Small advances grow. And so, after four years, thanks to the combination of two immunotherapies plus two courses of chemotherapy, 21% of patients with metastatic non-small cell lung cancer are alive compared to 16% of patients treated with chemotherapy alone. These numbers are the good news we bring to patients affected by this most common form of the lung cancer “family” who, along with their treating specialists, await with curiosity the most promising news The American Society of Clinical Oncology Annual Meeting (American Society of Clinical Oncology) takes place in Chicago. This data is the data published by Bristol Myers Squibb as part of the Phase 3 CheckMate-9LA study.
CheckMate-9LA is a multicenter, randomized, phase 3 study evaluating nivolumab (360 mg every 3 weeks) plus ipilimumab (1 mg/kg every 6 weeks) in combination with chemotherapy (two cycles) versus chemotherapy alone (up to to 4 cycles followed by maintenance therapy) as first-line treatment in patients with metastatic non-small cell lung cancer (NSCLC), regardless of PD-L1 expression and histology. Patients in the study arm (n=361) were treated with dual immunotherapy for up to two years or until disease progression or unacceptable toxicities. Patients in the control arm (n=358) received up to 4 cycles of chemotherapy and optional pemetrexed maintenance therapy (if available) until disease progression or unacceptable toxicity.
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Follow-up results presented at Asco show sustained long-term benefits with nivolumab plus ipilimumab and two cycles of chemotherapy compared to four cycles of chemotherapy alone. Of note, at at least 47.9 months, the dual immunotherapy combination continued to prolong overall survival, with 21% of patients treated with nivolumab plus ipilimumab and two courses of chemotherapy alive at four years, compared with 16% of patients treated only were treated with chemotherapy.
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Findings in patients with PD-L1 expression
With longer follow-up, the clinically meaningful efficacy benefit of nivolumab plus ipilimumab and two courses of chemotherapy was maintained across secondary endpoints and subsets of patients with tumor PD-L1 expression less than 1% and squamous cell histology, mostly those with high clinical unfulfillment. Especially in patients with tumor PD-L1 expression. Early Pancreatic Cancer: Minimally Invasive Surgery Works and Speeds Recovery
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Results on patients with squamous histology
Among patients with squamous cell histology, twice as many of those treated with nivolumab plus ipilimumab and chemotherapy were alive than those treated with chemotherapy alone at four years (20% vs. 10%). In this group, the combination based on dual immunotherapy reduced the risk of death by 36% compared to chemotherapy alone.
The Experimenter’s Commentary
These data were the subject of a recent poster presentation (Abstract #LBA9023) at the American Society of Clinical Oncology Annual Meeting. “The durable results observed over four years with nivolumab plus ipilimumab and chemotherapy, particularly in patients with a poor prognosis, demonstrate the long-term benefits of combining dual immunotherapy with reduced chemotherapy for patients with advanced or metastatic non-small cell lung cancer. “, which remains a particularly complex disease to treat,” says David P. Carbone, MD, Ph.D., investigator of the CheckMate-9LA study and director of the Thoracic Oncology Center at Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute. “Particularly encouraging are the data from patients with tumor PD-L1 expression below 1% and squamous cell histology. They show that after four years of follow-up, the combination therapy continues to reduce the risk of death by about a third compared to chemotherapy alone.” Patient groups who have had poorer outcomes in the past.
An increasingly tailored oncology
Lung cancer is the leading cause of cancer deaths worldwide. The two main types of lung cancer are non-small cell and small cell. Non-small cell cancer (NSCLC) is one of the most common cases, accounting for 84% of diagnoses. Survival rates vary depending on the stage and type of cancer at the time of diagnosis. “Oncology treatment – he explains to Abderrahim Oukessou, MD, vice president, development manager for breast cancer at Bristol Myers Squibb – it is not a one-size-fits-all approach because patients with breast cancer, such as non-small cell lung cancer, have different needs for such an approach. We are committed to finding solutions that work for more patients and have the potential to help improve outcomes and fill areas of high unmet clinical need.” Nivolumab plus ipilimumab combinations have been in six phase 3 clinical trials to date Five cancer types have shown a significant improvement in overall survival: metastatic NSCLC, metastatic melanoma, advanced renal cell carcinoma, malignant pleural mesothelioma and esophageal squamous cell carcinoma.