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John T, Sakai H, Ikeda S, Cheng Y, Kasahara K, Sato Y, Nakahara Y, Takeda M, Kaneda H, Zhang H, Maemondo M, Minato K, Hisada T, Misumi Y, Satouchi M, Hotta K, Li A, Oukessou A, Lu S. First-line nivolumab plus ipilimumab combined with two cycles of chemotherapy in advanced non-small cell lung cancer: a subanalysis of Asian patients in CheckMate 9LA. Int J Clin Oncol 2022; 27:695-706. [PMID: 35182247 PMCID: PMC8956544 DOI: 10.1007/s10147-022-02120-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 01/13/2022] [Indexed: 12/15/2022]
Abstract
Background CheckMate 9LA, a phase 3, randomized, open-label study in first-line advanced non-small cell lung cancer (NSCLC), showed significantly improved overall survival (OS) with nivolumab plus ipilimumab combined with 2 cycles of chemotherapy versus chemotherapy alone (4 cycles). We present results for the Asian subpopulation enrolled in Japan and China. Methods Patients aged ≥ 18 years with treatment-naive, histologically confirmed stage IV or recurrent NSCLC, Eastern Cooperative Oncology Group performance status 0–1 and no sensitizing EGFR/ALK mutations were randomized 1:1 to nivolumab [360 mg every 3 weeks (Q3W)] plus ipilimumab (1 mg/kg Q6W) combined with chemotherapy (Q3W for 2 cycles), or chemotherapy alone (Q3W for 4 cycles). Primary endpoint was OS; secondary endpoints included progression-free survival (PFS) and objective response rate (ORR). Results Twenty-eight patients received nivolumab plus ipilimumab combined with chemotherapy and 30 received chemotherapy. At a minimum follow-up of 12.7 months, median OS was not reached with nivolumab plus ipilimumab combined with chemotherapy versus 13.3 months with chemotherapy [hazard ratio (HR) 0.33; 95% confidence interval (CI) 0.14–0.80]. Median PFS was 8.4 versus 5.4 months (HR 0.47; 95% CI 0.24–0.92) and ORR was 57% versus 23%, respectively. Grade 3–4 treatment-related adverse events were observed in 57% versus 60% of patients, respectively. Conclusion Consistent with results in the all randomized population, nivolumab plus ipilimumab combined with chemotherapy improved efficacy in the Asian subpopulation versus chemotherapy alone and had a manageable safety profile, supporting its use as first-line treatment for advanced NSCLC in Asian patients. Supplementary Information The online version contains supplementary material available at 10.1007/s10147-022-02120-0.
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Affiliation(s)
- Thomas John
- Austin Hospital, 145 Studley Road, Heidelberg, VIC, 3084, Australia.
| | - Hiroshi Sakai
- Saitama Cancer Center, 780, Komuro, Ina, Kitaadachi District, Saitama, 362-0806, Japan
| | - Satoshi Ikeda
- Kanagawa Cardiovascular and Respiratory Center, 6 Chome-16-1 Tomiokahigashi, Kanazawa Ward, Yokohama, Kanagawa, 236-0051, Japan
| | - Ying Cheng
- Jilin Cancer Hospital, No. 1018 Huguang Road, Changchun, 130012, China
| | - Kazuo Kasahara
- Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Yuki Sato
- Kobe City Medical Center General Hospital, 2-1-1, Minatojima Minamimachi, Chuo Ward, Kobe, Hyogo, 650-0047, Japan
| | - Yoshiro Nakahara
- Kanagawa Cancer Center, 2 Chome-3-2 Nakao, Asahi Ward, Yokohama, Kanagawa, 241-8515, Japan
| | - Masayuki Takeda
- Kindai University Hospital, 377-2 Onohigashi, Osakasayama, Osaka, 589-8511, Japan
| | - Hiroyasu Kaneda
- Osaka City University Hospital, 1 Chome-5-7 Asahimachi, Abeno Ward, Osaka, 545-8586, Japan
| | - Helong Zhang
- Tangdu Hospital, Xinsi Road, Baqiao District, Xi'an, 710038, Shaanxi, China
| | - Makoto Maemondo
- Iwate Medical University Hospital, 2-1-1 Idaidori, Yahaba-cho, Shiwa District, Iwate, 028-3695, Japan
| | - Koichi Minato
- Gunma Prefectural Cancer Center, 617-1 Takahayashinishi-cho, Ota-shi, Gunma, 373-8550, Japan
| | - Takeshi Hisada
- Gunma University Hospital, 3 Chome-39-15 Showamachi, Maebashi, Gunma, 371-8511, Japan
| | - Yuki Misumi
- Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawa Nishimachi, Kanagawa Ward, Yokohama, Kanagawa, 221-0855, Japan
| | - Miyako Satouchi
- Hyogo Cancer Center, 13-70 Kita-Oji, Akashi, Hyogo, 673-8558, Japan
| | - Katsuyuki Hotta
- Okayama University Hospital, 2 Chome-5-1 Shikatacho, Kita Ward, Okayama, 700-0914, Japan
| | - Ang Li
- Bristol Myers Squibb, 3551 Lawrenceville Road, Princeton, NJ, USA
| | | | - Shun Lu
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 West Huaihai Road, Shanghai, China
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