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Current status of immune-checkpoint inhibitors in the first-line treatment of metastatic non-small cell lung cancer
Annals of Oncology 30 (Supplement 6): vi32, 2019 doi:10.1093/annonc/mdz325
SYMPOSIUM 6 : CANCER IMMUNOTHERAPY; A PARADIGM SHIFT IN THE FIRST-LINE TREATMENT OF LUNG CANCER SY6 1
Cancer immunotherapy; A paradigm shift in the first-line treatment of lung cancer
Despite advances in the treatment of cancer and reductions in smoking rates, lung cancer continues to be one of the leading causes of cancer death worldwide. For this reason, significant efforts have been made to examine the interaction between cancer and the immune system. Over the past decade, a handful of immune checkpoint inhibitors (nivolumab, pembrolizumab, atezolizumab) have been shown to improve survival when compared to chemotherapy, however only a minority of patients respond to these treatments and responders acquire resistance to the therapy. Biomarkers are required to help identify treatments most likely to benefit patients. PDL1, as a marker, has been shown to be predictive in some circumstances but is inconsistent. Other markers, such as tumor mutational burden and presence of tumor infiltrating lymphocytes, are being investigated for their ability to predict response. Furthermore, combinational approaches, using immunotherapy with other agents such as chemotherapy or targeted therapies are being investigated with some showing synergy (KEYNOTE 189). Master protocols like LUNGMAP are efficient trial designs used to quickly and safely investigate new therapies or combinations. This presentation will review the state of cancer immunotherapy and discuss results from key studies. In addition, mechanistic studies to identify predictive markers of response will be discussed along with markers of resistance (both primary and acquired).
SY6 2
SY6 3
Is Earlier Better? Immunotherapy for Resectable Lung Cancer
Patrick M. Forde Johns Hopkins University School of Medicine, United States PD-1 blockade has demonstrated survival benefits in advanced lung cancer patients both in combination with chemotherapy and as a single agent for PD-L1 high tumors. The majority of stage II and III lung cancer patients experience relapse of their cancer despite apparently curative surgery and perioperative chemotherapy delivers only modest benefits. Early data from neoadjuvant immune checkpoint studies in resectable lung cancer is promising with encouraging tolerability and pathologic response rates with single agent PD-1 blockade, PD-1/CTLA-4 combination, and chemotherapyimmunotherapy combination therapy. This session reviews data from neoadjuvant immunotherapy trials reported to date and discusses the landscape of current and planned clinical trials of neoadjuvant and adjuvant therapy.
Current status of immune-checkpoint inhibitors in the first-line treatment of metastatic non-small cell lung cancer
Kentaro Tanaka Respiratory Medicine Department, Kyushu Univerity Hospital Combination of immune-checkpoint inhibitors with platinum doublet (combination immunotherapy) has become one of standard first-line treatment options for metastatic non-small cell lung cancer (NSCLC).
C The Author(s) 2019. Published by Oxford University Press on behalf of the European Society for Medical Oncology. V
All rights reserved. For permissions, please email: [email protected].
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_6/mdz325.001/5582758 by guest on 24 October 2019
Roy S. Herbst Yale School of Medicine j Yale Cancer Center j Smilow Cancer Hospital at Yale-New Haven, United States
Although its efficacy seems quite remarkable, essential clinical questions have remained unsolved such as basic mechanisms of combination immunotherapy, development of biomarkers to predict response and its indication in patients with driver oncogene or elderly patients. To find a path for the ultimate purpose of cure in patients with metastatic NSCLC, I review pivotal trials regarding immunotherapies and discuss how to take advantage of immune-checkpoint inhibitors.
SYMPOSIUM 6 : CANCER IMMUNOTHERAPY; A PARADIGM SHIFT IN THE FIRST-LINE TREATMENT OF LUNG CANCER SY6 1
Cancer immunotherapy; A paradigm shift in the first-line treatment of lung cancer
Despite advances in the treatment of cancer and reductions in smoking rates, lung cancer continues to be one of the leading causes of cancer death worldwide. For this reason, significant efforts have been made to examine the interaction between cancer and the immune system. Over the past decade, a handful of immune checkpoint inhibitors (nivolumab, pembrolizumab, atezolizumab) have been shown to improve survival when compared to chemotherapy, however only a minority of patients respond to these treatments and responders acquire resistance to the therapy. Biomarkers are required to help identify treatments most likely to benefit patients. PDL1, as a marker, has been shown to be predictive in some circumstances but is inconsistent. Other markers, such as tumor mutational burden and presence of tumor infiltrating lymphocytes, are being investigated for their ability to predict response. Furthermore, combinational approaches, using immunotherapy with other agents such as chemotherapy or targeted therapies are being investigated with some showing synergy (KEYNOTE 189). Master protocols like LUNGMAP are efficient trial designs used to quickly and safely investigate new therapies or combinations. This presentation will review the state of cancer immunotherapy and discuss results from key studies. In addition, mechanistic studies to identify predictive markers of response will be discussed along with markers of resistance (both primary and acquired).
SY6 2
SY6 3
Is Earlier Better? Immunotherapy for Resectable Lung Cancer
Patrick M. Forde Johns Hopkins University School of Medicine, United States PD-1 blockade has demonstrated survival benefits in advanced lung cancer patients both in combination with chemotherapy and as a single agent for PD-L1 high tumors. The majority of stage II and III lung cancer patients experience relapse of their cancer despite apparently curative surgery and perioperative chemotherapy delivers only modest benefits. Early data from neoadjuvant immune checkpoint studies in resectable lung cancer is promising with encouraging tolerability and pathologic response rates with single agent PD-1 blockade, PD-1/CTLA-4 combination, and chemotherapyimmunotherapy combination therapy. This session reviews data from neoadjuvant immunotherapy trials reported to date and discusses the landscape of current and planned clinical trials of neoadjuvant and adjuvant therapy.
Current status of immune-checkpoint inhibitors in the first-line treatment of metastatic non-small cell lung cancer
Kentaro Tanaka Respiratory Medicine Department, Kyushu Univerity Hospital Combination of immune-checkpoint inhibitors with platinum doublet (combination immunotherapy) has become one of standard first-line treatment options for metastatic non-small cell lung cancer (NSCLC).
C The Author(s) 2019. Published by Oxford University Press on behalf of the European Society for Medical Oncology. V
All rights reserved. For permissions, please email: [email protected].
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_6/mdz325.001/5582758 by guest on 24 October 2019
Roy S. Herbst Yale School of Medicine j Yale Cancer Center j Smilow Cancer Hospital at Yale-New Haven, United States
Although its efficacy seems quite remarkable, essential clinical questions have remained unsolved such as basic mechanisms of combination immunotherapy, development of biomarkers to predict response and its indication in patients with driver oncogene or elderly patients. To find a path for the ultimate purpose of cure in patients with metastatic NSCLC, I review pivotal trials regarding immunotherapies and discuss how to take advantage of immune-checkpoint inhibitors.