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Nivolumab combined with ipilimumab safe as first-line therapy for lung cancer patients with comorbid diseases

Sunday, September 08, 2019


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Nivolumab combined with ipilimumab safe as first-line therapy for lung cancer patients with comorbid diseases

Barcelona—Combining the PD-1 immune check point inhibitor nivolumab with the monoclonal antibodyipilimumab showed a consistent safety profile in special populations with advanced non-small cell lungcancer (NSCLC), according to research presented today by at the IASLC 2019 World Conference on LungCancer hosted by the International Association for the Study of Lung Cancer.

The research was presented by Dr. Fabrice Barlesi from Aix-Marseille University, Assistance PubliqueHôpitaux de Marseille, Marseille, France.

Ipilimumab is a monoclonal antibody that works to activate the immune system by targeting CTLA-4, aprotein receptor that downregulates the immune system.

CheckMate 817 was started because data are limited on safety and efficacy of immunotherapy inpatients with advanced NSCLC with other comorbidities such as brain metastases, kidney and renaldisease and HIV.

Dr. Barlesi and researchers at other sites involved in CheckMate 817 tested two groups of patients whohad previously untreated advanced NSCLC. Cohort A1 consisted of 198 patients with an EasternCooperative Oncology Group (ECOG) score of PS 2 or ECOG PS 0–1 with asymptomatic untreated brainmetastases, hepatic or renal impairment, or HIV. An ECOG PS 2 score indicates the patient is ambulatoryand able to take care of themselves but cannot engage in most work activities. An ECOG PS 1 scoreindicates the patient is ambulatory and able to conduct most activities while a patient with PS 0 hasvirtually no restrictions.

The other group of patients (Cohort A) totaled 391 and had an ECOG of PS 0–1. Patients with knownEGFR mutations or ALK translocations sensitive to available targeted therapy were excluded from bothcohorts. Each group received nivolumab flat dose plus ipilimumab weight-based low dose for two yearsor until the patients achieved disease progression or unacceptable toxicity.

Both groups of patients experienced similar rates of treatment-related adverse events but ORR was 25percent in cohort A1 and 35 percent in cohort A. Progression-free survival was shorter in cohort A1 thancohort A.

“First-line flat-dose nivolumab plus weight-based ipilimumab showed a consistent safety profile inspecial populations with advanced NSCLC, including those with ECOG PS 2. Patients with either high TMBor higher tumor PD-L1 expression appeared to exhibit improved efficacy,” Barlesi reported.

About the WCLC:
The WCLC is the world’s largest meeting dedicated to lung cancer and other thoracic malignancies,attracting more than 7,000 researchers, physicians and specialists from more than 100 countries. Thegoal is to increase awareness, collaboration and understanding of lung cancer, and to help participantsimplement the latest developments across the globe. The conference will cover a wide range ofdisciplines and unveil several research studies and clinical trial results. For more information, visitwclc2019.iaslc.org.

About the IASLC:
The International Association for the Study of Lung Cancer (IASLC) is the only global organizationdedicated solely to the study of lung cancer and other thoracic malignancies. Founded in 1974, theassociation's membership includes more than 7,500 lung cancer specialists across all disciplines in over100 countries, forming a global network working together to conquer lung and thoracic cancersworldwide. The association also publishes the Journal of Thoracic Oncology, the primary educational andinformational publication for topics relevant to the prevention, detection, diagnosis and treatment of allthoracic malignancies. Visit www.iaslc.org for more information.


About the Author

Chris Martin, Vice President, Public Relations