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Paz-Ares L, Goto Y, Wan-Teck Lim D, Halmos B, Chul Cho B, Cobo M, Luis González Larriba J, Zhou C, Demedts I, Atmaca A, Baka S, Mookerjee B, Portella S, Zhu Z, Wu J, Demanse D, Dharan B, Reck M. Canakinumab in combination with docetaxel compared with docetaxel alone for the treatment of advanced non-small cell lung cancer following platinum-based doublet chemotherapy and immunotherapy (CANOPY-2): A multicenter, randomized, double-blind, phase 3 trial. Lung Cancer 2024; 189:107451. [PMID: 38354535 DOI: 10.1016/j.lungcan.2023.107451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 12/07/2023] [Accepted: 12/22/2023] [Indexed: 02/16/2024]
Abstract
OBJECTIVES Canakinumab, an interleukin-1 beta inhibitor, previously showed reduced lung cancer incidence and mortality (CANTOS). Here, we compare the efficacy/safety of canakinumab versus placebo in patients with advanced non-small cell lung cancer (NSCLC) who had progressed after platinum-based doublet chemotherapy (PDC) and immunotherapy. MATERIALS AND METHODS CANOPY-2, a randomized, double-blind, phase 3 trial, enrolled adult patients with stage IIIB/IV NSCLC, without EGFR or ALK alterations, who had received one prior PDC regimen and one prior programmed death-1/programmed death-ligand 1 inhibitor and experienced subsequent disease progression. Patients were randomized to canakinumab plus docetaxel or placebo plus docetaxel. RESULTS A total of 237 patients were randomly allocated: 120 (51 %) to canakinumab and 117 (49 %) to placebo, stratified by histology and prior lines of therapy. Three patients in the placebo arm did not receive study treatment. The trial did not meet its primary endpoint of overall survival: median 10.6 months (95 % confidence interval [CI], 8.2-12.4) for the canakinumab arm and 11.3 months (95 % CI, 8.5-13.8) for the placebo arm (hazard ratio, 1.06 [95 % CI, 0.76-1.48]; one-sided P-value = 0.633). AEs (any grade) were reported in 95 % of patients in the canakinumab group and in 98 % of patients in the placebo group. Grade 3-4 AEs were experienced by 62 % and 64 % of patients in the canakinumab and placebo groups, respectively, and grade 5 AEs were experienced by 8 % and 5 %. Prespecified, post-hoc subgroup analyses showed that patients with undetected circulating tumor DNA (ctDNA) and/or lower levels (< 10 mg/L) of C-reactive protein (CRP) achieved longer progression-free and overall survival than those with detected ctDNA or higher (≥ 10 mg/L) CRP levels. There was no association with treatment arm. CONCLUSION Adding canakinumab to docetaxel did not provide additional benefit for patients with advanced NSCLC who had progressed after PDC and immunotherapy. CLINICAL REGISTRATION NCT03626545.
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Affiliation(s)
- Luis Paz-Ares
- CNIO-H120 Lung Cancer Unit, University Hospital 12 de Octubre, Universidad Complutense de Madrid and CIBERONC, Madrid, Spain.
| | - Yasushi Goto
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | | | - Balazs Halmos
- Division of Medical Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA
| | - Byoung Chul Cho
- Department of Internal Medicine, Yonsei University Health System, YUCM, Seoul, Republic of Korea
| | - Manuel Cobo
- Unidad de Gestión Clínica Intercentros de Oncología Médica, Regional y Virgen de la Victoria Hospital, IBIMA, Málaga, Spain
| | | | - Caicun Zhou
- Department of Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Ingel Demedts
- Department of Pulmonary Diseases, AZ Delta Hospital, Roeselare, Belgium
| | - Akin Atmaca
- Department of Hematology and Oncology, University Cancer Center (UCT), Frankfurt, Germany
| | - Sofia Baka
- Oncology Department, European Interbalkan Medical Center, Thessaloniki, Greece
| | | | | | - Zewen Zhu
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Jincheng Wu
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | | | - Bharani Dharan
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Martin Reck
- LungenClinic, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Grosshansdorf, Germany
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Paz-Ares L, Goto Y, Lim W, Halmos B, Cho B, Dols MC, Gonzalez-Larriba J, Zhou C, Demedts I, Atmaca A, Baka S, Mookerjee B, Portella S, Zhu Z, Dharan B, Reck M. 1194MO Canakinumab (CAN) + docetaxel (DTX) for the second- or third-line (2/3L) treatment of advanced non-small cell lung cancer (NSCLC): CANOPY-2 phase III results. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1799] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Spira A, Ardizzoni A, Barlesi F, Cho B, De Marchi P, Goto Y, Kowalski D, Lu S, Paz-Ares L, Spigel D, Thomas M, Leung M, Baum J, Zhou W, Portella S, Chih-Hsin Yang J, Garon E. MO01.22 Canakinumab as Adjuvant Therapy in Patients with Completely Resected Non-Small Cell Lung Cancer (NSCLC): CANOPY-A Trial. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Braggio DA, Braggio E, Small IÁ, Bacchi CE, Lopes LF, Valadão M, Portella S, Romano S, Guimarães DP, Ferreira CG. The profile of platelet-derived growth factor receptor alpha (PDGFRA) gene alterations in GIST patients (pts) from Brazil. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.10561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Lobo S, Contrin L, Navegantes L, Orrico S, Queiroz M, Cury P, Lira E, Carta A, Yamamoto A, Portella S, Vincent J. Crit Care 2005; 9:P366. [DOI: 10.1186/cc3429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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