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Perioperative Nivolumab Beneficial for Resectable NSCLC

Perioperative nivolumab showed event-free survival benefit from time of surgery compared with neoadjuvant nivolumab

By Elana Gotkine HealthDay Reporter

THURSDAY, Sept. 12, 2024 (HealthDay News) — For patients with resectable non-small-cell lung cancer (NSCLC), perioperative nivolumab is associated with event-free survival (EFS) benefit compared with neoadjuvant nivolumab, according to a study presented at the International Association for the Study of Lung Cancer 2024 World Conference on Lung Cancer, held from Sept. 7 to 10 in San Diego.

Patrick Forde, M.B.B.Ch., from Johns Hopkins University School of Medicine in Baltimore, and colleagues presented an individual patient-level data analysis of CheckMate 77T and CheckMate 816 to assess the contribution of the adjuvant phase of the perioperative nivolumab treatment regimen in resectable NSCLC. Patients in CheckMate 77T received neoadjuvant nivolumab plus chemotherapy followed by definitive surgery and one or more doses of adjuvant nivolumab (perioperative nivolumab; 139 patients), and those in CheckMate 816 received neoadjuvant nivolumab plus chemotherapy followed by definitive surgery (neoadjuvant nivolumab; 147 patients).

The researchers found that compared with neoadjuvant nivolumab, perioperative nivolumab showed EFS benefit from time of surgery (hazard ratios: unweighted, 0.59; weighted [average treatment effect for the treated], 0.56; weighted [average treatment effect], 0.61). In patients with PD-L1 <1 percent or ≥1 percent and across clinical stages, there was landmark EFS benefit for perioperative versus neoadjuvant nivolumab. In patients with or without pathological complete response, landmark EFS favored perioperative nivolumab. Grade 3 to 4 treatment-related adverse events occurred in 27 and 35 percent of patients in the perioperative nivolumab and neoadjuvant nivolumab populations, respectively.

“Our analysis in individual patients in these two trials suggests that there is likely a further benefit from receiving additional immunotherapy treatment after surgery,” Forde said in a statement.

The study was funded by Bristol-Myers Squibb, manufacturer of nivolumab.

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