Preclinical studies have demonstrated that PARPi possesses cytotoxic activity as a single-agent and in combination with ICI in SCLC; however, this combination has not been tried to date as first-line therapy for SCLC. Investigators hypothesised that adding a PARPi to ICI therapy could enhance the efficacy of the ICI. To this end, a phase 2 trial (NCT03958045) evaluated the response and survival rates associated with the administration of nivolumab and rucaparib to patients with extensive-stage SCLC.
The trial recruited patients (n=20) with stage 4 extensive-stage SCLC who had achieved either a partial response or complete response following treatment with platinum-based chemotherapy. Participants were excluded if they had undergone prior ICI therapy. The starting dose of oral rucaparib was 600 mg twice daily; nivolumab was administered as an intravenous infusion once every 4 weeks at a fixed dose of 480 mg. The primary endpoint was progression-free survival (PFS) after response to initial platinum-based therapy.
Dr Aman Chauhan (University of Kentucky, KY, USA) presented interim data from the trial. All enrolled patients had achieved a partial response in accordance with Response Evaluation Criteria in Solid Tumours (RESIST) v1.1. The median PFS from initiation of maintenance therapy was 2.67 months; the median PFS from time of diagnosis on frontline therapy, which included treatment with chemotherapy followed by maintenance rucaparib and nivolumab, was 7.27 months. Dr Chauhan emphasised that 25% of patients remained on maintenance therapy.
No deaths occurred during the study. One patient withdrew from the trial due to grade 4 hepatotoxicity.
Dr Chauhan concluded that the combination of ICI and PARPi therapy seems to be well tolerated at the time of this interim analysis. Investigators are currently evaluating immune predictors of a durable response. Trial completion is anticipated in December 2021.
- Chauhan A. A phase 2 study of frontline rucaparib + nivolumab in platinum sensitive ES SCLC: Interim analysis. OA 07.03, WCLC 2021, 8–14 September.
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Table of Contents: WCLC 2021
Featured articles
Atezolizumab promising for treating NSCLC brain metastases
Novel Therapy Approaches
Atezolizumab promising for treating NSCLC brain metastases
Interim results of nivolumab + rucaparib in SCLC
Pembrolizumab shows potential in TKI-resistant EGFR+ NSCLC, not ALK+
Real-world data shows inferior survival compared with IMpower150 results
NSCLC metastases also benefit from nivolumab + ipilimumab + chemo
Trial explores potential benefit of adding atezolizumab to usual care for mesothelioma
COVID-19
COVID-19 sees decreased lung cancer diagnoses and use of support services in US
Experiences of lung cancer patients during COVID-19: survey finds room for improvement
Evidence-Based Advocacy
GLCC survey: Increased demand for patient-support services during COVID-19 pandemic
Lung Cancer Europe patient survey identifies gaps in lung cancer care
Discrepancies and lack of guideline adherence in EGFR+ NSCLC treatment
Response Predictors
Baseline CD8+ T-cells predict NSCLC immunotherapy safety
Genomic profiling of NSCLC may be predictive of immunotherapy response
New preoperative classification scheme proposed for oligometastatic NSCLC
Prognostic factors in immunotherapy for advanced lung cancer
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Interim results of nivolumab + rucaparib in SCLC
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