ESMO 2020 — Nivolumab plus chemotherapy and bevacizumab boosts PFS in advanced NSCLC


  • Kelli Whitlock Burton
  • Oncology Conference reports
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Takeaway

  • Adding nivolumab to first-line treatment with platinum chemotherapy and bevacizumab offered significantly better PFS than placebo in previously untreated patients with stage IIIB/IV NSCLC.

Why this matters

  • Studies suggest that cytotoxic chemotherapy and angiogenesis inhibitors such as bevacizumab may enhance therapeutic benefits of immune checkpoint inhibitors such as nivolumab.

Study design

  • Randomized, double-blinded phase 3 trial.
  • 548 patients with untreated stage IIIB/IV or recurrent patients with nonsquamous NSCLC without sensitizing epidermal growth factor receptor or anaplastic large-cell lymphoma kinase alterations received carboplatin, paclitaxel, and bevacizumab with either nivolumab (n=273) or placebo (n=275) every 3 weeks for up to 6 cycles, followed by bevacizumab and nivolumab or placebo until disease progression or unacceptable toxicity.
  • Funding: Ono Pharmaceutical Co., Ltd., Bristol-Myers Squibb.

Key results

  • Median follow-up, 13.7 months.
  • Median PFS was significantly better with nivolumab compared with placebo:
    • 12.12 vs 8.11 months.
    • HR, 0.56 (P<.0001>
  • Nivolumab group had better 12-month:
    • PFS rate: 50.1% vs 30.2%.
    • Objective response rate: 61.5% vs 50.5%.
  • OS trended longer with nivolumab:
    • HR, 0.85 (95% CI, 0.63-1.14).
  • Groups reported similar rates of treatment-related adverse events (TRAEs) of grade 3 or 4 (73.6% with nivolumab vs 72.0% with placebo) and TRAEs leading to treatment discontinuation (16.5% with nivolumab vs 4.4% with placebo).
  • Alopecia, peripheral sensory neuropathy, and decreased neutrophil count were most common TRAEs.

Limitations

  • OS data were not mature.

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