 1 (NCT02477826; minimum follow-up, 29.3 mo), 1L NIVO + IPI significantly improved overall survival (OS) vs chemo in treatment-naive patients (pts) with aNSCLC and tumor PD-L1 expression $ 1% (primary analysis) or , 1% (pre-specified descriptive analysis). Here we report data with 3-y minimum follow-up. Methods: Pts with stage IV / recurrent NSCLC and PD-L1 $ 1% (n = 1189) were randomized 1:1:1 to NIVO (3 mg/kg Q2W) + IPI (1 mg/kg Q6W), NIVO (240 mg Q2W) alone, or chemo. Pts with PD-L1 , 1% (n = 550) were randomized to NIVO + IPI, NIVO (360 mg Q3W) + chemo, or chemo. Primary endpoint was OS with NIVO + IPI vs chemo in pts with PD-L1 $ 1%. An exploratory analysis of OS in pts by response status (CR/PR, SD, progressive disease [PD]) at 6 mo was conducted. Results: After a median follow-up of 43.1 mo (database lock, 28 Feb 2020), pts with PD-L1 $ 1% continued to derive OS benefit from NIVO + IPI vs chemo (HR: 0.79; 95% CI, 0.67–0.93); 3-y OS rates were 33% (NIVO + IPI), 29% (NIVO), and 22% (chemo). At 3 y, 18% of pts with PD-L1 $ 1% treated with NIVO + IPI remained progression-free vs 12% with NIVO and 4% with chemo; 38% of confirmed responders remained in response in the NIVO + IPI arm at 3 y vs 32% in the NIVO arm and 4% in the chemo arm. In pts with PD-L1 , 1%, OS HR for NIVO + IPI vs chemo was 0.64 (95% CI, 0.51–0.81); 3-y OS rates were 34% (NIVO + IPI), 20% (NIVO + chemo), and 15% (chemo); 13%, 8%, and 2% of pts remained progression-free; and 34%, 15%, and 0% of confirmed responders remained in response, respectively. Pts with PD-L1 $ 1% with either CR/PR at 6 mo had longer subsequent OS with NIVO + IPI vs chemo; pts with SD or PD at 6 mo had generally similar subsequent OS between treatments (Table); results in PD-L1 , 1% pts will be presented. Any-grade / grade 3–4 treatment-related AEs were observed in 77% / 33% of all pts treated with NIVO + IPI, and 82% / 36% with chemo. Conclusions: With 3 y minimum follow-up, NIVO + IPI continued to provide durable and long-term OS benefits vs chemo for pts in 1L aNSCLC. Pts with PD-L1 $ 1% who achieved CR/PR at 6 mo had marked OS benefit with NIVO + IPI vs chemo. No new safety signals were identified for NIVO + IPI. Clinical trial information: NCT02477826. Research Sponsor: Bristol-Myers Squibb and Ono Pharmaceutical. Landmark analysis of OS by response status at 6 mo in pts with PD-L1 $ 1% (NIVO + IPI vs chemo). Response status at Post-landmark Post-landmark Post-landmark Pts alive at 6 mo 6 mo, % 1-y OS rate, % 2-y OS rate, % 3-y OS rate, % NIVO + IPI CR or PR, 39 vs 25 90 vs 73 76 vs 51 70 vs 39 (n = 295) vs SD, 14 vs 18 69 vs 54 45 vs 38 34 vs 33 Chemo PD, 46 vs 58 44 vs 47 22 vs 25 19 vs 17 (n = 306) © 2020 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information. LUNG CANCER—NON-SMALL CELL METASTATIC 9501 Oral Abstract Session, Fri, 8:00 AM-11:00 AM Nivolumab (NIVO) + ipilimumab (IPI) + 2 cycles of platinum-doublet chemotherapy (chemo) vs 4 cycles chemo as first-line (1L) treatment (tx) for stage IV/recurrent non-small cell lung cancer (NSCLC): CheckMate 9LA. Martin Reck, Tudor-Eliade Ciuleanu, Manuel Cobo Dols, Michael Schenker, Bogdan Zurawski, Juliana Menezes, Eduardo Richardet, Jaafar Bennouna, Enriqueta Felip, Oscar Juan-Vidal, Aurella Alexandru, Hiroshi Sakai, Arnaud Scherpereel, Shun Lu, Thomas John, David Paul Carbone, Stephanie Meadows-Shropshire, Jinchun Yan, Luis G. Paz-Ares; Department of Thoracic Oncology, Airway Research Center North, German Center for Lung Research, LungClinic, Grosshansdorf, Germany; Institutul Oncologic Prof. Dr. Ion Chiricuta and UMF Iuliu Hatieganu, Cluj-Napoca, Romania; Hospital Carlos Haya de M´alaga, Malaga, ´ Spain; SF. Nectarie Oncology Center, Craiova, Romania; Ambulatorium Chemioterapii, Bydgoszcz, Poland; Hospital Nossa Senhora Da Conceiç~ao, Porto Alegre, Brazil; Instituto Oncologico de C´ordoba, C´ordoba, Argentina; Thoracic Oncology Unit, University Hospital of Nantes, Nantes, France; Vall d’Hebron University Hospital, Barcelona, Spain; Hospital Universitario y Politecnico ´ La Fe, Valencia, Spain; Institute of Oncology "Prof. Dr. Alexandru Trestioreanu" Bucha, Bucharest, Romania; Department of Thoracic Oncology, Saitama Cancer Center, Saitama, Japan; Regional