AACR: Adding Nivolumab to Neoadjuvant Chemo Slows Resectable NSCLC

TUESDAY, April 12, 2022 (HealthDay News) -- Neoadjuvant nivolumab plus chemotherapy results in significantly longer event-free survival and increased pathological response among patients with resectable non-small cell lung cancer (NSCLC) compared with chemotherapy alone, according to a study published online April 11 in the New England Journal of Medicine to coincide with the annual meeting of the American Association for Cancer Research, held from April 8 to 13 in New Orleans.

Patrick M. Forde, M.B., B.Ch., from the Johns Hopkins Kimmel Cancer Center in Baltimore, and colleagues randomly assigned patients with stage IB to IIIA resectable NSCLC to receive nivolumab plus platinum-based chemotherapy or platinum-based chemotherapy alone, followed by resection. Event-free survival and pathological complete response were assessed as the primary end points.

The researchers found that the median event-free survival was 31.6 and 20.8 months for nivolumab plus chemotherapy and chemotherapy alone (hazard ratio for disease progression, disease recurrence, or death, 0.63). Correspondingly, 24.0 and 2.2 percent of patients had a pathological complete response (odds ratio, 13.94). Across most subgroups, the results for event-free survival and pathological complete response favored nivolumab plus chemotherapy over chemotherapy alone. The hazard ratio for death did not meet the criterion for significance at the first prespecified interim analysis. Among the patients who underwent randomization, 83.2 and 75.4 percent of those in the nivolumab-plus-chemotherapy and chemotherapy-alone groups, respectively, underwent surgery. In 33.5 and 36.9 percent of patients in the nivolumab-plus-chemotherapy and chemotherapy-alone groups, respectively, grade 3 or 4 treatment-related adverse events occurred.

"Although challenges remain, broad implementation of neoadjuvant therapy is expected to herald a new era for lung cancer," write the authors of an accompanying editorial.

The study was funded by Bristol Myers Squibb, the manufacturer of nivolumab.

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