The use of perioperative nivolumab in the treatment of non-small cell lung cancer (NSCLC) has shown promising results in reducing the risk of disease recurrence and death in post-surgical patients. An analysis of two phase III trials has revealed significant benefits in combining perioperative nivolumab with chemotherapy compared to neoadjuvant nivolumab and chemotherapy alone.
The analysis conducted by Patrick Forde, MD, of Johns Hopkins Medicine, highlighted a 40% reduction in the risk of disease recurrence or death after surgery among patients who received adjuvant nivolumab following neoadjuvant nivolumab plus chemotherapy and surgery. This comparison was made between the CheckMate 77T and CheckMate 816 trials, with CheckMate 816 demonstrating significant improvements in event-free survival (EFS) with the nivolumab/chemotherapy combination.
Nan Wu, MD, of Peking University Cancer Hospital, suggested that perioperative nivolumab could be considered as a treatment option for eligible patients with resectable NSCLC based on the patient-level data comparison between the two trials. However, Wu emphasized the need for phase III randomized clinical trials to validate these findings.
Exploratory Analysis
Forde and colleagues performed propensity score weighting analyses to adjust for baseline demographics and disease characteristics between the study populations. The results showed a substantial EFS benefit with perioperative nivolumab compared to neoadjuvant-only therapy, regardless of clinical stage, pathological complete response status, or PD-L1 expression in tumors.
The safety profiles of perioperative and neoadjuvant nivolumab were found to be comparable, with similar rates of treatment discontinuation and surgery-related adverse events in both groups. These findings suggest that perioperative nivolumab could be a valuable addition to the current treatment options for patients with resectable NSCLC, paving the way for further research and clinical applications in the field of lung cancer treatment.
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