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Sep 11 • 4 tweets • 3 min read
Dr. Silvia Novello presents 5y update on KEYNOTE 407 (platinum plus tax and +/- pembrolizumab for 1L squamous NSCLC #ESMO22
With longer follow up, OS favors pembrolizumab arm with mOS 17.2 vs 11.6m (OS HR 0.71) in squamous NSCLC. 5y OS rate 18.4% vs 9.7%. PFS benefit (HR 0.62) and higher RR across PDL1 strata. #ESMO22
For patients who complete 2y of pembrolizumab, 3y OS rate (after completing 2y pembro) was 70% - though not all of those patients are cured (44% were alive without PD or subsequent therapy). #ESMO22
No new safety signals including in subset with 2y of pembrolizumab therapy. Reaffirms SOC and refreshing to see long term benefit in subset of patients. Efforts now focusing on identifying who those patients are and how we can provide that benefit to more / all patients! #ESMO22

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More from @StephenVLiu

Stephen V Liu, MD Profile picture
Sep 11
Dr. @marinagarassino presents 5-year efficacy and safety update of KEYNOTE-189 (1L carboplatin plus pemetrexed +- pembrolizumab in non-squamous NSCLC) #ESMO22
KEYNOTE 189 is our SOC and has shown a consistent benefit including improving OS even with a crossover rate of 57%. #ESMO22
KEYNOTE 189 shows sustained OS benefit with longer follow up and a 5y OS rate of 18.4% with an OS HR of 0.60. Better PFS and OS also observed. Benefit across PDL1 strata. No new safety signals . #ESMO22
Read 5 tweets
Stephen V Liu, MD Profile picture
Sep 11
Dr. Baohui Han presents SUNRISE: randomized phase II study of sintilimab (PD1) and anlotinib (anti-angiogenic TKI) in metastatic NSCLC. #ESMO22
Study design here shows randomization to first-line sintilimab + anlotinib or chemo (with sintilimab at progression). Some concerns about randomization to chemotherapy without immunotherapy in a modern day study. #ESMO22
Baseline characteristics show a fairly high proportion of never smokers. SUNRISE excluded EGFR, ALK, and ROS1 - would like details on testing methods and presence of other drivers. More pts with brain and liver metastases in the sintilimab + anlotinib arm. #ESMO22
Read 5 tweets
Stephen V Liu, MD Profile picture
Sep 11
Dr. @LauraMezquitaMD discusses the DESTINY-Lung02 data at #ESMO22
Trastuzumab deruxtecan (T-DXd) is an antibody drug conjugate (ADC) targeting #HER2 and in DESTINY-Lung01, RR was encouraging at 55% but some concern for toxicity (adjudicated drug-related ILD in 26% of cases). #ESMO22
In DESTINY-Lung02, we have a randomization of pts with #HER2 mt NSCLC (with prior therapy) to the 6.4 mg/kg dose used in DESTINY-Lung01 or a lower, 5.4 mg/kg dose. RR higher at 5.4 (due to maintained intensity from less tox? or imbalance in baseline characteristics?) #ESMO22
Read 5 tweets
Stephen V Liu, MD Profile picture
Sep 11
Dr. Koichi Goto starts the lung mini oral session with results from DESTINY-Lung02 of the recently approved trastuzumab deruxtecan in #HER2 NSCLC #ESMO22
DESTINY-Lung02 compared two doses of trastuzumab deruxtecan (T-DXd) in #HER2 previously treated NSCLC (5.4 mg/kg vs 6.4 mg/kg): RR 58% and DoR 8.7m at the lower dose compared to 43% at 6.4 mg/kg. #ESMO22
Importantly- interstitial lung disease much less frequent at the 5.4 mg/kg dose (5.9%, only 1 case of G3). This is the FDA approved dose of trastuzumab deruxtecan in #HER2 NSCLC #ESMO22
Read 4 tweets
Stephen V Liu, MD Profile picture
Sep 11
Discussant Dr. @NReguart reminds us of the heterogeneity of stage III NSCLC and our teaching has been to determine resectability before treatment. The INCREASE study starts to challenge that. #ESMO22
The difference here is radiation and in T3/T4 NSCLC, local control is so critical. Largely unexplored to date. The INCREASE study explores quad-modality therapy and the results were quite impressive. High pCR rates and seen across PDL1 strata, not just in PDL1 high. #ESMO22
#ESMO22 High G3 TRAE rates but note that use of platinum + etoposide was common and many of these may have been paper toxicities. Any grade pneumonitis only 11% (note radiation dose was usually 50 Gy).
Read 4 tweets
Stephen V Liu, MD Profile picture
Sep 11
Dr. Eddie Garon presents data from CANOPY-A - adjuvant canakinumab for resected NSCLC #ESMO22
Canakinumab in the CANTOS study was associated with a reduction in NSCLC incidence. Led to CANOPY-A: large study of adjuvant canakinumab after surgery and chemotherapy for NSCLC. #ESMO22
Adjuvant canakinumab did not improve DFS (HR 0.939). CANOPY-A clearly a negative study. #ESMO22
Read 5 tweets

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