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ASCO 2021: Surgical Outcomes With Neoadjuvant Nivolumab Plus Chemotherapy in NSCLC

By: Julia Fiederlein
Posted: Monday, June 7, 2021

The phase III CheckMate 816 trial demonstrated a significantly improved pathologic complete response with nivolumab plus platinum-doublet chemotherapy in patients with resectable stage IB to IIIA non–small cell lung cancer (NSCLC). The surgical outcome data, which were presented by Jonathan Spicer, MD, PhD, of the McGill University Health Center, Montreal, and colleagues during the virtual edition of the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 8503), further support this combination as a potential neoadjuvant option.

Before undergoing definitive surgery, a total of 358 patients were randomly assigned in a 1:1 ratio to receive platinum-doublet chemotherapy with or without nivolumab. More patients treated with nivolumab underwent definitive surgery (83% vs. 75%). The minimally invasive surgery rate was 30% with nivolumab and 22% with chemotherapy alone; the conversion rates from minimally invasive to open surgery were 11% and 16%, respectively. Lobectomy was performed in 77% of patients treated with nivolumab and in 61% of those treated with chemotherapy alone; a total of 17% and 25% of patients, respectively, underwent pneumonectomy.

An R0 resection was achieved in 83% of patients treated with nivolumab and in 78% of those treated with chemotherapy alone. The median percentage of residual viable tumor cells was lower with nivolumab (10% vs. 74%). There did not seem to be an increase in the median duration of surgery (184 minutes vs. 217 minutes) and the length of hospitalization (10 vs. 10 days) between patients treated with and without nivolumab. Any-grade (41% vs. 47%) and grade 3 to 4 (11% vs. 15%) surgery-related adverse events were reported less frequently with nivolumab. Grade 5 surgery-related adverse events were reported in two patients treated with nivolumab; a total of three patients treated with chemotherapy alone died due to treatment-related adverse events.

Disclosure: For full disclosures of the study authors, visit coi.asco.org.



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