Older patients with non-small-cell lung cancer who have not progressed on platinum-based doublet therapy do not gain an overall survival advantage if treated with switch maintenance therapy rather than observation, study findings show.

Thomas Stinchcombe (Duke Cancer Institute, USA) examines the development of maintenance regimens and where they fit as immunotherapy continues to change treatment paradigms for NSCLC.

A significant overall survival benefit with the use of maintenance chemotherapy has been demonstrated by the RMS2005 trial of children who have completed standard treatment for high-risk, nonmetastatic rhabdomyosarcoma.

The PD-L1 inhibitor was associated with “a doubling of the 2-year survival rate, maintenance of quality of life, and a favourable safety profile compared with single-agent chemotherapy,” report Siow Ming Lee (University College London Hospitals NHS Foundation Trust, UK) and co-investigators.

Treatment: Four cycles of nivolumab 240 mg every 2 weeks then response-driven option of maintenance nivolumab or nivolumab 1 mg/kg plus ipilimumab 3 mg/kg combination therapy followed by nivolumab maintenance where appropriate. https://clinicaltrials.gov/ct2/show/NCT03219775 Sponsor: AIO-Studien-gGmbH Treatment in this tailored immunotherapy study was guided by each patient’s initial response to four cycles of nivolumab therapy.

Phase 2 data point to the potential of switch maintenance with darolutamide in men with metastatic castration-resistant prostate cancer that has not progressed after taxane therapy.

In the phase 3 study, 412 Chinese patients with stage IIIB–IV nonsquamous disease were randomly assigned to receive four to six cycles of camrelizumab 200 mg alongside carboplatin plus pemetrexed every 3 weeks or chemotherapy alone, followed by maintenance pemetrexed with or without camrelizumab.

In each case the drugs need to be given once every 3 weeks alongside four cycles of platinum-based chemotherapy, followed by maintenance treatment with durvalumab plus chemotherapy every 4 weeks.

The preliminary analysis of the real-world AVENANCE study bolsters the recommendation for avelumab maintenance in people with advanced urothelial carcinoma that has not progressed after first-line platinum-based chemotherapy. This independent news story was supported by an educational grant from Pfizer and Merck Healthcare KGaA, Darmstadt, Germany

In the current study, 466 patients with stage III (14.8%) or IV (85.2%) NSCLC without EGFR , ALK , or ROS1 genomic tumor aberrations were randomly assigned to receive cemiplimab 350 mg (n=312) or placebo (n=154) every 3 weeks for up to 108 weeks each in combination with four cycles of an investigator’s choice of platinum-doublet chemotherapy, followed by pemetrexed maintenance where indicated.

Chromatin conformation loops, especially the POU2F2 loop, may have clinical utility as a biomarker in advanced urothelial cancer, suggest exploratory data from the JAVELIN Bladder 100 trial of maintenance avelumab. This independent news story was supported by an educational grant from Pfizer and Merck Healthcare KGaA, Darmstadt, Germany

This was followed by maintenance treatment with toripalimab or placebo as per the random assignment, with nonsquamous NSCLC patients continuing with pemetrexed.

Final analysis of progression-free survival in the GEMSTONE-301 trial shows a significant improvement with use of sugemalimab versus placebo after chemoradiotherapy for stage III unresectable non-small-cell lung cancer, report Chinese researchers at the IASLC World Conference on Lung Cancer 2022 in Vienna, Austria.

This article summarizes the top-line results of the published trials of immunotherapeutic agents – used as monotherapy, in combination with chemotherapy, or as maintenance – in patients with previously untreated locally advanced or metastatic urothelial carcinoma.

Maintenance treatment with avelumab improves the long-term outcomes of advanced urothelial cancer patients regardless of their response to first-line chemotherapy and receipt of second-line therapy, suggest exploratory analyses of the JAVELIN Bladder 100 trial.

The presenter commented that the PFS results were “even more impressive,” as pembrolizumab continued to be associated with a benefit at the 3-year mark, despite the fact that the treatment duration was no longer than 2 years.

Maintenance treatment with cabozantinib after platinum-based chemotherapy does not significantly improve the outcomes of unselected patients with metastatic urothelial cancer relative to placebo, indicate findings from ATLANTIS. This independent news story was supported by an educational grant from Pfizer and Merck Healthcare KGaA, Darmstadt, Germany