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Published on: September 25, 2018
Nintedanib in NSCLC: evidence to date and place in therapy
Giuseppe Bronte1, Francesco Passiglia1, Antonio Galvano1
1Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Italy.
Abstract:
The treatment of advanced non-small cell lung cancer (NSCLC) is currently driven by the detection of targetable oncogenic drivers, i.e. epidermal growth factor receptor, echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase, etc. Those patients who are wildtype for known and valuable oncogenes can receive standard chemotherapy as first-line treatment, with the possibility of adding bevacizumab. With regard to second-line treatment, nintedanib can improve the efficacy of docetaxel. Nintedanib is a tyrosine kinase inhibitor targeting three angiogenesis-related transmembrane receptors. The usefulness of nintedanib as an anticancer agent for NSCLC has been proved by both preclinical and clinical phase I and II trials; however, its approval for the use in clinical practice has been possible because of the positive results of the LUME-Lung 1 trial (nintedanib + docetaxel versus docetaxel alone) in terms of progression-free survival and overall survival, and a manageable tolerability profile. Therefore, the good results seen in the clinical trials with nintedanib in the second-line setting for NSCLC patients with adenocarcinoma subtype are encouraging enough to recommend it in clinical practice.
Insights
Nintedanib combined with docetaxel improves progression-free and overall survival in advanced non-small cell lung cancer (NSCLC) patients with adenocarcinoma. This combination offers a manageable safety profile for second-line treatment.
Area of Science:
- Medical Oncology
- Pharmacology
Background:
- Advanced non-small cell lung cancer (NSCLC) treatment relies on identifying targetable oncogenic drivers.
- Standard chemotherapy with bevacizumab is used for patients lacking known oncogenic drivers.
- Second-line treatment options for NSCLC are crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the efficacy and safety of nintedanib plus docetaxel versus docetaxel alone in advanced NSCLC patients.
- To assess nintedanib's role as a second-line treatment option.
Main Methods:
- The LUME-Lung 1 trial investigated nintedanib plus docetaxel versus docetaxel alone.
- Progression-free survival (PFS) and overall survival (OS) were primary endpoints.
- Tolerability and safety profiles were also assessed.
Main Results:
- The LUME-Lung 1 trial demonstrated significant improvements in PFS and OS for the nintedanib plus docetaxel arm.
- Nintedanib, a tyrosine kinase inhibitor targeting angiogenesis-related receptors, showed efficacy in preclinical and early clinical trials.
- The combination therapy exhibited a manageable tolerability profile.
Conclusions:
- Nintedanib plus docetaxel is an effective second-line treatment for advanced NSCLC patients with adenocarcinoma.
- The positive results from the LUME-Lung 1 trial support the use of nintedanib in clinical practice for this patient population.
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