Editor's note: At this 2023 WCLC, the first Oral Presentation Session (OA01: Advancing Immunotherapy in ES-SCLC), which released the results of multiple studies of immunotherapy for small-cell lung cancer. Dr. Noemi Reguart, Head of the Thoracic Oncology Unit at the Hospital Clinic Barcelona, Spain, served as review expert. At this 2023 WCLC in Singapore, We were very glad to interview Dr. Reguart to share her views on small cell lung cancer immunotherapy data and clinical concerns.
Dr. Noemí
Reguart interviewed by Oncology Frontier at the 2023
WCLC conference.
Oncology Frontier: Please introduce yourself, including your name, profession and where are you from?
Dr. Reguart: It is a pleasure to be here. I am Noemi Reguart. I am a medical oncologist, specializing in thoracic malignancies. I am Head of the Thoracic Oncology Unit at the Hospital Clinic Barcelona, Spain.
Oncology Frontier: In 2023, the WCLC released the results of multiple studies of immunotherapy for extensive-stage small-cell lung cancer, including Tislelizumab，BI 764532 and Benmelstobart plus Anlotinib plus chemotherapy. Please share your views on the research data.
Dr. Reguart: Today, at this World Conference of Lung Cancer 2023 here in Singapore, we have had very nice updates of new clinical trials in small cell lung cancer. We had the opportunity to discuss three or four very important trials. One of the trials that I have discussed is the Imbrella trial, which has been presented by Dr Steven Liu. He presented the five-year overall survival outcomes for patients with atezolizumab included in the extension of the observational study of Imbrella. This is very important, because it is the first time that we have seen patients with small cell lung cancer can reach five years of survival at a rate of 12%. Very important data. Also very important was the data we saw from two Chinese phase III trials. This is very important, because Chinese-developed therapeutics are earning an important place in the Chinese market, and hopefully, in the future, in the non-Chinese market. So there were two different phase III trials. Both trials were very positive. One of the trials explored a new PD-1 inhibitor, tislelizumab, with chemotherapy in the RATIONALE-312 trial. Another trial which was very interesting too, and a positive trial for overall survival, that Dr Cheng presented, the ETER701 trial, exploring anlotinib/benmelstobart and chemotherapy in patients with small cell lung cancer. For this trial, the results are astonishing. They demonstrated a median overall survival of 19 months for patients with small cell lung cancer, with really nice progression-free survival, which suggests that antiangiogenic therapies can have a role in patients with small cell lung cancer. Very nice phase III trials that bring forth the use of immunotherapy for patients with this disease.
Oncology Frontier: Patients with advanced non–small cell lung cancer (NSCLC) may be able to stop receiving immunotherapy at 2 years or continue ICI indefinitely after 2 years. Which of the two options do you think is better?
Dr. Reguart: This is a very debatable question. It depends who you are talking to. I could say stop at two years or to continue beyond two years. The first thing is it depends on what immunotherapy is being used. The pivotal trials that are the basis of the standard-of-care in the first-line setting suggest pembrolizumab can be stopped at two years. When you have the patient with you, you have to individualize, depending on their response and safety of the drug, and how the patient is feeling. So we must individualize our patients whether they want to stop at two years, or if they want to continue beyond two years. What I think is very important is if a patient has responded and has reached the two-year mark, the data that has been updated for chemotherapy in combination with immunotherapies, is that it is safe to stop, and the majority of patients after discontinuation of pembrolizumab at one-year continue to show response. So I guess you have to individualize patients, but based on the clinical trials, discontinuation of pembrolizumab after two years is a reasonable way of approaching patients.
: