Abstract 1213P
Background
In the pivotal phase III RATIONALE-315 trial (NCT04379635) of patients with resectable stage II to IIIA NSCLC, perioperative TIS plus (+) neoadjuvant platinum-based CT led to a significant improvement in event-free survival [HR=0.56, p=0.0003] compared to placebo + neoadjuvant platinum-based CT. Here, we report results for PRO instruments from RATIONALE-315.
Methods
PROs were secondary endpoints assessed using the EORTC QLQ-C30 and QLQ-LC13 instruments. Key PRO endpoints included QLQ-C30 GHS/QoL, physical function, as well as QLQ-LC13 symptoms of dyspnea, cough, and chest pain. A mixed model for repeated measures was performed at Cycle 1 (baseline), Cycle 3 of neoadjuvant phase, the Cycles 3 and 7 of adjuvant phase. Time to deterioration (TTD) was examined using Kaplan-Meier method. All HRQoL analysis were performed on the intent-to-treat analysis set.
Results
A total of 453 pts were randomized (1:1) to receive neoadjuvant TIS (n=226) or PBO (n=227). By Cycle 7, no meaningful differences in least-squares (LS) mean change from baseline between arms were observed for GHS/QoL, physical functioning, and fatigue, or chest pain and dyspnea (Table); however, the TIS + CT arm experienced a meaningful improvement in LS mean for coughing (-4.37 [95% CI: -9.46 to 0.21]). TTD analysis showed that pts in the TIS + CT arm were at lower risk of worsening for chest pain (HR 0.59 [95% CI: 0.38-0.91]); risk of worsening was similar between the arms in all other PRO endpoints. Table: 1213P
HRQoL endpoint | Least squares mean (95% CI) | |||
Cycle 3: Adjuvant phase | Cycle 7: Adjuvant phase | |||
TIS | PBO | TIS | PBO | |
QLQ-C30 | ||||
GHS/QoL | -1.14 (-3.79, 1.52) | -1.97 (-4.77, 0.83) | 1.09 (-1.34, 3.53) | 1.90 (-0.66, 4.46) |
Physical functioning | -3.57 (-5.10, -2.05) | -3.61 (-5.22, -2.01) | -2.60 (-4.20, 1.00) | -2.23 (-3.92, -0.54) |
Fatigue | 2.52 (0.23, 4.81) | 2.97 (0.57, 5.37) | 2.54 (0.09, 4.99 | 2.87 (0.30, 5.45) |
QLQ-LC13 | ||||
Coughing | -4.58 (-7.75, -1.42) | -5.63 (-8.97, -2.29) | -12.15 (-15.60, -8.71) | -7.52 (-11.16, -3.89) |
Chest pain | 0.43 (-2.42, 3.28) | 5.42 (2.39, 8.44) | 0.36 (-2.34, 3.05) | 1.89 (-0.96, 4.75) |
Dyspnea | 4.62 (2.57, 6.67) | 6.57 (4.41, 8.74) | 3.18 (0.82, 5.55) | 4.56 (2.07, 7.06) |
Conclusions
Pts in the TIS + chemo arm experienced better HRQoL outcomes than those in the PBO + CT arm in this population of patients with resectable NSCLC, with improvements in coughing and lower risk of chest pain.
Clinical trial identification
NCT04379635.
Editorial acknowledgement
Medical writing support, under the direction of the authors, was provided by Jason C. Allaire, PhD of Generativity Solutions Group, and was funded by BeiGene. Editorial and submission support was provided by Envision Pharma Inc., and funded by BeiGene.
Legal entity responsible for the study
BeiGene, Ltd.
Funding
BeiGene, Ltd.
Disclosure
F. Cappuzzo: Financial Interests, Personal, Advisory Board: Roche, AstraZeneca, BMS, Pfizer, Takeda, Lilly, Bayer, Amgen, Sanofi, Mirati, PharmaMar, Novocure, OSE, GALECTO and MSD; Financial Interests, Personal, Invited Speaker: Roche, AstraZeneca, BMS, Pfizer, Takeda, Lilly, Bayer, Amgen, Sanofi, PharmaMar, Mirati, Novocure, OSE, and MSD. S. Wang, B. Yao, G. Barnes: Financial Interests, Personal, Full or part-time Employment: BeiGene; Financial Interests, Personal, Stocks/Shares: BeiGene. B. Barnes: Financial Interests, Personal, Full or part-time Employment: BeiGene. All other authors have declared no conflicts of interest.
Resources from the same session
1091P - Neoadjuvant cemiplimab for stage II–IV cutaneous squamous cell carcinoma (CSCC): 2-year follow-up and biomarker analyses
Presenter: Danny Rischin
Session: Poster session 04
1092P - Nivolumab plus relatlimab vs nivolumab in previously untreated metastatic or unresectable melanoma: 3-year subgroup analyses from RELATIVITY-047
Presenter: Dirk Schadendorf
Session: Poster session 04
1093P - Preliminary biomarker analysis in the phase III PIVOTAL study: Evidence for the mechanism of action of daromun in melanoma
Presenter: Paolo Ascierto
Session: Poster session 04
1094P - NeoRisk: Neoadjuvant immunotherapy (NeoIT) recurrence risk assessment tool
Presenter: Ines Pires da Silva
Session: Poster session 04
1095P - Pembrolizumab versus placebo after a complete resection of high-risk stage III melanoma: 7-year results of the EORTC 1325-MG/Keynote-054 double-blind phase III trial
Presenter: Alexander Eggermont
Session: Poster session 04
1096P - Camrelizumab plus apatinib in patients with advanced mucosal melanoma: A 3-year survival update with biomarker analysis
Presenter: Zhengyun Zou
Session: Poster session 04
1098P - Mechanisms of recurrence following mRNA-4157 (V940) plus pembrolizumab or pembrolizumab alone in resected melanoma from the mRNA-4157-P201 (KEYNOTE-942) trial
Presenter: Ryan Sullivan
Session: Poster session 04
1099P - COMBI-EU: Adverse event management of adjuvant dabrafenib plus trametinib (D+T) in patients with BRAF V600-mutant melanoma
Presenter: Peter Mohr
Session: Poster session 04
1100P - Anti-PD1 + low-dose anti-CTLA4 immunotherapy pathological response rate in patients with stage III resectable melanoma: Phase III NEOMIMAJOR trial interim analysis
Presenter: Igor Samoylenko
Session: Poster session 04