CheckMate -9LA临床试验数据积极!欧狄沃(纳武利尤单抗)联合伊匹木单抗及有限疗程化疗显著提高一线转移性非小细胞肺癌患者总生存

2020-05-14 MedSci MedSci

2020年5月13日,百时美施贵宝公布了III期临床研究CheckMate -9LA的首次报告结果。

2020年5月13日,百时美施贵宝公布了III期临床研究CheckMate -9LA的首次报告结果。结果显示,欧狄沃联合伊匹木单抗及两个周期的同步化疗,用于转移性非小细胞肺癌(NSCLC)患者一线治疗能够为其带来具有显著统计学意义及临床意义的生存获益。该研究达到了主要及关键次要研究终点。与单用化疗相比,双免疫联合化疗改善了患者的总生存期(OS)、无进展生存期(PFS)和客观缓解率(ORR)。
 
对主要研究终点总生存期(OS)的预设期中分析结果显示,随访最少8.1个月时,与单用化疗相比,欧狄沃联合伊匹木单抗及两个周期化疗能够使患者的死亡风险降低31% [Hazard Ratio (HR) 0.69, 96.71% Confidence Interval (CI): 0.55 to 0.87; p=0.0006]。 此外,在更长的随访期(最少12.7个月),与单用化疗相比,该联合治疗方式能够为患者带来持续的OS获益(中位OS:15.6个月vs 10.9个月, [HR 0.66,95%CI:0.55-0.80])。在关键的患者亚组中,无论患者PD-L1表达水平和肿瘤组织学类型(鳞癌或非鳞癌)如何,所有疗效评估均显示出临床获益。
 
欧狄沃(360mg,每3周一次)与伊匹木单抗(1 mg/kg,每6周一次)联合两个周期化疗的安全性特征与免疫治疗及化疗用于一线NSCLC治疗的已知安全事件谱一致。这些结果(摘要#9501)将于5月29日至31日在2020年美国临床肿瘤学会(ASCO)在线年会上进行口头报告。
 
CheckMate 9LA研究者、德国Grosshansdorf肺部研究中心胸部肿瘤科Martin Reck博士表示:“研究结果证实,纳武利尤单抗联合伊匹木单抗一线治疗非小细胞肺癌能够延长患者的生存期,而加入有限疗程化疗将有望降低疾病早期进展的风险。CheckMate 9LA的研究结果证实了双免疫联合两个周期的同步化疗能够为患者带来生存获益,在所有关键患者亚组中,我们在早期均观察到了生存获益,并且该获益在随访一年时仍在持续。随着数据越来越成熟,我认为生存获益将有望进一步提高。”
在随访最少12.7个月时,无论患者PD-L1表达水平如何,欧狄沃联合伊匹木单抗及有限疗程化疗均可改善患者的OS。在PD-L1 <1%的患者中,死亡风险降低38%(HR 0.62,95%CI:0.45-0.85);在PD-L1≥1%的患者中,死亡风险降低36%(HR 0.64,95%CI:0.50至0.82)。此外,在使用双免疫联合化疗的患者中,1年PFS率为33%,而在单用化疗的患者中,1年PFS仅为18%(HR 0.68,95%CI:0.57-0.82)。双免疫联合化疗组患者的ORR为38%,单用化疗患者的ORR为25%。
 
百时美施贵宝肿瘤临床开发副总裁Nick Botwood博士表示:“转移性非小细胞肺癌患者的情况不尽相同,面对庞大的患者群体,我们在研发时尽己所能提供多种潜在持久的治疗方案,以期为患者提供新的治疗选择。此次公布的CheckMate 9LA一年总生存期数据和CheckMate 227三年随访数据进一步证实了欧狄沃联合伊匹木单抗在非小细胞肺癌一线治疗中的临床价值,这也是在该领域首个双免疫治疗方案。” 
 
欧狄沃联合伊匹木单抗是两种免疫检查点抑制剂的独特组合,具有潜在的协同作用机制,针对两个不同的检查点(PD-1和CTLA-4)以帮助消灭肿瘤细胞:伊匹木单抗帮助激活和增殖T细胞,而欧狄沃有助于现有的T细胞发现肿瘤。伊匹木单抗激活的某些T细胞可以分化为记忆T细胞,从而有望实现长期的免疫反应。在欧狄沃和伊匹木单抗联合治疗的基础上,增加有限疗程的化疗有助于患者实现早期疾病控制。
 
注:伊匹木单抗尚未在中国上市

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  9. 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