There was quite impressive survival in this third-line or more cohort of patients, with a median survival in the strongest PD-L1–expressing patients that is clearly going to exceed 1 year.— Michael Boyer, MBBS, PhD
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“This drug [durvalumab] clearly shows activity in the third-line and beyond setting, and the higher the programmed cell death ligand 1 (PD-L1) expression, the higher the response rate,” noted Michael Boyer, MBBS, PhD, Chief Clinical Officer and Conjoint Chair of Medical Oncology (Thoracic Oncology), at the Chris O’Brien Lifehouse, Sydney, New South Wales, Australia. “There was similarly quite impressive survival if you bear in mind this is a third-line or more cohort of patients, with a median survival in the strongest PD-L1–expressing patients that is clearly going to exceed 1 year.”
“It would appear that the cohort 3 patients have slightly higher rates of toxicity, and in some ways this should not be surprising,” he added. “These patients did the best and had the greatest exposure to treatment.” In this study, more exposure to the drug led to more adverse events, and this is of relevance when considering the duration of treatment.
“For me, perhaps the biggest question about these data relates to the emerging data on first- and second-line use of this class of drugs,” concluded Dr. Boyer. “Clearly, the best performers in this study were the ones with the highest PD-L1 expression, but we know these are the very patients who in the future are likely to be receiving these drugs as part of their first-line treatment. Therefore, the future relevance of third- and fourth-line treatment is hard to determine.” ■
Disclosure: Dr. Boyer has received research funding and/or honoraria paid to his institution from Pfizer, Roche, Eli Lilly, Merck Sharpe and Dohme, Bristol-Myers Squibb, AstraZeneca, and Clovis.
Objective response rate was higher in patients whose tumors were PD-L1–high (≥ 25% tumor cells). However, the benefit spans all subgroups, and it is independent of the line of treatment.— Marina Garassino, MD
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