Emerging Evidence from Landmark Clinical Trials on Perioperative Immunotherapy in Resectable Non-Small Cell Lung Cancer

Article Sidebar

PDF Download
Published Oct 31, 2022
DOI: https://doi.org/10.18103/mra.v10i10.3190

Downloads

Download data is not yet available.

Submit your own article

Register as an author to reserve your spot in the next issue of the Medical Research Archives.

Author Registration

Join the Society

The European Society of Medicine is more than a professional association. We are a community. Our members work in countries across the globe, yet are united by a common goal: to promote health and health equity, around the world.

Join Europe’s leading medical society and discover the many advantages of membership, including free article publication.

Membership

Main Article Content

Emily M. Mackay, MD, MSc
Division of Thoracic Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada
Anna L. McGuire, MD, MSc
Division of Thoracic Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada; Division of Thoracic Surgery, Department of Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada; Vancouver Coastal Health Research Institute, Vancouver General Hospital, Vancouver, BC, Canada

Abstract

Non-small cell lung cancer (NSCLC) remains one of the most prevalent cancers worldwide, with high rates of local and distant recurrence limiting survival even after curative-intent surgical resection. Traditional adjuvant chemotherapy benefits only 5% of patients, and as such additional treatment modalities are urgently needed to improve NSCLC patient outcomes. Systemic therapy with PD1 and PDL1 immune check-point inhibitors (ICIs) has emerged as a promising treatment option in many types of solid malignancies, including lung cancer. Encouraging results from immunotherapy trials in metastatic lung cancer populations, and now newer results from ongoing clinical trials in early stage locally advanced lung cancers, suggested an evolving role for perioperative immune checkpoint inhibition in resectable NSCLC. In this review we examine the latest advances in the landscape of clinical trials on immunotherapy in resectable NSCLC. We discuss the key findings and specific clinical challenges related to neoadjuvant administration of these immune therapies in the CheckMate816, Impower030, AEGEAN and KEYNOTE671 phase III clinical trials. The role of adjuvant ICI is also discussed examining the ANVIL, Impower010, and PEARLS trials. By understanding the remaining unanswered questions and clinical dilemmas that exist in this rapidly evolving field for ICIs in early stage NSCLC, clinicians may provide patients options which may markedly improve survival outcomes for this life-threatening disease.

Article Details

How to Cite
MACKAY, Emily M.; MCGUIRE, Anna L.. Emerging Evidence from Landmark Clinical Trials on Perioperative Immunotherapy in Resectable Non-Small Cell Lung Cancer. Medical Research Archives, [S.l.], v. 10, n. 10, oct. 2022. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/3190>. Date accessed: 23 nov. 2024. doi: https://doi.org/10.18103/mra.v10i10.3190.
ABNT APA BibTeX CBE EndNote - EndNote format (Macintosh & Windows) MLA ProCite - RIS format (Macintosh & Windows) RefWorks Reference Manager - RIS format (Windows only) Turabian
Issue
Vol 10 No 10 (2022): October issue VOl.10 Issue 10
Section
Research Articles

The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.

 

