Horvath Lena, Pircher Andreas
Department of Hematology and Oncology, Internal Medicine V, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
Memo. 2021;14(1):66-69. doi: 10.1007/s12254-020-00673-2. Epub 2021 Jan 13.
In this article we summarize our personal non-small cell lung cancer (NSCLC) highlights of the virtual ASCO 2020 meeting, covering developments in early and advanced-stage NSCLC. Until recently early stage NSCLC patients were treated independently of their genetic profile. Now the ADAURA study proved that postoperative osimertinib significantly prolongs disease-free survival compared to standard chemotherapy in EGFR-mutated NSCLC , underlining the high efficacy of targeted therapies in early stages. In advanced-stage disease, of course immunotherapy (IO) was at the center of attention. Final analysis of KEYNOTE-189 (pembrolizumab plus chemotherapy versus chemotherapy alone) and 3‑year update of CheckMate 227 (nivolumab plus ipilimumab versus standard chemotherapy) proved the long-term overall survival benefit of IO combinations in the first-line setting independent of PD-L1 status. The innovative CheckMate 9LA study demonstrated rapid disease control with limited-course chemotherapy plus IO doublet, while sparing chemotoxicity and may soon become a new clinical treatment choice. Moreover, the phase II CITYSCAPE trial presented significant response rates of the TIGIT-inhibitor tiragolumab plus atezolizumab in PD-L1 positive NSCLC. For HER2-mutated patients a highly effective drug conjugate trastuzumab deruxtecan was presented in a phase II study, extending targeted agents in genetically driven NSCLC. Altogether, ASCO 2020 could excite with inspiring new data for an optimized and more individualized NSCLC treatment regimen, contributing to a better outcome for both early and late-stage diseased patients and continuing to decrease lung cancer mortality.
在本文中,我们总结了2020年美国临床肿瘤学会(ASCO)虚拟会议上我们个人关注的非小细胞肺癌(NSCLC)亮点,涵盖早期和晚期NSCLC的进展。直到最近,早期NSCLC患者的治疗都与其基因特征无关。现在,ADAURA研究证明,在EGFR突变的NSCLC中,术后使用奥希替尼与标准化疗相比,能显著延长无病生存期,突显了靶向治疗在早期的高效性。在晚期疾病中,免疫疗法(IO)无疑是关注的焦点。KEYNOTE-189(帕博利珠单抗联合化疗与单纯化疗)的最终分析以及CheckMate 227(纳武利尤单抗联合伊匹木单抗与标准化疗)的3年更新数据证明,在一线治疗中,IO联合治疗无论PD-L1状态如何,都有长期的总生存获益。创新性的CheckMate 9LA研究表明,短疗程化疗联合IO双药方案能快速控制疾病,同时减少化疗毒性,可能很快成为一种新的临床治疗选择。此外,II期CITYSCAPE试验显示,在PD-L1阳性的NSCLC中,TIGIT抑制剂替雷戈珠单抗联合阿替利珠单抗有显著的缓解率。对于HER2突变的患者,一项II期研究展示了一种高效的药物偶联物曲妥珠单抗德鲁昔康,扩展了基因驱动的NSCLC中的靶向治疗药物。总之,2020年ASCO会议令人振奋的新数据为优化和更个体化的NSCLC治疗方案提供了依据,有助于改善早期和晚期患病患者的预后,并持续降低肺癌死亡率。