The FDA has approved Novocure's Optune Lua for the treatment of adult patients with metastatic non-small cell lung cancer (mNSCLC) who have progressed on or after platinum-based therapy. This approval marks a significant advancement in the treatment landscape for this aggressive disease.
Optune Lua is a wearable, portable device that delivers Tumor Treating Fields (TTFields), which are alternating electric fields designed to disrupt cancer cell division and cause cell death. The device is approved for concurrent use with PD-1/PD-L1 inhibitors or docetaxel.
Clinical Trial Data
The approval is based on the Phase 3 LUNAR trial, a randomized, open-label, multicenter study. The trial compared Optune Lua in combination with PD-1/PD-L1 inhibitors or docetaxel to PD-1/PD-L1 inhibitors or docetaxel alone in patients with metastatic NSCLC who had progressed during or after platinum-based therapy.
The LUNAR trial met its primary endpoint, demonstrating a statistically significant and clinically meaningful 3.3-month extension in median overall survival (OS) for patients treated with Optune Lua in combination with either a PD-1/PD-L1 inhibitor or docetaxel (13.2 months vs. 9.9 months; P=0.04). Notably, patients treated with Optune Lua and a PD-1/PD-L1 inhibitor experienced a median OS of 19.0 months, compared to 10.8 months for those treated with a PD-1/PD-L1 inhibitor alone (P=0.02), representing an 8.0-month extension in median overall survival.
While the combination of Optune Lua with docetaxel showed a positive trend, the 2.2-month extension in median OS (11.1 months vs. 8.9 months) did not reach statistical significance.
Safety and Tolerability
Device-related adverse events, primarily skin-related disorders under the transducer arrays, occurred in 63.1% of patients. The majority of these events were low grade (Grade 1-2), with only 4% experiencing Grade 3 skin toxicity requiring a break from treatment. Importantly, there were no Grade 4 or 5 toxicities related to Optune Lua, and no device-related adverse events led to death.
Expert Commentary
Dr. Ticiana Leal, the primary investigator in the LUNAR Phase 3 study and Director of the Thoracic Oncology Program at the Winship Cancer Institute of Emory University School of Medicine, emphasized the significance of the findings: "The overall survival results we observed with Optune Lua in the LUNAR study mark the first substantial improvement in more than eight years in this patient population which, when combined with Optune Lua’s lack of systemic toxicity, make this a compelling development for many patients and their physicians who need better treatment options for this advanced disease."
Mechanism of Action
Optune Lua delivers Tumor Treating Fields (TTFields), which are alternating electric fields that exert physical forces on electrically charged components of dividing cancer cells, leading to cell death. This mechanism of action differs from traditional systemic therapies and offers a novel approach to cancer treatment.
Market Opportunity
Lung cancer remains the leading cause of cancer-related deaths worldwide, with non-small cell lung cancer (NSCLC) accounting for approximately 85% of all lung cancers. The approval of Optune Lua provides a much-needed option for patients with metastatic NSCLC who have progressed after platinum-based therapy, potentially addressing a significant unmet medical need. It is estimated that approximately 30,000 patients actively seek treatment for stage 4 NSCLC after progressing during or after platinum-based therapy each year in the U.S.
Ongoing Research
Novocure is also exploring the potential of TTFields in other cancers, including brain metastases, gastric cancer, liver cancer, pancreatic cancer, and ovarian cancer. Ongoing clinical trials are evaluating TTFields in combination with other therapies, with preliminary data expected from some of these studies in the near future.
