The major breakthroughs for Lung Cancer 2020

(Solomon B et al.; ESMO Virtual Congress 2020)

“In this double-blind, phase 3 trial, we randomly assigned patients with completely resected EGFR mutation–positive NSCLC in a 1:1 ratio to receive either osimertinib (80 mg once daily) or placebo for 3 years. The primary end point was disease-free survival among patients with stage II to IIIA disease (according to investigator assessment). The secondary end points included disease-free survival in the overall population of patients with stage IB to IIIA disease, overall survival, and safety.”

(Wu et al.; N Engl J Med 2020; 383:1711-1723)

T-DXd is an antibody-drug conjugate composed of an anti-HER2 antibody, cleavable tetrapeptide-based linker, and topoisomerase I inhibitor payload. In a phase I trial, patients (pts) with HER2-mutated NSCLC who received T-DXd had a confirmed objective response rate (ORR) of 72.7% (8/11) (Tsurutani et al, WCLC 2018). DESTINY-Lung01 (NCT03505710) is an ongoing, multicenter, phase II study of T-DXd in pts with non-squamous NSCLC overexpressing HER2 or containing a HER2-activating mutation.

(Smit et al.; ASCO 2020)

Pembro continues to show improvements in OS vs chemo as 1L treatment for metastatic NSCLC with PD-L1 TPS ≥50%. Despite the high crossover rate, the 5-year OS was approximately doubled among pts who received pembro (31.9% vs 16.3%).

(Brahmer et al.; Annals of Oncology (2020) 31 (suppl_4))

“However, the final analysis of the phase III IMpower150 study did identify a survival benefit associated with the quadruplet regimen in those with sensitizing EGFR mutations and liver metastases, according to Mark A. Socinski, MD, of the AdventHealth Cancer Institute in Orlando, and colleagues.”

(Socinski et al.; AACR2020)