Long-Term Survival With Nivolumab in Pretreated Patients With Advanced Lung Cancer
Posted: Wednesday, April 11, 2018
Because the “historic 5-year overall survival rates for stage IV non–small-cell lung cancer [NSCLC] [are] 1% to 8%, depending on the extent of metastasis,” the 16% 5-year overall survival results in a diverse cohort of pretreated NSCLC patients who then received nivolumab is “a milestone in the advancement of lung cancer treatment,” wrote Scott Gettinger, MD, of Yale Cancer Center, and colleagues in the Journal of Clinical Oncology.
Dr. Gettinger and his team analyzed the outcomes of 129 patients with advanced NSCLC treated with nivolumab in the phase I dose-escalation CA209-003 study. Five-year overall survival rates were similar for squamous (16%) and nonsquamous (15%) histologies.
Yet the characteristics of the 16 who survived 5 years were varied. Six patients received the maximum nivolumab dose of 10 mg/kg, for instance, whereas seven patients received 3 mg/kg and three patients, 1 mg/kg. Of the 16 patients, 12 had initially had an objective response to nivolumab treatment, but the others’ best response was progressive (n = 2) or stable (n = 2) disease. Also, of the 10 patients who survived 5 years and had quantifiable PD-L1 expression, 5 had at least 50% PD-L1 expression, and 3 had no less than 1% PD-L1 expression.
Just over half (9 of 16 patients) actually completed the maximum 96 weeks of nivolumab; 4 others discontinued treatment due to adverse events and 3 due to disease progression. Of the 16 patients, 12 ultimately had “received no subsequent therapy and were without evidence of progressive disease at last follow-up,” the team wrote.