- 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.
- 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.
- 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.
- OS data were not mature.
Follow all ESMO 2020 coverage on Univadis.