Photo Credit: Svitlana Hulko
The following is a summary of “Canakinumab Versus Placebo in Combination With First-Line Pembrolizumab Plus Chemotherapy for Advanced Non–Small-Cell Lung Cancer: Results From the CANOPY-1 Trial,” published in the December 2023 issue of Oncology by Tan et al.
Researchers sought to evaluate the efficacy of canakinumab, a human anti–interleukin (IL)-1β antibody when combined with pembrolizumab and chemotherapy (CT) in the first-line treatment of advanced non–small-cell lung cancer (NSCLC) lacking EGFR or ALK mutations.
The conducted CANOPY-1 phase III randomized, double-blind trial, with 643 patients to receive either canakinumab (200 mg subcutaneously every 3 weeks) or placebo alongside pembrolizumab (200 mg intravenously every 3 weeks) and platinum-based doublet CT. Key endpoints included PFS and OS, while secondary endpoints covered overall response rate, safety measures, and patient-reported outcomes.
After a median follow-up of 6.5 months, the canakinumab group demonstrated a median PFS of 6.8 months, comparable to the placebo group (HR 0.85, 95% CI 0.67–1.09, P=.102). At a median follow-up of 21.2 months, the median OS was 20.8 months for canakinumab and 20.2 months for placebo (HR 0.87, 95% CI 0.70–1.10, P=.123). The safety profile showed no unexpected signals, although higher rates of neutropenia and ALT increase (grade ≤2) were noted in the canakinumab arm.
Incorporating canakinumab into the first-line regimen with pembrolizumab and CT did not significantly impact progression-free or overall survival in advanced NSCLC patients. Although safety aligned with expectations, canakinumab-treated patients experienced a meaningful delay in the deterioration of lung cancer symptoms.