Thoracic Oncology Highlights. Highlights in 1st line therapy of NSCLC without oncogenic drivers. Benjamin Besse, MD, PhD Thoracic Oncology Unit

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1 Thoracic Oncology Highlights Highlights in 1st line therapy of NSCLC without oncogenic drivers Benjamin Besse, MD, PhD Thoracic Oncology Unit

2 Disclosures No personal financial disclosures Institutional grants for clinical and translational research AstraZeneca, BMS, Boehringer-Ingelheim, Lilly, Pfizer, Roche-Genentech, Sanofi-Aventis, Clovis, GSK, Servier, EOS, Onxeo, OncoMed, Inivata, New Oncology GUSTAVE ROUSSY THÈME DU DIAPORAMA

3 Outline New chemotherapies Targeted agents without drivers on site Immunotherapy Other promising drugs GUSTAVE ROUSSY THÈME DU DIAPORAMA 3

4 Outline New chemotherapies Targeted agents without drivers on site Immunotherapy Other promising drugs GUSTAVE ROUSSY THÈME DU DIAPORAMA 4

WJOG5208L: Study design randomized phase III Chemo-naive PS 0-1 Age 20-74 Stage IIIb/IV or

Institutions 1:1 ND Docetaxel 60 mg/m 2 d1 Nedaplatin 100 mg/m 2 d1 q3w, 4-6 cycles N= 175 CD

Secondary: PFS, RR, adverse events (AEs) Sample Size: Initial Sample Size, 250 Assumed HR, 0.

5 WJOG5208L: Study design randomized phase III Chemo-naive PS 0-1 Age Stage IIIb/IV or recurrent SqCLC N= 350 Stratification factors: Stage (IIIb, IV or recurrent) Gender Institutions 1:1 ND Docetaxel 60 mg/m 2 d1 Nedaplatin 100 mg/m 2 d1 q3w, 4-6 cycles N= 175 CD Docetaxel 60 mg/m 2 d1 Cisplatin 80 mg/m 2 d1 q3w, 4-6 cycles N= 175 Endpoints: Primary: OS Secondary: PFS, RR, adverse events (AEs) Sample Size: Initial Sample Size, 250 Assumed HR, (MST: CD 10mo v ND 14mo) Type I error=0.05 (one sided), Power=80% Revised Sample Size, Power=80% 90%

6 Primary endpoint: Overall survival ND (N=177) CD (N=172) Median, months year, % year, % HR (90%CI) 0.81 ( ) p* *stratified log-rank test, one-sided Median follow up time, 39.3 months At risk ND CD months

7 Progression-free survival ND (N=177) CD (N=172) Median, months months, % HR (90%CI) 0.83 ( ) p* *stratified log-rank test, one-sided At risk ND A taste of carboplatin, no? CD Nedaplatin : more bone marrow tox, less nausea less renal tox, same neurotox months

8 Outline New chemotherapies Targeted agents without drivers on site Immunotherapy Other promising drugs GUSTAVE ROUSSY THÈME DU DIAPORAMA 8

9 SWOG 0819: PHASE III SCHEMA NSCLC Adv Stage Tumor Tissue available Stratification Factors: 1) Appropriate for Bevacizumab treatment: yes vs. no 2) Smoking status: current or former vs. never 3) Stage: M1a vs M1b R A N D O M I Z E Study accrual: 7/15/2009-6/1/2014 *In Bevacizumab Appropriate: as piloted in S0536 Paclitaxel Carboplatin *Bevacizumab Paclitaxel Carboplatin Cetuximab *Bevacizumab *Bevacizumab Cetuximab *Bevacizumab Co-Primary Objectives: OS (entire study), PFS (EGFR FISH) 3612: A Randomized, Phase III Study Comparing Carboplatin/Paclitaxel or Carboplatin/Paclitaxel/Bevacizumab with or without Concurrent Cetuximab in Patients with Advanced Non-Small Cell Lung Cancer (NSCLC): SWOG S0819 R. Herbst 9

