OA08 Efficacy and Safety of Sintilimab Combined with 1st Line Chemotherapy in Advanced Squamous Cell Non-small Cell Lung Cancer

Sintilimab: A Promising Anti-Tumor PD-1 Antibody

Sintilimab (Tyvyt®) is a monoclonal antibody against programmed cell death protein 1 (PD-1). It could block the interaction between PD-1 and its ligands and help the anti-tumor effect of T-cells to recover. Sintilimab is developed by Innovent Biologics and Eli Lilly and Company and has been approved to treat relapsed or refractory classical Hodgkin lymphoma in patients who have undergone two or more lines of systemic chemotherapy by the National Medical Products Administration of China. Recently, sintilimab has been reported in plenty of literature and shows satisfying anti-tumor effect. Meanwhile, there are some reports showing its side effects. Overall, sintilimab has similar anti-tumor effects and a better safety profile compared to nivolumab and pembrolizumab in Hodgkin lymphoma, natural killer/T cell lymphoma and advanced non-small cell lung cancer. In this review, we aim to briefly describe the mechanisms, pharmacological characteristics, anti-tumor effects, predictive parameters of efficacy and side effects of sintilimab, providing valuable information of sintilimab for decision-making in the treatment of tumors in the future.

Promising response to a PD-1 inhibitor (sintilimab) in non-small cell lung cancer: A case report

RATIONALE

Lung cancer is the cancer with the highest incidence and mortality in China and worldwide. Among them, 85% are non-small cell lung cancer (NSCLC). No previous reports have been published to describe the clinical effect of the immune checkpoint inhibitor (ICI) sintilimab in NSCLC yet.

PATIENT CONCERNS

We report a case of a 64-year-old woman with a 20-day history of chest pain with computed tomography scan showing a right lower lung mass.

DIAGNOSES

Squamous NSCLC was diagnosed by bronchoscopy.

INTERVENTIONS

The patient was treated with sintilimab plus nedaplatin and paclitaxel as neoadjuvant therapy for 3 cycles, followed by right thoracotomy, right middle lobectomy, right lower lobectomy, hilar lymphadenectomy, mediastinal lymphadenectomy, and pericardiostomy.

OUTCOMES

The patient was discharged from the hospital 12 days after operation. Pathological report showed no cancer residue in the lung tissue, the bronchial stump, the anastomotic lung marginal tissue, 2nd, 4th, 7th, 9th, 10th, 11th lymph nodes or in the peribronchial lymph nodes after repeated sampling. The pathological stage was deemed T0N0M0. She remained disease free until the latest follow up in July 2019.

LESSONS

Sintilimab is a promising drug for patients with locally advanced NSCLC. However, its efficacy still requires further clinical investigations.

Sintilimab: First Global Approval

Sintilimab (Tyvyt^®) is a fully human IgG4 monoclonal antibody that binds to programmed cell death receptor-1 (PD-1), thereby blocking the interaction of PD-1 with its ligands (PD-L1 and PL-L2) and consequently helping to restore the endogenous antitumour T-cell response. It has been co-developed by Innovent Biologics and Eli Lilly and Company, and was recently approved in China for the treatment of classical Hodgkin's lymphoma in patients who have relapsed or are refractory after ≥ 2 lines of systemic chemotherapy. Sintilimab is undergoing phase I, II and III development for use in various solid tumours, including non-small cell lung cancer and oesophageal cancer, in China. Phase I/II development of sintilimab for use in solid tumours is underway in the USA, with the US FDA accepting an Investigational New Drug application for sintilimab in January 2018. This article summarizes the milestones in the development of sintilimab leading to this first approval for the treatment of classical Hodgkin's lymphoma in patients who have relapsed or are refractory after ≥ 2 lines of systemic chemotherapy.