Memorial Sloan Kettering Cancer Center, New York, NY
Matthew D. Hellmann, Scott Joseph Antonia, Ani Sarkis Balmanoukian, Julie R. Brahmer, Sai-Hong Ignatius Ou, Sang-We Kim, Myung-Ju Ahn, Dong-Wan Kim, Martin Gutierrez, Stephen V. Liu, Patrick Schoffski, Dirk Jaeger, Rahima Jamal, Joseph W. Leach, Guy Heinrich Maria Jerusalem, Jose Lutzky, John J. Nemunaitis, Yu Gu, Shaad Essa Abdullah, Neil Howard Segal
Background: Single-agent durvalumab is being evaluated in patients with advanced squamous and non-squamous NSCLC in an ongoing Phase 1/2 study (NCT01693562). Here we present updated survival and safety data in NSCLC patients. Methods: Treatment-naïve (1L) and previously treated (2L or 3L+) stage IIIB/IV NSCLC patients received durvalumab 10 mg/kg Q2W for up to 12 months. Patients were stratified by tumor PD-L1 expression (Ventana PD-L1 [SP263] Assay [PD-L1 high: ≥25% of tumor cells with membrane staining]), treatment line, and histology. Results: As of 05 September 2017, 304 NSCLC patients received durvalumab monotherapy. Median duration of follow-up was 35.6 (0.3–50.9) months. Investigator-assessed ORR ranged between 23.2% and 30.0% among PD-L1 high patients, and between 3.6% and 8.3% among PD-L1 low/negative patients. Median PFS and median OS were longer in PD-L1 high vs PD-L1 low/negative patients (Table). Any-grade treatment-related AEs (TRAEs) were reported in 57.2% of pts (including fatigue, 17.4%, decreased appetite, 9.2%, diarrhea, 8.9%); in 10.2% of pts these were Grade 3 or 4. TRAEs resulting in treatment discontinuation were reported in 17 patients (5.6%); 1 patient had a Grade 5 TRAE (pneumonia). Conclusions: In this ongoing phase 1 study, OS and safety profile appear encouraging in treatment-naïve and previously treated NSCLC patients, particularly among PD-L1 high patients. Further investigation regarding PD-L1 expression for selection of patients who most likely benefit from durvalumab is needed. Clinical trial information: NCT01693562
Cohort | PD-L1 high | PD-L1 low/neg |
---|---|---|
1L | N = 50 | N = 12 |
ORR, % (95% CI) | 30.0 (17.9–44.6) | 8.3 (0.2–38.5) |
Median OS, mos (95% CI) | 21.9 (14.5–NE) | 7.4 (1.7–36.2) |
12-month OS, % | 70.5 | 46.9 |
24-month OS, % | 47.0 | 37.5 |
2L | N = 59 | N = 29 |
ORR, % (95% CI) | 25.4 (15.0–38.4) | 3.6 (0.1-18.3) |
Median OS, mos (95% CI) | 17.1 (9.3–23.0) | 7.9 (4.2–13.8) |
12-month OS, % | 55.5 | 32.8 |
24-month OS, % | 32.1 | 23.4 |
3L+ | N = 56 | N = 79 |
ORR, % (95% CI) | 23.2 (13.0–36.4) | 6.3 (2.1–14.2) |
Median OS, mos (95% CI) | 13.4 (8.8–16.8) | 7.6 (5.4–12.8) |
12-month OS, % | 56.8 | 39.1 |
24-month OS, % | 29.4 | 19.5 |
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