10 MODIFIED STATISTICAL DESIGN EGFR FISH+ Entire Study Population Sample Size 618 -> > 1333 Primary Outcome PFS OS Power 92% -> 80% 86% -> 80% Alternative Hypothesis (HR) Type I Error (2-sided) 0.75 (33% improvement) 0.83 (20% improvement) Modification to study design: Observed rate of patients with a FISH result (70%) and observed rate of EGFR FISH+ (41%) 3612: A Randomized, Phase III Study Comparing Carboplatin/Paclitaxel or Carboplatin/Paclitaxel/Bevacizumab with or without Concurrent Cetuximab in Patients with Advanced Non-Small Cell Lung Cancer (NSCLC): SWOG S0819 R. Herbst 10

11 S0819 RESULTS: CO PRIMAY ENDPOINTS 100% 80% 60% Cetuximab Arm Control Arm N OS Overall Survival in overall population Events P = 0.34 HR=0.94 ( ) Median in Months % Conf. Int. ( ) ( ) 100% 80% 60% Progression Free Survival in FISH+ Cetuximab Arm Control Arm N PFS Events P = 0.37 HR=0.91 ( ) Median in Months % Conf. Int. ( ) ( ) 40% 40% 20% 20% 0% 0% Patients at Risk Months After Registration Patients at Risk Months After Registration Cetuximab Arm Cetuximab Arm Control Arm Control Arm : A Randomized, Phase III Study Comparing Carboplatin/Paclitaxel or Carboplatin/Paclitaxel/Bevacizumab with or without Concurrent Cetuximab in Patients with Advanced Non-Small Cell Lung Cancer (NSCLC): SWOG S0819 R. Herbst 11

12 S0819 RESULTS: SQUAMOUS CELL HISTOLOGY All SCCA Overall Survival SCCA, FISH+ 100% 80% 60% Cetuximab Arm Control Arm N Events P = 0.18 HR=0.85 ( ) Median in Months % Conf. Int. ( ) ( ) 100% 80% 60% Cetuximab Arm Control Arm N Events P = HR=0.56 ( ) Median in Months % Conf. Int. ( ) ( ) 40% 40% 20% 20% 0% 0% Patients at Risk Months After Registration Patients at Risk Months After Registration Cetuximab Arm Cetuximab Arm Control Arm Control Arm : A Randomized, Phase III Study Comparing Carboplatin/Paclitaxel or Carboplatin/Paclitaxel/Bevacizumab with or without Concurrent Cetuximab in Patients with Advanced Non-Small Cell Lung Cancer (NSCLC): SWOG S0819 R. Herbst 12

13 Survival based on biomarkers: Squamous cell NSCLC Hazard ratio Cetuximab Meta-Analysis Squamous 0.77 ( ) FLEX Squamous High H score 0.62 ( ) SWOG S0819 Squamous FISH positive 0.56 ( ) Necitumumab SQUIRE Squamous ITT 0.84 ( ) High H score 0.75 ( ) FISH positive 0.70 ( ) PLEN04.02: Discussant - Robert Pirker, Austria

14 Outline New chemotherapies Targeted agents without drivers on site Immunotherapy Other promising drugs GUSTAVE ROUSSY THÈME DU DIAPORAMA 14

15 Outline New chemotherapies Targeted agents without drivers on site Immunotherapy PDL1i : atezolizumab alone Other promising drugs GUSTAVE ROUSSY THÈME DU DIAPORAMA 15

16 IFNγ IFNγR MHC T-cell receptor Tumor cell PD-L1 PD-L2 PD-1 Shp-2 PI3K NFκB Other T cell PD-1

17 BIRCH: Phase II Trial of Atezolizumab in PD-L1 Selected Advanced NSCLC Locally advanced or metastatic NSCLC Tumor PD-L1 expression by IHC (TC2/3 and/or IC2/3) ECOG PS 0 or 1 No brain mets N = 667 Cohort 1 (1L) No prior chemo n = 142 Cohort 2 (2L) 1 prior platinum chemo n = 271 Cohort 3 (3L+) 2 prior chemos (including 1 platinum) n = 254 PD Until loss of clinical benefit Atezolizumab dosed at 1200 mg IV q3w in all cohorts. Primary endpoint: Objective response rate assessed by Independent Review Facility (IRF-assessed ORR) per RECIST v1.1 Secondary endpoints: IRF-assessed progression-free survival (PFS), duration of response (DOR) per RECIST v1.1 INV-assessed ORR, PFS, DOR per RECIST v1.1 and modified RECIST Overall survival (OS) Safety Besse B, et al, atezolizumab in NSCLC (BIRCH) 4

