Neoadjuvant chemotherapy and Avelumab in early stage resectable nonsmall cell lung cancer

Autor: Ghina Fakhri, Arafat Tfayli, Mohamad Haidar, Youssef H. Zeidan, Hazem I. Assi, Kamal Al Rabi, Ziad Mansour, Majd Al Assaad, Pierre Sfeir, Fouad Boulos, Ramy Mahfouz, Fadlo R. Khuri, Hady Ghanem, Fadi El Karak, Reem Akel, Rachelle Bejjany, Pierre Youssef, Alain Abi Ghanem, Fadi Farhat, Bassem Youssef, Hanine Atwi, Ibrahim Khalifeh
Rok vydání: 2020
Předmět:
Male
0301 basic medicine
Oncology
Cancer Research
medicine.medical_specialty
Lung Neoplasms
Time Factors
medicine.medical_treatment
Adenocarcinoma of Lung
Antibodies
Monoclonal
Humanized
oncogenic drivers
lcsh:RC254-282
immune checkpoint inhibitors
Avelumab
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Carcinoma
Non-Small-Cell Lung
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Radiology
Nuclear Medicine and imaging
Stage (cooking)
Pneumonectomy
Neoadjuvant therapy
Aged
Neoplasm Staging
Original Research
Aged
80 and over
Cisplatin
Chemotherapy
business.industry
Clinical Cancer Research
Middle Aged
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Neoadjuvant Therapy
Progression-Free Survival
Carboplatin
Gemcitabine
030104 developmental biology
Pemetrexed
chemistry
030220 oncology & carcinogenesis
Female
business
nonsmall cell lung cancer
medicine.drug
Zdroj: Cancer Medicine
Cancer Medicine, Vol 9, Iss 22, Pp 8406-8411 (2020)
ISSN: 2045-7634
DOI: 10.1002/cam4.3456
Popis: Multiple randomized studies have shown that combination of chemotherapy and immune checkpoint inhibitors (ICIs) leads to better response rates and survival as compared to chemotherapy alone in the advanced stage of NSCLC. Data suggesting a benefit to using ICIs in the neoadjuvant therapy of patients with early stage NSCLC are emerging. Eligible subjects were treatment naïve patients with stage IB, II, and resectable IIIA NSCLC. Patients received three cycles of neoadjuvant chemotherapy with four doses of avelumab every 2 weeks. Patients with squamous cell cancer received cisplatin or carboplatin on day 1 and gemcitabine on days 1 and 8 of each cycle of chemotherapy. Patients with nonsquamous histology received cisplatin or carboplatin with pemetrexed on day 1 of each cycle. Patients then proceeded to their planned surgery. Out of 15 patients accrued as part of stage 1 of the study, four had a radiologic response (1 complete response), lower than the minimum of six responses needed to continue to phase 2 of the study. The study was therefore terminated. Majority had adenocarcinoma histology and stage IIIA disease. The treatment was well tolerated with no unexpected side effects. Four patients (26.7%) had grade III/IV CTCAE toxicity. This study confirms that the preoperative administration of chemotherapy and avelumab is safe. There was no indication of increased surgical complications. The benefit of adding immunotherapy to chemotherapy did not appear to enhance the overall response rate of patients in the neoadjuvant setting in patients with resectable NSCLC because this study failed to meet its primary endpoint.
In this clinical trial, patients with resectable early stage non‐small cell lung cancer received a combination of neoadjuvant chemotherapy with avelumab, an anti‐PD‐L1 monoclonal antibody. The study found that there were no increased surgical complications. Also, the benefit of adding immunotherapy to chemotherapy did not appear to enhance the overall response rate of patients in the neoadjuvant setting in patients with resectable NSCLC because this study failed to meet its primary endpoint.
Databáze: OpenAIRE
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