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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Monday, February 26, 2024
Current efforts have focused on establishing an effective treatment regimen for patients with metastatic non–small cell lung cancer (NSCLC), according to the results of the CheckMate 722 trial published in the Journal of Clinical Oncology. However, the combination of nivolumab plus platinum-doublet chemotherapy did not improve progression-free survival in patients with EFGR-mutated NSCLC after disease progression on EGFR tyrosine kinase inhibitors. Thus, future studies should continue to investigate possible therapeutic alternatives, suggested Tony Mok, MD, FRCPC, FASCO, of The Chinese University of Hong Kong, and colleagues.
From 2017 to 2020, a total of 294 patients with EGFR-mutated metastatic NSCLC were recruited for the study. All patients had evidence of disease progression after treatment with a first- or second-generation EGFR tyrosine kinase inhibitor or the third-generation osimertinib. Patients were randomly assigned to receive nivolumab plus platinum-doublet chemotherapy (n = 144) or platinum-doublet chemotherapy alone (n = 150).
The study authors reported no significant improvement in progression-free survival (hazard ratio [HR] = 0.75) with nivolumab plus platinum-doublet chemotherapy (5.6 months) compared with the doublet alone (5.4 months). Post hoc analyses performed in patients with tumors expressing sensitizing EGFR mutations (HR = 0.72), patients with one line of previous treatment with an EGFR tyrosine kinase inhibitor (HR = 0.72), or patients with both (HR = 0.64) revealed trends favoring treatment with nivolumab plus platinum-doublet chemotherapy. Furthermore, patients treated with nivolumab plus chemotherapy had an increased median overall survival (19.4 months) compared with the chemotherapy-alone group (15.9 months). Moreover, patients who received combination treatment reported more treatment-related adverse events (44.7%) compared with patients who received chemotherapy alone (29.4%).
Disclosure: For full disclosures of the study authors, visit ascopubs.org.
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