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ClinicalTrials & Tribulations

Approval of an immunotherapy for adjuvant NSCLC indication gives us new reasons for finding early-stage disease

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FDA’s recent approval of an immunotherapy in the adjuvant setting for stage II-IIIA non-small cell lung cancer makes it all the more urgent to detect lung cancer at early stages.

The IMpower010 study compared adjuvant atezolizumab to standard of care in patients with complete resected stage IB-IIIA. For patients with stage IIA-IIIB the study demonstrated significant improved disease-free survival (DFS) in patients within PD-L1 ≥1% (HR=0.66;0.50-0.88) and for all randomized patients (HR=0.79; 0.64-0.96). 

Most impressive was the difference in patients with high PD-L1 expression (≥ 50%) (HR=0.43; 0.27-0.68), while no difference was seen in patients with tumors having PD-L1<1%, HR=0.97 (0.72-1.31). The adjuvant immunotherapy was given after 1-4 series of adjuvant chemotherapy for complete resected early-stage NSCLC. 

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Byline
Fred R. Hirsch, MD, PhD
Executive director, Center for Thoracic Oncology, Mount Sinai Cancer, Mount Sinai Health System; Professor of medicine and pathology, Icahn School of Medicine; Joe Lowe and Louis Price Professor of Medicine, Associate director, Tisch Cancer Institute
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Executive director, Center for Thoracic Oncology, Mount Sinai Cancer, Mount Sinai Health System; Professor of medicine and pathology, Icahn School of Medicine; Joe Lowe and Louis Price Professor of Medicine, Associate director, Tisch Cancer Institute
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