Lung cancer is the leading cancer killer and the most common type of cancer in Hong Kong. In a study, Professor Tony S.K. Mok of The Chinese University of Hong Kong’s (CUHK) Faculty of Medicine (CU Medicine) and an international team of experts in lung cancer, found that combining the immunotherapy drugs tremelimumab and durvalumab with chemotherapy, can significantly improve progression-free survival and overall survival of patients with metastatic non-small cell lung cancer (NSCLC). This regimen represents a potential new option in first-line treatment for these patients.
The teams recruited 1,013 patients from 142 sites in 18 countries for a Phase 3 study that compared treatment outcomes of combined immunotherapy and chemotherapy versus chemotherapy alone.
Patients were randomly assigned to one of three treatment arms: immune checkpoint inhibitors tremelimumab plus durvalumab with chemotherapy (T+D+CT arm); durvalumab with chemotherapy (D+CT arm); or chemotherapy only (CT arm).
The results showed that treatment outcomes were better for patients who received immunotherapy combined with chemotherapy. In particular, the T+D+CT arm showed significant improvement compared with patients who received only chemotherapy, as it doubled their 12-month progression-free survival rate and increased their 24-month overall survival rate by 50 percent.
Professor Mok, Li Shu Fan Medical Foundation endowed Professor and Chairman of the Department of Clinical Oncology at the CUHK Department of Clinical Oncology, said the study provides a new treatment option for metastatic NSCLC patients. Using the two drugs along with chemotherapy significantly improved survival without a clinically meaningful increase in tolerability burden. He said they are grateful to have obtained approval from the U.S. Food and Drug Administration to apply this new treatment regime for patients with metastatic NSCLC in the United States.
He also pointed out that adding the immune drug tremelimumab, an anti-cytotoxic T-lymphocyte-associated antigen 4, extended clinical benefits to patients with PD-L1-negative tumours. These patients appeared to make the greatest gains in survival outcomes from this new combined therapy.
Immune checkpoint inhibitors are a standard first-line therapy for advanced or metastatic NSCLC with PD-L1 expression, known as anti-PD-1 checkpoint inhibitors. Durvalumab is one of those drugs. However, patients with PD-L1-low or PD-L1-negative tumours are less likely to respond to anti-PD-1 therapy, underling the need for new therapeutic strategies with immunotherapy combinations.
