Long-term data comparing outcomes with immune checkpoint inhibitors versus chemotherapy in NSCLC are limited. The phase 3 trials CheckMate 017 and 057 demonstrated improved overall survival (OS), objective response rates (ORR), and quality of life, as well as a favorable safety profile, with the anti-programmed death (PD)-1 antibody nivolumab versus docetaxel in patients with previously treated advanced squamous and non-squamous NSCLC, respectively. Updated results based on a minimum follow-up of 3 y are reported.
Patients were randomized 1:1 to receive nivolumab 3 mg/kg Q2W (with option to change to 480 mg Q4W after Sep 2016) or docetaxel 75 mg/m2 Q3W until progression or discontinuation. After completion of the primary analyses, patients who ended treatment with docetaxel could cross over to receive nivolumab. The primary endpoint of each study was OS; other endpoints were ORR, progression-free survival, and efficacy by PD ligand 1 (PD-L1) expression.
After a minimum follow-up of 36.6 mo in each study (Feb 2017 database locks), 6% of the 427 total patients randomized to the 2 nivolumab arms remained on treatment; no patients remained on docetaxel. Nivolumab continued to show an OS benefit versus docetaxel, with 3-y OS rates of 16% versus 6% in CheckMate 017 and 18% versus 9% in CheckMate 057. Similar to prior reports, an OS benefit was observed in squamous NSCLC regardless of PD-L1 expression, and in non-squamous NSCLC was enhanced at higher PD-L1 expression levels (Table). Of 427 patients in the combined nivolumab arms, 71 (17%) had OS ≥ 3 y. Additional 3-y data across trial endpoints will be presented.Table: