Prolong the "cancer-free survival" of early lung cancer immunotherapy can reduce the risk of recurrence

From June 4th to June 8th this year, the American Society of Clinical Oncology (ASCO) annual meeting will be held online.

Lung cancer is one of the cancer types that cause the highest number of deaths in the world, and non-small cell lung cancer (NSCLC) patients account for 85% of the total number of lung cancer patients.
Therefore, the development of therapies for NSCLC has always been a hot spot for cancer therapy development.
In the treatment of NSCLC, cancer immunotherapy represented by PD-1/PD-L1 inhibitors has been approved.
The first-line treatment of patients with metastatic NSCLC, the use of immunotherapy for patients with earlier cancers to improve the possibility of disease cure.
It is one of the important directions of immunotherapy research and development.

IMpower010 is a pivotal phase 3 clinical trial for the treatment of patients with early stage NSCLC.
The trial recruited 1,280 patients with stage IB-IIIA NSCLC who were completely resected.
After cisplatin-based chemotherapy, 1,005 patients were randomized 1:1 to receive atezolizumab (Tecentriq) adjuvant therapy or optimal supportive care.
The primary endpoint is disease-free survival (DFS), and overall survival (OS) is the secondary endpoint.

The results showed that compared with the best supportive therapy, atezolizumab in II-IIIA NSCLC patients with tumor PD-L1 expression> 1%, as an adjuvant therapy, reduced the patient’s risk of disease recurrence or death by 34% (HR=0.
66, 95 % CI: 0.
50-0.
88).
These patients have previously received surgical treatment and adjuvant chemotherapy.
In this patient group, the median DFS of patients receiving atezolizumab adjuvant therapy has not been reached, while the median DFS of the optimal supportive therapy group was 35.
3 months.

According to a Roche press release, this is the first positive phase 3 clinical result obtained by cancer immunotherapy as an adjuvant lung cancer therapy.

In all patients with stage II-IIIA NSCLC (regardless of PD-L1 expression level), atezolizumab reduced the risk of disease recurrence or death by 21% (HR=0.
79, 95% CI: 0.
64-0.
96).
In this patient group, Atezolizumab extended the DFS by almost 7 months (42.
3 months vs 35.
3 months).

Based on the data of patients who received at least one dose of atezolizumab or at least one safety assessment in the best supportive treatment group, the researchers found that the incidence of adverse events of any grade in the atezolizumab group and the best supportive treatment group was 92.
7% and 70.
7%.
Compared with patients receiving the best supportive care, patients receiving immunotherapy had more grade 3/4 adverse events (21.
8% vs 11.
5%).

"Although surgery can cure some early-stage lung cancer patients, disease recurrence is still very common.
Prior to this trial, the only treatment known to reduce the risk of most patients was chemotherapy.
For a small number of patients with EGFR mutations, the choice was Osimertinib treatment.
" The study author, Professor Heather Wakelee, director of oncology at Stanford University, said, "These data show that for patients with PD-L1 expressing tumors, treatment with atezolizumab can reduce the risk of recurrence of NSCLC after surgery.
" (News in Medicine Viewpoint )

Note: The original text has been deleted

Reference materials:

[1] Pivotal Phase III data at ASCO show Roche's Tecentriq helps certain people with early lung cancer live significantly longer without their disease returning.
Retrieved May 20, 2021, from cor-2021-05-20.
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[2] Immunotherapy Delays Disease Recurrence in Patients With Early-Stage, Resected Non-Small Cell Lung Cancer.
Retrieved May 24, 2021, from /immunotherapy-delays-disease-recurrence-patients-early-stage