ELCC 2024 Daily highlight 1

Dr Jo Raskin, thoracic oncologist at Antwerp University Hospital summarises the first mini oral session.

In ES-SCLC, the standard treatment involves platinum and etoposide with immunotherapy, based on the phase III CASPIAN trial. The LEAD trial investigated the potential of adding low-dose radiotherapy to enhance immune response. However, a potential confounding factor was the variable administration of radiotherapy during the trial. Despite this, indirect comparison showed improved median PFS and ORR compared to the Caspian trial.

The potent and highly selective oral MET TKI savolitinib was evaluated in patients with locally advanced or metastatic NSCLC harbouring METex14. Findings revealed an ORR of approximately 60% in treatment-naive patients and roughly 40% in previously treated individuals. These response rates align closely with those observed with other available MET inhibitors. While MET inhibition has received FDA approval for first-line treatment and EMA approval for second-line treatment, none of these drugs are currently accessible in Belgium.

The PAPILLON trial in patients with EGFR Ex20ins advanced NSCLC demonstrated a significant PFS improvement with the combination of amivantamab plus chemotherapy compared to chemotherapy alone. Additionally, post-progression outcomes unveiled at ELCC indicated extended durations of time to treatment discontinuation and subsequent systemic anticancer therapy. These outcomes collectively underscore the efficacy of this therapeutic approach for EGFR Ex20ins-mutant advanced NSCLC.

The BECOME study, conducted in a comparable patient population, investigated the combination of becotarug with osimertinib. Results revealed a notable ORR of 50%, coupled with favourable intracranial responses, indicating promising efficacy in this cohort. However, a significant concern associated with this combination is its observed toxicity, potentially restricting its applicability in clinical practice.

The primary results of the CHECKMATE 77T study were already presented at ESMO and showed a clear improvement of EFS in patients with resectable NSCLC who were treated with perioperative nivolumab. In an exploratory analyses, clinical outcomes by number of neoadjuvant treatment cycles were presented. Patients with resectable NSCLC had improved efficacy with perioperative nivolumab versus placebo whether they completed 4 or < 4 neoadjuvant cycles. Additionally, EFS, pCR and MPR rates remained consistent among patients who underwent definitive surgery, irrespective of the number of neoadjuvant cycles of nivolumab plus chemotherapy they received.