Department of Hematology and Medical Oncology and the Molecular Therapeutics Program, Fox Chase Cancer Center, Philadelphia, PA.
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA.
Clin Lung Cancer. 2021 May;22(3):178-186. doi: 10.1016/j.cllc.2020.10.015. Epub 2020 Nov 10.
INTRODUCTION: The objective of the Lung-MAP sub-study S1400A was to evaluate the response rate to durvalumab, an anti-programmed death-ligand 1 (PD-L1) antibody, in patients with squamous non-small-cell lung cancer (SqNSCLC). PATIENTS AND METHODS: Patients who progressed on at least 1 prior platinum-based chemotherapy were eligible. The study was designed as a phase II/III trial comparing durvalumab with docetaxel but was modified to a single-arm, phase II trial with the primary endpoint of objective response when immunotherapy became an approved treatment. RESULTS: A total of 116 patients were registered to this sub-study; 78 to durvalumab and 38 to docetaxel. Of the 78 patients, 9 were ineligible, and 1 was not evaluable for endpoints. Responses were achieved in 11 patients among the 68 eligible and evaluable patients on durvalumab (overall response rate, 16%; 95% confidence interval [CI], 7%-25%). The disease control rate was 54% (95% CI, 43%-66%), the median overall survival was 11.6 months (95% CI, 10.2-14.3 months), and the median progression-free survival was 2.9 months (95% CI, 2.0-4.0 months). PD-L1 data was available for 43 patients on durvalumab, with 14 (33%) patients who were PD-L1-positive (≥ 25%) and 2 responses (overall response rate, 14%; 95% CI, 0%-33%), the disease control rate was 57% (95% CI, 31%-83%), the median overall survival and progression-free survival were 10.7 months (95% CI, 9.2-14.3 months) and 2.3 months (95% CI, 1.4-4.2 months), respectively. Grade ≥ 3 treatment-related adverse events occurred in 22 (32%) patients on durvalumab, with 6 discontinuing owing to drug-related adverse events (9%; 95% CI, 2%-16%). CONCLUSIONS: Durvalumab shows single-agent activity and toxicities in this sub-group of patients that is comparable with other anti-programmed cell death protein 1/PD-L1 antibodies.
介绍:Lung-MAP 子研究 S1400A 的目的是评估 durvalumab(一种抗程序性死亡配体 1(PD-L1)抗体)在鳞状非小细胞肺癌(SqNSCLC)患者中的反应率。
患者和方法:至少接受过 1 种既往铂类化疗进展的患者符合条件。该研究设计为 durvalumab 与多西他赛的 II/III 期比较研究,但在免疫治疗成为批准治疗时,该研究被修改为单臂、II 期试验,主要终点为客观缓解。
结果:共有 116 名患者被登记参加这项子研究;78 名接受 durvalumab 治疗,38 名接受多西他赛治疗。在 78 名患者中,9 名不符合条件,1 名终点不可评估。在 68 名可评估和可评估的 durvalumab 患者中,11 名患者获得缓解(总缓解率为 16%;95%置信区间 [CI],7%-25%)。疾病控制率为 54%(95%CI,43%-66%),中位总生存期为 11.6 个月(95%CI,10.2-14.3 个月),中位无进展生存期为 2.9 个月(95%CI,2.0-4.0 个月)。durvalumab 组的 PD-L1 数据可用于 43 名患者,其中 14 名(33%)患者 PD-L1 阳性(≥25%),2 名患者出现缓解(总缓解率为 14%;95%CI,0%-33%),疾病控制率为 57%(95%CI,31%-83%),中位总生存期和无进展生存期分别为 10.7 个月(95%CI,9.2-14.3 个月)和 2.3 个月(95%CI,1.4-4.2 个月)。durvalumab 组有 22 名(32%)患者发生≥3 级治疗相关不良事件,其中 6 名患者因药物相关不良事件而停药(9%;95%CI,2%-16%)。
结论:在这一组患者中,durvalumab 显示出单药活性和毒性,与其他抗程序性细胞死亡蛋白 1/PD-L1 抗体相当。
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