AACR 2018: Neoadjuvant Nivolumab for Resectable Lung Cancer
Posted: Tuesday, April 24, 2018
Given prior to surgical resection of stage I to III non–small cell lung cancer (NSCLC), the anti–PD-1 immunotherapy nivolumab appeared to be well tolerated, according to the early findings of a pilot study. In addition, this neoadjuvant nivolumab therapy resulted in major pathologic response in 45% of patients, regardless of PD-L1 expression. These data were presented by Drew Pardoll, MD, PhD, of Johns Hopkins School of Medicine, Baltimore, at the 2018 American Association for Cancer Research (AACR) Annual Meeting in Chicago (Abstract CT079) and simultaneously published in The New England Journal of Medicine.
“While it is still too early to tell whether our findings will translate into lower relapse rate and improved survival, pending confirmation in a larger study, we are very optimistic this approach will eventually be practice-changing and may augment, or even replace, chemotherapy prior to surgical resection,” Dr. Pardoll revealed in an AACR press release.
In the study, 9 of 20 patients who had surgery after 2 doses of nivolumab had a major pathologic response, defined as ≤ 10% of viable cancer cells detectable in the resected tumor. In most cases, surgery was done 4 weeks after the first dose. Recurrence-free survival at 18 months was 73%, and the median recurrence-free survival had not been reached at the time of data analysis.
The researchers also analyzed T-cell responses in the blood on the first day of nivolumab treatment and 44 days after surgery. The expansion of circulating tumor-specific T cells after treatment suggested nivolumab may have enhanced antitumor immunity systemically, they reported.
