Researchers are examining combination therapies with immunotherapy, with and without chemotherapy.
Combination treatments involving checkpoint inhibitors continue to gain attention, including both combinations involving more than 1 immunotherapy and those that involve immunotherapy and chemotherapy. Researchers continue to seek biomarkers that will allow them to match treatment combinations with patients who will most benefit.
On Monday, Bristol-Myers Squibb followed up on results it released earlier this year from the phase 3 Checkmate 227 trial in non-small cell lung cancer (NSCLC); it previously presented results from the nivolumab (Opdivo) and ipilimumab (Yervoy) combination, which showed that this combination reduced progression risk 42% for patients with a high tumor mutation burden.
Results presented at the American Society of Clinical Oncology (ASCO) involve patients in the trial arm treated with nivolumab and chemotherapy. Researchers report results for 550 chemotherapy-naïve patients with stage IV or recurrent NSCLC; they had no known EGFR/ALK mutations, and had < 1% PD-L1 expression. These included 177 in the nivolumab plus chemotherapy arm, compared with 186 who were treated with chemotherapy only.
Those taking the nivolumab-chemotherapy arm had improved progression-free survival (PFS) over the chemotherapy arm (hazard ratio = 0.74; CI, 0.58-0.94). Minimum follow-up was 11.2 months, and patients were treated up to 2 years. Most subgroups saw PFS with the nivolumab-chemotherapy combination, but the benefit was more pronounced among non-squamous (HR = 0.68) than among squamous (HR = 0.92).
The rates of adverse events that caused patients to stop taking therapy were about the same in both the nivolumab-chemotherapy arm (13%) and the chemotherapy arm (14%).
Borghaei H, Hellman MD, Paz-Ares LG, et al. Nivolumab + platinum doublet chemotherapy vs chemo as first-line treatment for advanced non-small cell lung cancer (NSCLC) with < 1% tumor PD-L1 expression. J Clin Oncol 2018; 36 (suppl; abstr 9001).