Abstract 4255
Background
Tumor Treating Fields (TTFields) are an anti-mitotic, regional treatment modality, utilizing low intensity alternating electric fields delivered non-invasively to the tumor. TTFields have significantly extended survival of patients with glioblastoma. In vitro, human MPM cells are highly susceptible to TTFields. In the phase 2 STELLAR study [NCT02397928], patients with unresectable MPM treated with first line chemotherapy in combination with TTFields had a significantly higher median overall survival compared with historical controls (18.2 Vs. 12.1 months). We report on radiological data from STELLAR patients whose tumors responded while receiving the combined therapy.
Methods
The STELLAR trial accrued 80 patients with unresectable, previously untreated MPM. Patients received continuous 150 kHz TTFields (>18h/day) combined with pemetrexed and cisplatin or carboplatin (standard dosing). Inclusion criteria: ECOG PS of 0-1, pathologically proven MPM and > measurable lesion per modified RECIST. Patients were followed q3w (CT scan q6w) until disease progression. Radiological assessments were done 6-weekly at study sites.
Results
Partial responses (PRs) were seen in 40.3% (29/72) of evaluable patients and clinical benefit (PR+SD) was seen in 97.2% (70/72) patients. The median time between treatment start and PR was 1.9 months (range: 1.4-4.4 months). All patients presenting with PR during the STELLAR study had continuous reduction in the total sum of lesion diameters, suggesting no initial/pseudo-progression. 83% of the patients who responded to the combined therapy finally had disease progression with a median response duration of 5.7 months (range: 1.4-13 months). One patient did not progress for more than 27 months. 28 responders (97%) reported at least 1 adverse event, and 7 patients (24%) had TTFields-related skin toxicities.
Conclusions
The STELLAR study significantly extended survival in previously untreated MPM patients. Response rates were similar to those reported for the current MPM standard of care treatment, but were of longer duration with the addition of TTFields. The only TTFields-related adverse event was skin irritation beneath the arrays.
Clinical trial identification
NCT02397928.
Editorial acknowledgement
Legal entity responsible for the study
Novocure.
Funding
Novocure.
Disclosure
F. Grosso: Travel / Accommodation / Expenses: Novocure. G.L. Ceresoli: Travel / Accommodation / Expenses: Novocure.
Resources from the same session
1851 - Nivolumab-induced and radiation recall pneumonitis in patients with non-small cell lung cancer: a multicenter real world analysis of 669 patients
Presenter: Nobuaki Mamesaya
Session: Poster Display session 1
Resources:
Abstract
851 - Retrospective analysis of immunotherapy prognostic scores in advanced NSCLC at Nottingham University Hospitals (UK)
Presenter: Cristina Lopez Escola
Session: Poster Display session 1
Resources:
Abstract
3639 - Applicability of lung immune prognostic index (LIPI) to predict efficacy of first-line pembrolizumab in advanced non-small-cell lung cancer (NSCLC)
Presenter: Xabier Mielgo Rubio
Session: Poster Display session 1
Resources:
Abstract
2950 - Delayed Onset Immune Related Adverse Effects (IRAEs) of Pembrolizumab in Non-Small Cell Lung Cancer
Presenter: Haixi Yan
Session: Poster Display session 1
Resources:
Abstract
3659 - Clinical implication of multiplex IHC and serologic biomarkers on Hyperprogression in NSCLC patients receiving Immune checkpoint blockers in real world.
Presenter: Joori Kim
Session: Poster Display session 1
Resources:
Abstract
4882 - Local ablative treatment and treatment beyond progression for oligo-progression in stage IV non-small cell lung cancer after tumor response to anti-PD1 treatment
Presenter: Florian Guisier
Session: Poster Display session 1
Resources:
Abstract
1358 - Atezolizumab in combination with chemotherapy for first-line treatment of advanced non-small cell lung cancer: A systematic review and meta-analysis of randomized controlled trials (RCTs)
Presenter: Francis Mogollon-Duffo
Session: Poster Display session 1
Resources:
Abstract
2170 - Prognostic Impact of Metastatic Sites for Pembrolizumab Efficacy as First-line therapy in Patients with PD-L1 tumor proportion score (TPS) ≥ 50% Advanced Non–Small Cell Lung Cancer: A Retrospective Multicenter Study
Presenter: Hayato Kawachi
Session: Poster Display session 1
Resources:
Abstract
3051 - Impact of visceral fat area as independent predictive factor in patients with advanced non-small cell lung cancer treated with nivolumab
Presenter: Yuki Sato
Session: Poster Display session 1
Resources:
Abstract
3409 - Effect and safety of immune checkpoint inhibitors for brain metastases from non-small cell lung cancer
Presenter: Toshihiko Iuchi
Session: Poster Display session 1
Resources:
Abstract