The FDA has granted approval to Optune Lua, a Tumor Treating Fields (TTF) device, for use in adult patients with metastatic non-small cell lung cancer (NSCLC) whose disease has progressed on or after platinum-based chemotherapy. This approval marks a significant advancement in the treatment landscape for NSCLC, offering a novel approach beyond traditional systemic therapies.
The approval was primarily based on the results of the phase 3 LUNAR trial (NCT02973789), a study that evaluated TTFields plus standard-of-care immune checkpoint inhibitors or docetaxel versus immune checkpoint inhibitors or docetaxel alone. The LUNAR trial's findings have demonstrated the potential of TTFields in improving patient outcomes in metastatic NSCLC.
LUNAR Trial Results
The LUNAR trial revealed that patients treated with Optune Lua in conjunction with a PD-1/PD-L1 inhibitor or docetaxel (n = 145) achieved a median overall survival (OS) of 13.2 months (95% CI, 10.3-15.5), compared to 9.9 months (95% CI, 8.2-12.2) in those who received a PD-1/PD-L1 inhibitor or docetaxel alone (n = 146; P = .04).
Specifically, the combination of Optune Lua and an immune checkpoint inhibitor (n = 66) resulted in a median OS of 18.5 months (95% CI, 10.6-30.3), while a checkpoint inhibitor alone (n = 68) yielded a median OS of 10.8 months (95% CI, 8.2-18.4; HR, 0.63; 95% CI, 0.41-0.96; P = .030). In the docetaxel arm, Optune Lua plus docetaxel (n = 71) led to a median OS of 11.1 months (95% CI, 8.2-14.1), compared to 8.7 months (95% CI, 6.3-11.3) for docetaxel alone (HR, 0.81; 95% CI, 0.55-1.19; P = .28).
Clinical Implications
The addition of Optune Lua to the current standard-of-care second-line treatment regimens for patients with NSCLC presents a valuable new option for individuals whose disease has progressed following platinum-based therapy. According to Dr. Rupesh Rajesh Kotecha, Miami Cancer Institute, the concurrent use of TTFields with standard options did not increase adverse effects impacting quality of life.
