NSCLC metastases also benefit from nivolumab + ipilimumab + chemo

Favourable survival benefits with the combination of nivolumab, ipilimumab, and chemotherapy versus chemotherapy alone in patients with stage IV non-small-cell lung cancer (NSCLC) as seen in the CheckMate 9LA trial extend to patients with brain metastases [1].

Brain metastases occur in 10% of patients with NSCLC; these patients have a poor prognosis. A post-hoc analysis, presented by Prof. David Carbone (Ohio State University, USA), investigated the efficacy and safety outcomes of patients with and without baseline brain metastases in the CheckMate 9LA (NCT03215706) trial. All CheckMate 9LA participants underwent a brain CT/MRI at baseline; those with untreated central nervous system metastases were included if they had been adequately treated and were asymptomatic for ≥2 weeks before beginning treatment under the trial protocol. Of the 719 participants, 101 had baseline brain metastases; 51 were randomised to the nivolumab, ipilimumab, and chemotherapy treatment arm while the remaining 50 were randomised to receive chemotherapy alone.

In participants with baseline brain metastases who received nivolumab, ipilimumab, and chemotherapy versus participants with baseline brain metastases who received chemotherapy alone:

• overall survival was 19.3 versus 6.8 months (HR 0.43; 95% CI 0.27–0.67);
• median systemic progression-free survival was 10.6 months versus 4.1 months (HR 0.40; 95% CI 0.25–0.64);
• median intracranial progression-free survival was 13.5 months versus 4.6 months in (HR 0.36; 95% CI 0.22–0.60);
• the objective response rate was 39% versus 20%;
• the median duration of response was 22.3 months versus 18.9 months; and
• the median time to development of new brain lesions was 9.0 months versus 4.6 months.

Safety profiles were similar between the 2 groups.

Dr Carbone concluded that these data support the use of nivolumab and ipilimumab with chemotherapy as first-line treatment for patients with NSCLC, including those with brain metastases.

1. Carbone D. First-line nivolumab + ipilimumab + chemotherapy in patients with advanced NSCLC and brain metastases: results from CheckMate 9LA. OA 09.01, WCLC 2021, 8–14 September.

 

Copyright ©2021 Medicom Medical Publishers



Posted on 21 September 202115 February 2024