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Wang C, Chen KN, Chen Q, Wu L, Wang Q, Li X, Ying K, Wang W, Zhao J, Liu L, Fu J, Zhang C, Liu J, Hu Y, Ntambwe I, Cai J, Bushong J, Tran P, Lu S. Neoadjuvant nivolumab plus chemotherapy versus chemotherapy for resectable NSCLC: subpopulation analysis of Chinese patients in CheckMate 816. ESMO Open 2023; 8:102040. [PMID: 37922691 PMCID: PMC10774966 DOI: 10.1016/j.esmoop.2023.102040] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/20/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Neoadjuvant nivolumab plus chemotherapy significantly improved event-free survival (EFS) and pathologic complete response (pCR) versus chemotherapy alone in patients with resectable non-small-cell lung cancer (NSCLC) in the global phase III CheckMate 816 study. Here, we report post hoc exploratory efficacy, safety, and surgical outcomes in the Chinese subpopulation of this study. METHODS Adults with stage IB-IIIA resectable NSCLC were randomized to receive nivolumab 360 mg plus chemotherapy or chemotherapy alone every 3 weeks for three cycles followed by surgery. Primary endpoints included EFS and pCR (both per blinded independent review). EFS and pCR results were from 14 October 2022, and 16 September 2020, database locks, respectively. RESULTS The Chinese subpopulation comprised 97 patients (nivolumab plus chemotherapy, 44; chemotherapy, 53). At 38.2 months of minimum follow-up, median EFS was not reached [95% confidence interval (CI) 23.4 months-not reached] in the nivolumab plus chemotherapy arm and 13.9 months (95% CI 8.3-34.3 months) in the chemotherapy arm (hazard ratio 0.47, 95% CI 0.25-0.88). pCR rates were 25.0% (95% CI 13.2% to 40.3%) and 1.9% (95% CI 0.0% to 10.1%), respectively (odds ratio 11.05; 95% CI 1.41-86.49). Of 97 Chinese patients, 36 (82%) in the nivolumab plus chemotherapy arm and 41 (77%) in the chemotherapy arm underwent definitive surgery. Grade 3-4 treatment-related adverse events occurred in 18/43 patients (42%) treated with nivolumab plus chemotherapy and 22/53 patients (42%) treated with chemotherapy. CONCLUSIONS Consistent with findings in the global study population of CheckMate 816, neoadjuvant nivolumab plus chemotherapy improved EFS and pCR versus chemotherapy in the Chinese subpopulation without impacting treatment tolerability or the feasibility of surgery. These findings support the use of nivolumab plus chemotherapy as a standard neoadjuvant treatment option for Chinese patients with resectable NSCLC.
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Affiliation(s)
- C Wang
- Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
| | - K-N Chen
- Peking University Cancer Hospital and Institute, Beijing, China
| | - Q Chen
- Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
| | - L Wu
- Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Q Wang
- Zhongshan Hospital and Fudan University, Shanghai, China
| | - X Li
- Tangdu Hospital, Xi'an, China
| | - K Ying
- Sir Run Run Shaw Hospital, Hangzhou, China
| | - W Wang
- Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - J Zhao
- Cancer Center of Guangzhou Medical University, Guangzhou, China
| | - L Liu
- West China Hospital of Sichuan University, Chengdu, China
| | - J Fu
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - C Zhang
- Xiangya Hospital of Central South University, Changsha, China
| | - J Liu
- The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Y Hu
- Chinese People's Liberation Army General Hospital (301 Hospital), Beijing, China
| | - I Ntambwe
- Bristol Myers Squibb, Princeton, NJ, USA
| | - J Cai
- Bristol Myers Squibb, Princeton, NJ, USA
| | - J Bushong
- Bristol Myers Squibb, Princeton, NJ, USA
| | - P Tran
- Bristol Myers Squibb, Princeton, NJ, USA
| | - S Lu
- Shanghai Chest Hospital and Shanghai Jiao Tong University, Shanghai, China.