University Hospital Center of Lille, Hospital Calmette, Lille, France; Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China; Austin Hospital, Victoria, Australia; The Ohio State University Com- prehensive Cancer Center, Columbus, OH; Bristol-Myers Squibb, Princeton, NJ; Hospital Universitario 12 de Octubre, CNIO, Universidad Complutense & CiberOnc, Madrid, Spain Background: NIVO + IPI was shown to improve overall survival (OS) and durability of response vs chemo in 1L advanced NSCLC in CheckMate 227 Part 1, regardless of PD-L1 expression. We hypothesized that a limited course of chemo combined with NIVO + IPI could provide rapid disease control while building on the durable OS benefit seen with dual PD-1 and CTLA-4 inhibition. CheckMate 9LA (NCT03215706) is a phase 3 randomized study evaluating NIVO + IPI + 2 cycles chemo vs chemo in 1L stage IV/recurrent NSCLC. Methods: Adults with tx-naive, histologically confirmed stage IV/recurrent NSCLC, ECOG performance status 0–1, and no known sensitizing EGFR/ALK alterations were ran- domized 1:1 to NIVO 360 mg Q3W + IPI 1 mg/kg Q6W + chemo (2 cycles) (n = 361) or chemo (4 cycles) alone (n = 358), stratified by PD-L1 (, 1% vs $ 1%), sex, and histology (squamous vs non-squamous). Chemo was based on histology. Pts with non-squamous NSCLC in the chemo-only arm could receive optional pemetrexed maintenance. Pts were treated with immunotherapy until disease progression, unacceptable toxicity, or for 2 y. The primary endpoint was OS; the interim analysis using Lan–DeMets alpha spending function with O’Brien–Fleming boundary was planned at ~80% information fraction (ie, after observing ~322 total events). Secondary endpoints included progression-free survival (PFS) and objective response rate (ORR) by blinded independent central review, and efficacy by PD-L1 subgroups. Exploratory endpoints included safety/tolerability. Results: Baseline characteristics were balanced across arms. At a preplanned interim analysis (minimum follow-up 8.1 mo), OS was significantly prolonged with NIVO + IPI + chemo vs chemo (HR 0.69, 96.71% CI: 0.55–0.87; P = 0.0006); statistically significant improvements in PFS and ORR were seen. With longer follow-up (minimum 12.7 mo), NIVO + IPI + chemo vs chemo continued to provide longer OS; median 15.6 vs 10.9 mo (HR 0.66, 95% CI: 0.55–0.80); 1-y OS rates were 63 vs 47%. Clinical benefit was consistent across all efficacy measures in key subgroups including by PD-L1 and histology. Grade 3–4 tx-related adverse events were reported in 47 vs 38% of pts in the NIVO + IPI + chemo vs chemo arms, respectively. Conclusions: CheckMate 9LA met its primary endpoint: a statistically significant im- provement in OS was observed with NIVO + NSCLC-optimized IPI + a limited course of chemo vs chemo (4 cycles) in 1L advanced NSCLC. No new safety signals were reported. Clinical trial information: NCT03215706. Research Sponsor: Bristol-Myers Squibb and Ono Pharmaceutical. © 2020 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information. LUNG CANCER—NON-SMALL CELL METASTATIC 9502 Oral Abstract Session, Fri, 8:00 AM-11:00 AM CCTG BR.34: A randomized trial of durvalumab and tremelimumab +/- platinum-based chemotherapy in patients with metastatic (Stage IV) squamous or nonsquamous non-small cell lung cancer (NSCLC). Natasha B. Leighl, Scott Andrew Laurie, Glenwood D. Goss, Brett Gordon Maxwell

View Full Text

Details

  • File Type
    pdf
  • Upload Time
    -
  • Content Languages
    English
  • Upload User
    Anonymous/Not logged-in
  • File Pages
    129 Page
  • File Size
    -

Download

Channel Download Status
Express Download Enable

Copyright

We respect the copyrights and intellectual property rights of all users. All uploaded documents are either original works of the uploader or authorized works of the rightful owners.

  • Not to be reproduced or distributed without explicit permission.
  • Not used for commercial purposes outside of approved use cases.
  • Not used to infringe on the rights of the original creators.
  • If you believe any content infringes your copyright, please contact us immediately.

Support

For help with questions, suggestions, or problems, please contact us