WCLC 2022 | Treatment resistance as a key challenge in patients with advanced NSCLC

One of the main challenges that we face today is patients with advanced non-small cell lung cancer, after resistance to chemoimmunotherapy. So either given together as combo or sequentially; immunotherapy followed by chemo for example. Post-chemo-IO the only drug that we have so far is docetaxel and the benefit of this drug and it’s toxicity is really not optimal. So we are looking for a lot of strategies to try to re-initiate the response to immunotherapy in these patients, so we re-sensitize to immunotherapy and HUDSON, the trial where all the patients plus chemo-IO received duralumin, this is an anti-PD-L1 antibody plus another drug that is, let’s say, put as a booster of immunotherapy. So the trial is designed to have many different drugs. It’s an umbrella trial, platform trial, and all the patients got a central testing on a new biopsy so that patients could be either biomarkers selected, so we have a few biomarker matched cohorts.

Duralumin plus a drug given based on the molecular profile that we call them the bio mark or match cohort, or for all the other patients, we call them the old commers. We have divided this old commers population into strata. The patients consider with primary resistance to immunotherapy and the definition we used here was a progression within 24 weeks after the initiation of immunotherapy. And the second strata is the secondary resistance to immunotherapy. Those patients that received at least 24 weeks of immunotherapy. So usually they have a partial response and then later a subsequent progression.