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Borghaei H, O'Byrne KJ, Paz-Ares L, Ciuleanu TE, Yu X, Pluzanski A, Nagrial A, Havel L, Kowalyszyn RD, Valette CA, Brahmer JR, Reck M, Ramalingam SS, Zhang L, Ntambwe I, Rabindran SK, Nathan FE, Balli D, Wu YL. Nivolumab plus chemotherapy in first-line metastatic non-small-cell lung cancer: results of the phase III CheckMate 227 Part 2 trial. ESMO Open 2023; 8:102065. [PMID: 37988950 PMCID: PMC10774956 DOI: 10.1016/j.esmoop.2023.102065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 10/09/2023] [Accepted: 10/18/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND In CheckMate 227 Part 1, first-line nivolumab plus ipilimumab prolonged overall survival (OS) in patients with metastatic non-small-cell lung cancer (NSCLC) and tumor programmed death-ligand 1 (PD-L1) expression ≥1% versus chemotherapy. We report results from CheckMate 227 Part 2, which evaluated nivolumab plus chemotherapy versus chemotherapy in patients with metastatic NSCLC regardless of tumor PD-L1 expression. PATIENTS AND METHODS Seven hundred and fifty-five patients with systemic therapy-naive, stage IV/recurrent NSCLC without EGFR mutations or ALK alterations were randomized 1 : 1 to nivolumab 360 mg every 3 weeks plus chemotherapy or chemotherapy. Primary endpoint was OS with nivolumab plus chemotherapy versus chemotherapy in patients with nonsquamous NSCLC. OS in all randomized patients was a hierarchically tested secondary endpoint. RESULTS At 19.5 months' minimum follow-up, no significant improvement in OS was seen with nivolumab plus chemotherapy versus chemotherapy in patients with nonsquamous NSCLC [median OS 18.8 versus 15.6 months, hazard ratio (HR) 0.86, 95.62% confidence interval (CI) 0.69-1.08, P = 0.1859]. Descriptive analyses showed OS improvement with nivolumab plus chemotherapy versus chemotherapy in all randomized patients (median OS 18.3 versus 14.7 months, HR 0.81, 95.62% CI 0.67-0.97) and in an exploratory analysis in squamous NSCLC (median OS 18.3 versus 12.0 months, HR 0.69, 95% CI 0.50-0.97). A trend toward improved OS was seen with nivolumab plus chemotherapy versus chemotherapy, regardless of the tumor mutation status of STK11 or TP53, regardless of tumor mutational burden, and in patients with intermediate/poor Lung Immune Prognostic Index scores. Safety with nivolumab plus chemotherapy was consistent with previous reports of first-line settings. CONCLUSIONS CheckMate 227 Part 2 did not meet the primary endpoint of OS with nivolumab plus chemotherapy versus chemotherapy in patients with metastatic nonsquamous NSCLC. Descriptive analyses showed prolonged OS with nivolumab plus chemotherapy in all-randomized and squamous NSCLC populations, suggesting that this combination may benefit patients with untreated metastatic NSCLC.
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Affiliation(s)
- H Borghaei
- Fox Chase Cancer Center, Philadelphia, USA.
| | - K J O'Byrne
- Princess Alexandra Hospital and Queensland University of Technology, Brisbane, Australia
| | - L Paz-Ares
- Hospital Universitario 12 de Octubre, Universidad Complutense & CiberOnc, Madrid, Spain
| | - T-E Ciuleanu
- Institutul Oncologic Prof. Dr. Ion Chiricuţă and UNF Iuliu Haţieganu University, Cluj-Napoca, Romania
| | - X Yu
- Zhejiang Cancer Hospital, Hangzhou, China
| | - A Pluzanski
- Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - A Nagrial
- Blacktown Hospital, Sydney, Australia
| | - L Havel
- Thomayer Hospital, Charles University, Prague, Czech Republic
| | | | | | - J R Brahmer
- Johns Hopkins, The Sidney Kimmel Comprehensive Cancer Center, Baltimore, USA
| | - M Reck
- Lung Clinic Grosshansdorf, Airway Research Center North, German Center of Lung Research, Grosshansdorf, Germany
| | - S S Ramalingam
- Winship Cancer Institute, Emory University, Atlanta, USA
| | - L Zhang
- Sun Yat-Sen University Cancer Center, Guangdong, China
| | - I Ntambwe
- Bristol Myers Squibb, Princeton, USA
| | | | | | - D Balli
- Bristol Myers Squibb, Princeton, USA
| | - Y-L Wu
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangdong, China
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Leighl N, Alexandru A, Ohe Y, Ruff P, Hida T, Nishio M, Rothenstein J, Tomiak A, Lowry P, Kumagai T, Gore I, Ntambwe I, Marimuthu S, Schenker M. FP04.01 Nivolumab 480 mg Every 4 Weeks as De Novo Second-line Treatment for Advanced Non-Small Cell Lung Cancer: CheckMate 907. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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