SEOUL — Across the two groups in the TAISHAN-302 study, 96.2% had systemic disease and 34.4% had a history or presence of brain metastases at baseline. A total of 393 patients (87.1%) in the TAISHAN-302 study had received previous anti-PD-L1 or anti-PD-1 therapy.

48.8% of patients in the TAISHAN-302 study had platinum-resistant disease. The median follow-up was 9.2 months in the TAISHAN-302 study.

At the data-cutoff date, the median duration of treatment was 7.2 months in the tambotatug pelitecan group and 2.3 months in the topotecan group in the TAISHAN-302 study. 71 patients (31.6%) in the tambotatug pelitecan group and eight patients (3.5%) in the topotecan group were still receiving the assigned treatment at the data-cutoff date in the TAISHAN-302 study.

Treatment with risvutatug rezetecan reduced the risk of death by 54% compared to topotecan (HR 0.46, 95% CI 0.35-0.62, P<0.0001) in the ARTEMIS-008 study. In the ARTEMIS-008 study, median progression-free survival was 7.2 months with risvutatug rezetecan versus 3.0 months with topotecan (HR 0.33, 95% CI 0.25-0.42).

Serious treatment-related adverse events occurred in 34.3% of patients treated with risvutatug rezetecan and 37.5% with topotecan in the ARTEMIS-008 study. Adverse events leading to dose reductions occurred in 20.4% of patients in the risvutatug rezetecan group and 38.0% in the topotecan group in the ARTEMIS-008 study.

Adverse events leading to treatment discontinuation occurred in 9.1% of the risvutatug rezetecan group and 4.2% of the topotecan group in the ARTEMIS-008 study. Mehmet Altan reported the LONESTAR trial results at the World Conference on Lung Cancer in Seoul, South Korea.

In the overall randomized population of the LONESTAR trial, median overall survival was 52.8 months with nivolumab/ipilimumab alone compared with 43.2 months with local consolidative therapy plus nivolumab/ipilimumab (HR 1.14; 95% CI, 0.75-1.74; P=.54). Median progression-free survival was 24.3 months with nivolumab/ipilimumab alone versus 31.3 months with local consolidative therapy plus nivolumab/ipilimumab in the overall LONESTAR trial population (HR 0.79; 95% CI, 0.54-1.15; P=.22).

Seventy-seven patients had oligometastatic disease at randomization in the LONESTAR trial. A post-hoc analysis demonstrated a link between mediastinal radiation and increased lymphopenia in the local consolidative therapy arm of the LONESTAR trial.

Survival in metastatic non-small cell lung cancer did not improve with the addition of sacituzumab govitecan to pembrolizumab in the EVOKE-03 trial. Median progression-free survival in the EVOKE-03 trial improved from 7.7 months with pembrolizumab alone to 11.8 months with sacituzumab govitecan, but the difference did not meet prespecified criteria for statistical significance.

Disease control rate favored the combination of sacituzumab govitecan and pembrolizumab (83.3% vs 73.1%) in the EVOKE-03 trial. Duration of response was 21.3-21.4 months in both treatment groups in the EVOKE-03 trial.

Why It Matters

The TAISHAN-302 and ARTEMIS-008 studies demonstrate that antibody-drug conjugates can extend survival in relapsed small-cell lung cancer compared to standard chemotherapy. The hazard ratios for death reduction were identical at 0.46 for both tambotatug pelitecan and risvutatug rezetecan against topotecan.

These results contrast with findings in non-small cell lung cancer, where the addition of sacituzumab govitecan to pembrolizumab did not improve overall survival in the EVOKE-03 trial. The LONESTAR trial also found no survival benefit from adding local consolidative therapy to immunotherapy in metastatic non-small cell lung cancer.

What's New

A study titled "Anti-PD-1/PD-L1 Therapy for Non-Small-Cell Lung Cancer: Toward Personalized Medicine and Combination Strategies" was published in 2018 in Journal of Immunology Research. Giannis Mountzios reported the EVOKE-03 trial results at the World Conference on Lung Cancer in Seoul, South Korea.

How Sources Differ

Anne Chiang predicted that antibody-drug conjugates will become the new second-line treatment for relapsed small-cell lung cancer within the next 2 to 5 years.