Dr. Reinmuth on Findings from the MYSTIC Study

Niels Reinmuth, MD, PhD, leader of the Thoracic Oncology Department, of the Asklepios Lung Clinic, discusses the results of the phase III MYSTIC study (NCT02453282), which evaluated the efficacy and safety of first-line durvalumab (Imfinzi) plus tremelimumab versus platinum-based chemotherapy in patients with metastatic non—small cell lung cancer.

Overall survival was analyzed in subgroups based on baseline clinical characteristics. Unfortunately, there was no single clinical characteristic identified. Although durvalumab was effective across all subgroups, it was not found to be statistically significant. This was predetermined, says Reinmuth, because there were 3 primary endpoints.

However, it appears that subsequent immunotherapy might have impaired the overall survival (OS) benefit of durvalumab in the first-line. About two-thirds of patients crossed over to receive a form of immunotherapy, although durvalumab was not permitted as a cross-over option. If statistical methods are applied, it appears that this subsequent immunotherapy may have led to improved outcomes in the chemotherapy-treated group.

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