Many tumor patients will find the corresponding patient group, in the face of the same experience, many topics are more "empathetic" and can be well talked about. But lung CA groups tend to be "dull".
A mainland 2003-2015 statistics show that the five-year survival rate of breast cancer patients can reach 82%; colorectal cancer is 56.9%; esophageal cancer and stomach cancer are 30.3% and 35.1%, respectively; lung cancer is only 19.7%, which is a high incidence and a very low clinical cure rate.
How can we better prolong the overall survival (OS) of lung cancer patients? Targeted and PD-1 immunotherapy see some light. Domestic lung cancer immunotherapy began with the approval of navuliyuzumab (Odivo) in 2018 for the second-line treatment of squamous non-small cell lung cancer. Subsequently, it includes atezizumab, pambolizumab, carolizumab, tirelizumab, sindilizumab, sugli maclizumab and so on have been approved. How effective are so many immunotherapy drugs on lung cancer treatment? Xiaobian sorted out the data of various trials this year to help you identify it.
Immune monotherapy versus chemotherapy monotherapy (docetaxel) second-line treatment
The results of the chemotherapy drug monotherapy versus PD-1 drug monotherapy trial are the earliest "introductory" trials of immunotherapy entering non-small cell lung cancer, and so far there are four drugs compared with docetaxel.
Navuliyu monoclonal antibody Checkmate017
and Checkmate057 trial
These two are comparative trials of non-small cell lung squamous cell carcinoma versus non-small cell lung non-squamous cell carcinoma versus docetaxel.
Second-line therapy in patients with non-small cell squamous cell carcinoma
Using navuliyuzumab and docetaxel, the gap in the five-year overall survival rate is significant, 12.3% and 3.6%, respectively.
Second-line therapy in patients with non-small cell non-squamous cell carcinoma
Using navuliyuzumab and docetaxel, the gap in the five-year overall survival rate widened further to 14% and 2.1%.
Regardless of PD-L1 expression, patients are guaranteed to benefit in terms of overall survival.
In a Checkmate-078 trial for domestic patient populations, compared with chemotherapy drugs. Three-year follow-up data resulted in an increase in survival rate from 12% to 19%
Drug offer information
Guangzhou Taihe Cancer Hospital Navuliyumab injection
Price: about 7400 yuan / stick 100mg / 10ml
About 3670 yuan / stick 40mg/4ml
Enquiries: 010 - 5957 5778
RATIONAL-303 is a domestic PD-1 drug tirelizumab in a trial in non-small cell lung cancer, the current trial has a two-year survival of the result of nearly 40%.
The OAK study, which is the PD-L1 drug atenizumab, has seen an overall four-year survival rate of 15.5% for patients when applied to second-line therapy.
KEYNOTE-010 is a study of pambolizumab, the data here are relatively early, divided into PD-L1 high expression (≥50%) and PD-L1 low expression (1% to 49%) two conditions, of which the three-year overall survival rate at high expression reached 34.5%, compared with 22.9% at low expression.
Immune monotherapy versus chemotherapy monotherapy effects
PD-1 immunotherapy began to penetrate into first-line therapy after gaining a second-line advantage.
The first to be approved is pambolizumab
Let's look at the atenizolizumab Impower-110
Empower-lung1 study with cimiprillimab
Impower-110 was shown in people with high PD-L1 expression, with atenizumab reaching a median OS of 20.2 months in patients with high PD-L1 expression, compared with a median OS of only 13.1 months in patients treated with chemotherapy controls.
Empower-lung1 also selected people with high PD-L1 expression, with a median overall survival (OS) of cimiprizumab of 22 months and chemotherapy of 14 months.
Immune monotherapy first-line treatment of non-small cell lung cancer, the benefit is more pronounced in patients with high PD-L1 expression
First-line effect of immunotherapy combined with chemotherapy
How can the first-line treatment of non-small cell lung cancer with PD-1 immune monotherapy further improve the survival of patients? The more classic combination treatment regimen is a mature idea.
Still pambolizumab, KEYNOTE189
and KEYNOTE407 test
In the KEYNOTE189 trial, pambolizumab combined with chemotherapy versus pambolizumab monotherapy.
The 2-year overall survival rates were 45.7% and 27.3%, respectively.
The KEYNOTE407 trial included an expanded study of patients with non-small cell lung squamous cell carcinoma in China. Parbolizumab + carboplatin + paclitaxel / albumin paclitaxel was compared with placebo + carboplatin + paclitaxel / albumin paclitaxel.
The results showed that the median OS in the pambolizumab combined chemotherapy group and the chemotherapy group were 17.3 months vs 12.6 months, respectively.
Two domestic immunotherapy drugs Camel-sq
and GEMSTONE-302 test results
Camel-sq was a controlled trial of carellizumab or placebo combined with carboplatin and paclitaxel, respectively, and the results showed that the median OS in the carrelizumab plus chemotherapy group reached 27.4 months and the chemotherapy group was 15.5 months. Combination therapy prolongs survival for nearly 1 year, with an overall OS survival rate of 42.8% at 3 years.
GEMSTONE-302 is a sugli maculizumab plus carboplatin and paclitaxel versus placebo plus carboplatin and paclitaxel for non-small cell squamous cell squamous carcinoma, and schugli monoclonal antibody plus carboplatin and pemetrexed with placebo plus carboplatin and pemetrexed for non-small cell non-squamous cell carbicinoma, respectively.
As of 2020, OS data are not yet mature, but the suglizumab combination group has shown an overall survival benefit compared with the placebo combination group.
Atenizumab combined with chemotherapy in the first line of therapy
Impower-130 and Impower-132 trials
Choice-01 trial and Origin-11 trial results
The Choice-01 trial was a terepliumab plus standard first-line chemotherapy versus placebo-plus chemotherapy by 2020 when data were released showing that the median OS, the treplelimab group had not been reached, compared with a placebo of 17.1 months.
Orient-11, a combination of cindilizumab injection or placebo combined with pemetrexed and platinum, showed that the median OS remained unattainable as of the beginning of last year, with a median OS of 16.8 months in the control group.
Combination therapy with PD-1 and CTLA-4 immunotherapy
The dual immunotherapy trial uses A combination of PD-1 drugs and CTLA-4 drugs, which is expected to achieve better results by further inhibiting the escape pathway of cancer cells and promoting immune cells to be more "active".
CheckMate227 trial of navuliyumab plus ipilimumab
KEYNOTE-598 test of pambolizumab plus ipicumab
KEYNOTE-598 study of pambolizumab with the addition of the CTLA-4 inhibitor epilimumab compared to the pabolizumab monotherapy plus placebo, the results of this trial showed that combined use did not improve progression-free survival PFS and overall survival OS in patients.