Airway Research Center North, German Center for Lung Research, LungClinic, Grosshansdorf, Germany
Martin Reck , Tudor-Eliade Ciuleanu , Manuel Cobo , Michael Schenker , Bogdan Zurawski , Juliana Janoski de Menezes , Eduardo Richardet , Jaafar Bennouna , Enriqueta Felip , Oscar Juan-Vidal , Aurella Alexandru , Hiroshi Sakai , Arnaud Scherpereel , Shun Lu , Luis G. Paz-Ares , David Paul Carbone , Arteid Memaj , Sathiya Marimuthu , Phuong Tran , Tom John
Background: In the randomized phase 3 CheckMate 9LA trial (NCT03215706), first-line NIVO + IPI combined with 2 cycles of chemo significantly improved overall survival (OS), progression-free survival (PFS), and objective response rate (ORR) vs chemo alone (4 cycles). Clinical benefit was observed regardless of programmed death ligand 1 (PD-L1) expression level and histology. Here we report data with 2 years’ minimum follow-up from this study. Methods: Adult patients (pts) with stage IV / recurrent NSCLC, ECOG performance status ≤ 1, and no known sensitizing EGFR/ALK alterations were stratified by PD-L1 (< 1% vs ≥ 1%), sex, and histology (squamous vs non-squamous) and were randomized 1:1 to NIVO 360 mg Q3W + IPI 1 mg/kg Q6W + chemo (2 cycles; n = 361) or chemo alone (4 cycles; n = 358). Pts with non-squamous NSCLC in the chemo-alone arm could receive pemetrexed maintenance. The primary endpoint was OS. Secondary endpoints included PFS and ORR by blinded independent central review, and efficacy by different PD-L1 levels. Safety was exploratory. Results: At a minimum follow-up of 24.4 months for OS (database lock: Feb 18, 2021), pts treated with NIVO + IPI + chemo continued to derive OS benefit vs chemo, with a median OS of 15.8 months vs 11.0 months, respectively (HR, 0.72 [95% CI, 0.61–0.86]); 2-year OS rates were 38% vs 26%. Median PFS with NIVO + IPI + chemo vs chemo was 6.7 months vs 5.3 months (HR, 0.67 [95% CI, 0.56–0.79]); 8% and 37% of pts who had disease progression received subsequent immunotherapy, respectively. ORR was 38% with NIVO + IPI + chemo vs 25% with chemo. Similar clinical benefit with NIVO + IPI + chemo vs chemo was observed in all randomized pts and across the majority of subgroups, including by PD-L1 expression level (Table) or histology. Any grade and grade 3–4 treatment-related adverse events were reported in 92% and 48% of pts in the NIVO + IPI + chemo arm vs 88% and 38% in the chemo arm, respectively. Conclusion: With 2 years’ minimum follow-up, first-line NIVO + IPI + chemo demonstrated durable survival and benefit versus chemo in pts with advanced NSCLC; no new safety signals were identified. Clinical trial information: NCT03215706
Summary of efficacy outcomes by PD-L1 expression. | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
PD-L1 < 1% | PD-L1 < 1% | PD-L1 ≥ 1% | PD-L1 ≥ 1% | PD-L1 ≥ 50% | PD-L1 ≥ 50% | All randomized | All randomized | |||
NIVO + IPI + chemo n = 135 | Chemo n = 129 | NIVO + IPI + chemo n = 204 | Chemo n = 204 | NIVO + IPI + chemo n = 76 | Chemo n = 98 | NIVO + IPI + chemo n = 361 | Chemo n = 358 | |||
Median OS, months | 17.7 | 9.8 | 15.8 | 10.9 | 18.9 | 12.9 | 15.8 | 11.0 | ||
OS HR (95% CI) vs chemo | 0.67 (0.51–0.88) | - | 0.70 (0.56–0.89) | - | 0.67 (0.46–0.97) | - | 0.72 (0.61–0.86) | - | ||
2-year OS rate, % | 37 | 22 | 41 | 28 | 45 | 32 | 38 | 26 | ||
2-year PFS rate, % | 20 | 5 | 20 | 9 | 28 | 10 | 20 | 8 | ||
ORR, n (%) | 42 (31) | 26 (20) | 87 (43) | 57 (28) | 38 (50) | 31 (32) | 137 (38) | 91 (25) | ||
Median duration of response, months | 17.5 | 4.3 | 11.8 | 5.6 | 26.0 | 5.4 | 13.0 | 5.6 | ||
Responders with ongoing response ≥ 2 years, % | 45 | 0 | 33 | 13 | 52 | 16 | 34 | 12 |
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2021 ASCO Annual Meeting
First Author: Luis G. Paz-Ares
2022 ASCO Annual Meeting
First Author: Luis G. Paz-Ares
2024 ASCO Gastrointestinal Cancers Symposium
First Author: Kohei Shitara
2020 ASCO Virtual Scientific Program
First Author: Martin Reck