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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Tuesday, September 10, 2024
Can patients with operable non–small cell lung cancer (NSCLC) benefit more from immunotherapy before and after surgery than from surgery alone? Based on research presented by Patrick M. Forde, MBBCh, of Johns Hopkins Kimmel Comprehensive Cancer Center, Baltimore, and colleagues during the International Association for the Study of Lung Cancer (IASLC) 2024 World Conference on Lung Cancer (WCLC; Abstract PL02.08), the answer may be yes.
“There’s been a big migration in lung cancer and in melanoma treatment in the last few years from doing surgery upfront and giving postoperative immunotherapy, to giving immunotherapy prior to surgery,” commented Dr. Forde in a Johns Hopkins Medicine press release. “But our analysis in individual patients in these two trials suggests there is likely a further benefit from receiving additional immunotherapy treatment after surgery.”
The researchers compared the outcomes of participants in two trials: CheckMate 816 and CheckMate 77T. In CheckMate 816, a total of 147 patients received three cycles of the PD-1 inhibitor nivolumab plus chemotherapy before surgery, whereas 139 patients in CheckMate 77T received up to four cycles of nivolumab plus chemotherapy before surgery and up to 13 cycles of nivolumab after surgery. All patients were followed for up to 4 years after surgery.
The investigators reported a 40% reduction in the risk of disease recurrence or death after surgery in those who received at least one dose of nivolumab after immunotherapy/chemotherapy and surgery. This benefit did not seem to be affected by the baseline cancer stage, they added. In addition, there appeared to be more of a benefit in those who had less than 1% tumor expression of PD-L1 than in those who had more than 1% tumor expression of PD-L1. Finally, this immunotherapy before and after surgery also seemed to be of benefit even in patients who did not achieve a complete pathologic response from presurgical treatment and surgery.
Disclosure: For full disclosure information, visit wclc2024.iaslc.org.
2024 World Conference on Lung Cancer
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