John Heymach, MD, PhD, Discusses the Use of Adjuvant Immunotherapy for Patients With NSCLC

At the 2021 American Society of Clinical Oncology Annual Meeting, CancerNetwork® spoke with John Heymach, MD, PhD, of The University of Texas MD Anderson Cancer Center in Houston, to discuss the use of adjuvant immunotherapy in the IMpower010 trial (NCT02486718),¹ as well as previous studies such as ADURA (NCT02511106) and CheckMate 816 (NCT02998528), in patients with non–small cell lung cancer (NSCLC).

IMpower010 aimed to determine if disease-free survival was extended in patients treated with adjuvant platinum-based chemotherapy followed by adjuvant atezolizumab versus best supportive care in patients with early-stage resected disease.

Transcript:

This is really a landmark study because for the first time, we can say that adjuvant immunotherapy reduces the likelihood of recurrences in resected, non–small cell lung cancer. If you couple this with the earlier ADURA study that showed benefit for targeted therapies in the EGFR-mutant population with osimertinib [Tagrisso], now for the first time in the past year or 2, you can see that we’re moving towards precision-guided therapies in the adjuvant setting.² We’re going to start stratifying patients based on their genomic driver and potentially getting targeted therapies like osimertinib, or if they don’t have a targetable mutation then using immunotherapy, in the adjuvant setting. There are also promising results to the CheckMate 816 study, with neoadjuvant nivolumab [Opdivo] and chemotherapy that was reported earlier as well.³ That wasn't recurrence-free or disease-free survival that was reported; that was just pathologic response rate. We believe that also correlates with benefit. That was with neoadjuvant chemotherapy plus nivolumab followed by just nivolumab in the neoadjuvant setting. We can see the space really rapidly evolving. I think it’s very exciting for patients with lung cancer where there’s going to be multiple choices. I expect in the near future different types of adjuvant therapy including immunotherapy for those without driver alterations [to become available]. I expect we’re [going to] have traces of both neoadjuvant and adjuvant therapy, or just adjuvant therapy alone, when all these different phase 3 trials readouts that are ongoing right now.

References

1. Wakelee H, Altorki N, Zhou C, et al. IMpower010: Primary results in a phase III global study of atezolizumab versus best supportive care after adjuvant chemotherapy in resected stage IB-IIIA non-small cell lung cancer (NSCLC). J Clin Oncol. 2021;39(suppl 15):8500. doi: 10.1200/JCO.2021.39.15_suppl.8500

2. Wu YL, Tsuboi M, He J, et al. Osimertinib in Resected EGFR-Mutated Non-Small-Cell Lung Cancer. N Engl J Med. 2020;383(18):1711-1723. doi:10.1056/NEJMoa2027071

3. Neoadjuvant Opdivo (nivolumab) Plus Chemotherapy Significantly Improves Pathologic Complete Response in Patients with Resectable Non-Small Cell Lung Cancer in Phase 3 CheckMate -816 Trial. News release. Bristol Myers Squibb. April 10, 2021. Accessed July 19, 2021. https://bit.ly/3kyTjG1