Meagan Miller, Nasser Hanna, Shadia Jalal, Salma K Jabbour, Robin Zon, Goetz Kloecker, Michael Williamson, Karen Reckamp, Ebenezer Kio, Robert Langdon, Bamidele Adesunloye, Ryan Gentzler, Wael Harb, Radhika Walling, Christina Yeon, Marianna Koczywas and Greg Durm
Indiana University Simon Cancer Center, Indianapolis, USA Department of Biostatistics, Indiana University, Indianapolis, USA Fort Wayne Medical Oncology and Hematology, Fort Wayne, USA Rutgers Cancer Institute of New Jersey, New Brunswick, USA Michiana Hematology-Oncology, South Bend, USA University of Louisville, Louisville, USA IU Health Ball Cancer Center, Muncie, USA City of Hope Comprehensive Cancer Center, Duarte, USA Goshen Center for Cancer Care, Goshen, USA Nebraska Methodist Hospital, Omaha, USA IU Health Arnett Cancer Center, Lafayette, USA University of Virginia Cancer Center, Charlottesville, USA Horizon Oncology Research, Lafayette, USA Community Regional Cancer Care, Indianapolis, USAFulltext PDF
Despite the improved survival rates with consolidation PD-1/PD-L1 inhibitors after CRT, patients still experience disease recurrence. To date, there is no reported data about the efficacy of subsequent treatments, including re-treatment with checkpoint inhibitors, at the time of progression in this patient population. HCRN LUN 14-179 was a phase II, single-arm, multi-center trial which enrolled patients with stage III NSCLC who had received CRT (cisplatin/pemetrexed, carboplatin/paclitaxel, or cisplatin/etoposide + range 59.4 Gy to 66.6 Gy) of 92 total patients. A total of 37 (40%) participants developed progressive disease. Of those, 24 went on to receive subsequent therapy. 19/24 received chemotherapy only with response rates similar to those reported in a similar population of patients with stage IV disease. 6/24 were re-trialed with immunotherapy at some point . Of those receiving subsequent immunotherapy, 5/6 had progressive disease as their best response; however, a patient receiving 2nd line Pembrolizumab achieved a partial response. Re-challenging patients with a PD-1 inhibitor may be reasonable to consider if the patient had disease progression after completing 1 year of consolidation immunotherapy.
Stage III NSCLC; Consolidation immunotherapy; Salvage therapy
Miller M, Hanna N, Jalal S, Jabbour SK, Zon R, Kloecker G, et al. Post-Progression Therapy after Chemoradiation and Consolidation Pembrolizumab: An Analysis from the Hoosier Cancer Research Network LUN 14-179 Phase 2 Clinical Trial. Ann Integr Oncol. 2020; 1(2): 1009..