Adding First-Line Ipilimumab to Chemotherapy for Squamous NSCLC
Ramaswamy Govindan, MD, of Washington University School of Medicine, St. Louis, and colleagues found that adding first-line ipilimumab to chemotherapy did not improve overall survival in patients with advanced squamous non–small cell lung cancer (NSCLC). They reported their phase III trial findings in the Journal of Clinical Oncology. However, studies are underway to evaluate the combination of ipilimumab and nivolumab in this patient population.
This double-blind trial included 956 patients with stage IV or recurrent chemotherapy-naive disease from 233 sites in 34 countries. Approximately half of them received paclitaxel and carboplatin plus ipilimumab, and the other half received paclitaxel and carboplatin plus placebo. The modified intent-to-treat population contained 388 patients in the ipilimumab group and 361 patients in the control group.
The median overall survival reported for the ipilimumab group was 13.4 months, compared with 12.4 months for the control group. The median progression-free survival was 5.6 months in both groups.
In an attempt to explain the failure of the study, the authors noted the reduced chemotherapy exposure in the ipilimumab group, which they think may have been triggered by the toxicity and higher discontinuation rates in the chemotherapy plus ipilimumab arm.