Immunotherapy-Chemo Offers Survival Advantage in Low PD-L1 NSCLC

Adding durvalumab (Imfinzi) and tremelimumab to chemotherapy improved progression-free and overall survival in patients with metastatic, nonsquamous non-small cell lung cancer (NSCLC), according to the phase III POSEIDON trial presented at the virtual World Conference on Lung Cancer (WCLC).

Study author Melissa Johnson, MD, of the Sarah Cannon Research Institute in Nashville, Tennessee, discussed the clinical implications of her data.

Following is a transcript of her remarks:

I think this is a potential new addition to the armamentarium that we have to consider. As Dr. [Julie] Brahmer mentioned in her discussion, we tend to use PD-L1 to decide whether a patient will be best served with a monotherapy checkpoint approach or chemotherapy and checkpoint inhibitors.

In the subgroup analysis based on PD-L1 level, patients with all levels of PD-L1 with a cutpoint of 1% and a cutpoint of 50% benefited from the addition of immunotherapy to chemotherapy, in particular for PD-L1 high. But if you look for patients that received tremelimumab in combination with durvalumab plus chemo, that did lessen the hazard ratio in favor of more survival benefit for patients with PD-L1 low tumors.

So if I had to tell you what the clinical significance may be in my clinic, I could see using this regimen for patients with PD-L1 low expression of their lung cancer.