A phase II trial of durvalumab (MEDI4736) and tremelimumab with chemotherapy in metastatic EGFR mutant non-squamous non-small cell lung cancer (NSCLC) following progression on EGFR tyrosine kinase inhibitors (TKIs) (ILLUMINATE).

Authors

null

Chee Khoon Lee

St George Hospital, Kogarah, Australia

Chee Khoon Lee , Shalini Subramaniam , Antony Mersiades , Jenna Mitchell , Hannora Jurkovic , Mariya Walker , Loc Le , Chris Brown , Benjamin J. Solomon , Tom John , Martin R. Stockler , Bin-Chi Liao , James Chih-Hsin Yang , Chao-Hua Chiu

Organizations

St George Hospital, Kogarah, Australia, NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia, Peter MacCallum Cancer Centre, Melbourne, Australia, National Taiwan University Hospital, Taipei, Taiwan, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

Research Funding

Pharmaceutical/Biotech Company
AstraZeneca

Background: Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) have proven remarkably effective in the treatment of advanced EGFR mutant non-small cell lung cancer (NSCLC). However, drug resistance is inevitable and outcomes with subsequent platinum-pemetrexed chemotherapy are poor. The role of immune-checkpoint inhibitor monotherapy in EGFR mutant NSCLC remains uncertain with trials demonstrating inferior survival outcomes compared to chemotherapy. However, a recent randomised study with combination checkpoint inhibitor-chemotherapy demonstrated improved survival over chemotherapy alone in this patient population. This study aims to evaluate the efficacy and tolerability of combination dual immune-checkpoint blockade, durvalumab and tremelimumab, with platinum-pemetrexed chemotherapy in metastatic EGFR mutant NSCLC following progression on EGFR-TKIs. Methods: This international phase II cohort study will recruit 100 participants from Australia and Taiwan with advanced EGFR mutant NSCLC following disease progression with EGFR-TKIs [Cohort 1 (n=50): T790M mutation negative on tissue and plasma; Cohort 2 (n=50): T790M mutation positive on tissue and/or plasma, and progression on3rd generation TKIs]. Participants will receive 4 cycles of induction durvalumab 1500mg and tremelimumab 75mg with platinum-pemetrexed chemotherapy every 3 weeks, followed by maintenance durvalumab 1500mg and pemetrexed 500mg/m2 every 4 weeks until disease progression. Response will be assessed at 6 and 12 weeks, then 8-weekly during the first year, and 12-weekly thereafter. Major endpoints include objective tumour response rate (OTRR; RECIST1.1; primary), disease control rate, OTRR (iRECIST), progression-free survival, overall survival, and adverse events. Correlative studies include biomarker assessment as potential predictive/prognostic factors. ILLUMINATE is a collaboration between the Australasian Lung Cancer Trials Group, National Health Research Institutes (Taiwan) and the NHMRC Clinical Trials Centre, University of Sydney. As of 6/2/2020, 11 of planned 100 participants have been recruited. Clinical trial information: NCT03994393.

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Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

Session Type

Poster Session

Session Title

Lung Cancer—Non-Small Cell Metastatic

Track

Lung Cancer

Sub Track

Metastatic Non–Small Cell Lung Cancer

Clinical Trial Registration Number

NCT03994393

Citation

J Clin Oncol 38: 2020 (suppl; abstr TPS9631)

DOI

10.1200/JCO.2020.38.15_suppl.TPS9631

Abstract #

TPS9631

Poster Bd #

397

Abstract Disclosures