Abstract
The aim of this short review is to summarize the randomized phase III trials with the highest impact on daily clinical practice relating to the field of lung cancer presented at the ASCO annual meeting 2015. With the presentation of data from the CheckMate 017 and 057 trials, comparing the anti-PD1-antibody nivolumab to standard docetaxel in the second-line treatment of patients with metastatic squamous and non-squamous non-small-cell lung cancer, immunotherapeutic strategies have finally arrived in daily routine, as the antibody treatment in these trials led to superior results concerning survival, toxicity, and response rates. However, especially in the non-squamous cohort, a heterogeneous treatment-effect of nivolumab was detected, with not all patients gaining the same benefit. To better define these subgroups by establishing robust predictive biomarkers will be of high priority in the near future. In the field of targeted therapies, the overall survival analysis from the LUX-Lung 8 trial, comparing afatinib to erlotinib in the second/third-line treatment of patients with metastatic squamous non-small-cell lung cancer, revealed a statistical significant survival-advantage for the afatinib-treatment arm. However, due to low survival-gains and added toxicity in absolute numbers, it is debatable whether this difference will change daily practice. Once again it is hoped, that the still pending biomarker analysis for this trial will be able to define a subgroup with a better risk/benefit ratio than in the overall population.
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References
Garon EB, Rizvi NA, Hui R, et al. Pembrolizumab for the treatment of non-small-cell lung cancer. N Engl J Med. 2015;372(21):2018–28.
Rizvi NA, Mazieres J, Planchard D, et al. Activity and safety of nivolumab, an anti-PD-1 immune checkpoint inhibitor, for patients with advanced, refractory squamous non-small-cell lung cancer (CheckMate 063): a phase 2, single-arm trial. Lancet Oncol. 2015;16(3):257–65.
Spigel DR, Reckamp KL, Rizvi NA, et al. A phase III study (CheckMate 017) of nivolumab (NIVO; anti-programmed death 1 [PD-1]) vs docetaxel (DOC) in previously treated advanced or metastaic squamous (SQ) cell non-small cell lung cancer (NSCLC). J Clin Oncol. 2015;33(suppl; abstr 8009).
Paz-Ares L, Horn L, Borghaei H, et al. Phase III, randomized trial (CheckMate 057) of nivolumab (NIVO) vs docetaxel (DOC) in advanced non-squamous cell (non-SQ) non-small cell lung cancer (NSCLC). J Clin Oncol. 2015;33(suppl; abstr LBA 109).
Ott PA, Fernandez MEE, Hiret S, et al. Pembrolizumab (MK-3475) in patients (pts) with extensive-stage small cell lung cancer (SCLC): Preliminary safety and efficacy results from KEYNOTE-028. J Clin Oncol. 2015;33(suppl; abstr 7502).
Antonia SJ, Bendell JC, Taylor MH, et al. Phase I/II study of nivolumab with or without ipilimumab for treatment of recurrent small cell lung cancer (SCLC): CA209-032. J Clin Oncol. 2015;33(suppl; abstr 7503).
Shepherd FA, Pereira JR, Ciuleanu T, et al. Erlotinib in previously treated non-small-cell lung cancer. New Engl J Med. 2005;353(2):123–32.
Soria JC, Felip E, Cobo M, et al. Afatinib (A) vs erlotinib (E) as second-line therapy of patients (pts) with advanced squamous cell carcinoma (SCC) of the lung following platinum-based chemotherapy: Overall survival (OS) analysis from the global phase III trial LUX-Lung 8 (LL8). J Clin Oncol. 2015;33(suppl; abstr 8002).
Conflict of interest
The author has received honoraria for advisory-board participation and lectures from Bristol-Myers-Squibb, Roche, and Boehringer Ingelheim.
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Pall, G. ASCO update 2015: lung cancer. memo 8, 213–215 (2015). https://doi.org/10.1007/s12254-015-0231-7
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DOI: https://doi.org/10.1007/s12254-015-0231-7