2019 Lung Cancer Fall Preview - Episode 9

Expanding the NSCLC Armamentarium: IMpower131


Mark Kris, MD: We have been very excited about the use of T-cell checkpoint inhibitors in the treatment of lung cancers, and what we have seen is for those patients who have a very high degree of expression of PD-L1 [programmed death-ligand 1], the benefits are greatest. And for many of those people who have very high expression of PD-L1, a checkpoint inhibitor by itself can be used. That, unfortunately, is a minority of patients. What we have also seen is that when you combine a checkpoint inhibitor with traditional cytotoxic chemotherapy, a platinum-based regimen with a taxane or with pemetrexed, you see benefit for a broader group of patients. Also, what you see is a higher rate of response, so when patients have symptoms of their lung cancer—be it a cough, or pain, or whatever—by giving chemotherapy and a checkpoint inhibitor, more of those patients have benefit.

We now have at least 1 drug in this space, pembrolizumab, with chemotherapy. We now are looking at this trial, the IMpower131 trial, using atezolizumab, another checkpoint inhibitor, with chemotherapy. It’s a slightly different chemotherapy program here, carboplatin and paclitaxel, really a mainstay of therapy with chemotherapy across the world. So what’s exciting about this trial is that there is another regimen combining T-cell checkpoint inhibitor with chemotherapy. And what we’re hoping here is to see even higher rates of response, more durable response as well, and also a greater amount of time before the cancer grows back. Having more drugs and more combinations of drugs to broaden the benefit of checkpoint inhibitors is absolutely critical. And this trial has the potential to give us more information about that.

Transcript Edited for Clarity