ORR, % BIRCH: IRF-assessed ORR by Line of Therapy TC3 or IC3 and TC2/3 or IC2/3 subgroups 27% 17% 17% 24% 19% 26% TC2/3 or IC2/3 TC3 or IC3 n = 253 n = 115 n = 267 n = 122 n = 139 n = 65 BIRCH met

18 ORR, % BIRCH: IRF-assessed ORR by Line of Therapy TC3 or IC3 and TC2/3 or IC2/3 subgroups 27% 17% 17% 24% 19% 26% TC2/3 or IC2/3 TC3 or IC3 n = 253 n = 115 n = 267 n = 122 n = 139 n = 65 BIRCH met its primary endpoint in all predefined subgroups per protocol-specified criteria Majority of responses were ongoing (> 61% in TC3 or IC3) Median DOR was 7 mo in 3L+, NR in 1L/2L in TC3 or IC3, although follow-up is limited IRF- and INV-assessed ORRs (per RECIST v1.1) were similar. In TC3 or IC3, eg, 27% vs 29% in 3L+; 24% vs 25% in 2L; and 26% vs 31% in 1L, respectively Data cutoff May 28, Besse B, et al, atezolizumab in NSCLC (BIRCH) 8

19 BIRCH: Overall Survival by Line of Therapy TC2/3 or IC2/3 Subgroup Median OS, mo (95% CI) 6-mo OS, % 1L (Cohort 1) 14.0 (14.0, NE) 82% 2L (Cohort 2) NE (11.2, NE) 76% 3L+ (Cohort 3) NE (8.4, NE) 71% Median follow up: 8.8 mo (1L), 7.9 mo (2L) and 8.6 mo (3L+) Data cutoff May 28, Besse B, et al, atezolizumab in NSCLC (BIRCH)

20 BIRCH: PFS by Line of Therapy TC2/3 or IC2/3 Subgroup Median PFS, mo (95% CI) 6-mo PFS, % 1L (Cohort 1) 5.5 (3.0, 6.9) 46% 2L (Cohort 2) 2.8 (1.5, 3.5) 29% 3L+ (Cohort 3) 2.8 (2.7, 3.7) 31% Data cutoff May 28, Besse B, et al, atezolizumab in NSCLC (BIRCH)

21 BIRCH: Treatment-related AEs 5% of treated patients a Grade 1-2 AEs Grade 3-4 AEs AE profile consistent with previous atezolizumab studies Most commonly reported AEs (all grades) were fatigue, diarrhea and nausea % of Patients a Treatment-related AEs that occurred during and up to 30 days from last day of atezolizumab administration. Data cutoff May 28, Besse B, et al, atezolizumab in NSCLC (BIRCH) 21

22 1 st line Nivolumab Monotherapy in NSCLC Encouraging Survival and Safety Profile ORR OS* Grade 3 /4 AE All patients (n=52) 21% 98.3 w 15% PD-L1 + 31% NR PD-L1-10% 98.3 w * Min Follow-up: 8 months Gettinger SN. J Clin Oncol 2015 (suppl; Abstr 8025) PD1 Axis Immunotherapy Discussant G Goss

23 Outline New chemotherapies Targeted agents without drivers on site Immunotherapy PDL1i : atezolizumab alone PDL1i : atezolizumab + CT Other promising drugs GUSTAVE ROUSSY THÈME DU DIAPORAMA 23

