答雅各布同志问
Programme for the 22nd (!!) annual meeting of the Chinese Society of Clinical Oncology bit.ly/2LYigru #CSCO19 Who knew?
What were the big themes? What should we be looking out for in I-O? What's coming up in the targeted small-mol space? Thx!
IO is absolutely the most hot topic:
1) camrelizumab
Final result in 2L HCC
efficacy：ORR 14.7%， 6-mo OS 74%，DCR 44.2%， OS 13.8mo similar to Pembro or Nivo ， but patients with worse baseline（high AFP，HBV，prior therapies）
Safety：
Any Gr TRAE 90.8% similar with others except skin RCEP(mostly Gr1-2)，
Gr3-4 TRAE 21.7%，SAE 11.1%，
TRAE leading to death/discontinuation/dosage reduce ：0.9%/3.7%/14.7%
One KOL mentioned they will start a camrelizumab plus Apatinib combo in 1L NSCLC ASAP based on the promise early data
https://ascopubs.org/doi/abs/10.1200/JCO.2019.37.15_suppl.9112
2）Tislelizumab
Updating of R/R cHL：ORR 87%，CR 63%， DoR NR，PFS NR
in Chinese pts with ESCC, GC, HCC and MSI-H/dMMR Tumors
ORR 8%, 17%, 17% and 19% respectively
Response obtained regardless of PD-L1 status
3）Toripalimab in 2L UC
ORR 26.4%， PFS 2.3 mo， OS 10.9 mo
Maybe they use a more effective mAb to detect PD-L1 expression， ORR 42.4% in PD-L1+ and 16% in PD-L1- pts
to watch in esmo19
Tislelizumab in ≥2L PD-L1+(≥ 25% of tumor or immune cells had PD-L1 expression) UC
109pts: ORR 23%; PFS 2.1 mo; OS 9.8 mo
what a shame～
4）Asian subgroup analysis of KN-181
very significant OS benefit in Pembro group due to 96% belong to SCC
ITT：OS 10.0 vs 6.5 mo，
HR 0.63 ， P<0.0001，
1y OS：43.5% vs 23.9%
ESCC：OS 10.0 vs 6.5 mo，
HR 0.63 ， P<0.0001，
1y OS：43.5% vs 24.2%
CPS≥10 ：OS 12.0 vs 6.0 mo，
HR 0.52 ， P<0.0001，
1y OS：54.2% vs 22.8%
5）Atezolizumab plus Bevacizumab in 1L HCC： ORR 36%， DCR 71%， DOR NE（54%≥9mo，30%≥12mo ）PFS 7.3 mo， OS 17.1 mo （in 104 pts）
Compared to Pembrolizumab plus lenvatinib（in 67 pts）：ORR 44.8%， DCR 82.1%， DoR 18.1 mo
Some guys also try bispecific antibodies， but no excited data seen
6）AK104（PD-1 X CTLA-4）
good safety but too early to evaluate this kind of combination
7）KN046（PD-L1 X CTLA-4）
Affinity of PD-L1 binding is designed as 24 times of CTLA-4 binding for enrichment in TME.Safety is good but mild anti-tumor efficacy：28% in NPC and lower in other types of tumor
Target Therapies
1）HER2 ADC RC-48 in 2L UC
~30% mUC with HER2 IHC 3+ or IHC 2+/FISH+，CDR of RC48 is totally differently from that of trastuzumab
IRC ORR 51.9% in 51pts， DCR 90.7%，PFS 6.9 mo， OS 13.9 mo
Maybe another choice in 2L UC beside of PD-1/-L1 or Nectin-4 ADC
2）X-396 in crizotinib pre-treated ALK+ NSCLC
IRC ORR 52.6%，DCR 87.8%，PFS 11.2 mo
intracranial ORR 71.4%，intracranial DCR 95.2%
Also effective in mutations resistant to other 2nd gen ALK TKI，such as G1202R etc
Main common any Gr AEs are rash， evelated AST/ALT，but most are Gr1-2，no serious Gastrointestinal and Hematology AEs were seen