Long-term survival with nivolumab treatment in non-small cell lung cancer

This study investigated the long-term survival of patients with non-small cell lung cancer (NSCLC) treated with nivolumab (Opdivo).

They found that this treatment is well tolerated and improved survival in these patients.

Non-small cell lung cancer (NSCLC) is the most common form of lung cancer (LC). Over 50% of patients are diagnosed with advanced stage LC. Treatment options can be limited at this stage. Targeted therapies (TTs) are needed to treat advanced NSCLC. One new TT is immunotherapy. Immune checkpoint inhibitors (ICIs) are drugs that enhance the immune system response to kill cancer cells. 

Nivolumab is an ICI. It targets a receptor called PD-1. Blocking PD-1 stops a protein called PD-L1 from binding to it. This is how cancer cells grow undetected by the immune system. Nivolumab has been shown to increase survival rates in NSCLC patients. It Is unclear if nivolumab is associated with long-term survival in NSCLC patients. 

This study included 111 patients with advanced NSCLC. Patients were grouped depeding on tumor type. These were squamous (SQ) and non-squamous (NSQ). All patients were treated for with nivolumab for 3 years or until death/no response. Progression-free survival (PFS; survival without cancer growing or spreading) and overall survival (OS) were the main outcome measures. Tumor samples were taken to measure PD-L1 expression. 

Patients with SQ had average survival rates of 71.4% at 1 year, 37.1% at 2 years, and 20% at 3 years. Patients with NSQ had average survival rates of 68% at 1 year, 37.4% at 2 years, and 31.9% at 3 years. The average OS for all patients was 17.1 months. The average PFS was 3.5 months. 76.9% of patients that responded to nivolumab survived for more than 3 years. 

The authors concluded that nivolumab leads to prolonged survival in patients with NSCLC.

This study was conducted in Japan. The results may not extend to other ethnicities. The number of patients was also relatively small. Nivolumab treatment was not compared to any other ICI drugs. 

This study was funded by Ono Pharmaceutical Co., Ltd. and Bristol?Myers Squibb, the manufacturers of nivolumab.