Nivolumab plus erlotinib in patients with EGFR-mutant advanced NSCLC Journal Article
| Authors: | Gettinger, S.; Hellmann, M. D.; Chow, L. Q. M.; Borghaei, H.; Antonia, S.; Brahmer, J. R.; Goldman, J. W.; Gerber, D. E.; Juergens, R. A.; Shepherd, F. A.; Laurie, S. A.; Young, T. C.; Li, X.; Geese, W. J.; Rizvi, N. |
| Article Title: | Nivolumab plus erlotinib in patients with EGFR-mutant advanced NSCLC |
| Abstract: | Introduction: This phase I study evaluated nivolumab combined with erlotinib in patients with advanced EGFR-mutant NSCLC. Methods: Patients with advanced EGFR-mutant NSCLC who were EGFR tyrosine kinase inhibitor (TKI)–naive or TKI-treated but had not received chemotherapy were treated with nivolumab 3 mg/kg every 2 weeks and erlotinib 150 mg/d until disease progression or unacceptable toxicity. The primary objective was safety and tolerability. Results: Twenty patients with TKI-treated and one with TKI-naive EGFR-mutant NSCLC were treated with nivolumab plus erlotinib. Treatment-related grade 3 toxicities occurred in five patients (liver enzyme elevations, n = 2; diarrhea, n = 2; weight loss, n = 1), with no grade ≥4 toxicities. In the TKI-treated population, the objective response rate was 15% (3 of 20, including one complete response), and the 24-week progression-free survival rate was 48%. Responses lasted 13.8, 17.6, and 38.2 months per investigator records. A fourth patient had a nonconventional immune-related response lasting 12.5 months. Among these four patients, two were never-smokers and one each had 35– and <1-pack-year histories. Post-EGFR TKI pre-trial tumor biopsy specimens from these patients detected EGFR T790M mutations in two patients and MNNG HOS Transforming gene (MET) amplification in a third; two patients each had primary EGFR exon 19 deletions or L858R mutations. The TKI-naive patient, who had compound EGFR mutations (L858R and S768I) and ultimately achieved a complete response, had an ongoing response lasting more than 5 years based on investigator records. Conclusions: Nivolumab plus erlotinib was tolerable, with durable responses in patients with EGFR-mutant, TKI-treated NSCLC. © 2018 International Association for the Study of Lung Cancer |
| Keywords: | erlotinib; combination therapy; nivolumab; egfr-mutant nsclc; programmed death 1 axis inhibitor |
| Journal Title: | Journal of Thoracic Oncology |
| Volume: | 13 |
| Issue: | 9 |
| ISSN: | 1556-0864 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2018-09-01 |
| Start Page: | 1363 |
| End Page: | 1372 |
| Language: | English |
| DOI: | 10.1016/j.jtho.2018.05.015 |
| PROVIDER: | scopus |
| PUBMED: | 29802888 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 4 September 2018 -- Source: Scopus |
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