TTFields and Immune-Checkpoint Inhibitor in Metastatic Non-Small Cell Lung Cancer: PD-L1 Subgroups in the Phase 3 LUNAR Study

Tumor Treating Fields (TTFields) are electric fields that disrupt processes critical for cancer cell survival via a multimodal mechanism of action, leading to immunogenic cell death and an enhanced antitumor immune response. TTFields are delivered by a noninvasive portable device that is FDA-approved for glioblastoma and mesothelioma. The global, randomized, phase 3 LUNAR study (NCT02973789) in patients with metastatic non-small cell lung cancer (mNSCLC) after platinum-failure demonstrated that TTFields therapy with standard of care (SOC; investigator’s choice immune checkpoint inhibitor [ICI] or docetaxel) significantly extended overall survival (OS) compared to SOC alone (median OS [mOS] 13.2 vs 10.0 months; HR 0.74 [95% CI 0.56-0.98]; P=0.037), and the survival benefit was particularly pronounced in patients who received an ICI (mOS 18.5 vs 10.6 months; HR 0.63 [95% CI 0.41-0.96]; P=0.032).