Primary trial results show no benefit from anti-TIGIT addition in small cell lung cancer
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CHICAGO — Adding tiragolumab, an anti-TIGIT agent, to atezolizumab and carboplatin plus etoposide did not provide more benefit compared with atezolizumab and carboplatin plus etoposide alone, according to findings from SKYSCRAPER-02 trial.
“The IMpower130 trial defined a new standard of care for the treatment of extensive-stage small cell lung cancer, demonstrating a benefit for the addition of the PD-L1 inhibitor atezolizumab to a backbone of carboplatin and etoposide for the treatment of extensive-stage small cell lung cancer,” Charles M. Rudin, MD, chief of thoracic oncology at Memorial Sloan Kettering Cancer Center, said during his presentation at ASCO Annual Meeting. “Although this was a clinical advance, the vast majority of patients with extensive-stage small cell lung cancer continue to suffer disease progression with a median of about 5 and a half months from the time of diagnosis. So, there is clearly a major unmet need for the treatment of these patients.”
SKYSCRAPER-02, a phase 3, randomized, double-blind, placebo-controlled study, investigated the impact the addition of tiragolumab (Genentech) may have on the antitumor effect and survival benefits currently experienced from the combination of atezolizumab (Tecentriq, Genentech) and carboplatin plus etoposide in patients with extensive-stage small cell lung cancer.
All 490 eligible patients received atezolizumab and carboplatin plus etoposide, with 243 randomized to receive tiragolumab and 247 patients to receive placebo. As of Feb. 6, 2022, the median duration of follow-up was 13.9 months. According to the abstract, the primary analysis set showed that tiragolumab conferred no additional benefit for progression free survival or overall survival compared with placebo.
Grade 3 and 4 treatment-related adverse events (TRAEs) occurred in 52.3% of patients receiving tiragolumab compared with 55.7% for the placebo group. Moreover, 0.4% of patients in the tiragolumab group and 2% of patients in the placebo group experienced grade 5 TRAEs. Treatment discontinuation due to TRAEs occurred for 5% of patients receiving tiragolumab and 5.3% for patients receiving placebo.
The researchers concluded that among patients with extensive-stage small cell lung cancer, with or without brain metastases, the addition of tiragolumab did not improve on the benefits seen with atezolizumab and carboplatin plus etoposide. However, the treatment was well-tolerated and did not cause any new safety concerns.
“We’re continuing to follow these folks, and biomarkers analyses will be forthcoming. I think those will be interesting in informing us about the subgroup that benefits from immunotherapy,” Rudin said. “But, really, I think from a clinical standpoint, based on these data our conclusion is targeting TIGIT in extensive-stage small cell lung cancer does not appear to be therapeutically relevant.”
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Rudin CM, et al. Abstract LBA8507. Presented at: ASCO Annual Meeting; June 3-7, 2022; Chicago.
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