Cabozantinib + Pembrolizumab for Lung Cancer

(LUNG-IST-127 Trial)

This trial tests a new maintenance treatment for individuals with metastatic squamous non-small cell lung cancer. Researchers aim to evaluate the effectiveness of combining two drugs, cabozantinib (a cancer medication) and pembrolizumab (an immunotherapy drug), in controlling the disease after initial treatment. Individuals with this specific type of lung cancer who have responded well to their first round of therapy might be suitable candidates. The study also examines the treatment's safety and its impact on patients' quality of life. As a Phase 2 trial, the research focuses on assessing the treatment's effectiveness in an initial, smaller group of participants.

The trial protocol does not specify if you must stop taking your current medications. However, you cannot have received certain cancer treatments or radiation therapy shortly before starting the trial, and some medications like specific anticoagulants are not allowed. It's best to discuss your current medications with the trial team.

Research shows that the combination of cabozantinib and pembrolizumab is generally well-tolerated. In earlier studies, patients with various types of cancer, including lung cancer, received these treatments and often improved without severe side effects.

Some patients experienced side effects, which are common with cancer treatments. These included fatigue, diarrhea, and high blood pressure. However, most side effects were manageable with medical care.

This study is in phase II, indicating that earlier research has already demonstrated some safety. This phase helps researchers learn more about the safety and effectiveness of the combination for patients with specific cancers, like lung cancer.

Researchers are excited about cabozantinib and pembrolizumab for lung cancer because these drugs work together in a unique way. Cabozantinib targets multiple pathways that help tumors grow and spread, offering a broader attack on cancer cells compared to standard treatments like chemotherapy. Pembrolizumab, on the other hand, is an immune checkpoint inhibitor that helps the immune system recognize and attack cancer cells more effectively. This combination aims to not only halt cancer growth but also harness the body's own defenses to fight the disease, potentially leading to better outcomes for patients.

Research has shown that using cabozantinib and pembrolizumab together may help treat metastatic squamous non-small cell lung cancer (sqNSCLC). In one study, 65.8% of patients experienced tumor shrinkage, indicating a positive response to the treatment. On average, patients lived for about 10.45 months without their cancer worsening. This combination is already approved for certain lung cancers and has successfully reduced tumor size and improved patient health. In this trial, all participants will receive cabozantinib and pembrolizumab as maintenance therapy following induction therapy. These findings suggest that cabozantinib and pembrolizumab could serve as an effective ongoing treatment option for patients.¹²⁶⁷⁸