Checkmate9LA demonstrates benefit of combination therapy in advanced NSCLC
A 2-year update on Checkmate9LA suggested that combining nivolumab with ipilimumab and two cycles of chemoradiation may be better than four cycles of chemoradiation alone, according to a speaker at the virtual 2021 ASCO Annual Meeting.
Martin Reck, MD, PhD, head of thoracic oncology and head of the clinical trial department in the department of thoracic oncology at the Lung Clinic in Grosshansdorf, Germany, and colleagues observed 917 patients with advanced non-small cell lung cancer in a randomized trial. The patients were treated with either two cycles of chemoradiation, nivolumab (NIVO) and ipilimumab (IPI), or four cycles of chemoradiation alone until disease progression, non-acceptable toxicity, or treatment of 2 years if the patient received immunotherapy.
The primary endpoint of the trial was overall survival, and the secondary endpoints were survival without disease progression and efficacy related to the programed death ligand (PDL-1) expression. Of the two groups, only 13% completed the combined therapy whereas 29% finished the four-cycle chemoradiation.
“The major reason for treatment discontinuation was disease progression,” Reck said. “With a minimum follow-up of 2 years, there was a consistent benefit in overall survival, favoring the combination therapy. Median overall survival was 15.8 months compared to 11 months. The hazard ratio was 0.72, and the 2-year overall survival rate was 38% compared with 26% in the control arm.”
Benefits of the combined treatment were seen across subgroups, including by PD-L1 expression level, histology and patients with brain metastases. Additionally, a post-hoc analysis showed that discontinuing the combined treatment due to treatment-related adverse events did not have a negative impact on the long-term benefits seen in all patients, according to the presentation.
“These results continue to support the combination of nivolumab and ipilimumab, together with two cycles of chemotherapy, as a very efficacious first line treatment opportunity for patients with advanced non-small cell lung cancer,” Reck concluded.
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Reck M, et al. Abstract 9000. Presented at: 2021 ASCO Annual Meeting; June 4-8, 2021 (virtual meeting).