Neoadjuvant nivolumab with or without relatlimab in resectable non-small-cell lung cancer: a randomized phase 2 trial

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Martin Schuler - , Universität Duisburg-Essen, Nationales Zentrum für Tumorerkrankungen (NCT) West (Autor:in)
  • Kristof Cuppens - , Jessaziekenhuis, Hasselt University (Autor:in)
  • Till Plönes - , Klinik und Poliklinik für Viszeral- Thorax- und Gefäßchirurgie, Universität Duisburg-Essen, Universitätsklinikum Essen, Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)
  • Marcel Wiesweg - , Universität Duisburg-Essen, Nationales Zentrum für Tumorerkrankungen (NCT) West (Autor:in)
  • Bert Du Pont - , Jessaziekenhuis (Autor:in)
  • Balazs Hegedus - , Universität Duisburg-Essen (Autor:in)
  • Johannes Köster - , Universität Duisburg-Essen, Nationales Zentrum für Tumorerkrankungen (NCT) West (Autor:in)
  • Fabian Mairinger - , Universität Duisburg-Essen (Autor:in)
  • Kaid Darwiche - , Universität Duisburg-Essen, Nationales Zentrum für Tumorerkrankungen (NCT) West (Autor:in)
  • Annette Paschen - , Universität Duisburg-Essen (Autor:in)
  • Brigitte Maes - , Jessaziekenhuis (Autor:in)
  • Michel Vanbockrijck - , Jessaziekenhuis (Autor:in)
  • David Lähnemann - , Universität Duisburg-Essen (Autor:in)
  • Fang Zhao - , Universität Duisburg-Essen (Autor:in)
  • Hubertus Hautzel - , Universität Duisburg-Essen, Nationales Zentrum für Tumorerkrankungen (NCT) West (Autor:in)
  • Dirk Theegarten - , Universität Duisburg-Essen (Autor:in)
  • Koen Hartemink - , Antoni van Leeuwenhoek Hospital (Autor:in)
  • Henning Reis - , Universität Duisburg-Essen, Universitätsklinikum Frankfurt (Autor:in)
  • Paul Baas - , Antoni van Leeuwenhoek Hospital (Autor:in)
  • Alexander Schramm - , Universität Duisburg-Essen (Autor:in)
  • Clemens Aigner - , Universität Duisburg-Essen, Medizinische Universität Wien (Autor:in)

Abstract

Antibodies targeting the immune checkpoint molecules PD-1, PD-L1 and CTLA-4, administered alone or in combination with chemotherapy, are the standard of care in most patients with metastatic non-small-cell lung cancers. When given before curative surgery, tumor responses and improved event-free survival are achieved. New antibody combinations may be more efficacious and tolerable. In an ongoing, open-label phase 2 study, 60 biomarker-unselected, treatment-naive patients with resectable non-small-cell lung cancer were randomized to receive two preoperative doses of nivolumab (anti-PD-1) with or without relatlimab (anti-LAG-3) antibody therapy. The primary study endpoint was the feasibility of surgery within 43 days, which was met by all patients. Curative resection was achieved in 95% of patients. Secondary endpoints included pathological and radiographic response rates, pathologically complete resection rates, disease-free and overall survival rates, and safety. Major pathological (≤10% viable tumor cells) and objective radiographic responses were achieved in 27% and 10% (nivolumab) and in 30% and 27% (nivolumab and relatlimab) of patients, respectively. In 100% (nivolumab) and 90% (nivolumab and relatlimab) of patients, tumors and lymph nodes were pathologically completely resected. With 12 months median duration of follow-up, disease-free survival and overall survival rates at 12 months were 89% and 93% (nivolumab), and 93% and 100% (nivolumab and relatlimab). Both treatments were safe with grade ≥3 treatment-emergent adverse events reported in 10% and 13% of patients per study arm. Exploratory analyses provided insights into biological processes triggered by preoperative immunotherapy. This study establishes the feasibility and safety of dual targeting of PD-1 and LAG-3 before lung cancer surgery. ClinicalTrials.gov Indentifier: NCT04205552.

Details

OriginalspracheEnglisch
Seiten (von - bis)1602-1611
Seitenumfang10
FachzeitschriftNature medicine
Jahrgang30
Ausgabenummer6
PublikationsstatusVeröffentlicht - Juni 2024
Peer-Review-StatusJa

Externe IDs

PubMed 38689060

Schlagworte

Ziele für nachhaltige Entwicklung

Schlagwörter

  • Humans, Carcinoma, Non-Small-Cell Lung/drug therapy, Nivolumab/therapeutic use, Female, Male, Middle Aged, Lung Neoplasms/drug therapy, Neoadjuvant Therapy, Aged, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Lymphocyte Activation Gene 3 Protein, Adult, Antibodies, Monoclonal, Humanized/therapeutic use, Antigens, CD, Aged, 80 and over