Dr. Sabari Discusses Role of Immunotherapy in SCLC

Joshua K. Sabari, MD
Published: Thursday, Jan 17, 2019



Joshua K. Sabari, MD, assistant professor of medicine, NYU Langone's Perlmutter Cancer Center, discusses the role of immunotherapy in the treatment of patients with small cell lung cancer (SCLC).

SCLC is a difficult disease, Sabari says. Frontline chemotherapy seems to work very well, with response rates in the order of 70% to 80%. Unfortunately, all patients will eventually relapse with chemotherapy-refractory disease. Until the past year, no changes had been made beyond that setting in over 2 decades.

The first drug approval in over 20 years came in August 2018, when single-agent nivolumab (Opdivo) was granted an accelerated FDA approval for the treatment of patients with SCLC with disease progression following platinum-based chemotherapy and 1 other line of therapy. Objective response rates were low, at approximately 10%, Sabari notes, but the checkpoint inhibitor was still approved.

Additionally, atezolizumab (Tecentriq) in combination with platinum-based therapy and etoposide could also become the standard of care in the frontline setting, based on data from the IMpower133 study. Results of this trial demonstrated an estimated 2.0-month improvement in overall survival for the atezolizumab arm. Although this is modest, it is a major advance for the field, Sabari explains. Additional immunotherapy combinations could be a part of future SCLC management.
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Joshua K. Sabari, MD, assistant professor of medicine, NYU Langone's Perlmutter Cancer Center, discusses the role of immunotherapy in the treatment of patients with small cell lung cancer (SCLC).

SCLC is a difficult disease, Sabari says. Frontline chemotherapy seems to work very well, with response rates in the order of 70% to 80%. Unfortunately, all patients will eventually relapse with chemotherapy-refractory disease. Until the past year, no changes had been made beyond that setting in over 2 decades.

The first drug approval in over 20 years came in August 2018, when single-agent nivolumab (Opdivo) was granted an accelerated FDA approval for the treatment of patients with SCLC with disease progression following platinum-based chemotherapy and 1 other line of therapy. Objective response rates were low, at approximately 10%, Sabari notes, but the checkpoint inhibitor was still approved.

Additionally, atezolizumab (Tecentriq) in combination with platinum-based therapy and etoposide could also become the standard of care in the frontline setting, based on data from the IMpower133 study. Results of this trial demonstrated an estimated 2.0-month improvement in overall survival for the atezolizumab arm. Although this is modest, it is a major advance for the field, Sabari explains. Additional immunotherapy combinations could be a part of future SCLC management.

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