Dr. Bunn on Immunotherapy Advances in Small Cell Lung Cancer

Paul A. Bunn Jr, MD, distinguished professor, Division of Medical Oncology/University of Colorado, James Dudley Chair in Lung Cancer Research, University of Colorado Denver, 2014 Giant of Cancer Care^® in Lung Cancer, discusses clinical data focusing on immunotherapy in patients with small cell lung cancer (SCLC).

The main immunotherapeutic agents being studied in this landscape are PD-1/PD-L1 inhibitors. One of the biomarkers that has been explored with this is PD-L1 expression, Bunn explains. This has been useful in non—small cell lung cancer; however, patients with SCLC tend to have lower levels of PD-L1 expression. Therefore, tumor mutational burden (TMB), which tends be high in patients with SCLC, could be a better biomarker especially for treatment with PD-1 inhibitors in combination with CTLA-4 inhibitors.

Clinical trials have shown efficacy with these agents, including the phase I/II CheckMate-032 trial which explored nivolumab (Opdivo) alone as well as nivolimab combined with ipilimumab (Yervoy). Patients who received the combination had an improvement in survival, especially if they had high levels of TMB, Bunn explains.

In April 2018, the FDA granted a priority review designation to a supplemental biologics license application for nivolumab for the treatment of patients with SCLC with disease progression following 2 or more lines of therapy, based on the CheckMate-032 findings.

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