KEY TAKEAWAYS
- A phase 1 atezolizumab and varlilumab combo with radiation in patients with metastatic NSCLC.
- The study found the varlilumab and atezolizumab combo and RT safe and well-tolerated.
Combining varlilumab (anti-CD27 antibody) with anti-PD1/PD-L1 immunotherapy and targeted radiation (RT) shows potential synergy against metastatic NSCLC resistance. Researchers believe that this approach may enhance immune response by improving antigen presentation and infiltration, addressing therapy resistance.
So for a study, they examined the safety and benefits of combining atezolizumab, varlilumab, and palliative RT in advanced or metastatic NSCLC patients who showed progression on prior PD-1/PD-L1 therapy. The treatment regimen involved varlilumab followed by atezolizumab every 21 days, with palliative RT administered between cycles. Blood samples were collected before and after treatment for immunophenotyping.
Between September 2019 and April 2021, the study enrolled 15 patients for treatment evaluation in metastatic NSCLC. Fourteen patients were evaluated for safety, with a median age of 64 years. The most common treatment-related adverse events were liver transaminitis and hyperthyroidism.
Around 21% experienced severe adverse events, but no treatment-related deaths occurred. There was one case of severe immune-related adverse event (diarrhea/colitis) requiring steroids. No complete or partial responses were observed among the 12 patients evaluated for efficacy. Three patients had stable disease; the clinical benefit rate was 25%. Median progression-free survival (PFS) was 2.0 months, while median overall survival (OS) was 6.4 months.
The combination of varlilumab, atezolizumab, and RT was found safe without additional toxicity concerns. However, the trial showed modest clinical activity, with 25% of patients achieving stable disease. Further research will delve into biomarker analyses for future research guidance.
Source: https://jitc.bmj.com/content/11/Suppl_1/A685
Clinical Trial: https://clinicaltrials.gov/study/NCT04081688
Malhotra J, Lin Y, Patel M, et al602 A phase I trial of atezolizumab and varlilumab in combination with radiation in patients with metastatic non-small cell lung cancer (NSCLC)Journal for ImmunoTherapy of Cancer 2023;11:doi: 10.1136/jitc-2023-SITC2023.0602.
