Advanced NSCLC: second-line nivolumab tops docetaxel for OS, PFS

  • Xu Z & al.
  • Cancer Med
  • 9 Jan 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Nivolumab offers better OS and PFS with fewer adverse events (AEs) than docetaxel‐based chemotherapy as second-line treatment for stage III-IV NSCLC that progresses after platinum-based chemotherapy or targeted therapy.

Why this matters

  • Docetaxel‐based chemotherapy is the standard second‐line therapy for patients with NSCLC.

Study design

  • Meta-analysis of 6 studies with 949 patients with stage III-IV NSCLC who received second-line therapy with nivolumab (n=469) or docetaxel (n=480).
  • Funding: None disclosed.

Key results

  • Nivolumab offered better PFS (HR, 0.70; P=.03), OS (HR, 0.70; P<.00001 and objective response rate ratio p=".0008)" compared with docetaxel.>
  • Complete responses were similar between groups, but nivolumab had a higher partial response rate compared with docetaxel (RR, 1.66; P=.003).
  • More AEs in the docetaxel group (RR, 0.77; P=.006), including more grade 3‐5 AEs (RR, 0.18; P<.00001 and more treatment discontinuations mainly resulting from toxicity p>
  • Antitumor efficacy of nivolumab was positively correlated with PD-L1 expression levels for PFS and OS, and was better in squamous (PFS HR, 0.62 [P=.0006] and OS HR, 0.62 [P=.0004]) than nonsquamous (PFS HR, 0.92 [P=.37] and OS HR, 1.04 [P=.51]) NSCLC.

Limitations

  • Only 6 studies and no individual-level patient data.

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