SAFIR 02: Durvalumab compared to maintenance chemotherapy for metastatic non-small cell lung cancer

Prof Fabrice Barlesi - Gustave Roussy, Villejuif, France

Hi everyone, I’m Fabrice Barlesi from Gustave Roussy cancer campus in Paris and ex-Marseilles University. This year during the ESMO 2020 we presented the first results of the SAFIR 02 lung trial. This trial included around 1,000 patients. Those patients were genotyped during their induction chemotherapy and had to provide a biopsy before the second cycle of chemotherapy. For those patients with an actionable molecular alteration they were randomised between a targeted treatment or the standard maintenance chemotherapy and for those without an identifying actionable molecular alteration they were randomised between the standard maintenance chemotherapy or immunotherapy.

This is the part that has been presented during ESMO 2020 recently. What we showed in this patient population is the fact that in the patients with the high PD-L1 expression, more than 1%, there was a PFS benefit and an overall survival benefit with a hazard ratio of 0.32 regarding the overall survival of the patients treated with immunotherapy compared to the patients receiving the standard pemetrexed-based maintenance chemotherapy.

Then this study is adding another piece to the data showing the activity of the immunotherapy in advanced non-small cell lung cancer patients. Especially it highlights the fact that the sooner the immunotherapy is started, the higher seems to be the benefit and it provides an opportunity for the patients who are not able to receive an immunotherapy combined with chemotherapy as a frontline treatment to receive it as a maintenance treatment.

Of course those results are just preliminary and it’s to be confirmed.