FDA Approves Nivolumab for Certain Patients With Previously Treated Small Cell Lung Cancer

Excerpt:

“Today, nivolumab (Opdivo) received approval from the U.S. Food and Drug Administration (FDA) for patients with metastatic small cell lung cancer (SCLC) whose cancer has progressed after platinum-based chemotherapy and at least one other line of therapy. Approval for this indication has been granted under accelerated approval based on overall response rate and duration of response.

“This approval for nivolumab had been granted Priority Review from the FDA. It was based on data from the SCLC cohort of the ongoing phase I/II CheckMate-032 study evaluating nivolumab monotherapy in patients who experienced disease progression after platinum-based chemotherapy.”

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PARP Inhibitor Improves Overall Response Rates in Small Cell Lung Cancer Patients

Excerpt:

In a randomized, Phase II trial led by researchers at The University of Texas MD Anderson Cancer Center, adding the PARP inhibitor veliparib to a standard chemotherapy agent improved overall response rates (ORR) in patients with small cell lung cancer (SCLC). Researchers also identified a select group of patients—those whose tumors expressed SLFN11— who also saw a progression-free survival (PFS) and overall survival (OS) benefit, suggesting a promising biomarker for the PARP-inhibitor sensitivity in SCLC.

“The study was published in Journal of Clinical Oncology. Ongoing follow-up studies are underway to confirm the results, which could result in the first new therapeutic option for this rare and aggressive lung cancer in more than three decades, said Lauren Averett Byers, M.D., associate professor of Thoracic/Head and Neck Medical Oncology.”

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FDA Grants Opdivo Priority Review for Small Cell Lung Cancer

Excerpt:

“The FDA has granted a priority review to a supplemental biologics license application (sBLA) for Opdivo (nivolumab) for the treatment of patients with small cell lung cancer (SCLC) with disease progression following two or more lines of therapy, according to Bristol-Myers Squibb, the manufacturer of the PD-1 inhibitor.

“The sBLA is based on data from the phase 1/2 CheckMate-032 trial, in which single-agent Opdivo led to a median overall survival (OS) of 4.4 months and a one-year OS rate of 33 percent in patients with progressive SCLC following one or more prior lines of therapy. Under the priority review, the FDA is scheduled to make its decision by Aug. 16, 2018.”

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Trilaciclib Reduces Chemotherapy-Induced Myelosuppression in Small Cell Lung Cancer

Excerpt:

“Trilaciclib appeared associated with reduced chemotherapy-induced myelosuppression and was well tolerated among patients undergoing first-line therapy for extensive-stage small cell lung cancer, according to results from a double-blind, placebo-controlled phase 2 trial.

“Trilaciclib (G1 Therapeutics) is a short-acting CDK4/6 inhibitor that preserves hematopoietic stem cells and enhances immune system function — myelopreservation — during chemotherapy.”

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Opdivo Alone or Combined with Yervoy Shows Encouraging Response and Survival Rates in Recurrent Small Cell Lung Cancer Patients with High Tumor Mutation Burden, in Exploratory Analysis from Phase 1/2 Study CheckMate -032

Excerpt:

Bristol-Myers Squibb Company (NYSE:BMY) today announced data evaluating Opdivo (nivolumab) and Opdivo plus Yervoy (ipilimumab) in previously treated small cell lung cancer (SCLC) patients whose tumors were evaluable for tumor mutation burden (TMB), from the Phase 1/2 CheckMate -032 trial. The primary objective of this trial was objective response rate (ORR) as assessed by a blinded independent central review (BICR), for which results were previously presented; in the pooled intent-to-treat (ITT) population (n=401), the ORR was 11% with Opdivo alone and 22% with the combination. Among the ITT population, 211 (53%) patients had an evaluable TMB result for these analyses and were divided into subgroups of high, medium and low levels of TMB.”

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Pembrolizumab Shows Promise in Small Cell Lung Cancer

Excerpt:

“Pembrolizumab (Keytruda) induced an overall response rate (ORR) of 33% in patients with extensive-stage small cell lung cancer (SCLC), according to findings from the open-label, phase Ib KEYNOTE-028 trial published in the Journal of Clinical Oncology.

“One patient (4.2%) experienced a complete response, 7 (29.2%) had partial responses, and 1 (4.2%) had stable disease for less than 6 months. Thirteen patients (54.2%) experienced disease progression as the best overall response.”

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Maintenance Pembrolizumab Benefits Certain Patients With Small Cell Lung Cancer

Excerpt:

“Improvements in OS, but not PFS, indicate that maintenance treatment with pembrolizumab may benefit a subset of patients with small cell lung cancer, and biomarkers are needed to identify individuals in whom pembrolizumab may be effective, according to findings presented at the ASCO Annual Meeting.

” ‘The standard of care for these patients – 4 to 6 cycles of platinum plus etoposide – has not changed in the United States in the last 30 years,’ Shirish Gadgeel, MD, of the Karmanos Cancer Institute in Detroit, said during a presentation. ‘Despite a high response rate with this therapy, overall outcomes for these patients are quite poor. There is a need to identify other agents that can provide benefit in these patients.’ ”

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Proton-Beam Therapy in Limited-Stage SCLC Shows Promising Efficacy

Excerpt:

“Proton-beam therapy (PBT) was found to be safe for patients with limited-stage (LS) small-cell lung cancer (SCLC) in the first prospective registry study of the therapy, with only a small number of high-grade toxicities.

” ‘Radiation therapy is essential for the management of limited-stage SCLC,’ wrote study authors led by Jean-Claude M. Rwigema, MD, of the Hospital of the University of Pennsylvania in Philadelphia. ‘When it is given with concurrent chemotherapy, radiation therapy can result in substantial toxicities.’ PBT can reduce the exposure to nearby organs at risk in non–small-cell lung cancer, and is under substantial investigation in that setting; before the new study, though, only a six-patient case series had examined its use in SCLC.”

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Video: Nivolumab With Ipilimumab for Small Cell Lung Cancer

Excerpt:

“Matthew D. Hellmann, MD, medical oncologist, Memorial Sloan Kettering Cancer Center, discusses the CheckMate-032 study, which explored nivolumab (Opdivo) with or without ipilimumab (Yervoy) for patients with small cell lung cancer (SCLC).”

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