Moreno Victor, Garrido Pilar, Papadopoulos Kyriakos P, De Miguel Luken Maria Jose, Gil-Martin Marta, Aljumaily Raid, Rosen Lee S, Rietschel Petra, Mohan Kosalai K, Yoo Suk-Young, Stankevich Elizabeth, Lowy Israel, Fury Matthew G
START Madrid-FJD, Hospital Fundación Jiménez Díaz, Madrid, Spain.
Medical Oncology Department, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain.
Lung Cancer. 2021 May;155:151-155. doi: 10.1016/j.lungcan.2021.02.034. Epub 2021 Mar 4.
Blockade of programmed cell death-1 (PD-1) and its ligand (PD-L1) has transformed the treatment of NSCLC. In a first-in-human, Phase 1, dose escalation and cohort expansion study, cemiplimab, a monoclonal antibody directed against PD-1, was evaluated for the treatment of patients with advanced solid tumors (NCT02383212). Here, we report results in patients with advanced NSCLC from the dose expansion cohort.
Immune-checkpoint inhibitor naive patients with advanced NSCLC (stage III/IV), irrespective of PD-L1 status, who had progressed after, or were refractory to first- or later-line therapy were enrolled and received cemiplimab 200 mg every 2 weeks intravenously for up to 48 weeks. Primary study objectives were to assess safety and tolerability, and to evaluate clinical activity of cemiplimab.
Twenty patients with NSCLC were enrolled. Median age was 64.0 years (range: 50-82); 65.0 % were male; 80.0 % had an ECOG performance status of 1; 60.0 % had a histology of adenocarcinoma. Median number of prior lines of systemic therapy was 2 (range: 1-4). Median duration of follow-up was 7.0 months (range: 1.0-18.2). All patients experienced ≥1 treatment-emergent adverse event (TEAE) of any grade. Most common TEAEs were arthralgia, asthenia, cough, and dyspnea (each 4/20; 20.0 %). Grade ≥3 TEAEs occurred in 60.0 % (12/20) of patients. Of patients with measurable disease per independent central review (ICR), five had partial response (PR), four had stable disease (SD) and 10 had progressive disease. Objective response rate (ORR; complete response + PR) was 25.0 % (95 % CI: 8.7-49.1 %). Duration of response exceeded 8 months in four of the five responding patients at the time of data cut-off (April 30, 2019). The disease control rate per ICR (ORR + SD) was 50.0 % (95 % CI: 27.2-72.8 %).
Cemiplimab showed an acceptable safety profile and demonstrated antitumor activity in pretreated patients with NSCLC.
程序性细胞死亡蛋白1(PD-1)及其配体(PD-L1)的阻断已改变了非小细胞肺癌(NSCLC)的治疗方式。在一项首次人体、1期剂量递增和队列扩展研究中,评估了靶向PD-1的单克隆抗体西米普利单抗治疗晚期实体瘤患者的疗效(NCT02383212)。在此,我们报告剂量扩展队列中晚期NSCLC患者的结果。
入组未经免疫检查点抑制剂治疗、患有晚期NSCLC(Ⅲ/Ⅳ期)、无论PD-L1状态如何、在一线或多线治疗后病情进展或难治的患者,每2周静脉注射200mg西米普利单抗,最长治疗48周。主要研究目的是评估安全性和耐受性,并评估西米普利单抗的临床活性。
入组20例NSCLC患者。中位年龄为64.0岁(范围:50-82岁);65.0%为男性;80.0%的东部肿瘤协作组(ECOG)体能状态为1;60.0%的组织学类型为腺癌。既往全身治疗的中位线数为2(范围:1-4)。中位随访时间为7.0个月(范围:1.0-18.2)。所有患者均经历了≥1次任何级别的治疗中出现的不良事件(TEAE)。最常见的TEAE为关节痛、乏力、咳嗽和呼吸困难(各4/20;20.0%)。60.0%(12/20)的患者发生≥3级TEAE。根据独立中心审查(ICR),有可测量疾病的患者中,5例部分缓解(PR),4例疾病稳定(SD),10例疾病进展。客观缓解率(ORR;完全缓解+PR)为25.0%(95%CI:8.7-49.1%)。在数据截止时(2019年4月30日),5例缓解患者中有4例缓解持续时间超过8个月。根据ICR计算的疾病控制率(ORR+SD)为50.0%(95%CI:27.2-72.8%)。
西米普利单抗显示出可接受的安全性,并在经治NSCLC患者中表现出抗肿瘤活性。