Lung cancer: new data from Esmo that extend patients’ lives

2023-10-23 12:20:46

One day after the closing of the Congress of the European Society of Medical Oncology, in a Well-attended presidential symposium new data was presented for patients with operable lung cancer. They are those of the Checkmate 77T study in which the neoadjuvant use of chemo and immunotherapy with nivolumab, followed by nivolumab alone after removal of the tumor, reduced the risk of recurrence by 42% compared to the use of chemotherapy alone.

Lung cancer

Lung cancer is the leading cause of cancer death globally. Non-small cell lung cancer (NSCLC) is one of the most common types, accounting for 84% of diagnoses. Non-metastatic cases constitute the majority of NSCLC diagnoses (approximately 60%, half of which are resectable), and it is estimated that the percentage is increasing over time thanks to advanced screening programs. While many patients with non-metastatic NSCLC are cured with surgery, 30%-55% develop recurrence and die of the disease despite resection, confirming the need for therapeutic options administered before surgery (neoadjuvant) and/or after surgery (adjuvants) to improve long-term outcomes. “In recent years we have seen incredible progress in the treatment of patients with non-metastatic non-small cell lung cancer. Today we are analyzing therapeutic strategies that build on these advances with the aim of offering clinical benefit to a greater number of patients with resectable disease,” he says Tina CasconeM.D., Ph.D., Professore Associato di Thoracic/Head and Neck Medical Oncology, presso The University of Texas MD Anderson Cancer Center.

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Lo studio Checkmate 77T

Here at Esmo Bristol Myers Squibb presented data from the Phase 3 CheckMate -77T study evaluating the perioperative regimen of neoadjuvant nivolumab and chemotherapy followed by surgery and adjuvant nivolumab in patients with resectable non-small cell lung cancer (NSCLC) stage IIA to stage IIIB. In the study, the perioperative regimen showed a statistically significant and clinically relevant improvement in the primary efficacy endpoint of event-free survival (EFS) compared to neoadjuvant chemotherapy and placebo followed by adjuvant surgery and placebo. At a median follow-up of 25.4 months, in patients treated with nivolumab and neoadjuvant chemotherapy followed by surgery and adjuvant nivolumab, the risk of disease recurrence, progression or death decreased by 42%. Furthermore, nivolumab and neoadjuvant chemotherapy showed improvement in the secondary efficacy endpoints of pathological complete response and major pathological response.

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Treat early for long-lasting benefits

The study is ongoing to determine the other secondary endpoint of overall survival (OS). Definitive surgery rates were 78% with the nivolumab-based regimen versus 77% with chemotherapy and placebo, with complete resection achieved in 89% versus 90% of patients, respectively. The safety profile of the nivolumab-based regimen was consistent with previously reported studies in NSCLC. “I am very pleased with the encouraging results of the CheckMate -77T study evaluating neoadjuvant nivolumab and chemotherapy followed by surgery and adjuvant nivolumab, and that continuing adjuvant nivolumab after surgery can further improve outcomes and provide a potentially more lasting benefit for our patients. The results of the CheckMate -77T study are promising for doctors, patients and their families. I look forward to seeing how the data from this ongoing study will continue to develop, especially regarding the secondary endpoint of overall survival,” adds Tina Cascone.

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The next steps

To date, nivolumab and nivolumab-based combinations have shown greater efficacy in the neoadjuvant, adjuvant and perioperative treatment of four types of cancer: lung, bladder, esophagus/gastroesophageal junction and melanoma. Based on these results, we await further discussions with regulatory authorities to offer another option to patients with non-metastatic NSCLC that could potentially reduce the risk of recurrence, progression or death and lead to better long-term outcomes.