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ELCC 2024 Updates
Key Updates in Lung Cancers From the ELCC 2024 Annual Meeting

Released: May 03, 2024

Expiration: May 02, 2025

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Key Takeaways
  • In the PACIFIC-2 trial, starting durvalumab with chemoradiotherapy followed by durvalumab consolidation did not improve outcomes but did increase early toxicity in patients with unresectable stage III NSCLC.
  • Consistent with other trials of immunotherapy-based regimens in NSCLC, perioperative tislelizumab did not affect surgical outcomes in RATIONALE-315, and patient-reported outcomes supported first-line cemiplimab plus chemotherapy plus ipilimumab in EMPOWER-Lung 3 Part 1.
  • Tarlatamab, a DLL3-targeted bispecific T-cell engager under FDA review, was associated with a notable median overall survival of 17.5 months in patients with pretreated advanced SCLC enrolled on the phase I DeLLphi-300 trial.

At the 2024 European Lung Cancer Congress (ELCC), important results were reported from multiple clinical trials of non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC). In this focused commentary, Luis Paz-Ares, MD, PhD, and Zofia Piotrowska, MD, highlight their most important abstracts, which we cover as a part of CCO’s Independent Conference Coverage of ELCC 2024.

Notable studies in early NSCLC include:

  • An analysis reporting minimal effects on surgical outcomes when the PD-1 inhibitor tislelizumab was added to neoadjuvant chemotherapy in the phase III RATIONALE-315 trial (abstract 108O). Earlier, this trial demonstrated that tislelizumab plus neoadjuvant chemotherapy followed by adjuvant tislelizumab significantly improved the pathologic complete response rate and event-free survival in patients with resectable stage II-IIIA NSCLC.
  • Negative late-breaking final results of the phase III PACIFIC-2 trial (abstract LBA1). In patients with unresectable stage III NSCLC, starting durvalumab with chemoradiotherapy followed by durvalumab consolidation did not improve progression-free survival or overall survival (OS) but did increase early toxicity compared with placebo plus chemoradiotherapy followed by placebo consolidation. Standard of care in this setting continues to be the PACIFIC regimen of chemoradiotherapy alone followed by durvalumab consolidation.

Notable studies in advanced NSCLC and SCLC include:

  • Improved patient-reported outcomes with first-line cemiplimab plus ipilimumab and chemotherapy vs chemotherapy alone from the phase III EMPOWER-Lung 3 Part 1 trial (abstract 64P). Earlier, this trial demonstrated that the cemiplimab-based combination significantly improved OS vs chemotherapy alone in patients with advanced NSCLC and PD-L1 expression <50%.
  • A prespecified analysis of the phase III FLAURA2 trial that showed benefit in postprogression outcomes and numerical improvement in OS when intensifying first-line osimertinib by adding platinum-based chemotherapy in patients with NSCLC harboring EGFR exon 19 deletion or L858R mutation (abstract 4O). Positive progression-free survival data from this trial led to FDA approval of the combination regimen.
  • Safety and pharmacokinetic results from a phase Ib PALOMA study cohort treated once monthly with a novel subcutaneous formulation of amivantamab being investigated as an alternative to the currently approved intravenous formulation (abstract 6MO). This EGFR-MET bispecific antibody is approved by the FDA in combination with carboplatin/pemetrexed for first-line treatment and is approved by the FDA and European Medicines Agency as monotherapy for later-line treatment of advanced NSCLC with EGFR exon 20 insertion.
  • A long-term analysis of the large phase I DeLLphi-300 trial evaluating tarlatamab, an investigational bispecific T-cell engager targeting DLL3. Tarlatamab was associated with a notable median OS of 17.5 months in 152 patients with pretreated advanced SCLC, including one fourth with stable, treated brain metastases at baseline (abstract 195MO). Only 1 patient experienced neurotoxicity, which was grade 1. Almost 60% of patients experienced cytokine-release syndrome, but these events were all grade 1/2. Tarlatamab is under FDA review in this setting based on phase II data from DeLLphi-301.

Remember to Check the CCO Website!
Remember to check back on the CCO website for downloadable slidesets summarizing these individual studies and for a CME-certified online text module featuring comprehensive expert analysis of how the new data will affect clinical practice in Europe and the United States.

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