Imfinzi May Be Better in a Combination for Advanced Lung Cancer

Imfinzi alone is the standard of care in this patient population, however two combinations may have better outcomes.

Imfinzi combined with either oleclumab or monalizumab improved objective response rates (the rate of measurable tumor shrinkage as a result of treatment) and progression-free survival (average time from treatment until disease progression) in patients with unresectable, stage 3 non-small cell lung cancer.

Additionally, no new side effects were observed compared with the standard of care, Imfinzi alone, according to recent phase 2 study results.

Imfinzi alone has been shown to improve overall survival and is already standard of care when treating patients with unresectable stage 3 non-small cell lung cancer.

“Despite progression, additional work remains to further improve outcomes for this patient population,” the authors wrote in the study, which was published in the Journal of Clinical Oncology. “Therefore, immunotherapy combination strategies that build upon the (Imfinzi) standard of care are being explored to expand the number of patients who respond and remain progression free.”

Researchers evaluated if Imfinzi alone (66 patients), or in combination with either oleclumab (59 patients) or monalizumab (61 patients) would have better outcomes.

A total of 186 patients were included in the study, and at a median follow up of 11.5 months the objective response rate was higher with Imfinzi plus oleclumab (30%) and Imfinzi plus monalizumab (35.5%), compared to Imfinzi alone (17.9%).

Progression-free survival was also improved in the combination groups, with 12-month rates of 62.6% and 72.7% with oleclumab and monalizumab, respectively. Imfinzi alone had a 12-month progression-free survival rate of 33.9%.

“In addition, (progression-free survival) benefit was observed with both combinations across a range of clinically important subgroups including histology, ECOG (performance status) and prior platinum-based chemotherapy, although the patient numbers in these subgroups were small,” the authors added.

Severe or worse side effects were similar across all groups occurring in 40.7%, 27.9% and 39.4% of patients in the Imfinzi plus oleclumab, Imfinzi plus monalizumab and Imfinzi alone groups, respectively. The most common side effects included cough, shortness of breath, pneumonitis, weakness and pruitus.

“A larger study will be required to better understand any differences in the incidences of specific (side effects) and immune-related (side effects) across the different combinations versus Imfinzi alone.

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