Non-Small Cell Lung Cancer Coverage from Every Angle

ASCO20: 3-Year Update on Nivolumab Plus Ipilimumab as First-Line Treatment of NSCLC

By: Joshua Swore
Posted: Thursday, June 25, 2020

According to a 3-year update of the phase III CheckMate 227 Part 1 trial, presented during the ASCO20 Virtual Scientific Program (Abstract 9500), patients with non–small cell lung cancer (NSCLC) treated with nivolumab plus ipilimumab in the first-line setting continued to display better overall survival benefits than patients treated with chemotherapy. Suresh S. Ramalingam, MD, of Emory University, Atlanta and colleagues also reported no new safety signals for the combination immunotherapy.

Included in the study were 1,189 patients with stage IV recurrent NSCLC and of PD-L1 expression ≥ 1% and 550 patients with of PD-L1 expression < 1%. Patients with PD-L1 expression ≥ 1% were randomly assigned 1:1:1 and treated with nivolumab plus ipilimumab, nivolumab alone, or chemotherapy. Patients with PD-L1 expression < 1% were treated with nivolumab plus ipilimumab, nivolumab plus chemotherapy, or chemotherapy alone.

At a 3-year minimum follow-up, patients with PD-L1 expression ≥ 1% had an overall survival rate of 33% with nivolumab plus ipilimumab, 29% with nivolumab, and 22%  with chemotherapy. Progression-free survival was improved in the nivolumab-plus-ipilimumab arm compared with nivolumab alone or chemotherapy (18% vs. 12% vs. 4%, respectively). A total of 38% of patients with a confirmed response remained in response in the-nivolumab-plus-ipilimumab arm versus 32% in the nivolumab arm and 4% in the chemotherapy arm. Similar results were found in patients with PD-L1 expression < 1%. These patients responded better and exhibited longer overall survival rates when treated with nivolumab plus ipilimumab compared with chemotherapy.

Adverse events occurred in 77% of patients in the nivolumab-plus-ipilimumab arm and 82% in the chemotherapy arm. Grade 3 or 4 treatment-related adverse events occurred in 33% of all patients treated with nivolumab plus ipilimumab compared with 36% of those treated with chemotherapy. 

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