New Study Shows Nivolumab Improves Survival Rates in Non-Small Cell Lung Cancer Patients

One of the most common types of lung cancer is non-small cell carcinoma (NSCLC). A recent study published in The New England Journal of Medicine examined the perioperative use of the immunotherapy treatment nivolumab among people who had non-small-cell lung cancer. 

The study points to nivolumab’s usefulness in improving event-free survival in people with non-small-cell lung cancer (NSCLC).This study was the international CheckMate 77T trial, a phase three, double-blind study. It included participants with operable non-small-cell lung cancer who had not received previous systemic anticancer treatment. In total, 229 were in the nivolumab group, and 232 were in the chemotherapy group. Participants then underwent surgery within six weeks of this pre-surgical intervention. Researchers looked at event-free survival as a primary outcome. Secondary outcomes included: 

A complete lack of viable tumour cells in the primary tumour location and sampled lymph nodes (pathological complete response) after surgery.10% or less viable cancer cells in primary tumour location and sampled lymph nodes (major pathological response) after surgery. The average follow-up time with participants was 25.4 months. For patients with respectable stage IIA to IIIB non-small cell lung cancer (NSCLC), neoadjuvant nivolumab plus chemotherapy followed by surgery and adjuvant nivolumab had a significantly extended event-free survival compared with neoadjuvant placebo plus chemotherapy followed by surgery and adjuvant placebo. Additionally, about a quarter of the intervention group also experienced a pathological complete response, while less than 5% of the chemotherapy group did. 

About 35% of the intervention group experienced major pathological responses compared to about 12% of the chemotherapy group. The findings offer hope for improving survival rates for this deadly form of cancer. 

The study reported that 70% of patients are now alive and without any evidence of disease at that same time interval using perioperative therapy and 50% using preoperative therapy alone, which is tremendous progress. Moreover, the benefit from both approaches adds very little to the side effects already known with chemotherapy alone. Despite the promising implications, the study does have certain limitations. Less than 40% of participants completed one full year of nivolumab treatment post-surgery, which could have also impacted the results. Researchers also acknowledge that Black participants were underrepresented, which suggests the need for more diverse follow-up.