ALL PATIENTS with advanced non-small-cell lung cancer (NSCLC) should receive immunotherapy according to Prof Solange Peters, ESMO President Elect, following the results of a Phase 2 study showing that the anti-PD-L1 antibody atezolizumab provides significant long-term survival benefits for lung cancer patients.
Higher Overall Survival
Presented at ELCC 2018, the Phase 2 POPLAR trial randomised 287 advanced NSCLC patients from 13 countries to either atezolizumab or the chemotherapy drug docetaxel. At 2 years, overall survival rate of patients treated with atezolimumab was 32.2%, and at 3 years, 18.7%. This compared to an overall survival rate of 16.6% and 10.0% at 2 and 3 years, respectively, in patients in the docetaxel group. These results were seen across histology and regardless of PD-L1 expression.
Fewer Adverse Events
Additionally, the median duration of response with atezolizumab was three-times as long compared with docetaxel (22.3 versus 7.2 months, respectively) and fewer adverse events occurred with atezolizumab. The study authors also believe that patients can take this immunotherapy drug for several years because it was well-tolerated.
The results add further evidence to the long-term survival benefits of immunotherapy and could potentially lead to this type of therapy being offered to all advanced NSCLC patients in the future. Prof Peters stated: “Before immunotherapy, the long-term survival of NSCLC patients was close to 0%. POPLAR supports the concept that long-term survival is possible with immunotherapy. The 3-year survival results of POPLAR are consistent with the 3 and 5-year survival with the anti-PD-1 antibodies pembrolizumab and nivolumab, respectively, in Phase 1 trials. These latest results are exciting because unlike the previous two trials, POPLAR was a large, randomised trial and provides convincing proof that long-term survival now exists in lung cancer.”
To create a sustainable strategy for treating all advanced NSCLC patients with immunotherapy, Prof Peters added that a method for identifying those patients who will not benefit from immunotherapy needs developing, and that the implantation of trials that assess the ability of a combination of biomarkers to make this prediction should now be a major focus. The first stage will be to identify the characteristics of such patients.
James Coker, Reporter
For the source and further information about the study, click here.