ASCO Expert Perspective
“These results confirm that the combination of immunotherapy and chemotherapy improves survival of patients with previously untreated advanced non-small-cell lung cancers that do not have driver mutations.”
– Maximilian Diehn, MD, PhD, ASCO Expert in Lung Cancer
Patients with advanced non-small cell lung cancer (NSCLC) without EGFR/ALK mutations who were treated with toripalimab plus first-line chemotherapy had better progression-free survival (PFS) and overall survival (OS) compared to patients who received chemotherapy alone, according to research from the CHOICE-01 trial. These data will be presented in an ASCO Plenary Series session on March 15, 2022, at 5:00 p.m. ET.
Researchers in China studied 465 patients with advanced NSCLC without EGFR/ALK mutations who had not yet undergone systematic treatment for metastatic disease. Patients were randomized 2:1 to receive toripalimab (309 patients) or placebo (156 patients) in combination with chemotherapy, followed by maintenance of toripalimab or placebo plus standard care until disease progression, intolerable toxicity, or completion of 2 years of treatment.
At the prespecified final PFS analysis, PFS was 8.4 months in the toripalimab arm compared to 5.6 months in the placebo arm. The 1-year PFS rate was 36.7% in the toripalimab arm and 17.2% in the placebo arm. At the interim OS analysis, median OS had not yet been reached in the toripalimab arm compared to 17.1 months in the placebo arm. The incidence of adverse events with a grade of 3 or higher was similar between the two arms. In the toripalimab arm compared to the placebo arm, there were more adverse events leading to discontinuation (14.3% vs. 5.5%) and more fatal adverse events (3.2% vs 2.6%).Patients with high tumor mutational burden had significantly better PFS in the toripalimab arm over the placebo arm (13.1 months compared to 5.5 months) and patients with mutations in the FA-PI3K-Akt pathway or IL-7 signaling pathways had significantly better PFS in the placebo arm (8.9 months compared to 4.2 months).
“Toripalimab plus chemotherapy represents a first-line treatment option for patients with advanced NSCLC without driver mutations,” said lead author Jie Wang from the National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College in Beijing, China.
This research was funded by Shanghai Junshi Biosciences.
View the disclosures for Dr. Diehn: https://coi.asco.org/share/3VV-SX36/Maximilian%20Diehn
View the Author Disclosures: https://coi.asco.org/Report/ViewAbstractCOI?id=362936
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