No Survival Bump in Metastatic NSCLC With Addition of ADC to Immunotherapy
(MedPage Today) -- Survival in metastatic non-small cell lung cancer (NSCLC) did not improve with the addition of the antibody-drug conjugate (ADC) sacituzumab govitecan (Trodelvy) to immunotherapy, a large randomized trial showed. Median progression...
A recent randomized trial, EVOKE-03, did not find improved survival in metastatic non-small cell lung cancer (NSCLC) patients when the antibody-drug conjugate sacituzumab govitecan (Trodelvy) was added to immunotherapy, reported lead investigator Giannis Mountzios, MD, PhD. Median progression-free survival (PFS) did not reach the required statistical significance, despite an improvement from 7.7 months with pembrolizumab alone to 11.8 months with the combination.
The study also showed a slight advantage for the control arm in overall survival (OS), but this difference was not statistically significant. An interim analysis revealed more treatment-emergent adverse events in the sacituzumab group, including serious, treatment-discontinuation, and fatal events. The results indicate that sacituzumab govitecan plus pembrolizumab adds a chemotherapy-like effect without a lasting survival benefit.
Pembrolizumab monotherapy remains the standard for PD-L1-high groups, and future trials should focus on overall survival with proper biomarker selection and stratification.
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