【CSCO 2022 Preview】CHOICE-01 research promotes precision treatment of lung cancer

Compared with lung adenocarcinoma, patients with lung squamous cell carcinoma have a worse prognosis and are more challenging
to treat.
The rise of immunotherapy has brought new treatment options to patients with lung squam cell carcinoma, because lung squamous cell carcinoma has a higher frequency of somatic mutations and is more immunogenic, and is theoretically more likely to benefit from immunotherapy
than lung adenocarcinoma.

The CHOICE-01 study (NCT03856411) is the first randomized, double-blind, placebo-parallel-controlled, multicenter phase III clinical study
in China to include both squamous cell carcinoma and non-squamous cell carcinoma NSCLC patients and anti-PD-1 monoclonal antibody combined with chemotherapy as first-line therapy.

A total of 465 patients with stage III.
B~IV.
squamous/non-squamous NSCLC without EGFR/ALK mutation without systematic treatment in 63 centers across the country were randomized 2:1 to receive first-line treatment
with trepilimab + chemotherapy (309 cases) or placebo + chemotherapy (156 cases).
Patients in the placebo + chemotherapy group during the period were allowed to continue treatment with trepilimab
if their disease progressed.

On October 8, 2022, the CHOICE-01 study, led by Professor Wang Jie of the Cancer Hospital of the Chinese Academy of Medical Sciences, was published
online in the authoritative journal Journal of Clinical Oncology (IF: 50.
717).

In terms of PFS, the primary endpoint of the CHOICE-01 study, PFS was significantly better in the trepilimab group than in the placebo group (median PFS: 8.
4 versus 5.
6 months).

In terms of secondary endpoint OS, OS was significantly longer in the trepilimab group than in the placebo group [median OS: not reached (NE) vs 17.
1 months].

In terms of drug safety, the incidence of grade 3 and above adverse events (AEs) was similar
in the trepilimab group and the placebo group.

More ingeniously, CHOICE-01 is the first PD-1 monoclonal antibody to use whole exome sequencing (WES) in a large phase III study, and has obtained valuable data, such as FA-PI3K-Akt or IL-7 or SWI/SNF signaling pathway mutations patients are more likely to benefit
from trepilimab combined chemotherapy.

According to the results of CHOICE-01, the National Medical Products Administration (NMPA) has approved a new indication for the first-line treatment of teruplimab combined with standard chemotherapy for advanced driver gene-negative non-squamous NSCLC, bringing a new option
to Chinese patients.
It is believed that there will be more opportunities to obtain more data in the real world in the future to further verify the value of
the above biomarkers.

On November 9, 2022, Professor Chu Tianqing of the Department of Respiratory Medicine of Shanghai Jiao Tong University Chest Hospital will introduce the latest interpretation of the CHOICE-01 study at the CSCO 2022 Annual Conference, which has a long way to overcome lung cancer, and many Chinese doctors are seeking
to do so.
It is believed that in the future, more Chinese forces will emerge from precision immunotherapy for lung cancer to benefit the majority of patients!

Resources:

https://mp.
weixin.
qq.
com/s/ECDNKjHVRDNsVy8n0ohQkw

https://mp.
weixin.
qq.
com/s/Q5sJpSMpG5oyYxjgudkw_w

https://mp.
weixin.
qq.
com/s/_WbwSnM3EeOwVZWQIsbpNg

https://mp.
weixin.
qq.
com/s/BtA15kwZn3_XtHsRxgMQaw