24 Phase Ib GP28328 (NCT ) study design and endpoints: NSCLC cohort Arm C: NSCLC Atezolizumab 15mg/kg i.v. q3w + carboplatin AUC=6 i.v. q3w + paclitaxel 200mg/m 2 i.v. q3w (4 6 cycles)* Solid tumours ECOG PS 0 1 (n=58 NSCLC cohort at data cut-off; n=25 per arm planned) Arm D: NSCLC Atezolizumab 15mg/kg i.v. q3w + carboplatin AUC=6 i.v. q3w (4 6 cycles) + pemetrexed 500mg/m 2 i.v. q3w (maintenance pemetrexed permitted)* Arm E: NSCLC Atezolizumab 15mg/kg i.v. q3w + carboplatin AUC=6 i.v. q3w + nab-paclitaxel 100mg/m 2 i.v. q1w (4 6 cycles)* Primary endpoint: safety (including dose-limiting toxicities) Secondary endpoints: pharmacokinetics; best overall response; objective response rate (ORR); duration of response (DOR); progression-free survival (PFS) Date of cut-off: 10 Feb 2015; median safety follow-up: days (4.2 months) *supportive care (including steroids if necessary) was permitted, at the investigators discretion; atezolizumab was given until loss of clinical benefit

25 Treatment-related grade 3/4 AEs* in 3% of patients AE, n (%) Arm C (cb/pac) (n=14) Arm D (cb/pem) (n=24) Arm E (cb/nab) (n=20) All NSCLC patients (n=58) Neutropenia 5 (35.7) 9 (37.5) 9 (45.0) 23 (39.7) Anaemia 2 (14.3) 2 (8.3) 4 (20.0) 8 (13.8) Thrombocytopenia 0 5 (20.8) 2 (10.0) 7 (12.1) Fatigue 1 (7.1) 2 (8.3) 2 (10.0) 5 (8.6) ALT increased 0 1 (4.2) 2 (10.0) 3 (5.2) AST increased 0 1 (4.2) 2 (10.0) 3 (5.2) Dehydration 1 (7.1) 2 (8.3) 0 3 (5.2) Hypokalemia 0 1 (4.2) 1 (5.0) 2 (3.4) Leukopenia 0 2 (8.3) 0 2 (3.4) Nausea (10.0) 2 (3.4)

26 Maximum SLD reduction from baseline (%) Maximum SLD reduction from baseline (%) Maximum SLD reduction from baseline (%) WP by treatment arm 100 Arm C (cb/pac) n=8 100 Arm D (cb/pem) n= Arm E (cb/nab) n= ORR = 50.0% (4/8) ORR = 76.5% (13/17) ORR = 56.3% (9/16) * * Data cut-off 10 Feb 2015; efficacy population includes all patients dosed by 10 Nov 2014; waterfall plots show all patients in the efficacy population who had at least one tumour assessment; SLD = sum of longest diameters Complete response *target lesions included lymph nodes, which normalised on treatment Partial response Progressive disease Stable disease

27 Ongoing Atezolizumab Development in NSCLC Multiple Phase III 1L trials in NSCLC studies IMpower 150, NCT IMpower 130, NCT IMpower 131, NCT IMpower 110, NCT IMpower 111, NCT Atezolizumab + chemotherapy (unselected) Atezolizumab vs chemotherapy (PD-L1 selected) 27 Besse B, et al, atezolizumab in NSCLC (BIRCH)

28 Outline New chemotherapies Targeted agents without drivers on site Immunotherapy PDL1i : atezolizumab alone PDL1i : atezolizumab + CT PD1i + CTLA4i : nivolumab + ipilimumab Other promising drugs GUSTAVE ROUSSY THÈME DU DIAPORAMA 28

Rationale for Combined CTLA-4 and PD-1 Blockade in NSCLC APC T-cell Interaction Tumor Microenvironment Activation (cytokine secretion, lysis, proliferation, migration to tumor) MHC TCR TCR MHC

