ASCO 2024: Study Analysis Focuses on Nodal Status With Neoadjuvant Nivolumab in Stage III NSCLC

By: Joshua D. Madera, MD
Posted: Thursday, June 27, 2024

For patients with resectable, stage IIA to IIIB non–small cell lung cancer (NSCLC), the neoadjuvant use of the PD-1 inhibitor nivolumab may improve clinical outcomes, according to the results of the CheckMate 77T study. In an exploratory analysis of this trial, which was presented at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract LBA8007), the clinical benefit with this therapy in this patient population was seen regardless of N2 status, according to Mariano Provencio, MD, PhD, of Puerta de Hierro University Hospital, Madrid, and colleagues.

A total of 293 patients with resectable NSCLC were recruited for the study. Patients were randomly assigned to receive neoadjuvant treatment with nivolumab and chemotherapy followed by adjuvant use of nivolumab (n = 146) or neoadjuvant use of placebo and chemotherapy followed by adjuvant use of placebo (n = 147). All clinical analyses were performed in patients with stage III disease stratified by N2 status (N2 disease = 181, non–N2 disease = 112).

The study authors reported improvements in 1-year event-free survival (70%, hazard ratio [HR] = 0.46) and pathologic complete response (22%) for patients with N2 disease treated with nivolumab compared with placebo. Similarly, patients with non–N2 disease treated with nivolumab had an improved 1-year event-free survival (74%, HR = 0.60) and pathologic complete response (25.5%) compared with placebo-treated patients. In addition, postsurgical tumor downstaging to ypT0 was more pronounced in patients treated with nivolumab (33% for N2 disease, 27% for non–N2 disease) than in those given placebo (14% for N2 disease, 11% for non–N2 disease). Moreover, more treatment-related adverse events were reported by patients treated with nivolumab (34% for N2 disease, 29% for non–N2 disease) compared with recipients of placebo (26% for N2 disease, 21% for non–N2 disease).

Disclosure: For full disclosures of the study authors, visit coi.asco.org.

2024 ASCO Annual Meeting