A new analysis of data from the CheckMate 816 and CheckMate 77T trials indicates that patients with resectable non-small cell lung cancer (NSCLC) who receive nivolumab both before and after surgery experience a significant reduction in the risk of disease recurrence or death. The study, presented at the IASLC 2024 World Conference on Lung Cancer, suggests a potential shift in treatment strategies for this patient population.
The research compared outcomes from 147 participants in the CheckMate 816 trial, who received three cycles of neoadjuvant nivolumab plus chemotherapy, with 139 participants in the CheckMate 77T trial, who received up to four cycles of neoadjuvant nivolumab plus chemotherapy followed by up to 13 cycles of adjuvant nivolumab. The follow-up period extended up to four years post-surgery.
Significant Reduction in Recurrence and Death
The analysis revealed a 40% reduction in the risk of disease recurrence or death in patients who received at least one dose of nivolumab after surgery, in addition to the neoadjuvant treatment. This benefit was consistent across different baseline cancer stages, indicating a broad applicability of the perioperative approach.
Impact of PD-L1 Expression
Interestingly, the study also found that patients with less than 1% tumor expression of the PD-L1 protein experienced greater reductions in disease recurrence and death compared to those with 1% or greater expression. This suggests that patients with lower PD-L1 expression may derive a greater benefit from the addition of postoperative nivolumab.
Expert Commentary
"There's been a big migration in lung cancer and in melanoma treatment in the last few years from doing surgery upfront and giving postoperative immunotherapy, to giving immunotherapy prior to surgery," said Patrick Forde, M.B.B.Ch., an adjunct professor of oncology at the Johns Hopkins University School of Medicine. "But our analysis in individual patients in these two trials suggests that there is likely a further benefit from receiving additional immunotherapy treatment after surgery."
The CheckMate 77T and 816 trials were sponsored by Bristol-Myers Squibb, the manufacturer of nivolumab.
