Edward Garon, MD

Edward B. Garon, MD, MS, professor of medicine, Geffen School of Medicine, Department of Medicine, Division of Hematology/Oncology, University of California, Los Angeles, discusses the mechanism of action of canakinumab (Ilaris).

Canakinumab is an interleukin-1beta inhibitor (IL-1β) being evaluated as a potential treatment option for patients with non–small cell lung cancer (NSCLC).

Within the phase 3 CANOPY-A study (NCT03447769), adjuvant canakinumab is being explored in patients with completely resected NSCLC. However, the agent

failed to meet its primary end point of disease-free survival

according to data presented at the 2022 ESMO.

Canakinumab is a high-affinity monoclonal antibody directed against an interleukin-1beta. IL-1β has been considered a key mediator of inflammation. One of the unique aspects of canakinumab is that it is an approved drug in many countries, including the United States, for a variety of inflammatory disorders.

 There has been a tremendous amount of preclinical data looking at IL-1β and other mediators of inflammation in lung cancer. Prior to the development of canakinumab, there was much less clinical data available looking at this pathway.

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Edward B. Garon, MD, MS, discusses the mechanism of action of canakinumab.


 Discussing the Option of Canakinumab in NSCLC

Edward E. Garon, MS, MS, discusses results from the phase 3 CANOPY-A study (NCT03447769) of adjuvant canakinumab for the treatment of patients with completely resected non-small cell lung cancer (NSCLC). Garon presented the results during the 2022 European Society for Medical Oncology Congress.

CANOPY-A failed to meet its primary end point according to Garon, however, there was a numerical advantage in the canakinumab arm compared with placebo. The DFS in the canakinumab arm was 30.0% vs 31.6% with placebo. The median DFS was 35.0 months in the canakinumab arm vs 29.7 months in the placebo arm (HR 0.94; 95% CI 0.78-1.14; one-sided 


Across predefined subgroups of patients, there was also no meaningful difference in DFS with canakinumab compared with placebo.

 The primary endpoint, which was disease-free survival was not positive, although numerically it did favor canakinumab, particularly at the median. The p value was one-sided and was 0.26, reflecting the similarity of the curves throughout the entirety of the curve with a hazard ratio that was not particularly impressive. In addition, when we looked for different subgroups, we really were not able to find subgroups where the 95% confidence interval excluded 1 and so as a result, this is a study that really was not able to show the value of canakinumab in the setting of completely resected non–small cell lung cancer.

Edward E. Garon, MS, MS, discusses results from the phase 3 CANOPY-A study of adjuvant canakinumab for the treatment of patients with completely resected non-small cell lung cancer.

Canakinumab Fails to Improve DFS in Resected NSCLC

Edward Garon, MD, assistant professor of Medicine, Department of Medicine, Division of Hematology/Oncology, Geffen School of Medicine at University of California, Los Angeles, discusses the future of combination therapies in lung cancer. Garon says the likely place to start when looking into combination therapies are cytotoxic chemotherapy and tyrosine kinase inhibitors, given these treatments are currently approved in lung cancer.

Garon says that some immunotherapies are in early phase trials for the treatmnet of lung cancer. CTLA-4 inhibitors, popular in melanoma treatment, may also play a role in lung cancer treatment along with the inhibition of the PD-1 checkpoint, says Garon. He adds that he is hopeful that these therapies will be effective in treating lung cancer, though he is concerned about the potential toxicities that may come along with them.

Garon says the likely place to start when looking into combination therapies are cytotoxic chemotherapy and tyrosine kinase inhibitors, given these treatments are currently approved in lung cancer.

Edward Garon, MD | Authors

Articles

Discussing the Option of Canakinumab in NSCLC

Canakinumab Fails to Improve DFS in Resected NSCLC

Dr. Edward Garon on the Future of Combination Treatments in Lung Cancer