29 Rationale for Combined CTLA-4 and PD-1 Blockade in NSCLC APC T-cell Interaction Tumor Microenvironment Activation (cytokine secretion, lysis, proliferation, migration to tumor) MHC TCR TCR MHC +++ Dendritic +++ cell T cell B7 CD28 T cell Tumor cell +++ PD-1 PD-L1 B7 CTLA anti-ctla-4 anti-pd-1 PD-1 PD-L2 --- anti-pd-1 CTLA-4 Blockade (Ipilimumab) PD-1 Blockade (Nivolumab) 29

30 1 st Line Nivolumab + Ipilimumab in Advanced Melanoma Limited PFS improvements that come at price ORR ORR (+) ORR (-) PFS PFS (+) PFS (-) Grade 3 / 4 AE Combination Nivo: 1 mg/kg, q3w Ipi: 3 mg/kg, q3w x 4 Maintenance: Nivo: 3mg/kg, q2w 57.6% 72.1% 54.8% 11.5 m 14.0 m 11.2 m 55% NIVO alone Nivo: 3 mg/kg q2w + placebo IPI alone Ipi: 3 mg/kg q3w x 4 + placebo 43.7% 57.5% 41.3% 6.9 m 14.0 m 5.3 m 16% 19.0% 21.3% 17.8% 2.9 m 3.9 m 2.8 m 27.3% Larkin J et al. NEJM 2015; 373 (1): Adapted from G.Goss, WCLC 2015

31 CHECKMATE 012 PHASE I (1 st Line) Nivolumab Monotherapy or Combination therapy in NSCLC 3mg/kg Q2W 1+3mg/kg Q3W 3+1mg/kg Q3W Rizvi N. 16 th World Conference on Lung Cancer, Sept , Denver CO

32 Initial Nivolumab and Ipilimumab data what benefit at what cost? Checkmate Phase I, NIVO + IPI ARMs ORR PFS OS Grade 3 /4 AE NIVO1/IPI3 (n=24) 13% 16.1 w NR 51% NIVO3/IPI1 (n=25) 20% 14.4 w 47.9 w PD-L1+ 19% - - PD-L1-14% Gettinger S. Annal Oncol 2014; 25 (supp 4): iv Antonia SJ. IJROBP 2014; 90 (supp 5):

33 Checkmate 012 New Cohorts Rizvi N. 16 th World Conference on Lung Cancer, Sept , Denver CO

34 Nivo 1 + Ipi 1 Q3W (n = 31) Any Grad e Grad e 3 4 Nivo 1 Q2W + Ipi 1 Q6W (n = 40) Any Grad e Grad e 3 4 Nivo 3 Q2W + Ipi 1 Q12W (n = 38) Any Grad e Grad e 3 4 Nivo 3 Q2W + Ipi 1 Q6W (n = 39) Any Grad e Grad e 3 4 Nivo 3 Q2W a (n = 52) Any Grad e Treatment-related AEs, % Treatment-related AEs leading to discontinuation, % Nivolumab Median number of doses (range) Median duration of therapy, wks (range) Ipilimumab Median number of doses (range) Median duration of therapy, wks (range) Grad e b 8 8 c 5 3 d e f 4 (1 42) 12.0 ( ) NC 1 4 g 11.6 ( ) 7 (1 26) 16.0 ( ) 3 (1 9) 17.6 ( ) 13 (1 26) 28.7 ( ) 3 (1 5) 35.7 ( ) 8 (1 25) 18.0 ( ) 2 (1 9) 15.0 ( ) 8 (1 62) 16.0 ( ) NA NA a Results for Nivo 3 Q2W are reported based on a March 2015 DBL; b Increased AST, rash, and pneumonitis (n = 1 each); c Autoimmune hepatitis (n=2), increased ALT, and increased, AST (n = 1 each); d Colitis (n = 1); e Increased transaminase, encephalopathy, facial nerve disorder, rash, and pneumonitis (n = 1 each); f Increased lipase, increased ALT, increased AST, cardiac failure, hyperglycemia, and pneumonitis (n = 1 each); g Median number of ipilimumab doses was not calculated as patients received a maximum of 4 doses 34

