The European Society of Medical Oncologists (ESMO) hosted its ESMO Congress 2023 this past weekend in Madrid, Spain. ESMO represents more than 34,000 oncology professionals, including lung cancer specialist, who practice in more than 170 countries. Every year, this meeting of oncologists from across Europe presents numerous findings about innovation within lung cancer–and this year didn’t disappoint. Read on for some of the ESMO 2023 lung cancer announcements we’re following that are relevant to patients.
Results from the phase 3 KEYNOTE-671 trial presented at the ESMO Congress show that adding perioperative pembrolizumab to neoadjuvant chemotherapy increased overall survival (OS) in patients with resectable non-small cell lung cancer (NSCLC). The difference in OS between patients receiving pembrolizumab versus those receiving the placebo increased over time. The respective OS rates were 79.0% and 74.7% at 24-months, 71.3% and 64.0% at 36 months, and 67.1% and 51.5% at 48 months. Researchers working on the study say this is the first time a phase 3 study for neoadjuvant treatment in resectable lung cancer has demonstrated a substantial enhancement in overall survival (OS) since the 1990s.
A head-to-head trial of PD-1 inhibitors compared Merck’s Keytruda and GSK’s Jemperli in patients with newly diagnosed, nonsquamous NSCLC. This analysis of the phase 2 PERLA trial found a 25% lower risk of death in patients taking Jemperli. Previous results show that Jemperli also has a better tumor response rate and time to tumor progression when compared with Keytruda, though its performance was less impressive in PD-L1-negative patients.
Phase 3 ALINA study results show that Alectinib (Alecensa) significantly reduced risk of disease recurrence or death by 76% when compared to chemotherapy in patients with fully resected ALK-positive NSCLC. The tolerability and safety profile of Alectinib are similar to those of chemotherapy, so it could become the new standard of care treatment for ALK-positive NSCLC patients, many of whom are at high risk of disease recurrence.
Adding the immunotherapy drug nivolumab before and after surgery significantly improved event-free survival (EFS) in patients with early-stage NSCLC compared to pre-surgical chemotherapy alone, according to study results presented at the ESMO Congress. The CheckMate 77T study showed a 42% lower risk of disease progression, recurrence, or death with perioperative nivolumab. Patients on this regimen also had higher rates of complete response and fewer remaining tumor cells at surgery, offering a promising option to reduce the risk of lung cancer recurrence in operable NSCLC patients.
The phase 3 LIBRETTO-431 trial evaluated Eli Lilly’s Retevmo in patients with RET fusion-positive NSCLC in comparison to the standard of care chemotherapy plus pembrolizumab. The trial results demonstrate the significant benefits of Retevmo, which offered a median progression-free survival of 24.8 months compared to 11.2 months on the standard of care treatment. While overall survival data from the study is still pending, Retevmo also showed a better time to progression and higher response rates among patients with brain metastases.
Presented as a ESMO 2023 lung cancer update, the TROPION-Lung01 phase 3 trial demonstrates positive results for datopotamab deruxtecan (Dato-DXd) in patients with advanced or metastatic NSCLC who had received at least one prior line of therapy. Dato-DXd significantly improved progression-free survival (PFS) compared to docetaxel, the current standard of care, with a 25% reduction in the risk of disease progression or death. Median PFS was 4.4 months for Dato-DXd versus 3.7 months for docetaxel.
Data from the FLAURA2 trial showed that Tagrisso plus chemotherapy offered significant improvement of central nervous system (CNS) progression-free survival (PFS) in patients with advanced or metastatic NSCLC as compared to Tagrisso as a monotherapy. In fact, adding chemotherapy to Tagrisso led to a 42% improvement in CNS-PFS over Tagrisso alone.
Findings from the MARIPOSA1 trial demonstrated the potential of a combination of Rybrevant and Leclaza as treatment for metastatic, EGFR-positive NSCLC. The drug combination had a 86% objective response rate and reduced the risk of death or disease progression by 30% compared to Tagrisso alone. Researchers from the study say the combination of Rybrevant and Leclaza showed clinically meaningful and significant improvement in progression free survival and could be the new standard of care of EGFR-mutated NSCLC.
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