Immunotherapy Combination vs Standard Chemotherapy for Metastatic NSCLC
Researchers have discovered that therapy with first-line nivolumab in combination with ipilimumab may improve the 6-year survival and quality of life of patients with metastatic non–small cell lung cancer (NSCLC) compared with standard chemotherapy, according to findings presented by Peters et al at the International Association for the Study of Lung Cancer (IASLC) 2023 World Conference on Lung Cancer (Abstract OA14.03).
"Our findings represent a pivotal moment in the management of metastatic NSCLC. The extended survival and enhanced quality of life observed with nivolumab [plus] ipilimumab underscore the potential for a paradigm shift in treatment strategies," emphasized co–study author Solange Peters, MD, PhD, Full Professor and Chair of Medical Oncology at the Lausanne University Hospital.
Study Methods and Results
In the CheckMate 227 Part 1 trial, researchers enrolled adults with treatment-naive stage IV or recurrent NSCLC and excluded those with known EGFR or ALK alterations and with an Eastern Cooperative Oncology Group performance status of up to 1. The patients were then divided into different cohorts based on their tumor PD-L1 expression levels and randomly assigned to receive nivolumab plus ipilimumab, nivolumab alone, nivolumab plus chemotherapy, or chemotherapy alone.
The latest data with a minimum follow-up of 73.4 months reaffirmed the significant survival benefits of nivolumab plus ipilimumab over chemotherapy. Of note, the 6-year overall survival rates were substantially higher in the patients receiving this treatment combination—reaching 22% vs 13% and 16% vs 5%, respectively, for patients with tumor PD-L1 expression levels of ≥ 1% or < 1%.
Additional endpoints, including objective response rate, duration of response, and quality of life, consistently favored nivolumab plus ipilimumab across all patient subgroups. For instance, patients who saw substantial tumor burden reduction exhibited improved overall survival with nivolumab plus ipilimumab compared with chemotherapy.
Further, after conducting a comprehensive assessment of patients' health-related quality of life, the researchers demonstrated a clear association between better baseline health-related quality of life and improved overall survival, regardless of the treatment received.
"The evidence we present offers a compelling case for the transformative potential of nivolumab [plus] ipilimumab in metastatic NSCLC treatment. Our findings underscore the significance of personalized care and better outcomes for patients,” concluded Dr. Peters.The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.