regn2810 (anti-pd-1 antibody), platinum-based doublet chemotherapy, and ipilimumab (anti-ctla-4 antibody) versus pembrolizumab monotherapy in patients with lung cancer

Conditions: Non-small Cell Lung Cancer

Summary: the primary objective of the study is to compare the progression-free survival (pfs) of regn2810 (cemiplimab) plus ipilimumab combination therapy (hereinafter referred to as regn2810/ipi) and regn2810 plus 2 cycles only of platinum-based doublet chemotherapy plus ipilimumab combination therapy (hereinafter referred to as "regn2810/chemo/ipi") with standard-of-care pembrolizumab monotherapy in the first-line treatment of patients with advanced squamous or non-squamous non-small cell lung cancer (nsclc) whose tumors express programmed death ligand 1 (pd-l1) in ≥50% of tumor cells. the key secondary objectives of the study are to compare the overall survival (os) of regn2810/ipi and regn2810/chemo/ipi with pembrolizumab monotherapy in the first-line treatment of patients with advanced squamous or non-squamous nsclc whose tumors express pd-l1 in ≥50% of tumor cells and to compare the overall response rate (orr) of regn2810/ipi and regn2810/chemo/ipi with pembrolizumab monotherapy in the first-line treatment of patients with advanced squamous or non-squamous nsclc whose tumors express pd-l1 in ≥50% of tumor cells.


Eligibility criteria:
key inclusion criteria: 1. patients with histologically or cytologically documented squamous or non-squamous nsclc with stage iiib or stage iv disease, who received no prior systemic treatment for recurrent or metastatic nsclc 2. availability of an archival (≤5 months) or on-study obtained formalin-fixed, paraffin-embedded tumor tissue sample which has not previously been irradiated 3. expression of pd-l1 in ≥50% of tumor cells determined by the commercially available assay performed by the central laboratory 4. at least 1 radiographically measureable lesion by computed tomography (ct) or magnetic resonance imaging (mri) per recist 1.1 criteria. target lesions may be located in a previously irradiated field if there is documented (radiographic) disease progression in that site 5. eastern cooperative oncology group (ecog) performance status of ≤1 6. anticipated life expectancy of at least 3 months key exclusion criteria: 1. patients who have never smoked, defined as smoking ≤100 cigarettes in a lifetime 2. active or untreated brain metastases or spinal cord compression 3. patients with tumors tested positive for epidermal growth factor receptor (egfr) gene mutations, anaplastic lymphoma kinase (alk) gene translocations, or c-ros oncogene receptor tyrosine kinase(ros1) fusions 4. encephalitis, meningitis, or uncontrolled seizures in the year prior to informed consent 5. history of interstitial lung disease (eg, idiopathic pulmonary fibrosis or organizing pneumonia), of active, noninfectious pneumonitis that required immune-suppressive doses of glucocorticoids to assist with management, or of pneumonitis within the last 5 years 6. ongoing or recent evidence of significant autoimmune disease that required treatment with systemic immunosuppressive treatments, which may suggest risk of immune-related treatment-emergent adverse events (irteaes) 7. previous treatment with idelalisib at any time (zydelig®) 8. patients with a condition requiring corticosteroid therapy (\>10 mg prednisone/day or equivalent) within 14 days of randomization note: other protocol defined inclusion/exclusion criteria may apply

Keywords: stage iiib stage iv non-squamous nsclc squamous nsclc