A regimen of pre-surgical immunotherapy and chemotherapy followed by post-surgical immunotherapy significantly improved event-free survival (EFS) and pathologic complete response (pCR) rates compared to chemotherapy alone for patients with operable non-small cell lung cancer (NSCLC), according to Phase III trial results presented today by researchers from The University of Texas MD Anderson Cancer Center at the American Association for Cancer Research (AACR) Annual Meeting 2023.
The AEGEAN trial evaluated durvalumab given perioperatively, meaning therapy is given both before and after surgery. Participants on the trial received either pre-surgical (neoadjuvant) durvalumab and platinum-based chemotherapy followed by post-surgical (adjuvant) durvalumab or neoadjuvant placebo and chemotherapy followed by adjuvant placebo.
These represent the first data presented on the benefits of perioperative immunotherapy for resectable NSCLC and adds to the growing evidence supporting the benefits of both neoadjuvant and adjuvant immunotherapy for these patients.
Our goal is to increase cures for lung cancer. Throughout decades of research with adjuvant and neoadjuvant chemotherapy, we only succeeded in increasing cures by around 5%. This one study alone has the potential to increase that percentage significantly, and we look forward to many more improvements going forward.”John Heymach, M.D., Ph.D., principal investigator, chair of Thoracic/Head & Neck Medical Oncology at MD Anderson
Of the patients receiving perioperative durvalumab, 17.2% had a pCR compared to just 4.3% of those receiving chemotherapy alone. At the first interim analysis of EFS, with a median follow-up of 11.7 months, the median EFS was 25.9 months in the placebo arm, but it had not yet been reached in the durvalumab arm.
These data correspond to a 32% lower chance of patients experiencing disease recurrence, progression events or death with the immunotherapy-based treatment when compared to chemotherapy alone. Approximately four times as many patients treated with perioperative durvalumab plus chemotherapy achieved a pCR when compared to those treated with chemotherapy alone.