Long-Term Survival With Nivolumab in Advanced Lung Cancer
Posted: Wednesday, October 23, 2019
Scott J. Antonia, MD, of Duke Cancer Institute, Durham, North Carolina, and colleagues suggest that the checkpoint inhibitor nivolumab may offer long-term survival benefits among patients with previously treated non–small cell lung cancer (NSCLC). According to the study published in The Lancet Oncology, patients who received nivolumab experienced a greater duration of response than those treated with docetaxel.
The authors evaluated survival outcomes using pooled data from four clinical studies of patients with previously treated NSCLC: CheckMate 017 (n = 131), 057 (n = 287), 063 (n = 117), and 003 (n = 129). Trials were included if nivolumab was a second-line or later treatment with at least 4 years of follow-up. CheckMate 017 and 057 were the comparison studies of nivolumab (n = 427) versus docetaxel (n = 427). Patients who did not have a radiographic tumor assessment at 6 months were excluded.
For all patients across the four clinical trials, the 4-year overall survival with nivolumab was 14%. In CheckMate 017 and 057, the 4-year overall survival was 14% for patients treated with nivolumab and 5% for those treated with docetaxel. Survival was better among patients with a PD-L1 expression of at least 1%. A landmark analysis by response status at 6 months revealed survival after response to nivolumab or docetaxel was longer than after progressive disease. The hazard ratios for overall survival were 0.18 and 0.43 for nivolumab and docetaxel, respectively. The study did not reveal any new long-term safety data on nivolumab.
“Additional analyses assessing the effect of various factors on long-term survival with immunotherapy vs chemotherapy are planned,” the investigators concluded.
Disclosure: For full disclosures of the study authors, visit thelancet.com.