HCRN LUN13-175 recently had its findings published in The Oncologist. Led by Nisha Mohindra, MD of Northwestern, this trial was a phase I/II trial of carboplatin, Nab-paclitaxel, and pembrolizumab for advanced non-small cell lung cancer (NSCLC).

Historically, combination chemotherapy and immunotherapy regimens have significantly improved survival for patients with previously untreated advanced non–small cell lung cancer (NSCLC). The authors of the study noticed improvements in overall survival in two separate pembrolizumab trials have demonstrated survival improvements over chemotherapy alone, regardless of PD-L1 status. The optimal chemotherapy backbone for combination with immunotherapy is unknown.

The investigators hypothesized nab-paclitaxel may be a well-suited platinum partner to use in combination with checkpoint inhibitor therapy for both adenocarcinoma and squamous histology and conducted a phase I/II trial to assess the efficacy of this regimen in advanced NSCLC.

This study enrolled a total of forty-six patients. 14 patients in phase I and 32 patients in phase II, from June 2015 to July 2018. In the intention-to-treat population, the overall response rate was 35%, median progression-free survival was 5.6 months (95% CI, 4.6-8.2), and median overall survival was 15.4 months (CI, 12.4-28.1). There were no statistical differences in progression free survival or overall survival by PD-L1 status. The 2- and 3-year landmark overall survival rates were 33% and 24%, respectively.

This study found that carboplatin, nab-paclitaxel, and pembrolizumab are a safe and effective regimen for patients with both squamous and nonsquamous NSCLC. The authors note that although this study did not meet the prespecified endpoints, the median and landmark overall survival results are consistent with durable benefit of this regimen as seen in phase III trials for first-line treatment of advanced NSCLC.

Read the full article.

Authors: Ryan D Gentzler, Nisha A Mohindra, Shadia I Jalal, Karen L Reckamp, Richard D Hall, Nasser H Hanna, Young Kwang Chae, Marianna Koczywas, Irene B Helenowski, Jyoti D Patel

Institutions: Northwestern, City of Hope, University of Virginia Health Centers, IU Health Cancer Centers, IU Melvin and Bren Simon Comprehensive Cancer Center

About Hoosier Cancer Research Network:

Hoosier Cancer Research Network conducts innovative cancer research in collaboration with academic and community physicians and scientists across the United States. The organization provides comprehensive clinical trial management and support, from conception through publication. Created in 1984 as a program of the Walther Cancer Institute, Hoosier Cancer Research Network became an independent nonprofit clinical research organization in 2007. Since its founding, Hoosier Cancer Research Network has conducted more than 230 trials in a variety of cancer types and supportive care, resulting in more than 350 publications. More than 9,000 subjects have participated in Hoosier Cancer Research Network clinical trials.