“Also encouraging is that [Tecentriq] was generally well tolerated,” said Herbst, who is also associate cancer center director for translational research at the Yale Cancer Center in New Haven, Conn. “Side effects for patients were similar to those seen in other trials of the drug, which has been approved for treatments of several types of cancer.”
The trial also assessed how Tecentriq performed among patients with a “high tumor mutational burden,” which means that they had high levels of genetic mutations in scraps of cancer DNA detected in blood tests. In some types of cancers, high mutational burden is tied to better responses to immunotherapy drugs like Tecentriq.
“Among these patients with NSCLC, those with high tumor mutational burden who received [Tecentriq] showed improved progression-free survival of seven months versus four months for those given chemotherapy,” Herbst said. “This finding suggests that the [blood] biomarker should be explored further.”
For her part, Seetharamu noted that “there are many commercially available and experimental drugs that target PD-L1.” And she noted that the study did have one flaw.
Tecentriq “was compared to platinum-based chemotherapy alone, which is now not the most common standard treatment,” Seetharamu pointed out. Instead, oncologists are increasingly using standard chemotherapy plus another type of immunotherapy drug, Keytruda.
The new study didn’t present a head-to-head comparison of Tecentriq against chemotherapy-plus-Keytruda, however.
“That is understandable,” Seetharamu said, “since the study started before these new treatments made it into common clinical practice.”
Regardless, she said, “the overall survival of 20 months in selected patients with high PD-L1 expression treated with Tecentriq alone is impressive and may provide yet another non-chemotherapy treatment option for patients diagnosed with PD-L1-high lung cancer.”