Ivonescimab Outperforms Keytruda in NSCLC, Shows Promise as New Standard of Care

Akeso and Summit's ivonescimab has delivered impressive phase 3 trial results, potentially establishing it as a new standard of care in treating PD-L1-positive non-small cell lung cancer (NSCLC). In the HARMONi-2 study, ivonescimab reduced the risk of disease progression or death by 49% compared to Merck’s Keytruda. The trial, conducted in China, also extended progression-free survival for patients by 5.32 months, reaching a median of 11.14 months without tumor progression.

The drug’s superiority was consistent across various patient subgroups, including those with different tumor types, smokers, non-smokers, and those with brain metastases. These findings were presented at the 2024 World Conference on Lung Cancer, where experts highlighted ivonescimab’s potential as a breakthrough treatment for first-line NSCLC patients.

Ivonescimab combines PD-1 and VEGF targeting, offering an advantage over existing treatments like Roche’s Tecentriq and Avastin, particularly for squamous patients, where Avastin is contraindicated due to bleeding risks. Ivonescimab, however, showed low rates of serious hemorrhages in the study.

While some VEGF-related side effects such as proteinuria and hypertension were more frequent in ivonescimab-treated patients, they were manageable, with no treatment discontinuations linked to them. Experts like Dr. John Heymach of MD Anderson Cancer Center noted that these results could disrupt the current treatment landscape, ushering in a new era of cancer immunotherapy if future trials confirm these benefits.