Early antitumor activity has been observed in patients with metastatic non–small cell lung cancer (NSCLC) treated with the combination of sacituzumab govitecan-hziy (Trodelvy) and pembrolizumab (Keytruda) in the first-line setting, according to findings from EVOKE-02 trial.
About Trodelvy (sacituzumab govitecan (IMMU-132)
Trodelvy is a precision cancer medicine that is designed to deliver a toxic payload directly to cancer cells. Trodelvy is a fusion of an antibody that recognizes a protein expressed by cancer cells known as TROP-2 and the metabolite of an established chemotherapy drug (irinotecan), SN-38. TROP-2 is a calcium signal transducer that drives cancer cell growth. SN-38 is the active anti-cancer metabolite of Irinotecan chemotherapy that is 1000 times more active than Irinotecan itself. Trodelvy binds to receptors on cancer cells and delivers the SN-38 cancer killing drug directly to the cells.
About Non-Small Cell Lung Cancer
Lung cancer is the most common cancer in the world and is the leading cause of cancer death, with 160,000 deaths in the U.S. annually. There are two main kinds of lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), which together account for over 90% of all lung cancers. Malignant mesothelioma is a rare cancer that develops in the tissues that comprise the lining of the lung. Non-small cell lung cancer accounts for approximately 75% of these cancers and consists of squamous cell, adenocarcinoma, and large cell types. Small cell lung cancer represents 20-25% of all lung cancers and is also referred to as “oat cell cancer.” Non-small cell lung cancer can be subdivided into numerous different cancers based on the genetic mutation causing the cancer.
Current standard treatment of stage IV NSCLC without a cancer growth driving mutation consists of Checkpoint Inhibitor Immunotherapy with or without chemotherapy.
The phase 2 EVOKE-2 trial is evaluating whether the addition of the TROP-2–directed antibody-drug conjugate (ADC) can improve patient outcomes when used as initial treatment in combination with the PD-1 checkpoint inhibitor Keytruda.
The initial trial results were recently released and an objective response rate of 56% among 61 patients with newly diagnosed metastatic NSCLC and no “driver mutations” was reported.
The combination was well tolerated with the most common side effects being diarrhea, anemia, hair loss, nausea, constipation, decreased appetite, low white blood cells and fatigue. Immune-mediated pneumonitis, hyperthyroidism, colitis, and hypothyroidism occurred in less than 5% of patients.
The study authors summarized that these preliminary results are encouraging and an open label, global, randomized, phase 3 EVOKE 03 trial (NCT05609968), as a first-line treatment for patients with metastatic NSCLC with PD-L1 TPS of at least 50% is ongoing.
Connect With Others for Support and information
CancerConnect was the first social network created for people with cancer. Founded by oncologists to support cancer patients and their caregivers, over 40 million individuals have accessed CancerConnect programs since 1997. CancerConnect is used by leading cancer centers like Dana Farber, Roswell Park and The James at Ohio State to support their patients. Join the conversation, ask questions, share your experience, and learn how the best cancer centers are treating cancer from others. Share your experience, ask a question, or start a conversation by posting on CancerConnect.
References
- Cho B, Dols MC, Cabanillas RR, et al. Sacituzumab govitecan + pembrolizumab in 1l metastatic non small cell lung cancer: preliminary results of the EVOKE 02 study. Presented at: International Association for the Study of Lung Cancer 2023 World Conference on Lung Cancer; September 9-12, 2023; Singapore. Abstract OA05.04.
- Gilead’s phase 2 EVOKE-02 study of Trodelvy (sacituzumab govitecan-hziy) in combination With Keytruda (pembrolizumab) demonstrates promising clinical activity in first-line metastatic non-small cell lung cancer. News release. Gilead Sciences Inc. September 10, 2023. Accessed September 10, 2023. https://www.gilead.com/news-and-press/press-room/press-releases/2023/9/gileads-phase-2-evoke02-study-of-trodelvy-sacituzumab-govitecanhziy-in-combination-with-keytruda-pembrolizumab-demonstrates-promising-clinica
