Hossein Borghaei, DO, MS
Subgroup findings from the phase III CheckMate-227 trial, which were presented at the 2018 ASCO Annual Meeting, showed promising responses with the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) in select patients with non–small cell lung cancer (NSCLC).
Treatment-naïve patients with metastatic PD-L1–negative (<1% expression), tumor mutation burden (TMB)-high NSCLC who were given the combination of nivolumab and low-dose ipilimumab had a 52% reduction in the risk of progression or death compared with standard doublet chemotherapy. This subgroup had a median progression-free survival (PFS) of 7.7 months compared with 5.3 months for chemotherapy, and 6.2 months with the combination of nivolumab and chemotherapy.
Lead author on the abstract, Hossein Borghaei, DO, MS, said that more work must be done to find biomarkers to best select these patients, as PD-L1 is not necessarily the most reliable indicator of response. TMB may be 1 of these biomarkers used to predict response to combination immunotherapy in advanced NSCLC.
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