35 Confirmed ORR, % (95% CI) Nivo 1 + Ipi 1 Q3W (n = 31) 13 (4, 30) Nivo 1 Q2W + Ipi 1 Q6W (n = 40) 25 (13, 41) Nivo 3 Q2W + Ipi 1 Q12W (n = 38) 39 (24, 57) Nivo 3 Q2W + Ipi 1 Q6W (n = 39) 31 (17, 48) Nivo 3 Q2W a (n = 52) 23 (13, 37) Confirmed DCR, % (95% CI) 55 (36, 73) 58 (41, 73) 74 (57, 87) 51 (35, 68) 50 (36, 64) Best overall response, % Complete response Partial response Unconfirmed partial response Stable disease Progressive disease Unable to determine PFS rate at 24 wks, % (95% CI) 55 (36, 71) NC 63 (44, 76) NC 41 (27, 54) Median PFS, mos (95% CI) 10.6 (2.1, 16.3) 4.9 (2.8, ) 8.0 (4.2, ) 8.3 (2.6, ) 3.6 (2.3, 6.6) Median OS, mos (95% CI) NR (11.5, ) NR (8.9, ) NR NR (8.7, ) 22.6 (14.9, ) Median length of follow-up, mos (range) Summary of Efficacy 16.6 ( ) 6.2 ( ) ( ) ( ) ( ) Median DOR was not reached in any arm Unconventional immune-related responses were observed in arms Nivo 3 Q2W + Ipi 1 Q12W (n = 2), Nivo 3 Q2W + Ipi 1 Q6W (n = 1) and Nivo 3 Q2W (n = 3) NR: the time point at which the percent of survivors drops below 50% has not been reached due to insufficient number of events and/or follow up. a Results for Nivo 3 Q2W are reported based on a March 2015 DBL 35

36 Percentage Change from Baseline 220 Best Percentage Change in Target Lesion Tumor Burden by Tumor PD-L1 Expression PD-L1 expression n (%) 1% PD-L1 a 77 (68) <1% PD-L1 a 36 (32) Unknown b 35 (24) * Confirmed ongoing responses ** ** * * ***** * ********** *** *** ***** ** 100 Includes all patients with baseline target lesion and 1 post-baseline assessment of target lesion. Positive change in tumor burden indicates tumor growth; negative change in tumor burden indicates tumor reduction. Not all reductions of 30% from baseline are PRs. a Based on patients with known PD-L1 expression; b Based on all treated patients 36

37 Randomize CheckMate 227 (NCT ): Study Design Nivolumab monotherapy Treatment-naïve patients with stage IV or recurrent NSCLC Anticipated enrollment: approximately 1980 Tumor PD-L1 assessment at screening Nivolumab + Ipilimumab PT-DC Non-SQ: Pemetrexed + cisplatin or carboplatin SQ: Gemcitabine + cisplatin or carboplatin Treatment until disease progression or unacceptable toxicity Primary endpoints OS PFS Secondary endpoints ORR Disease-related symptom improvement (measured using LCSS) Naiyer Rizvi et al, IASLC

38 Outline New chemotherapies Targeted agents without drivers on site Immunotherapy Other promising drugs GUSTAVE ROUSSY THÈME DU DIAPORAMA 38

39 Outline New chemotherapies Targeted agents without drivers on site Immunotherapy Other promising drugs DRUG-CONJUGATES GUSTAVE ROUSSY THÈME DU DIAPORAMA 39

40 Drug Conjugates Vintafolide Anti-Trop-2 monoclonal Ab Camidge et al, WCLC 15 Sacituzumab Govitecan (IMMU-132), an antibody drug conjugate SN-38= the active moiety of irinotecan Hanna et al, WCLC 15 Vintafolide, a small molecule drug conjugate GUSTAVE ROUSSY THÈME DU DIAPORAMA

