Nivolumab Monotherapy for First-Line Treatment of Advanced Non-Small-Cell Lung Cancer
Scott Gettinger, Naiyer A Rizvi, Laura Q Chow, Hossein Borghaei, Julie Brahmer, Neal Ready, David E Gerber, Frances A Shepherd, Scott Antonia, Jonathan W Goldman, Rosalyn A Juergens, Scott A Laurie, Faith E Nathan, Yun Shen, Christopher T Harbison, Matthew D Hellmann, Scott Gettinger, Naiyer A Rizvi, Laura Q Chow, Hossein Borghaei, Julie Brahmer, Neal Ready, David E Gerber, Frances A Shepherd, Scott Antonia, Jonathan W Goldman, Rosalyn A Juergens, Scott A Laurie, Faith E Nathan, Yun Shen, Christopher T Harbison, Matthew D Hellmann
Abstract
Purpose: Nivolumab, a programmed death-1 (PD-1) immune checkpoint inhibitor antibody, has demonstrated improved survival over docetaxel in previously treated advanced non-small-cell lung cancer (NSCLC). First-line monotherapy with nivolumab for advanced NSCLC was evaluated in the phase I, multicohort, Checkmate 012 trial.
Methods: Fifty-two patients received nivolumab 3 mg/kg intravenously every 2 weeks until progression or unacceptable toxicity; postprogression treatment was permitted per protocol. The primary objective was to assess safety; secondary objectives included objective response rate (ORR) and 24-week progression-free survival (PFS) rate; overall survival (OS) was an exploratory end point.
Results: Any-grade treatment-related adverse events (AEs) occurred in 71% of patients, most commonly: fatigue (29%), rash (19%), nausea (14%), diarrhea (12%), pruritus (12%), and arthralgia (10%). Ten patients (19%) reported grade 3 to 4 treatment-related AEs; grade 3 rash was the only grade 3 to 4 event occurring in more than one patient (n = 2; 4%). Six patients (12%) discontinued because of a treatment-related AE. The confirmed ORR was 23% (12 of 52), including four ongoing complete responses. Nine of 12 responses (75%) occurred by first tumor assessment (week 11); eight (67%) were ongoing (range, 5.3+ to 25.8+ months) at the time of data lock. ORR was 28% (nine of 32) in patients with any degree of tumor PD-ligand 1 expression and 14% (two of 14) in patients with no PD-ligand 1 expression. Median PFS was 3.6 months, and the 24-week PFS rate was 41% (95% CI, 27 to 54). Median OS was 19.4 months, and the 1-year and 18-month OS rates were 73% (95% CI, 59 to 83) and 57% (95% CI, 42 to 70), respectively.
Conclusion: First-line nivolumab monotherapy demonstrated a tolerable safety profile and durable responses in first-line advanced NSCLC.
Trial registration: ClinicalTrials.gov NCT01454102.
Conflict of interest statement
Authors’ disclosures of potential conflicts of interest are found in the article online at www.jco.org. Author contributions are found at the end of this article.
© 2016 by American Society of Clinical Oncology.
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Source: PubMed