Perioperative Nivolumab Tops Chemo for Survival in Resectable Lung Cancer

HealthDay News — For patients with resectable non-small cell lung cancer (NSCLC), perioperative treatment with nivolumab results in significantly longer event-free survival, according to a study published in the May 16/23 issue of the New England Journal of Medicine.

Tina Cascone, MD, PhD, from the University of Texas MD Anderson Cancer Center in Houston, and colleagues conducted a phase 3, randomized trial involving adults with resectable stage IIA to IIIB NSCLC. Participants were randomly assigned to receive neoadjuvant nivolumab plus chemotherapy or neoadjuvant chemotherapy plus placebo every 3 weeks for 4 cycles, followed by surgery and adjuvant nivolumab or placebo every 4 weeks for 1 year.

The researchers found that the percentage of patients with 18-month event-free survival was 70.2 and 50.0% in the nivolumab and chemotherapy groups, respectively, at the prespecified interim analysis (median follow-up, 25.4 months; hazard ratio for disease progression or recurrence, abandoned surgery, or death, 0.58). A pathological complete response occurred in 25.3 and 4.7% of patients in the nivolumab and chemotherapy groups, respectively (odds ratio, 6.64); a major pathological response occurred in 35.4 and 12.1%, respectively (odds ratio, 4.01). Grade 3 or 4 treatment-related adverse events occurred in 32.5 and 25.2% of those in the nivolumab and chemotherapy groups, respectively.

“We found that the addition of perioperative nivolumab to neoadjuvant chemotherapy resulted in significantly longer event-free survival than perioperative placebo added to neoadjuvant chemotherapy in patients with resectable NSCLC,” the authors write.

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

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