Non-Small Cell Lung Cancer Combo Shows Promise in Early Trial

An early clinical trial found promising results for a new drug combination that stimulates the immune system to kill cancerous cells for patients with non-small cell lung cancer.

Tumor cells express a protein called PD-L1 that allows it to evade detection from the immune system. By binding to a receptor found on immune cells, PD-L1 activity is able to be downregulated.

During a study published in Lancet Oncology, researchers from Moffitt Cancer Center enrolled 102 patient with advanced non-small cell lung cancer to evaluate the efficiency, safety, and maximum tolerated dose of the drugs durvalumab and tremelimumab.

These experimental drugs are designed to block the PD-1/PD-L1 and CTLA-4 pathways. It also targets tumor cells by re-stimulating the immune system.

Durvalumab and tremelimumab have been used individually in other clinical studies of different tumor types, and have shown promising results. This caused researchers to hypothesize that combining them could prove to have beneficial outcomes.

The results of the study showed there was manageable toxicity along with anti-tumor activity in patients with non-small cell lung cancer.

Twenty-three percent of patients treated with the combination had a complete or partial response to the treatment regimen. Also, the combination therapy was active in patients with or without tumor expression of PD-L1.

"The results suggest that this combination has potential as a treatment option for patients with PD-L1-negative tumors whose needs are not addressed by current therapies, including immunotherapies," said co-lead study author Scott J. Antonia, MD, PhD. "It also reinforces the benefits of combination therapy in oncology."

The most common overall adverse events experienced during the trial were diarrhea, fatigue, and itching. While the most common high grade adverse events were diarrhea, colitis, and altered pancreas activity.

When given the immunosuppressive drugs, most of the toxicities could be reversed, according to the study.

Although the combined activity of durvalumab and tremelimumab were greater than when administered alone in previous studies, the data still needs to be confirmed in larger trials.