Expert discussion between Dr Brandao and Dr Roch: CheckMate 77T

The ESMO 2023 conference featured exciting data on lung cancer, including insights from the CheckMate 77T trial. The study was presented by Prof Tina Cascone, from the Department of Thoracic, Head and Neck Medical Oncology at The University of Texas MD Anderson Cancer Center, Houston

CheckMate 77T is a perioperative study that combines immunotherapy with chemotherapy before surgery and includes adjuvant immunotherapy. An interim analysis revealed impressive results, with significantly improved event-free survival in the interventional group compared to the traditional arm. At 18 months, an absolute difference of 20% between the two arms was observed. The pathological complete response (PCR) rate reached a remarkable 25%.

Although CheckMate 77T has yet to provide overall survival data, it suggests a signal indicating potential complete responses and longer survival. Further mature data is needed to confirm these promising trends. A comparison with purely neoadjuvant regimens, especially for patients achieving PCR, will be valuable to assess the necessity of additional immunotherapy.

The combined chemotherapy and immunotherapy regimen in CheckMate 77T did not reveal new safety signals. Adverse events were consistent with expectations, primarily associated with chemotherapy and immunotherapy. The safety profile appears favourable. Approximately 20% of patients in both arms did not proceed to surgery, a rate consistent with other perioperative trials.

Conclusion:

CheckMate 77T presents compelling evidence for the efficacy of perioperative immunotherapy in lung cancer, showing substantial improvements in event-free survival and PCR rates. While awaiting mature overall survival data, the results suggest the potential for complete responses and extended survival. The safety profile is reassuring, and future comparisons with neoadjuvant regimens will provide valuable insights into treatment strategies for these patients.