Advertisement


Nagla Abdel Karim, MD, on Small Cell Lung Cancer: SWOG S1929 Results on Atezolizumab Plus Talazoparib

2023 ASCO Annual Meeting

Advertisement

Nagla Abdel Karim, MD, of the Inova Schar Cancer Institute, University of Virginia, discusses phase II data showing that maintenance atezolizumab plus talazoparib improved progression-free survival in Schlafen-11–selected patients with extensive-stage small cell lung cancer. This study demonstrated the feasibility of conducting biomarker-selected trials in this disease, paving the way for future evaluation of novel therapies in selected populations (Abstract 8504).



Transcript

Disclaimer: This video transcript has not been proofread or edited and may contain errors.
Small cell lung cancer is the most aggressive cancer amongst all types of lung cancer. We basically need to find better novel therapies, in addition to finding predictive biomarkers to select the best therapy for the appropriate patient population. We do know that PARP is highly expressed in small cell lung cancer and large cell neuroendocrine carcinoma tumors. And thus, PARP inhibition has been one of the promising novel agents to use. However, we also know that Schlafen-11 is a predictive biomarker. It has been shown by Dr. Byers and colleagues that PARP inhibitors have been noted to have improved outcome in patients with Schlafen-11 positive patients. Also, Talazoparib has been noted to be one of the most potent PARP inhibitors. We designed our study to enroll patients with Schlafen-11 positive small cell lung cancer in order that they can receive the standard of care induction therapy with platinum etoposide Atezolizumab. However, when it comes to the maintenance part, they were randomized into arm A where they would receive standard of care Atezolizumab versus Atezolizumab plus Talazoparib, which is a PARP inhibitor. Reason is because we wanted to utilize that the PARP inhibitors are going to act very well in patients with Schlafen-11 positive status, and also because they do have a synergism to immunotherapies like PD-L1 inhibitors like Atezolizumab. That was the concept of the study and the design, with the main primary objective of progression-free survival. The study actually achieved its primary endpoint, and primary objective was met, where patients with Schlafen-11 positive small cell lung cancer when treated with atezolizumab and Talazoparib, they had a median progression-free survival of 4.2 months compared to 2.8 months of patients on the control arm. Having said that, we mentioned that it is still a small study. It's a phase two study. This is a good signal into a predictive biomarker based therapy. But in addition, also, the feasibility of having a biomarker in small cell lung cancer is very, very promising. There were only seven days median time to obtain the results of Schlafen-11, which is very reasonable for patients to select their maintenance therapy. Having said that, also, I want to mention that we are going to work into the levels of Schlafen-11, where they have high expression or lower expression, in correlation with the clinical outcome. That's the next step. Another follow up part is that this study actually starts the wave of new concepts where we can design studies in small cell lung cancer towards personalized approach rather than all comers, which of course was very useful to see in non-small cell lung cancer. If we can implement this in small cell lung cancer and get even more predictive biomarkers with basically Schlafen-11, but also with the subtypes of small cell lung cancer, and other markers, we also heard about in our ASCO 2023, like Dll3 and so on. If we can combine all those efforts together as the next step, this will be one of the best next movements.

Related Videos

Issues in Oncology

Carmen E. Guerra, MD, MSCE, on Diversity, Equity, and Inclusion in Clinical Trials: Expert Commentary

Carmen E. Guerra, MD, MSCE, of the University of Pennsylvania Abramson Cancer Center, discusses three key abstracts presented at ASCO: strategies to increase accrual of underrepresented populations in Alliance NCTN trials, how patient-clinician education can strengthen partnerships and improve diversity in breast and lung cancer trials, and mediators of racial and ethnic inequities in clinical trial participation among U.S. patients with cancer from 2011 to 2022 (Abstracts 6509, 6510, 6511).

Colorectal Cancer

Sebastian Stintzing, MD, on Colorectal Cancer: Influence of Liquid Biopsy in First-Line Combination Treatment

Sebastian Stintzing, MD, of the Charité Universitätsmedizin Berlin, discusses results from the phase III FIRE-4 study, which showed that liquid biopsy is clinically relevant in verifying mutational status in patients with metastatic colorectal cancer and is efficacious in first-line treatment of FOLFIRI and cetuximab for patients with RAS wild-type disease (Abstract 3507).

Lymphoma

Tycel J. Phillips, MD, and Alex F. Herrera, MD, on DLBCL: New Data on ctDNA Status and Clinical Outcomes

Tycel J. Phillips, MD, and Alex F. Herrera, MD, both of the City of Hope National Medical Center, discuss findings from the POLARIX study, which provided the largest prospectively collected circulating tumor DNA (ctDNA) data set on patients with previously untreated diffuse large B-cell lymphoma. Achieving ctDNA-negative status was associated with improved outcomes when patients were treated with polatuzumab vedotin-piiq plus combination chemotherapy vs combination chemotherapy alone (Abstract 7523).

Lymphoma

Muhit Özcan, MD, on DLBCL: Now Recruiting Previously Untreated Patients for a Study of Zilovertamab Vedotin Plus Chemotherapy

Muhit Özcan, MD, of Turkey’s Ankara University School of Medicine, discusses waveLINE-007, a two-part study now recruiting in more than 20 locations, to determine the safety and recommended phase II dose of the antibody-drug conjugate zilovertamab vedotin in combination with R-CHP (rituximab, cyclophosphamide, doxorubicin, prednisone) in previously untreated patients with diffuse large B-cell lymphoma (DLBCL). Efficacy of this regimen will be investigated in the second half of the study (Abstract TPS7589).

Prostate Cancer

Alicia K. Morgans, MD, MPH, and Praful Ravi, MRCP, MBBChir, on Localized Prostate Cancer: Prognostic Impact of PSA Nadir

Alicia K. Morgans, MD, MPH, and Praful Ravi, MRCP, MBBChir, both of Dana-Farber Cancer Institute, discuss an individual patient-data analysis of randomized trials from the ICECAP collaborative. A PSA nadir of ≥ 0.1 ng/mL within 6 months after radiotherapy completion was prognostic for prostate cancer–specific, metastasis-free, and overall survival in patients receiving radiotherapy plus androgen-deprivation therapy for localized prostate cancer. These findings may help identify patients for therapy de-escalation trials (Abstract 5002).

Advertisement

Advertisement




Advertisement