References

1. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. A Cancer Journal for Clinicians. 2021;71(3):209-249.
2. Suster DI, Mino-Kenudson M. Molecular Pathology of Primary Non-small Cell Lung Cancer. Archives of Medical Research . 2020;51(8):784-798.
3. Bade BC, dela Cruz CS. Lung Cancer 2020: Epidemiology, Etiology, and Prevention. . Clinics in Chest Medicine. 2020;41(1):1-24.
4. Arriagada R, de Radiomedic-Ina I, Santiago C;, et al. Cisplatin-Based Adjuvant Chemotherapy in Patients with Completely Resected Non-Small-Cell Lung Cancer The Writing Committee for the International Adjuvant Lung Cancer Trial (IALT). NEJM. Vol 350.; 2004. www.nejm.org.
5. Topalian SL, Taube JM, Pardoll DM. Neoadjuvant checkpoint blockade for cancer immunotherapy. Science (1979). 2020;367(6477). doi:10.1126/science.aax0182.
6. Wang C, Qiao W, Jiang Y, et al. The landscape of immune checkpoint inhibitor plus chemotherapy versus immunotherapy for advanced non-small-cell lung cancer: A systematic review and meta-analysis. J Cell Physiol. 2020;235(5):4913-4927. doi:10.1002/jcp.29371.
7. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Non-Small Cell Lung Cancer. NCCN Guidelines Version 3.
8. Lee JM, Tsuboi M, Brunelli A. Surgical Perspective on Neoadjuvant Immunotherapy in Non-Small Cell Lung Cancer. Annals of Thoracic Surgery. Published online 2021. doi:10.1016/j.athoracsur.2021.06.069.
9. Forde PM, Chaft JE, Smith KN, et al. Neoadjuvant PD-1 Blockade in Resectable Lung Cancer. New England Journal of Medicine. 2018;378(21):1976-1986. doi:10.1056/nejmoa1716078.
10. NADIM II: Neo-Adjuvant Immunotherapy (NADIMII). ClinicalTrials.gov Identifier: NCT03838159.
11. A Study of Atezolizumab as Neoadjuvant and Adjuvant Therapy in Resectable Non-Small Cell Lung Cancer (NSCLC) - Lung Cancer Mutation Consortium (LCMC3). ClinicalTrials.gov Identifier: NCT02927301.
12. Study of ctDNA as Prognostic Factor on Resectable Stage IIIA NSCLC Patients Treated With Neoadjuvant Treatment (REAL-NADIM). ClinicalTrials.gov Identifier: NCT05382052.
13. A Neoadjuvant Study of Nivolumab Plus Ipilimumab or Nivolumab Plus Chemotherapy Versus Chemotherapy Alone in Early Stage Non-Small Cell Lung Cancer (NSCLC) (CheckMate 816). ClinicalTrials.gov Identifier: NCT02998528.
14. A Study of Neoadjuvant Atezolizumab Plus Chemotherapy Versus Placebo Plus Chemotherapy in Patients With Resectable Stage II, IIIA, or Select IIIB Non-Small Cell Lung Cancer (IMpower030). ClinicalTrials.gov Identifier: NCT03456063 .
15. A Study of Neoadjuvant/Adjuvant Durvalumab for the Treatment of Patients With Resectable Non-small Cell Lung Cancer (AEGEAN). ClinicalTrials.gov Identifier: NCT03800134.
16. Efficacy and Safety of Pembrolizumab (MK-3475) With Platinum Doublet Chemotherapy as Neoadjuvant/Adjuvant Therapy for Participants With Resectable Stage II, IIIA, and Resectable IIIB (T3-4N2) Non-small Cell Lung Cancer (MK-3475-671/KEYNOTE-671). ClinicalTrials.gov Identifier: NCT03425643.
17. A Study of Neoadjuvant Chemotherapy Plus Nivolumab Versus Neoadjuvant Chemotherapy Plus Placebo, Followed by Surgical Removal and Adjuvant Treatment With Nivolumab or Placebo for Participants With Surgically Removable Early Stage Non-small Cell Lung Cancer. ClinicalTrials.gov Identifier: NCT04025879.
18. Comparing the Efficacy and Safety of a New Additional Treatment With Tislelizumab in Non-Small Cell Lung Cancer (NSCLC). ClinicalTrials.gov Identifier: NCT04379635.
19. National Cancer Institute (NCI). Nivolumab After Surgery and Chemotherapy in Treating Patients With Stage IB-IIIA Non-small Cell Lung Cancer (An ALCHEMIST Treatment Trial) (ANVIL). ClinicalTrials.gov.
20. Study to Assess Safety and Efficacy of Atezolizumab (MPDL3280A) Compared to Best Supportive Care Following Chemotherapy in Patients With Lung Cancer [IMpower010]. ClinicalTrials.gov Identifier: NCT02486718.
21. Study of Pembrolizumab (MK-3475) vs Placebo for Participants With Non-small Cell Lung Cancer After Resection With or Without Standard Adjuvant Therapy (MK-3475-091/KEYNOTE-091) (PEARLS). ClinicalTrials.gov Identifier: NCT02504372.
22. Canadian Cancer Trials Group. Double Blind Placebo Controlled Controlled Study of Adjuvant MEDI4736 In Completely Resected NSCLC. ClinicalTrials.gov Identifier: NCT02273375.
23. Niu M, Yi M, Li N, Luo S, Wu K. Predictive biomarkers of anti-PD-1/PD-L1 therapy in NSCLC. Exp Hematol Oncol. 2021;10(1). doi:10.1186/s40164-021-00211-8.