CheckMate 9LA: Dual Immunotherapy Plus Chemotherapy for Patients With NSCLC and Brain Metastases
Posted: Tuesday, October 12, 2021
According to the phase III CheckMate 9LA trial, first-line nivolumab plus ipilimumab combined with chemotherapy appeared to significantly improve survival results compared with chemotherapy alone among patients with advanced non–small cell lung cancer (NSCLC) with or without brain metastases. David Carbone, MD, PhD, of The Ohio State University, Columbus, and colleagues observed durable survival benefits and identified no new safety signals. The findings of this post hoc analysis of efficacy and safety were presented during the International Association for the Study of Lung Cancer (IASLC) 2021 World Conference on Lung Cancer (Abstract OA09.01).
The study team randomly assigned 719 patients with advanced NSCLC 1:1 to receive nivolumab plus ipilimumab and chemotherapy or chemotherapy alone. Overall, 101 patients (14%) had baseline brain metastases.
Regardless of baseline brain metastases, the median overall survival was better among patients who received the dual immunochemotherapy versus chemotherapy alone. In patients with baseline brain metastases, the median overall survival was 19.3 months versus 6.8 months in patients treated with immunochemotherapy versus chemotherapy, respectively. Similarly, in patients without brain metastases, the median overall survival was 15.6 months versus 12.1 months, respectively. The duration of responses was also significantly longer among patients who received the dual immunochemotherapy than with chemotherapy alone (with brain metastases: 15.4 months vs. 4.4 months; without brain metastases: 13 months vs. 5.7 months). Similar benefits were observed for median progression-free survival and overall response rates.
In patients with baseline brain metastases, most adverse events were grade 1 or 2. Any-grade neurologic treatment-related adverse events were reported in 22% of patients who received nivolumab plus ipilimumab and chemotherapy compared with 10% of patients who received chemotherapy alone.
Disclosure: For full disclosures of the study authors, visit library.iaslc.org.