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J Clin Oncol: Duvalibumab combined with Tremelimumab combined with chemotherapy can be used as the first-line treatment for mNSCLC
▌ Clinical question: Can
devalimumab combined with Tremelimumab combined with Tremelimumab combined with the first-line treatment for metastatic non-small cell lung cancer (mNSCLC)?
A study from J Clin Oncol shows that T+duvalimumab+ chemotherapy can be used as the first-line treatment for mNSCLC.
▌ Research Program:
This study is an open label, phase 3 POSEIDON study. The investigators randomly assigned (1:1:1) to receive 75 mg Tremelimumab plus 1500 mg valimumab combined with platinum chemotherapy for 4 21-day cycles, followed by valimumab every 4 weeks until the disease progression, and Tremelimumab; valimumab combined with chemotherapy for 4 21-day cycles, followed by valimumab every 4 weeks until the disease progression; or chemotherapy for 6 21-day cycles (with or without pemetrexed maintenance; all groups). The primary endpoints were progression-free survival (PFS) and overall survival (OS) of duvalilizumab + chemotherapy and chemotherapy. The primary α-control secondary endpoints were PFS and OS for T+duvalizumab+chemotherapy and chemotherapy.
▌ Mainly found:
1) Compared with chemotherapy, duvalimumab + chemotherapy significantly improved PFS [hazard ratio (HR), 0.74; 95%CI, 0.62-0.89; P=0.0009; median , 5.5 vs 4.8 months]; the trend of improvement in OS did not reach statistical significance (HR, 0.86; 95%CI, 0.72-1.02; P=0.0758; median, 13.3 vs 11.7 months; 24 months OS, 29.6% vs 22.1%). Compared with chemotherapy, the PFS (HR, 0.72; 95% CI, 0.60-0.86; P=0.0003; median, 6.2 vs 4.8 months) and OS (HR: 0.77; 95% CI, 0.65-0.92; P=0.0030; median: 14.0-11.7 months; 24 months OS, 32.9%-22.1%) were significantly improved.
3) Among patients receiving T+duvalizumab+chemotherapy, duvalizumab+chemotherapy and chemotherapy, the highest treatment-related adverse events was grade 3/4, 51.8%, 44.6% and 44.4% respectively; 15.5%, 14.1% and 9.9% of patients were discontinued due to treatment-related adverse events, respectively.
▌ Outlook:
In summary, adding a limited course of Tremelimumab on the basis of duvalilizumab and chemotherapy can significantly improve OS and PFS without significant additional tolerability burden, representing a potential new option for first-line treatment of mNSCLC.
References:
[1]https://ascopubs.org/doi/full/10.1200/JCO.22.00975
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This article was first published: Medical World Tumor Channel
Author: Dingchao Jingyao Group
Editor: Sweet
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This article is original If you need to reprint, please contact the authorization
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