Nivolumab for Advanced Lung Cancer: 5-Year Survival
Posted: Monday, August 26, 2019
Patients with advanced non–small cell lung cancer (NSCLC) treated with nivolumab had a 5-year overall survival rate of 15.6%, according to long-term follow-up data from a phase I trial. The research was published in JAMA Oncology by Suzanne Topalian, MD, of the Johns Hopkins Bloomberg–Kimmel Institute for Cancer Immunotherapy, and colleagues.
“We report, to our knowledge, the longest combined clinical follow-up for patients with multiple cancer types receiving any anti–PD-L1 drug,” the authors wrote.
The phase I dose-escalation trial plus expansion cohort included 129 patients with advanced NSCLC and 141 patients with kidney cancer or melanoma. Patients had received at least one previous treatment, and 72% had received between two and five previous treatments. Patients were enrolled between 2008 and 2011. Clinicians gave patients 0.1, 0.3, 1.0, 3.0, or 10.0 mg/kg of nivolumab every 2 weeks for up to 96 weeks or until progressive disease, complete response, toxicity, or patient withdrawal from the trial.
The median overall survival was 9.9 months. At 3 years, the overall survival rate was 18.4%, and at 5 years, it was 15.6%. There were three treatment-related deaths.
In an analysis that also included the trial’s patients with renal cell carcinoma and melanoma, pretreatment liver and bone metastases were independently associated with poorer overall survival. In contrast, an Eastern Cooperative Oncology Group performance status of 0 was associated with better survival. Overall survival was longer for those with treatment-related adverse events (median overall survival of 19.8 months) than for those with no such adverse events (median overall survival of 5.8 months). The authors also suggested that objective tumor regression may be “an early surrogate for long-term clinical benefit,” because it was associated with 5-year overall survival.
Disclosure: The study authors’ disclosure information may be found at jamanetwork.com.