Patients with stage 1–3 non-small cell lung cancer (NSCLC) given a combination immunotherapy prior to surgery (neoadjuvant) had a better major pathological response (10% or less residual cancer) when the cancer was removed than those who took a single immunotherapy agent alone, according to results of a novel multicenter phase 2 NeoCOAST platform trial that included two investigators from the Johns Hopkins Kimmel Cancer Center and its Bloomberg-Kimmel Institute for Cancer Immunotherapy.
Reviewed by Megan Craig, M.Sc.Sep 14 2023 The results were published online Sept. 14 in Cancer Discovery, a journal of the American Association for Cancer Research.
Among participants, 27 patients received durvalumab alone, 21 received durvalumab plus oleclumab, 20 received durvalumab plus monalizumab, and 16 received durvalumab plus danvatirsen. Treatment was administered over a four-week period prior to surgery. Major pathological response rates were seen in 11.1% of patients receiving durvalumab alone ; in 19% of patients receiving durvalumab plus oleclumab ; and in 30% of patients receiving durvalumab plus monalizumab .
There's a whole host of novel immunotherapy agents being developed in lung cancer and other tumor types for advanced disease, but the evaluation of those drugs for treatment of earlier-stage disease has been very slow. The trial was successful, and demonstrated that patients who received the novel combinations of durvalumab with monalizumab and durvalumab with oleclumab had higher levels of response, where the tumor had regressed by the time of surgery.
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