Immunotherapy for Small Cell Lung Cancer (SCLC)
Immunotherapy for Small Cell Lung Cancer (SCLC)
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Immunotherapy for Small Cell Lung Cancer (SCLC)
- December 9, 2016
- Read time: 2 minutes
This article presents the latest results from a Phase 1/2 clinical trial (CheckMate-032) by Bristol Myers Squibb, evaluating combination therapy with Opdivo (nivolumab) and Yervoy for small cell lung cancer (SCLC) patients.
Both Opdivo and Yervoy are immune checkpoint inhibitors—Opdivo is a PD-1 antibody and Yervoy is a CTLA-4 antibody. Their combination has been established for melanoma, while Opdivo has shown efficacy for non-small cell lung cancer (NSCLC). This study focuses on small cell lung cancer, as reported in CheckMate-032. The trial is a non-blinded clinical study examining efficacy and safety for patients with advanced or metastatic solid tumors, using either Opdivo alone or in combination with Yervoy. Notably, the trial includes both PD-L1 positive and negative patients.
A total of 217 patients participated. The conclusions are as follows—for readers who wish to continue:
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Response rate: Opdivo + Yervoy combination achieved 25% versus 11% for Opdivo monotherapy, with three complete responses (CR) in the combination arm.
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Two-year survival rate: 30% for combination therapy versus 17% for Opdivo monotherapy.
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While this data is published, it does not yet establish whether combination therapy or Opdivo monotherapy should be the treatment standard.
This treatment approach shows a response rate of 11% for Opdivo monotherapy and 25% for combination therapy. Regardless of previous platinum resistance or prior treatment exposure, three patients in the combination arm achieved complete response. Grade 3-4 adverse events (Opdivo vs. combination) included fatigue (1% vs. 0%), diarrhea (0% vs. 5%), nausea (0% vs. 2%), pruritus (0% vs. 2%), and rash (0% vs. 5%). Treatment discontinuation occurred in 4% versus 10% of patients. Two deaths were reported in the combination arm (renal failure and myasthenia gravis), and one in the monotherapy arm.
The study was conducted at Memorial Sloan Kettering Cancer Center, with Dr. Matthew D. Hellmann (M.D.) leading the research:
"Small cell lung cancer is highly aggressive and progresses rapidly—most patients experience recurrence within one year of diagnosis. Over the past thirty years, systemic chemotherapy has made limited progress. The CheckMate-032 trial demonstrates that Opdivo and Yervoy combination achieves a 25% response rate in SCLC patients, with a two-year survival rate of 30%. This represents an important new treatment option for SCLC. The combination of Opdivo and Yervoy provides valuable information for patient care."
Note: Opdivo = Nivolumab
Original source: http://www.bms.co.jp/press/pdf/20161207.pdf
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