41 IMMU-132 AEs (All Grades) > 10% Patients (8 & 10mg/kg) IMMU-132 Weekly 10 8 & 10 8 mg/kg Dosing mg/kg mg/kg Adverse Event N=23 N=31 N=54 Diarrhea 43% 26% 33% Nausea 52% 26% 37% Fatigue 57% 6% 33% Alopecia 39% 16% 26% Neutropenia 30% 13% 20% Abdominal pain 30% 6% 20% Anorexia 30% 3% 17% Vomiting 26% 10% 17% Anemia 30% 3% 15% Constipation 26% 3% 13% Dyspnea 22% 6% 13% Hypomagnesemia 17% 10% 13% 41

42 B e s t r e s p o n s e (% c h a n g e fr o m b a s e lin e ) NSCLC Best Response 12 mg/kg (N = 19 Assessable Patients) Median prior therapies = 3 (range, 1-8) Apr P a r tia l r e s p o n s e S ta b le d is e a s e P r o g r e s s io n 2 p ts w ith P D n o t s h o w n b e c a u s e th e y h a d n e w le s io n s q u a m o u s c e ll h is to p a th o lo g y, a ll o th e rs a d e n o c a r c in o m a S ta r tin g d o s e 8 m g /k g 1 0 m g /k g 1 2 m g /k g Patients had -9% and -2% shrinkage of target lesions Objective response (CR+PR; 6/19) = 32% Disease control (CR+PR+SD; 14/19) = 74% Clinical benefit ratio [PR+(SD 4 mo)] = 59% CR = 0; PR = 6; SD = 8; PD = 5 28 patients enrolled; 1 non evaluable; 8 too early 8 mg/kg (N = 8) 10 mg/kg (N = 10) 12 mg/kg (N = 1) At 10 mg/kg, ORR 3/10 (30%) 42

$Phase I study of a DLL3-targeted ADC, Rovalpituzumab Tesirine, in patients with relapsed and refractory SCLC 1 Rudin CM., 1 Pietanza C., 2 Spigel DR., 2 Bauer T., 3 Glisson BS., 4 Robert F.$ 1 Memorial Sloan Kettering Cancer Center, New York, NY; 2 Tennessee Oncology, Nashville, TN; 3 MD Anderson Cancer Center, Houston TX; 4 U.

1 Memorial Sloan Kettering Cancer Center, New York, NY; 2 Tennessee Oncology, Nashville, TN; 3 MD Anderson Cancer Center, Houston TX; 4 U.

43 Phase I study of a DLL3-targeted ADC, Rovalpituzumab Tesirine, in patients with relapsed and refractory SCLC 1 Rudin CM., 1 Pietanza C., 2 Spigel DR., 2 Bauer T., 3 Glisson BS., 4 Robert F., 5 Ready NE., 6 Morgensztern D, 7 Kochendoerfer M., 8 Patel, M., 9 Salgia R., 10 Strickland DK., 6 Govindan R, 2,10 Burris HA. and 11 Dylla SJ. 1 Memorial Sloan Kettering Cancer Center, New York, NY; 2 Tennessee Oncology, Nashville, TN; 3 MD Anderson Cancer Center, Houston TX; 4 U. Alabama-Birmingham, Birmingham, AL; 5 Duke Cancer Institute, Durham, NC; 6 Washington U., St. Louis, MO; 7 Blue Ridge Cancer Care, Roanoke, VA; 8 Florida Cancer Specialists, Sarasota, FL; 9 U. Chicago, Chicago, IL; 10 Sarah Cannon Research Institute, Nashville, TN; 11 Stemcentrx, Inc., South San Francisco, CA

44 Conclusion No new chemotherapies We still need predictive factors Few Targeted agents without drivers on site Minor role in squamous for EGFR Ab Lots of Immunotherapies Very small numbers but phase III ongoing Other promising drug-conjugates My number 1 highlight GUSTAVE ROUSSY THÈME DU DIAPORAMA 44

Immune checkpoint blockade in lung cancer

Immune checkpoint blockade in lung cancer Raffaele Califano Department of Medical Oncology The Christie and University Hospital of South Manchester, Manchester, UK Outline Background Overview of the data