Epacadostat in combination with durvalumab is safe and effective for advanced solid tumours

A recent study demonstrated the safety, tolerability and efficacy of epacadostat in combination with durvalumab in adult patients with advanced solid tumours. This study was published in the journal, Cancer.
The study was an open-label, phase 1/2 ECHO-203 study which evaluated the safety, tolerability, and efficacy of epacadostat (indoleamine 2,3-dioxygenase inhibitor) in combination with durvalumab (antiprogrammed cell death protein 1 monoclonal antibody).
The most common treatment-related adverse events reported were fatigue, nausea, decreased appetite, pruritus, maculopapular rash, and diarrhea. Higher objective response rate was observed in immune checkpoint inhibitor (CPI)-native patients (16.1%) compared with patients who had received previous CPI (4.1%). Moreover, the 300-mg epacadostat dose showed evidence of kynurenine level modulation.
Based on the results of the study, it can be concluded that the epacadostat in addition with durvalumab was beneficial in patients with advanced solid tumours. Based on the evaluation of kynurenine concentration from baseline it is suggested that >300 mg epacadostat twice daily will provide sufficient drug effect.
 

Tremelimumab plus durvalumab and chemotherapy as first-line treatment for metastatic non-small-cell lung cancer

A recent study suggests that tremelimumab plus durvalumab and chemotherapy improved patient reported outcomes in metastatic non-small-cell lung cancer (NSCLC). The findings of this study were published in the journal, Lung Cancer.

This phase 3 POSEIDON study included 972 patients randomized 1:1:1 to receive tremelimumab plus durvalumab and chemotherapy, durvalumab plus chemotherapy, or chemotherapy alone. The European Organisation for Research and Treatment of Cancer 30-item core quality of life questionnaire version 3 (QLQ-C30) and its 13-item lung cancer module (QLQ-LC13) were used to evaluate the PROs (prespecified secondary endpoints). The time to deterioration (TTD) of symptoms, functioning, and global health status/quality of life (QoL) from randomization were analyzed through the log-rank test, while the improvement rates were analyzed using logistic regression.

At the end of the study, it was shown that patients who received tremelimumab plus durvalumab and chemotherapy had longer median TTD for all PRO items compared to chemotherapy alone. Hazard ratios for TTD favored tremelimumab plus durvalumab and chemotherapy for all items except diarrhea and durvalumab plus chemotherapy favored for all items except nausea/vomiting and diarrhea. It was also observed that improvement rates in all PRO items were numerically higher for both immunotherapy plus chemotherapy arms compared to the chemotherapy arm alone.

Based on the above findings, it can be concluded that tremelimumab plus durvalumab and chemotherapy delayed worsening in symptoms, functioning, and overall health status/quality of life when compared to chemotherapy alone. Additionally, this treatment approach demonstrated significant improvements in survival. Consequently, these findings provide strong evidence for considering tremelimumab plus durvalumab and chemotherapy as a viable first-line treatment option for individuals with metastatic non-small cell lung cancer.

Management of the breathlessness-cough-fatigue symptom cluster in lung cancer through respiratory distress symptom intervention

A recent study showed that the use of respiratory distress symptom intervention (RDSI) has shown to be an effective and low-risk intervention in aiding the management of the respiratory distress symptom cluster in individuals diagnosed with lung cancer. This study’s findings were published in the journal, BMJ Supportive & Palliative Care.

A total of 263 patients diagnosed with lung cancer were enrolled in this clinical trial, with 132 patients assigned to receive RDSI and 131 patients assigned to receive standard care. To be eligible for the trial, participants had to self-report experiencing adverse effects in their daily lives from at least two out of the three symptoms, in any combination. The outcomes measured were the changes in each symptom within the cluster, namely Dyspnoea-12 (D-12), Functional Assessment of Chronic Illness-Fatigue, and Manchester Cough in Lung Cancer (MCLC) at the 12-week mark.

Nearly 60% of the participants reported experiencing all three symptoms at the baseline. By the end of the trial, there was a total attrition of 109 participants (41.4%). When compared to the control group, the RDSI group demonstrated a statistically significant improvement in D-12 (p=0.007) and MCLC (p<0.001). Each outcome reached the minimal clinically important difference (MCID): MCLC -5.49 (MCID >3), D-12 -4.13 (MCID >3), and FACIT-F 4.91 (MCID >4).

Thus, RDSI has proven its effectiveness and safety in supporting the management of the respiratory distress symptom cluster in patients with lung cancer. However, it is important to consider the significant attrition observed in the study while interpreting these findings.

Association between allergic rhinitis or hay fever and lung cancer

According to a recent study, an inverse association has been identified between allergic rhinitis (AR) and lung cancer. However, further epidemiological investigations are needed to fully assess the current landscape. The findings of this study were published in the journal, Medicine.

Following an extensive search of PubMed, ScienceDirect, and Google Scholar, a total of 7 suitable articles were incorporated into this systematic review and meta-analysis, with 4724 cases and 9059 controls, with 5 originating from the USA, and one each from Germany and Canada.

A strong inverse correlation between AR and lung cancer was seen in the pooled analysis, with an odds ratio of 0.55 (95% confidence interval: 0.45-0.68; P value < .00001).

The above study demonstrated a negative relationship between AR and lung cancer. However, additional epidemiological studies are required to comprehensively evaluate the present situation.